Pumpkin, the Icteric Kitty

Pumpkin is a four month old kitten that wasn't born yellow, he was healthy and fine up until a few days ago. Now he wasn't acting right, he stopped eating, and was developing soft stools. When I saw him in the office he was alert but subdued. He had a normal respiratory rate, and his hair coat was healthy. But he was definitely orange. We call this yellowish pallor jaundice.

Icterus, the yellowness we see in sick animals comes from the buildup of bilirubin. Buildup occurs when bile ducts are clogged, as in liver disease, and also occurs when the red blood cells are being destroyed too fast, allowing the buildup of red cell breakdown products. That's what happened to this fellow.

Jaundice is caused either by liver problems or blood issues.

A quick blood test showed this cat's anemia was caused by red blood cells's breaking apart inside his bloodstream.

The PCV showed the yellowness was from the destruction of red cells. Look at how low the blood is on the PCV graph: Less than 10% of the blood is from blood while the other 90% is blood serum colored yellow from the destruction of the red cells.

Compare this to a normal blood sample:

Normally serum, or blood liquid, is clear. Compare this to the yellow serum in the diseased sample. Also notice the amount of red cells in normal blood is near 50%, but in the kitty's case it registers an anemic 10%.

So this kitty has jaundice due to anemia. There was something breaking the cells apart. The yellow color comes when the broken cells are dismantled by the liver into components that are excreted or reused. Hemoglobin from the red cells is degraded into the bile pigment after the iron is collected for reuse. Jaundice shows up when the bile pigments overwhelm the excretion avenues, so I needed to see what was destroying the red cells.

What's destroying the red cells?

It was Mycoplasma, small micro-organisms attaching to the surface of the red cells, causing the RBC destruction. If enough RBCs are destroyed, anemia develops.

I suspected that Pumpkin was infected with mycoplasma, especially when I checked the blood smear. See the dark spots inside the translucent areas? Those are likely the organisms living on the surface of the red cells, which are colorless here. The white cells are stained blue-purple.

Right away I thought about FIA, feline infectious anemia, because the kitty was too young to have liver problems. Feline infectious anemia (FIA) is caused by parasitic bacterial microorganisms that attach to the surface of red blood cells, leading to potentially fatal hemolytic anemia. The bacteria are transmitted from infected to naïve cats by blood-sucking arthropods (fleas and ticks, and possibly mosquitoes). Outdoor cats prone to fighting with other cats can become infected via bite wounds. Outdoor cats that have poor flea and tick control are at an increased risk of developing FIA. Young, intact, male cats are also at a higher risk of becoming infected with this organism.

Need to run a Kitty Aids test too: Infected cats should be checked for the presence of underlying illnesses, including FeLV and FIV infection, which may exacerbate hemoplasma infections.

The FELV-FIV test showed Pumpkin was positive for FIV, that's why the cat was hit so hard by the mycoplasma, he has a concurrent kitty aids problem. (See the line under the T?).

Pumpkin went home on Orbax and doxycycline and waited for more lab results.

But even with FIV, Pumpkin did well. When I saw him a few days later his temp had gone from 99.8 to 102.8, a good thing, his body was rallying along with the antibiotics to kill this red cell parasite.

The lab verified the anemia was regenerative, so I felt we were on the right track. I added prednisolone to the meds on recheck to slow down the body's own reaction against the defective cells. On last recheck Pumpkin was doing great. He is less yellow these days and the family is whispering about castrating him.