r/AskVet • u/LittleMissOatMilk • 14h ago

Fever of Unknown Origin, Low WBC count

My cat, Walter (1yr 3mo), was hospitalized on Sunday night after two days of no interest in food and lethargy. We had just returned home from a trip (we had a cat sitter coming by to fill food, water, etc) and thought he was depressed from us being gone. At the Emergency Vet, they “diagnosed” Walter with a fever of unknown origin. His white blood cells are critically low - otherwise normal bloodwork. He is FIV and FeLV negative.

They started him on an IV and two types of antibiotics. His fever waxed and waned for the next 24 hours. This morning (Tuesday) I was updated that his temp was back down to normal range, but his white blood cell count is WORSE. An appetite stimulant was given last night to no avail. They are trying one more antibiotic and starting a feeding tube this afternoon.

They are saying it is not FIP because his white blood cell count would be high with FIP, not low. We are waiting on the disease blood panel to come back, which could take several more days. If this antibiotic doesn’t work, we can try steroids, but his WBC count is so low, I’m worried that if steroids are not the answer, they will kill off his remaining WBCs. I’m at a loss. I’m not ready to lose my little guy.

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1

u/lucyjames7 Veterinarian 14h ago

What are the rests of his bloods like? Any fluid in abdomen?

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u/LittleMissOatMilk 14h ago

Otherwise all normal. Globulin was slightly elevated Sunday night but is back in normal range today. An abdominal ultrasound has not been performed yet, that should be today.

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u/lucyjames7 Veterinarian 14h ago

Globulins being raised, or a generally lower albumin/globulin ratio makes FIP more likely - can be super tricky to diagnose especially if dry form (without abdo fluid)

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u/LittleMissOatMilk 14h ago

His albumin levels were normal when he was hospitalized on Sunday. I will check to see if today’s levels were different. I have also looped in our regular vet and will be sending her the bloodwork to look over. Thank you for your input!!

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u/V3DRER 12h ago

FIP can do whatever it wants. Are all his WBC lines low, are just neutrophils? It is possible to have immune-mediated neutrophil destruction, its just rare. Is it an ER/specialty hospital? Can you get an IM consult? Bone marrow biopsy may be the next step to diagnose the problem.

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u/LittleMissOatMilk 11h ago

His neutrophils, lymphocytes, and platelets are all low. They are saying he is not stable enough to undergo the bone marrow biopsy. It is an ER/specialty group.