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selfe's avatar

How do we find out the cause of high white blood cell (WBC) count for our cat?

Asked by selfe (272 points ) January 2nd, 2011

Our cat (approximately 13years old) started having diarrhea on Dec. 23 and looked really bad on Dec. 27. Her Dec. 27 blood test (pasted in their entirety in the following) revealed among other things a high WBC so I would like to find out if what she has is an infection and what is causing it (the WBC was normal the week before). What other tests could be done? Cultures?

On Dec. 16 she had lost a tooth (canine?) and the gums in that area were dark pink. She has had bad breath and on Dec. 21 the vet noticed gingivitis and a moderate amount of tartar. The vet suggested she have a dental cleaning (has not had one in at least 6 years). Can the teeth be causing the diarrhea even though the results for the blood test done on Dec. 21 were fine?

Her food has not been changed but we did just open a new case of Felidae wet food on Dec. 20 and have been offering it to her more frequently in case her teeth are bothering her. Can this cause diarrhea after eating cans from this case for three days?

If you need more background the details are in the following.

• Jan 2 – Some sneezing and teary eyes. Phenobarbital at 4 AM and 4:14 PM, Flagyl at 10 AM, 6 PM SubQ fluid therapy (120 cc), Mirtazapine at 7:10 PM. Small formed stool produced during the night, small formed stool produced in the early afternoon. Ears are almost back to normal temperature.
• Jan. 1st, 2011 – No more bad breath. Good apetite. Given Phenobarbital at 2:55 AM. Some twitching. Small formed stool produced during the night. Given Phenobarbital in the afternoon, Flagyl, SubQ fluid therapy. Ears are slightly cooler today (room temperature is back to what we usually had) and normal in the evening. Small formed stool produced at 5 PM. Some sneezing.
• Dec. 31: Ears are warmer than normal: is she running a fever? Good apetite. Formed stools early AM and at 4:55 PM. Amount seems OK considering she used to have a bowel movement every two days. Twitching every now and then. Given Flagyl, subQ fluid therapy (120 cc), Mirtazapine, Phenobarbital at 2:45 PM. Gums are light pink instead of bright pink. First good day.
• Dec. 30 – Ears are warmer than normal: is she running a fever? First good day except for the 9 PM seizure. Flagyl 10:20 AM, Phenobarbital restarted at 2:45 PM after 78 hours off as suggested by the vet and SubQ fluid therapy (120 cc). At 5 PM first formed stool after several days of diarrhea. Gums are light pink instead of bright pink where she lost tooth. Prescribed more Mirtazapine 3.75 mg every 48 hours (other four doses).
• Dec. 29 – Ears are hot? Gave Flagyl in the morning, Mirtazapine and SubQ fluid therapy with Lactated Ringer’s (180 cc in the morning and 60 cc in the afternoon). Would like to go on the couch but moving slowly and as if weak. Drank on her own and eats also the dry food.
• Dec. 28 – Seems better. Back to vet for second SubQ fluid treatment and to teach me how to do it. Prescribed Flagyl 62.5 mg once daily for next 12 days. Cat is nervous. Diarrhea at 4 AM and 4 PM. Started eating the new food given by the vet (Purina Veterinary Diets “EN gastroenteric”) as soon as she got back home.
• Dec 27 – Doubled the morning dose of phenobarbital thinking she was not absorbing it properly cause of the diarrhea. Cat appeared weak, even too weak to throw up. I brought her to the vet (had to walk for half a mile in frigid temperatures to reach the car). When we got there she wasn’t even standing up much. Temperature of 100.2 F? Vet thought situation was bad (dramatic change from week before) and prepared us for the worse. I can’t remember if by then I had had a chance to tell her that cat had a double dose of phenobarbital but I eventually did and vet asked to stop phenobarbital. The vet said the cat was dehydrated. Vet said I could bring her to the vet ER where they would have given her IV fluids and admitted her for days or I could ask our vet to do what she could which I did so blood was drawn for blood tests, cat was given Mirtazapine 3.75 mg every 48 hours (a total of four doses) to stimulate apetite, and a SubQ fluid therapy. Seemed better at our next stop (alert and exploring the new place enjoying our company but hiding under the furniture if alone) and started eating when offered her tuna and then her Felidae wet food (not the Royal Canine “recovery” wet food nor the Wellness dry food). Apparently not drinking on her won). Diarrhea continued. The results of the blood test follow:
 CBC/Profile
• ALB = 2.5 g/dL (reference range: 2.3 – 3.9)
• ALKP = 46 U/L (reference range: 14 – 111)
• ALT = 51 U/L (reference range: 12 – 130)
• AMYL = 1400 U/L (reference range: 500 – 1500)
• BUN = 45 mg/dL (reference range: 16 – 36) >>> HIGH (a little high is OK in this situation according to vet)
• Ca = 8.6 mg/dL (reference range: 7.8 – 11.3)
• CHOL = 85 mg/dL (reference range: 65 – 225)
• CREA = 1.7 mg/dL (reference range: 0.8 – 2.4)
• GLOB = 4.1 g/dL (reference range: 2.8 – 5.1)
• GLU = 162 mg/dL (reference range: 71 – 159) >>> HIGH
• PHOS = 6.9 mg/dL (reference range: 3.1 – 7.5)
• TBIL = 0.6 mg/dL (reference range: 0.0 – 0.9)
• TP = 6.6 g/dL (reference range: 5.7 – 8.9)
• HCT = 47.3% (reference range: 24.0 – 45.0) >>> HIGH due to dehydration?
• HGB = 15.0 g/dL (reference range: 8.0 – 15.0)
• MCHC = 31.7 g/dL (reference range: 30.0 – 36.9)
• WBC # 28×10^9/L (reference range: 5.0 – 18.9) >>> HIGH (was normal the previous week)
• GRANS # 27.7×10^9/L (reference range: 2.5 – 12.5) >>> HIGH
• %GRANS # 96%
• L/M # 1.1×10^9/L (reference range: 1.5 – 7.8) >>> LOW
• %L/M # 4%
• PLT # 577×10^9/L (reference range: 175 – 500) >>> HIGH
• Lymph/mono layer has not separated distinctly from the other cell layers, possibly due to inadequate staining. Confirm differential results with a blood smear (?)
• FeLV Antigen (ELISA) negative
• FCV (IFA)
o 1:400 negative
o 1:1600 negative
• Toxoplasma Ab (IgG)
o Toxoplasma IgG Antibody negative
• Toxoplasma Ab (IgM)
o Toxoplasma IgM Antibody negative
• FIV Antibody negative
• Sodium = 142 mEq/L (reference range: 145 – 158) >>> LOW
• Potassium = 5.1 mEq/L (reference range: 3.4 – 5.6)
• Na/K ratio = 28
Stool test results:
• fecal float (for intestinal parasites) negative
• Giardia (snap test) negative

• Dec 26 – Diarrhea and almost not eating and threw up three times (once maybe cause we gave her too much of the tuna water she likes to see if she would at least drink)
• Dec 25 – Diarrhea and not much food (stopped eating the dry food)
• Dec 24 – Diarrhea
• Dec 23? – Double amount of stool of a lighter color (light brown as opposed to very dark brown)
• Dec 21 – Annual checkup at the vet after 18 hours fasting for blood test (blood that was drawn was “cloudy”) and tooth. Has gingivitis, moderate amount of tartar, bad breath and gums are dark pink. Vet suggested a dental cleaning (has not had one in at least 6 years). While at the vet she was exposed to other cats (she is otherwise an indoor cat and the only cat in the household).
• Dec 20 – Opened a new case of Felidae wet food.
• Dec ~16 – Lost tooth (canine?) and bad breath.
• Dec 13: seizures’ cluster (three?)
• Noticed once that second batch of watery puke was slightly pink.
• For at least a few weeks I’ve been noticing that jaws get stuck when I open her mouth to pill her.
• June 2010: blood drawn but serum that separated was like a gel therefore they were not able to do the blood test
• Adopted from the humane society with a history of seizures pretty well controlled by 4.05 mg of phenobarbital twice a day

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6 Answers

syz's avatar

My best suggestion for you at this point is to ask your regular veterinarian for a referral to an Internal Medicine Specialist. An internist will be able to take the available information, suggest additional tests (if needed) and then formulate a treatment plan. Unlike your general practice veterinarian, internists tend to spend hours researching and assimilating information and formulating treatment plans for each case.

gondwanalon's avatar

The bottom line up front here is: Get your cats teeth cleaned by a veterinarian ASAP!

The blood test results look good. High WBC counts and high glucose levels can be caused by stress such as the stress that a cat will go through while having its blood drawn. WBC counts can very dramatically in a very short period of time. A lot of it depends on what your cat is doing. High activity and stress causes the WBC count to go up in the peripheral blood.

Having your cat’s teeth cleaned is a very good thing to do for your cat’s health. Infected teeth and gums give mouth bacteria a free ride into the blood system. And this also would result in a high peripheral blood WBC count. (I’m sure that a teeth cleaning has saved the life of my 16 year old cat a couple of months ago). While doing a teeth cleaning the veterinarian will examine the mouth and teeth for other problems and will extract abscessed teeth.

P.S. Get your cats teeth cleaned ASAP!

Blueroses's avatar

I agree with @gondwanalon . The gingivitis is a symptom and a good cleaning/removal of dead teeth or infected gum tissue can clear up a lot. Her high kidney values make her a riskier anesthesia candidate but your vet will know how to compensate (probably fluids during the procedure)

The diarrhea could be related to the subQ fluids and additional canned food.

selfe's avatar

Dear syz:

Thank you for your prompt reply and suggestion! Have you heard of good Internal Medicine Specialists for cats in New England (USA)? What are the things a general practice veterinarian deals with and when instead should a specialist be involved? I hear of general practice veterinarians doing surgeries so I’m a little bit confused regarding their area of expertise…

By the way, does the antibiotic Flagyl coupled with Phenobarbital cause problems?

Thank you for any other tips you all might have!

selfe's avatar

Hi gonwanalon:

Thank you for taking the time to answer. I understand. Do they really have to intubate cats for teeth cleanings? Are there dental specialists or do all vets do it? This is the first time in six years that we’ve been told our cat needs this done. How often are dental cleanings done in cats? Do they do x-rays of the teeth too? Do vets have equipment to check the blood pressure of cats?

One more question: has anybody heard of blood that was “cloudy” when looking at the tube after it has been drawn?

Should you have any other suggestions, please let me know. Thank you!

selfe's avatar

Hi Blueroses:

Thank you for your reply!

> cleaning/removal of dead teeth or infected gum tissue

Do you mean they could remove gum tissue too?

> The diarrhea could be related to the subQ fluids

But the fluids were started after she had diarrhea for four days to help her since she was dehydrated…

Since in the last blood test she had a high WBC, how do we go about finding out if what she has is an infection and what is causing it (the WBC was normal the week before). What other tests could be done? Cultures?

Thank you for any suggestion you might have!

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