Low Platelet Count

Hello Everyone. It has been a while since Jazzy and I have been on FDMB. Jasmine has been insulin free - diet controlled for 6 1/2 months. However, over the past few months I have noticed her still consuming large amounts of water. I had her blood checked with her vet and he found her cholesterol high at 10.98 mmol, globulin high at 53 g/L and that she has a low platelet count. He couldn't determine what causes this or what we should do? Her diabetes tested fine. Does anybody have any advice they can give me about low platelet counts? The only noticable symptom is her consumption of water and in turn peeing a lot. I am very scared and concerned as she has come such a long way. Any help would be greatly appreciated :sad:

 

Could be many things. Was the low platelet count verified by examining a blood smear via a microscope? Not infrequently platelets in feline blood will clump rendering the machine count of platelets low. Usually a smear is looked at and an assessment of platelets made. Tis is what one lab results gave:

AUTO PLATELET 169 170 - 600 THOUS./uL LOW

PLATELET COMMENTS PLATELETS- CLUMPED
REMARKS SLIDE REVIEWED MICROSCOPICALLY. PLATELETS APPEAR ADEQUATE.

Without the reference range the values do not mean that much. Also, what zare some of the other values such as albumin and the A/G (albumin/globulin) ratio?

 

Renal disease comes to mind.

Roughly 70-80% of the kidney must be impaired before lab tests will show it. What you are seeing may be an attempt to cope with reduced filtering ability.

 

Erythropoetin is responsible for the production of red cells (erythrocytes), not platelets. (thrombocytes).

The anticoagulant in purple top tubes (EDTA) can sometime cause platelets to clump in the tube. While it happens infrequently in humans, it is a much more common occurrence in cats. Larry is correct in saying that the slide should be visually examined to get an accurate assessment of the true platelet count.

 

Yup, I agree with Larry and Deanie. Thrombocytopenia (abnormal lack of platelets) is unusual in cats and I would want a pathologist to tell me it was true. Call your vet tomorrow and have him ask the lab for a pathology review of the blood. It is *extremely* important to know if a cat is truly thrombocytopenic so I would pursue this tomorrow.

 

The attachment doesn't work, it says it doesn't exist?

 

Thanks everybody. The vet did a CBC and 1 blood profile W electrolytes? Also, my vet said she has low platelet count so I am not sure how that conclusion was drawn. Here are the blood results that I was given:
ALB = 33 g/L (23-39)
ALKP = 65 U/L (14-111)
ALT = 22 U/L (12-130)
AMYL = 1000 U/L (500-1500)
Ca = 2.43 mmol/L (1.95-2.83)
CHOL = 10.98 mmol/L (1.68-5.81) HI
CREA = 171 umol/L (71-212)
GLU = 6.02 mmol/L (3.94-8.83)
PHOS = 1.53 mmol/L (1.00-2.42)
TBIL = 9 umol/L (0-15)
TP = 86 g/L (57-89)
UREA = 10.4 mmol/L (5.7-12.9)
GLOB = 53 g/L (28-51) HI
HCT = 36.6% (24.0-45.0)
HGB = 11.1 g/dL (8.0-15.0)
MCHC = 30.3 g/dL (30.3-36.9)
WBC # 5.5x10^9/L (5.0-18.9)
GRAN# 4.5x10^9/L (2.5-12.5)
%GRN# 82%
L/M # 1.0x10^9/L (1.5-7.8) LO
%L/M# 18%
PLT # 1x10^9/L (175-500) LO

I do not know how to interpret this. The only noticable symptom she has is excessive drinking and urinating.

 

Hi Jodi

Can you just double check that you transcribed this exactly?
Regardless, it doesn't look like human investigated this -- I'd call the vet, have him call the lab tomorrow and request a pathology review. As i mentioned, thrombocytopenia can have devastating consequences and this warrants confirmation or revision.

Regarding the PU/PD -- did you have a urinalysis and urine culture done?

 

Thanks. I double checked these numbers and they are correct from the print out from the vet. There were no other tests done besides the blood tests. What are some noticable symptoms of thrombocytopenia? Water drinking?

 

Hi Jodi

The symptoms of thrombocytopenia are profuse bleeding; sometimes from the nose and mouth, if it's really bad, or often it will be seen as extensive bruising and there may be internal bleeding. PU/PD in an otherwise normal cat does not fit with thrombocytopenia.

Have you asked for the pathology review to clear this up? Also regarding the PU/PD, you should bring in a urine sample from the vet. I don't know if your cat will allow you to catch a "mid-stream" sample -- this is impossible in most cats -- but if you can, you can submit that sample for culture as well. Until the platelet thing is settled, she shouldn't be poked in the bladder which is the most sterile means of obtaining a sample.

Hope this helps. Let us know what the pathologist says.

 

This isn't a case of platelet clumping--that's a clotted sample. I can't believe your vet doesn't know what to do with that result. The first thing you do is repeat it, for two reasons. The first reason is because it's a life threatening value and you need to take action if that number is correct. The second reason is because cat is asymptomatic and you don't believe the number.

What lab did they send that sample to for analysis? I've been seeing too much of this lately--bad results produced from bad samples and neither the tech running it or the vet interpreting it knowing how to handle it. (or at least troubleshoot the problem!)

Your vet needs to repeat that test immediately.

 

It doesn't really require pathologist review. Any qualified lab tech should be bale to look at the slide and see whether there are platelets present or not.

Of course, I don't think there would be any on this particular slide because I think the sample is clotted, not clumping.

 

As you noted, a tech should have checked a slide as soon as s/he saw the machine spit out this result. However I don't think the vet can request that the lab have a tech do a review, he can only request a path review.

Now that I look at the result again, though, I wonder if this is an in-house machine. In-house CBC analyzers aren't great in general for cats or dogs, but esp. cats. Feline CBC results should always come with a manual review ... AFAIK the lab we use does this, actually. Path reviews are generated automatically if the tech flags certain things like RBC inclusions, schistocytes, etc. As noted, the platelets are easily activated in this species and clumps frequently include WBCs too, sometimes to a significant degree. It's not an absolute, but whenever you see extensive platelet clumping, you'd expect to see falsely lowered WBC (PMN) results in cats.

 

Thanks for all the information guys. It may likely be an in house machine, I know the blood was not sent out anywhere to be analyzed. It was done right after her blood was taken and within half an hour it was determined she had low blood platelets. What confuses me is her symptom of drinking all the water .... unrelated to low platelet counts. A urine test will not be a problem. She had ketones back in February where I had to catch her pee mid stream to test for ketones. She is pretty easy going. Once I collect her urine, how long will it keep in a bottle until I get it to the vet? My vet had to do abit of research first about platelets and wasn't really able to advise.

 

These two articles provide some information about urine storage:
http://www.clinchem.org/cgi/content/full/46/9/1384
http://www.brighthub.com/science/medica ... 71492.aspx