Bad Bloodwork No Symptoms

This is my 14 year old male cat latest blood work. Absolute neutrophils were around 10,000+ in February. My vet gave him 2 weeks of Zeniquin. Then redo blood work. His hands on physical was fine. Heart and lungs good. He is eating fine. Maintaining his weight. Activity level normal. No diarrhea or vomiting. Any thoughts? Is this bad? Suggestions? Tests to do if things do not improve? Thank you.

Hello.  Before I get to the juice of this issue, let's revisit something I say quite frequently on this site;  it's important and crops up a lot in different scenarios.  That is, that bloodwork out of context is often unhelpful.  Your vet knows a lot more about the cat in front of them than I know; they know how they looked, what temperature, why they took the blood, what they think is going on.....  I am therefore unqualified to give a second opinion.  Second opinions should come from someone with more information than the first vet, not less.  Usually, the information comes in the form of specialist exertise about a certain body-system, imaging technique or just a way of handling cases.  I am not that person; I am another GP level vet, who has seen much less of your cat than the vet.   So.  Rather than making lots of judgements about a patient and mixing things up, let me tell you the questions I'd be putting to your vet in order to understand this case better.

1.  What can cause high neutophils (also called neutrophilia) in cats?   I asked the MSD Veterinary Manual, the textbook, and found: inflammation, Corticosteroids (steroid use) and Epinephrine (Adrenaline) ie stress.  Now; infection is one cause of inflammation in cats.  But as far as you've told me, there were no other signs of infection (your vet might have been aware of something I am not).  Even high temperatures can happen because of stress without there being an infection.   So there may have been lots of other things causing the high neurophils in this scenario. Which leads to the bit I am not following: 2.  What led to the vets' decision to treat this neutrophilia with Marbofloxacin (Zeniquin)?  How did they know there was an infection? In the UK at least, antibiotics are only used to treat proven or presumed-and-life-threatening bacterial infections.  Marbofloxacin is often considered a 'strong' antibiotic (simplifying here), so it is often reserved for severe infections, in order to prevent normal bacteria from becoming resistant to it.  You can read more about the problems of antibiotic overuse (search for 'antibiotic resistance, David Harris') in various blogs on this site.  I would expect your vet to have a good reason to pick that antibiotic up.  Based only on what I know, I'm not clear how they ruled out stress as the most likely cause of neutrophilia in a cat with no clinical signs (symptoms) having a routine blood test at the vets. 3)  But you then asked what to do if things do not improve - so what symptoms was the patient showing?   Or if none, how will that improvement be measured?  If the neutrophilia was simply caused by stress, what's to prevent an equally big one happening again the next time the patient is sampled? - again, a good q for your vet. These are the perils of trying to answer questions online about a cat we have no clinical history for -  hopefully, once you've had a chat with your vet, you may have a clearer picture.   If the cause of the neutrophilia is uncertain, I usually find that a lab pathogist, medical specialist or microbiologist can give good advice to your vet about how to proceed.  I know that some labs, on finding a lot of neutrophils, will check to see whether any of them are digesting bacteria, or whether any have been found. Good luck in getting to the bottom of this case and wishing you and your cat all the best from here.

My apologies, to expand on that last bit:..... . or whether any neurophils digesting bacteria (ie actively mopping up an infection) have been found.....   (or whether the neurtophils might have been high for some other reason).

I hope that something there helps.

Thank you for the response. His blood work was originally done in January as part of his annual checkup. Neutrophils were around 10,000. Did another blood draw 2 weeks later.  About the same.  Then a twist blood draw last week and that was the results in posted.  Now Neutrophils almost doubled and WBC high.  So that's why antibiotic prescribed.  Repeat blood work again.  If comes down then great,  if not then vet thought cancer in middle intestine. Thank you again.

Hi - I suppose that what I'm saying is, that not every animal with a (sudden big increase in neutrophils) has a bacterial infection that necessitates antibiotics.  Merecks veterinary manual cites the following list of things that might cause a neutrophilia:  steroid-induced (eg a steroid injection), internal-steroid (ie severe acute stress), inflammation (can include but certainly not limited to infection), haemorrhage, sudden haemolysis (red cell breakdown), granulocytic anaemia, inherited granulocyte defects.  Only infection is appropriately treated with antibiotics and we would expect to identify the cause, location or evidence of infection before reaching for a third line antibiotic. As it stands I suspect that there is part of the discussion I am missing. Best of luck to all of you.