Recurring infections (high lymphocytes) and low platelet.

Hello! My Dumpling is lethargic, has low appetite, and just wants to hide in the attic all the time. Sometimes she will play with her favorite wand toy and roll around on the floor and will await her meals, but mostly she sleeps. And she eats at most only a quarter cup of food a day. She is skinny; I can easily feel her ribs and hip bones. She currently also has some slight gingivitis. We've been to the vet clinic so many times and sought 2nd, 3rd, 4th opinions. She has not gotten any better. I've detailed her background below. Is there anything else I could ask my vet to look into? Dumpling was rescued from the street when she was about 4 weeks old (Nov 2019). When she was 3 months, she got a nasty URI that resulted in some conjuctival tissue in her right eye adhering to the cornea. Our vet said it's just scar tissue, but a whitish film forms over the eye every few months or so and she has some clear/brown discharge. We treat it with Tobramycin drops and it clears up within a few days.  She is nearly two years old now and has been spayed. She continues to have recurring infections (most cbc results showed high lymphocytes and low platelet), and we always get prescribed amoxicillin (one time, it was doxycycline) 3x a day for 7 days. I've attached photos of her eye (1 year progression - the tissue has become smaller) and her most recent blood test results. The only normal result she had was the one right before her spay on Oct 20, 2020.   Could the eye be the cause of the infections? Does it need surgical intervention? I worry about the seemingly delicate nature of the surgery and the chance that it could attach again and even become worse. At the moment, her vision does not seem to be impacted, that is she can navigate around fine and she does not rub her eye unless she's having some discharge. She also had a problem with her hips in late Oct 2020. I observed lethargy, hunched lower back (like her back end was very low to the ground when she walked), pain reaction when I touched the area. The attending vet said she had a fracture, but another, more senior vet at the same clinic said there wasn't any. Got meloxicam for her that time and she got better. Wondering if she's having hip problems again and is in pain and that's why she's hiding? She is up to date on deworming, 4in1 vaccine (FVRCP + Chlamydia) and rabies vaccine. She gets offered both wet and dry food and takes a multivitamin and vitamin c supplement. Our last check up was a month ago (June 2021). Her liver and kidney levels were good, and she tested negative for both felv and fiv.  

Here are her x-rays. Would just like to confirm whether or not there was a fracture. Because it seems that her gait has changed recently. It looks to me that her back legs are swinging outwards as she walks. Then when I look again, she's walking fine. My mind might be playing tricks on me. She has no pain reaction though when I touch the area or even carry her.

Hello!  So the clinical signs are lethargy and weight loss (with poor appetite), apparent pain in the lumbar area, recurrent film developing over one eye, and infections.  Where are the infections - are these respiratory? - responsive to Antibiotics. First, I'm afraid that we are forbidden from reading radiographs for you under the basic veterinary code of practise to which UK vets adhere.  If you are unsatisfied with your vets' reading of a radiograph or want a more informed opinion, the standard procedure is to ask for it to be referred to a radiography specialist, or to ask your vets to arrange a second opinion.   Of course, even if a fracture is not seen, this doesn't rule out soft tissue skeletal pain.  Nor does it rule out abdominal pain - this would have to be ruled out by the vet. Lethargy, weight loss and pain could certainly occur with neuromuscular trauma such as an undetected fracture or soft tissue damage.  They might also occur with eg pancreatitis or a tumour. It sounds to me as though more tests may be necessary to get to the bottom of this problem.  What is your vet proposing next? Sometimes it can help to ask them of a list of 'things it could still be' (remember, there could be multiple diagnoses explaining some of the symptoms) and then which is most likely, and what would need to be done to diagnose it. A good follow-up question would be whether further diagnostic tests would lead to a huge increase in quality of life for your cat, or be whether it is better to keep treating the symptoms. Finance and your vets' level of certainty would play a huge part in this Good luck in working out the best plan for you and your Dumpling going forward.

Hello!  So the clinical signs are lethargy and weight loss (with poor appetite), apparent pain in the lumbar area, recurrent film developing over one eye, and infections.  Where are the infections - are these respiratory? - responsive to Antibiotics. First, I'm afraid that we are forbidden from reading radiographs for you under the basic veterinary code of practise to which UK vets adhere.  If you are unsatisfied with your vets' reading of a radiograph or want a more informed opinion, the standard procedure is to ask for it to be referred to a radiography specialist, or to ask your vets to arrange a second opinion.   Of course, even if a fracture is not seen, this doesn't rule out soft tissue skeletal pain.  Nor does it rule out abdominal pain - this would have to be ruled out by the vet. Lethargy, weight loss and pain could certainly occur with neuromuscular trauma such as an undetected fracture or soft tissue damage.  They might also occur with eg pancreatitis or a tumour. It sounds to me as though more tests may be necessary to get to the bottom of this problem.  What is your vet proposing next? Sometimes it can help to ask them of a list of 'things it could still be' (remember, there could be multiple diagnoses explaining some of the symptoms) and then which is most likely, and what would need to be done to diagnose it. A good follow-up question would be whether further diagnostic tests would lead to a huge increase in quality of life for your cat, or be whether it is better to keep treating the symptoms. Finance and your vets' level of certainty would play a huge part in this Good luck in working out the best plan for you and your Dumpling going forward.

Hello!  So the clinical signs are lethargy and weight loss (with poor appetite), apparent pain in the lumbar area, recurrent film developing over one eye, and infections.  Where are the infections - are these respiratory? - responsive to Antibiotics. First, I'm afraid that we are forbidden from reading radiographs for you under the basic veterinary code of practise to which UK vets adhere.  If you are unsatisfied with your vets' reading of a radiograph or want a more informed opinion, the standard procedure is to ask for it to be referred to a radiography specialist, or to ask your vets to arrange a second opinion.   Of course, even if a fracture is not seen, this doesn't rule out soft tissue skeletal pain.  Nor does it rule out abdominal pain - this would have to be ruled out by the vet. Lethargy, weight loss and pain could certainly occur with neuromuscular trauma such as an undetected fracture or soft tissue damage.  They might also occur with eg pancreatitis or a tumour. It sounds to me as though more tests may be necessary to get to the bottom of this problem.  What is your vet proposing next? Sometimes it can help to ask them of a list of 'things it could still be' (remember, there could be multiple diagnoses explaining some of the symptoms) and then which is most likely, and what would need to be done to diagnose it. A good follow-up question would be whether further diagnostic tests would lead to a huge increase in quality of life for your cat, or be whether it is better to keep treating the symptoms. Finance and your vets' level of certainty would play a huge part in this Good luck in working out the best plan for you and your Dumpling going forward.

Sorry for posting three times.   I believe they are all the same.

Sorry for posting three times.   I believe they are all the same.