A story broke earlier this summer that cats were becoming sick with a mysterious disease linked to pet food. Initial investigations revealed that pet food from one particular manufacturer may have been linked to deadly feline pancytopenia. Subsequently, no link has been proven, as of early September 2021. How did this all start? What is pancytopenia? What is really happening to our cats?

What is pancytopenia?

Pancytopenia is the name of a disease that causes complete (pan-) cell (-cyto-) loss (-penia). 

In a cat’s bloodstream, there are three main groups of cells that work to keep your cat healthy. Red blood cells transport oxygen to provide energy and carbon dioxide to remove it from the body; white blood cells are part of the immune system and fight off infection; and platelets form blood clots if your cat is injured. All of these are made in a cat’s bone marrow. Pancytopenia usually occurs due to destruction of the bone marrow. The bone marrow cannot produce any more cells, so the numbers start to decrease. Pancytopenia has many causes, including autoimmune diseases, viruses like feline leukaemia (FeLV) and feline AIDS (FIV), fungal disease, toxins (relevant for later), drug overdose, certain cancers, and sepsis.

A cat with pancytopenia often starts acting ‘just not right’. They may go off their food, be very tired and slow, or restless, and may look pale and feel cold. As the disease progresses and the cell numbers drop further, your cat can get very sick, may bleed from their eyes, nose and mouth, have blood in their poo or wee, and may collapse. At this late stage, untreated cats often die. If your cat has any of these symptoms see your vet immediately.

Diagnosis of pancytopenia can be tricky. A cat’s symptoms may give clues, and a blood sample will usually show the low levels of cells. Definitive diagnosis can usually only be achieved via taking a sample of the bone marrow. This is quite an invasive procedure and not commonly performed. Identifying a specific cause may involve testing for FeLV and FIV, x-rays and ultrasound scans of the cat, or culturing the blood.

Specific treatment can sometimes be offered depending on the cause, but often treatment is just symptomatic. A cat with pancytopenia will have to be hospitalised, they may be given a blood transfusion, antibiotics and fluids. Even with all this treatment, many cats will die.

The Breaking Story

Historically, pancytopenia is generally very rare in cats – the Royal Veterinary College only reports a few cases a year. However, there was a huge jump in Spring 2021. As of 23rd August, they have reported 563 cases (of which over 60% died) in all of their hospitals or reported to them by vets as part of an optional disease monitoring programme. Given that the RVC’s hospitals are only a small number of veterinary hospitals UK wide, and not every vet reports pancytopenia to the RVC, the actual number is likely to be much higher.

On 15th June, the Food Standards Agency, responsible for maintaining food safety, declared that a number of cat food products produced by one manufacturer were being recalled due to a possible link with feline pancytopenia (note: the company’s name and products are listed on the FSA website). 

Early investigations found that the products may contain high levels of mycotoxins – mycotoxins are naturally occurring toxins produced by fungi. Two in particular, T2 and HT2 toxins, can cause pancytopenia. Cats are known to be particularly affected by these toxins. The story naturally made it onto the news, with heart-breaking stories from owners who lost their cats to this terrible illness.

Where Are We Now?

As of 26th August, after a lot of testing and analysis, the FSA reported their findings so far. So what did they report?

Their biggest announcement was that “no causative link between pancytopenia and the recalled cat food products has been established.” In short, the recalled cat food has not been proven to cause pancytopenia. The FSA also feel confident enough to permit the manufacturer to resume production of cat food. However, absence of a definitive cause does not imply there isn’t one, and the FSA continue to put out recall orders on these products. They clearly feel there could still be a link and are continuing to recall them just to be on the safe side.

They also announced that the products did contain higher levels of the T2 and HT2 mycotoxins. However, the presence of these toxins does not imply they caused pancytopenia; through their testing, the FSA has not found this link. Indeed, many food products contain mycotoxins and cause no harm to humans or animals. The fact that the levels were increased though is notable and may or may not be coincidental.

Some viral social media posts showed cat food that contained mycotoxins. But the FSA wants to emphasise that the presence of mycotoxins does not necessarily mean the food is harmful. Remember that mycotoxins are naturally occurring and found in many foodstuffs at low levels. Try to ignore these kinds of viral posts and look for expert advice online.

What’s Next?

The FSA are going to continue their investigation into the cause of pancytopenia but have given no specific likely cause as of yet. The manufacturers themselves state that the investigation will include looking at “non-feed related causes”, and the FSA have “not ruled out cat food or any other possible causes either.”

So in short, the story is not yet over. We cannot yet answer what it was that caused such a spike in pancytopenia in cats. It stands to reason it was likely a toxin, something that caused an autoimmune response, or an infectious disease found in the food or packaging, but this is just speculation. The specific manufacturer and its products are currently the most likely culprit, as no other manufacturer or food is being investigated. Remember, however, that the FSA are confident that the mystery problem has been corrected as the company is starting to produce food again.

We will have to wait for more answers… 

Encouragingly, the RVC is reporting much lower cases of pancytopenia in recent weeks, and we hope that it continues to decline. 

What Should I Do?

As a cat owner, look at the list of recalled food products. Be on the lookout for any of the above listed symptoms and get your cat checked by your vet if you are worried. Ask your vet to report any confirmed pancytopenia to the RVC. If your cat has been eating the listed products but is otherwise healthy, speak to your vet. The RVC recommends that cats are blood tested – if there is any sign of reduced cell levels, they should be monitored closely and tested again later on. You should also keep an eye on the FSA website, as they will list updates to this story, as well as any further product recalls.

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