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Old 01-08-2011, 04:16 PM
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Unhappy Help! High platelets count - what steps to take?

One of my cats, Lucky (2 years old, female, spayed, indoor, 3.25kg), was recently treated for a stomach bug which left her not eating or drinking, she was on a drip for a few days and finally started eating and drinking again, thank goodness! While she was sick she had a blood test done, which found a high platelet count (847 K/uL - normal range 175-600) with platelet aggregates detected and abnormal distribution. Vet at that point thought it could be at least partly down to dehydration.

Anyway, now she's fully recovered from her stomach bug, I took her back to the vets for another blood test to see if everything had returned to normal. This time, the results said that her platelets count was "over 593", with again platelet aggregates detected and abnormal distribution. The vet said the aggregates were somehow interfering with the platelets count test and that's why there wasn't an exact figure, just "more than 593".

The only other out-of-range result was a slightly low neutrophil count.

My usual vet, who is the head vet there, had left a bit earlier than usual so the vet I saw advised me to come back tomorrow and discuss a plan of action with my usual vet, because he said basically they need to do lots more tests.

Since a high platelet level can cause thrombosis, plus there are aggregates (clots, as far as understand) detected, I'm sitting here petrified that at any minute she's going to suffer an embolism and drop dead or be paralysed and there won't be anything I can do, because as far as I understand it there are no warning signs.

What I need to know is what are the possible causes? So that I can make sure I ask all the right questions and get all the right tests done, to rule out each possible cause. Any ideas about possible causes, questions to ask, things to have checked, and tests to have done, are much appreciated! Thank you!!!
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Old 01-08-2011, 06:09 PM
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Re: Help! High platelets count - what steps to take?

Hi Nattie,

There will be people far better placed to comment than me however as I understand it both an increased platelet and reduced neutrophil count can occur as a result of viral infection therefore it may well be that the stomach bug your cat was suffering has caused these and if so they will normalise given time. Platelet clumping is notoriously common in cats and can be a result of how the sample was taken and how long after it was tested and the mechanism used. I had a blood test done about 3 months ago and they couldn't get an accurate platelet count because of the clumping, but on the latest tests I had done about a fortnight ago the platelet count was in the lower end of the normal range. I'd try not to worry too much (easier said than done I know) and see what your regular vet has to say tomorrow.
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Last edited by Ali82; 01-08-2011 at 06:58 PM..
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Old 01-08-2011, 06:58 PM
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Re: Help! High platelets count - what steps to take?

One of my cats, Tarka often had odd platelet activity at blood test time. They never did get to the bottom of it, but it didn't have any consequences, as far as I can tell. Hopefully Ianthe will step in and gives us all a clue as to what's going on.
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Old 01-08-2011, 07:49 PM
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Re: Help! High platelets count - what steps to take?

Thank you both, I feel a bit more reassured now!

Quote:
Originally Posted by Ali82 View Post
Hi Nattie,

There will be people far better placed to comment than me however as I understand it both an increased platelet and reduced neutrophil count can occur as a result of viral infection therefore it may well be that the stomach bug your cat was suffering has caused these and if so they will normalise given time. Platelet clumping is notoriously common in cats and can be a result of how the sample was taken and how long after it was tested and the mechanism used. I had a blood test done about 3 months ago and they couldn't get an accurate platelet count because of the clumping, but on the latest tests I had done about a fortnight ago the platelet count was in the lower end of the normal range. I'd try not to worry too much (easier said than done I know) and see what your regular vet has to say tomorrow.
Thanks, I will add viral infection to my list of queries. Hopefully it's that! Do you know how long after an infection should the count normalise? Also, do you know how they might definitively find out that it is just the result of a viral infection and not anything more serious?

The vet today did advise me that platelet clumping can be the result of how the sample is taken, but he didn't seem to think so in this case given that both tests a week apart both had a high platelet count with clumping

Quote:
Originally Posted by Misi View Post
One of my cats, Tarka often had odd platelet activity at blood test time. They never did get to the bottom of it, but it didn't have any consequences, as far as I can tell. Hopefully Ianthe will step in and gives us all a clue as to what's going on.
Cheers - good to know! I don't suppose you remember what they looked for while they were trying to get to the bottom of it, do you?
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Old 01-08-2011, 08:12 PM
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Re: Help! High platelets count - what steps to take?

Glad to hear Lucky is over her recent problems.

Yes, platelets clumping is fairly normal with feline blood testing which can make counting difficult and I expect this is why the result was returned this way. Therefore since the actual result isn't clear I wouldn't panic too much.

However if it does turn out they are higher than 600 it could well be due to iron deficiency caused by her recent problems. Iron deficiency can occur in times of infection - since bacteria feed on iron, the body as a defence mechanism, sequesters it away. If the MCV was low this is what I would suspect. I would discuss this with the senior vet tomorrow before undergoing any further tests. Of couse he may not wish to run any more at all!

If it persisted I'd imagine the vets would want to carry out some tests on bone marrow function since this is where platelets are made. In some cases consistent high platelets can points to an immune blood disease.

I would like to add that vets in my experience aren't always the most competent where interpreting bloodtests is concerned. The amount of times I would hear over the phone that the bloodtests were 'fine' and when I actually got copies myself it was a different story!

Good luck with the senior vet and let us know what he says!
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Old 01-08-2011, 08:42 PM
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Re: Help! High platelets count - what steps to take?

Quote:
Originally Posted by Ianthi View Post
Glad to hear Lucky is over her recent problems.

Yes, platelets clumping is fairly normal with feline blood testing which can make counting difficult and I expect this is why the result was returned this way. Therefore since the actual result isn't clear I wouldn't panic too much.

However if it does turn out they are higher than 600 it could well be due to iron deficiency caused by her recent problems. Iron deficiency can occur in times of infection - since bacteria feed on iron, the body as a defence mechanism, sequesters it away. If the MCV was low this is what I would suspect. I would discuss this with the senior vet tomorrow before undergoing any further tests. Of couse he may not wish to run any more at all!

If it persisted I'd imagine the vets would want to carry out some tests on bone marrow function since this is where platelets are made. In some cases consistent high platelets can points to an immune blood disease.

I would like to add that vets in my experience aren't always the most competent where interpreting bloodtests is concerned. The amount of times I would hear over the phone that the bloodtests were 'fine' and when I actually got copies myself it was a different story!

Good luck with the senior vet and let us know what he says!
Thank you so much Ianthi! The MCV is at the high end of the normal range, 56.3 fL (normal range 41-58). I have noted all your points down for discussion tomorrow with the doctor, will keep you posted! Thank you again!
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Old 01-08-2011, 09:11 PM
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Re: Help! High platelets count - what steps to take?

Quote:
Originally Posted by Nattie View Post
Thank you both, I feel a bit more reassured now!

Cheers - good to know! I don't suppose you remember what they looked for while they were trying to get to the bottom of it, do you?
They didn't look for anything. As he seemed okay otherwise, they just put it down to "one of those things". He was in early stage renal insufficiency, so he was very probably slightly dehydrated. They didn't seem overly concerned, though
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Old 01-08-2011, 09:13 PM
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Re: Help! High platelets count - what steps to take?

Quote:
Originally Posted by Ianthi View Post
Glad to hear Lucky is over her recent problems.


I would like to add that vets in my experience aren't always the most competent where interpreting bloodtests is concerned. The amount of times I would hear over the phone that the bloodtests were 'fine' and when I actually got copies myself it was a different story!
Tell me about it! But that's another story...
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Old 01-08-2011, 09:46 PM
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Re: Help! High platelets count - what steps to take?

Quote:
Originally Posted by Misi View Post
They didn't look for anything. As he seemed okay otherwise, they just put it down to "one of those things". He was in early stage renal insufficiency, so he was very probably slightly dehydrated. They didn't seem overly concerned, though
Thanks Misi!
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Old 02-08-2011, 01:52 PM
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Re: Help! High platelets count - what steps to take?

Thanks so much everyone for your help! I had quite a positive trip to the vets!

Positive thing #1 - vet thinks Lucky is fine, and that the low LEU and high platelets are a result of the viral infection. He discounted iron deficiency (MCV is very good) and seriously doubted anything more serious like bone marrow or immune blood disease. He said that the blood can take up to 30 days to balance itself after an infection, and that's why we got those readings even though she's now back to normal. I suggested I bring her back after another couple of weeks for another blood test to make sure, he didn't think it would be necessary but I insisted! I am much happier about it now (although can't wait for those weeks to pass to get 100% peace of mind!) although I'm a little teed off that when I phoned up Monday morning suggesting a blood test to check everything up, that I wasn't warned it was still too soon for the blood to have fully recovered. But better safe than sorry!

Positive thing #2 - yesterday as I was leaving the vets, a stray cat walked literally right in front of me, totally dragging its back leg and then sat under their ambulance! I thought it was quite a smart cat for having come to the right place for treatment so I asked the doctors to help me with it. It refused to come out from under but the doctors promised to keep trying and I said I could contribute financially to its treatment if necessary. Anyway, update today was that they managed to get her out, and found she has some kind of severe infection in her leg. They're going to amputate, and I asked them to spay her at the same time. Very kindly, they're doing all this for free. I'm going to pop back at the end of the week to see how she's doing.

Positive thing #3 - found out the vet who's very cute no longer has a girlfriend
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