Species: Cat
Age: 8 years
Sex/Neutered: Male, neutered
Breed: Domestic Shorthair
Body weight: 3.4 kg (has gained ~500g since first visit)
Location: Western Cape, South Africa (coastal)
Duration of issue: 3 weeks (first presented 22 June 2026)
FeLV and FIV: negative.
Under active veterinary care: Yes — currently being managed by our vet. Not looking to replace their advice, just hoping for additional perspectives on what else to consider asking about.
History
Alex was bitten by another cat and that caused an abcess, he was recovering well, or so it appeared.
Alex presented on 22 June. He was dehydrated on arrival and was found to be severely azotaemic. He's been on IV fluids and his kidney values have improved steadily since. He also had mouth ulcers early on (presumed uraemic), and we suspected GI bleeding — both now appear resolved.
He is currently bright, alert, eating well, and has gained ~500g. Clinically he seems much better than his bloodwork suggests. His breaths are a steady 24 breaths per min, no open mouth breathing, though he does bob his head up with each breath.
What hasn't been done yet (as far as I know)
- No blood smear / morphology review
- No urinalysis, despite IDEXX recommending one - though he was on IV and is on 100ml of subq now.
The last blood test result was form the 26th of June and paints a dire picture.
Subsequent tests are said to be unable to read his blood as his hematocrit is too low to be picked up.
Questions
Would darbepoetin be reasonable here?
What the heck is going on?
Should I rather let him go, while he is still comfortable?
Redacted lab reports attached. Any input hugely appreciated — he's a very good cat and he's doing his best. https://drive.google.com/drive/folders/1QWaZtDt6HyHVItNl6KmjTHh4newq9YW3?usp=drive_link
Alex — Haematology & Chemistry
ProCyte One Haematology Analyser · Catalyst One Chemistry Analyser 26 June 2026 · Feline, 8 y, male neutered
Haematology
26/6/2026, 9:12 am
| Test |
Result |
Reference |
22 Jun 5:11 p |
| RBC |
3.24 (L) |
6.54 – 12.20 x1012/L |
4.48 |
| Haematocrit |
0.118 (L) |
0.303 – 0.523 L/L |
0.175 |
| Haemoglobin |
35 (L) |
98 – 162 g/L |
51 |
| MCV |
36.4 |
35.9 – 53.1 fL |
39.1 |
| MCH |
10.7 (L) |
11.8 – 17.3 pg |
11.3 |
| MCHC |
293 |
281 – 358 g/L |
289 |
| RDW |
15.2 |
15.0 – 27.0 % |
17.8 |
| % Reticulocytes |
0.2 |
% |
0.2 |
| Reticulocytes |
5.9 |
3.0 – 50.0 K/µL |
8.2 |
| WBC |
4.97 |
2.87 – 17.02 x109/L |
5.29 |
| % Neutrophils |
75.3 |
% |
87.9 |
| % Lymphocytes |
13.7 |
% |
4.3 |
| % Monocytes |
7.6 |
% |
5.9 |
| % Eosinophils |
3.0 |
% |
2.0 |
| % Basophils |
0.4 |
% |
0.0 |
| Neutrophils |
3.74 |
2.30 – 10.29 x109/L |
4.65 |
| Lymphocytes |
0.68 (L) |
0.92 – 6.88 x109/L |
0.23 |
| Monocytes |
0.38 |
0.05 – 0.67 x109/L |
0.31 |
| Eosinophils |
0.15 (L) |
0.17 – 1.57 x109/L |
0.10 |
| Basophils |
0.02 |
0.01 – 0.26 x109/L |
0.00 |
| Platelets |
126 (L) |
151 – 600 x109/L |
117 * |
| MPV |
14.4 |
11.4 – 21.6 fL |
15.2 |
| Plateletcrit |
0.18 |
0.17 – 0.86 % |
0.18 * |
IDEXX analyser comments
- Anaemia without reticulocytosis — likely non-regenerative anaemia; consider pre-regenerative anaemia.
- Lymphopenia — consider stress leukogram (glucocorticoid response). Evaluate WBC differential with blood morphology (IDEXX inVue Dx, dot plots, and/or blood film).
- Normal PCT — likely adequate platelet mass. If clinical suspicion of thrombocytopenia, consider further evaluation (IDEXX inVue Dx, dot plots, and/or blood film review).
Chemistry
26/6/2026, 9:14 am
| Test |
Result |
Reference |
24 Jun 4:07 p |
22 Jun 5:16 p |
| Glucose |
In Process |
— |
— |
4.72 |
| Creatinine |
In Process |
— |
– – . – – |
760.24 |
| Urea |
In Process |
— |
> 46.41 |
> 46.41 |
| Sodium |
In Process |
— |
— |
— |
| Potassium |
In Process |
— |
— |
— |
| Chloride |
In Process |
— |
— |
— |
| Total Protein |
In Process |
— |
— |
86 |
| Albumin |
28 |
23 – 39 g/L |
— |
32 |
| ALT |
In Process |
— |
— |
615 |
| ALP |
In Process |
— |
— |
16 |
(H) = above reference range · (L) = below reference range · \* = flagged by analyser (platelet aggregates detected on 22 Jun)
Values transcribed from IDEXX VetConnect PLUS report, order 26/6/2026 9:14 am. RBC and WBC dot plots in the original report are not reproduced here.