BACKGROUND: RILEY'S STORY

I am fostering a lovely persian kitty named Riley. He was originally fostered to us from the SPCA. On October 15, Riley was diagnosed with feline leukemia, based on an ELISA test. I received a call from Barb at the SPCA to bring him in for euthanasia. I was told that this illness was dooming the little fellow to a painful death. If true, this would be correct.

Dr. Karsten of Island Veterinary Hospital called later the same day to say that there was no point in retesting (which I had asked about) as the results were beyond dispute -- less than a 1/200 chance of error. I was told that I could hold him during the euthanasia.

I was told that I could try to find a rescue group that would accept Riley.

As a result of a desperate Brindleweb plea for help, both the Orphan Kitten Rescue and Forgotten Felines came through immediately and offered Riley a home, for which I will be eternally grateful. That’s true rescue.

As you may remember from my previous posts, I then decided to have Riley retested because I noticed on my copy of the test results that the blood sample was “grossly hemoloyzed ”, which means that the sample may not be of any value diagnostically and can lead to erroneous results. I wonder how many foster parents would have retested, as most of them probably aren’t familiar with hemolyzed blood samples and their possible significance. They would just believe the vet and get the cat euthanized. Most people would not know where to turn for help if they received this diagnosis and would think that euthanasia was the sensible, humane solution.

DR. GREY COMES TO RILEY’S RESCUE!

The IFA test and the IDEXX test, done five days later by Dr. Grey of the Duncan Animal Hospital, proved conclusively that Riley did not have this dread disease.

THE CENTRAL LAB WILL IMPROVE TEST PROTOCOLS

I wrote to The Central Lab about Riley's case, and in response, they sent me a detailed reply and promised improved protocols for conducting and reporting on feline leukemia tests. I am grateful to them despite their initial error.

DR. ____________'s COMMENTS

As a follow-up to what happened I would like to quote a few comments on this case made by Dr. ___________, BVMS, BSc, PhD, CBiol, FIBiol, MRCVS, an eminently qualified person to address issues like these. She is also the director of a veterinary testing lab in England and an author of veterinary texts.

I quote from 2 e-mails, both dated December 2.

From E-MAIL 1:

“I'm just horrified, but it seems to happen all the time! "

“If it was an ELISA, well, what have the recommendations for the ELISA been from the very inception of the test? "All positive results should be confirmed by IFA (or VI) before the cat is assumed to be infected. In fact, Bill Hardy always said this should be done before the result is even communicated to the owner. Depending on the figures you plug into the predictive value sums, you can easily show that when testing clinically well cats, around 90% of the ELISA-positive results you get will be spurious.----"

FROM E-MAIL 2:

“I should stop reading this stuff. It makes me cry.

If I caught any of my junior vets just rubber-stamping a positive FeLV result without any supporting clinical or haematological data (and no, a slight leucopenia doesn't count), heads would roll.”

“But reporting an FeLV as positive without question, on a test that is known to have problems with haemolysis, on a haemolysed sample, and in a clinically healthy cat.... well, I don't think it's on. I'm just glad somebody put their foot down and it all ended well.”

LETTER TO ISLAND VETERINARY HOSPITAL

I have written to Dr. Langelier, the head of Island Veterinary Hospital twice about this misdiagnosis. I have received no response. We requested his assistance to find out what went so horribly wrong. We hoped that steps would be taken at his hospital to prevent errors like this from happening again. They may have been taken already, but in the absence of a reply, I do not know. Hopefully the staff at the hospital have been in-serviced about avoiding hemolysis when drawing blood samples and on how to interpret FELV test results.

For this scheduled appointment, three of us just sat in the reception area for a seemingly endless hour despite our request to stay with our foster cat. After this “check-up” a young hospital receptionist came to the reception area to give a report. The veterinarian never spoke to us, so our concerns were not addressed. Imagine if I sent the school receptionist to do my parent/teacher interviews!

We were given eye drops by the receptionist, but as the cat was already on two sets of eye medication, I didn’t like to put a third set in without discussing it with a veterinarian.

WHAT WE CAN LEARN FROM THIS

GET A COPY OF ALL BLOODWORK REPORTS ON YOUR ANIMALS! IF THE SAMPLE IS MARKED "GROSSLY HEMOLYZED", INSIST ON A RETEST, ESPECIALLY ON A FeLV TEST BECAUSE THERE IS A POSSIBILITY THAT THE RESULTS COULD BE INACCURATE.

UNLESS THERE IS A MEDICAL REASON NOT TO, TRY TO STAY WITH YOUR PETS DURING EXAMINATIONS!

Previous posts.....