Rise of pancytopenia cases and what you need to know

Pancytopenia in cats is heartbreaking to see as you may feel a little helpless. With the recent surge in the number of cases of pancytopenia, we’d like to send our heartfelt condolences to anyone whose cat may have lost their life as a result of this situation.

Our guide to pancytopenia in cats is here to help raise awareness of the symptoms and current issues revolving around the disease. To make sure all cats get the care and attention they need, we’ll keep you updated with news from the Royal Veterinary College (RVC) and the Food Standards Agency, who’ve been investigating what’s happened.

The rise in cases of pancytopenia in cats has potentially been linked to a number of different brands of dry cat foods. Applaws, Sainsbury's (own brand) and AVA (Pets at Home own-brand) are a handful of those listed on the recall list. These brands all use the same manufacturer, called Fold Hill. You can find a list of all the recalled products and their batch numbers at the bottom of this article, and if you recognise any that you might have fed your cat, please stop immediately.

We want to assure you that KatKin is in no way affiliated with Fold Hill. Our food has not been affected, and our Fresh cat food meals are very safe to eat.

Table of Contents:

• What is pancytopenia in cats?

• What are the symptoms of pancytopenia in cats?

• Is there any treatment for a cat with pancytopenia?

• Is KatKin affected by the rise in pancytopenia in cats?

• What is the current situation of pancytopenia in cats?

• Products being recalled over pancytopenia in cats

• Pancytopenia in cats - Timeline of events so far

• What are mycotoxins?

• What effects do trichothecene mycotoxins have on cats?

Pancytopenia in cats is not a specific disease, but a very rare syndrome defined by a rapid decline of all three cellular components of the blood:

• A reduction in red blood cells - resulting in anaemia, typically non-regenerative, meaning the body cannot replace the deficiency.

• A reduction in neutrophils - a type of white blood cell that helps fight off infections, is referred to as neutropenia.

• Decline in platelets - also known as thrombocytes, involved in clotting. A reduction in platelets is known as thrombocytopenia.

Sadly pancytopenia in cats is often fatal to those affected.

In many cases pancytopenia in cats is related to disease within the animal's bone marrow. There are very few diseases outside of the bone marrow that can cause pancytopenia, although an exception to this is severe bacterial sepsis. When this happens, it could result in pancytopenia due to marked inflammation and endotoxemia. Feline infectious peritonitis can also result in such haematological changes, likely due to similar reasons.

The Food Standards Agency (FSA) and the RVC are advising that if you have bought any of the below products, you should stop feeding them to your cat and contact your veterinary surgeon.

Initial signs of pancytopenia in cats can include:

• Lethargy

• Malaise

• Lack of appetite

Due to the reduced number of platelets, affected cats might also:

• Spontaneously bleed (including from their mouth)

• Develop bruising.

If you’ve been feeding your cat any of the recalled products and recognise any of those symptoms, get in touch with your vet immediately.

We’re sorry to say it, but no, there’s currently no specific treatment for cats with pancytopenia, yet. Currently, treatment is based on supportive care, meaning your vet will treat the symptoms present. For example, in patients with severe anaemia, a blood transfusion may be required and antibiotics may be recommended, given the reduction in neutrophils.

No – we aren’t affected. Our Fresh-cooked cat meals aren’t part of the rise in pancytopenia, and we have no affiliation with Fold Hill. We make all our own cat food in our KatKin Kitchen, so we aren’t related to any of these brands.

Fold Hill is what’s known as a ‘contract manufacturer’ or ‘private label manufacturing’ company. This means they make dry food for other companies, and these companies will sell it using their own packaging. It’s likely you won’t have heard of Fold Hill – but you’ll know the brands that use their service.

The difference between us and many other cat food brands is that we don’t rely on any other companies to make our meals. When we started up KatKin, we always wanted to have our own kitchen. That way we could:

• run our own production

• have our own staff

• source our own ingredients

• manage our own supply chain.

In short, we can keep complete control and visibility over every step of the process.

We only source premium quality ingredients and use trusted suppliers who otherwise supply supermarkets with food that you or I would eat. It’s not industry standard, it’s above and beyond.

So far, over 130 cases of feline pancytopenia have been recorded.

The Royal Veterinary College (RVC) have launched an investigation into this unprecedented spike in cases of pancytopenia in cats and are asking for help to gain further insight into the situation. The condition of pancytopenia in cats is so rare that the RVC has previously only seen on average one case a year.

A spokesperson from RVC has stated: "Based on the evidence to date, the one aspect of these cases that formed a consistent pattern was the diet of the affected individuals". The spokesperson noted that researchers have data relating to diet from ~80% of cases.

Further details of this finding can be found on the food.gov website.

Below we’ve outlined the current retailers recalling their cat food products over the rise in pancytopenia in cats. Last updated on 15/06/21, Fold Hill’s recall notice states three major retailers who have had to put these precautionary measures in place:

Sainsbury's Recall Notice:

• Sainsburys Hypoallergenic Recipe complete dry cat food with salmon 1+years 800g

• Sainsburys Hypoallergenic Recipe complete dry cat food with chicken 1+years 800g

Pets at Home Recall Notice:

• Ava Kitten Chicken 300g and 2kg

• Ava Adult Chicken 300g, 2kg and 4kg

• Ava Adult Fish 2kgAva Mature Chicken 7+ 2kg and 4kg

• Ava Senior Chicken 12+ 2kg

• Ava Sensitive Skin & Stomach 1.5kgAva Weight Management 1.5kg

• Ava Hairball 1.5kgAva Oral Care 1.5kg

• Ava British Shorthair 1.5kgAva Persian 1.5kg

• Ava Maine Coon 1.5kg

Applaws Recall Notice:

(best before date between December 2022 to June 2023 with a site reference code of GB218E5009):

• Applaws Cat Dry Chicken 400g, 2kg and 7.5kg

• Applaws Cat Dry Senior Chicken 400g, 2kg and 7.5kg

• Applaws Cat Dry Chicken & Salmon 400g, 2kg and 7.5kg

• Applaws Kitten Dry Chicken 400g, 2kg and 7.5kg

• Applaws Cat Dry Chicken & Lamb 400g, 2kg and 7.5kg

• Applaws Cat Dry Chicken & Duck 400g, 2kg and 7.5kg

• Applaws Cat Dry Ocean Fish 350g, 1.8kg and 6kg

The RVC is aware of 209 cats with pancytopenia. This number is based on cases treated at their own hospitals and information provided by some vets in the UK.

Of these 209 cats with pancytopenia, there was a 72.5% percent mortality at time of reporting.

NB. This data probably represents only a percentage of cases, as many cats may not be presented to a veterinary practice and/or investigated by a vet.

Only a small percentage of the vets in the UK are actively reporting to the RVC at this time. The data from our survey is provided by third parties and has not been independently verified and is correct when provided by the vets concerned.

Therefore, the percentage of mortalities may change after submission of the information.

Wilko Cat Food - Product Recall Notice

Wilko have issued an important safety warning for a selection of their Wilko branded dry cat food products which are manufactured by Fold Hill.

They have chosen to voluntarily recall these products as a precautionary measure due to the rise in pancytopenia in cats.

Whilst there is no evidence their products have been affected they are currently recommending that you do not feed them to your cat.

If you have bought any of these products please return them to the store.

0267053 wilko meaty feast cat rabbit/ chicken/veg 950g

0463508 wilko best salmon & tuna dry cat 800g

0463507 wilko best beef & chicken dry cat 800g

0470811 wilko cat food active health salmon 800g

0481421 wilko active health cat food chicken 2kg

0481422 wilko active health cat food salmon 2kg

0470808 wilko dry cat food active health 7+ 800g

0470809 wilko cat food active health hairball control 800g

0470807 wilko dry cat food active health s.800g

0470810 wilko cat food active health

Update from The Royal Veterinary College

The Royal Veterinary College (RVC) is currently aware of 278 cats that have been affected by pancytopenia. This is based on cases treated at their own hospitals and information provided by some vets in the UK.

Of these cats with pancytopenia, there was 70.2% percent mortality at the time of reporting.

NB. This data probably represents only a percentage of cases, as many cats may not be presented to a veterinary practice and/or investigated by a vet.

Only a small percentage of the vets in the UK are actively reporting to the RVC at this time.

The data from our survey is provided by third parties and has not been independently verified and is correct when provided by the vets concerned.

Therefore, the percentage of mortalities may change after submission of the information.

Update from The Royal Veterinary College

The RVC is currently aware of 352 cats that have been affected by pancytopenia based on cases treated at their own hospitals and information provided by some vets in the UK.

Of these, there was 70% percent mortality at time of reporting.

NB. This data probably represents only a percentage of cases, as many cats may not be presented to a veterinary practice and/or investigated by a vet.

Only a small percentage of the vets in the UK are actively reporting to the RVC at this time.

The data from our survey is provided by third parties and has not been independently verified and is correct when provided by the vets concerned.

Update from The Royal Veterinary College

The RVC is currently aware of 394 cats with pancytopenia that have been affected based on cases treated at their own hospitals and information provided by some vets in the UK.

Of these there was 67% percent mortality at time of reporting.

NB. This data probably represents only a percentage of cases, as many cats may not be presented to a veterinary practice and/or investigated by a vet.

Only a small percentage of the vets in the UK are actively reporting to the RVC at this time.

The data from our survey is provided by third parties and has not been independently verified and is correct when provided by the vets concerned.

Update from The Royal Veterinary College

The RVC is currently aware of 443 cats with pancytopenia that have been affected based on cases treated at their own hospitals and information provided by some vets in the UK.

Of these there was 64% percent mortality at time of reporting.

NB. This data probably represents only a percentage of cases, as many cats may not be presented to a veterinary practice and/or investigated by a vet.

Only a small percentage of the vets in the UK are actively reporting to the RVC at this time.

The data from our survey is provided by third parties and has not been independently verified and is correct when provided by the vets concerned.

Therefore, the percentage of mortalities may change after submission of the information.

A spokesperson for the RVC said:

“Our investigations are ongoing and we are still collecting data from vets, as well as testing food samples and samples from affected cats. We have not yet found a definitive cause for the syndrome.

"We are now, sadly, aware of over 400 affected cats with pancytopenia. Common signs that owners of affected cats note include lethargy and loss of appetite, although in some cases they see signs of spontaneous bleeding or bruising. We encourage owners to contact their veterinary practice if they are worried that their cat may be affected.

“To further support these efforts, we are encouraging vets who have seen cats with unexplained severe thrombocytopenia and/or neutropenia with or without concurrent anemia to complete our survey.”

The RVC is currently aware of 464 cats that have been affected by pancytopenia based on cases treated at their own hospitals and information provided by some vets in the UK.

Of these there was 64% percent mortality at time of reporting.

NB. This data probably represents only a percentage of cases, as many cats may not be presented to a veterinary practice and/or investigated by a vet.

Only a small percentage of the vets in the UK are actively reporting to the RVC at this time.

The data from our survey is provided by third parties and has not been independently verified and is correct when provided by the vets concerned.

The RVC is currently aware of 480 cats that have been affected by pancytopenia based on cases treated at their own hospitals and information provided by some vets in the UK.

Of these there was 63.4% percent mortality at time of reporting.

NB. This data probably represents only a percentage of cases, as many cats may not be presented to a veterinary practice and/or investigated by a vet.

Only a small percentage of the vets in the UK are actively reporting to the RVC at this time.

The data from our survey is provided by third parties and has not been independently verified and is correct when provided by the vets concerned.

The RVC is currently aware of 499 cats that have been affected by pancytopenia based on cases treated at their own hospitals and information provided by some vets in the UK.

Of these there was 62.5% percent mortality at time of reporting.

NB. This data probably represents only a percentage of cases, as many cats may not be presented to a veterinary practice and/or investigated by a vet.

Only a small percentage of the vets in the UK are actively reporting to the RVC at this time.

The data from our survey is provided by third parties and has not been independently verified and is correct when provided by the vets concerned.

The RVC is currently aware of 506 cats that have been affected by pancytopenia based on cases treated at their own hospitals and information provided by some vets in the UK.

Of these there was 62.5% percent mortality at time of reporting.

NB. This data probably represents only a percentage of cases, as many cats may not be presented to a veterinary practice and/or investigated by a vet.

Only a small percentage of the vets in the UK are actively reporting to the RVC at this time.

The data from our survey is provided by third parties and has not been independently verified and is correct when provided by the vets concerned.

A spokesperson for the RVC said:

“The Royal Veterinary College (RVC) continues its investigation into the sudden increase in feline pancytopenia in cats in the UK.

“Currently, we are sadly aware of over 500 cases of pancytopenia in cats. Investigations into an underlying cause do not suggest a link with common feline infectious diseases, common toxins (e.g., heavy metals, oestrogen) or deficiencies/excesses in vitamins or minerals.

“Results of analyses by the RVC of cat food involved in the product recall published by the Food Standards Agency (FSA) have been shared with the FSA. We would like to draw your attention to a revised published FSA statement published 16th July.”

“Our investigations are ongoing and we are still collecting data from practising veterinarians. We are also testing food samples associated with affected and unaffected cats to determine the significance of these findings. We have shared our results with the FSA in order to assist them with their investigations into this matter.

“To support our ongoing efforts, we are encouraging vets who have seen cats with unexplained severe thrombocytopenia and/or neutropenia, with or without concurrent anaemia, to complete our survey.”

FSA Statement:

“The presence of mycotoxins has been identified in a small number of samples of the recalled cat food tested to date. Mycotoxins are naturally occurring toxins produced by certain moulds.

Mycotoxins are widely found in some types of feed and food and do not, in themselves, indicate they are the cause of feline pancytopenia.

The business, FSA and other regulators continue to investigate including undertaking wider sampling and also broader screening for any possible toxins.

The FSA’s product recall notice details all the affected products that were recalled by the business as a precaution on 17 June. We are urging cat owners to check the list of products, stop feeding them to their cats and return them to the store they purchased them from.”

Mycotoxins are toxic compounds that are naturally produced by different types of fungi. They can grow on a variety of different crops (e.g. grains and vegetables) before or after harvest.

The food which can be affected includes:

• Cereals

• Nuts

• Spices

• Dried fruits

• Apple juice

• Coffee

For a food to become affected, it is often under warm and humid conditions.

Trichothecenes are a large family of chemically related mycotoxins produced by moulds like Fusarium, Trichoderma, Trichothecium and others. Type A trichothecenes include the T-2 and HT-2 toxin.

T-2 and HT-2 toxins have a wide range of toxic effects in animals.

The effects include:

• Weight loss

• Loss of appetite

• Decreases in blood cell concentrations (white / red blood cells and platelets), leading to an increased risk for infections and/or bleeding.

The European Food Safety Agency (EFSA) reports that cats are particularly sensitive to T-2 and HT-2 mycotoxins (EFSA Scientific Opinions 2011, 2017). But a lack of data hinders the establishment of a legal safe value for T-2/HT-2 concentrations in feed for cats. In some countries, a legal safe limit has been established in feeds for these mycotoxins for some species.

For Further Publicly Available Resources: RVC Update.

The RVC is currently aware of 521 cats with pancytopenia based on cases treated at their own hospitals and information provided by some vets in the UK.

Of these there was 63% percent mortality at time of reporting.

NB. This data probably represents only a percentage of cases, as many cats may not be presented to a veterinary practice and/or investigated by a vet.

Only a small percentage of the vets in the UK are actively reporting to the RVC at this time.

The data from our survey is provided by third parties and has not been independently verified and is correct when provided by the vets concerned.

We will continue to update this post as new updates become available.