Sick Cat -- Stumped but well fed Vets

[Newt]

Hi all. We have a one year old cat, Newt, who has been sick for the past month. To try and keep is short, I will do a brief recap. My wife and I boarded our cat at a local "luxury" cat clinic. The cat got a runny nose while we were away and the clinic treated with clavamox and an antihistimine (both pill form). We had to have them administer because we have no luck with cats and pills. After a week they said he was fine and to stop giving pills.

A week later his nose was completely stuffed (breathing through mouth) and his eye was dripping. We took him back and they prescribed more clavamox and anihistimine (chlormepherine) sp. After three days we asked for a liquid in clavamox and transdermal of the anihistimine. We went back a few days later and he still wasn't well. The changed the antibiotic to something else then a day later switched him to Zithromax, still kept him on the transdermal of anihistimine. They also gave him eye drops and suggested L-Lysine and nasal spray. A week later he still wasn't well, no change so we switched vets.

New vet put him on sub-q liquids for dehydration, interferon and to continue anhistimine transdermal if we wanted. After a few days his nose still wasn't clearing so we took him off the transdermal. After the interferon dosage (7 days) he still wasnt well, stuffed nose, drippy eye and no eating. Vet gave him more liquids sub-q and kept him for the day to see if he would eat. He ate some while there and they ran a bunch of tests. Vet prescribed an appetite stimulant, which has gotten him to eat, eye has dried up, and he is more active. After the appetite stimulant ran out, he stopped eating and is getting thin again. We called vet and she wants to try a steroid because she "thinks" there is a secondary infection but is not sure why he is not eating.

Here is what the tests show:

Negative = feline leukemia
Negative = liver/kidney problems
Slightly elevated protein
Slightly anemic

Anyone know what we should do? We are running out of cash with all the "guessing" going on.

[Mona]

I am very sorry for what you are going through with you precious kitty.

It sounds as though it was picked up at the boarders and is a tough virus to get rid of. Was your cat healthy before he was boarded?

Has the vet tried Baytril in a shot form and pills. This was given to my cat when she had a cold that would not go away.

I am sure Traci from this board will be able to expertly help you, but I wanted to offer some kind of support to you.

Please post updates.

Mona, Honeybun and Chloe

[Traci]

First, was your kitty up-to-date on his vaccinations, and if so, what vaccinations were last given and when?

You mentioned blood testing, but was no CYTOLOGY testing done? By this, I mean an exudate from either nasal, eye or throat/esophagus to rule out other viruses and/or mycobacterials. Calicivirus and rhinotracheitis need to be ruled out (would maybe respond better to amoxicillin rather than clavamox, plus antibiotic opthalmic ointments would be another approach). You should know that calicivirus treatment is non-specific, broad spectrum antibiotics are usually the approach, but need to be concerned with development of pneumonia, check with your vet about that. Recovered cats may actually be persistently infected and may be slow to respond to treatment.

Did anyone ask the boarding facility if there was an outbreak of a virus amoung the other boarding cats?

Given the anemia, I would not suggest prednisone at this point. Not trying to step on your vet's toes, but unless he/she feels this is non-regenerative anemia, prednisone might be contraindicated at this point. It's unlikely that FELV or FIV is a concern, and exposure/manifestation of clinical signs wouldn't occur this early after exposure. But, if in doubt, you can certainly opt for a full feline serology which would need to be sent to an outside lab. At this point, I would highly recommend a cytology to rule out calicivirus and/or rhinotracheitis.

As for appetite stimulation, ask your vet about Hill's Rx A/D, it might do the trick in this case, also provides extra protein and calories for recovery. Also ask about using a nebulizer to help clear congestion, or, steam up your bathroom and let him be in there for a few minutes at a time. HOWEVER, if there is a potential for pneumonia, this is the last thing you'd want to do, you need to get that ruled out.

[Guest]

Thanks for the reply.

First, was your kitty up-to-date on his vaccinations, and if so, what vaccinations were last given and when?

He was due for his shot the week after this happened.

You mentioned blood testing, but was no CYTOLOGY testing done? By this, I mean an exudate from either nasal, eye or throat/esophagus to rule out other viruses and/or mycobacterials.

I specifically asked for a culture to be taken but she disagreed. She said she would have to get it from his lungs and that anesthetic would need to be applied that might make things worse.

Calicivirus and rhinotracheitis need to be ruled out (would maybe respond better to amoxicillin rather than clavamox, plus antibiotic opthalmic ointments would be another approach). You should know that calicivirus treatment is non-specific, broad spectrum antibiotics are usually the approach, but need to be concerned with development of pneumonia, check with your vet about that. Recovered cats may actually be persistently infected and may be slow to respond to treatment.

So far he has been on clavamox, zithromax, (another for a day), and interferon (taken orally). My dad, a pharmacist, said that interferon would due little good given orally.

Did anyone ask the boarding facility if there was an outbreak of a virus amoung the other boarding cats?

Boarding facility said he may have caught it from a bird that was in the room for the cats to look at. My new vet said that was almost impossible. She called and talked to them and they denied the bird story.

Given the anemia, I would not suggest prednisone at this point. Not trying to step on your vet's toes, but unless he/she feels this is non-regenerative anemia, prednisone might be contraindicated at this point. It's unlikely that FELV or FIV is a concern, and exposure/manifestation of clinical signs wouldn't occur this early after exposure. But, if in doubt, you can certainly opt for a full feline serology which would need to be sent to an outside lab. At this point, I would highly recommend a cytology to rule out calicivirus and/or rhinotracheitis.

I'll ask about this today. So far he has had:

FELV/FIV bloodwork = negative
Pre-Surgical bloodwork = slight anemia/increased protein in blood
autoimmune panel = negative
multichem = not sure what this is

As for appetite stimulation, ask your vet about Hill's Rx A/D, it might do the trick in this case, also provides extra protein and calories for recovery. Also ask about using a nebulizer to help clear congestion, or, steam up your bathroom and let him be in there for a few minutes at a time. HOWEVER, if there is a potential for pneumonia, this is the last thing you'd want to do, you need to get that ruled out.

I've been taking him in the shower with me since last Tuesday because his nose was so stuffed he was breathing out of his mouth all the time. There was a smell of BO coming from his mouth. Today he is breathing out of his nose almost 90% of the time. We have been giving him every known cat food from grocery store brands through pet store through whats found at the vet (Hills A/D and Purina Pro Plan Ocean). The cat was always finicky but did eat his dry most of the time with very little wet. Now, his throat hurts so he does not touch the dry. We are giving him 2mg of cyproheptadine once a day to stimulate his appetite. This seems to work but leaves him a little wired for a few hours after taking it. So far, this is the only positive we have seen while he hase been sick. I also started giving him the clavamox once a day to fight any infection that may still be present.

[Traci]

I strongly suggest another opinion right away. I realize you've seen two vets now, but it's obvious they are not doing enough (let alone with diagnostics)....the second vet may have been referring to a tracheal wash to detect bacteria or fungal disease (which might be a potential), but ideally, a cytology should be done before anesthesia. Exudates from nasal cavities, eye discharge, etc generally do not require anesthesia.

Why do you feel his throat is sore? Is there evidence of ulcerations? Is his oral health optimal? (no gingivitis, no diseased teeth, etc)

At this point, I still recommend a cytology, and given the failure to respond to antibiotics, I would rule out fungal disease, maybe opt for a feline serology (needs to be sent to outside lab), this might explain the failure to respond to broad-spectrum antibiotics, some fungals necessitate treatment with sulfa-drugs.

Please try to find a feline-only vet and get a cytology/potential serology done. Not responding to such a long course of antibiotics indicates something else might be going on, undetected. You may also want to opt for an x-ray of his chest, to rule out diffuse areas of the lungs, etc.

[Newt]

Thanks again. I was the one who posted as Guest if that is not already obvious.

The current vet is feline only, I did not get a chance to go with my wife today so I will call and ask about this on Monday. The reason I thought his throat was sore was due to his lack of eating dry food, tilts his head forward to swallow, and whispers (no meow).

It reminds me of having nasal drainage down ones throat. I have seasonal alergies, and when I have drainage at night sometimes it sits on the back of my throat when sleeping and makes it soar. During this time, it is tough to swallow due to the drainage. Newt seemed to have those exact same symptoms. When he first showed signs of a soar throat he would sleep in odd places with his head resting in an up position. I often times have to sleep on two or three pillows so that the drainage will not sit in one area and cause pain. It just seemed very familiar, but I do not know if a cats nasal cavities work the same way a person's do. After Newt started drinking water again, you could hear the "snot" moving in his nose and even see it.

Another reason I think he has drainage is because one night he began coughing (sounded like a smoker cough) and some white flim came up on his tongue. Do you know if this is feasible? If I have enough drainage, it sometimes makes me ill and not want to eat. I can only imagine what that would do to a cat.

[Traci]

Ok, you are obviously dealing with either an upper or lower respiratory problem, but, whether from a virus, bacterial or fungal, still needs to be determined. This is a long shot, but would also ask your vet about checking kitty's esophagus to check for signs of damage, forced pressure, ulcers or infection. etc. (I only mention this due to your account of the head tilt and not being able to eat dry food)

Usually, in upper respiratory infections, discharge is only noted from nasal cavities and from conjunctivitis from the eyes. Mild forms of rhinotracheitis for example, usually do not cause lung infection, mucous or serious breathing problems. Calicivirus however, can, it can also cause pneumonia, mucous from nose, eye, mouth, chest, etc. A lung infection, whether bacterial or fungal in nature, might cause all three symptoms.

I would ask your vet to call the boarding facility again, demand to know if other cats came down with a viral, and also rule out cleaning agents, dust in the building, etc. Find out what food was fed to your kitty, including any treats, catnip, etc. I would also find out about their vaccination policy, obviously they are not too strict on their policies if they allowed you to board kitty in view of his upcoming vaccination. (for what it's worth, if they do not have a strict policy, I would never use this facility again, ever, the risk of transmissable viruses is too great)

Lastly, has anything in your own home environment changed since the boarding event.....such as remodelling, excess dust, smoke, anything else you can think of that may be currently irritating him, and slowing the response of recovery?

[kk]

Hi,

First of all, I'm so sorry to hear that your baby is so sick. I commend you for working so hard to find a solution.

Traci, I know it's a long shot, but the first thing that popped into my head when I heard about the bird was Psittacosis infection. I know that humans can get pretty sick from it, but from what I hear, cats would mostly get only conjunctivitis. But I did find mention that Chlamydia has been known to cause a pneumonia-like disease in cats, as well as conjunctivitis and a runny nose. I assumed it would be extremely rare, but if kitty was stressed, perhaps it is possible?? Would it be a good idea for them to just try doxycycline and see if that helped? You recommended a cytology on exudates, which I very much agree with.

No matter what your baby has, I certainly hope that you will find an answer soon, and get your baby well as soon as possible.

((hugs)), kk

[Newt]

Vet #2 thought he may have Chlamydia. She prescribed the interferon. Right now he is breathing out of his nose 90% of the time and is eating/drinking while on the appetite stimulant.

He is showing no other symptoms (no runny nose and no runny eye). Vet #2 did look down his throat and did not see any ulcers or redness when he was at his sickest. We think at this time he is just weak from not eating. He shows signs of improvement when he is eating, so we thought we would continue the appetite stimulant for another week or two and see if there is a change.

We're also going to request all of his records to send to my inlaws vet, who is very good from what I am told to see if he has any opinions on it.

[kk]

Perhaps Newt is on the way to getting better, having no more runny nose and runny eye. I hope he will start eating on his own very soon. I had mentioned doxycycline, but I realize you gave Zithromax at one point, and this works against Chlamydia too. I hope your inlaw's vet will be able to help you find some answers. Please keep us informed of how things turn out. ((hugs)), kk