Hi Newt,
It is very difficult to definitively diagnose FIP. FIP is a coronavirus, so the test you are referring to is just for coronavirus, not specific for FIP (there are other coronaviruses such as FECV or feline enteric coronavirus) and they only indicate previous infection. There is no single diagnostic lab test as of yet. Other signs might include, leukopenia (low white blood cell counts), mild anemia(low PCV as I described in my last post) , High globulins, high bilirubin in both blood and urine.
How old is your kitty? What other symptoms does she have? I probably need to check previous posts. I will do so now. Good luck with your kitty.
Test Results
Newt, lets recap for a moment.....
9-5-03
On the 6th, you reported an autoimmune profile was negative, but was this a serology that was sent out to an outside lab (taking at least 5 days to get results)?
On the 8th, you reported gastrointestinal ulcers, how were these diagnosed? If they are indeed present, this could be one reason he is not eating sufficiently (your vet could have prescribed sucralfate for this)... As for the neurological abnormalities, what exactly has Newt presented regarding neurological? Is weakness being mistaken for neurological problems, or has there been obvious signs of a neurological deficit?
And now, is jaundice still noticeable? Were any liver enzymes elevated or out of normal range when the last chem profile was done? (as for the sodium chloride and protein, both can indicate dehydration as well, which might correlate with a liver problem--hepatic lipidosis for example--insufficient nutrition and fluid intake)....the hepatic lipidosis if diagnosed, could be secondary to a primary disease, such as calicivirus or chlamydia we talked about earlier.
To answer your last questions, yes a sinus problem or allergy could be a suspicion, the former can be detected through a thorough scope exam (would need anesthesia), the latter a process of elimination through diet and environmental factors. But, I doubt the latter is the culprit. As for a potential sinus problem, I still, still, still suggest a full cytology done on any exudate from nasal cavity, mouth, or esophageal exudate, this could help rule out much of what we've talked about, prior to any surgical or invasive procedure. (although a tracheal wash would require anesthesia)
As for Newt's feeding schedule, I don't think it's enough. Even based on his weight, if the liver is the least bit compromised (which I highly suspect it is), nutritional support is going to be the mainstay in his treatment, as well as fluids support, you may have to opt for sub-q fluids at home, need to discuss that with your vet. Can you remind me what food you're feeding? Ideally, Hill's Rx A/D would be a good approach (providing this is a liver condition that requires added protein and calories)
I want to stress again, that you discuss in full, the cytology from exudates, ask about the autoimmune profile and what exactly it included, what exactly was ruled out from that. By all accounts, this does not fit the FIP profile, not to say it isn't something you shouldn't rule out, but it seems more of a viral or even fungal disease. Imperative those are ruled out. The congestion you are describing and it's progression are very very concerning.
9-5-03
On the 11th, was a chemistry profile ran again? (enzymes, like protein, liver/kidney enzymes, sodium, etc)Newt wrote:Slightly elevated protein
Slightly anemic
9-6-03
autoimmune panel = negative
multichem = not sure what this is
9-8-03
Gastrointestinal and eye ulcers
Jaundice
Mild anemia
Neurological abnormalities
Severe conjunctivitis
9-10-03
Low Sodium Chloride
Slightly jaundice
Anemia levels have changed
9-11-03
new panel of tests, two of which: FIP and coronavirus
On the 6th, you reported an autoimmune profile was negative, but was this a serology that was sent out to an outside lab (taking at least 5 days to get results)?
On the 8th, you reported gastrointestinal ulcers, how were these diagnosed? If they are indeed present, this could be one reason he is not eating sufficiently (your vet could have prescribed sucralfate for this)... As for the neurological abnormalities, what exactly has Newt presented regarding neurological? Is weakness being mistaken for neurological problems, or has there been obvious signs of a neurological deficit?
And now, is jaundice still noticeable? Were any liver enzymes elevated or out of normal range when the last chem profile was done? (as for the sodium chloride and protein, both can indicate dehydration as well, which might correlate with a liver problem--hepatic lipidosis for example--insufficient nutrition and fluid intake)....the hepatic lipidosis if diagnosed, could be secondary to a primary disease, such as calicivirus or chlamydia we talked about earlier.
To answer your last questions, yes a sinus problem or allergy could be a suspicion, the former can be detected through a thorough scope exam (would need anesthesia), the latter a process of elimination through diet and environmental factors. But, I doubt the latter is the culprit. As for a potential sinus problem, I still, still, still suggest a full cytology done on any exudate from nasal cavity, mouth, or esophageal exudate, this could help rule out much of what we've talked about, prior to any surgical or invasive procedure. (although a tracheal wash would require anesthesia)
As for Newt's feeding schedule, I don't think it's enough. Even based on his weight, if the liver is the least bit compromised (which I highly suspect it is), nutritional support is going to be the mainstay in his treatment, as well as fluids support, you may have to opt for sub-q fluids at home, need to discuss that with your vet. Can you remind me what food you're feeding? Ideally, Hill's Rx A/D would be a good approach (providing this is a liver condition that requires added protein and calories)
I want to stress again, that you discuss in full, the cytology from exudates, ask about the autoimmune profile and what exactly it included, what exactly was ruled out from that. By all accounts, this does not fit the FIP profile, not to say it isn't something you shouldn't rule out, but it seems more of a viral or even fungal disease. Imperative those are ruled out. The congestion you are describing and it's progression are very very concerning.
..........Traci
Julie,
Newt is a little over one year old. He only has a stuffy nose, slightly lethargic, and anorexia.
Traci,
Thanks for the detailed response. I'll try to address all your questions:
Along with the food we mix the following in per half a can:
500mg of Lysine (backed off a little)
500mg of buffered vitamin C
2 tsp of Energel (Nutri-Cal)
Thanks again for the advice. Keep it coming, I'll let you know what I find from this blood test results this week.
Newt is a little over one year old. He only has a stuffy nose, slightly lethargic, and anorexia.
Traci,
Thanks for the detailed response. I'll try to address all your questions:
1)No, there has not been another chemistry profile ran.On the 11th, was a chemistry profile ran again? (enzymes, like protein, liver/kidney enzymes, sodium, etc)
2)On the 6th it was sent to an outside lab. I don't know all the details other than the 27% anemia and raised protein.On the 6th, you reported an autoimmune profile was negative, but was this a serology that was sent out to an outside lab (taking at least 5 days to get results)?
3)There were no ulcers, but the vet suspected there were some possibly further down. We were never given a definative answer from Vet2 on ulcers, just her suspicions. There are also no neurological disorders as of yet, they said these would come around with FIP eventually but he has not shown any signs...just lethargic and anorexic.On the 8th, you reported gastrointestinal ulcers, how were these diagnosed? If they are indeed present, this could be one reason he is not eating sufficiently (your vet could have prescribed sucralfate for this)... As for the neurological abnormalities, what exactly has Newt presented regarding neurological? Is weakness being mistaken for neurological problems, or has there been obvious signs of a neurological deficit
He definitely was dehydrated a few times over the course of the month as well as not getting proper nutrition. We feed him 24cc three times a day of Hills A/D or I/D switching back and forth to keep him somewhat interested in eating. When the jaundice was diagnosed, he had some yellow on the back of his mouth and his eyes were a darker yellow. Today ( a week later) his eyes look much improved and I don't notice any yellow on the back of his mouth. How much should he get? The vet tech said that was good, but I cannot find a definitive amount per his weight (5.5 pds).And now, is jaundice still noticeable? Were any liver enzymes elevated or out of normal range when the last chem profile was done? (as for the sodium chloride and protein, both can indicate dehydration as well, which might correlate with a liver problem--hepatic lipidosis for example--insufficient nutrition and fluid intake)....the hepatic lipidosis if diagnosed, could be secondary to a primary disease, such as calicivirus or chlamydia we talked about earlier.
Along with the food we mix the following in per half a can:
500mg of Lysine (backed off a little)
500mg of buffered vitamin C
2 tsp of Energel (Nutri-Cal)
Were still waiting for the latest blood panel to come back, but will mention these to the new vet as well....scope...full cytology done on any exudate from nasal cavity, mouth, or esophageal exudate, this could help rule out much of what we've talked about, prior to any surgical or invasive procedure. (although a tracheal wash would require anesthesia)
Thanks again for the advice. Keep it coming, I'll let you know what I find from this blood test results this week.
Re: Test Results
Ok, assuming the 10th was the last chem profile, and pending the incoming results, I would at least ask for a liver profile to check those enzymes and rule out potential hepatic lipidosis or other liver condition. (your vet can break these down somewhat to save costs)
In my assumption, the autoimmune profile sent out would be a serology to test for AIHA, blood-borne parasites like hemobart, FELV/FIV, toxoplasmosis, etc. Protein and anemia as you noted, could have been tested right there in the clinic lab, giving you immediate results. So for this reason, I would ask that you ask your vet was was "included" in that autoimmune profile (he'll know what you mean). Such a profile would have taken approximately 5-7 buisness days to get the results back. The protein and maybe some other blood might have been sent to a local human hospital lab for more accuracy in testing (which would only take hours or at most, two days)
As for the feeding, it depends on the condition. I suspected hepatic lipidosis as a potential concern, given the suddeness, the obvious insufficient intake, dehydration, jaundice etc. For patients with HL, although we do base their food intake on weight, we also base it on liver enzyme levels, degree of severity, dehydration concerns, and to the degree the patient can tolerate food (i.e., vomiting). Anti-vomiting meds and antibiotics are usually given as agressive treatment with the nutritional and fluid support. Some liver conditions do not require a higher caloric intake, but where weight loss is a concern or elevated liver enzymes, nutritional support is generally the key to treatment and recovery. In severe cases of HL, hospitalization with IV fluids and potentially a parenteal feeding tube is surgically placed to ensure nutritional support. When owners decline this, home care with forced feeding can be done, but it's not as sufficient a treatment plan as that in the initial clinical setting with a feeding tube placed. Again, we're talking about HL, at this poiint, we still do not know if the liver is severely compromised or not. This is one area you really need to talk to your vet about so that you understand if agressive feeding and fluids support are necessary.
I hope the tech advised you on the premises a vet told her what to tell you (as in relaying a message). Otherwise, don't take her word for it, speak directly to your vet. However, half a can of food is not truly sufficient in view of Newt's condition, and especially in view of not having an understanding of current liver enzymes. I would understand if he were consistently vomiting and could not tolerate forced feeding, or that the amounts would be less than 45 cc's per feeding, but if there is no vomiting, no fever, no direct signs of distress, then I would call your vet and demand a feeding schedule guide tailored to Newt in particular. Another major concern here is dehydration, this can put a big strain on his entire system, let alone liver function.
You might want to remind your vet about the inital, primary complaints...those are severe (and sudden I might add, initially) congestion, mucous, conjuctivitis, coughing, breathing distress, anorexia and lethargy. All of which have not seemed to respond to current treatment, and which may be inducing secondary infections, or secondary disease (i.e., the liver)....I'm sure your vet is entirely aware of the potential for secondary problems and complications, but the focus here needs to be ruling out the cause of these symptoms, treating any secondary infections, and not getting conflicting conflicting opinions from the vets involved.
If you're unable to talk to your vet directly today, then do so first thing tomorrow morning, and be agressive about it. Start from the beginning if necessary in reviewing the initial primary symptom complaints, ask about that autoimmune profile and find out what WAS ruled out, and ask about liver enzymes, and food schedule and fluids administration.
In my assumption, the autoimmune profile sent out would be a serology to test for AIHA, blood-borne parasites like hemobart, FELV/FIV, toxoplasmosis, etc. Protein and anemia as you noted, could have been tested right there in the clinic lab, giving you immediate results. So for this reason, I would ask that you ask your vet was was "included" in that autoimmune profile (he'll know what you mean). Such a profile would have taken approximately 5-7 buisness days to get the results back. The protein and maybe some other blood might have been sent to a local human hospital lab for more accuracy in testing (which would only take hours or at most, two days)
As for the feeding, it depends on the condition. I suspected hepatic lipidosis as a potential concern, given the suddeness, the obvious insufficient intake, dehydration, jaundice etc. For patients with HL, although we do base their food intake on weight, we also base it on liver enzyme levels, degree of severity, dehydration concerns, and to the degree the patient can tolerate food (i.e., vomiting). Anti-vomiting meds and antibiotics are usually given as agressive treatment with the nutritional and fluid support. Some liver conditions do not require a higher caloric intake, but where weight loss is a concern or elevated liver enzymes, nutritional support is generally the key to treatment and recovery. In severe cases of HL, hospitalization with IV fluids and potentially a parenteal feeding tube is surgically placed to ensure nutritional support. When owners decline this, home care with forced feeding can be done, but it's not as sufficient a treatment plan as that in the initial clinical setting with a feeding tube placed. Again, we're talking about HL, at this poiint, we still do not know if the liver is severely compromised or not. This is one area you really need to talk to your vet about so that you understand if agressive feeding and fluids support are necessary.
I hope the tech advised you on the premises a vet told her what to tell you (as in relaying a message). Otherwise, don't take her word for it, speak directly to your vet. However, half a can of food is not truly sufficient in view of Newt's condition, and especially in view of not having an understanding of current liver enzymes. I would understand if he were consistently vomiting and could not tolerate forced feeding, or that the amounts would be less than 45 cc's per feeding, but if there is no vomiting, no fever, no direct signs of distress, then I would call your vet and demand a feeding schedule guide tailored to Newt in particular. Another major concern here is dehydration, this can put a big strain on his entire system, let alone liver function.
You might want to remind your vet about the inital, primary complaints...those are severe (and sudden I might add, initially) congestion, mucous, conjuctivitis, coughing, breathing distress, anorexia and lethargy. All of which have not seemed to respond to current treatment, and which may be inducing secondary infections, or secondary disease (i.e., the liver)....I'm sure your vet is entirely aware of the potential for secondary problems and complications, but the focus here needs to be ruling out the cause of these symptoms, treating any secondary infections, and not getting conflicting conflicting opinions from the vets involved.
If you're unable to talk to your vet directly today, then do so first thing tomorrow morning, and be agressive about it. Start from the beginning if necessary in reviewing the initial primary symptom complaints, ask about that autoimmune profile and find out what WAS ruled out, and ask about liver enzymes, and food schedule and fluids administration.
..........Traci
Re: Test Results
Traci,
I reread my post and you may have read that I am feeding a half can per day. Is that how you read it? What I meant to say is that he gets those mixtures per 1/2 can but is eating one whole can per day...we just mix per half can since that is all the coffee mug we are using to mix his food with the other ingredients will hold. Is one can per day plus 4 tsps of Energel enough food for a 5.5pd cat? I know you said it depends on liver condition, but just go based on weight. Thanks again!
I reread my post and you may have read that I am feeding a half can per day. Is that how you read it? What I meant to say is that he gets those mixtures per 1/2 can but is eating one whole can per day...we just mix per half can since that is all the coffee mug we are using to mix his food with the other ingredients will hold. Is one can per day plus 4 tsps of Energel enough food for a 5.5pd cat? I know you said it depends on liver condition, but just go based on weight. Thanks again!
Re: Test Results
Actually yes, that's what I was getting....Thank you for clarifying that!!
One can per day might be sufficient for him in particular, providing you are no longer giving the I/D.....it is the A/D that provides the caloric content and extra protein. The I/D is generally intended for gastrointestinal conditions or as a bland diet given for patients during surgical recovery, vomiting episodes, etc. If you need the I/D to tempt him, by all means, keep it on hand, but I don't think I would use it as the major part of the nutritional support. I would still rather you confirm this with your vet.
One can per day might be sufficient for him in particular, providing you are no longer giving the I/D.....it is the A/D that provides the caloric content and extra protein. The I/D is generally intended for gastrointestinal conditions or as a bland diet given for patients during surgical recovery, vomiting episodes, etc. If you need the I/D to tempt him, by all means, keep it on hand, but I don't think I would use it as the major part of the nutritional support. I would still rather you confirm this with your vet.
..........Traci
I think there might be a problem. Newt's eyes have been dilated for a while, but that is not unusual for him even in direct lamp light or overhead light...its outside light that makes him close his lens.
I looked at his eye this morning and the lens is in a weird shape...like half is contracted and the other half is half dilated. The other eye contracted almost all the way in sunlight but not quite. Does this mean neurological problems? Also, his eyes are more reflective than normal.
I looked at his eye this morning and the lens is in a weird shape...like half is contracted and the other half is half dilated. The other eye contracted almost all the way in sunlight but not quite. Does this mean neurological problems? Also, his eyes are more reflective than normal.
Re: Test Results
given the history of this cat you need to get to a vet. having one dialated and one contracted might be the early sign of a stroke or something else.
a vet needs to see this kitty now to be sure.
a vet needs to see this kitty now to be sure.
Re: Test Results
Yes, that much is obvious.
What we are trying to find out is some info on causes since he won't be able to be seen until tomorrow or Wednesday.
What we are trying to find out is some info on causes since he won't be able to be seen until tomorrow or Wednesday.
Re: Test Results
PLEASE understand, the causes are numerous, too numerous to mention here, only your vet can determine this, Newt, please, get kitty to your vet immediately before this gets out of control. Even an emergency vet if available...one dilated pupil only is not a good sign, we cannot diagnose here....don't take the risk!Newt wrote:Yes, that much is obvious.
What we are trying to find out is some info on causes since he won't be able to be seen until tomorrow or Wednesday.
Jason is absolutely correct, given Newt's history and present condition, the last thing you need to do is mess around with something else...do NOT wait! Call your vet and explain the seriousness and your concerns, chances are he will get you seen immediately, if not, get to ER vet!!
..........Traci