My cat was poisoned and I need some advice.

[kim]

We believe our cat ate a poisoned rat and he's been taken to the vet several times and received antidote, antibiotics and immune system boosters. The vet was quite surprised that he was still alive this morning. He's stopped producing a bloody froth from his mouth but is experiencing weakness in his back legs. I don't believe he's had any seizures, but was shaking his head a great deal and drooling.

He used to be feral and we've "adopted" him to the extent he will allow, so keeping him indoors full time was not an option. He's allowed us into his life since he was about six months old, and is an absolute sweetheart.

My questions are: once he's experienced weakness in his legs, is this irreversible? If it is permanent, can he have any quality of life with enough love and attention? Is there any chance at all of survival? I'll do anything to help him, but don't want to prolong his suffering if there's no chance. When do you know? He's very quiet and clearly doesn't feel well.

I'd appreciate some advice. Thanks.

[Traci]

First, while there is not enough evidence to suggest a cat eating a poisoned rodent will cause toxicosis in the cat, it depends on the amount of rodenticide the rat initially ate, and if the cat was exposed to further amounts of rodenticide, especially over a varying period of time.

When exactly did this occur, and what tests did your vet run to determine rodenticide toxicity? Were clotting factors done? (i.e., ACT, PT, PPT) Were liver and kidney enzymes tested to differentiate from other toxins? Was a serology considered to differentiate from causes of anemia or hemmorhage? Were xrays done to determine if the bleeding was caused by injury as opposed to rodenticide toxicity? What are his blood parameters now? Are they stable? Are his clotting abilities stabilized? Is there any hemmorhage or anemia still present? Is your vet checking these every day or at least every 3 days? Other than the weakness, are kitty's symptoms resolving? Is he interested in food/water, urinating/defecating normally? No vomiting or diarrhea? Any fever activity?

Typically, if rodenticide toxicity is identified at the start (with proper bloodowrk), and if the patient responds to the antidote (vit K) within the first 48 hours after the incident, the chances for recovery are greater. The weakness in the hind legs does not sound typical of rodenticide toxicity, nor does the head shaking, although anything is possible. It sounds like this may have been some other toxicity or injury, or reaction to whatever treatment might have been given (reaction to the vit K may be possible, along with other injections, ask your vet about that)

If your vet is in any way uncertain, then seek a second opinion TODAY if possible, since you want to rule out other causes of toxicity or hemmorhage (i.e., traumatic injury, infectious viral disease, other toxins). Don't wait on this, your vet needs to address the hind leg weakness ASAP and make darn sure that he differentiated rodenticide toxicity from other toxins or injury.

Once kitty recovers, do NOT allow him outdoors again, and if you have other cats, keep them too, INDOORS ONLY!. Since you've experienced one of the many outdoor hazards, it is incumbent upon you to keep him and your other cats protected from these dangers. Feral or not, there are ways to acclimate any cat indoors. You simply have to be comitted to the acclimation and make the home environment interesting and safe for them.

Edited to ask: What was the "immune system booster" your vet gave?

[Cindy]

This is all I can offer: We had a cat in our shelter who had distemper as a kitten and he survived. But he had nerve damage in his hind end and ended up being weak limbed in the rear. He could walk, but if he ran the back end had trouble taking corners and he could not jump well. But otherwise he was fine. He was adopted by a wonderful man and is living the good life

I hope your kitty pulls thru!

[kim]

Thank you for your very comprehensive reply. I have sent it on to my husband who is in Oman with the cat. The problem is exacerbated by the fact that the Omanis do not have a high regard for pets and therefore think he should be put to sleep. Finding a small animal practice is challenging enough. The language barrier is also something of a problem since our Arabic is minimal and their English is good for casual conversation. Another opinion is not an option.

My husband has told me that Kitty has attempted to finally drink, but doesn't seen able to lap any water. I suggested he dribble some from the end of his finger, but he indicated that it activated a gag reflex. Kitty was producing a bloody foam orally, but that appears to have stopped. He is laying horizontally near the sunshine and is no longer hiding under a blanket. I don't believe there was any talk of diarrhea. No one has seen him use the catbox, but other than the glucose shots, I don't think he's had anything.

Probably, because it is Oman, they may use all sorts of poisons that would certainly be banned in the US and Europe.

Here is the text of the most recent update I received from my husband:

"Bob is a little improved this morning though still very poorly.
He voluntarily took a few sips of water in the kitchen and is a little cleaner around the chops than he was when I went to bed.
I took him again to the vet and she gave him some injections to support his organs and system including some glucose fluid. Same as yesterday except then he got an antibiotic dose which is good for 48hrs so it's back again tomorrow morning for another one. The vet confessed that 24hrs ago she didn't think he was going to make it.

I'm going to check Bob into 'hospital' on Monday evening, depending on his condition, before I go away on Tuesday morning."

There was mention to expect a reaction to one of the injections, so I'm hoping it was a Vitamin K injection.

I appreciate your very thorough response and will keep you posted as I learn more or his condition changes.

Thank you so much for the direction.

[Traci]

Sheesh, I assumed you were in the UK! Are you a US or UK citizen on travel or something?

Knowing nothing about this country or it's veterinary facilities, please see this page for US or UK embassies or consulates in which you might be able to ask someone for proper veterinary care....an embassy might have people who own pets and have veterinary resources they can refer you to.

http://www.state.gov/r/pa/ei/bgn/35834.htm

From just a quick search, your best bet might be to have someone get in touch with a veterinary facility in Muscat, or the nearest veterinary teaching hospital for help. Tell the vet you want more help from a more qualified vet. In any event, find an interpreter to help you with this!

Vit K injections can be painful, and if given in the wrong dose or wrong location on the body (or wrong size needle used), can cause something like what you are describing as the weak hind legs. But, in view of your last post and in view of not knowing the experience of this vet, the possibilities are endless. Further compounding the problem is not knowing what treatment was done, I only posted to you what typical treatment is comprised of for rodenticide poisoning, which I don't know is even the problem or not. Yes, it's possible, but if the vet isn't experienced, how does he know?!

In any event, kitty needs proper care by a more qualified vet, I'd strongly suggest getting in touch with a consulate or embassy for more direction, but time is of the essence here. Is your husband in the military? Is he stationed there, or is this for some other reason? If military, can he not consult with a military veterinarian who can help further?

[kim]

I'm a US citizen currently in the UK, but we live in Oman (husband is British). Kitty was taken to the finest vet that will work on small animals. I was just told by my husband that he was informed by the vet that "it's a matter of time" and that Bob will probably die during the night. His temp is 4 degrees below normal and his mucosa is very pale. My husband says that he seems very calm and his breathing isn't labored and he doesn't appear to be in distress. The vet feels that any more testing would be too stressful for Bob at this point. If he's alive in the morning he goes back to the vet for another antibiotic injection and more glucose. My husband has to leave on Monday evening (work, no option) and has made arrangements for Bob to stay in the surgery there even though the vet feels it will be very stressful for him. Bob had some bloody diarhea earlier today. I can only pray. Thank you for your help.

[Traci]

Is Bob on IV fluids? If distemper, IV fluids should probably be given. If rodenticide toxicity, not sure if fluids is appropriate at this point.

There is obvious an anemic crisis is going on. What exactly are the antibiotics? And why are they given by injection? Injections should probably be avoided at this point, and oral antibiotics instead. Ask the vet if he knows about regenerative anemia in which doxycycline may be a consideration, but the vet needs to know what he's doing before giving doxycycline! (this medication is not without risks, but doxycycline and prednisone are often used for regnerative anemias, only problem is, the vet needs to determine if this is regenerative anemia caused by a viral or blood parasite like hemobartonella, or from traumatic injury, etc BEFORE giving either of these meds). Glucose may also be contraindicated here, but again, the difficulty is not knowing what this vet knows and what he's doing!

Surely, there has got to be a way to communicate with this vet and amoung other vets, don't just give up on your kitty, he's depending on you and hubby to be his voice! Again, if your husband is military, can he not consult a military veterinarian to interpret to the Oman vet???

[kim]

Not in the military. If it weren't so tragic, it would be almost funny. The person he found to help translate is Russian with a heavy accent. No one understands why we're going through all this for a cat. Poor husband keeps getting dragged over to the bulletin board to see his replacement options. Is the temperature being so low a definite sign that he doesn't have long? Or can I cling to some hope that he can recover from this? Is it a good or bad sign that he isn't panting or doesn't seem to be in distress? His eyes are clear and he responds vaguely when he's spoken to.

The vet thinks paralysis is setting in, but could it be that he's just too weak, or that his abdominal area is so sore that it hurts to walk? I realize I'm clutching at straws here, but I guess I want to believe there's hope for as long as I can.

[Traci]

Normal feline temp = 100-102.5 degrees F, so if it's at or below 99 F, the vet should probably attempt to use IV fluids, and to warm the fluids bag before administering IV, however, this could be contraindicated in a severely anemic patient, he needs to refer to a more experienced vet, talk to a more qualified vet about Bob's vital signs, and if platelets are low, treat as hemmorhage or regenerative anemia (or even non-regenerative anemia). The problem, again, is not knowing exactly if this is rodenticide toxicity or a hemorrhage going on somewhere internally (like spleen or other organ). A hematocrit and Packed Cell Volume (PCV), and thrombin time should be done. Realizing the stress of these tests, it only takes a quick blood draw, and to draw enough blood in one venipuncture to do all three tests, can we hope the vet is competent enough to do labwork, and results obtained right then and there?

A major concern is bloody diarrhea, which wouldn't be uncommon in a rodenticide toxicity patient, but this indicates a possible sign of hemorrhage and the vet needs to identify the source immediately in which to know how to treat it!

If the vet has proper lab equipment, knows how to do a hematocrit, pcv and thrombin time (clotting factor test), and can do so right there in the clinic with results in minutes, and if he knows how to treat anemic crisis, then yes, there is a chance for recovery, but it must be addressed NOW.

It may not be paralysis, unless there is a clear indication that traumatic injury was the cause (like blunt force, hit by a car, etc), in which the pelvis could be fractured, or the bladder is injured, or nerve damage has occured (xrays are useful to determine internal injury, where's the blood coming from, is it a punctured lung or other organ, is it a ruptured spleen, is it free-flowing in the chest or abdomen, etc). It could also be due to the anemia in which Bob is severely weak and cannot control his bladder function. The vet needs to check the hematocrit, pcv to determine red blood cell function (or red blood cell destruction), determine platelet count, blood clotting factors, etc, in order to distinguish regnerative vs non-regenerative anemia vs hemorrhage, etc and in which to treat effectively.

Again, the vet needs to consult with a more experienced vet. I don't know the country, but surely, he can phone another more experienced vet or vet teaching facility and/or get a british/american translation for help, this is mission critical however because when anemia is this serious, and if the platelet count is too low, it will be much more difficult to treat.

I understand your limitations, but if hubby is at least in the position to talk to the vet again TODAY, he should request the current vet consults with another more experienced vet IMMEDIATELY, by phone, by teleconference, by fax, by whatever means possible. You can still try the embassy or consulate for help in locating a more experienced veterinarian in the area, or at least, a vet in any other area the current vet can call and consult with.

[kim]

I have forwarded your very informative email and thank you again for your help. I'll keep you posted.