New here - looking for any advice

[samshane]

I just joined - I am tryingt o look for some other thoughts and ideas as to what might be wrong with my 12 yr old cat.

Two weeks ago I took her to the vet for her yearly check-up. They did blood work and everything came back normal, including her kidney values which had been elevated the year before but she had been on KD wet food since that time. The Dr said to me that she was in great shape, and there was no reason she couldn't live another 5 or 6 yrs.

8 days later my daughter finds the cat curled up and lethargic and refusing food. As we were leaving for vacation in 2 days - my Dh rushes her to the vet. There is blood in her urine and initial tests show that she might have a kidney infection (thought the culture came back later as being all clear - ??). Her blood work comes back normal again - and an x-ray shows that she has no kidney stones or any type of masses. The vet sends her home after keeping her overnight... she is on antibiotics.

We leave for our 5 day vacation - leaving her with a pet sitting service who has a vet tech watching our pets. The cat still refuses to eat... they force feed her a couple times while we are gone. But - the odd thing is, her energy begins to increase and she is acting better - but not eating.

We come home and she has lost weight - and this cat was only 6 1/2lbs to begin with... she has been a tiny, petite cat ever since we have had her (she was abandoned in military housing 11yrs ago and Dh's friend found her... she has been roaming the country with us on our military moves ever since). Dh takes her back to the vet - she is down to 5 1/2lbs, but active and still refusing to eat. Our vet still cannot find anything wrong with her - they send us off to a specialist - for an ultrasound.

Dh gets the cat to the u/s - only to find out the u/s tech is not there til monday (this was late on Friday). So - he has another vet look at her for a second opinion and she feels no masses or anything - and says the cat looks good, except for being dehydrated and thin... but that the cat has a good energy level.

She tells Dh that she feels fine with sending the cat home - they gave her something to increase her appetite and an injection of fluids.

Finally - this morning, she ate - she wanted to eat EVERYTHING. And she has not thrown the food back up again (the vet told us to give her pepcid AC to help with her nausea). We are feeding her in small amounts... and she almost seems back to her normal self. We are still coninuing the antibiotics as well.

The next 3 days are ciritcal - because the appetiite meds and fluids will wear off and we will have to see what she does on her own. Both vets do not suspect cancer... and her kidney values are within the normal range.

I was hoping that someone might have some other thoughts on this that I could bring up with the vet... another possibility the vet suggested what that the antibiotics supressed her appetite and she was just mad at us leaving. I admit, she is quite a diva of a cat - and is the princess of this house (and my 9yr olds best friend).

I just wish the vet found something - anything... instead we get a second opinion to hear that no one can find anything wrong with her.

Sorry this was so long - I appreciate any input!

EDITED to add that she is strictly and indoor cat. She has escaped into the back yard a couple of times, but quickly brought back in the house. I wanted to add this just in case someone thought it might be something external to the house she got into.

Samantha

[Traci]

Hi Samantha,

Just a few questions,...

As for the urine culture, do you know what your vet was looking for specifically?

Was oral health checked? A bad tooth can lead to infection, which can travel through the bloodstream and end up in the kidneys, heart, gastrointestinal system. Inflammed gums, bad teeth, oral ulcers or abcesses can be painful enough to cause anorexia as well.

The fact she was curled up, if that is how you intended to describe her, might indicate she was/is painful in some area, so that's a very important thing to bring up with the vet during diagnostics. Similarly, cats, when in pain, generally sit in a sternal position (laying straight, abdomen on floor, paws tucked under, sometimes a hunched back, and seem depressed), but a curled position can also indicate pain. Hematuria in the urine could indicate the beginning of a urinary tract infection or inflammation somewhere in the urethra, bladder, or higher up in the kidney tubules.

Any chance she is anemic? (A CBC should detect this, the CBC is separate from a chemical blood profile).

Was a thyroid panel done? This is wise to do for any cat over the age of 7. Hyper or hypothyroidism can be a silent condition when developing and one of the most common symptoms is sudden weight loss. A sudden loss of a pound of weight in a week or less is concerning and is not always due to not eating sufficiently.

Did the vet do a CBC to determine her hydration status, her electrolytes and to find any hint of infection, inflammation or high white blood cell counts? (the latter would more than likely indicate infection, although it can also be due to inflammatory process, or electrolytes out of balance etc)

Did she develop any vomiting, or undigested food/regurgitation or soft stool/diarrhea while on the antibiotics? Was she on amoxicillin or clavamox or something else? Did the vet suggest ceasing the antibiotics and/or substituting them for another type?

It's possible the antibiotics made her nauseated but I doubt it was enough to cause total anorexia, and the weight loss was too much in a short amount of time. In the absence of vomiting and/or diarrhea, it may not have had anything to do with the antibiotics. Plus, you noticed she was anorexic and lethargic before your vacation/before the pet sitting.

I would suggest following up with the ultrasound on Monday. Also ask the vet about infection somewhere that might have been missed (GI tract perhaps, or a bad tooth, an oral absess etc) and see about a CBC if it wasn't done already. I'm assuming the pancreatic enzymes were included in the blood profile, but if they weren't, ask the vet to rule out pancreatitis and IBD. Also strongly suggest a thyroid panel is performed. Lastly, make sure heart function is thoroughly checked.

Not trying to worry you, but don't dismiss the possibility of cancer just yet, the ultrasound would be a vital tool to rule that out. Let's hope it isn't cancer. Usually, symptoms progress rather than wax and wane if left undetected/untreated.

See about the ultrasound on Monday, run these suggestions by your vet and take it from there. Please post an update when you know more. With any luck, it is just a mild case of hematuria in the urine, perhaps the start of a UTI or mild infection somewhere, but in a 12-year-old kitty, you don't want to leave anything unchecked. In the meantime, please do everything you can to limit stress for her, short of getting her to and from the vet and diagnostics, do what you can to encourage her to eat, drink, keep warm and comfortable etc. and take note of anything unusual like pain when picked up, held, etc, increased thirst and urination etc.

[samshane]

Thanks for your prompt response... she was sitting in the sternal position as you described - she typically sleeps curled up, I confused my terminology with that.

Her thyroid levels were elevated but within the normal range. So the vet felt there was no need to be concerned with that. As for anemia - I don't see anything about it on the paperwork.

Her teeth were check - and the vet suggested a cleaning after the bloodwork came back as being "normal" (I don't know if I know what "normal" is anymore!). We didn't even have time to pursue that since things when downhill within 8 days of the initial visit. I am rereading the paperwork as I type this and vet #2 found no oral ulcers.

The vet did suggest a GI tract infection as well... it is so strange because since the injection of fluids on Friday and the appetite medication - she is acting like herself again. She slept most of the day to begin with - so she still does that. But this morning, like clockwork, she woke me up to feed her. And again, she ate. We have been feeding her assorted items (per the vet recommendation) to get her to eat. This includes her treats, some tuna, meat baby food, her KD food... and she has started to eat all fo it again. And she is drinking more regularlay as well.

She has been keeping everything down as well. She did throw up a little water yesterday - but then she ate and was fine (and believe me, I watched her like a hawk).

I will let you know how the u/s goes... my husband drove over 100 miles all over our area taking her to the different vets on Friday. I like our regular vet - but she was not the one who looked at Scarlett as our vet was not there (there are 4 vets in the practice). My Dh did not really like her - as he likes everyone. He liked the vet who gave him the second opinion much better... and that is where the u/s is. Unfortunately that vet is also 35 miles from our home.

For today she is such, much better. I am just worried it is temporary.

[Traci]

Well, chances are, she will continue to improve, regardless of the current meds, but...keep the appointment for tomorrow's ultrasound, just so you have all bases covered.

It's possible she just had a GI bug or slight amount of inflammation, even the start of a urinary tract problem (the antibiotics should target that).

Depending on the ultrasound results will determine the next steps, if any.

Hang in there, keep encouraging her to eat and drink, but not too much of the baby food, treats or tuna, these should only be used as tempters to encourage her to eat her normal food. If she's eating dry K/D, perhaps consider giving canned K/D.

Overall, and again depending on the ultrasound results, I'd strongly suggest repeating bloodwork (and thyroid panel) in a few months, or sooner if she develops unusual symptoms again.

[samshane]

Well, everything checked out normally and she continues to improve. They did tell us one kidney is smaller than the other, but that this is nothing to worry about. She is back on her K/D exclusively and eating it up (well, along with her treats that she always looks forward to). She is drinking and using her litterbox as well.

In fact, she is seemingly back to her normal self - she just needs to gain some weight back.

Honestly - on Friday I thought this was going to be the end... I really did. But today she is grumpy old-lady Scarlett again. And she gives the sweetest head-butts again that my 9yr old calls "kitty kisses" again.

But, we're still watching her carefully and plan to go back for bloodwork in a few months - unless she goes downhill again.

Thanks again for all your adivce and suggestions - it is appreciated.

[Traci]

Glad to hear she is feeling better! But, please don't put off the bloodwork in a few months (including rechecking thyroid)....the three month interval is actually ideal in this case (usually every 6 months is recommended) because she obviously had something going on and the sudden weight loss is still concerning.

[Laurie and Tasha]

Hi,

I only have one thing to add to what Traci said, and that is about blood in the urine. I know from my own experience that not all kidney or bladder stones will appear on a regular xray - but they will on a CT scan. I don't know if this would even be available in your area or worth the expense ( because she is doing so well now), but I don't see where you ever got an explanation for that particular symptom.

So glad she seems back to normal!

[Traci]

Just for future reference: Blood in the urine as a single symptom is almost always difficult to pin a condition on, that's why we like to look at other urine markers and add bloodwork (and other diagnostics if necessary). Many times, a urinalysis is all that is needed to diagnose or treat. Oftentimes, a small amount of blood in urine is (sort of) meaningless in terms of diagnostics, when other markers point to the true case (like infection, obstruction, crystals, etc) Having said that, a large amount of blood or consistent blood would indicate a greater problem.

Sometimes the blood is from stress. Sometimes it's a lone crystal or artifact or formation in the bladder that eventually passed on it's own, leaving blood due to irritation. Sometimes it is indeed a kidney problem, bloodwork (usually) can indicate the extent of a problem enough to warrant additional testing. In almost every diagnostic workup, most of the time a small amount of blood in the urine is the least of problems.

Of course we don't want to undermine and ignore it's significance, just want to say that pet owners will rarely get a full explanation from the vet why there is hematuria in the urine. (because he's looking for more accompanying evidence to confirm a diagnosis).

While not great for the cat, seeing obvious blood in the urine is a good thing in terms of alerting us to a problem which demands a vet visit.

[samshane]

Scarlett continues to improve... we finihsed her anitbiotics - and she has no blood in her urine at this point. For a cat I suspected wouldn't make it through the weekend 2 weeks ago, she has made a remarkable recovery.

She has gained weight and does not feel as "boney" anymore... though she could still stand to gain more. We're working on it.

We'll be following up with more blood work in the next couple of months. It's nice to have our old kitty back again.

Thanks again for all the great information.

[Traci]

Samantha, thank you so much for the update on Scarlett, what wonderful news!

Since she's 12 years of age, you want to get twice-yearly checkups for her, please get bloodwork done each time (or sooner if necessary). It sounds like you take excellent care of her.