Kitten with mystery illness - definitely anemic...

[Traci]

17 from 8 is improvement!! And, considering the timing has been longer this time, it's hopeful!! Also that he's showing interest in drinking on his own, that's a good sign - now, if they can just get him interested in tasting food, I think once he's feeling better, he will be pretty interested - once he can start eating on his own, those liver values may reduce to more manageable levels as well. Do ask your vet about that tomorrow morning, how he's feeling and if they have at least offered him something to gauge his interest.

Awwww, I love your photo of Logan, regal indeed, look at those big Maine Coon ears and tufts! He's so precious!

[LoganPenelope]

Yes, definitely improvement and good point about the timing being longer and holding his values! I know before they were offering him food. They wold offer a buffet style and monitor. The one wet food we could always count on was wellness - which, was recalled the day he first got sick - UGH. So I think I've found some online and we'll see if they actually ship....

In the meantime, 2 more pics of Logan with his sister Penelope. That's Logan watching Penelope jumping, and Logan is on the left, sleeping on my desk. Yes, it's hard to get any work done with these guys taking over my desk haha.

[Traci]

Re: the Wellness cat food, did you mention that to your vet? While the recalled food was a thiamine deficiency issue and the symptoms are similar but possibly not related now, it's something you want to keep recorded in Logan's health record.

As he's being hospitalized, however, I would recommend a veterinary diet that your vet has readily available, such as a bland one at first (Hill's kitty I/D or even small amounts of G/D so as not to stress his GI tract) - ultimately your vet might want to feed A/D because it is high in calories which would benefit him greatly if he has lost a significant amount of weight. Once he's eating on his own, your vet may recommend at some point, his regular food.

The fluids will probably need to be continued, since they are also treating dehydration, replenishing electrolytes, and helping to regenerate the liver. But, they can use an infusion pump to meter it out to prevent fluid overload. If he continues drinking on his own sufficiently, they may opt to cease the IV's but be prepared they may want to leave the IV's in for a little while longer for easier delivery of medications.

Logan and Penelope look so much alike, such cuties! I'll be they are the best of friends, the video I peeked at pretty much confirms that, LOL!

[LoganPenelope]

Well, the can food was only given as a treat for them - 1 can per week at the most. Their primary diet is Wellness dry food.

While he was home and not feeling well, we were syringe feeding him Hills AD and still have 3 cans here at home we got from the vet. They did say should they go to a feeding tube, we would be giving him AD.

Good to know about the fluids too. Hoping to post new photos of Logan in about 4-6 weeks when he is back at full weight

[Traci]

Yes, because the A/D is not only great caloric content but it is easiest to mix with water and deliver through a an oral syringe or feeding tube.

I hope they're not talking about a surgically placed feeding tube, but rather just using the tube on a temporary basis. He's not a candidate for anesthesia right now (unless it was a quick procedure such as the naso-gastric tube) - it would be ideal if Logan shows interest in eating on his own, it is so much less stressful. If the liver values don't normal off though, a naso-gastric tube would most likely be better because you have to ensure he's getting an adequate amount of food on a consistent schedule and the quickest sufficient way to regenerate the liver.

One day at a time, he's being such a good trooper. Post an update when you can, and again, try to visit him when you can.

[LoganPenelope]

Oh yes, the dr. went over both the stomach based one and the neck based one. They want to do a neck based one because it can be temporary. Initially, back on Friday, she was talking about having it in for several days to maybe up to 10 days then being able to take it out.

We've been talking to a different doctor on Sat and Sun since the initial one was out of town over the weekend...

We definitely want to avoid the feeding tube - just trying to prep myself for what the potential conversation might be tomorrow, since Logan hasn't eaten on his own in over 2 weeks, I'm not holding much hope he'll just up and decide to. Then again, with the fever gone, and anemia on the possible decline, who knows - he is starting to drink, so here's hoping!

[Traci]

They will most likely opt for the naso-gastric tube, since he has lost so much weight, he has probably used his fat reserves, and the liver has to regenerate....fast. The naso-gastric tube would be the fastest way to ensure consistent feeding (the endo-gastric tube can do this as well but the procedure requires longer anesthesia and there is risk for infection at the incision site). Don't be surprised if the vet mentions hepatic lipidosis, this is a condition that can be treated successfully if treated at the onset, and that treatment is consistent. It was more critical to address the anemia, and as long as the RBC's continue to improve, your vet will then need to address nutrition needed to support the liver function. This too will take time, but usually, improvement is seen each day or so.

Don't let the feeding tube scare you, or hepatic lipidosis, while serious, if caught early on, it can be treated successfully. The point is, it is necessary to get vital nutrition to support the liver's function and aid in Logan's overall health status. The liver might only be secondary to the anemia, but if hepatic lipidosis, it will require aggressive treatment (fluids, antibiotics, nutrition). It may not be a significant liver problem at all, but rather related to the anemia.

Again, take it one day at a time, heed your vets' advice, give Logan a kiss for me if you can.

[LoganPenelope]

More "mixed" news, but I believe to be good.

This morning the report is his RBC is up to 20! Still on the rise. This is actually the highest its been since March 17. March 17, he was at 18.5.

His electrolytes are still low and his liver numbers have gone up. They said his bilirubin is at 6.2. ALT, I think she said that, is down. (not sure what that is).

They're going to put a needle in to pull some cells to see exactly what's going on. They don't want to do a biopsy because they say it would be a lot for him to go through.

As expected, she said it's time for a feeding tube. They're going to do the one in the neck this morning. That was she can pull it out once it's time. Also she said it is less stressful on him.

I asked about when he can come home. She said maybe Tuesday, Maybe wed. just depends on how he responds.

I asked her over all opinion, since she said she last saw him on Friday. She said guarded. She said because of the underlying FeLV, it's like taking one step forward , 2 steps back. She also said he's young, at 10 months, so it's tough too.

She was also cautious about the RBC being concentrated from dehydration.

I asked his overall look and feel. She said very good - he's alert, purrs a lot, and so on.

While I understand this is still a very critical moment, I just see a overall improvement.

RBC is highest in a long time. Logan has been "dehydrated" for over 2 weeks now. When they did the RBC test back on the 17th, he was only occasionally getting fluids injected in the back, and when they did the test he hadn't had fluids for several days. Therefore, it seems to me that relatively speaking, we're at a positive here.

I definitely feel good from this call. What do you think?

[LoganPenelope]

Correction, she said 2 steps forward, 1 step back...

[Traci]

The good news is that the RBC's are improving after the second blood transfusion and I expected that second transfusion was needed - sometimes we have to even give a third in very critical cases (It seems unlikely Logan would have to have another one).

The bilirubin may decrease as aggressive nutrition is introduced and maintained. The cause of the high bilirubin is most likely due to the anemia, or as a secondary problem like hepatic lipidosis from insufficient nutrition (or GI tract issues).

The ALT is a common liver enzyme that can elevate easily during times of stress or due to any number of liver problems and diseases. The decrease in the ALT might be the use of cyclosporine if the vet is using that in treatment. Either way, the ALT is probably insignificant at this point. It is the bilirubin that is significant right now.

Do you know what the ALP level was? The ALP and AST in this case would be better indicators for what's going on with the liver and the degree of seriousness.

My guess is nutritional deficiency leading to hepatic lipidosis, in which aggressive nutritional support may help considerably - your vet can also add vitamins to the treatment (specific vitamins such as B12 or K, the K to be used generally only if there is a blood clotting problem). sAME can also be added to the treatment to help support the liver.

Did your vet say naso-gastric feeding tube or pharyngostomy tube? The latter is with an incision in the neck, it requires anesthesia, the naso-gastric tube does not necessarily require anesthesia and in Logan's compromised state might be the better option.

Yes, at this point, it seems optimistic, however, vet wants to monitor the RBC's and depending on the liver aspirate, will want to start that aggressive nutritional support - once Logan starts the feeding schedule, hopefully each day will show improvement. Be warned that this can take some time if hepatic lipidosis, because not only is his FELV status compromising, but because the most common time-frame in nutritional treatment is up to 4 weeks (in most cases). During his initial feeding schedules, his bilirubin hopefully and ideally, will reduce within 7 days or so, which will can be indicative of healing. I'm not saying you have to wait 7 days to see improvement, I'm just saying it can take that long to see that much improvement and a more favorable prediction for recovery.