Cat Drooling Excessively and Refusing to Eat

[Tina B and crew]

No Whiskas treats aren't the greatest, but getting Neco to eat is most important. I know when my big boy Gizmo (God rest his soul) had hepatic lipidosis and we had to feed him through a PEG tube, we were very happy when he started showing interest in ANY food. Probably a good idea to continue to syringe feed, but also offer things like the treats that you know Neco will eat. It just may help get her appetite back. I'm glad to see she is showing interest in at least something. Good news! Continued healing thoughts.

[Traci]

Here in the US, the use of oxytetracycline is generally reserved for swine, poultry and livestock, and may not be effective in cats - it also causes pain at the injection site, and as noted earlier, you don't want Neco in pain and possibly delayed healing.

No, tetracycline is in either tablet form or injectable form.

The best choice for treating feline hemobart is doxycycline (Vibramycin) - please ask your vet if he has it or can get it from another vet? Vibramycin is available in tablet form as well as oral liquid form, and in fact I prefer to give the oral liquid form to cats. Please, please, please tell your vet that doxycline (Vibramycin) is most effective for treating feline hemobart.

You can allow a few Whiska's treats daily, but don't overdo it because she just got over the hurdle of nasea/vomiting, you don't want anything upsetting her tummy. Keep providing her normal food, even if she isn't interested yet, at least offer it to her daily, and soon enough, she'll become more interested in it each day that she's feeling better.

[Neco]

We have started a new medication routine now. No more IVs and injections. She's getting Monodox/doxycycline for haemobartonella treatment. We open the capsules, solve the powder in water, divide according to the dose prescribed, and administer orally, twice per day (mixing it with a little food so that she doesn't hate the experience.) She has been administered a Primabolan shot to speed up the metabolism. The rest are vitamins and minerals, especially iron and Vitamins E and D.

As for her new blood test, her WBCs are quite high! Her platelets and red blood cells seem to be within the lower boundaries of normal range. Her bilirubin levels are back to normal, as well.

RBC: 6,37 µl (x1,000,000)
WBC total: 29,2 per µl (x1000)
Lymphocytes: 10,22 per µl (x1000)
Platelets: 149 per µl (x1000)
HCT: 24%
HGB: 8,4 g/dl
Total bilirubin: 0,4 mg/dl
Total serum protein: 8,2 g/dl
Albumin: 2,7 g/dl

Still unclear whether she has FIP at this point. According to this website:

In an attempt to try to make the best diagnosis we can while the cat is still alive, we can follow these criteria for a cat with clinical signs of FIP:

1. The cat has a low number of lymphocytes: 1.5x1,000 cells/µl.
2. The cat has a positive FCoV test result (titer > 1:160).
3. The cat has elevated globulins in his blood > 5.1 gm/dl.

If the cat meets all three criteria, the probability the cat has FIP is 88.9%. If the cat does NOT meet all three criteria, the probability the cat does NOT have FIP is 98.8%.

(I don't know how reliable this chart is.) The tests satisfy condition 3, but violate condition 1. Neco has very high lymphocyte levels according to the tests carried out yesterday. The lab at the hospital does not measure the globulins in blood, but I was told by a vet that subtracting the albumin level from total serum protein would give the approximate level of globulins. If we accept this, the globulin levels in her blood are around 5.5 mg/dl, thus above the critical threshold. As for condition 2, the FeCoV/FIPV PCR titre, I discovered that there are no labs that carry out this test in my country. I would have to send the blood sample abroad. (The FIP test previously carried out, which came out as positive, was a "rapid test," whatever that means.) I want to see the results of a new blood test next week, or the week after, before doing this. Hopefully her lymphocytes will remain high and her globulin levels will decrease.

She's now eating Whiskas dry food, though I still prepare a mixture of A/D and canned tuna for syringe-feeding, to make sure that she eats a lot and to give her medications without stressing her. She's back to her old habits now and seems quite happy.

Thanks for everything so far.

[Traci]

Please ask the vet if he knows the difference between anabolic steroids and corticosteroids, the two are completely different, and he's giving the WRONG ONE! Corticosteroids, like prednisone, are appropriate for treating immune problems, as I stated before. Giving anabolic steroids like Primabolin is going to do nothing for Neco, except possibly induce serious side effects.

Cease giving the Primabolan, tell your vet to research prednisone.

The quote you posted is not necessarily reliable, every cat will have different markers, along with clinical symptoms and bloodwork. We've talked about this already. You have to understand that many of these markers are going to be affected because of the hemobart.

Tell your vet to consult with a nearby or even out-of-country veterinary university who can help him determine where and how to acquire and submit blood serum for an FIP titer test. I don't know how vets in Turkey get these critical tests done, or what labs they use, but your vet needs to find out.

Again, at this point, I think it's much more important to treat the hemobart, consider a new blood smear or Coomb's test for hemobart in 4 weeks, to determine if treatment has been successful. If there is no evidence for FIP at this point, I'd wager a guess that subsequent bloodwork will improve, just by having treated the hemobart. Of course, this could change, but focus on the hemobart.

In the meantime, keep Neco indoors only, don't allow her access to ANY stray cat outdoors. Since she has hemobart, she will likely remain a carrier and can infect other cats via bitewounds. The method of transmission of hemobart is generally via flea, tick, mosquito, and an infected or previously infected but healed cat can remain a carrier for life. This doesn't mean she will remain sick, it simply means she can be a carrier and infect other cats in the future.

Don't feed too much tuna. Fish of any variety fed in high amounts or long-term can cause pansteatitis, vitamin and mineral deficiencies and excesses. Used as a slight tempter to get a cat to eat is fine, but don't use long term or too high amounts.

I'm glad to hear she is feeling much better and seemingly eating on her own. Be prepared you may need to keep her on doxycycline for another 3 weeks or more - then bloodwork and a repeat blood smear or Coomb's test for hemobart should be done to monitor and determine if treatment was successful.

[Neco]

Primobolan was prescribed as a single shot only, to speed up the anabolic metabolism as far as I was told. The FIP titre test via PCR, as I've mentioned in the last post, is not available here. We'll consider sending the blood sample abroad if other signs remain suggestive of FIP. I've been through the catvirus.com FIP diagnosis flowchart as well, which doesn't seem to support an FIP diagnosis at this point either.

Why prednisole? We're trying to strengthen Neco's immune system, not weaken it. I understand that immunosuppressants are sometimes used in advanced forms of FIP, but I doubt they would be required, or even beneficial, in this case. As for stray cats, Neco has always been indoors-only. She escaped once but we quickly took her back home.

I'll keep your suggestions in mind. No more tuna in her feeding mix. What do you think about the sudden explosion (from 0.69 to 10.22) of lymphocyte numbers and the drastic decrease in blood bilirubin, Traci? Is this good or bad?

[Traci]

The prednisone is not for FIP, the prednisone is for treating the hemobart. It can sometimes be used in conjunction with doxycycline in treatment.

I'm not sure about the lymphocytes at present, let's wait on that until the next bloodwork.

The bilurubin getting closer to normal is always a good sign!