Having just lost Kona to an inoperable adenoma (slow growing tumor) in
the junction of his sinus/throat area, I can tell you what I learned
about generally during the course of having him treated and maybe some
of it will be of some help regarding the nosebleed issue; obviously
don't take it as gospel because this is based upon my understanding as
a layman of what I was told by the vets.

Kona had a few episodes of sneezing blood which his regular vet
initially treated, apparently satisfactorily, with antibiotics.  I was
told that cats sometimes sneeze blood when they get a sinus infection.
Long story short, about six months later I had to help him to the
Bridge when his breathing was blocked by the adenoma I mentioned above.
I posted a more detailed version in RPCA if you want to look there.

I think they have to do some exploration inside the sinuses to really
get a definitive idea of what's going on, usually a rhinoscopy.
Otherwise, they are pretty much just playing the odds as to the cause
without really knowing what the problem is. I suspect that initially
treating the cat conservatively for the most likely cause, such as a
bacterial sinus infection, is a standard procedure.

When Kona began experiencing some noticable interferance with breathing
through his nose in early July, I took him to an internist, who did a
rhinoscopy.  I don't think most GP vets do them. It cost a few hundred
dollars.  If they spot a polyp, sometimes they can snare it in the same
procedure depending upon where exactly it is, its shape, and its size.
If they do this, the cat's pretty much good to go right after. I met a
woman in the waiting room of my regular vet who had that happen to her
cat and she said he was fine just a day or so after and his problem was
completely eliminated.

Although Kona's tumor was inoperable, in order to make that
determination he underwent an more extensive endoscopy and an MRI after
the initial rhinoscopy to figure out the tumor's exact location and
size before the vets concluded  that it was inoperable. These things
don't show up well on X Ray. If a cat does have a growth that is more
than a minor polyp in its sinuses, I believe that whether surgery is
feasible in a given case depends largely upon the location, size and
type of the tumor. I don't believe that the blanket statement that
sugery can't ever be done to remove a growth in the sinuses is true. In
addition, depending on the particular circumstances radiation or chemo
can be an option.

One consideration as to whether surgery or radiation is feasible is
that if attacking the the tumor via those methods would result in the
loss of the cat's sinuses, the cat loses its sense of smell.  My
understanding is that they will stop eating on their own if this
happens and will thereafter have to be force fed, which is not
something that many people who care for their cats will want to subject
he/she to for its entire life.

To be honest, I would say your vet is in over his head and you need to
find someone else. Sneezing blood or nosebleeds means that some snall
blood vessals in the sinus area have broken.  I believe there are a
variety of things other than growths/tumors that could cause that, such
as  infections of various kinds, certain types of parasites, allergies,
or even foreign bodies stuck in there.  Surgery isn't required to treat
some of the things that could cause a cat to sneeze blood, but it's
desirable to have the cat treated by a vet who has an idea of what the
possibilities are and whether its appropriate to have the cat examined
by a specialist.

Bless you for caring for Harriet, I hope she has many more years with
you.

I picked Harriet up this afternoon.  The bleeding seems to have stopped.
She didn't sneeze at all today and every time I checked, her nose was clear.
I hadn't noticed any other respiratory problems with her before the nose
bleed.  Hopefully it was just some freak thing that happened once and will
go away.  They did prescribe an antibiotic, just in case, Baytril.

I've been saying that for the past couple of weeks.  She usually just walks
away in a huff, saying nothing.  When I got in this morning she asked me if
I had called the vet again.  I hadn't, since I had been busy standing around
outside for 40 minutes waiting for my bus that never showed up.  She said
that she had called and wanted to know if the cisapride could cause nose
bleeds.  I don't know exactly what she said to them, but she told me that
Harriet was now "off the medication".  I asked her what Harriet should take,
if not the cisapride.  She walked away.  When I picked Harriet up, the vet
mentioned that "your manager called" and wanted to stop the cisapride.  I
asked him if he thought that it would be the cause and he said no, so I told
him that I wasn't going to stop it.  I told him that the "manager" had no
say in Harriet's care.  He said that I could give it to her twice a day, so
that's what I'll do.

Oh, and she did have a "cure" for chronic constiptation - giving Harriet
fish oil and taking her to a holistic vet.

Harriet usually will attack people who get nervous around her after an
initial attack.  She absolutely hates this one poor guy who never did a
thing to her.  He only works on Saturday and she hasn't been there the last
2 weekends, and I had been going in on Saturdays before that to keep an eye
on her.  Harriet doesn't attack me and she doesn't attack my boss, and we
both pick her up and we don't pull our hand away quickly if she does go to
bite.  She will go after other people who aren't afraid of her , though.
Her new favorite victim is Tim - she's gone for his ankle all week.  He
pretty much just looks down at her and says something in a calm voice.  He
had the nerve to squeeze by her on Monday while she was blocking an aisle,
so that's why he's on her list.  She doesn't really make much of an effort
with him in her attack.  Just a quick bat-bat-bat with the paws, maybe lunge
forward for a quick nip.

Well, Harriet did come home with me tonight.  I told everyone that I'd watch
her carefully and that if her constipation issue doesn't improve by Monday
(and at this point, I doubt it will) I'd have to bring her to the Cat
Practice.  Today the vet said that if she gets blocked again the only choice
would be surgery to remove her colon.  I told my boss and he said that if
she still can't poop I should take her elsewhere.  We've been to The Cat
Practice a few times and I like the vets there.

I have been giving it to her about 15 minutes before feedings.  She's been
very good and so far every capsule has gone down.  She handles the Lactulose
much better than she did in the beginning, when she would fight like mad.

Yes.  She'll eat for a bit, then bury it, but comes back within minutes for
some more.  I'll sprinkle a little freeze dried chicken powder on top to
encourage her to finish after her second trip to the bowl.  Today she ate
very little at work.  I gave her some when we got back from the vet around
2:30 and she ate very little.  Gave her more around 6:00 (and the cisapride
before) and she only ate a tiny bit of that too.  I gave her 1/4 can when we
got home, around 8:30 and she did eat all of that.  At work sometimes she
would eat half of what I gave her and other times she'd clean the bowl.
She's probably been eating 1/2 to 2/3 of a 5.5oz can recently (total for the
day).  A few days she's eaten close to a whole can between the two meals.

Crap.  Of course I forgot to ask for copies.  The Cat Practice is only 3
blocks away from the current vet so I can always just run back to get them
if they can't/won't fax them over.  I will bring the bills with me.

The bloody nose has seemed to resolved itself but she's still going to see
another vet.  I'm thinking of calling a vet near home and bringing her this
weekend, if I can get an appointment, to have a third opinion.

When I go to work tomorrow, Harriet will be alone in my bedroom all day.
When I've had her here over the weekends I was able to check on her
thoroughout the day.  I feel bad that she'll be all alone, since she really
is a people cat.  I wish I had a floor-to-ceiling cat tree to put in my
bedroom, but I do have a small cat condo (which she ignores).  She doesn't
enjoy playing with toys on her own but during her last visits she would
chase the laser pointer on my bed and also go after a string type toy.

On the bus coming home tonight she was very restless in the Sherpa bag.  The
other times she would look out the bus window through the mesh.  Tonight she
was really pushing her head against the mesh & sides of the bag trying to
get out.  She was pawing at the towel and I finally unzipped the bag a bit.
She stuck her head out and looked out the window.  I guess she wasn't
afraid, and she seemed very interested in all the passing vehicles.  She
tried to push her whole body out so I had to zip her back up.  In the past,
during regular checkup trips to the vet, she would huddle in the back of the
carrier with her head tucked in.  I don't think she likes the process of
being outside in the bag but she seems fine once we're actually on it.

--
Liz