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Cat Forum / Health and Behavior / September 2006

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Does this vet seem to be on the right track?

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Mig - 19 Sep 2006 20:20 GMT
Greetings all,

I have a 10 year old cat who recently lost a ton of
weight very fast (over a period of 6 weeks). He was
very weak, and didn't eat very much at the time.

After taking him to the vet, I was told that his White
Blood Count was very high (see below for details),
indicating an infection. He was also diagnosed with
Stomatitis years ago, and has been on 5mg of Prednisone
for at least 5 years. He tested negatively for
Hyper-Thyroid, Diabetes and Kidney disorder.

He stayed at the vet's overnight, and was given a
Baytril injection and Sub-Q fluids. He returned home
much more alert and active, with a voracious appetite.
The doctor reasoned that his teeth were causing a
buildup of bacteria, and prescribed Clavamox and Orbax
for home medication.

A week later he had grown more lethargic, and was not
eating as much as he did when he came home. A 2nd CBC
showed that his WBC had gone even higher and that his
Platelet count was now elevated. He also lost half a
pound more (down to 6.5 pounds). The doctor suggested
that whatever bacteria he had must be highly resistant
to antibiotics (due to his prednisone usage), and sent
me home with Clinamycin and liquid Metronidazole.

Unfortunately, the Metronidazole makes him vomit when
administered orally, and we won't eat food with it mixed
in with. When I asked the vet about alternate methods
of administering Metronidazole, I was told "Oh well,
just don't give him the Metronidazole".

This response has me very worried, since I am fighting
for his life, and my doctor has just thrown her hands
in the air and apparently given up trying. She suggested
that I just put him down...

Does this sound like a reasonable course of treatment?
Are these drugs sound prescriptions based on the symptoms?
Should I consider going to a different vet?

Any and all thoughts would be greatly appreciated!

Mig

<-- CBC Results -->

First one was WBC at 41000 (I don't have the details)

Second one

WBC    45.71
LYM    0.70
MON    1.59
GRA    42.42
LY%    1.5
MO%    3.5
GR%    95.0

PLT    1015

All other results were within normal ranges
Grawun - 19 Sep 2006 20:38 GMT
take your cat to another vet fast.

> Greetings all,
>
[quoted text clipped - 61 lines]
>
> All other results were within normal ranges
Mig - 19 Sep 2006 20:56 GMT
>take your cat to another vet fast.

That's what I'm thinking. Is there something specific that you see
this vet doing wrong?
Matthew - 19 Sep 2006 21:23 GMT
>>take your cat to another vet fast.
>
> That's what I'm thinking. Is there something specific that you see
> this vet doing wrong?

Stomatitis  I can understand why he throws up the medicine since that
disease effects the lining of the mouth.  Did the vet check the mouth to
make sure there was no abscess or an other oral problem.

A vet that actually cares  would  never say Oh well    and say put him down
unless it was absolutely necessary to do.  A good vet would discuss the
options that would be going on before they told you to put him down.

Second  a lot of vets that can not determine what is wrong  will never admit
that they don't know.

What  type of other blood work was done.  Did they test for Feliv and such.

I have a question  when he was diagnosed with Stomatitis   was he or did he
take Metronidazole if  so that medicine can cause it as a side effect
http://encyclopedia.thefreedictionary.com/Metronidazole
Mig - 20 Sep 2006 03:18 GMT
>Stomatitis  I can understand why he throws up the medicine since that
>disease effects the lining of the mouth.  Did the vet check the mouth to
>make sure there was no abscess or an other oral problem.

Now that you mention it, I don't recall seeing the vet do an oral
exam, but she was alone with him for some time so I can't say for
sure. She never said "he *has* such and such problem with his mouth",
it was more of an assumption she made when I told her he had
Stomatitis.

But she did say that whatever mouth problem he might have wouldn't be
able to be treated due to his frail condition.

>A vet that actually cares  would  never say Oh well    and say put him down
>unless it was absolutely necessary to do.  A good vet would discuss the
>options that would be going on before they told you to put him down.

She did do that. She said that if this 2nd batch of antibiotics didn't
work then we may be looking at cancer. X-Rays and MRI's were
mentioned. Putting him down was suggested in a "think of the quality
of life" context. But from my point of view it was like "well, he
didn't respond to antibiotics, might as well give up on him".

>Second  a lot of vets that can not determine what is wrong  will never admit
>that they don't know.

That's what I'm deathly afraid of.

>What  type of other blood work was done.  Did they test for Feliv and such.

I don't know what type it was. The bill says "Chem - Full
w/Electrolytes, CBC". He was tested for Feliv a year and a half ago,
and the current doctor didn't test him again.

>I have a question  when he was diagnosed with Stomatitis   was he or did he
>take Metronidazole if  so that medicine can cause it as a side effect

No, he was prescribed Prednisone (5mg per day), and has been taking it
for years.

I guess my big worry is that since I'm not a Vet nor a Pharmacist, I
can't be sure this treatment regiment is correct. I find myself asking
"why is she making guesses at what antibiotics to use?". "Aren't there
tests that can determine what bacteria are present, and the
appropriate antibiotic be prescribed?". Not to mention that I'm
starting to feel like she just isn't trying very hard (but that's just
gut feeling, and I have no way to know if that is true or not). Hence
my question here, where perhaps people more knowledgeable than I might
comment on these antibiotics/symptoms.

Thanks so much for the replies!

Mig
Rhonda - 20 Sep 2006 01:46 GMT
>>take your cat to another vet fast.
>
> That's what I'm thinking. Is there something specific that you see
> this vet doing wrong?

Did the cat have elevated sugar at all? It almost sounds like diabetes,
especially since the cat has been on steroids.

There is something wrong and you need another opinion -- another vet who
can think of different things to check. I would keep going until you can
find someone who can get a diagnosis.

If the next vet can't help, could they refer you to an internist vet?
They're a bit expensive but usually very good at tracking down
mysteries. They normally have more equipment and more avenues to try.

Good luck,

Rhonda
Mig - 20 Sep 2006 03:24 GMT
>Did the cat have elevated sugar at all? It almost sounds like diabetes,
>especially since the cat has been on steroids.

He was tested for Diabetes and came back negative.

>If the next vet can't help, could they refer you to an internist vet?

Question: What is an "internist vet"? I've never heard that term
before.

Thanks,
Mig
Rhonda - 20 Sep 2006 05:28 GMT
>>Did the cat have elevated sugar at all? It almost sounds like diabetes,
>>especially since the cat has been on steroids.
[quoted text clipped - 5 lines]
> Question: What is an "internist vet"? I've never heard that term
> before.

They are specialists and deal with a lot of diseases -- cancer, etc. We
were sent to one when our vet needed helping controlling our cat's
diabetes. She was incredible at diagnosing the problems, not just for
the diabetes. Ours worked out of an emergency clinic only.

Rhonda

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