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Cat Forum / Health and Behavior / February 2005So worried - what could this be?
Well just as I thought things were finally on the up - so my beloved cat is once again admitted to cat hospital. Approximately 2 to 3 weeks ago she suddenly started vomitting one evening and as it continued for several hours she had to be admitted to hospital. Her back legs went very weak and she was generally very weak and unable to stand. At the time they diagnosed her glands in her throat as swollen and a lower than normal body temperature. Overnight she stabilised assisted by a drip and antibiotics and within a couple of days she was fully recovered. Her blood tests were all ok - and the creatine and urea (for which she is periodically tested) were the best results ever. Tonight she vomitted twice within 30 mins - the first time bringing up undigested food and the second time fluid only. I did not feel I could leave things so took her straight to the vet. Upon examination her body temp. was normal although she seemed to deteriorate before our eyes - just beoming weaker and refusing to stand. He put her on the floor and she just rolled onto her side. The symptons are EXACTLY the same as before. Tonight he has said he will do a full blood screening and test the electrolytes. She will be back onthe drip and given more antbiotics. I have asked him what this could be - as the first time was put down to a bug of some sort. (She is a CRF cat but the CRF was discounted the first time as being relevant). Where do I go from here with this? On both occasions I've been lucky enough to be home and get her promt attention. I'm so worried this will happen when I'm at work. He said it may be gastroenteritis or at this stage 'it could be anything'. I'm so worried for her. sarah :( > Tonight she vomitted twice within 30 mins - the first time bringing up > undigested food and the second time fluid only. I did not feel I could leave > things so took her straight to the vet. Upon examination her body temp. was > normal although she seemed to deteriorate before our eyes - just beoming > weaker and refusing to stand. He put her on the floor and she just rolled > onto her side. I'm completely clueless, but is it possible she's having some sort of a seizure?  Signaturemonique, roommate of Oscar the (female) grouch ~~~~~~~~~~~~~~~~~~ Eros was adopted! Eros has a home now! *cheer!* Has your cat had her blood pressure checked? Hyperension is common in cats with CRF and sometimes there are no symptoms, but when there are they can mimic other illnesses. It would be worth checking out so you can rule it in or out. http://www.lbah.com/Feline/hypertension.htm Hypertension can also cause heart problems, which can sometimes have the symptoms of hind leg weakness you describe. An ultrasound may help with a diagnosis as well. Megan Signature"The only thing necessary for the triumph of evil is for good men to do nothing." -Edmund Burke Learn The TRUTH About Declawing http://www.stopdeclaw.com Zuzu's Cats Photo Album: http://www.PictureTrail.com/zuzu22 "Concerning all acts of initiative (and creation), there is one elementary truth the ignorance of which kills countless ideas and splendid plans: that the moment one definitely commits oneself, then providence moves too. A whole stream of events issues from the decision, raising in one's favor all manner of unforeseen incidents, meetings and material assistance, which no man could have dreamt would have come his way." - W.H. Murray > Well just as I thought things were finally on the up - so my beloved cat is > once again admitted to cat hospital. [quoted text clipped - 9 lines] > bug of some sort. (She is a CRF cat but the CRF was discounted the first > time as being relevant). I'm not sure what stage of CRF your cat is in, but I'll give my experience. When my first cat was diadnosed with CRF she was considered late stage, often her back legs would go weak and she'd tumble on her side and just lay there. My vet recommended iron and potassium, this did seem to help as well as an increase in fluids. I hope your cat feels better when you bring her home. Trish > Well just as I thought things were finally on the up - so my beloved cat is > once again admitted to cat hospital. [quoted text clipped - 27 lines] > > Where do I go from here with this? Potassium supplementation - quick if not sooner! Speak to your vet immediately about potassium supplementation *regardless* if she has normal serum potassium levels. Most (>90%) of the body stores of potassium are contained in the cells (ICF) where it can't be measured. Thus, muscle potassium levels can be very low despite her normal serum potassium levels. IOW, a total body potassium deficit *can* develop well *before* she develops hypokalemia. Potassium depletion can produce similar symptoms to those she's displaying. There's also a very high probably that her hindlimb muscle weakness may be a symptom of hypokalemic myopathy. As long as she's urinating normally (or increased), potassium supplementation should not present any problems. Just be sure to monitor her serum potassium levels. You're target serum potassium should be in the upper half of the normal range. Do not use potassium chloride supplements because they *contribute* to metabolic acidosis. Please make *absolutely* sure your vets includes a potassium supplement with her fluid therapy! Many cats have *died* of complete muscle paralysis because the diuresis produced by fluid therapy lowered already critically depleted body potassium stores. If you live within range of a veterinary university hospital or top-shelf private veterinary hospital such as the Animal Medical Center in NYC, have your cat's urinary excretion of potassium assessed. Potassium depletion and metabolic acidosis often go hand in hand in cats with CRF and lead to a self=perpetuating, vicious cycle; potassium depletion induces metabolic acidosis in cats, and metabolic acidosis in turn further increases potassium losses - which further increases metabolic acidosis.. Chronic metabolic acidosis promotes anorexia, nausea, vomiting, lethargy, weakness, muscle wasting, and weight loss -- the *identical* symptoms you cat is displaying. Metabolic acidosis is *often* overlooked and underdiagnosed because if the blood collection tube isn't filled to the *very top* the vacuum or air above the blood in the tube can draw CO2 out of the serum and *falsely* lower the CO2 concentration. These are lessons I learned the *hard* way. If my suspicions are correct, with a little bit of luck, both her metabolic acidosis and potassium depletion can be easily treated simultaneously with just potassium citrate. We got lucky a few times with potassium citrate because the doses needed to correct potassium depletion in the cats didn't exceed the dose the cats needed to correct their acidosis. Otherwise, there's a serious risk of *overalkalization* if the correct potassium dose is more than the citrate dose needed to correct the cat's acidosis. One last suggestion: Its very importnt you speak to your vet about a taurine supplement because potassium depletion and metabolic acidosis can produce *fatal* decreases in serum taurine concentrations in cats. Best of luck. Phil. > On both occasions I've been lucky enough to be home and get her promt > attention. I'm so worried this will happen when I'm at work. [quoted text clipped - 6 lines] > > :( Sarah - I am so sorry to hear about your kitty. I hope she will be better quickly. -Enid Lapkitty and Snowflake's mom Thanks for all the replies. I have just rung the surgery for an update and was told she is a bit brighter but not yet eating. I'm just waiting for the vet to phone me to discuss the results of the blood (and any other) tests tey have done. Thanks for you comprehensive reply Phil. I will certainly ask the vet about potassium. regards sarah Well an update but not really.... I went to see my cat this morning in hospital. She really is much brighter and was purring and a lot happier. She still has not eaten but I think it may have been due to them giving her food she does not eat usually so that will be remedied shortly. Her blood tests are a bit of a mystery. They have tested her creatine and urea and the results continue to amaze me in terms of how good they are. The urea is normal and the creatine is down to 232 which is the lowest I've ever known. However - last night upon being admitted her glucose was 17% (normal being about 6%). Today it was retested and showed normal - although she had not eaten anything. I have asked about diabetes in case it is that - but they are not sure yet although tending to think it will not be diabetes. The vet said diagnosing diabetes in cats is not always straightforward. (Is it possible to have a CRF diabetic cat?) I have asked about the potassium deficiency - apparently all her tests were normal for that and I don't feel I can argue with the vet over it. He did concede however, that if a diagnosis cannot be made then he will consider the potassium supplement. I'm not happy with NO diagnosis - if it comes to that. This is the second time in less than 3 weeks. It's costing me nearly ?200 a time - and whilst money is absolutely secondary to my cats health and well being - it is also becoming another worry as her insurance expires in May. If these 'episodes' continue then whilst her quality of life is excellent between times - I'm starting to wonder if the prospect of constant and sudden hospitalisation is actually detrimental to her quality of life. They are keeping her in for today and all being well she might be home again tomorrow. sarah :( Have just spoken to the vet. Unfortunately still no diagnosis.They have retested the blood sugar and it is normal so she does not have diabetes. They have also done her blood pressure - and depite it being a stressful procedure for a cat - it came back as the 'low end of normal'. It is possible her ong term medication (2.5mg) Fortekor is affecting her aqdversly so the dose is being halved and she will be put onto a potassium supplement to cover the possiblility of a a deficiency there. He still has not ruled out a gastric problem like gastroenteritis and will continue the antibiotics just in case. She has started eating again so that's an excellent sign. She is staying in again overnight tonight and, God willing, will be back home tomorrow morning. sarah > Have just spoken to the vet. Unfortunately still no diagnosis.They have > retested the blood sugar and it is normal so she does not have diabetes. [quoted text clipped - 15 lines] > > sarah I've been this route with my first cat, no diagnosis, no change, fluids and she feels better, finally after thousands of dollars and many trips to the vet, I demanded a potassium supplement, (after reading extensively) and placed her on sub-q`s. She lived a happy life for a full year after that. My one regret is that I didn't push sooner and harder. But since then I've had two more CRF cats, and my first action is sub-q's and potassium (the potassium as soon as I see weakness). My 19 year old cat was diagnosed two years ago and is still healthy and strong, my vet just gave me the supplements immediately and the sub-q;s no questions asked. He said you know better than me, so go ahead. My only advice is CRF is very hard to diagnose and its my understanding each cat needs different treatment. Seems when she goes to your vet, they provide fluids for her, perhaps she needs her fluids increased at home, are they providing something else that you can provide at home? Trish > Have just spoken to the vet. Unfortunately still no diagnosis.They have > retested the blood sugar and it is normal so she does not have diabetes. > > They have also done her blood pressure - and depite it being a stressful > procedure for a cat - it came back as the 'low end of normal'. If the cuff is too wide or its not positioned right, the measurement will be falsely low. Also, he should take 4 or 5 measurements to make sure low or high readings aren't false. The disposable BP cuffs can be reused several times with accuracy before its no longer reliable. However, vets in general are notoriously cheap and some will continue to reuse the disposable cuffs long after it should have been discarded because they can't bring themselves to throw a $7 cuff away - even though they've probably already made a couple of hundred dollars with the cuff. > It is possible her ong term medication (2.5mg) Fortekor is affecting her > aqdversly so the dose is being halved and she will be put onto a potassium > supplement to cover the possiblility of a a deficiency there. In addition to the likely possibility of potassium depletion due to her renal disease, she should have been given a potassium supplement because she received fluid therapy! Fluid therapy causes diuresis -- rapid urine formation increases potassium excretion. What about her acid-base balance? Did the vet check the CO2 concentration in her blood? She has the classic symptoms of metabolic acidosis. If this vet can't reach a diagnosis, its time to find another vet. Your first loyalty is to your *cat* not your vet. Best of luck. Phil Thanks for all the replies. Just a bit of an update. My cat was discharged from hospital this morning as she is now eating and a lot brighter. She has been sent home with the potassium supplement (Kamilox 2mg twice per day to start with). It's a liquid that goes on her food. I've also been told to halve the dose of Fortekor and she goes back for a check up on Friday. As an aside - her paw is very swollen and twice the size of her other paw. She's refusing to walk on it at the moment. (She had the drip in on this leg). I've never noticed such swelling before or her refuse to put her foot on the floor. I rang the vet who said she's been wee'ing on her bandage so they had to keep changing the bandage - whilst the bandage was off she tried to chew out her drip line! Apparently the swelling should go down in a day or so. She's very tired but happy to be home. I'm very tired too - but happy to have her back. Sunday afternoons are definitely made for snoozing - which is what we'll be doing. Thanks again to everyone for the replies, information, suggestions and good wishes. The future is still uncertain but now she's on the potassium supplement and on less Fortekor, hopefully things will settle. I've given her a target of growing out her shaved patches before she needs anything further (other than the check up) from the vet. regards to all sarah Sarah, How is your kitty? Hope she's better by now. Is he paw less swollen? Rhonda > Thanks for all the replies. > > Just a bit of an update. My cat was discharged from hospital this morning as > she is now eating and a lot brighter. Hi Rhonda My cat is much better and so far today has been the best since being back home. Although physically I think she is now ok she has seemed a bit depressed which is understandable - but today she's back to her usual 'chatty' self. I think the last spell in hospital was worse for her than before. Her paw has gone down to the right size now although I think her leg is a bit sore still. She's going back to the vet on Friday evening for a check up. She is taking her potassium supplement really well - it just goes on her food and she's now on half a dose of the Fortekor. Hopefully these measures will sort her out and stabilise things. It's just me who needs cheering up now as I can't stop worrying. I must be driving my other half mad! sarah Hi Sarah, I'm glad your cat is better. She sounds like a tough cookie. I'm sure her leg is sore after all of that swelling, but what a great sign that it's gone down already! My boyfriend had surgery awhile ago and his foot/ankle swelled up enormously. It turned out they had damaged the lymph system, which is like a spider-web of nearly invisible little lines. It took a couple of months for it to return to normal. I'm glad your girl is better so quickly. I hope they've fixed the problem. I know how hard it is living with a cat with a chronic condition, each thing that happens is so scary. The cats don't worry, though, they're great. They just keep doing their best. You've just got to love their spirit. Take care, Rhonda > Hi Rhonda > [quoted text clipped - 3 lines] > 'chatty' self. I think the last spell in hospital was worse for her than > before. > I went to see my cat this morning in hospital. She really is > much brighter and was purring and a lot happier. She still has > not eaten but I think it may have been due to them giving her > food she does not eat usually so that will be remedied shortly. I don't know much about CRF or diabetes, but I hope they get to the bottom of it. I just wanted to say that its hard for them to eat when they're at the vet and in a cage, plus not feeling well. So don't automatically worry if she doesn't eat when you bring up her regular food. The vet will probably monitor her hydration and give fluids if necessary and that'll help while she's not eating. SignatureCheryl Dear Sarah -- You are a wonderful cat mom to your kitty. I will be praying for her to make a full recovery. It is so upsetting when our cat kids are sick. One of mine (Lapkitty) is diabetic, as am I. Since I lost my job last year, I can no longer afford his shots, and I am no longer able to pay for my meds. He seems to be doing ok. I am very strict about feeding him now. Regards, Enid Hi Enid Thanks for your prayers. I'm sorry to hear about you losing your job. It must be really hard being diabetic never mind having a diabetic cat too! In the UK people who are out of work can get a reduced rate for pet medications. It's still expensive though. If you are not in the UK - perhaps there is similar scheme where you are? Maybe a local pet rescue centre may be able to help with reduced rate medication for your cat - perhaps in return for some voluntary work? It's worth a try. regards Sarah > Hi Enid > [quoted text clipped - 10 lines] > > Sarah It is worth a try to look or ask around at vets to see if there is a program. I know we have one here that buys food and medicine for pets of elderly and disabled people. Thanks, Sarah. There are no programs here (south New Jersey) that I know of. How is your cat? What is her name? Lapkitty will be 12 on March 10th. He keeps getting a cyst-like thing under his chin, near his jaw. I keep expressing it, cleaning it and applying antibiotic cream. It eventually dries up and goes away, but it keeps coming back. I have no idea what it is -- perhaps an allergy? He is my loving, purring best buddy. He loves to sit in my lap and put his paws over my heart. He sits and purrs for the longest time. I hope he will be okay. -Enid Hi Enid Maybe your cat just has some sort of small abscess that needs removing by the vet? My cat is definitely much better - despite the fact she is usually too ladylike to RUN round the house - so it was that she was RUNNING round the house this morning chasing goodness knows what whilst some of us were trying to sleep off the night shift. Still, it was music to my ears after recent events. Her name is Izzy regards Sarah
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