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Cat Forum / Health and Behavior / June 2005FIP cat?
Hello all, our cat 8-10 years old suddenly developed some disease: it started from severe vomiting, fever and jaundicing. He was previously fat and was slowly loosing wait last months when hot days come. That weight loss didn't concern us as he stayed active or somewhat become even more active. We went to the vet who run blood test and said that it shows high bilirubin level; FeLeuk/FIV (Feline viral 2-Eliza) and Feline Hemobartonella both negative. Possible causes were called: liver tumor, bile duct obstruction or infectious agents. We were given two alternatives: hospitalization (prohibitevely expensive) or euthanasia. Vet didn't mention FIP though. He was given Clavamox for a week. Now his fever is gone, jaundice is dicreased but he is very weak (lies almost without movement all the time) and can't even coordinate his back legs when he decides to make couple steps. He hasn't eaten or drinked by himself for about 10 days now. We started to give him water since the 2 day using syringe without a needle. We also started to give him some food after about a week and second visit to a vet. When he urinated couple times urine had unusual bright yellow color, smell and was thick due to dehydration, probably. Our most concern is that in the course of the last two days his belly visibly increased in size. This was the reason for a second vet visit. Vet performed physical examination, found that temperature is lower than normal but didn't feel any unusual objects in his abdomen. He has lost 3 kilos from 7 to 4 over period of 8 months and I think, 2 of them in the last 10 days. Can somebody shed some light on what can we do to help him? We're inexperienced owners and cat himself was given us at the age of 4-5, so his previous history is unknown. Your help is greately appreciated. > Hello all, > our cat 8-10 years old suddenly developed some disease: it started from [quoted text clipped - 25 lines] > inexperienced owners and cat himself was given us at the age of 4-5, so > his previous history is unknown. Your help is greately appreciated. I haven't seen the bloodwork, but it sounds like Hepatic Lipidosis (Fatty Liver Syndrome) possibly secondary to pancreatitis. You can find out more about this disease here: http://www.maxshouse.com/Feline_Hepatic_Lipidosis.htm I hope this is all it is. HL is reversible in >80% of the cases but requires aggressive nutritional support- usually enteral nutrition efficiently and consistently using a high-protein, calorie-dense diet and feeding by the least stressful means possible until the cat is willing to eat sufficient amounts of food on his own. In many cases, feeding through a nasoesophageal tube for 3-5 days is enough to jump-start his appetite. However, in most cases, feeding must be accomplished through a PEG tube (percutaneous endoscopic gastrostomy tube). These tubes can be placed without surgery. If your vet hasn't mentioned HL and tube feeding, I strongly suggest you seek a second opinion. Best of luck, Phil Hi, definately check out the liver, I'd say foresure he has a liver problem. Even if the FIV turned out negative you could get a bone marrow test, it's pricey and painful but he could have something going on in there and if it turns into leukemia it will get very complicated. Good luck, Jacquie > I haven't seen the bloodwork, but it sounds like Hepatic Lipidosis (Fatty > Liver Syndrome) possibly secondary to pancreatitis. You can find out more > about this disease here: > http://www.maxshouse.com/Feline_Hepatic_Lipidosis.htm I hope this is all it > is. Thank you all for your input! I've got his blood test results: CBC/CC2 Hematology WBC 26.8 RBC 6.3 Hemoglobin 109 PCV 37 MCV 59 MCH 18 MCHC 298 Platelets 658 Differential Bands 0.0% Neutrophils 79.8% (21.3) Lymphocytes 14.5% (3.9) Monocytes 2.4% (0.7) Eosinophils 3.1% (0.8) Basophils 0.0% Morphology WBC Morphology: Neutrophilia RBC Morphology: Unremarkable Platelets: Unremarkable Biochemistry: Total Protein 71 Albumin 31 Globulin 40 A/G ratio 0.8 Bilirubin (Total) 181.7 ALP 116 ALT 710 Amylase 755 Glucose 13.9 Urea 7.1 Creatinine 90 Sodium 144 Potassium 4.2 Na/K 34 Chloride 110 Hemolysis Normal Icteria 4+ Lipemia Normal Immunology results: FIV antibody ELISA: Negative FELV Antigen ELISA: Negative Hemobartonella: Negative I'd appresiate if someone could provide comments based on these results. They were taken in most acute time, 2 days after onset. Today he is still in the same state - very weak but his belly doesn't increase and may be even decreased in size. > > I haven't seen the bloodwork, but it sounds like Hepatic Lipidosis (Fatty > > Liver Syndrome) possibly secondary to pancreatitis. You can find out more [quoted text clipped - 56 lines] > he is still in the same state - very weak but his belly doesn't > increase and may be even decreased in size. The Hemoglobin looks a little low, and looks like he could stand a little more Eosinophils. Other than these, I would try to get the MCHC up to at least 300 pts, or not. > > > I haven't seen the bloodwork, but it sounds like Hepatic Lipidosis (Fatty > > > Liver Syndrome) possibly secondary to pancreatitis. You can find out more [quoted text clipped - 61 lines] > Eosinophils. Other than these, I would try to get the MCHC up to at > least 300 pts, or not. Ignore this. He's the village idiot. > > I haven't seen the bloodwork, but it sounds like Hepatic Lipidosis (Fatty > > Liver Syndrome) possibly secondary to pancreatitis. You can find out more [quoted text clipped - 32 lines] > Globulin 40 > A/G ratio 0.8 The A:G ratio of 0.8 rules out FIP. Alb., Glob., TP- are all too low for FIP. > Bilirubin (Total) 181.7 > ALP 116 [quoted text clipped - 10 lines] > Icteria 4+ > Lipemia Normal The liver enzymes indicate a liver problem. Probably HL. Speak to your vet about a fine needle aspirate of liver cells- its not very expensive and minimally invasive (just a needle). > Immunology results: > FIV antibody ELISA: Negative [quoted text clipped - 5 lines] > he is still in the same state - very weak but his belly doesn't > increase and may be even decreased in size. The most important thing right now is *nutritional support*. He probably needs a feeding tube, but you can try to stimulate his appetite with tuna (packed in water) and/or canned kitten food. Both are packed with protein and highly palatable. Best of luck, Phil > > I'd appresiate if someone could provide comments based on these > > results. They were taken in most acute time, 2 days after onset. Today [quoted text clipped - 9 lines] > > Phil Phil, you're great! I've read article you recommended on HL and I've also got email from one of the members of this group supporting HL diagnosis. As a matter of fact I was syringe feeding him small amounts of mixture made of water and pure whey protein on idea to support his life, I wasn't aware of HL before my post here. It seems to work - yesterday night I gave him additional 30 mL of mixture made of water/AD cat food given us by second vet/whey protein since I've found that he is not getting enough to reverse HL. Today in the morning I haven't found him at the place where I left him for night - he walked (!) by himself to the staircase and was sleeping on the second stair. He slept there before this all started. So, it seems he is getting better, thanks to you and that person who sent me very discriptive articles on syringe feeding. I did figure that the person who made a comment on blood test didn't make any sense. I'm not a doctor but it still didn't look quite right. Hope others won't be confused either thanks to your reply. > > > I'd appresiate if someone could provide comments based on these > > > results. They were taken in most acute time, 2 days after onset. Today [quoted text clipped - 26 lines] > didn't make any sense. I'm not a doctor but it still didn't look quite > right. Hope others won't be confused either thanks to your reply. Mike, I'm really happy he's improving, but I'm a little nervous about syringe feeding at this point. Force feeding is usually not a good idea for HL cats. Even if your cat is cooperative, its virtually impossible to feed enough food by this method. Also, HL cats are already very stressed and force-feeding is very stressful, - additional stress should be avoided at all costs. Cats also seem to develop food aversions pretty quickly-- and the association between food and the unpleasant experience of force-feeding might delay his return to eating voluntarily. So, in the clinical phase of the disease the only reliable and effective treatment option is tube feeding. If you absolutely must force-feed him rather than tube-feeding, you must make sure you're meeting his daily caloric requirement- about 45 kcals/kg/day. Science Diet Kitten food contains more protein and calories (kcals) than a/d (Kit: 210 kcals/can 10.5 g protein/100 kcals; a/d: 180 kcals/can, 9 g protein/100 kcals). Kitten is also more palatable than a/d- which means there's a good chance that he'll return to eating voluntarily sooner on SD Kitten than a/d. You can also add a little NutiCal to the SD Kitten to boost his caloric intake even further without increasing abdominal distention and risking vomiting. Several small feedings are better than 2 or 3 large feedings. Just be sure to feed him s l o w l y so he doesn't choke or aspirate the food into his lungs. There's a gap (diastema) just behind his canine teeth (between the canine and premolars) where the tip of a syringe fits perfectly without having to force open his mouth. Feeding him through the diastema is much easier for you and a lot less stressful for him than struggling to open his mouth. There's also less of a risk of him aspirating the food. Here's a picture of the diastema: http://www.maxshouse.com/anatomy/mandible__right__medial_view.jpg I've found the Top Paws Mothering Kit syringe much better than medical syringes. Here what it looks like: http://www.maxshouse.com/Illustrations/Kitten_feeding_kit.jpg Also, you can cut off a little the tip of the syringe to make the hole a little bigger. Puree the SD Kitten just enough to pass through the syringe- you don't want him to become bloated with water. SD Kitten contains enough moisture to meet practically all his daily water needs. If he does have HL, and you caught it in the early stages, syringe-feeding might work. But if you can't get his daily caloric requirement into him everyday- speak to your vet about a nasoesophageal tube. Best of luck, Phil Phil, I'm sorry to write this but today I agreed to put my cat to sleep. Last week he was slowly improving by getting A/D and then S/D food until Thursday when he started to vomit again and became weaker and weaker. I tried boiled rice on idea of possible pancreatitis but it didn't work - he was getting worse. Today I tried to wash his paws that is a stress, I know but I had to do something since he was urinating under himself and wiping it out wasn't enough. Anyway, he lost consciousness and stopped breathing for 5-10 seconds. He then came back and I decided to go to the third vet to get yet another opinion. Upon physical examination she said that she found some "object" in the liver area that "is not supposed to be there" and week ago another vet didn't feel anything there either. She said that HL is not the main reason for her recommendation but that he probably has a tumor and in order to confirm that she needs to perform biopsy but he wouldn't survive the procedure. He lost about 600 grams for this week too. I hope, I did everything I could and used every chance he had to bring him back. Thank you for your time and all valuable information you provided. > Phil, I'm sorry to write this but today I agreed to put my cat to > sleep. Last week he was slowly improving by getting A/D and then S/D [quoted text clipped - 14 lines] > bring him back. Thank you for your time and all valuable information > you provided. I'm so sorry to hear this :( It does sound like you did the best you could and that most probably there really was nothing you could do. > Phil, I'm sorry to write this but today I agreed to put my cat to > sleep. Last week he was slowly improving by getting A/D and then S/D [quoted text clipped - 14 lines] > bring him back. Thank you for your time and all valuable information > you provided. Mike, I'm so sorry for your loss. It sounds like you did everything humanly possible to save him, and in the end you gave him the kindest gift - even though it must have hurt you to do so. Purrs to help heal your heart and a candle will be lit tonight to help guide all the kitties we lost today to the Rainbow Bridge. Hugs, CatNipped Thank you all for your sincere condolences. It did make me feel better. After some time we'll probably get ourselves another cat. I'll also need to find caring vet around here. I still not get used to idea that putting pet to sleep is considered as a second option right away. The first is usually something very expensive. I've gone through this with very same cat and yet another vet 1 year(!) ago when he got urinary tract inflammation and was urinating with blood literally everywhere. Eventually he was given proper medication that helped him recover that time and he lived one more happy year. Leaves you wondering how much is worth such recommendation next time... Good luck to everybody and your wonderful purring friends. > Phil, I'm sorry to write this but today I agreed to put my cat to > sleep. Last week he was slowly improving by getting A/D and then S/D [quoted text clipped - 14 lines] > bring him back. Thank you for your time and all valuable information > you provided. I'm very sorry. I was really hoping for the best. I hope you find this site comforting: http://www.indigo.org/rainbowbridge_ver2.html Condolences, Phil > I hope, I did everything I could and used every chance he had to > bring him back. Thank you for your time and all valuable information > you provided. Mike, I am so sorry for your loss. It's always so hard to make that decision, and one can't help questioning it afterwards. Believe me, from everything you've posted here, it definitely sounds like you did everything possible for your kitty, and ultimately you give him peace. Lauren
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