Need assistance with diagnosing breathing problem (link to streaming video included)

Here's the video: http://media.putfile.com/Cat-with-health-problem
(Sorry about the poor video quality, it was taken with a basic Sony Cybershot digital camera.)

General Symptoms/ Possible symptoms:
- Very frequent licking of nose/ lips as though trying to provide moisture to
his air entry points - or in attempt to unblock something that isn’t
really there to unblock (not quite as bad as when he is about to vomit though
- at which point it is constant rapid tongue lapping just before the heaves)

- Much more frequent and lengthy water drinking sessions (as though having
trouble retaining his liquids- or moisture in his airways? Eating habits
remain consistent however)

- Possibly more frequent urinating (and seemingly of greater volume as well)
- Feces seems much more dry and indicative of constipation (although, as of
the last few weeks or so - he has been having diarrhea like bowel movements?)

- Vomiting of clear (sometimes brownish yellow tinted) liquid every few days
or so (although he has been doing this for the last few years or so - long
before this breathing issue came to light ) always 2 -3 separate heaves per
vomit period.


Anyway, here's some more specific background info that should help with diagnosing what the problem(s) may be:

He's almost 20 years old now - In September of 2006 we started to notice he
was having a lot more trouble breathing than ever before (which we soon
noticed would really only happen when he was purring / starting to try to
purr - which happens to be most of the time anyone is around him.)

We took him to the emergency clinic around the end of September/ beginning of October, as he showed no signs of getting better since we first noticed his
problem (which at the time - we thought might just be a cold of some kind).
The vets at the emergency clinic took x-rays (no echocardiogram yet) and
checked for fluid in the lungs etc - they could not find any fluid in the
lungs and were not able to determine anything of urgent concern while we were
there.

When we went to our regular vet with the x-rays etc the next day- they
checked him over and also couldn't come up with any concrete diagnosis on the spot, and were only able to offer up a variety of general possibilities (most of which I had brought up to them before hand, the things I had read about on this site and others the night before.
Including possibilities such as: Respiratory disease, Hypertrophic
cardiomyopathy (hcm), mitral regurgitation, pulmonary edema, athsma, aortic
thromboembolism, pleural effusions, atrial fibrillation, thoracocentesis,
tricuspid valve dysplasia, lymphoma, vestibular syndrome, idiopathic
chylothorax, Chylo, fibrosing pleuritis, FeLV etc )

The problem of course is the fact that he won’t purr when at the vet clinic
(since he has little to purr about) - so they can never get first hand proof
of what I am trying to convey to them about his specific "purring and
breathing” problems etc.

The vet also took a blood sample, and later when the results came back - said his white blood cell count was low, but that his test for Feline Leukemia
Virus (FLV) came back negative.

About the only thing I can think of that I did not discuss with the vet at
the time (and still haven’t up to this point as I hadn't read about it before
the last visit) was the possibility of FIP (Feline Infectious Peritonitis).

He sleeps well for the most part - but when he starts purring in any way
at all - that's when he cannot breath right. If you pet him or give him any
sort of attention - he will soon have to walk away to try to isolate himself
from any contact or distraction (if possible) then he stops and assumes a
stiff pose, showing a very uncomfortable look of concentration in his
eyes/face - while he extends his head straight out, with his chin/ neck
pushed out as much as possible as though attempting to create the best
possible position/ passageway to allow air to get in and to clear/ unblock
his airways to regain his breath.

This usually produces a lot of irruptive spluttering echo-like wheezing and
guttural sounds, and random squeaks/ pops coming from his throat and or
stomach area as he struggles to regain his breath/energy (with nostrals flared, and very deep compression of his abdomin during each inhalation)

The whole matter tends to end up leading to him having to slouch, and then
finally almost collapse, down to the floor because he can't get enough oxygen
in to stay on all fours or even sit in an upright position.

The dry cough sort of attack (as shown in the beginning of the video) has
just recently surfaced (perhaps within the last 3 weeks or so) and now has
become a more regular occurrence. Before that, it was more just him
experiencing the purring / breathing problems as described above.

The purring heard in the video after the initial dry cough episode - is not
nearly as bad as what typically happens before he gets into a laying position
- it's still noticeably more distorted/ obstructed to me compared to how he
used to purr – but it is not what I'm describing when I refer to the severity
of the purring/ breathing problems he's been showing since September, and
this particular video was more to show this recent turn for the worst with
the rapid gasping dry coughing issue.

So, I can't tell if any of this is most closely related to FIP (possibly the
Dry form - which I understand is much less severe but still incurable none
the less) or if it's related to some other kind of heart disease, bacterial
infection, asthma, some other respiratory issue or any of the other specific
terms I listed above?

It's so difficult to trace a root cause with something like this - especially
with geriatric cats, since- just as with any living being- the mechanisms
start to break down, and one or two things may give out long before the rest
of the system starts to show signs of significant degradation. It's just the
way that he seems to be in relatively good health (when not being burdened bythese purring/ breathing troubles), and I can't help but feel like there must
be a simple fix available (even if all the veterinary knowledge goes against
this assumption/ hopeful outlook)



Thanks for your time, and sorry about the post length.

Welcome to TCS.

I am sorry that you are having problems with your senior kitty.
What is your kitty's name?

Please understand that we cannot possibly know what is wrong with your boy.
Cats sometimes purr when they are stressed.

Has your vet given you a diagnosis?
What does your vet suggest for a treatment plan?
When will your kitty be seen again?

My only suggestion would be to get a referral to a vet school or a specialist.
Other members may have a different take on it.

I am sure that you are very concerned.
Please stay around and keep us informed about how your boy is doing.
I am sending lots of calming thoughts your way.

catterbrain, a friend of mine who is very knowledgeable alerted me to your post. She listened to the video and here are her comments:

Listened to the video, definately some congestion going on somewhere.
Needs to see a more experienced feline-only vet or feline specialist ASAP.

Last vet exam was in early October, have there been follow-ups since then?


Xrays are NOT enough, kitty needs an ECG to rule out various forms of cardiomyopathy, congestive heart failure, etc. Be prepared you may be referred to a feline cardiologist.

Nose/Throat/Esophageal problems also need to be ruled out, like a stricture, foreign body, megaesophagus, bacterial infection, inflammation, nasal or sinus polyps, tracheal collapse (rare in cats), severe viral infection (complete oral health exam to rule out abcesses, infection as well).

Swabs or a tracheal or bronchial wash can be done to collect sample for cytology although a tracheal wash might necessitate anesthesia, would need to determine anesthesia-candidacy carefully.

Bacterial/viral/fungal infection needs to be ruled out via this process, a fungal infection in the lungs could also be culprit.

If kitty doesn't have a history of outdoor access or exposure to infected cats, chances are, this is NOT FIP. If kitty has/had outdoor access, rule out pulmonary parasite infections, fungal infections (like cyrptococcosis, etc), and heartworm.

FIP possible with outdoor access, but last bloodwork and symptoms don't necessarily correlate with FIP.


By this time, an xray would probably show significant changes in the thoracic cavity, most likely fluid, or congestion, possibly a mass...neoplasia needs to be ruled out, most of these start in or around a certain organ and spread to the lungs, this is a necessary, prudent rule-out.

Be careful with anesthesia-candidacy....if there is breathing distress, fluid in the lungs, or significant fluid in the thoracic cavity, other diagnostics, such as ECG, ultrasound are less invasive, do not require anesthesia unless fine-needle-aspirate are required.

If a baseline bloodwork panel has not been repeated since October, this should be repeated ASAP, but cannot stress a breathing-distressed cat with venipuncture, be careful!

Again, feline-only vet with extensive experience or a feline specialist IMMEDIATELY!

Medications can be attempted to reduce load on the heart, and fluid overload (pending diagnosis), sounds like the progression is worsening, diagnosis/treatment is truly warranted immediately.

catterbrain, this friend has been instrumental for me in the past in helping find the right course of action for the many sick cats that pass through my home. I would not take her words lightly, she does not say them lightly. I know that she offers them in a hope she can help.

Thanks for the welcome Xocats, and thank you for the detailed post Hissy.

The tracheal wash option was suggested during our last visit as well as the ECG, and I think we should try each of those things next (if they’re still advisable that is.)

We haven’t taken him for any check-ups since the one in October. There is one Vet at our regular clinic that has many cats of her own and she seems to be best suited to dealing with “cat only” issues. I hope to make an appointment with her next.

I decided to make this post with the video first - to provide as much of a chance as possible that I can find out what is wrong with him without having to go back to the vet a bunch of times with a high probability of no real progress being made from visit to visit. (Also hoping that perhaps I'd get really lucky and someone might watch the video and read my post and reply with “That’s exactly what my cat was doing… this is what’s wrong/ here’s what you should do” type of thing).

So when I do take him in for the next check-up – hopefully I'll be able to offer more complete/informed suggestions to the vet. The main thing for me is trying to avoid the actual vet clinics (not them personally or their input) altogether when possible – I don’t want to bother him with more unnecessary stress, failed diagnoses and therefore more time spent doing things he hates doing and being places he hates being. Because I know just going to the clinics (the travel to/from as well as the stay) gets him worked up, makes him feel even worse, and there’s even more trust lost between him and I each time, since it's like bringing him back to hell with every visit (of course I know that’s the risk that must be taken sometimes, and that time is now in this case.)


He does go outside fairly frequently (one of the 3 or 4 things he ”lives for” that make up his daily routine : Sleep, Eat/Drink, get attention, Go outside - front or backyard). Even though the backyard is fenced off and he never strays more than 5 meters or so from the porch in the front – he does occasionally come into contact with other cats (so there’s always that possibility as far as him having caught something from them over the years)

The direct relationship between his purring and then having that action initiate his breathing troubles, makes me think it must be some sort of Nose/Throat/Esophageal issue as you mentioned – either sinus polyps or something along those lines at least.

It's really like a cruel joke life is playing on him - because when he gets happy it hurts him most (what kind of life is that to live?). Even when he anticipates getting to a favorite/ comfortable sleeping spot - such as jumping up onto a bed etc, he will begin to purr in anticipation of reaching the spot, but then because the purring takes his breath/ energy away - he can't even maintain enough energy to make the jump up to the spot he just thought about getting to 2 seconds earlier. Then he just ends up essentially collapsing in distress on the little stool he uses to assist his jump (and I end up lifting him up to where he wants to get to)

Your sweetie pie sounds so sweet.
I would get him to your vet ASAP.
What is his name?

More from my friend

Don't mistake the happy purring from purring as a symptom of pain and discomfort. Congestion is *always* a discomfort, and can be quite serious, frightening, painful for the cat. I agree with her here catterbrain, I have cats that have died in my arms that purr to the last second of their last breath, It comforts cats to purr and many cats in pain will purr. Owners thinking the cats are "okay" put the cat at greater risk by not responding quick enough to the situation.



Don't let the frequency in vet visits discourage you. A feline specialist is your best bet because he/she can retrieve all health records from your current vet, review them, have much of the history and clinical information already at hand...oftentimes, this is how problems are found, that is, that the first vet missed something quite obvious to another vet with more experience. The number and frequency of vet visits can also be reduced significantly in this regard.

Don't wait for a "checkup" with your vet. Make an appointment with a feline specialist right away (TODAY, depending on your area!). It's rather alarming (and appalling) that nothing further has been addressed by this vet since October (keep in mind you didn't mention the vet's plan of action, we don't know what medications etc were prescribed, if any, or if you declined diagnostic options, etc). You cannot afford to wait another day on this, it really sounds like the situation is worsening with each day. The sooner it is correctly diagnosed, the sooner it should be treated.

The specialist will narrow down as much as possible regarding the least invasive diagnostics to pinpoint the problem, and will try to keep costs reduced for you as much as possible.


It doesn't sound like the current vet is experienced, nor comitted to your cat. Lots of missing information between October and today. If the vet wasn't agressive in wanting to investigate further, you truly need a new vet, specialist NOW.


Please, start keeping him INDOORS ONLY from this point on. Make sure the specialist is aware of his outdoor history.


I can't stress enough the importance of proper diagnosis in a case like this, most importantly, in a timeley manner. Too many factors to consider and rule out. It could be as simple as an infection that may be easily treated. It could be a progressing condition that if left untreated, could cause very serious consequences. Given that he has had (according to your posts) a relatively good health history, in a senior kitty this age, you cannot afford to let a condition like this linger....our senior pets are much more susceptible to secondary infections that exacerbate and progress considerably. Don't let that happen, get to a specialist TODAY.

Again, this person knows what she is talking about and is an expert in senior cat care as well as other areas of cat health


Good luck!

Sorry Xocats - I forgot to mention his name again, his name is Tamer.

Thanks again for the input Hissy. I'll be sure to set up the appointment early tomorrow morning. He really does seem to be getting worse and worse over the last few days in particular (having those dry cough/ congested wheezing attacks at least 3-4 times a day now.)

Since it's really cold outside now - he doesn't feel the need to go out nearly as much or for nearly as long as when it's warm out. However, he seems to almost benefit from going outdoors and breathing in fresh (at least fresher) air. In fact, when he goes to the door and sniffs the air/ breathes it in and looks to see if it's OK for him to go out - he has an instant sort of eruptive sputtering hollow echo breathing adjustment reaction - like his airways are adapting to the changes in air pressure/ air quality etc. It may just be a case of wishful/ delusional thinking on my part - but when he's outside he really seems to show far less struggle while purring etc.

I think it would be very wise to pursue a trach wash as a diagnostic at this point. With a very elderly kitty, it's even more important to find out exactly what is going on and treat it.

Did the vet find any evidence of a heart arrythmia or murmur when he was last examined?

I think it is pretty safe to rule out FIP, mostly because of your cat's age. FIP is much more common in younger cats.

Do you have an update on your Kitty? I hope he is doing well

I was searching the net trying to find some info about our cat that has the EXACT same problem for about a week now. I took her to the vet Monday and they didn't really diagnose the problem. Our cat is 21 years old and I just figured she had a respiratory infection. She hasn't been eating well and we're getting worried. We've been giving her an atibiotic since monday and we haven't seen much/ any real improvement.

Please let me know if your situation has improved.

Thanks

I can't tell very well from the video, but he definitely sounds congested somewhere in there, and he seems to have a weak cough towards the beginning half (when he extends his head out and breathes in and out in huffs).

I hope you can find a correct diagnosis and treatment... keep us posted!

It doesn't sound like FIP. FIP progresses quickly and your baby would most likely be gone by now. The two most at risk age groups, are the very young and the very old due to weakened immune systems. It is NOT just a disease for the young. BUt I dont think thats what you are dealing with.

Did your vet say if your kitty had a heart murmur or not? Have you done any other bloodwork besides the FeLV/FIV test and the CBC? If so, where there any abnormalities?

Let me know if you find out what it is... My mothers cat does the same thing sometimes when he really gets purring....

Sorry I couldn't be of more help...