warning long: difficult diagnosis

big mondowski

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Hello all. I'm brand new to this forum. I've got 4 cats, the youngest of whom, Sherman, is a 19 month old neutered male Maine Coon. He's been having some serious health issues, and we're still a bit stumped. I hope this isn't too long, please bear with me.

In late November, I found a couple of fleas on him (all cats in the house are strictly indoors and the two dogs are treated with monthly Frontline). There was no evidence of fleas on any of the other animals, but we treated with biospot since it was of course late on a Saturday night we found this - and figured a trip to Petsmart was warranted, not a trip to the e-vet. He seemed to get a bit depressed after this - nothing specific, but generally not quite right.

In early December, I took him tot he vet for a regular appointment. We found that he was down to 13 pounds, 2 - 3 below his normal weight. He also had a runny eye, which on closer inspection was the start of uveitis. The vet was afraid it might be FIP, but the blood work only showed an increase in white blood cell count, consistent with an infection. She put him on a 10 day course of Clindamycin. He responded well to it but it killed his appetite and he lost nearly another pound. However, within a day of completing the course, his appetite returned with gusto and he began gaining weight, back up to almost 13 pounds again. But the eye looked worse, so she recommended another round of Clindamyacin as well as a trip to the opthamologist. We considered the possibility of Bartonella but the results were not definitive.

He tanked. No appetite, lethargy, and was having a hard time with the antibiotics. The opthamologist suggested switching him to Azithromyacin, which my regular vet supported. He started that and there was no improvement. It got to the point that the only way he'd eat was if I force fed him. He got down to 11 pounds. He developed severe congestion and his gums became alarmingly inflamed. However, the eye began to improve.

Last week, I took him in again and left him overnight for IV fluids; they also gave him an anti-nausea medication and some decongestants. I brought him home and he immediately went to the kitchen where he ate a small amount on his own for the first time in over a week, maybe two. We pulled him off the oral antibiotics when his blood work came back with normal white and red cell counts. But he did have slightly elevated (5.6) globulin. So FIP was back on the table.

He still barely ate so I suplemented with active-culture plain yogurt enriched with powdered KMR (vet's suggestion) for calories and to try to "reset" his GI tract. He's also on triple antibiotic with dex nosedrops twice a day. His eye is nearly completely cleared, still a little swelling around the surrounding tissues but the cloudiness and discoloration in the eye are gone. His congestion is considerably lessened, and his gums are returning to normal. But because I couldn't come close to meeting his full nutritional needs via force-feeding, his weight has continued to decline, now down to just over 10 pounds which is dangerously thin.

But he's eating more on his own, so I leave him in a room by himself with lots of food bowls during the day (so the other kitties, all of whom have remained completely healthy, don't eat his food). His energy and activity levels are slowly returning to normal. Throughout all of this, his temperature was only slightly elevated at most, usually normal.

I think we are finally getting him back, but I still don't know what the cause of all this is. I plan to get him into a specialist but since there is improvement right now, I'd kind of like to give him a chance to build up a bit of strength before he is subjected to more stress.

Ideas? Do you think that if it is FIP that there might be a period of spontaneous remission and I'm about to go through the crushing heartbreak of watching him deteriorate again? Or is that so unlikely that this was probably all caused by something else? Has anyone experienced something similar?

Sorry this is so long, and thanks for your replies!
 

otto

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FIP is a heart breaking disease, and yes there can be spontaneous remissions. Thinking positive, hopefully it's not that.

I would be more inclined to suspect the biospot. It's too late now, but never ever again, never use over the counter flea medications on cats, they can be deadly.

But if the blood work shows no kidney or liver problems...I am assuming he has been tested for FeLV/FIV and herpes?

Welcome to TCS (though I am sorry it is such a problem that led you here) and please do keep us updated on Sherman.
 
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big mondowski

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Thanks for the response. I've been doing a lot of research on FIP, and unfortunately there's a lot of conflicting information out there. One thing that seems consistent is that the elevated globulin usually goes with increased lymphocytes, which we didn't see, and his protein ratios were also normal. One vet at the practice is quite certain that's not what we're seeing, and another thinks we can't rule it out but his response to the antibiotics lessens the chace of that being the cause of what we're seeing. Clinical signs are likewise vague and could be attributable to something else especially since he doesn't have any fluid accumulation happening (I know, there's a "dry" form, too.).

He's been tested negative for FeLv and FIV, I'm not sure about herpes and I do understand that it could explain the URI symptoms. But maybe not the rest.

I was not aware of spontaneous remissions. Obviously, I'm going to be very worried about him until we can get him back to a normal weight and see improvement over a lengthy stretch of time.

Believe me, I'm NEVER going to treat my cats with OTC flea meds again! I carefully read all the packaging, and even used less than the recommended dose on him. But either that set this off somehow and made him suseptible to all these other things, or the fleas themselves were the cause (back to Bartonella, which also hasn't been ruled out). The timing was just too coincidental.
 

mrblanche

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The eye problem makes me wonder if he's having a problem with feline herpes. There's no cure for that, but check around; supplementing his diet with l-lysine can put this in check pretty quickly. We have an 18-year-old cat at the shelter that I wouldn't have given you a nickel for his chances 6 weeks ago, but since he's been getting l-lysine, he's show amazing improvement.
 

kittkatt

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Originally Posted by Big Mondowski

Thanks for the response. I've been doing a lot of research on FIP, and unfortunately there's a lot of conflicting information out there.

Clinical signs are likewise vague and could be attributable to something else especially since he doesn't have any fluid accumulation happening (I know, there's a "dry" form, too.).
First of all, there is no actual diagnosis for FIP: that can only be determined after a cat dies, and they do an autopsy to determine if it was indeed FIP. All the FIP info IS indeed conflicting - I know. I have 2 cats which were "diagnosed" with the dry form.

Ask your vet about Interferon if he comes to the conclusion that it is the dry form of FIP. My two babies have been on the Interferon now for about 3 years, and have been doing really well on it and staying in remission.


If it is indeed the dry form, I hope your kitty stays well and stays in remission. FIP is a horrible disease. I was just heartsick when I heard those dreaded words.
 

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First of all, I'm very sorry to hear that you boy is feeling so poorly. Vibes that you get to the root of this and he recovers.

But your post struck me in a strange way, so bear with me on this respose.

Why would the vet prescribe Clindamycin again when he's had a bad reaction to it previously? That raises a big red flag with me concerning their competency. I had a chronic herpes cat that couldn't handle Clavamox at all, but since he was on antibiotics a few times a year, we would swap him out on things his system could tolerate. Plus, we never medicated him with every minor problem, as cats build up tolerances to medications, which over time, can hurt you.

I'm certainly not a vet, but the sense that I get from your post is that this poor baby has been over medicated for a while now. Suspecting FIP with one thing out of whack is really odd - something I had never heard of before. Being on this site for so long, I've heard far too many stories of vets not knowing what is wrong so the problem is labeled as FIP related. There are no tests for FIP while a cat is alive. It is highly misdiagnosed. I question every diagnose here on FIP.

If you want to read about potential medical conditions, go down the path of renal problems associated with poisonings (OTC flea medications), which can cause weight loss. Also read up on herpes, which can cause eye problems and respiratory illnesses (mrblance suggested L-Lysine which is a good preventative supplement for this disease). If you stay with this vet, challenge him/her on how they came to their conclusions with their diagnose. If you arm yourself with information, you can raise the right questions. (vets hate me sometimes)
 
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big mondowski

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Originally Posted by Momofmany

First of all, I'm very sorry to hear that you boy is feeling so poorly. Vibes that you get to the root of this and he recovers.

But your post struck me in a strange way, so bear with me on this respose.

Why would the vet prescribe Clindamycin again when he's had a bad reaction to it previously? That raises a big red flag with me concerning their competency. I had a chronic herpes cat that couldn't handle Clavamox at all, but since he was on antibiotics a few times a year, we would swap him out on things his system could tolerate. Plus, we never medicated him with every minor problem, as cats build up tolerances to medications, which over time, can hurt you.

I'm certainly not a vet, but the sense that I get from your post is that this poor baby has been over medicated for a while now. Suspecting FIP with one thing out of whack is really odd - something I had never heard of before. Being on this site for so long, I've heard far too many stories of vets not knowing what is wrong so the problem is labeled as FIP related. There are no tests for FIP while a cat is alive. It is highly misdiagnosed. I question every diagnose here on FIP.

If you want to read about potential medical conditions, go down the path of renal problems associated with poisonings (OTC flea medications), which can cause weight loss. Also read up on herpes, which can cause eye problems and respiratory illnesses (mrblance suggested L-Lysine which is a good preventative supplement for this disease). If you stay with this vet, challenge him/her on how they came to their conclusions with their diagnose. If you arm yourself with information, you can raise the right questions. (vets hate me sometimes)
Thanks. I just wrote a long response and it disappeared.

Actually, he did respond well to the first round of Clindamycin. That's why he was given a second. The second round was when he completely stopped eating, and the Azithromycin was prescribed because it should have been less disruptive to his system. Scary as it was to watch him fade, though, the antibiotics did their job - his white blood cell count was down and the infection was fought off.

I agree with you that he's been overmedicated. That's why I'm trying to give him a little break now that he's eating again. I'd like to see him gain some strength before subjecting him to the stress of doctors.

I'm also a bit of a high-maintenance pet-mom, and I ask lots of questions and do lots of research (I'm also a scientist by profession). I've been consulting with three of the vets at the practice. Only one is leaning toward FIP, and even she is just saying we can't rule it out. fair enough. I have started supplementing his diet with l-lysine but it's early days to tell if it's helping.

The good news is he's continuing to improve. It's slow, and he's not gaining weight yet. But he's not losing weight anymore, and his appetite is improving, as is the congestion. I'm still giving him the high-cal "sherman shakes" (yogurt and KMR powder along with the l-lysine), but I'm hoping that he'ss soon be getting enough calories on his own to discontinue those. Ever day is a little better, so things are moving in the right direction.

I really appreciate the advice I've gotten here and even more, the support and concern you've shown me and Sherman. Thanks so much!
 

momofmany

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Originally Posted by Big Mondowski

I'm also a bit of a high-maintenance pet-mom, and I ask lots of questions and do lots of research (I'm also a scientist by profession).

The good news is he's continuing to improve. It's slow, and he's not gaining weight yet. But he's not losing weight anymore, and his appetite is improving, as is the congestion. I'm still giving him the high-cal "sherman shakes" (yogurt and KMR powder along with the l-lysine), but I'm hoping that he'ss soon be getting enough calories on his own to discontinue those. Ever day is a little better, so things are moving in the right direction.
We have a lot of high-maintenance meowmy's on this site!
Welcome to our club!!


It's good to hear that things are slowly improving. If he is congested, are you taking him into the bathroom when you shower to give him a good steaming, or do you have a vaporizer for him? I've had cats with severe congestion that I've had to lock in a small room with a vaporizer to break up the congestion. It does help a lot.

 
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big mondowski

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Originally Posted by Momofmany

We have a lot of high-maintenance meowmy's on this site!
Welcome to our club!!


It's good to hear that things are slowly improving. If he is congested, are you taking him into the bathroom when you shower to give him a good steaming, or do you have a vaporizer for him? I've had cats with severe congestion that I've had to lock in a small room with a vaporizer to break up the congestion. It does help a lot.

Yes, he likes to hang out in the bathroom when I shower, so that's easy. I've also got a decongestant for him, which I give him when he seems to be the most stuffed up. But since he's had so much in his system, I try to minimize that. I also give him saline drops (Little Noses, only saline, no other meds), which seem to help a bit, too.

I forgot to mention that last week, I got a terrible head-cold, congestion, fever, cough, the works. And MY doctor put me on Azithromycin. I think it's Sherman's revenge.
My husband says it's Cat Flu.
 
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