Is this arthritis? Or something worse??

Hi all,

I've noticed lately that Waggles is lying with his front paws really curled under. Not like cats usually do, but imagine bending your wrist down towards your arm until it touched. I'm including some photos that I hope show what I mean (he did move when I started fussing with him). It doesn't appear to cause him any pain as I've felt all over his paws and legs and he doesn't flinch. It does bother him in the sense that when he stands up after he's been lying a while the wrist joint doesn't want to fully support him and it 'kicks' out a bit.

Waggles has bad arthritis in his back end and we recently started Adequan injections (he's had 2) and is going for his next one in 2 days. I plan on discussing this with my vet then but I was just wondering if anyone else has noticed this in their cat. Is it arthritis or some type of injury? It happens with both wrists. I read something about tendon injuries in cats but he doesn't jump at all so I don't think he could have injured himself.

Thanks,
Dolly

Geez, I sure don't know. Anyway you could print off or email those pics to the Vet, for him to see?

Is kitty declawed at all?

It look like a sprain or injury but I really don't know
Poor cat

Poor thing! I think a trip to the vet to find out what's going on is in order.

Originally Posted by stephanietx

Poor thing! I think a trip to the vet to find out what's going on is in order.

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How is he/she today? Is he fine or getting worse ?

I'll be interested in hearing what your vet thinks about this.

I'm also interested in how Waggles does with the adequan injections. When Ootay (rb 5/09) was suffering so much with arthritis pain my vert and I discussed adequan, but I opted against it, after reading how painful the muscle injections are, she was so fragile already.

Now I know that it's been discovered that the injections are just as effective being given subcutaneously, so I will definitely be considering them for my next kitty with severe arthritis problems.

Please do let us know how Waggles is doing.

Thanks for the input and support. I took Waggles to the vet yesterday and my vet said she thinks it's a neuropathy. The curled wrists isn't typical of arthrtitis.

We immediately re-checked his blood glucose as neuropathy is most commonly associated with diabetes in cats. He glucose was fine and it has always been normal. So it's not diabetes. He also has CRF and his recent bloodwork showed his potassium and phosphorus are also fine (which could contribute to muscle wasting).

My vet says it's basically an idiopathic neuropathy which can happen in particular in older cats, it's degenerative nerve damage. We don't know how old Waggles is as he was rescued as a stray but I'd say he's probably 15 anyways. She suggested methylcobalamin (B12) which has been shown to be successful in treating neuropathy in cats and people. I had been giving him this but not enough. B12 is safe to give as the excess is urinated out, so he's getting 3 mg a day. I'm keeping my fingers crossed that we'll see some improvement with this.

As for the adequan--I think it has been helping as his back end seems to be more comfortable, before he would snap at me if I even petted him there but now he seems to be more comfortable and is sitting up straighter. Waggles is generally grumpy at the vet but he literally didn't even move when she gave him the injection--I don't think it hurt him at all and he didn't show any ill effects afterwards.

The adequan won't help the neuropathy though so I'm really hoping the B12 will help.

Dolly

Hopefully the B 12 will help. It should. Based on the info below, has thyroid function been checked? Can hyperthyroidism be ruled out as a possible underlying cause?

http://www.vetinfo.com/feline-neurop...cobalamin.html

The most commonly known feline neuropathy is feline diabetic neuropathy. Neuropathy is also seen in cats suffering from hyperthyroidism.

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Thanks Violet, his thyroid was also checked in January and it was 12.6 (normal 11-46, metric units of nmol/L which converts to 0.98 in US units) so he's actually on the low end of the scale. I'm not sure if this could be a cause or not, my vet didn't mention it. I think certain drugs can lower the T4? Waggles is on several meds. for CRF and pancreatitis.

Thanks so much for the info you've just shared. So I'm looking for answers. Not done yet, but so far this is what I've found. (In humans) among a list of conditions, neuropathy can be associated with hypothyroidism, arthritis and B 12 deficiency.
The list of medications (for humans) that can cause neuropathy is practically endless. The question is whether some of these meds (some antibiotics and metronidazole for instance) can cause the same side effect in cats.
Medications that can interfere with thyroid function (in humans) include sucralfate and some antacids. Also, high doses of steroids, etc. I don't have the detailed info I'd like on this just yet, but from what I've found so far, possible side effects of different meds in general would be worthwhile to think about. This is an area where many medications have not been studied extensively and so their side effects in animals are not known.

May I ask what meds you're using for the CRF and pancreatitis? Also, are you using any herbal or other natural remedies?

Originally Posted by Violet

Thanks so much for the info you've just shared. So I'm looking for answers. Not done yet, but so far this is what I've found. (In humans) among a list of conditions, neuropathy can be associated with hypothyroidism, arthritis and B 12 deficiency.
The list of medications (for humans) that can cause neuropathy is practically endless. The question is whether some of these meds (some antibiotics and metronidazole for instance) can cause the same side effect in cats.
Medications that can interfere with thyroid function (in humans) include sucralfate and some antacids. Also, high doses of steroids, etc. I don't have the detailed info I'd like on this just yet, but from what I've found so far, possible side effects of different meds in general would be worthwhile to think about. This is an area where many medications have not been studied extensively and so their side effects in animals are not known. So so true ... even in humans many side effects are found out years after the drug is released.

May I ask what meds you're using for the CRF and pancreatitis? Also, are you using any herbal or other natural remedies?

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Along the above lines... I dont feel like writing out the PDR tonight on the list of meds with this side effect known in humans..

here is a article on basic in cats
http://www.vin.com/VINDBPub/SearchPB...00/PR00325.htm

http://www.ehow.com/about_4605461_fe...europathy.html

Thanks for looking into this Violet, I really appreciate it. Waggles gets the following:
1/8 pill zantac 2x/day (total pill=75 mg)
1/4 ondansetron/day (total pill=4 mg)
1/2 Fortekor/day (ACE inhibitor)
5 mg prednisolone every other day
potassium gluconate supplement
sub-q fluids every other day
now 3 mg B12 methylcobalamin/day

I had been giving him 1 mg B12, but started him on 2.5 mg about 3 weeks ago but that doesn't seem to have helped yet--at least not with his front paws. If anything it seems to be getting worse. His back legs though seem to be a little better, he isn't walking on his hocks as much. After seeing the vet yesterday I'm going to 3 mg and might go higher since it can't hurt him.

Any idea how long it might take for the B12 to help?

This has me quite concerned. With everything else going on, I would hate for this to ruin his quality of life.

Be careful the link I gave you above states b12 and what should not be done... Personally I have seen a b12 SHOT work very well with accupucture in a semi paralyzed animal

some ideas to discuss with a vet...
http://www.merckvetmanual.com/mvm/in...%2cinvolvement

Read the below link first it may help more than the above
http://www.merckvetmanual.com/mvm/in...%2cinvolvement


http://www.merckvetmanual.com/mvm/in...ch/advsrch.jsp

Spookzilla, hi again. Thanks so much for the list of meds. I have one more quick question, hope you don't mind. When was the last time blood potassium was checked and would you happen to know what the value was at that time?

According to Vetinfo
http://www.vetinfo.com/feline-neurop...cobalamin.html

Methylcobalamin Supplementation

Methylcobalamin is a form of vitamin B12 that contains the mineral cobalt. Deficiency of B12 leads to nerve damage, anemia and gastrointestinal problems. The supplement is given in a dosage of one 3 mg tablet, once a day. Methylcobalamin tablets successfully treat the symptoms of feline diabetic neuropathy in a short period of time. Although neuropathy is cured once the diabetes is regulated, administration of methylcobalamin supplements aid in faster recovery.

The reason for tissue repair due to methyl-B12 supplements or methylcobalamin is not well established. Research indicates a link between specific nerves deficient in methyl-B12 and neuropathy or nerve damage.

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So if this will work, you should see results very soon.

Originally Posted by Violet

Spookzilla, hi again. Thanks so much for the list of meds. I have one more quick question, hope you don't mind. When was the last time blood potassium was checked and would you happen to know what the value was at that time?

According to Vetinfo
http://www.vetinfo.com/feline-neurop...cobalamin.html




So if this will work, you should see results very soon.

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http://www.ehow.com/about_4605461_fe...europathy.html This link states up to a year .. Yet another lovely thing the experts cant seem to agree...

I have seen a b12 SHOT used for this issue work within a few minutes( since acupuncture was stimulating it like a bit of a quicker result...

PS:

Sorry, one more question, a very important one. How high is phosphorus?
Do you have a recent value?

And a question about the sub-q fluid you're using. Is it lactated ringers solution or saline solution?

Originally Posted by Violet

PS:

Sorry, one more question, a very important one. How high is phosphorus?
Do you have a recent value?

And a question about the sub-q fluid you're using. Is it lactated ringers solution or saline solution?

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Great ?s ....

Thanks again Sharky and Violet for your input and questions. His potassium and phos. have always been in the normal range. His most recent values (Jan. 23) are

potassium 4.6 (3.7-5.8), has ranged from 4.4 to 5.0 since CRF diagnosis in Sept. 08
phos. 1.5 (0.8-2.5), has ranged from 1.2 to 1.8 since Sept. 08 (sorry these are Canadian values)

His sub q is lactated ringers, 100 ml eod.

I see the vet again next week for another adequan shot. Maybe I will mention the B12 injection idea.

thanks,
Dolly

Thanks again, Spookzilla. These numbers look good. Not out of range, not even too high or too low. Everything seems to be under control. Also, going by these numbers, clearly, nothing on the list of meds is causing an imbalance that in turn would cause muscle weakness. (That was one possibility I was worried about.)

Lactated ringers is a very good, safe choice for sub q fluid, so again, I'm relieved. All this is very good.

I would also urge you to give B 12 injections a try. There are times when bypassing the stomach is very helpful. In injection form absorption of the vitamin is infinitely better and so treatment is more effective. You can't go wrong if you try the injections. And they are as easy to give as the sub q fluids, so no problems even with that.

Thanks Violet, is the injectable B12 the methyl or cyano form? Is is only available from the vet or can it be ordered online?

Would the cyano form help at all in this situation, or is it primarily for malabsorption issues?

One other thing I forgot to mention is that Waggles has been on a 6-week course of baytril for a suspected infection (his Jan. 23 bloodwork showed elevated white blood cells and pancreatitis). He had been showing more signs of nausea when we did the bloodwork. Fingers crossed I think the infection may be under control as he seems to be feeling much better and is eating well, but now that I think of it the curled wrists has just started in the past few weeks. I don't necessarily think that Baytril itself would cause it, but it does make them drink and urinate more, so could he possibly be losing more B12 from that? Just a thought.