New to site: boy cat not doing well post-dental

Hello fellow cat lovers. I'm so glad I found this forum--there's so much great knowledge here.

My boy cat, Leo, is an adopted stray of unknown age. He was energetic and youthful when I got him; dashed madly around the house and was sometimes aggressive with my girl cat. He had some dental inflammation when I got him 3 years ago, and I stupidly didn't get it addressed until three months ago. He had 5 tooth extractions including a lower canine. The vet put him on oral antibiotics (clindamycin) before and after the surgery and did an antibiotic injection immediately after. His mouth has healed well and his appetite so far has stayed pretty good.

But he's not thriving. He's lost 12 ounces since the surgery and he was skinny to begin with. His coat looks poor. He drinks too much water and pees too much (2 softball size clumps of urine per day). Stool is good.

He loses his balance when he sits or lies down like he's either dizzy or it hurts to move. His rear legs are bowed inward, and he can barely climb stairs. Until last week he was still jumping onto the bookshelf, but this week he's stopped, so he's getting worse. When he walks, his mid back is curved up high while his head and butt are low--looks awful. He seeks out the cool floor by the patio door (I live in Michigan), which is very un-catlike. He tries to rest but gets up and moves frequently like he's uncomfortable in one position for long.

I have a 7-month old kitten in the house who thinks he's a toy, so Leo is under some stress. At least he still purrs!

Yesterday I had bloodwork and urinalysis done. Here are his numbers:

Urine concentration: 1.036, probably too high for diabetes although not as concentrated as I would like
RBC normal
HCT 31.8 (low range of normal)
HGB normal
MCV 44.5 (low range of normal)
MCHC 36 (high range of normal)
RDW 21.8 (borderline high)
WBC 6.85 (borderline low)

NEU, BASO, and PLT are all borderline low

BUN 35 (borderline high)
CREA 1.9 (normal, so CRF probably not an issue)
GLOB 5.1 (borderline high)
ALT normal
ALKP 142-high
CHOL 309-high
AMYL - 528, borderline low, so again, probably not CRF
LIPA 1677 -high
Glucose 385-high
K 3.9-borderline low
Cl 114-borderline low

I have a thyroid panel coming back Monday. He eats a low-carb diet (Innova Evo canned and dry).

My vet is as stumped as I am. She said probably not CRF or diabetes, maybe pancreatitis. I did a lot of reading around on this forum and am wondering if it's just a leftover infection from having such horrible teeth (I finally took him to the vet when he started drooling blood-tinged saliva. I feel like such a jerk.)

I'm going to suggest to the vet that we do another round of antibiotic when I talk to him Monday, if it won't hurt anything. Any other suggestions? I'm at my wits end--it's like he got old overnight.

Do you have a Feliway diffuser going? I'm wondering if it's stress related due to the little kitty. Could he possibly be suffering from arthritis, too? You can get some Cosequin to help with that.

Thanks for the suggestions. Leo improves a bit when I separate him from Mr. Rowdy Kitten, but he's still not right (although he can still jump up onto the bed without help). The lethargy and excessive drinking/urination are what concern me.

I spoke with the vet this morning about his lab results and he agreed that they're confusing. He said the high glucose and the sugar in Leo's urine put diabetes at the top of the list right now but we're going to wait for the thyroid panel to come back before we treat, as there are other lab numbers that don't indicate diabetes. He said he can't completely rule out CRF but it's not on top of the list due to the normal CREA numbers.

We're also going to do a short term round of antibiotics in case there's a lingering infection from his gum disease.

At least he's stable, so I have some time to try different things.

I'd be very concerned with the amount of water he's drinking, especially since he's eating canned food. Do you add any additional water to his food when you feed him? Has he been checked for diabetes?

I don't think he's peeing too much, especially if he's drinking a lot. My girls don't have huge pee puddles, but they do go more than once a day.

I see the glucose is high. I'd be thinking diabetes with the excessive water intake. I have had two diabetics.

Also with unchecked diabetes, it can start to affect the hind legs. It is called neuropathy.

I hope you find what is going on. Poor boy. Many vibes and prayers too you both.

I just checked and normal glucose is 80-120. I'd get him back in asap and address this.

Leo has improved greatly this morning. Yesterday afternoon I switched his canned food from Innova Evo to Friskies with low carb (7%) because it likes it better than the Evo, and took away the dry Innova Evo kibble. He hasn't had wanted more than a few laps of water since 4 p.m. yesterday, and urine output is down near normal. He also has more energy, is purring more, and his eyes look better.

Until noon yesterday he was eating almost all dry food because he prefers it over the Evo canned, and I was so worried about his weight loss that I just gave him whatever he wanted. I hate dry food. Even the low carb kibble makes them drink way too much water.

My vet went with Clavamox for this round of antibiotic. Leo has tolerated antibiotics well in the past. I realize it's not without risk, but it's low risk compared with treating for diabetes if he's not diabetic. My vet felt that the 1.036 urinalysis was a bit concentrated than we would expect with diabetes. Some labs start normal range at 1.03; others at 1.04. And glucose labs can go high just due to the stress of visiting the vet. Not trying to deny, just concerned about starting treatment without a 100% sure diagnosis.

Considering how awful his mouth was when he had dental surgery, and the fact that he just flat out refused to take oral antibiotic starting with the fourth day after surgery, I have to wonder about a long term infection. It seems like he should have an elevated temperature for that (it was only 99.6 during his exam last week), but read here that long term infections can actually suppress, not increase the WBC.

When his thyroid panel comes back on Monday and we see how he's responding to the antibiotic, I'll make a decision with my vet about whether to treat for diabetes right away or wait a bit. If the drinking and urination stay within normal range following the change in diet, then I feel safe waiting another week before going the diabetes route.

Thanks for the vibes--they seem to be working!

Glad to hear he's improving. That's great! When you talk with the vet for the results of the thyroid test, do mention the high glucose. Perhaps you can retest the bloodwork after this round of antibiotics and see an improvement in all the numbers. Sometimes illness will throw off the bloodwork. You're doing a good job with him and definitely keeping an eye on him!