5 yrs FIV cat with now liver problems... need advice

Dear all... I am breaking my head now for 2 days, literally....

I have this cat, who when I made him a family member he had already FIV. I knew he would not have a long life, but I was definetely not expecting this. He's been with us for 4 years now (approx)

I must explain first my geological situation, this makes things really much harder.

I live on a greek island where there is no proper vet and the closest clinic is 3 hrs by ferry, and there is only 1 ferry/day - if there is at all,..

Last July - August he started his problems.... he had long fever periods which we managed to control with cortisone.

December 8th he started to feel down again and had some fever, but he turned YELLOW  so we rushed him to the vet in the nearby island (next day) and had bloodwork, all liver enzymes were high

In the next 2 days he was getting better, he was with fluids and cortisone. after 5 days we came back home and was given instructions to feed him l/d and cortisone pills - Prezolon.

We were fine for 10 days and then he started caughing, so I called the vet, he said to lower the dose of cortisone and introduce antibiotics twice a day.  After 5 days he was down again, at first he did not wanted to eat the l/d so I gave him something else, then not even the something else and he started to turn yellow.

So yesterday we arrived at the vet clinic again... we did an ultrasound and liver was huge with abnormalities, same shows the x-ray

The vets said also that there is something wrong in a part of the intestine, that this specific part looks bigger than normal.

In general they explained I should do a biopsy to see what is it the cause of all this. They explained that the invasive operation is better than the needle one (cell examination) cause some times it does not show anything

So I have two opinions to consider

if I do DO the biopsy, I would learn if is a cancer (short life probably) or if is just any other liver problem

IF it is a cancer, there's nothing to be done... just have him comfortable

IF is only anyhting else liver related, then the course to take is again cortisone and antibiotics...

so anyway there is nothing I can do to save him because liver never recuperates 100% as far as the vets told me

The other thought is not to put him through all this pain and suffer of the surgery as he will anyway not have a long life, and I must probably be making him feel more miserable having to pass through this surgery - vet said about 10 cm opening as will need to see the intestines too.

So will I be doing the surgery just for me ?

Another vet in Athens told me there's no point on opening him because all the liver problems are treated equal - cortisone and antibiotics, so if he has cancer there is no difference.

Now he stayed at the clinic and I must come back home to take care of my other 3 home cats and 50 strays.....

I am in a HUGE dilemma.... not sure which decision is the right one to take.

IF anyone would have gone through something similar I will appreciate the input.... I want to do the best for him, the less trouble he has to go through, and I am not sure what actually IS BEST FOR HIM ... or maybe for ME ? does it really makes a difference if we open and they find cancer and have an expiration date on my cat ? or any other liver issue which will in any case be treated equally if we open him or not.....

I am totally ignoring the intestine thing.

Thank you and I hope that I have a new years' miracle.... as I definetely did not have my x-mas one.

Thanks  and Happy New Year full with HEALTHY HAPPY CATS !

Ronit

OH dear..... I am truly sorry your cat is not well. AND you do have this dilemma of traveling back and forth by ferry to care for your other cat's. I really am not sure there is a "right" or "wrong" answer to this. Hard as it is, yes, we have to think about what is really best for our kitties in these situations, instead of letting our emotions take over, the panic and fear of losing that so loved kitty. Your vet should be able to help you rationalize what is best or at least help you realize the possible outcome and expectation of doing the surgery, I hope . How old is the cat? I am thinking young - five years. It does sound like there is a multitude of health issues going on... the FIV, the liver, and now the intestines..... I wish I could give you an answer, I really do :heart3: I don't know if I would go through with the surgery - I might just confer with my vet and try to make this cat as comfortable as possible for the time he might have left :dk:....... If the vet thinks the cat is strong enough to go through the biopsy and recover, then maybe I would consider doing it. It just sound's like this cat has some serious health issues - and will doing the biopsy/surgery prolong this cat's life ??? It really is more diagnostic, it sounds...... I think I might try to consider, if anything, the cell aspiration if that is possible. Just to give you a possible answer if it IS cancer..... Again, So very, very sorry..... I hope other's will come along soon and offer some support that may have gone through the same thing you are right now... :hugs and many many many

I am so sorry hun
Please please don't take me wrong on this question...... But do you have another vet to go for a second opinion? Here is the reason why: Yes - the liver will regenerate.... So that is getting to me a bit..... If there is a liver problem, as long as it is not liver cancer, or a complete liver failure, your cat can get well again and live a very good life. The liver is actually one of the only organs we have that have this capacity.
As far as the biopsy goes, I am afraid he is correct - I think he is looking for IBD as well, not only cancer - if he does it via endoscope, parts of the intestine wall can be missed. With an open exploratory they can get biopsy of the entire digestive system, and the surrounding organs too. The risk is not too much in the surgery - the anesthesia is always a bit risky, but the risk is on the recovery. Generally, as my vet explained to me, cats recover very very well from it, and this type of surgery is done quite often.
IMHO, this is not being done to you..... but for him.
It is a large surgery, no doubt - but one that will also, bring you answers, and allow you to treat him accordingly.
The advantage of this surgery as well, is if there is cancer, they can remove it right there and then - they don't even need to open him up again. Cats do VERY well with chemotherapy also.....
If you are going to do it, or not, it is entirely up to you..... But know, that you are not out of options.... Even though this is a large surgery, it will bring answers your way...... and yes, the liver does regenerate

Did the cat not eat while having the fever? I'm just wondering if we know the reason for the liver problem, and not eating is often the culprit. That's easily addressed by syringe feeding.

And has he been tested for diabetes? I realize he has something going on with his liver... but there are just so many potential reasons for jaundice...

I don't know about liver cancer, but our Lazlo is fighting lymphoma, his is a mass in his stomach. He's doing great on chemo. Chemo in cats is very different than in people, and with supporting meds, can actually really improve the quality of their lives. That said... you would need to know what kind it is, and being as far away from vet services as you are, it might not be a practical solution anyway.

I don't know if any FIV groups can help. But there is a Yahoo FIV cat group, and there is a separate group via http://www.fivtherapy.com (click on Forums)

Many vibes headed your kitty's way....

LDG said:

Did the cat not eat while having the fever? I'm just wondering if we know the reason for the liver problem, and not eating is often the culprit. That's easily addressed by syringe feeding.
And has he been tested for diabetes? I realize he has something going on with his liver... but there are just so many potential reasons for jaundice...
I don't know about liver cancer, but our Lazlo is fighting lymphoma, his is a mass in his stomach. He's doing great on chemo. Chemo in cats is very different than in people, and with supporting meds, can actually really improve the quality of their lives. That said... you would need to know what kind it is, and being as far away from vet services as you are, it might not be a practical solution anyway.
I don't know if any FIV groups can help. But there is a Yahoo FIV cat group, and there is a separate group via http://www.fivtherapy.com (click on Forums)
Many vibes headed your kitty's way....

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good point Laurie.... and by the way, with excellent results :nod:
I was also wondering what has the kitty been tested for, how, and what were the results of the tests? Blood tests?
The ultrasound showed abnormalities..... did they say they found any mass? Abnormalities/larger organs can be inflammation..... that can be different things that they are looking for in the biopsy, but not necessarily cancer.... It can be IBD, pancreatitis, hepatic lipidosis.... a bunch of things.... many of them do have treatments :nod:
Is there another radiologist you could send those results to?
Why is he being treated with Steroids and antibiotics? What for exactly? Liver is not necessarily treated with steroids and antibiotics.... in fact, a lot of antibiotics will affect the liver.... And Steroids sometimes will too. Depends on what is going on - if it is fatty liver for example, FOOD will be the medication.
In an ultrasound/x-ray, if the kitty has fatty liver, the liver will generally be big, but round and smooth.
Can you post the blood test results?
when you post it - post with the normal range too, as it varies from lab to lab.....

Hi all,

Thanks for your replies.

it is definetely not fatty liver because he never stopped eating completely for more than a day, even when he had the fever, he always ate a bit but that was also 5 months ago. The last fever was only a short 24hr one, which again, he did ate.

Unfortunately the other option I have is out of my economic possibilities, it is already too much for me, this is the best I can get for him, and they are very good doctors.

I have a consulting vet in athens but he does not have a surgery, he makes only small routine ones in his office, and the major ones in a clinic which i cannot afford, unfortunately.

I was just reading about IBD and he never had irregularities in his litterbox.. always nice stools and pee... so could it still be that ? I read also that it can lead to liver problems...

Now I am more confused again, I want him to be happy, as long as he lives..

I will post his blood tests later as I have them in the office

Thanks

R

Does he throw up? IBD will come with Diarrhea or vomit....
Have you inquired about pancreatitis?
Also.... about fatty liver.... and I am not saying that's it: Kitty doesn't need to go completely off food - if it eats less than 50% of the food it is supposed to eat for a while, or if it has a sudden weight loss..... That can do it too.....
The thing is, the fever. But then that can be a coincidence too.... Just the stress of going to the vet can cause a fever sometimes.... Or kitty might have had an infection - related or unrelated.
I am pretty sure, not completely, that kitties can have hepatitis too..... again, not certain......

Carolina said:

Does he throw up? IBD will come with Diarrhea or vomit....
Have you inquired about pancreatitis?
Also.... about fatty liver.... and I am not saying that's it: Kitty doesn't need to go completely off food - if it eats less than 50% of the food it is supposed to eat for a while, or if it has a sudden weight loss..... That can do it too.....
The thing is, the fever. But then that can be a coincidence too.... Just the stress of going to the vet can cause a fever sometimes.... Or kitty might have had an infection - related or unrelated.
I am pretty sure, not completely, that kitties can have hepatitis too..... again, not certain......

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Hi Carolina,

No, he hasn't throw up just once this last time, and never had diarrhea in his life... let's not forget that he is FIV positive and that can lead to many symptoms I think, at least the inexplicable fever he had in the summer.

He hadn't lost a lot of weight before first time he got yellow, he was about 7 kilo, and that's what he weiged at vets in the previous visit. Now he was 200gr less though. (3 weeks since prev. visit)

I have not asked anything about pancreatitis... but if it was inflamed, wouldn't it show in the ultrasound ?

Don't know what to do.... so comfused...

Thanks !

R

It would, and those "abnormalities, and enlarged liver", could be part of it too..... I don't think it hurts to ask..... It can affect a lot of organs, and not all cats show vomit and diarrhea. Jaundice, lethargy, lack of appetite, etc..... very common....
http://pets.webmd.com/cats/pancreatitis-cats
http://manhattancats.com/Articles/pancreatitis_test.html

On average FIV+ cats live about 5 years after diagnoses. It sounds like you have a lot going on with your little one. Think of his quality of life if he has to have these surgeries and the healing involved in them. Its alot to go through for such a short life. However, only you can make that choice. Do what you think is best.

Sending prayers your way for strength and peace of mind.

Hi All 

I talked to the vet again, nothing has changed in his situation, he is eating poorly and stable, he did another ultrasound to double check intestines and liver, still all the same.

So I took the decision that I am not going to put him through surgery, he is not strong enough in my opinion, and of course he is going to feel worse in the clinic that in the house, so I can treat him with cortisone + antibiotics and give him sub-q fluids home. I've done that many times, so it is easy for me.

And I believe that he will have a better quality of life here, as long as he is capable of fighting for... I definetely do not want him to spend the last days, cause it could be the last days, in an aluminum cage.  That is what I feel, that he will be better home...

There is not a matter of right and wrong decision I think, that now, I have to think of what my baby would want, and he is not in the mood for all that, he just wants to come back home.

Thanks and I will let you know how he is doing, I am leaving tonight and be back tomorrow afternoon.

Happy New Year to all !

I'm sure he will be comfortable at home with his loving parent to care for him. It sounds like you have made the best decision for both of you. I know it must be extremely hard. I will continue to pray for both of you!

Good luck with your furbaby.  I am glad that you are experienced in the sub-qs and giving him meds, and know he will be much more comfortable at home.  Plus, now that you have made the decision, you will be more relaxed, which will help him be more relaxed too.  









for your guy. 

You are so right, there is no right or wrong with these decisions. :heart3: It's all about what we think - or know - THEY want.

for you and your boy. :rub:

I hope the New Year brings some happy surprises.... :cross:

Well, so far we're hanging on, he licks a bit of canned food and I am force feeding a bit of a/d with a syringe... it is too much stress for him, pills, food and fluids, so I try not to disturb him more when he's really fed up

Now his belly has swollen even more, he's like 'ready to give birth' called the vet, he said I could give him 1/4 furosemide pill am /pm.... but that can damage his kidneys, so it got me thinking again.

Is there anything easy to get (remember I live on a greek island) that I can give him as a diuretic ?

I am sure if we get rid of some of the fluids he will feel much better.

Thank you for your input !

Ronit

Oh, I wish I knew hun! But with the fluids, it does sound like his body is struggling with cancer. :heart3:

ronit said:

Well, so far we're hanging on, he licks a bit of canned food and I am force feeding a bit of a/d with a syringe... it is too much stress for him, pills, food and fluids, so I try not to disturb him more when he's really fed up

Now his belly has swollen even more, he's like 'ready to give birth' called the vet, he said I could give him 1/4 furosemide pill am /pm.... but that can damage his kidneys, so it got me thinking again.
Is there anything easy to get (remember I live on a greek island) that I can give him as a diuretic ?

I am sure if we get rid of some of the fluids he will feel much better.

Thank you for your input !

Ronit

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I would seriously not worry about the side effects of Furosemide (Lasix) at this point, if that's what works for him..... That medication is given for cats with CHF (Congested heart failure) for life, twice a day, with very little problems....... Much longer, probably then what you will give to him....
If that's something that will make him feel better, IMHO I would not hesitate..... My cat for example was going to be on it for life (unfortunately she had a heart attack).... There is other kitty here who has been on it for several years.... It is an excellent diuretic..... It really works well....
My opinion for what is worth it....

ilovemia said:

On average FIV+ cats live about 5 years after diagnoses. It sounds like you have a lot going on with your little one. Think of his quality of life if he has to have these surgeries and the healing involved in them. Its alot to go through for such a short life. However, only you can make that choice. Do what you think is best.

Sending prayers your way for strength and peace of mind.

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I didn't see this post before, and just wanted to address this comment. This is a widely circulated number on the web, but the problem with it is that testing for FIV is happening on a more regular basis: it is being detected at rescue, not because sick animals are being tested. It was thought that FIV was similar to FeLV, where the average life span from point of detection is four years. But far more is known about FIV now than previously, and according to Cornell:

It is impossible to accurately predict the life expectancy of a cat infected with FIV. With appropriate care and under ideal conditions, many infected cats will remain in apparent good health for many months or years. If your cat has already had one or more severe illnesses as a result of FIV infection, or if persistent fever and weight loss are present, a much shorter survival time can be expected.

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and according to Dr. Mike Richards at about.cats.com ( http://cats.about.com/cs/healthissues/a/fiv_in_cats.htm )

It is important to realize that a positive test for FIV is not a mandatory death sentence. With a high protein diet and aggressive treatment of secondary infections, an FIV-positive cat can lead a reasonably normal life span. Dr. Mike Richards says, "Feline immundeficiency virus infection does not lead to acquired immunodeficiency syndrome in cats as often as human immunodeficiency virus leads to AIDS in people." The largest threat to FIV-positive cats is secondary infections, such as bladder, skin, and upper respiratory infections. Kidney failure is also frequently seen in cats with FIV. These secondary infections should be treated promptly and aggressively in any cat, but especially with an FIV cat.

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(Bold, my emphasis).

Ronit, if you have his blood work results, and the vet is willing to send the ultrasound report, you may want to consider a consult with Cornell: http://www.vet.cornell.edu/fhc/camuti.cfm

:heart3:

Two nights ago Splinanderaki started to cry, painfully, when hiding in  a cold dark place in our basement, yesterday afternoon the same... I understood he was in pain, he is pain free now.

It was the hardest decision I could ever make and I feel the deepest pain and sorrow now that he is not with us any more, but I felt it was his way of telling us that he was tired of fighting.

I am so glad I did not do the suggested biopsy, it would have been harder for him and it was more needless pain.

RIP Splinanderaki, you had a short life, and I will never forget you, I hope you understood how much I loved you and how much I wanted to free you from your pain.

Splinanderaki was the best cat, and I mean that, the best cat I ever had, he had a huge good and gentle heart.

This is him, last summer.