Adult Manx with unusual (?) spinal pain

Our ~8-year-old Manx cat Sophie has been experiencing health problems over the past year that are baffling our vets and worry us.

Symptoms

• She developed constipation a few years ago, which I understand is a common problem for Manx due to the foreshortened spine.  We have been treating it with 1/8 tsp Miralax mixed into her wet food most nights.
• About a year ago, her back started popping, similar to the sound and feel of knuckles cracking.  It started with just one pop, and has progressed to ~10 in a row along her spine (I can feel them on separate vertebrae) a few times a day, usually when she curves her body.  There's no apparent pain from these pops.
• A few months ago, she started experiencing what appears to be sharp pain in her lower back.  Several times a day, often a few times in a row, her eyes will go wide and she will sharply twist around to the right to bite or lick near the base of her tail stump.  She will then sprint away as if something invisible is biting her, and often hide in a drawer for hours.  We can usually distract her from this pain by petting her or playing with string.
• About a week ago, the vet found blood in her urine, and she has had more frequent urination since then (normally 1-2 x per day, now 3-5).  The vet dismissed the possibility of a urinary tract infection because she found no elevated white blood cell counts.

Otherwise, Sophie is sleeping for longer and exploring outside less often, but still jumping around, playing with her toys most evenings, and eating normally.  She weighs 7.4 lbs.

Tests

• The vet tested for fleas, in case they were causing the sudden pain on her spine, but found none.
• The vet prodded her body and found good range of motion and no abnormalities, but did find two apparent sensitive or painful locations on her mid- and lower-spine, and possibly near her colon or abdomen.
• An x-ray of her spine showed nothing unusual.
• The bloodwork showed a relatively high number of red blood cells, a slightly elevated calcium, and a low neutrophil count (one of the white blood cells).

• We haven't yet done a bone marrow aspirate, abdominal ultrasound, MRI, or CT scan.

Treatments

• We have been giving her 3 ml of Gabapentin squirted in her mouth once a day for about a month.  It apparently is supposed to treat neurological pain, but it's not clear whether it's helping.

Causes

• We assume this is not a case of the fatal Manx syndrome, since that apparently only affects kittens up to 6 months and I believe causes spinal deformities that can be seen in an x-ray.
• The vet's current guesses include some sort of urinary tract inflammation or cancer (does not yet explain the spinal pain), bone marrow disease, or some neurological inflammation.

Does anyone have any idea what might be causing Sophie's problems?  Or places to search or vets to contact for more information?  She is such a sweet cat and it's heart-breaking to see her in pain.

Thank you,
Noah & Heather

The only thing I can suggest is getting a 2nd opinion from another Vet.  Maybe you could contact a Manx breeder in your area to find a Vet that specializes in that breed? Or at least if you could find a Vet who specializes in cats?  But you're correct, it doesn't seem like it would be Fatal Manx Syndrome, since she's 8 years old. 

that you can get to the bottom of this and get her some relief! 

I agree with a second opinion from another vet.

Sophie could have irritation in her bladder without having an infection, as the vet suggested, so medication to relax and smooth the muscles in her bladder might help her. Did the vet think the problem could be in her kidneys since she has both blood in her urine and some abdominal/back pain?

The back pain does appear to be neurological, perhaps parasthesia, and (having had this myself in my mouth area for about 30 years after jaw surgery) it's a "pain" like no other so I'm not surprised she runs from it. Gabapentin is an excellent, and the number one, medication for nerve pain. I gave it to an FIV+ foster with nerve pain in his jaw (of unknown origin) for years and it really worked. Is she still showing signs of sudden pain in her lower back? Can she get the medication twice a day? Perhaps as the vertebra have been popping they have damaged nerves in her back?

Sometimes cats have more than one problem at a time which can be very confusing and frustrating. You are heading in the right direction and doing everything you can for Sophie, something everyone here really appreciates seeing.
 

Thanks to you both for your kind words and ideas.  We've contacted a Manx breeder in VT to see if she has any other ideas.
 

Simka, what dosage of gabapentin did you give your cat, and how large was the cat?  I'm wondering whether we can try giving Sophie her medication in large or more frequent doses.  Your suggestions of possible causes make sense, and I'll pass them on to the vet to see if she knows how we could test for them.

Noah

Noah - I can't remember the dosage, it was about three years ago and I have fosters in my home all the time. I'll look through my notes to see if I can find the dosage. I have massive notes on Diego because he had multiple problems and no vet could come up with a perfect way to treat him. 
 

We have a similar issue with our Bo. He will only tolerate a raw diet - see catinfo.org for a recipe- we cannot use the egg but we use the rest. Works great- eliminates the runs immediately if yours will eat it.

Pain- Vetionx pain management works. And so does acupuncture. It works great if the cat will tolerate it. Bo does. Blue light therapy is another proven option. We will do that if he doesn't like acupuncture anymore.

 Add Cosequin if she will tolerate it. Bo throws it up- so we have to find something else. Vetionyx makes one for that as well. You may also try StemPet- not cheap- works on horses- says it works on dogs and cats- We may try that but not sure he will stomach it.

The condition may still be a minor form of Manx syndrome. It may have been there all along as a mild condition. As they age, it comes on out. We had x-rays done and it effects the last vertebrae of the spine. Bo actually has half of his back effected at his age now. But ours is visible and pronounced at this stage.

It will continue to get worse- monitor the pain. And cats don't respond that great to pain meds- there are some- you have to try them as needed.

I hope this helps. Try holistic and non- prescription options first. Resort to drugs last.

T-

Oh- and you might try a little raw liver or raw chicken thigh as a treat to see if she likes it.

That sharp pain are her nerves firing along the pressure points in the vertebrae. Bo had the same issues. Acupuncture fixed him. Are you sure the Xray had no the discs either bulging, crushed and or fused. Get another angled look via xray. We pulled 3.

Acupuncture will also relieve the blood in the urine- My vet had a cat doing that in Mooresville, nc- he treated the cat and no more blood in the urine.

Call Dr. Dunning in Newton-Conover Vet Hospital in NC- acupuncturist and vet. He has seen it all.