What is wrong with my baby?

Hello everyone, I am new to the site but I have a strange situation with my cat.

My cat Diesel (aka Bomby) is a 4.5 yr old MN domestic short haired.  I have had him since about 8 months of age.  Since Ive had him, he has chronic diarrhea that is now being controlled (FINALLY) with Hills ZD dry/ wet and Proviable capsules once daily.  In February 2012 he was straining to urinate and when his urine was tested he had crystals (vet didnt tell me what kind) and blood in his urine however no stones on xray.  August 30,2012 he went to the vet for his yearly exam and rabies vaccine.  Since then (and I dont believe it's related), he has not been himself.  Lethargic, eating but not nearly what he usually does, and not drinking a lot.  Took him to the vet this past Wednesday and they did bloodwork where they found that he had Hypercalcemia.  They also found blood and calcium oxalate crystals in his urine.  We had more bloodwork drawn and sent to Michigan to test his ionized calcium, see if he has cancer or if something is wrong with his parathyroid glands.  Im really hoping he does not have cancer given that he's only 4.5 yrs old, however I dont know what to think.  Along with this, he has progressively been losing weight. 

September 2009: 12.4#

November 2009: 12.2#

August 2010: 13.2#

December 2010: 13.3#

January 2011: 12.5#

May 2011: 11.4#

August 2011: 11.2#

September 2011: 11.7#

February 2012: 11.5#

August 30, 2012: 11#

September 12, 2012: 10.6#

Can someone maybe give me some opinions on what you think might be going on?  If you have any questions, let me know.  Thanks for reading!

So sorry Diesel has been having problems.

I always suggest starting with the foundation upon which the health of a kitty is most often based on--what they eat. Kitties are obligate (strict) carnivores and need quality meat in their food to thrive. They don't need grains, fruits, or veggies--or at most 5% or less of ther diet of veggies as a fiber source. They also need to derive the majority of their moisture (water) from the foods they eat because they don't have the thirst drive that humans and dogs do--they just will not drink enough water to stay hydrated like other species do. They will be in a state of dehydration because of this and that leads to issues with crystals, etc., not to mention kidney failure and other diseases later in life.

In this case, looking at the ingredients of Hills Z/D kibble, the number one ingredient is a grain: rice. SO not good! Kitties can't process plant-based ingredients effectively (they don't have the enzymes to do so) because they are true carnivores, and therefore there is none to very little nutritional value for them from grains, fruits, or vegetables. Grains, etc. also have an alkalizing affect on their urinary/digestive system which is not good because kitties naturally need to have an acidic digestive environment--this upsets that balance. Kibble in particular is bad for a kitty with urinary issues because of its very low moisture content compared to canned or raw diets.

The canned Z/D is awful too. The only listed meat in there is liver, an organ meat.

I find it confounding that Hills doesn't know enough about cat physiology/biology to even attempt to produce a food appropriate for cats--strict carnivores who need real meat to thrive. Dogs can handle and to a good extent process grains, etc.--kitties can not.

I am thinking that the only reason Diesel is not having diarrhea is because of the Proviable, which is a prebiotic and probiotic--not the diet. He is most likely losing weight because his nutritional needs are not being met by his diet.

I would SO ditch the Z/D and go with a NO grain, fruit, veggy canned food--or a balanced raw diet (there are many commercial raw diets if you aren't open to making your own; RadCat is a good one). We can help with transitioning if you decide to go the raw diet route. Because he has urinary problems I would also add extra water to the food to a consistency that Diesel will eat without turning his nose up at it.

Besides an appropriate diet, water is a key thing for kitties prone to crystals. It helps flush crystals and other sludge out so they can't build up and cause problems. Add it to food, syringe by mouth, or do sub-Q fluids (Lactated Ringers Solution). Water, water, water. Did I say "water?" Yup, I did!

Did the vet say what his urine pH was?

I could go on here, but I'll suggest a couple sites that will help: A site you will find helpful regarding diet and other info for kitties with crystals is catinfo.org and Feline Urinary Tract Health. Some treatment options can be found at this link: Feline Lower Urinary Tract Disease (I used a lot of the info from holisticat and from catinfo when my boy, Abby, had problems).

I'll let others weigh in on the Hypercalcemia.

For what it's worth, I've fed my kitties a balanced home-prepared raw diet for the past 7 or so years. Any problems, I can easily tweak their diet.

Thanks for the information.  Diesel was originally on Science diet Optimum (I believe it was called) then was switched to California Natural chicken and brown rice and put on Fortiflora to help the diarrhea.  Didnt help.  I then switched vets for a second opinion.  We dewormed him again, checked bloodwork including TLI and PLI as well as a chemistry and profile.  We tried Metronidazole, Baytril, canned pumpkin, and Metamucil.  We tried him on Royal Canin Rabbit and pea as well as Venison and pea.  Then they wanted me to do an endoscopy and I just couldnt see putting him through that if it was going to just confirm IBD or not (treatment of IBD is steroids and diet change),  So we tried ZD and Proviable as a last resort before  doing steroids and the endoscopy.  So far it is helping but he has had to have Metronidazole because he had a bout of diarrhea.

I mentioned about a month ago to see if I could get him off the ZD and see if he could tolerate a different food and the vets response was "Well we have worked so hard to get him where he's at; if it's not broken , dont fix it."  So he has been seeing a different vet in the same practice and I am going to talk to her about a food change.  Since you talked about the ingredients in ZD, I feel terrible for feeding him that!  I feel like Im poisoning him .  Hopefully we will get test results back soon and I will make another post with the results.  Thanks!

Oh becbec, I'm so sorry! Chronic diarrhea can be SO frustrating. We rescued an older feral kitty that turned out to be FIV+. Poor thing had EXPLOSIVE diarrhea. We treated him for parasites, gave him a LONG round of metro. Because of his FIV, we could not use steroids. He also started itching - so much that he made bare spots on his legs and he "mowed" his abdomen clean.

Here's what we did.

We put him on a boiled chicken and rice diet for about two weeks. That at least stopped the explosive diarrhea. We tried the z/d, canned and kibble. That did not help at all. I learned later that an all wet diet is best for cats given their physiology. If he were on only the wet z/d, it might have helped - the dry has brewer's rice in it, and that's an allergan trigger for some cats.

So two western-medicine based vets could not stop the itching (despite a zillion tests) and could not stop his diarrhea.

So we saw a holistic vet, trained in Chinese Medicine, acupuncture, nutrition, and western herbs. The first thing she did with us was review his diet. She then basically lectured us on how inappropriate ANY kibble is for cats. I learned more about that here: http://www.catinfo.org

And I started learning about feline nutrition. :lol3: Mostly through discussion here on TCS, actually, and a LOT of research. She wanted us to feed Chumley raw food. I was opposed to that, and argued against it. But in doing the research to argue against it, in the end, I decided she was right - it IS best for our kitties. Now - in the meantime she knew I had issues with raw, I told her I wasn't ready for that. So she prescribed an herbal treatment based on his symptoms (diagnosed via Chinese Medicine, not western). And he stopped itching and his diarrhea cleared up. But we did put ALL our kitties on an all wet food, grain-free diet. When I finally decided to switch to raw (Chumley was rescued in May 2010, we saw her October 2010, I switched to all wet food November 2010, and I switched to raw food January of this year), Chumley stopped eating his herbal pills. And he's had no recurrence of the diarrhea OR the itching.

I've seen a rather dramatic change in all my cats. I do know that it's an anti-inflammatory diet. And if you stop to think about it... in the wild, cats eat mice, rabbits, and other small mammals. People don't put up fences to stop cats from raiding the vegetable garden. :lol3: So while you may not want to go that far, there are anti-inflammatory, more species-appropriate diets. That said - some kitties are so sensitive - especially when it's gotten to the point of being IBD - that managing the problem with anything other than either steroids or raw is difficult. Raw doesn't help all kitties with IBD. But it has helped quite a few.

There is a site that you may find very helpful if you haven't seen it yet: http://www.ibdkitties.net.

Many vibes for you and your kitty! : vibes:

Hi Becbec
I so know what you are going through..... I am so sorry your baby is going through so much
I was there not long ago too..... Your story is quite similar to my cat Bugsy's story.... The one difference is that he didn't have Crystals, he had an UTI.
His IBD was out of control. Like your baby, he had soft stools for all his life... The worst time though was after his UTI - he was prescribed Clavamox for it, and that REALLY messed him up
From that day on, 14 months of daily violent diarrhea. It was awful.
We went through so many diets, medications, vet visits, tests.... Emergencies.... It was a mess. There was a point I couldn't medicate him anymore as all those meds started affecting his liver - we had tostop everything, even his stomatitis meds.
It was not good. Being off his stomatitis meds got his mouth in a bad bad shape - in this short time he ended up having several extractions because of it, and a bad tooth infection.
Once his liver got better, he got back on the stomatitis meds. But he never got better on his diarrhea....
Since there was no options anymore - we couldn't treat him, diets were not working..... the only option for him was an exploratory surgery - we scheduled that.
Thing is, no matter what we found, I wouldn't be able to treat him anyways..... So in desperation I turned to the only option I had before the surgery: A raw diet.

I had been against raw, for fear of it, for a very long time..... But at that point I didn't really have a choice. I did a lot of research, and took the plunge. Lo and behold, it worked!
Because of his IBD and his very very sensitive system (Bugsy was the type of cat that if ANYTHING could go wrong, it WOULD), I started very slowly. His transition took 8 days. The 8th day was the first day he ate 100% raw...... and also the first day in his life he had 100% solid poop!
And the rest is history - Bugsy has been doing phenomenal since then. He is completely off meds - guess what - even for his stomatitis! But not because he can't deal with it, but because the inflammation in his mouth is so greatly reduced, his vet decided to stop it.
He is now only on probiotics - he DOES take holistic drops for a seasonal allergy he is going through now, and his holistic vet put him on drops for his stomatitis. Aside from that..... Nothing, not a drug, not a steroid, not an antibiotic, and the vet visits have been wellness visits and follow up to check his teeth (because we discontinued the drugs for the stomatitis, and need to see what's going on closely).
His immune system is SO good in fact, that his last dental, which included an extraction (broken tooth), he didn't need antibiotics during his recover. On the same day he was eating, and on the next day it was as though nothing happened.
I guess what I want to say is, don't give up hope - because there IS hope. If you are in a corner and think that there are no more options, there ARE.
I thought this way too..... And everyday it lightens my heart to see how healthy my boy is, and how much longer he is going to stay around with this one small change in his life :heart3:
If you decide to keep on Z/D, I highly recommend you feeding the wet - for one thing it is grain free, it has chicken, even if hydrolyzed, and it has the moisture your boy needs to keep his urinary tract in good shape. IMHO ditching the dry is the best thing you can do for your boy.
If you have any questions at all, feel free to ask.... We are here for you
Good luck for you and your baby - please keep us posted on his progress and the tests results

I've been doing a little work on hypercalcemia.

To condense it down, here are two good pieces:

http://www.cat-world.com.au/hypercalcemia-in-cats
http://felineihc.org/resources/Hypercalcemia.pdf

The calcium oxalate crystals are consistent with the hypercalcemia. Has the vet suggested further tests or imaging to rule out a problem with the parathyroid or testing for Addison's? Because that's the direction I think I'd want to take (in addition to at least moving to an all wet food, grain free diet). :heart3:

Thanks everyone for the vibes and good information!  We are waiting to hear back from the vet on the test results.  The bloodwork that was sent out was called a Malignancy panel.  The vet said it was testing his ionized calcium level since that would be more accurate, test his parathyroid gland and test for cancer (Im not sure of the exact names for those, she told me but I cannot remember).  If the test results come back normal then we will do radiographs to see if he has stones.  When he was straining to urinate in Feburary and had blood and crystals in his urine then, the vet wanted to switch him to Royal Canin SO but opted not to since we had just got the diarrhea under control with the ZD and Proviable.  She suggested to try and add more water to his diet which we tried.  If we put water in his dry kibble, he got gassy (I thought that was strange).  So he LOVES ice cubes!  If he hears the freezer open, he runs over and begs for an ice cube to be put in the water so he can drink it.  We have also been feeding more of his ZD canned.

There are just so many things running through my head right now and I am so anxious to get the results back!  I will talk to the vet about putting him on different food.  If we go back to getting diarrhea, then so be it.  I can deal with that, but I feel like the urinary issues are a little bigger since he is male and I dont want him to become obstructed.  Who knows, the Proviable capsules (probiotic) that he gets may be the thing doing the trick and not the ZD.  I will update when I get results, which hopefully will be soon!

Oh, with his initial bloodwork, his calcium was 13.8.  They rechecked a new sample to make sure it wasn't error and it was in the low 14's.  Normal calcium ranges from 8.0-11.8.  So the ionized calcium they sent bloodwork to test will be more accurate.

Yes, please keep us posted! you can find the source of the problem and it's treatable, and not cancer! :cross: :heart2:

The adding water to his kibble made him gassy because most kibble has bacteria. Adding the water provides a medium for it to grow....

What is a good website tof ind information on raw diets?

This one.

The raw feeding forum: http://www.thecatsite.com/f/65/raw-feeding-for-cats

The resources thread: http://www.thecatsite.com/t/240809/raw-feeding-resource-thread. This lists many helpful resources.

A current thread asking the same question! http://www.thecatsite.com/t/248794/...-whether-their-nutritional-needs-are-met-help

Sorry this has taken me so long to update but I have finally gotten some answers after 3 DAYS of calling the vet!  So Diesel's Parathyroid Hormone was 0 and his Parathormone related peptide was also 0.  His ionized calcium was 2.17 (reference range 1.4), so this confirms Hypercalcemia and no error.  Next step is either radiographs or an ultrasound.  The doctor said it is either idopathic hypercalcemia or some kind of malignancy.   I will update again once we find something else out.  Im really sad now, my baby is only 4.5 yrs!  He can't have cancer.

Okay, so Diesel's doctor called me and said that she thinks he has Idiopathic Hypercalcemia since his Parathyroid Hormone and Parathormone related peptide were both 0.  However, some cancers will not be picked up by those tests so the next thing is to get an abdominal ultrasound and chest rads to "hunt" for anything that may be causing the hypercalcemia.  She said if both of those look good, then she is gonna stop at that and will most likely put him on a steroid and get a diet change.  I am waiting to hear back from the vet as to when I can take him in for the other diagnostics.

Well here's vibes it's not cancer! !!!!!!

Quick questions:

Was Diesel ever put on one of the urinary (vet) diets for his urinary problems? If so, which one(s) and for how long?

On the labs (blood and urine) are his kidney values within normal range, high end of normal, or high? (BUN, Creatinine, Calcium (Ca) <==already know this is, Phosphorus (P), Potassium (K), Sodium (Na), and Packed Cell Volume (PCV) to name a few.)

I will ask for a copy of the blood work, but the dr did not mention anything abnormal about his kidney values.  He has never been on a kidney diet.  When he went to the vet in February when he was straining to urinate and he had blood and crystals in his urine, the dr was going to switch his diet but since we just got his diarrhea (he has has the diarrhea since we've had him) under control on the ZD, she said just to add more water to his diet and if it happens again, we would have to change.  When we talked yesterday, she said we would have to find a low calcium diet now.  Well when I was researching hypercalcemia, they said Wellness has low calcium so I picked up a couple cans and he's had that since Monday night.  He LOVES it!  And Ive still put his proviable probiotic capsules on it and his poop has been formed!  So Im hoping he can just stay on the Wellness since it is low calcium.

How was he treated in February for the blood and crystals in his urine.  That doesn't go away on its own.
 

He got Buprenex and sent home.  The dr was debating putting him on a urinary diet, but since we had just found a diet (Hill's ZD) that helped his diarrhea she suggested that we just add more water to his diet and if he strains again then we need to change his diet.  He was not blocked and Im not sure what or how many crystals he had.  Xrays were done and he did not have any kidney or bladder stones.  I had originally taken him in on 9/12 because he wasn't acting right, lethargic and decreased appetite.  Tomorrow he goes for the abdominal ultrasound and chest xrays and the dr said we would be able to see if he has stones anywhere.

Prayers for your kitty.  It sounds like you are making the right decisions. 
 

Thanks, I hope so.  I keep blaming myself for what had happened.  I cant help but think that the ZD started this but I dont know.  I know it's not me deep down but it's hard to deal with.  He is so young :/