6-month-old kitten ONLY 2.6 lbs!

Real quick also: what's your opinion on the low white blood cell count, considering Charlie's state?

http://www.petplace.com/cats/unders...omplete-blood-count-cbc-for-cats-2/page2.aspx

It's usually indicative of an infection, or suppressed immune function. Not surprising, right now, as your little one has been battling something for a while..... :rub:

As usual Laurie, great link! 

Perfect, just wanted to make sure that I had some sort of a response prepared.  The white blood cell count seemed to be the reason they wanted to do one of the tests that I should be cancelling.  They want us to fast Charlie for 12 hours before bringing him in tomorrow.  Is that for one of the tests I'll be cancelling?

I'm taking notes on all the advice.  The more info I get, the more intelligent of a conversation I can have with the vet, and hopefully keep up with what her plans are.

Oh, and off the fecal tests this morning, we had results of no Giardia, no Coccidia, and he had some other small parasite (they claimed not to be a big deal? from what I recall) and those were gone.

Well, the coronavirus titre testing would be done with the blood they already took, I believe. It was probably already sent out to have done. That's likely something you would have had to already call to cancel.

I don't know what they want to do tomorrow. :dk:

Here is info on the nasties we've been discussing:

http://veterinarymedicine.dvm360.com/vetmed/article/articleDetail.jsp?id=509560&sk=&date=&pageID=5

http://www.capcvet.org/capc-recommendations/giardia

Now - there is an office SNAP test for Giardia apparently. I'm not familiar with this. We've rescued plenty of kitties with giardia, though the last one was two years ago. But our vet has never had giardia results in-office, same day. The only in-office stuff we've ever gotten same day is round worm, lung worm, tape worm, that kind of stuff. The "cyst shedding" parasites have always been something our vet had to send out to have testing done in a lab, and results were usually the next day or day after. I have no clue where you are, what your vet office equipment is like, what diagnostic tools they have available there... we work with three different vet practices, and all of them would send the fecal out for testing for giardia, coccidia, T. Foetus, etc. I'm not saying it's not possible to do it accurately in-house... :dk:

But as you can see from the articles, they're not necessarily easy things to find.....

Now, maybe you've got some really advanced vet thing going on there, and they want to do the coronavirus titre testing, and want some more blood work based on fasting numbers, and the combination of results may point them somewhere... :dk:

At this point, I guess you'll just have to find out!

In the end, we don't want to second-guess the vet. We can only provide advice and guidance based on our own experiences.

I just know that if your kitty is eating and playing and doesn't have a fever... trying to "diagnose" FIP seems like an expensive red-herring, because there isn't anything that can be done other than provide palliative care anyway. So it seems like a lot of expense for no point. :dk: And while we're the first to run to our vet when something seems off... we've also rescued cats intensively for over 10 years now, and we've learned what we want to spend the money on, and what we don't. :rub: I'll go to the ends of the earth for a cat. But FIP is just one of those things that... time will tell. I'd be looking for all the other things it could be. And if blood work indicates all his organs are working properly, that most likely leaves you with a parasite, bacterial overgrowth, or food sensitivity. And none of those should be overly expensive to treat, though the diagnostics for the parasite nasties can be frustrating. But once those are ruled out - you're left with things best treated by a holistic DVM, as bacterial overgrowth and food sensitivity can be addressed with diet and supplements, and most tradition-only vets aren't really familiar with much in the way of treatment apart from steroids, antibiotics, and prescription food - none of which are particularly good long term solutions - especially with a young kitten that is likely resilient, and will heal up nicely with proper food and supplements, if it IS "just" an IBD-related kind of thing. :dk:

Okay thank you so much!  They keep disregarding my request to test for T. Foetus, but I've got them on track for it.

Here's where we REALLY need your BEST advice.  We're limited on funds now, or are coming to it after all these tests.  The two tests they had scheduled tomorrow are: Fecal Culture and a GI Panel.  BOTH are so expensive, and almost out of reach as far as affordable for two college students goes.  We can afford the test for T. Foetus however.  Do we need to have either of the two prior tests done?

I'm starting to wonder if this isn't parasitic at all, but possibly a shunt?

Worth checking into.
 

They've ruled out a shunt.

EDIT: So I believe I re-call the vet stating.  Like I said, she just went off on a tangent today and my mind was trying to process each bit of information as it came out, unfortunately it came out a little too fast for me to catch all of it.  I have his records and I see that "TLI tl - bile acids esp due to possible shunted/abnormal growth" (that's my best de-coding of veterinarian hieroglyphics) on his vet records earlier on.

FURTHER UPDATE: Just got back from the local health store.   Picked up George's Aloe Vera Juice, Slippery Elm Bark, and they had this tuff called "Pet Dophilus." So I picked that up for the acidophilus supplement.  It's 1 billion per gram?  Will this work?  It suggests 1/8 to 1/4 teaspoon for a kitten (0.5 - 1g).

Well, the Pet Dophilus only has 1 billion cultures per gram. And it has yeast extract? http://www.jarrow.com/product/145/Pet_Dophilus But since you have it, I guess try it and see? :dk: As our vet recommended something with 10 billion live cultures, and the kitten equivalent would be 5 billion, I'd use the 1/4 teaspoon 2x a day in the slippery elm bark powder/aloe vera juice mix. Can't hurt to try!

As to the tests... I'm not sure what to recommend. The GI panel ... well, here:

Once we have ruled out the diseases that are easy to test for the next step is usually a set of blood tests that look at the function of the pancreas and the small intestine. We refer to this set of tests as a gastrointestinal or GI panel.

There are four tests in the panel: PLI is an enzyme produced by the pancreas. An elevated PLI means the pancreas is inflamed and the pet has pancreatitis. Pancreatitis is treated with pain medication and special low-fat diets. The other pancreatic test is TLI. This one tells us whether the pancreas is making enough digestive enzymes to properly digest food. If not, we can add enzymes to the food to replace what the pancreas isn’t producing.

The intestinal tests are both looking for changes in vitamin levels. Low cobalamin and/ or high folate levels mean intestinal disease is present. When the intestine is thickened and not functioning properly vitamin B12, or cobalamin, is not absorbed well and the level of cobalamin in the bloodstream becomes too low. If your pet’s B12 level is low we will teach you how to give vitamin B12 injections at home to improve the blood level and also start treatment for intestinal disease. When bacteria overgrow in an unhealthy intestine they produce excess folate, which then shows up in the bloodstream. If this is the case we treat with antibiotics. Treatment may be needed anywhere from a few weeks to forever. Probiotic supplements may also be used to reintroduce healthy, good gut bacteria.

A GI panel costs about $165 and it takes 10-14 days to get results back from the lab.

Click to expand...

This is from: http://www.bestfriendsvet.com/pdffiles/Chronic GI disease 2011.pdf

And I don't know what would be different about the fecal tests they're proposing vs. what's already been done. :dk:

I'm not sure what I'd do in your shoes. I think I would have wanted the B12 shot, regular blood work, a fecal sent out.... and I'd probably try DiaGel, diet, and the SEB/aloe vera/probiotics for a week or two and seeing how kitty responds before wanting more tests. I've pinged Lisa (finnlacey) because she has a LOT more experience with issues with pancreatitis and nutritional malabsorption issues. I have none.

But let's face it... a 2.6 pound kitty at 6 months sounds like there may be more than "just" parasites going on. Of course, there are very small kitties. For instance, a full grown Russian Blue female kitty may only weigh 5 pounds. A TCS member had one that weighed less than that, fully grown.

Taking a step back here... your kitty WAS eating normally? Hungry? Interested in food?

And playing? Running around, happy, a lot of energy?

The "only" problem has been this horrid, foul, diarrhea?

Right now, yes we're looking to try to maintain the problems ourself (got the probiotic formula, though perhaps maybe I need a stronger probiotic?) until we can figure out what's best to test and do.  As of now we decided to take him in and have a test sent out for T. Foetus.  It'll cost about $75 they said.

Okay let's lay out how he's been acting and such then:

- FOUL diarrhea

- FOUL farts

- Seepage from bum

- Protruded bum

- Goes NUTS when he knows he's being fed

- Runs and plays around SOMETIMES, usually it's when his bum is no longer protruded and seepage has ceased for maybe... 12 hours?

- Lately however, he won't really jump but rather climb when he does attempt to get up higher and his energy levels have decreased over the past couple of days.  He'll still run occasionally, not really playing much for the past couple of days either.  If you toss his favorite ball or toy it may catch his attention, though he won't chase it. About a week ago he was floppin around, throwing his ball all over the place and such.  I'd compare his progress to a roller coaster.  Up, down, up, down, up, down, etc.

I believe that's about the gist currently.

His seeping is pretty bad tonight.  It's pretty clear that it's the EVO.  I can see some of the little red chunks every so often.  His anus didn't look too swollen when I checked it, but he's just seeping out liquidy stool.

I don't understand why he can't absorb any of his food, this is alarming if he's seeping out stool like that. 

It didn't post my last post for some reason?

But his CURRENT symptoms are:

- FOUL chronic diarrhea

- FOUL farts

- Goes NUTS when he knows he's being fed (thinks our food we prepare on the counter is HIS)

- Runs around and plays SOMETIMES (usually seems to play and run after about 12 hours after diarrhea and protruded anus ceases temporarily)

- The past couple of nights his energy levels aren't quite as high, and in the past week or so rather than jumping, he uses his claws and climbs; maybe a slight struggle)

- Protruded anus

- Stomach visibly distended (after eating, eventually it goes back down)

- Seepage from anus

- Won't gain weight

That's why I thought it was EPI from the beginning?

EDIT: He doesn't have enough digestive enzymes?

http://www.vetdepot.com/exocrine-pancreatic-insufficiency-cats.html

Perhaps this is why the vet wants Charlie fasted. The test for EPI is done after fasting.

A veterinarian may suspect that your cat has EPI based on her medical history and symptoms, but a definitive diagnosis requires confirmatory testing. The trypsin-like immunoreactivity test (TLI) is the most common diagnostic tool used and requires only one sample of blood taken after a 12-18 hour fast. Fecal testing may also be appropriate under certain circumstances.

Click to expand...

Of course, I've had kitties with diarrhea and they've passed undigested food, and they don't have EPI. It IS possible this is a very inflamed GI system now further upset by a strong antibiotic.

And http://www.merckvetmanual.com/mvm/index.jsp?cfile=htm/bc/23404.htm

Sounds like the GI panel should be done. And it seems you'd want to ensure they're doing the serum trypsin-like immunoreactivity test. :nod:

....and if this is in some way related to pancreatitis, then EVO would be the wrong food. It's high in fat - good for a kitty to put on weight, but not for a kitty with pancreatitis. I'd try boiled chicken and rice for a little while after his fast.

Here is a close up of a drip.


As you can see, it's like dripping every step he takes. (It'll stop after a bit, or after he decides to use the litter box)


Usually his rear looks just as his bum (the whole surrounding area).  As well as protruded.  This looks MUCH better than where he was.


This took quite the photo shoot, but as you can see it just leaks right on out.