Sick older cat (diagnosed with hemobartonella)

Hi:

I have a very sick cat, and this site was recommended to me as being supportive. Sorry this is so long. I'm not sure what I'm looking for - except maybe some hopeful words.

Dexter is 13 years old and has been healthy up until a few months ago. He's been a mostly outdoor cat. He'd come in for a mouthful or two of food then head out again immediately. A few months ago I noticed he was going out less and less until he was staying inside all the time. I just figured he's getting older, and it's cold outside. No biggie.

He's always been very standoffish. Doesn't want to be petted much and absolutely refuses to be picked up. So, the fact that he was making himself scarce around the house wasn't concerning to me.

I noticed he vomited a few times, but it wasn't frequent. Maybe once every other week. And he was still eager to eat.

Then last Friday morning I got up to make coffee. When I got back to my bed, Dexter was lying in my spot. This was so totally uncharacteristic of him that I was alarmed. It was like he was planting himself in my path and saying, "Pay attention! I'm sick!" And when I picked him up, I was scared. He was so thin.

I took him to the vet that day. The vet said he was anemic, anorexic, and dehydrated. The vet didn't look like he held out much hope, and we talked about several hopeless possibilities of what might be wrong with him. So, we were surprised when his urine and blood tests came back looking good.

The vet diagnosed him with hemobartonella. He kept him over night to get him better hydrated and give him some medicine. Then he prescribed an antibiotic and sent him home. After a few false starts in getting the medicine into him, I think I've worked out a system.

He's eating very little, though. Very little.

And tonight when I got home, he'd pulled a patch of hair out on his lower back, near his tail. He looks so fragile and weak. He staggers when he walks. And I don't think he has the strength to jump up on the furniture. It's hard to believe this is the same cat who was so vigorous only a few months ago. To me it looks like he'll die soon.

Any thoughts?

Welcome and glad you were recommended to TCS!! I am pulling a couple of links about his condition in the hopes that it will help you and your cat. This is a blood parasitic condition and can be treated with antibiotics - usually paired together are Baytril and Doxy. Your vet must be on top of this and treat aggressively if this is what he says your cat has. IF you kitty has had this condition for some time then it has taken its toll. I do think there is hope so don't despair. Your boy may even need the addition of Presnisone - a steroid. Please be after your vet to help you and your cat. Call daily to report on how your cat is doing. We can support you here and offer understanding of your worries and concerns but your vet is your only ally right now in helping your cat. I would also recommend not letting your cat outdoors anymore and keeping your cat on a topical flea product via your vet. Most times this condition is brought on by flea bites. I hope others come along with first hand experience on hemobartonella.

http://www.cat-world.com.au/haemobartonellosis-feline-infectious-anaemia
http://www.winnfelinehealth.org/Pages/03_Lappin_Summ1_final.pdf

P.S. If your kitty is not drinking - he will need fluids too from the vet. We can also help guide you in syringe feeding your cat. There are videos on Youtube on how to syringe feed a cat. The best food I found for syringe feeding an ailing cat is Hill's A/D canned. I am not a fan of Hill's prescription diets in particular but they do have a place and the A/D is a good one for cats who need a highly dense nutritional and calorie packed meal via syringe. Your cat might even eat it readily on its own. Again, stay in close contact with your vet and call tomorrow and ask about the A/D food.

Mega, mega vibes to your kitty It is so very hard on us, the ones who love them so, to see them unwell.

Hi Costello.  I'm so happy you joined the site.  I know there are several people here that will be able to offer good advice and support for you and Dexter.  Way better than what I have already been able to give to you.  I'm just a newbie in comparison to the majority of cat owners here!

I received your other message.  I'll try and find some time in my day to get back to you.  

More  for you both!

Laurie

Thanks, sivlayeah.

Had a strange night last night. I have a new neighbor with barking dogs. After getting only 3 1/2 hours of sleep the night before, I decided to pack the dogs and my bedding in the back of my car and sleep elsewhere. When I got home this morning at 5 am, I found Dexter sleeping in the cat bed I have for him next to the space heater in my bedroom. It was kind of sad, because the heater wasn't on. I don't leave it on when I'm not home.

Anyway I hope it's a good sign that he's sleeping out in the open rather that under the couch or the bed as he has been recently.

That's a great sign!  Means that he's feeling better.

stephanietx said:

That's a great sign!  Means that he's feeling better.

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I hope you're right. I gave him his medicine this morning and offered food. He refused food and went to hide under the bed.

Just checking in on Dexter today. I am sorry that he went back under the bed. I wish I knew more about Hemobartonella. Will see if I can find some older threads with good helpful info. in them. More of those cute vibes smileys for you and Dexter. Did you call the vet?

Hemobart is completely treatable. I realize your kitty was probably in an advanced stage of anemia. Was complete blood work done, or did the vet just test for the red blood cell count (RBC) / hematocrit? When gauging anemia, it's very typical to refer primarily to the hematocrit.

A normal hematocrit is above 25%, usually 30% - 35%.
24% and below is technically anemic.
A hematocrit in the teens makes a kitty lethargic, but it's not life threatening.

12% - 15% is very, very low.

Anything below 10%, and if he doesn't respond to the antibiotics quickly, the vet might suggest a blood transfusion, just to provide support until the antibiotics kick in.

Doxy is typically the treatment of choice, but it really is important you get those pills in him.

Does he like butter? A little bit of cream cheese?

To pill him with those pills, coat the pill in a little butter or cheese. A light coating, just to make it slippery. If he's at least sniffing at his food, put the dish up against the wall, even better in a corner. Kneel down behind him - set your butt on the heels of your feet, with your knees out in a "V" so he's inside that "V." Assuming you are right-handed, hold his head firmly with your left hand, tilt it slightly up. Push your forefinger at the very back of his jaw to open his mouth. Use your right forefinger to push the pill into his mouth - best if you push it in at the back of his jaw. And push the slippery pill over the hump of his tongue - basically into the back of his throat. Then hold his mouth closed for a moment, and stroke his throat.

You may want to practice the motions using a pillow or something, so you're comfortable, because the real "trick" to successfully pilling a cat is simply confidence. Take a big, deep breathe, "see" yourself doing this, talk to him softly and calmly as you do it, tell him how important his medicine is, he needs to to feel better, and WHAT a good boy he is... and do it as quickly as possible. It does take a little practice, but after the 2nd or 3rd time you do it, it will be MUCH easier. :heart2: You'll never get to the point of being able to pill him so quickly he doesn't even really notice it's happening until it's done unless you try (and then try again). Just remind yourself - he cannot survive without this medication, because the parasites in his blood are literally destroying his red blood cells.

But the good news is that with this medication, he can beat this thing - fully and completely! He's just 13 years old - he may have many wonderful years left. :rub:

Now - as to the not eating. Unfortunately, cats liver's are very sensitive, and they are not designed to "eat" stores of body fat. Food is also a much needed component of his recovery right now. I don't know what you're offering him, but try chicken baby food (just chicken, no spices/salt, etc), umm... I don't know where you're located. If you're in the U.S., the Fancy Feast classic Pate style foods are good for him, and usually strong smelling enough to entice a cat to try some.

Part of his problem, right now though, is that he is very weak. We had a kitty that fought anemia for six years. Our cat's anemia was caused by an autoimmune disease, but when he was very, very anemic, he would walk to his bowl, stand there and stare at it, like he'd forgotten why he was there, and then retreat to his hiding spot. The vet did NOT tell us about syringe feeding, which we would have done had we known. What he did tell us was feed him ANYTHING he will eat. We tried all kinds of cat foods, baby foods, human foods - and we found he liked warm boiled shrimp we shredded up for him. :lol3: So that's what he ate for a week, until he gained enough strength to want other foods.

But if he is not eating, you're at the point where this isn't OK. You will have to help him eat. Does offering it to him on the end of your finger or a spoon help? Because of his severe hydration issue, I would not offer him kibble, but any wet food, just about any people food (the plainer the better). You can also try cat food with the pet probiotic called Fortiflora sprinkled on it. It's not a good probiotic, but it makes the food smell like kibble, so if he likes kibble, this will help.

If you cannot get him to eat, ask the vet for the prescription food called a/d and syringes. The syringes the vet has are a little difficult to use, but they work. If you'll need to syringe feed him for a little while, I suggest ordering these, if they're available where you live: (Just cut the ends of the tips off). These are VERY easy to use and clean.

Because he isn't eating, you start with less than his daily needs, but within a few days at most, if he won't eat on his own, you need to get his full daily caloric needs into him. I don't know what his weight is, but most cats need about one can a day. It's best if done one or two syringes at a time, multiple times a day. Again, the method of pilling is a great way to do the syringe feeding - just point the tip of syringe at the back of his cheek, rather than at his throat. You push just a little bit at a time into his mouth, let him swallow. Talking calmly to him during the process can really help.

Some kitties fight - some are too weak. When I needed to syringe feed my Lazlo, he actually seemed to appreciate it. And it was so obvious the food made him feel better. I think he figured out pretty quickly it did - he just wasn't motivated to eat on his own.

So don't assume your boy doesn't want to fight. He may just be too weak, though he may have the will. And if he's fighting you pilling - or if you try syringing him, he fights that - even better! It doesn't mean he doesn't want to get better - but it means he's feisty enough to be an obstreperous kitty. :lol3: If he still won't eat on his own, it's worth buying a cat bag. I never could master the art of making a blanket into a wrap that actually contained a cat's legs. :lol3: This is the one we have:
Get those drugs into him, get some food into him, and I think, you'll be impressed at how quickly he'll improve. :heart2:

for you and vibes for your boy.

Thanks all.

I didn't ask about the specifics of what blood tests were run and the results. I can tell you from observing him that he's extremely weak and listless. I stepped on the scale with him tonight, and he's only about 7 pounds. I'd guess he should be twice that.

I called the vet today and asked about feeding and Frontline. He okayed the Frontline, so I put that on him. And he prescribed the Hills A/D. I've just finished syringe feeding him a very small amount. He'll definitely need more. He didn't fight the food too much, and he even sniffed at it a couple of times, but he's still not eating it spontaneously.

It's like feeding a cat with three feet in the grave. He's eyes are sunken, and he has no strength in him at all.

I've managed to consistently get the entire dose of the medicine in him for the last three doses. It's discouraging to not see much improvement, if any. I'm hoping the food will help.

Uh oh, he just vomited. It looks like most of what I just fed him. And, of course, the medicine must have come up with it too.

Hun, he may need an anti-emetic at this point. :nod:

He's gone a while without much food to speak of. But it's the lack of food and anemia combined that is causing him to look and feel this way - he really needs the food. Because he's vomiting, they may want to give him a shot - really, this would be the best option for him. He's not in pain - he's just really, really weak.

It will take a few days of food before he starts to perk up. But with three days of pills already in him, they're fighting the parasites. Now he needs protein, vitamins and minerals. :heart2:

Ever had the flu so bad you can't keep anything down and don't eat for a few days? You feel really weak and light-headed after that? Imagine that but with anemia (like your blood pressure was really, really low) on top of it. That's how he feels right now.

With something to help him keep the food down, after a few days of food, you WILL start to see that spark back in his eye, and he'll feel a little stronger. It takes some time, but when he's holding his head up with brightness in his eye, you'll know you're over the hump. Hang in there! He just needs some nourishment now. The vet should be able to give him something to help him keep that food inside.

Thanks. Think I should give him another dose of the medicine tonight? I'm sure most of what I gave him came up with the food. It was meant to be 28 doses, and maybe four of those have been 'wasted.' I wonder if the vet will give me a few more to tack on the end.

I think I'm going to try to give him another dose. It's not doing him any good if it's not in his stomach.

If he's kept the other pills down without food, it's worth a try. And I'm sure the vet will give you the pills needed to make up those lost. :heart2:

Hun - I was here with our kitty, Tuxedo, several times. I remember when he was just skin and bones. He barely moved. How could he? He had no energy! But you have been getting the meds into Dexter, so that's a really important start. :rub: Hang in there! Your baby just needs some food now to start feeling better. It's just been a little too long without anything, so he needs an anti-emetic to help him keep it down. Once the vet takes care of that, with some food in him, he'll perk up. :heart2:

Thanks, LDG. I did give him another pill last night. Didn't bother grinding it up and syringing it in. Just used your instructions and dropped the tablet down his throat. I'm pretty sure it went down.

I did the same thing this morning. And I gave him no food this morning because I had to leave for work and was afraid he'd vomit the pill up again. I have tomorrow, Saturday, and Sunday off, so I'm going to give frequent small feedings and see if that's easier on him.

I want you to know that I am routing for you, hun, and your kitty whom you care for dearly. I am so happy that Laurie has given such great advice and support too. I would not give up hope either. I do think that at this point, I would get that Antiemetic right away. Dexter's stomach is so empty, he is so weak from anemia and not eating, that nothing will stay down. He might need help with the addition of the medicine that Laurie mentioned. He really, really needs to eat and keep food down to gain some strength. We have seen cats come back from much worse and I also believe that once you can get the A/D into him you will see the light in his eyes once again. Such a difficult time for you both.

Costello, how's Dexter doing tonight?  Any better?

I'm just checking in too.. :cross: :heart2:

sivyaleah said:

Costello, how's Dexter doing tonight?  Any better?

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No change, sivyaleah. I'm getting better at getting the pills into him, but food is still a problem. I just gave him a tiny, tiny bite of the Hills A/D. I gave him the pill two hours ago, so hopefully it's moved on through and is doing its job. If he needs to vomit, the pill won't come up too.

I just held him for a while this evening. Now he's lying on the bed next to me.

I'm off work tomorrow, so I can spend time trying to feed him. If nothing stays down, I'll ask the vet for something.

Poor old man. It must be awful to be so sick and weak.

At least you're getting the pills into him now.  That's a good step.

I mentioned to you privately, to try getting him to eat anything possible right now.  When Casper was ill recently, he was refuses every flavor of canned food we offered until we discovered that he would eat anything which was "people" food, or as close to it as possible.  So, it became plainly cooked chicken,  I started with breast, but at the suggestion of a couple of people here went to thigh as it's higher in fat, shredded.  No expensive at all.  I also would give him a small amount of canned tuna fish.  My vet suggested plain ground beef with rice, but he really didn't think that was satisfactory so out that went.

As for canned food, Weruva makes extremely high quality foods.  The chicken ones look exactly like shredded people food, but of course have the added nutrients cats require.  The only problem is they are crazy expensive but, for the short term, to get him to eat, you may want to try a couple out.  The Paw Lickin' Chicken went over big here as did the ones that have any kind of fish in them (usually I stay away from fish in general - I only feed it maybe a couple of times a month at most).  It was a huge relief to see him eat, and he started to rebound quickly once he did.

Also, freeze dried treats sometimes get their interest.  I get ones that are chicken and shrimp.  No matter how they are feeling, they ALWAYS want those.  You can try crushing them up, and sprinkling it over the regular food.  I did that also, and while he may not have chowed down on the food, he at least got some of it by trying to pick out the treat 

Hope the weekend sees improvement with you being around so much 

Laurie