advice on managing a sick kitten

My lovely, healthy 6 month old Siberian kitten (Charlie) went in for his neuter last Friday.  He did great after the surgery, but on Wednesday he started vomiting and refused to eat.  He was also lethargic, not grooming or playing.  I brought him to the vet that evening, since I was worried about a surgical complication.  His temp was 102.9 and he was dehydrated.  They thought it was gastroenteritis and suggested treating symptomatically with fluids and pepcid.  On Thursday, he continued vomiting and refused all food (including treats) and water.  I took him back and was told "we can do blood work if you want, up to you" which I found confusing - either it's necessary or it isn't!  This time his temp was normal, but he was once again dehydrated.  The vet thought it was cystitis (??), gave him a shot of Unasyn, more subq fluid, and sent me home with amoxicillin/clavulanic acid. 

Today, he is no longer vomiting and is acting more himself.  I think he's also drinking a bit.  But he is still refusing to touch food.  I gave him a bit of food through a syringe to go with his antibiotic, so he's not taking it on an empty stomach.   Because of the improvement, I'm thinking this might resolve on its own.  Any advice on how to manage food though?  How long should I wait for him to start eating on his own, before it's time to start force feeding?  Also, I'm trying to figure out where this came from.  The vet says it's not related to the neuter, but that's kind of hard to believe.  My guess is that he picked up a bug from another cat at the vet's.

Thanks for any and all advice!  I'm a new cat owner and this is all a bit overwhelming.  My friends/family with cats say they've never experienced anything like this.

If he has not been eating since Wednesday, I would start syringe feeding now. Cats can start developing fatty liver issues in as little as 48 hours of not eating.

I do think it's likely that he picked up something at the vet's. I'm not sure how much of all this is related to the neuter. Was a urinalysis done to determine cystitis (which is generally bladder inflammation of unknown origin but some vets use this term for all urinary tract issues. It seems like the Unasyn was for the possible gastroenteritis, but what is the amoxicillin for? Is the vet thinking possible infection from the neuter or is this to treat the cystitis?

It sounds like your vet is taking a broad spectrum approach to whatever the problem is and throwing a lot at it. I do think that he needs food and water in order to help him recover. So, if he were my cat, I would ask the questions above and find out what each medication is trying to treat, continue what makes sense and keep getting food and water into him. If he does not start improving in a few days, I would do bloodwork to see if something else is going on.

Hi and welcome to the cat site!

It is very dangerous for a cat to go more than a couple of days without as they can very easily develop hepatic lipidosis (http://healthypets.mercola.com/sites/healthypets/archive/2011/12/13/feline-hepatic-lipidosis.aspx). It was very irresponsible of your vet not to inform you of this and to let your kitten go so long without food.

Here is a good video describing what it is:



You need to start syringe feeding right away. Go to the drugstore and get the largest syringe you can find (30 cc is good) and you will also need canned food. Any canned food can be used but most have to be blended with water for it to work in the syringe but Hills AD works without blending. 

Here is a helpful thread on how to do it (http://www.thecatsite.com/t/227858/syringe-feeding-lucky-video-if-your-cat-is-not-eating). And a video:

Oh I also just thought to mention that if your cat is nauseous then cerenia is a wonder drug to treat that and cyproheptadine is great to stimulate appetite. I am not sure if these drugs are safe for kittens but I would for sure ask about them if your kittens vomits again. 

Thanks everyone so much!  - that is kinda what I thought and it's nice to have some support.  I was confused about the vet seeming not to be terribly concerned about the lack of food, and focusing mostly on whether to do more diagnostic procedures.  To me, diagnostic procedures are something you do when a problem is either worsening, immediately life threatening, or not improving after a decent amount of time, and what I really needed was help with conservative management.  I've put in a call and will definitely ask about appetite stimulants.

I think the antibiotics were a shotgun approach to cover both urinary tract and gastrointestinal infections.  I was a bit hesitant about the Augmentin but it seems that he may have responded to the Unasyn so I figured it's worth doing.  Though I will stop it if the vomiting recurs (side effect).  It's possible that there was a urinary tract contamination during the neuter procedure also, even though the vet denied this as a possibility.

A followup:

I took him to the vet for the 3rd time in 3 days - something just wasn't sitting right with me, and I didn't believe the cystitis diagnosis.  The vet (different one) immediately zeroed in on the problem:  obstruction, with severe dilation of the stomach and duodenum to the point where rupture was imminent.  He was rushed to a nearby major animal hospital and underwent surgery last night.  The culprit was a piece of a sock!  Then I remembered my sister had come over and (while I was at work) set up this great little arts and crafts project for her kids making sock puppets.  She almost hit the ceiling when I told her what the surgeons found.  I can't wait until she finds out what the bill is going to be :-).

He is doing very well this morning, eating and happy, and will come home this afternoon.  Lesson learned:  keep a clean house!!!  And, I now have my new favorite vet.  He was wonderful, and had the right clinical instincts.

Wow!  Soooo glad you took him to the vet, the vet figured out what was going on, and you got him the treatment he needed.  Poor guy!  Hope his recovery is problem free and speedy.
 

I am glad you took him back and a different vet knew what was going on.  It is amazing the difference in vets.  I went through 3 questionable ones, the fourth one was good and my kitties still go to her.