So worried about my kitty, five vet visits later and now concerned about FIP

aspendaisybelle

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My first post, and I wish it wasn't such a desperate one. I am really hoping some kind souls out there could lend their expertise and advice. Please bear with me, this will be a lengthy post but I just want to give as much information as possible in the hope of receiving the most informed and accurate advice in return.

Daisy is a British Shorthair, about to turn three later this month. She came from one of the most reputable breeders in Beijing, and I got her when she was five months old. When she came home, she had ringworm and also tested positive for the coronavirus after I took her to the vet for a bout of diarrhea. 

Other than those initial issues, Daisy has been a fairly healthy cat for most of her life. She'll have soft-ish stools every now and then, and a couple of instances of slightly bloody/mucus-covered stools, but it always stopped before I could get a sample or take her to the vet. 

In June 2013, my fiance and I relocated from Beijing to Singapore. Part of the reason was because we wanted eventually to move back to Australia (where I am from) and the only way we could take Daisy under the current quarantine rules is via a six-month period in Singapore. So Daisy arrived in Singapore in June, did a month on quarantine, and happily came home to our new apartment. Between the months of June to December, she had no health issues.

In mid-December, she was treated for a case of conjunctivitis. Maxitrol eyedrops cleared up the problem within a couple of days. Then at the end of December, she had the first flare-up of what would become a repeated issue. It starts with her incessantly licking her hindquarters - her bottom, the underside of her tail, and the surrounding area. It got to the point where the skin became swollen and inflamed, and the fur turned yellow. The vet said it was likely an allergic reaction to any number of things, or an anal gland issue. He expressed her anal glands, but said there wasn't actually that much in there. He put her on a course of Clavamox and gave her a Dexafort injection. That cleared up within a few days, and Daisy was right as rain. 

In February, under the strong recommendation of our cat sitters, we started Daisy on a half-raw diet. Previously, she'd been on a combination of good dry food (Royal Canin and Wellness) and a number of different wet foods (Applaws, Addiction, Merrick Purrfect Bistro, and the occasional Fancy Feast/Dine). We started her on hormone-free chicken breast, frozen for three days and then defrosted the night before. The vet has since told us that this could have been a source of bacteria, especially given the warm weather in Singapore and the fact that she doesn't always finish her meal in one go. We stopped the raw diet entirely towards the end of March.

In early March, Daisy's bottom issue returned. The vet gave her another Dexafort jab, prescribed a course of Metronidazole, which helped for a few days. He also started her on a course of Drontal in case it was a worms/parasitic issue (1.5 tablets every two weeks, which she has now completed). At this point, I also started her on Revolution again (stupidly, thinking she was an indoor cat, I'd stopped giving her deworming/parasite treatment for nine months). He recommended using the Epi-Smoothe Shampoo once a week, which seemed to help somewhat for a while. At this time, he tested her for FIV/FELV which turned out negative. 

We were away between March 23-26, and during that time the cat sitters advised that they were finding a yellowish residue when they wiped Daisy's behind after going to the toilet. It had small dark specks on it too. When we got back to Singapore, Daisy quickly fell back into the constant licking, and her behind was looking very sore. 

This is where the nightmare of vet visits and uncertain diagnosis starts. 

In the afternoon of Sunday March 30th, I took Daisy in to the vet, after making an appointment with one of the most senior vets in the hope of getting another opinion on her bottom inflammation. He once again said it was likely an allergy, and advised us to change to the Hills Prescription Z/D dry food, gave her a steroid injection for relief, and another course of Clavamox. He gave her a heartworm test upon my insistence (there are major mosquito issues in Singapore), which was negative. He also gave her the Fel-O-Vax vaccination, for which she was out of date.

The following evening (Monday), Daisy started getting diarrhea, very much liquid. The vet said I could bring her back in, for a complete blood test and fecal analysis. The blood test was normal for everything, and the fecal smear showed no indication of parasites. Again, he said it could have been something from the raw chicken. The vet put her on Metronidazone Syrup for the diarrhea, plus Ranitidine Syrup and Benebac probiotics for her tummy. 

Over the next couple of days, we really struggled to give her the medication (Clavamox tablet, Metro and Ranitidine Syrup, probiotics two hours later). It seemed to really traumatise her, and our apartment was covered in cat drool from her reaction. Whether it was because of the difficulty of getting the Metro down or otherwise, her diarrhea did not improve. 

On Thursday morning (3rd), I woke up to two piles of vomit - one on my slippers (looked like there was quite a bit of saliva) and another on the bathroom mat (a couple of small furballs, but it didn't resemble the solid furball vomits she had done in the past). Worried, we took her back to the vet straight away. She did a bunch of other tests - pancreatic snap test came back negative, her blood glucose and T4/Cholestrol came back normal as well. She gave her some shots (Cerenia, Metomide, Ranitidine) and prescribed Metro tablets for Daisy, as well as Baytril tablets. They had a lot of trouble getting a vein, ended up shaving her neck (and nicking her in the process) and using the jugular. It was a very traumatic experience for her. 

When I got home that afternoon, I noticed Daisy was experiencing very irregular breathing (up to 60-70 breaths per minute). I took her back to the vet that same evening to see the vet that seemed most popular with their clients. He listened to her heart, which he said was a bit muffled, and decided that warranted an x-ray. That showed nothing - no fluid in the lungs, or congestion in the heart. He put her on a different type of probiotic, LactoGold, to help firm up her stools, and said that the breathing could have just been due to stress.

On Friday morning (4th), I woke to a frightening sight of Daisy having trouble walking. She could still walk, but her movements were laboured and she would occasionally stumble. The previous night, she had tried to jump on the coffee table and failed. That morning, she had difficulty getting onto a box that she usually liked sleeping on (about the size of a small step). She would walk a couple of steps, and then have to lie down. She was still eating and drinking fine though, having had a full meal the night before. Her eyes, her gaze - it didn't look right. Her eyes were listless and hooded.

I took her back to the vet AGAIN. They were initially concerned about the possibility of a blood clot, but the vet ruled that out after confirming a pulse in both her legs. He also made her walk around a bit, and she actually seemed to improve - definitely looked more alert and mobile, perhaps because of the adrenalin. 

At this point, the vet very honestly told me that he was a bit stumped, and that the best course would be for me to either hospitalise her with fluids, or take her home and monitor her. He thought the latter might be better, because keeping her in hospital would add to her stress levels. He was encouraged by the fact that she was still eating and drinking well. He also said I could stop giving her all the other drugs except the Metro, if it was too stressful for her. 

So I took her home, and it's now Saturday night. She spent most of yesterday seeking out and sleeping in dark places, under my bed etc. Foaming at the sight of me, presumably a psychological response to thinking I would give her medication. In the evening, she seemed to improve a little - I managed to play with her with her favourite mouse-on-a-string toy, and she ate half a can of wet food. She slept in the lid of a box (her favourite thing, even though she's too big for it) and I heard her getting up to chomp on dry food throughout the night. This morning, she jumped up on the sofa (where I had slept to keep an eye on her), and her eyes looked bright and normal again. She seemed to have a good appetite, eating wet food and then continuing to snack on dry food throughout the day. She also started to groom herself again this afternoon, and her breathing back to normal (between 25-30 at rest). She's moving around and walking as per normal, albeit a little slower and weaker than when she's at full health.

HOWEVER, I have noticed that a) her diarrhea is still happening and b) she is drinking a lot. She would maybe visit the water bowl once every 20 minutes (with some longer periods in between if she's napping). She'd paw at the surface before drinking. Initially, she'd go to the litter box and do a tiny little pee - about a quarter of the size of the clump she usually makes when she's urinating. And for the past 2-3 times, she's gone into the litter box, pawed around but never manages to produce any urine. In the meantime, she's gotten sleepy and lethargic again, after coming out and eating her dinner.

I called the vet this morning to report the new drinking/urinating symptom, and he said that normally it would be diabetes or kidney issues - but her tests seemed to rule out all that. He said it could just be because she's dehydrated by the diarrhea and fever (she's had a slight temperature for the past few days, but her ears are now cool).

When I asked whether we could rule out FIP, the vet said I should keep it "at the back of your mind"...which is incredibly distressing. If she has it, I guess it would be the dry form...because the x-ray didn't show up any liquid in her abdomen. I'm also worried that the stress of multiple visits to the vet could have brought on the FIP...I'm kicking myself for not restraining myself from taking her all those times this past week, especially when it hasn't seemed to help her symptoms at all.

Can anyone shed any light on what might be wrong with my sweet Daisy? Could it just be a serious case of gastro? Or should I brace myself for something more sinister? I have spent the past two days bawling my eyes out, we have been through so much to get her to Singapore and I just can't even fathom the idea of losing her now.
 

stephanietx

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I'm so sorry you and your girl are going through this!  It sounds like a couple of things are going on to me.  First the diarrhea issue could be directly related to food or to a parasite such as tritrich.  Has she been tested for tritrichomonas foetus?  http://www.highgait.com/page/page/3485008.htm   It could also be that she has developed an intolerance to one of the ingredients in the food you were feeding her, or you changed her diet too quickly.  I don't know if you can get it where you live, but ask the vet for something that's gentle on the tummy or for sensitive stomachs.  I give my kitty Royal Canin Gastrointestinal HE, a dry food.  (He also gets grain-free canned food, too.)

Secondly, the foaming and all that other stuff that's recently developed, sounds like a reaction to the vaccine.  While reactions are rare, they do happen.  Call the vet and ask what the treatment is for the reaction. 

Just my thoughts and I hope it helps.  Again, I'm so sorry you're going through this with your kitty.  Hope she pulls through!
 

stephenq

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With regard to the diarrhea the most striking thing to me is the diet. Z/D is a hydrolized protein diet that has a reputation for causing very bad diarrhea in some cats. I know this because my cat has inflammatory bowel disease and we were told to put him on ZD with the warning that it might cause bad diarrhea. Which is exactly what it did. It took 2 weeks on W/D food (has a lot of fiber that absorbs water) along with 3 different Antibiotics and a probiotic to get him back in balance.

So if he was on Z/D I would talk to your vet about stopping this, and putting him on a gentle food like WD, probiotics, and possibly some antibiotic to get her bowels back in balance.

Your cat has had so many treatments that it might even be possible that the treatments are partly responsible, lots of antibiotics can cause an inbalance of intestinal bacteria.

Next, have you ever talked to your vet about IBD (inflammatory bowel)? Chronic diarrhea and bloody mucous in diarrhea when absent a different diagnosis is symptomatic for IBD. it sounds like your vet might even suspect this because trying ZD is one way of dealing with this.

Generally the most effective treatment for IBD is prednisolone which works to reduce inflammation in the intestines. A bad case of IBD is when the cat starts loosing weight, so if your cats weight is stable that is something to consider. Diet change to a novel protein diet like venison is important too.

At one point your cat was clearly very sick but seems to have bounced back. Cats with FIP don't bounce back as a rule, they just get worse and worse, depending on whether is the wet or dry verizon of the illness..

I have to commend you on your dedication, taking her to Singapore, and all the vet work.
If she is on ZD, this needs to be addressed right away. I still think FIP isn't likely.

Stephen
 
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aspendaisybelle

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I'm so sorry you and your girl are going through this!  It sounds like a couple of things are going on to me.  First the diarrhea issue could be directly related to food or to a parasite such as tritrich.  Has she been tested for tritrichomonas foetus?  http://www.highgait.com/page/page/3485008.htm   It could also be that she has developed an intolerance to one of the ingredients in the food you were feeding her, or you changed her diet too quickly.  I don't know if you can get it where you live, but ask the vet for something that's gentle on the tummy or for sensitive stomachs.  I give my kitty Royal Canin Gastrointestinal HE, a dry food.  (He also gets grain-free canned food, too.)

Secondly, the foaming and all that other stuff that's recently developed, sounds like a reaction to the vaccine.  While reactions are rare, they do happen.  Call the vet and ask what the treatment is for the reaction. 

Just my thoughts and I hope it helps.  Again, I'm so sorry you're going through this with your kitty.  Hope she pulls through!
I'm not sure which parasites she has been tested for, the vet just looked at her stool sample under a microscope and said he didn't see anything. He also said that because she's on Drontal and Revolution, even if the cause was worms/parasites, it should have been dealt with by now.

I also thought the foaming, slight ataxia, vomiting was as a result of the vaccine...but the vaccine was given on Sunday afternoon and some of those symptoms only started showing up later in the week. I thought any vaccine side effect would be within the first 24 hours?

Thanks for your kind thoughts x
 
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aspendaisybelle

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Thanks for your replies. I just tried to answer them, quoting the original reply, but for some reason it's been flagged for moderation.

Stephanie, I don't know which parasites Daisy was tested for...the vet just examined her stool sample under a microscope and said he didn't see anything of concern. He (and the other vets) also say that given she is on Drontal and Revolution, if it was a parasite or worm that was the cause, it should have been dealt with by now. 

Stephan, thanks for your reply...the weird thing is that she's not even on the Z/D dry food right now, she had a few mouthfuls when she was first prescribed it but has since then avoided it. BUT she has been on the Z/D wet food for the last day or so, I'm guessing it has the same ingredients (although the diarrhea started before the switch to it).

I have always suspected IBD, because of her tendency towards loose stools/occasional bloody stools since she was a kitten. She also seems to have the most efficient digestive tract in the world - most mornings she will literally walk from her food bowl to the litter tray, still chewing as she does her business. It never seemed to bother her, although I thought it was a little odd. 

What I am worried about right now is that she was again a little flat today - when she wasn't eating or drinking or attempting to urinate (which was a lot of the time), she wanted to sleep. She's awake now, having just scoffed some more food and had a bowel movement (still soft, with a small streak of fresh blood - should I be concerned or is this just from the GI irritation that's going on?). Her appetite seems almost ravenous and she's still spending a lot of time at the water bowl, drinking and pawing at the water. A couple of times I've noticed her jerk her head forward (almost like reflux movement, although I'm scared it's neurological) and I can occasionally hear a gassy, burpy kind of noise coming from her stomach and throat.

ALSO - her temperature seems to fluctuate. When she's resting in my bedroom, her ears are cool, borderline cold. When she's in the living room, they become hot again. Is this normal?

After taking her to the vet so many times, I'm now scared I overdid it - it seems to have done her more harm than good. Her skin condition has cleared up, but I really felt like she got worse after each dose of medication. 

She's still walking around a lot, restless, but some of her normal habits are coming back - she played a bit with the mouse again just now, jumped up on the side of the sofa (which she hasn't done for a couple of days) and is now grooming herself. 
 

stephenq

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It's the wet ZD that caused such a bad diarrhea in my cat, not the dry as much. So again I think the ZD Is a suspect here's long with IBD Which is another big suspect. A definitive diagnosis of IBD is eitherd one by endoscopic biopsy or surgical biopsy, there are pros and cons for both.

I would talk to your vets about IBD.

How is her weight? She could benefit from her weight taken regularly to check against a baseline weight. Has she lost weight? You might want to invest in a baby scale to keep track of this. If she starts loosing weight then it's likely to be a progressing IBD that is serious. My cats IBD was stable for many many years, soft stools, some blood and mucous, and occasional bouts of vomiting until last summer when he started loosing weight and then we decided to do a surgical biopsy as we also wanted to rule out small cell intestinal lymphoma which is the other possibility in this situation.

Bloody mucous in soft stools is a classic sign of IBD if you've ruled out parasites which I believe you have.

Also taking her temp by touching her ears isn't reliable. A better way to get her temp is to Go to a drug store and buy a fast reacting (10 second or so) digital thermometer and KY jelly and taking her temp rectally. YouTube videos or your vet can show you how to do this safely and easily, it's actually quite easy especially if you have one person to hold her while you do this.

So to summarize:
- ZD wet, an issue even if diarrhea preceded it.
- IBD Should be discussed with vet.
- baby scale for weight
- digital thermometer for temp.

And you might want to get a new vet, maybe an ingernal medicine specialist to review the entire situation with fresh eyes.

Stephen
 

stephanietx

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TF needs a special test; it can't be diagnosed by looking under a microscope like regular parasites. 

I'm glad you're here to have others to "talk through" this situation with you.
 
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aspendaisybelle

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It's the wet ZD that caused such a bad diarrhea in my cat, not the dry as much. So again I think the ZD Is a suspect here's long with IBD Which is another big suspect. A definitive diagnosis of IBD is eitherd one by endoscopic biopsy or surgical biopsy, there are pros and cons for both.

I would talk to your vets about IBD.

How is her weight? She could benefit from her weight taken regularly to check against a baseline weight. Has she lost weight? You might want to invest in a baby scale to keep track of this. If she starts loosing weight then it's likely to be a progressing IBD that is serious. My cats IBD was stable for many many years, soft stools, some blood and mucous, and occasional bouts of vomiting until last summer when he started loosing weight and then we decided to do a surgical biopsy as we also wanted to rule out small cell intestinal lymphoma which is the other possibility in this situation.

Bloody mucous in soft stools is a classic sign of IBD if you've ruled out parasites which I believe you have.

Also taking her temp by touching her ears isn't reliable. A better way to get her temp is to Go to a drug store and buy a fast reacting (10 second or so) digital thermometer and KY jelly and taking her temp rectally. YouTube videos or your vet can show you how to do this safely and easily, it's actually quite easy especially if you have one person to hold her while you do this.

So to summarize:
- ZD wet, an issue even if diarrhea preceded it.
- IBD Should be discussed with vet.
- baby scale for weight
- digital thermometer for temp.

And you might want to get a new vet, maybe an ingernal medicine specialist to review the entire situation with fresh eyes.

Stephen
Just a little update on Daisy, the superstitious part of me daren't hope that she's improving, but I can cautiously say her condition seems to be looking better right now. Last night she played a bit with me, and when my fiance came home, she was waiting for her usual energetic playtime with him. Jumping about and chasing after the mouse on a string. Even after we went to bed (it was 3AM), she was meowing and pawing at the mouse (her usual middle-of-the-night routine when she feels she hasn't had enough playtime). 

I've stopped feeding her the wet Z/D and also taken away her dry food (read somewhere on the site that it could be making her drink more). So far today, she's urinated twice (8:30AM and 2PM, about small golf ball sized clumps) AND had her first semi-solid bowel movement in almost a week (no blood, it's not exactly solid, but is starting to look more like a formed piece of poop - TMI I know, but I was so excited to see this). And she's only gone to the water bowl once to drink, at 10:30AM (it's now 5PM). I'm wondering what it could be - the diminished impact of the three different antibiotics on her little body, the improvement in her diarrhea and therefore dehydration, or the removal of the dry food. 

But of course like any other neurotic cat parent, I'm on the lookout for other symptoms. Her tummy looks a bit puffy, but feeling it I can't tell if it's fluid or just gas from the gastro she's had (there's still a bit of gas passing when she goes to poop). She had an x-ray three days ago that didn't show any fluids in her abdomen or lungs, so surely it couldn't have started accumulating during that time? The skin around her belly is still pretty floppy (the way it's been since her spaying). 

I've also taken her temp - took your advice and got a digital thermometer - but it keeps coming up with different numbers. First 37.7 C, then 37.6 and then 37.4 just minutes apart (rectal). I tried her underarm and it came up as 37.4 as well. That places her as a bit under the normal range, doesn't it? My vet said the norm is between 38.5 and 39.6? How accurate are these digital thingies anyway? I hope I did it right, I just slid in the silver part (the rest being rubber). She was pretty good about it all.

Her breathing is at about 27 breaths per minute at rest. I tried to take her pulse too, but can't seem to find it under all the furriness...

The one other thing I am a little concerned about is her eyes - her third eyelid is showing. When she's looking straight at me, it's just a sliver in the inside corner of her eye - just a thin line. When she looks up, or left or right, I can see a sliver of white on the outside edge of her eye. Should this be a concern, or is it just a symptom of her recovering diarrhea/dehydration?

Thanks guys. I really wish I'd found this site earlier, I can't believe the wealth of knowledge, experience and support here. I'm going to look for a feline vet but honestly, finding even a decent vet in Singapore is a struggle. There are several well-known clinics in this city that have an easy-kill policy, and I am far too paranoid to take Daisy there in case they just don't want to work hard enough to find a treatment for her. I have spent so many of the past few days in uncontrollable tears, praying, plaintively negotiating with God on what I would give up for her to be healthy again (i.e., pretty much everything).

It has been such a journey getting her to Singapore, and I've been wracked with guilt at the idea that the stress of flying, quarantine, adapting to a new home (albeit this was nine months ago) might have triggered an FIP mutation. I'm also concerned about the repercussions of relocating her again to Australia sometime in the near future. I was never advised by her previous pet that FIP could be brought on by stress, otherwise I may well have considered rehoming her in Beijing. As much as that would have broken my heart, I would do anything that meant that she gets to enjoy the long and happy life that she so deserves. I have had the privilege of sharing the lives of many cats over the years - happy cats, clever cats, neurotic cats, chatty cats - and she is by far the sweetest, most emotionally-intuitive feline I've ever known. When I first got her, she walked into the apartment and hopped straight up onto the sofa next to me. She came up to my face, placed her arms around my neck and nuzzled me. I had spent all of half an hour with her at the breeder, but it was as though she knew "I am yours, and you are mine. We've finally found each other." I have never had a moment like this with any other animal (and to be honest, not many humans). Since then she's saved me from a gas leak (came howling upstairs, and led me downstairs to the kitchen where she growled and frowned and meowed until I realised it smelt funny), and banged on the bathroom door until my then-boyfriend came upstairs and realised I'd fainted. She is so full of goodness and sweetness, she is so loved, and I just hope the universe can be fair for once and allow her to stay with us until a grand old age. 

I'm sorry for the long, emotional spiel...it's been a horrible, scary few days and I'm still right on the edge of desperation.  
 

stephanietx

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I've stopped feeding her the wet Z/D and also taken away her dry food (read somewhere on the site that it could be making her drink more). So far today, she's urinated twice (8:30AM and 2PM, about small golf ball sized clumps) AND had her first semi-solid bowel movement in almost a week (no blood, it's not exactly solid, but is starting to look more like a formed piece of poop - TMI I know, but I was so excited to see this). And she's only gone to the water bowl once to drink, at 10:30AM (it's now 5PM). I'm wondering what it could be - the diminished impact of the three different antibiotics on her little body, the improvement in her diarrhea and therefore dehydration, or the removal of the dry food. 
The change in drinking is probably a combination of all 3 things.  Cats who are on a mainly wet food diet generally consume less water because of the higher water content in the wet food.  Also, with her stools firming up, that cuts down on the dehydration which means less water intake.  As for celebrating more normal poopies, we totally understand!!  We've all celebrated a tootsie roll looking stool as well as been on poop patrol following diarrhea or possible ingestion of a foreign object, like toy parts, plastic bags, and other various objects. 
 

One thing to remember, she will pick up on your stress, so try not to be too stressed out.  I know that's much easier said than done, but give her time to recover and recuperate.  When it's time to move back to Australia, talk to the vet about a sedative and be sure she travels in the cab with you.  Don't let her be put in cargo.  I don't know if it's available to you in Beijing, but there are a couple of anti-stress products available that are very effective, Rescue Remedy and Feliway.  Rescue Remedy is a liquid that you can add to food, water, or rub into the ear flaps.  Feliway comes in a diffuser or spray that can be sprayed in/around the carrier or other areas during travel.
 

stephenq

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Hi

I've rad your posts carefully and you are a great mom.  But don't try and be a vet.  I mean this in the nicest way possible.  I think you are starting to over analyze a bit, a little third eyelid here and a tiny bit of distended belly there .....

Normally when taking a temp you would go a little bit past the silver part of the thermometer  and the fact that you got low readings supports this.

I've never heard of an easy-kill facility.  Normally, a vet would never euthanize a pet without the owners permission. Is this not the case in Singapore.

Stress will cause diarrhea i cats, and a very stressed cat will produce pancake style stool.

So i suggest to everything you an to calm her down and give her a stress free time.  Gentle food, and continue to monitor her and consult with vets as needed.

Cats self regulate their water intake so i wouldn't worry about this so much.

It sounds like things are improving.  Hang in there.
 
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