Advice please - FIP or not?

Hopefully some of you can help me with your knowledge. We have a 6 month old kitten called Arthur. Early on he was a very active kitten, running around, wrestling with his sister (who is our other cat), very playful. About a month ago we noticed he was getting a bit subdued, and not eating much. After a week we decided to take him to the vet. She took an X-ray, and we found out he was full of.. Wait for it... Sand and grit! I had noticed that sometimes outside he would eat sand, or dirt at the base of trees. In the summer I think he was chasing ants, but even when the ants were gone he kept doing it. I also caught him eating cat litter some times - the clumping type, not good! She also did a complete bloodwork, and his results were perfect. He had no fever.
So she told us to keep him in, and keep him eating, and change his litter (we went for a corn based one) We did this, he seemed to be getting better, but then he seemed to get lethargic again, and didn't want to eat much. So we went back to the vet. No fever, so we were just to keep doing what we were doing, and she gave him a painkiller. But things didn't improve; he was always quite perky after the vet and for the next day or two, then it was back to being lethargic. So next week, back to the vet. This time he had a fever. This time we got 4 days painkiller to give him, and a course of antibiotics. We also got some high fibre food. Back home we went, and things were looking up, he was more playful, chasing his sister etc., and we allowed him outside - supervised. He wasn't interested in eating sand or dirt, and seemed quite happy. But over the next couple of days he started to have trouble jumping. He used to be able to jump 4ft up on to our deck, but now he was struggling to jump on to the sofa seat. He was more playful though, but still not up to full energy.
So today it was back to the vet, about 6 days since the last appt. she did another CBC and it was still fine. She says it's very peculiar, there is no indication of what's causing the problems. He still had a fever, it was 0.3 less than the last time. She thought the jumping problems were because he's not eating enough so he's becoming weak; he is looking thin. So now we have a different antibiotic, some high-calorie food, and our fingers crossed. Today was the first time she mentioned the possibility of FIP, and as a result I've been crying off and on all evening, he is such a lovely cat, if can't bear the idea of losing him so soon.
He's been very sleepy this evening (but I think the vet visit was stressful) but I have managed to get him to eat about 1/5 of a tin of high calorie food, by mixing it with a little warm water.

I've no idea the chances that he has FIP (dry form). It sounds rare, but that doesn't mean he doesn't have it. I would have expected some indication in his bloodwork, it wasn't there. After the sand eating incident, could it be something else? He's also suffering quite badly with teething, his gums are very red.

I'd love your thoughts...

Really..... So the vet takes an X-Ray, sees that he is full of sand and grit then never bothers with a followup X-ray to see if his system cleared it out. If he ate clumping litter it could form a solid rock in his GI tract.

That's what I would check first rather than FIP. Btw, FIP cannot be diagnosed from a regular blood panel. There are specific tests that have to be run for it.

She has thoroughly felt his stomach on each examination... would she be able to feel if there was an issue there? We've to go back on Monday (unless he gets worse) so I may mention the idea of another xray to check how he's doing getting rid of the (stupid!) stuff he ate.

I really hope that's what it is...

Did the vet palpate anything on the first vet visit that prompted the initial x-ray? I certainly don't think it would hurt to do another x-ray.

As for FIP...
What type of blood tests have been done at the vet? Any note of what his Albumin/Globulin levels are? You could have your kitten tested for Coronavirus. BUT, please know that about 90% of cats have been exposed to a coronavirus and testing positive for it does NOT equate a diagnosis of FIP. Less than 5% of cats that test positive for coronavirus will develop FIP. However, if he tests negative, you can pretty much eliminate FIP.

There isn't a test that will tell you if it is FIP or not. You basically have to look at the collective diagnostics (a full blood panel, x-rays, ultrasound, etc...) and rule out other possibilities.

I've had 2 cats develop FIP. The first was 3 1/2 yrs old at onset and he developed the wet form. We had him PTS the day he was diagnosed as his abdomen was full of fluid which was drained and then it proceeded to full back up within hours.

The second was 8 months old at time of diagnosis. She had the dry form. Her initial symptoms were weigh-loss and failure to thrive. We used an experimental treatment with her, though she had a very difficult time gaining any weight (just 0.5 an ounce a week.) Then one weekend I noticed her belly getting larger and she was jaundice. We reran bloodwork the following Tuesday which confirmed she was progressing (prior bloodwork was stable, though it never improved.) At that point we knew she had developed the wet form. We Had her PTS that day...14 weeks after diagnosis.

Thanks for the reply Catpack. Yes I seem to remember she felt something in his stomach, I didn't make the connection to the odd stuff he was eating until she showed us his X-ray.

As for blood tests, I'm afraid I don't know for sure but the first test she did she described as a complete blood test, so I'm presuming it was a full blood panel, whereas as today she just did a CBC. Both times they have been fine - I don't know the values but everything is in the margin it should be (which is why she's a bit mystified).

Your second cat who had the dry form, you said the blood panel was stable, do you mean it looked fine? Or just that it stayed the same, showing an issue? How did you diagnose the dry form?

He hasn't been tested for coronavirus yet, though she mentioned that today, I guess we might do hat next visit, just in the hope it's negative if nothing else.

Her bloodwork was NOT normal. By "stable" I meant it didn't get much worse until the last blood test.

Here is my thread talking about "G." It is mostly pertaining to the initial onset of symptoms and what we did to conclude her diagnosis.
http://www.thecatsite.com/t/273016/urgent-need-input-for-very-sick-kitten

Thanks Catpack, sorry to read about your cat, this is the first pet I've owned as an adult and I'm already distraught, I can't imagine what it would be like to go through real FIP. Sorry for your loss
I'm trying to see the positive in that the bloodwork was normal, and he's not losing weight, he's just not putting any on. I hope I can keep getting him to eat and that will help him get over whatever this is.

An update; he's getting worse, mainly because he's not eating. He seems at his best in the morning, wants to investigate outside, play with his sister, eat a tiny amount of food, but it goes downhill from there. He sleeps all afternoon and evening and doesn't look at all well, 3rd eyelid very visible. We're trying everything food wise and he just won't eat... Although he seems to want to he comes over and sniffs at everything I offer on a spoon (pumpkin, sardine, boiled chicken, high energy cat food, various other cat foods). He will eat a little, but 4 teaspoons a day is not enough for a 6mth kitten
One thing I've found is he wants to eat temptation treats but often can't keep hem in his mouth, either they fall out straight away or when he's chewing. He'll eat one on 3 perhaps.

We're going back to the vet today, for another X-ray and I'm going to insist on some way to get nutrients into him. If he's not eating nothing else really matters, he has no energy to fight off anything! Really hoping the X-ray shows something fixable...

I'm so sorry that your kitty is not well.     It's incredibly frustrating when you know something is wrong, but diagnostics give you nothing. Did he have a urinalysis and fecal test done? How is his elimination (peeing/pooping)? Any talks of an ultrasound? FIP is possible, unfortunately.     Since he's not eating, you could start syringe feeding him for nutrition. For him to continue not to eat would just bring on another problem - hepatic lipidosis (fatty liver disease) cause by not eating.

Hi GoHolistic. He is peeing and pooping OK (not much poop as he's not eating much at all). We haven't had tests done, and there hasn't been any talk of an ultrasound. We were at the vets today and she said that she's pretty certain (as much as she can be) that it's FIP. He's had a fever for over a week now, and it's not being affected in any way by the medications - in fact it was higher today than previously. She also spoke with the other vets in the practice and has done a fair bit of research herself and she thinks that's what it is.

We have some high calorie gel to feed him but he hates the syringe.  I've been crying off and on since she told us her diagnosis... it seems to unfair to have the most wonderful kitten ever and then to lose him. Sometimes he almost seems fine; when we got back from the vet it was snowing (we're in Nova Scotia, first snow of the year). He was really interested so we let him and his sister go out in it and he had a great time, jumping around and chasing falling leaves. I really thought maybe the vet was wrong. But now he's curled up asleep on our bed looking poorly again, 3rd eyelids really visible. It's so frustrating to have him this sick and not to know exactly what's wrong. We're going to syringe feed him over the weekend and see what happens. Maybe he'll perk up, but if he doesn't I think we may have to say goodbye to him next week. I had to stop writing for a minute there because I couldn't see for the tears :-(

We're worried about his sister too, who we also have. Not so much for FIP (although that is a worry) but about how she'll handle him not being there any more. I've no idea if we'll get another cat... maybe, but certainly not soon.

Here's hoping he turns around over the weekend, but if I'm honest I think that's just my heart talking, not my head :-(

A persistent fever that is unresponsive to treatment is one of the more common indicators of FIP.  I'm so, so sorry that you and your little guy are going through this.    I can certainly understand how upset you are. Be sure to give him lots of love. 

I have been reading online about FIP diagnosis and just about every site mentions indicators in the blood panel. He has all these symptoms, but she's always said his bloodwork has been fine. How can his be? The last thing I want is to assume its FIP when actually it's something else.
Someone somewhere needs to develop a test to identify FIP before the cat has died....

I don't ever recall seeing that FIP could be diagnosed from a blood panel. Certainly not a regular blood panel. There may be some extended tests for certain markers that MAY support a diagnosis of FIP but it's usually in combination with clinical observation of symptoms that leads to a confirmed diagnosis.

I am praying that you find the strength you need to get thru this difficult time.

I have been given an interesting route to follow by someone on another FIP forum. They asked if he'd been tested for toxoplasmosis, which he hasn't. I read up about it and the symptoms are almost identical to dry form FIP, along with another couple that he also has. Cats catch it from eating dirt, which he was doing before all this started. So we're going to try and see a different vet tomorrow and get them to do a test to see if that's what it is - if so then it's definitely treatable. Keep your fingers crossed for me and Arthur...

I really hope its not FIP.  I have never even heard of it before until my 6month old kitten Max got sick.  Started as being lethargic, then fever, not much of an appetite, then fluid.  It was about 2 weeks that passed from when I took him to the vet, to when I had to put him to sleep, which was a month ago.  It was the worst thing I have ever done or gone through.  I have had to put a sick cat to sleep before, but there is something about having to put a kitten who hasn't had a chance to live, to become whatever kind of cat he would have become if he had the chance. He went to the vet 3 different times before anyone said anything about FIP, and by then I knew that's what it was...but I was praying it wasn't.  It was when he had the fluid in his abdomen that let me know for sure. I really hope everything turns out well for you.  I know what its like to have a cat who has FIP. It's a terrible disease and they really need to do more about diagnosis...Good luck, and please keep us posted.

I'm very sorry that you are going through this with your guy.  Praying that it is not FIP

Izzi81 said:

 
I have been given an interesting route to follow by someone on another FIP forum. They asked if he'd been tested for toxoplasmosis, which he hasn't. I read up about it and the symptoms are almost identical to dry form FIP, along with another couple that he also has. Cats catch it from eating dirt, which he was doing before all this started. So we're going to try and see a different vet tomorrow and get them to do a test to see if that's what it is - if so then it's definitely treatable. Keep your fingers crossed for me and Arthur...

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This is certainly encouraging news.   It is lucky that you happened to notice him ingesting the dirt so that you could put 2+2 together.   

They recommend to bring a stool sample with you if possible as it will speed diagnosis along.   I know poor Arthur hasnt pooped much lately but maybe there is something in the litterbox left over.

Thanks for the update.   It is amazing how much we can learn from each other.

God bless

So I took Arthur to a different vet for a second opinion. He got the medical record faxed over from the other vet, but certainly didn't use it to guide his diagnosis which I was pleased about. He wasn't sure about toxo - he'd never seen it in a cat - and I didn't manage to bring a fecal sample (poor Arthur hasn't been eating much). So he gave him a thorough exam, did another full blood panel, and I was amazed at what he said. He was 95% sure it's an oral/dental issue. I was stunned. He showed me how his gums were inflamed, and one area in particular that was red and swollen. He showed how he could barely touch the area and Arthur would cry and try to get away. The more he explained, the more it fit Arthur's symptoms.

So he gave me a dose of pills to give him, steroids, and gave him a pain injection. 5 mins after we got back to the house he was rolling around chasing his catnip mouse. The steroid pill has made hi a bit 'wired' I think, as he's not been eating, but I've it seen him this happy for about a month. He's been cuddling, and rolling about, and playing, and purring. The worrisome part was he still wasn't eating or drinking, until about 10 mins ago when he suddenly started eating *a lot*. It's like his appetite turned on (or rather his mouth stopped hurting).

I am... I can't describe how I feel about the first vet. They were very nice, but they basically told us 2 days ago there is no hope for your cat and we're going to have to have a serious talk about putting him down. I think if we'd asked they would have done it then and there. And yet a second vet didn't need any fancy test to decide dental was a major possibility worth checking. He would have died unnecessarily. Granted we can't say for sure we've found the problem, but this is the best I've seen him in quite some time.

On the fever - his fever has never been a high fever; 39.4, 39.6. Today it was 39.3, and the vet said he thought it was stress. The other vet never said it could be stress, even though Arthur was clearly uncomfortable.

The last thing I'd like to say is thanks to you guys for making me question things. If I hadn't gone for a second opinion we wouldn't have hope now...

I am so happy you may have found the source of Arthur's problems! We have a kitten in the rescue right now with "Juvenile Periodontal Disease"...something very similar to stomatitis. We're lucky that even with inflamed gums, this baby still eats a lot!

Here's hoping that with meds on board, Arthur will continue to eat and therefore will regain both weight and energy!

Looks like I may have been happy too soon. He was perfectly fine last night - eating loads of food - even up until 3.30am (my OH was up late). But when I got up this morning he was staggering around, head tilted to the left, he couldn't walk properly. We took him in to the vets and they are now concerned there's something neurological; they're still not saying FIP, mainly because of the dental issues (apparently some of his adult teeth haven't grown in as they should which is odd). They don't know if it's something he's had from birth, or something that's developed; whether it's treatable or not. They were talking about a CT scan, which is $2000-$3000, not something we can afford. It was bad enough not knowing, but now not being able to afford something that might help is even more frustrating.

He is back off the steroids (in case that was part of this new problem) but has some painkillers.

Has anyone heard of this kind of thing? Anyone have any experience of it coming on after a dose of steroid medication? That's the only real thing that's changed... if it wasn't just coincidence.