Sick senior cat ;(

gaberules

TCS Member
Thread starter
Kitten
Joined
Mar 22, 2015
Messages
8
Purraise
1
Hello all,

I'm new here but have gotten such great information from this site.. I figured I'd reach out for some thoughts on my old man.  My cat Gabriel is almost 18, he's been healthy his whole life (thankfully!).  But, he is not doing well these last few days.  He has seen his vet and we get blood work back tomorrow.  Here is what has been going on:

5 days ago I noticed he was stumbling a lot and drunk walking.  Then he was only eating about 1/4 of his normal amount so I brought him to his vet and he said he was stable.  Didn't do blood work because he had it done on 3/1 and everything looked great.  He has had a lump on the side of his neck on and off for a few months.  Mentioned it each time I have been and vet says it doesn't concern him.  About 6 months ago the lump was more long and almost oval shaped and it actually went away.  This time, it feels more rounded.  He has no temperature, is drinking water (sometimes obsessively), and will eat if I hand feed him.  Vet suggested mirtazapine every 72 hours.  He did ok on that, it did make him eat a little bit more but still only about 1/2 of his normal amount.  Vet suggested pain meds, I have some left over buprenex from 3/1 gave him a few doses of that but I don't think he's in pain and he isn't pooping, so, I stopped that. He is peeing normally, perhaps even more than normal (due to all the water he's drinking?).  

Now that it is a few days later, he seems weaker... the most alarming thing is that he goes into such a deep sleep that he doesn't respond to us at all.  Usually he would respond when we touch him with at least a little murmur. He seems to be sleeping very deep/hard.  But perhaps this is due to the meds as he wasn't doing that two days ago?

He is still going to the littler box, drinking water, every few hours he walks around a bit, and every time he is awake, I hand feed him. His breathing and temperature are normal. He is not purring or interacting with us at all, which is devastating as he is usually very vocal and very affectionate. 

Not satisfied with my vets approach, I got in touch with a highly recommended home care vet in my area.  She was great!  She took blood and we get the results tomorrow.  She agreed with checking his thyroid. She is also concerned about the twitching.

It is so hard to see him like this while we wait ;(.  I know he is almost 18, but, with healthy blood work on 3/1.. I don't know... To just take him home to deteriorate without at least running blood work didn't feel right!  I don't want him to suffer, but, I'm also not going to put him down because what if he is just sick?

All the symptoms line up with apathetic hyperthyroidism.  Has anyone experienced this?  

Thanks in advance!

Gabe's mamma

 

betsygee

Just what part of meow don't you understand.
Staff Member
Moderator
Joined
Mar 17, 2013
Messages
28,330
Purraise
17,465
Location
Central Coast CA, USA
Oh boy, I'm sorry.  Things like this are tough--at that age, things can change quickly.  I don't have personal experience with apathetic hyperthyroidism--hopefully someone will come along here who does.  

In the meantime, I'm glad to hear you got a second opinion  and will be getting blood work results tomorrow, that will tell you a lot.  Please let us know what the vet says.
 

samnmag

TCS Member
Young Cat
Joined
May 12, 2014
Messages
89
Purraise
14
I am so sorry Gabe is having a rough time.  I know the older they get the more concerned we get.  You were very wise to get a second opinion.  My heart goes out to you because tomorrow can seem like five months away.  You and Gabe are in my thoughts and prayers.  Please keep us posted and give Gabe a big snuggle for me.   
 

Mother Dragon

Cat slave
Top Cat
Joined
Oct 17, 2006
Messages
1,514
Purraise
7
Location
Suburban Houston, TX
It's also possible that he's become diabetic. Make sure they check his blood sugar. 

My heart aches for both of you. I'm not sure which is worse, knowing or not knowing. Either way, let us know what the bloodwork shows.
 

rosalie sorg

TCS Member
Kitten
Joined
Mar 20, 2015
Messages
11
Purraise
1
I think you have to provide him probiotics and vitamins. The more a living creature gets older, the more it needs more vitamins and nutrients. My cat is almost reaching her older year so I make sure I provide her more vitamins and nutrients. I chose OmNutra Pet Digestive Enzymes to maintain her good health. Hope this one helps.
 
  • Thread Starter Thread Starter
  • #6

gaberules

TCS Member
Thread starter
Kitten
Joined
Mar 22, 2015
Messages
8
Purraise
1
Thank you everyone!  It has been a difficult few days but we find out what is going on today.   Vets hunch is that it is neurological as apathetic hyperthyroidism is very rare.  We'll see...
 
  • Thread Starter Thread Starter
  • #7

gaberules

TCS Member
Thread starter
Kitten
Joined
Mar 22, 2015
Messages
8
Purraise
1
Hi everyone, thanks agin for your support!

It turns out Gabe's blood work is very good/normal.  Which is great I suppose but the vet is almost certain it is neurological which is scary.  We started him on prednisone and are hoping that helps. ;(
 

puck

TCS Member
Adult Cat
Joined
Mar 8, 2015
Messages
205
Purraise
153
Location
North Carolina, USA
The stumbling he was initially seen for can be due to ataxia or lethargy, symptoms of a deeper seated cause. Not necessarily neurological based on normal bloodwork, as that doesn't rule out other possibilities.

When he had bloodwork and Rx buprenorphine 3/1, was that his initial exam for the problem, or unrelated wellness/procedure done 3/1? And it worsened or developed into his reduced appetite and more lethargy by 3/17?

Cats have lymph nodes high and low in their neck, on both sides of the neck. This could be the intermittent swelling you've felt recently. Did either vet discuss aspirating his lymph nodes with you? If centrally located in the neck, thyroid inflammation/mass is ruled out by palpating along trachea during exam; your vet would've recognized this while palpating his lymph nodes during exam. Plus, his bloodwork was normal, making hyperthyroidism improbable now.  If his thyroid values weren't included in the labwork, and hyperthyroid disease is still a possibility, this should be added on to his lab orders. Hyperactivity and ravenous appetite are class signs of hyperthyroid disease.

If his lymph nodes were palpated as normal sized, and not enlarged, during his exam 3/1 and 3/22, the "mass" you've felt should be aspirated to discern if it's cancerous. Ataxia, lethargy, and inappetance can be symptoms of being exposed to/ingesting environmental toxin, neoplasia (cancer), or inflammation along the GI tract/endocrine system; all possible despite normal blood chemistry/CBC. Since no fever, and normal bloodwork, infection is unlikely; not impossible though.

Other than buprenorphine, has he had other meds, including monthly meds, when his symptoms started? It's not uncommon for geriatric cats to develop sensitivities to meds they've previously tolerated, even benefited from for years in the past.

After reporting the normal bloodwork results, your new vet likely has a list of diagnostics to help rule out the cause of his symptoms. A fine needle aspirate of the mass or lymph node is a good second step. Ultrasound would be good also, if the aspirate cells are normal, to rule out inflammation of organs, tumor growth, abdominal fluid wave, etc. These are all possibilities even with normal bloodwork. She can guide you to the next step. If all her rule outs include only diseases or conditions with poor prognoses and worsening condition, at least you will have that much information to help make decisions about continuing diagnostics to find the answer, treating his symptoms empirically without exact diagnosis, or electing euthanasia in the face of unlikely recovery/further deterioration.

Meanwhile, with buprenorphine on board, at least you know you're managing any pain while he's coping with weakness and diminished appetite. Some of the possible diagnoses can cause pain, and being less active and less hungry are symptoms of pain, be it due to a mass, inflammation, or other cause. Steroids will help with symptoms of cancer, decreasing inflammation, improving appetite, and helping ease pain also; used carefully in older cats, ensuring their hearts are healthy prior to starting. Prednisolone has the best absorption with cats, aptly dubbed Vitamin P (as is prednisone for dogs) for its restorative effects as part of palliative care in vet med.

Sometimes once lymph nodes/mass swelling is decreased on steroids, interimmitent repeat of the Rx can keep it small and minimize cancer's effect on nerves, appetite, and energy level. Hope Gabe responds well to his Vitamin P!
 
Last edited:
  • Thread Starter Thread Starter
  • #9

gaberules

TCS Member
Thread starter
Kitten
Joined
Mar 22, 2015
Messages
8
Purraise
1
Thank you puck!

on 3/1 we took him to emergency vet because he was crying in pain and was sitting weird (kind of crunched over).  We thought he hurt his back or something.  The vet there had no answers, blood work was good and his back seemed tender.  So , we gave him the bupronex for a few days and he was fine after 2 days of rest.  We stopped the bupronex.

The new symptoms started last week.  Stumbling walk, walking around crying, not eating.  Twitching/jerking more than in the past.

He was not on any other meds other than the addition of miralax (he's been constipated on and off for the last few months).  He did great with it.  He is indoor, and I don't think he got into anything.  He doesn't snoop around and get into things.. he never really has even when he was a kitten.  

The doc did not suggest aspirating the mass.  I will talk to her about that, thank you so much!!!
 
  • Thread Starter Thread Starter
  • #10

gaberules

TCS Member
Thread starter
Kitten
Joined
Mar 22, 2015
Messages
8
Purraise
1
Also, I realized I forgot to mention in my original post.. we do know he has a mass on his liver but he has not had any symptoms with that (other than what has been going on recently). Doc does not know if it is related and did not suggest further diagnostics with that.  We don't know if it is benign or not.
 
Top