Fluid in lungs in cat, need advice

Hi,

My cat had been wheezing and eating less. I took her to the vet on 4/8 when she was panting hard and had not eaten or drank in 24 hrs. The vet did x-rays and it showed fluid around heart and lungs. The vet drained a blood tinged fluid from her, about 6 oz. They also started Zenequin to treat what they believed to be an infection causing the fluid.

I took my cat home and she ate and drank immediately when we walked in the door. Her behavior was still the same, hiding in the closet or under the bed. Also, she showed indifference to us, just kind of staring at us, not really wanting affection.

Her panting started to get worse on Sunday, 4/12 and she had several wheezing "attacks."  I took her back to the vet on 4/13 and they drained 4 oz of fluid again. They re-did the x-rays and completed an ultrasound. Also they did comprehensive lab work. The ultrasound didn't show any abnormalities in the heart and surrounding areas. The lab work showed her kidney and liver function to be fine and she was negative for any of the common feline viruses. However, her white blood cell count was extremely high. They added Clindamycin in addition to the Zenequin. An appetite stimulant was also prescribed.

The vet also gave us A/D food to help her eat. It is now 4/17 and she isn't doing much better. She still doesn't want to eat, even when I offer it to her by me feeding her. Giving her the meds is a struggle, but we get them in eventually.

Any suggestions of what could be wrong or what I should do next?

hi and welcome to TCS!

i'm so sorry that your girl is having these medical issues. i do think you're doing the best possible thing by working with your vet to treat these issues. the only thing i can think of that might be something to consider would be getting a second opinion, from a different vet. not because your vet isn't handling the diagnosis and treatment well, but because (just like with us humans) it doesn't hurt to have a fresh set of eyes seeing what they might be able to find going on with your girl.

you might want to try some jar baby food for your girl, the stage 1 gerber or beechnut -- the kind that has only the meat (chicken, beef, turkey, or ham), water, and some have a little cornstarch added to it. many cats just love the jar baby food, and it's very easy on the tummy/easy to digest. it's not nutritionally complete for cats, but for a short term use it's fine. i use the jar baby food for my IBD girl when she's having a flare up, and it's gotten her past the flare ups and eating well again many times.

I had a cat with a reaction just like that when he had heartworm and the worm had died and broken up and was being flushed into his lungs.  If your cat goes out, he could have gotten heartworm from a mosquito bite.  They can even get them from mosquitos INSIDE.  The cat is not a natural host so they usually only have one worm and it lives for two years or so without causing problems.  When it dies, however, then it causes problems.  If this IS heartworm and you can just get him through this allergic inflammtory reaction, he will be fine.  My cat didn't make it but a friend's cat with the same thing did.  That's an unlikely but possible diagnosis but you might ask your vet to consider it.  Google heartworm in cats to learn more about it. 

Liz88 said:

 
Hi,

My cat had been wheezing and eating less. I took her to the vet on 4/8 when she was panting hard and had not eaten or drank in 24 hrs. The vet did x-rays and it showed fluid around heart and lungs. The vet drained a blood tinged fluid from her, about 6 oz. They also started Zenequin to treat what they believed to be an infection causing the fluid.

I took my cat home and she ate and drank immediately when we walked in the door. Her behavior was still the same, hiding in the closet or under the bed. Also, she showed indifference to us, just kind of staring at us, not really wanting affection.

Her panting started to get worse on Sunday, 4/12 and she had several wheezing "attacks."  I took her back to the vet on 4/13 and they drained 4 oz of fluid again. They re-did the x-rays and completed an ultrasound. Also they did comprehensive lab work. The ultrasound didn't show any abnormalities in the heart and surrounding areas. The lab work showed her kidney and liver function to be fine and she was negative for any of the common feline viruses. However, her white blood cell count was extremely high. They added Clindamycin in addition to the Zenequin. An appetite stimulant was also prescribed.

The vet also gave us A/D food to help her eat. It is now 4/17 and she isn't doing much better. She still doesn't want to eat, even when I offer it to her by me feeding her. Giving her the meds is a struggle, but we get them in eventually.

Any suggestions of what could be wrong or what I should do next?

Click to expand...

How old is your cat?

Has the vet ruled out congestive heart disease and Feline Infectious Peritonitis?

I adopted her when she was 2 according to the rescue agency. So she would be turning 4 in May. However, the vet indicated that she believed that she was older perhaps 8 or 9 as indicated from the x-rays and her bone health.

The vets are not ruling out congestive heart disease and Feline Infectious Peritonitis but the ultrasound showed that her heart was in fine condition. But otherwise the symptoms are very similar.

What do you think I should do?

I don't want her to suffer and I don't know how long it should take for the medications to make a difference.

oh I'm so sorry... my son's cat who is littermate to ours... was diagnosed through blood tests with hystoplasmosis... a fungal infection they can get from the dirt, especially in the midwest. At first we thought..well that's so unlikely because he lives in Texas...oops... we lived in Ohio when the litter was in the shelter...they were found outside and the hysto can be dormant before acting up. He didn't make it.

My Minnie had fluid "in the chest cavity" ...it was diagnosed as chylothorax... both lost their battles with their conditions... Fingers crossed they find out what's wrong and can treat it... again..so sorry you are dealing with this.

Liz88 said:

 
I adopted her when she was 2 according to the rescue agency. So she would be turning 4 in May. However, the vet indicated that she believed that she was older perhaps 8 or 9 as indicated from the x-rays and her bone health.

The vets are not ruling out congestive heart disease and Feline Infectious Peritonitis but the ultrasound showed that her heart was in fine condition. But otherwise the symptoms are very similar.

What do you think I should do?

I don't want her to suffer and I don't know how long it should take for the medications to make a difference.

Click to expand...

Well if it was me I would work on both symptom relief and diagnosis.  FIP is very rare, but your vet knows what to look for.  An echocardiogram may be needed to diagnose heart issues. The diuretic should work fairly quickly, within a day or so there should be relief.

StephenQ said:

 
Well if it was me I would work on both symptom relief and diagnosis.  FIP is very rare, but your vet knows what to look for.  An echocardiogram may be needed to diagnose heart issues. The diuretic should work fairly quickly, within a day or so there should be relief.

Click to expand...

but was a diuretic even prescribed? i just see 2 antibiotics and an appetite stimulant. 

Took her back to the vet this afternoon. The vet drained 220mL from her. This is the most since we started treatment.

She was prescribed lasix and the vet gave her a dose of steroid.

Hoping this will help her go in the right direction. However, when we got home she still does not want to eat.

detmut said:

 
but was a diuretic even prescribed? i just see 2 antibiotics and an appetite stimulant. 

Click to expand...

You are correct it hadn't been prescribed until now, see the OP's post just above.  Hopefully the Lasix will help her turn a corner as her condition appears serious.

My Tigger had similar to your describing... Put on Zydaclin, 1 ml for being right under 10 lbs.. a/d, h2o by syringe.. Rub him started to purr a lil, BUT still freaking me out..  Then saw another vet at same clinic, WERE faceing a 48 hour put down decision if NO SIGN of improvement(s)..................

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SO he treated Tigger as if he had Meningitis and I took pics of him in my lap on the car ride home... just cast it was our last hours together...  Left a/d food out and plenty of cool water...................... i'd say 5-8 hours later I noticed some SIGNS of HOPE...   The next day a lil better, BY 3rd DAY he was atleast 80% Bettter...

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This was back ON February 11 a WEDNESDAY and by the 13th -----  a FRIDAY....

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SO Recap,....  Did the Zydaclin, x-rays... same... Full blood work...CAME BACK Normal;;;;; . Initially cause Vet THOUGHT he had dry or wet FIPsss?!?

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BUT after STEROIDS and Meningitis Treatment and Water Pockets under the skin...  HE is around and doing great!

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I'll be saying a prayer for you...  I would get to the vet Saturday....   

What was the treatment for meningitis? And water pockets under the skin? Was that part of the treatment?

My cat is refusing to eat the a/d food but i have her the usual wet food she eats to see if she would eat of that and she licked the gravy off. Going to buy some baby food tomorrow to see if she will eat that or perhaps blend her current wet food entirely into a "gravy" since she liked that.

If this is a dead and dissolving heartworm having been flushed into the lungs, the steroid should help as the fluid in the lungs is an allergic reaction to the presence of the heartworm proteins.  The treatment for the cat who survived included steroids an subQ fluids to keep the cat super hydrated and help flush out the remaining heartworm proteins.  It took a little time but the cat gradually improved.  He's fine now.

I asked the vet to send me her lab work today and ultra sound results.

Everything was normal in the lab work except

WBC 21.4  with the range of 3.5-16.0

neutrophils were 19046 with range of 2500-8500

monocytes were 642 with range of 0-600

FIV antibody was negative

FeLV antigen was negative

FCV IFA at 1:400 was less than 1:400

FCV IFA at 1:1600 was negative

Toxoplasma IgG Antibody was negative

Toxoplasma IgM Antibody was negative

ULTRASOUND:

"A moderate amount of mildly echogenic pleural fluid is present. No mediastinal masses are seen. Cranial lung lobes appears partially collapsed. No discrete thoracic masses are observed; however, some amorphous possible abnormal tissue is found in the right hemithorax lateral to the heart (rule-out fat). Average heart rate is ~210 bpm; no rhythm abnormalities are seen. Ventricular measurements are within normal limits; LV fractional shortening is high normal, ~61%. Left atrial and aortic dimensions are within normal limits; normal LA;Ao ratio."

Impressions:

"No evidence of heart failure is found. Mildly echogenic pleural effusion; rule-out neoplastic or inflammatory effusion. Pulmonary atelectasis. Questionable abnormal tissue; rule-out possible poorly defined mass, mesothelioma."

Any comments or suggestions?

She is currently finishing her last Zenequin pill today and she is on Clindamycin and Lasix. She received a small steroid injection on 4/17. Not really eating as much, but she still is drinking.

She rests a lot and not really interested in playing. She has had fluid drained from around her lungs three times. The vet is still unsure of where the fluid is coming from. When they draw the fluid out it is yellowish and blood tinged.

I'm looking for some hope to get her better.

Impressions:

"No evidence of heart failure is found. Mildly echogenic pleural effusion; rule-out neoplastic or inflammatory effusion. Pulmonary atelectasis. Questionable abnormal tissue; rule-out possible poorly defined mass, mesothelioma."

Two possibilities I can think of based on what we know already.  One is still the heartworm theory, and in that case it's an inflammatory effusion.  The "questionable abnormal tissue" COULD be leftover heartworm depending on how large it is or what shape it is, and that would be the cause of the inflammation, an allergic reaction, and if that were so and it was removed (cat heartworms have been sucessfully removed surgically, as it is the only safe way to cure the cat because killing the worm causes trouble.)

The other possibility is one I don't like to consider but only bring up because you said the fluid is "yellow and blood tinged."  FIP produces yellow fluid which is thick and viscous.  It is not usually bloood tinged.  It is usually in the abdomen but occasionally in the pleural cavity (I had one cat who initially presented with that symptom), and she seemed to recover when treated with antibiotics, but over time it progressed to abdominal fluid, loss of appetite and low grade fever, typical of wet FIP.  DRY FIP is more insidious. 

"Respiratory distress may develop when abdominal fluid accumulation is excessive or, more commonly, when accumulation of fluid occurs within the chest cavity, resulting in compression of the lungs. Other signs that may be seen include jaundice (yellowing of the mucous membranes and skin) and a mild anemia (low red blood cell count)." (from maxshouse.com article on FIP). 

The GOOD news is that you said she does NOT have a low red blood cell count.  Also, if the fluid is watery rather than viscous, it's probably not FIP fluid.  There is no way to diagnose FIP with certainty but there are some things your vet can test for that will support or disprove that theory.  If she were to test negative for corona virus, that would rule out FIP.  However, if she were to test positive for it, that would not prove FIP because up to 75% of cats have some form of this virus and it is harmless.  Only when it mutates (like SARS) does it cause disease. 

What I would ask the vet to do is to consider both of these possibilities.  Rule out FIP and rule out heartworm.

Impressions:

"No evidence of heart failure is found. Mildly echogenic pleural effusion; rule-out neoplastic or inflammatory effusion. Pulmonary atelectasis. Questionable abnormal tissue; rule-out possible poorly defined mass, mesothelioma."

All I can add is from my personal experiences with my babies over the years...

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If something anything turns the tables and boggles the VET & you....  Its definitely affecting/compromising the Kitty's' IMMUNE System...

I WOULD recommend getting natural things that help give the IMMUNE system what it needs to naturally fight off this Enemy...

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Keep us posted & i'll say a prayer for your baby..