Very sick kitten - Large abdomen (ascites), high WCC, low RBC, not eating

Hello. My approx 10-11 week old kitten (that was found as a stray) is very unwell. I live in Australia.

He became unwell the day after he received his very first F3 vaccine at a busy vet clinic, sleepy, not eating or drinking, diarrhoea and vomiting. The date of vax was Friday 1st of May. Before the vax, he was fasting because they were going to microchip and desex him too, but didn't in the end because of an undescended teste. He did receive the F3 vax and they gave him some food (which I'm guessing was contaminated). I will never return to that highly publicised vet clinic again.

The next day I took him to a 24 hour vet. They didn't get IV access, so he received 3 loads of peritoneal fluids 87mls (Hatmann's Solution), and was on 10mg Tribrissen daily and 25mg Metronidazole twice daily. The vet suspected he had coccidia. He also had worms which he was treated for and he is no longer passing any in his stools. He had 2 days of very watery and bloody diarrhea when I brought him home on Monday the 4th of May, his weight at this stage was 720gms (when he was previously 900gms before getting sick). His stools were bloody when he was passing the worms/recently passed the worms, they are no longer bloody. He is not eating or drinking (I am orogastric feeding him), he's quite malrourished and skinny. He does sleep a lot but is still relatively alert. It has now been 13 days since he first became unwell. About 4 days ago his abdomen started to get very large, I initially thought it could be wind or constipation due to slow bowels, but it's now evident that it's a build up of fluid (ascites). He does not have any cold symptoms, no coughs, sneezes, nasal discharge. Some difficulty breathing after feeds but I think that's due to his huge belly. He is not vomiting anymore and is having formed stools, but they are a bit mucousy and not normal poos, they look more like half digested food. They don't smell foul or smell like normal stools.

I took him to a different vet (my local) on Monday the 10th. He received about 5 hours of IV fluids (about 30mls in total) and they sent off blood work. His red blood cells are low (likely due to his bloody stools), infant RBC are high (which apparently is a response to his low RBC), high WCC, high infant WCC, normal potassium, normal kidney function, slightly off liver function (which the vet said is common in little kittens), and a very low Albumin (which unfortunately I can't remember the number). I mentioned the possibility of FIP to the vet, but he thinks it's unlikely. The vet thinks it's likely a severe intestinal infection or virus that has caused his body to go into a bit of shut down. The kitten't current weight is 870gms, which is a very large weight gain, that I'm sure almost all of it is in his abdomen. His highest temp was 39.5 celcius on Saturday the 2nd of May, but now he's 38.6 (today).

He is only slightly dehydrated and still relatively alert and active. He has bright eyes and puts up a good fight with some meows when tube feeding him or taking a rectal temperature. He is kept isolated from my other cats in a calm, warm room. 

I am orogastric feeding him a slurry of Hills A/D wet cat food mixed with a bit of water so it passes through the orogastric tube relatively easily. I was feeding him 20mls every 3-4 hours, meaning he would have about 120mls/day. I might drop this volume back a bit now though because the Vet said his maintenance fluids is only about 60mls/day. 

The vet's plan was to introduce 2 more antibiotics - Clavulox (Clavulanic Avic and Amoxycillin) and Baytril (enrofloxacin) both to be given twice daily. We are going back to the vet in 2 days to recheck bloods and see how the kitten is generally going, if there is no improvement and he's not eating by himself, the vet said he'd consider putting him to sleep. I just want to make sure we're covering all bases before we make this decision. The cat does not appear in pain or too much discomfort - he's getting used to his big belly and cannula in his front leg. He is a darling kitten with an incredible nature. 

I asked the vet if they do plasma or albumin infusions and they said not really for cats. The access to plasma is difficult, we'd need to take him to an Animal emergency centre for plasma, and they don't do Albumin infusions. Has anyone here had experience with Albumin? I have access to 4% and 20% human albumin that I could administer with or without IV Furosemide. I've read quite a few articles and although there are limited studies of giving human albumin to cats and dogs, there were limited reactions and the outcomes seemed quite good. I'm considering giving him the 20% Albumin myself as I feel like I'm running out of options and this is my last resort. I have access to sterile equipment. 

Please, please help. 

P.s. Tagging @catwoman707  @StefanZ  @StephenQ as they have helped me wonderfully in the past. 

Oh boy........doesn't sound too good.

13 days of sickness and his lack of eating on his own is no good.

The difficulty in breathing after feedings is due to fluid not only in the tummy, but it gets in the chest as well.

I personally would ask for fluid analysis from his tummy asap. They can also syringe some of it out for comfort.

FIP fluid is high in protein, yellow colored, gets frothy/bubbles when shook, and will show-

• If the gamma globulin fraction in the fluid is greater than 32%, the chances that the cat has FIP are almost 100%.
• If the albumin fraction is greater than 48% or the ratio of albumin to globulin is greater than 0.81, it is almost 100% certain that the cat does NOT have FIP

I have to agree with @catwoman707, it sounds a lot like FIP to me also, and if the fluid is as described, along with the clinical course of his illness, that is pretty much diagnostic of FIP and once they stop eating on their own, the kindest thing is to let them go with love.  It is not at all uncommon in our area and our vets are very good at early diagnosis, but no vet wants to tell you it's FIP if it could possibly be anything else.  Unfortunately, I have had too much experience with it and I usually know, and the vet just confirms it with a belly tap.  The belly fluid does not cause them pain, but it is a sign the disease is attacking the organs.

Thank you for the replies. Could the FIP have been caused when he received the peritoneal fluids from the 24 hour vet? I know that Vet didn't use glucose/dextrose, just Hartmann's solution, as he said Glucose can cause peritonitis. But now I'm thinking that the intraperitoneal access for the fluids may have caused an infection, thus potentially leading to the potential FIP. 

This is so heartbreaking  

The only cause of fip is exposure to the very common coronavirus, and although most does not, it can mutate in to fip.  It's a simple and mild virus, often times an owner will not know that their cat has been exposed as the symptoms can be basically invisible.

Kitty might not seem to feel well for a day, a bit under the weather type thing, sometimes it will look like a little cold.

But if the kitten has a negative titer test then he was never exposed. If it tests positive, then he was exposed, and with his symptoms I would conclude it is fip, despite the fact that a positive titer for coronavirus exposure is not in any way a diagnosis for fip, his symptoms being as they are, would speak loud and clear that it is fip.

Same with the belly fluid testing, high protein levels, yellow fluid in indicative of fip.

Poor baby. 

As I said prior, I would get the tummy fluid tested asap so you know.

snoph said:

 
Hello. My approx 10-11 week old kitten (that was found as a stray) is very unwell. I live in Australia.

He became unwell the day after he received his very first F3 vaccine at a busy vet clinic, sleepy, not eating or drinking, diarrhoea and vomiting. The date of vax was Friday 1st of May. Before the vax, he was fasting because they were going to microchip and desex him too, but didn't in the end because of an undescended teste. He did receive the F3 vax and they gave him some food (which I'm guessing was contaminated). I will never return to that highly publicised vet clinic again.

The next day I took him to a 24 hour vet. They didn't get IV access, so he received 3 loads of peritoneal fluids 87mls (Hatmann's Solution), and was on 10mg Tribrissen daily and 25mg Metronidazole twice daily. The vet suspected he had coccidia. He also had worms which he was treated for and he is no longer passing any in his stools. He had 2 days of very watery and bloody diarrhea when I brought him home on Monday the 4th of May, his weight at this stage was 720gms (when he was previously 900gms before getting sick). His stools were bloody when he was passing the worms/recently passed the worms, they are no longer bloody. He is not eating or drinking (I am orogastric feeding him), he's quite malrourished and skinny. He does sleep a lot but is still relatively alert. It has now been 13 days since he first became unwell. About 4 days ago his abdomen started to get very large, I initially thought it could be wind or constipation due to slow bowels, but it's now evident that it's a build up of fluid (ascites). He does not have any cold symptoms, no coughs, sneezes, nasal discharge. Some difficulty breathing after feeds but I think that's due to his huge belly. He is not vomiting anymore and is having formed stools, but they are a bit mucousy and not normal poos, they look more like half digested food. They don't smell foul or smell like normal stools.

I took him to a different vet (my local) on Monday the 10th. He received about 5 hours of IV fluids (about 30mls in total) and they sent off blood work. His red blood cells are low (likely due to his bloody stools), infant RBC are high (which apparently is a response to his low RBC), high WCC, high infant WCC, normal potassium, normal kidney function, slightly off liver function (which the vet said is common in little kittens), and a very low Albumin (which unfortunately I can't remember the number). I mentioned the possibility of FIP to the vet, but he thinks it's unlikely. The vet thinks it's likely a severe intestinal infection or virus that has caused his body to go into a bit of shut down. The kitten't current weight is 870gms, which is a very large weight gain, that I'm sure almost all of it is in his abdomen. His highest temp was 39.5 celcius on Saturday the 2nd of May, but now he's 38.6 (today).

He is only slightly dehydrated and still relatively alert and active. He has bright eyes and puts up a good fight with some meows when tube feeding him or taking a rectal temperature. He is kept isolated from my other cats in a calm, warm room. 

I am orogastric feeding him a slurry of Hills A/D wet cat food mixed with a bit of water so it passes through the orogastric tube relatively easily. I was feeding him 20mls every 3-4 hours, meaning he would have about 120mls/day. I might drop this volume back a bit now though because the Vet said his maintenance fluids is only about 60mls/day. 

The vet's plan was to introduce 2 more antibiotics - Clavulox (Clavulanic Avic and Amoxycillin) and Baytril (enrofloxacin) both to be given twice daily. We are going back to the vet in 2 days to recheck bloods and see how the kitten is generally going, if there is no improvement and he's not eating by himself, the vet said he'd consider putting him to sleep. I just want to make sure we're covering all bases before we make this decision. The cat does not appear in pain or too much discomfort - he's getting used to his big belly and cannula in his front leg. He is a darling kitten with an incredible nature. 

I asked the vet if they do plasma or albumin infusions and they said not really for cats. The access to plasma is difficult, we'd need to take him to an Animal emergency centre for plasma, and they don't do Albumin infusions. Has anyone here had experience with Albumin? I have access to 4% and 20% human albumin that I could administer with or without IV Furosemide. I've read quite a few articles and although there are limited studies of giving human albumin to cats and dogs, there were limited reactions and the outcomes seemed quite good. I'm considering giving him the 20% Albumin myself as I feel like I'm running out of options and this is my last resort. I have access to sterile equipment. 

Please, please help. 

P.s. Tagging @catwoman707  @StefanZ  @StephenQ as they have helped me wonderfully in the past. 

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Tx for calling me in.   I dont have much deep medical knowledge, so I wont say more than is said already.

I do have some common care advices, thought.

1. If you can get raw goat milk, try with this.  Cant hurt, may help.  Possibly other type of raw unpasteurized milk are useful and good too, but me dont having sure knowledge, I cant wholeheartly recommend them.  Goat milk is safe, and raw goat milk is useful - not seldom used as the main treatment in many cases, both for cats and other severly sick cat animals alike lions.

2.  Some form of  a good probiotic may be useful, as he gets lotsa of antibiotics, which prob play havoc with his intestines and the bacteria flora there.  BeneBac, S Belouardii  are prob the two best.

3.  As he seems to protest to rectal temp, and it must stress him extra, you can use some other ways to take temp.  Best and easiest if you have such a modern ear termometer.

Be sure to calibrate it, though, as it prob shows a different, lower temp than rectal.

The alternative is to take it in the armpit of the foreleg. Pretend this is a new game!  Works quite nice, not so entirely reliable as the rectal, but gives good feeling of the tendencies.

The temp in armpit is somewhat lower than rectal - about 1C lower, or 2-3F lower.

I wish you and this kitten Good  luck!

Please, please help. 

P.s. Tagging @catwoman707  @StefanZ  @StephenQ as they have helped me wonderfully in the past. 

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Hi I'm sorry being late to this, but i agree with all the above.  It sounds very serious, I too would tap some of the fluid, both for kitten's comfort and for diagnosis of possible FIP.  I wish I could offer more.

Hello @catwoman707  @StefanZ  @StephenQ  and @Red Top Rescue  Thank you all so, so much for your kind time and responses. Can you believe that today of all day's, my darling kitten has taken a huge turn for the better! His abdomen, though still just a little bit swollen, is much softer to touch and not nearly as huge as it was. The kitten has so much energy, walking around his room and meowing up a storm. We offered him some food and HE ATE IT! He hasn't eaten in 13 days! He was much more content with less meows after his food. 

I think cutting back his orogastric fluids has made a great difference. I think I may have been giving too much fluid initially, which may have been causing too much stress on his body to absorb/digest, and maybe leading to some sort of fluid shift? I also think the new antibiotics are making a huge difference. 

Anyway, I'm aware the kitten is still not out of the woods yet, but I'm trying to take this as positively as I can, because I've had a couple of months of heartbreak for various reasons.

I'll keep you updated on his progress - keep the little guy in your thoughts  

snoph said:

 
Hello @catwoman707  @StefanZ  @StephenQ  and @Red Top Rescue  Thank you all so, so much for your kind time and responses. Can you believe that today of all day's, my darling kitten has taken a huge turn for the better! His abdomen, though still just a little bit swollen, is much softer to touch and not nearly as huge as it was. The kitten has so much energy, walking around his room and meowing up a storm. We offered him some food and HE ATE IT! He hasn't eaten in 13 days! He was much more content with less meows after his food. 

I think cutting back his orogastric fluids has made a great difference. I think I may have been giving too much fluid initially, which may have been causing too much stress on his body to absorb/digest, and maybe leading to some sort of fluid shift? I also think the new antibiotics are making a huge difference. 

Anyway, I'm aware the kitten is still not out of the woods yet, but I'm trying to take this as positively as I can, because I've had a couple of months of heartbreak for various reasons.

I'll keep you updated on his progress - keep the little guy in your thoughts  

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This is wonderful news, we were all really worried for you and your kitten.  A turn around like this suggests it is not FIP which is great news, and thanks to your intervention and an obviously excellent and caring vet, you are winning the battle on whatever it was that could easily have taken your kitten's life.  Keep going!!!!  Keep us updated please, i'm so happy for you!

Wow, that's an amazing turnaround! It's a testament to your good care. I hope he keeps on surprising us all!

Of course we all feel relieved with this news!!

Just remember to consider him in a guarded state, one short period or one day after 13 bad days is not necessarily meant to say he is on the road to recovery, but a light of hope compared to the grim outlook it was just before this day.

Even as awful as fip is, I've seen kittens have 'up' times too, almost as a last ditch effort for normalcy and get some of that repressed spunk out of them!

He has lost alot of weight, and not eating on his own for 2 weeks is pretty substantial for an 11 week old.

Definitely not wanted to bring you down either, just a reminder not to be too confident that by tonight he won't show some of the old signs again.

Let's all hope not!!!  Wouldn't that be the best?!!                     

catwoman707 said:

 
Of course we all feel relieved with this news!!

Just remember to consider him in a guarded state, one short period or one day after 13 bad days is not necessarily meant to say he is on the road to recovery, but a light of hope compared to the grim outlook it was just before this day.

Even as awful as fip is, I've seen kittens have 'up' times too, almost as a last ditch effort for normalcy and get some of that repressed spunk out of them!

He has lost alot of weight, and not eating on his own for 2 weeks is pretty substantial for an 11 week old.

Definitely not wanted to bring you down either, just a reminder not to be too confident that by tonight he won't show some of the old signs again.

Let's all hope not!!!  Wouldn't that be the best?!!  

 

     

  

  

  

 

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Yeah.  Because you mention it, it isnt unusual with severly and longly sick humans and animals, whom sometimes seems be clearly better a couple of days, but then they crash and dyies in hours.

My own hypothesis is  its when the immune system ceases the fight and gives up..   So the fever goes down, pus is no longer made, etc.  All the biproducts of fight ceases.  But of course,  the contagion takes over quickly now over the now defenceless body, and the end comes soon thereafter,  in a quick crash...

Lets hope this is NOT this case, and this here is a real, true improvement.   The tip on raw goat milk is still useful also during the recovalescency.  Even double so.

Good luck!

Thanks for your positive thoughts and cautious concerns. I'm happy to say I took Budd to the vet again this morning and he and the nurses were so impressed with his progress. He has so much energy today! I have recently given him a bath and complete dry, and now he's a pro at grooming himself. He is incredibly affectionate, looking for kisses (but I actually think he's looking to suckle). He purrs appropriately too. He's eating wet food, dry biscuits and water.  I'm not tube feeding him at all anymore and he's just flourishing. I will however keep a close eye on him over the next several days in particular. 

He will continue on the antibiotics until Monday and we'll give him a few days off to see how he goes. If all goes well, then we'll keep him off them! I'm also giving him probiotics, iron, lysine and B vitamins. We were both happy not to do a repeat blood test because we can see his improvement, and his RBC are already low, we don't want to be taking any more blood off him! 

The vet still doesn't think it's FIP, as his protein levels were low, and I think typically with FIP protein levels are high. He's thinking something more perhaps along the lines of an intense gastro which caused significant intestinal inflammation. His intestines will still be healing, so keeping an eye on his poop is what I'll be doing. 

Thanks all again! I will update in another day or two  

We are all hoping that this is a sign he turned the corner.  It certainly does sound promising.  The best part is that it sounds like he is enjoying life again.

I'm glad to hear about your kitten's improvement! As I was reading along I had to agree with everyone else that it sounded like FIP but perhaps it isn't! However if he still has any fluid in his abdomen I think it's worthwhile to have it analyzed for FIP just in case. Has he been FIV/FLV tested yet?

Just checking in again to let you all know Budd is still coming along very nicely. I would say he is completely back to his original self, absolutely loving life! He is playing with his toys and eating and drinking heaps! He is gaining weight steadily and his belly is definitely not getting any larger, slowly reducing in size. His nose and paws are definitely getting their pink colour back too, which suggests his RBC is getting better  

To answer @CatLadyVetTech  - no he hasn't been FIV/FLV tested that I'm aware off. When they drew his blood, they didn't take too much because he was so pale and they didn't want to risk making his RBC any lower. He hasn't had the fluid in his abdomen tested, and I don't think his abdomen has any fluid in it anymore, so taking a fluid test now won't be possible. 

Thank you all for keeping Budd in your thoughts  

 

I think with 4 days of steady incline it is not fip, as he would not be gaining weight and doing so well, for a day or two here and there perhaps, but not actually becoming well again.

What a huge relief THAT is!  

It certainly does sound hopeful.  I have never seen that kind of improvement in a kitten with wet FIP so it is certainly not typical.  Fingers crossed it keeps going so well.  Keep us posted, we LOVE good news, and give hugs when we get bad news.

yOur kitten has FIP I work with cats. theSymptoms. Your describe are exactly what it is.There is no cure the kitten if confirmed will have to be put to sleep

catkids said:

yOur kitten has FIP I work with cats. theSymptoms. Your describe are exactly what it is.There is no cure the kitten if confirmed will have to be put to sleep

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We all know it could be FIP. But the problem with FIP is there is no definitive diagnosis, and the disease does mimic other conditions. So as long as the kitten is doing well, and the relevant (but non-definitive) tests have been done, there is hope that it is not this very nasty disease.