My cat is in the hospital with a blood infection :(

prairiepanda

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My 17-year-old CKD cat PJ (Princess Jasmine) is hospitalized right now and it's tearing me apart.

A little background on what's happening: PJ has been stable for a long time, getting sub-Q fluids daily and eating prescription renal foods, both canned and dry. This year, starting mid-February,  she had 2 urinary tract infections which were both treated with 4-week courses of amoxicillin; in both cases, we had run cultures which showed that amoxicillin was effective and did follow-up urinalysis a week after treatment to confirm the infection was completely gone. We had also done bloodwork both times, which showed that her kidneys were not affected by the infections. Both of those infections were caught because she had been straining in the litter box.

Fast forward to this past week: PJ was perfectly normal in every aspect. On Thursday she didn't eat very much, but everything else was normal so I just picked up a new flavour of her renal diet and that got her eating a little bit more. But on Friday, something was off. She didn't wake me up at 6am like usual, and when I checked her food bowls I found that she hadn't eaten anything during the night. She did follow me around and go through our usual morning routine, acting pretty normal, but she wasn't interested in food at all. She didn't want treats, or Fancy Feast, or even meat baby food. Normally when she refuses food she at least shows interest, but this time she wouldn't even acknowledge any sort of food. I brought her to the vet that morning. Since she had eaten the day before and was full of energy and acting normal, we weren't too worried. The vet gave her an extra large hit of sub-Q fluids along with a vitamin B shot and mirtazapine to give her a boost. They also took urine for a urinalysis and culture, suspecting another UTI. PJ had taken mirtazapine in the past and it had been very effective, although it made her pretty sleepy and confused. She had a similar reaction this time, but her appetite did not improve very much. She ate a little bit of Fancy Feast, though, so I just encouraged her to eat what she would throughout the day. Then, Saturday morning(today) I slept in until 10:30am because I hadn't set an alarm and PJ once again had not woken me up. What was stranger was that she didn't get excited when I got out of bed; she just stayed comfy where she was. With some encouragement she eventually followed me, slowly and without any enthusiasm, out of my bedroom. Once again, I found that she hadn't eaten anything overnight and wasn't interested in any kind of food I could offer. I checked the litterbox and found that she had peed quite a lot more than usual during the night(I had cleaned it out before bed). PJ was spaced out and lethargic; all she wanted to do was sleep or get up to stare at her water dish(but not drink) and she wouldn't talk to me. So of course I we went straight back to the vet. The urinalysis results were in as well and apparently found a very severe UTI. I left PJ at the vet, where they immediately put her on IV fluids, antibiotics, and painkillers. In light of this morning's developments we also decided to run bloodwork and do an ultrasound. The ultrasound came up clean. But a couple hours later I got a call about the bloodwork, and the news was devastating; PJ's kidney function has actually improved since the last time we ran bloodwork(last month), but the infection has spread into her blood.

The vet is treating the infection very aggressively and will be running a CBC every 12 hours to see how she's responding. The urine culture results will be in tomorrow or Monday, so that may be of help.

I'm really scared right now. Even the vet sounded scared when she phoned me about the blood results...I don't really know what kind of response I'm hoping to get here, but any kind of input would be appreciated, whether it be encouragement, stories of your own experiences, or a serious reality check, or whatever....I'm just so upset that things got so serious without me noticing anything was wrong. I feel like I've failed my cat, and I'm terrified of losing her.
 

stephanietx

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I'm so sorry you're going through this with your baby.  It's so hard when our little ones are sick.  Sounds like you've got a great vet to work with who cares about her as you do.  Keep us posted on her progress.
 
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prairiepanda

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The vet has reported that PJ has perked up quite a bit and is much more alert and responsive than she was this morning and is showing some interest in food. They didn't see significant change in her blood counts yet, but said that they don't expect to see a major difference until tomorrow. They're going to do an X-ray tonight to see if it might provide any more information. Unfortunately, despite PJ's behavioural improvement, her outlook is still worrying. I'll be getting a call later tonight about the X-ray, and hopefully tomorrow we'll have a better idea of how the treatment is going.
 
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prairiepanda

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Last night's X-ray didn't find anything unusual, but did show quite a bit of constipation so she was given an enema to get things moving. It worked well, and she has been using the litterbox on her own.

I visited PJ this morning. Apparently she had cleaned a full bowl of food before I arrived, which is very good for her (she's the type to insist that bowl half empty = bowl completely empty). For the first couple minutes she didn't really acknowledge me at all, but then she suddenly sat up, looked right at me bright-eyed, and said "Good Morning!" the way she always does. After that she wouldn't let me stop petting her. She showed a lot of interest in food but didn't eat(not surprising since she ate just a short while before I arrived), and was also interested in the various smells and sounds around her. Her eyes were much more clear and focused than they were before; she had a complete dead fish gaze when I had dropped her off yesterday.


I was very happy to see her like this and to hear that she had finally eaten a decent amount. She did seem exhausted, though, and I could tell she wasn't feeling well. I'm still very nervous, though, as these improvements might just be resulting from the drugs and don't necessarily reflect real progress with fighting the infection. She's getting another blood count this afternoon which will give us a better idea of how she's really doing.
 

denice

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It sounds like she is improving.  Constipation can really affect a kitty as far as not wanting to eat and just generally feeling really bad.  
 

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She looks really good.

I agree with Denise-constipation makes them feel crummy and I am sure the blood infection isnt helping-did they take her temperature? If she had a fever that would also explain not wanting to eat but the constipation sounds like it would do the same. Did they discuss adding Miralax or canned pumpkin in her diet? 

My 17 yr old girl struggles with this as well. She had early levels of kidney disease which we feed wet food and try to keep more of that available instead of kibble but sometimes she strikes and wont eat until i put the kibble down.  When she is constipated she only lays in one spot and I notice her breathing is faster-they said its from pain. They sent me home with pain meds if it gets really bad but normally as long as I remember the miralax then she is pretty regular now. She enjoys sleeping on the front porch step or on the deck. 

I hope your girl continues to improve-they are so good at hiding illness so don't be giving yourself a guilt trip=if they could they would never tell us something is wrong-the only way to know is watch their behavior and patterns-sometimes it is hard to tell something is off. 
 
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prairiepanda

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She has had issues with constipation since switching to her prescription foods, which I heard is a common issue with those diets(although I think it probably has more to do with the kidney disease than with the food). She gets Miralax for that but I stopped giving it to her when she wasn't eating much on Thursday because she's more cooperative about eating without it. She had a substantial BM the night before so I wasn't too concerned at the time, and after our Friday vet visit I was advised not to give it to her for the time being as she was dehydrated. Her hydration is very good now, though, so if she keeps eating they'll likely resume the Miralax.

I forgot to mention that she did develop a mild fever last night. I didn't ask what her exact temperature was, but was told that it was not alarmingly high.
 

foxxycat

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just make sure you mix miralax in hot water before adding to the food-like i use the foodcan that I emptied-poor hot water and the pellets and stir to dissolve=I also put a dish of water on the front porch-she sometimes wants to go out on the porch just so she can drink that slimy water-if I change it often she wont drink it-if I leave it overnight then the next morning she drinks-maybe your cat rather have a water dish in a different location? My cats are strange-they wont drink water if its next to the food-we got a bowl in the bathroom and a cup on the counter-two of the three drink out of the cup. Strange kitties.

I don't blame you for discontinuing the miralax because of dehydration. that makes sense. I hope things get better for you. 
 
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prairiepanda

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Yeah, water is always a tricky issue. PJ likes bathroom tap water in a plastic dish in the morning and bottled water in a stainless steel dish in the evening, and kitchen tap water in a cat fountain the rest of the time. Took a long time to figure that out, for sure, but once I did I was able to reduce the amount of sub-Q fluids she was getting.

PJ's white blood cell count has gone down, but is still extremely high. If she does push through this, it's going to be a long process. But the good news is she has been eating all day, having healthy BMs, and is continuing to perk up, so she's definitely fighting this. Hopefully we'll start to see more significant changes in her blood counts as her physical condition improves.

We might send a blood sample in for a pathologist to assess tomorrow, since we couldn't do that over the weekend. 
 

cleopatras mom

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I just wanted to post here and offer you my support, and my ear. I understand completely how much these two things can help someone when they are facing difficult times. I truly hope she gets better, and although this is still dangerous, she seems to be doing better, so we MUST hope, and there is most definately a chance things will turn out fine. She is a beauty, by the way. <3
 

cleopatras mom

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Oh, I also wanted to add that the constipation thing is SO weird! Cleo has been struggling with bloody stools for a while, so we put her on a novel prescription diet. A month and a half later, she was diagnosed with high calcium.
 
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prairiepanda

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I really appreciate the kind words and support from everyone 


Today's visit was very encouraging! PJ's IV was disconnected for my visit and it was immediately clear why: she was full of energy! She was running around everywhere, and she had an extensive conversation with me while she explored every piece of furniture in the room. When I sat down she ran straight to me and jumped into my lap to rub all over me. She's like her old self again. If she continues like this, and also continues to eat and drink, she'll be coming home tomorrow so that she can be in a less stressful environment. 

Unfortunately her blood counts are still very high. We're going to send blood to a pathologist tomorrow morning so we can get more details and advice. 
 
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prairiepanda

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PJ is now a home and will be receiving clavaseptin(antibiotic), Baytril(antibiotic), buprenorphine(painkiller), mirtazapine(appetite stimulant), cerenia(anti-nausea), and subcutaneous fluids(lactated Ringer's). I'll hold off on the mirtazapine though unless it's absolutely necessary, as it does make her pretty restless. We're expecting the antibiotic sensitivity results sometime today, so the antibiotics may be changed to better focus on PJ's infection. In the meantime, the bacteria was identified as E coli, likely from PJ's own gut flora(a common source of UTIs). We're not sure of the pathotype yet, but the pathologist will be able to tell us once they've had a chance to look at the blood we've sent in. I ordered a complete work-up on the sample as well just to be safe. We should have those results sometime tomorrow.
 
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