My cat's fever hasn't broken - Out of options?

slashfiend

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Hello everyone,

My 3-year old domestic shorthair kitty, KitKit, is having another bout of fever. She was adopted from our local Petco when she was 1 year old, and they diagnosed her as having FVR/URI. This is the third time this fever flare-up has happened since we've had her.

All of her flare-ups have included high levels of fever, so we've had no other choice but to take her to her regular vet during the weekdays and emergency/specialist hospitals over the weekends. During this time she does not get any eye or nasal discharge, nor does she have diarrhea or vomits. She will usually be fine, energetic, and eating the night before, but then I wake up the next morning to find her lethargic and not interested in her food, which is a big warning sign for me to check her temperature. Of course, when she has a fever I have no choice but to take her to the vet to get fluids into her system.

The last time this happened back in October, we took her to a specialist 24-hour hospital to see what they could offer. By the end they gave her 250mg of Famciclovir and she seemed to bounce back from that and break her fever. From there, the vet prescribed 3 months of Famciclovir so she was on that until January. All was well with her up until this past Friday.

So, we took her to the vet this weekend with a fever of 106. They started her on fluids, gave her vitamin additives, Vibramycin, Cerenia injection, Mirtazapine (15mg), anti-inflammatory injection, Convenia injection, 1/4 of a tablet of Famciclovir, appetite stimulant, and a urinalysis. Her fever did not break by the end of the day (was ~104-105), so we took her back to the specialist hospital on Friday night with all of the oral antibiotics that she was given at her regular vet.

I believe they ran a blood test on her, as well as giving her IV antibiotics and the oral medication that we have (including the Famciclovir). They did mention that her CMV test numbers were a little wonky so they were going to send that in to get a re-check (no news about that). Yesterday, her fever came down to about 103.1 and it was looking like I would be able to bring KitKit home later that evening. Then, 2 hours later, her fever spiked again to 105 and they wanted to keep her for a second overnight observation. During this time, she's eaten very little and I know she's been stressed out with the new sounds, smells, and people touching and prodding her.

The latest update I got from the vet was that, while her lungs sound clear, her lymph nodes are still swollen and her fever was at 104.7. They are going to up her dosage of Famciclovir from 250mg to 500mg (one whole tablet) 2-3 times a day and see if that will help her immune system fight this thing. They said they weren't sure what else to do at this point, since it's now day 3 with a fever. What they did suggest was a blood test for bartonella, which is somewhere around $200-$300 to do (yikes!), but I haven't authorized that yet. My understanding is that bartonella is lyme disease and is caused by fleas (or flea feces), but I honestly don't think my cat has fleas as she has had no signs of having fleas like scratching or biting. I brush her constantly and check for things like that, I keep my apartment/her environment as clean as possible, and she's an indoor cat and hasn't had contact with plants or other cats. Even with all of these precautions, I understand that sometimes fleas can come in from us humans from the outside world. 

Do you guys have any suggestions as to what we should do here? Should we get the bartonella test done, just to potentially rule out that possibility? Should we transfer her to another specialist vet and get a second opinion? I'm just at a loss for what to do for my kitty. Maybe she just needs more time to break her fever? Last time I recall her needing about this much time to nip her fever in the bud, so a part of me thinks she just has a weaker immune system.

When she gets out of this ordeal I promise to introduce Lysine power to her regimen. I purchased Tomyln Immune Support L-Lysine supplement powder, and my vet was definitely agreeing with me to give it to her as well as some low doses of Famciclovir for (possibly) the rest of her life.

Any help or thoughts on this matter are greatly appreciated! <3

- Noelle
 

stephanietx

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Has she had the PCR URD test done to check for other upper respiratory diseases (URDs)?  That might help rule some things out.  Has she been tested again for FIV?
 
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slashfiend

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Yep! They ran both of those the last time she was in to confirm it. I'm honestly not sure if she's been retested for FIV.
 
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