What could be wrong with my Cat?!

I know it's a long shot, but Thomas the 5 year old farm cat is very sick and I was hoping someone out there might recognize his symptoms.
The weekend was normal. A strange unneutered, unvaccinated cat has been showing up in my yard over the past month (I live in the country). I know the owner, so I caught the stranger on Saturday and returned him again. I saw Thomas in the yard chowing down on a bird when I got home. The next night I commented to my partner that tom's purr was broken. Normally Thomas starts to purr as soon as you touch him, but even a thorough snuggle couldn't get him purring. I noticed when I fed my cats Monday evening that Tom didn't eat, but sometimes my kitties catch their own food or sneak the dog's food, etc so I wasn't too worried. He threw up Monday night, a clear-ish watery vomit, and I assumed he had eaten something earlier that wasn't agreeing with him. My partner fed them Monday morning on his way out the door and didn't notice who ate what.
When I got home from work Tuesday evening, Tom was NOT himself. He had no interest in food and he was just laying on the bed. I knew something wasn't right and immediately suspected crystals (a urinary blockage), so I brought him to the emergency after-hours vet. He peed in the carrier on the way there. The vet found quite a high fever, felt his belly and mentioned there seemed to be fluid in his abdomin. She said he was a pretty sick kitty, but it didn't look like crystals. She put him on fluids and admitted him for the night to run blood and urine tests. I don't have the results, but I was told his white blood cells were extremely low, and his red cells were on the low side of normal. His bilirubin was high. He was yellow/jaundiced. There was bile in his urine(?). He was showing sugar levels consistent with diabetes or pancreatitis. She wanted to do an ultrasound, but we really can't afford it. The vet put Tom on some antibiotics and told us she would consult with other vets and specialists in the morning. This happens around midnight on Tuesday. Six hours after he was brought in. Since that point he has been receiving vitamins, antibiotics and antinausea medications through iv. 24 hours after he was brought in, I suggested trying a different antibiotic, since he was deteriorating. The vet added doxycilin(?). He has had blood work done every 24 hours since he was brought in.
His white cells recovered after 48 hours and have now been normal for 24 hours.
His red cells tanked after the first 24 hours. They stabilized and have shown modest improvement since but are still low. Same with his platelets. His fever went away after 48 hours. It returned 24 hours ago. The vet added a pain/fever medication she likened to aspirin that starts with an 'm'.
I visited on Wednesday and it broke my heart to see my sweet Tom so down. It looked like he was hallucinating. He had little interest in me, though he did seem to like gentle cuddling. Food repelled him. He was urinating on the blanket was was laying on. He did not look happy or comfortable.
Thursday my partner and I both went for a visit with the expectation he would need to be put down. His blood work was not looking good at this point- his red cells had crashed. But when we visited with him, He was acting like his old self. We knew he had to eat or be put on a feeding tube. So my partner syringe- fed him half a can of wet food which he didn't mind and kind of seemed to enjoy. He was literally jumping around (tricky when still hooked up to an iv). He was unquestionably feeling much better.
Friday I went in by myself. He passed the food we had given him as diarrhea. His fever was back, but he was still acting fairly normal. He was fed nearly a full can of food on Friday. He wasn't as active as the day before, but nowhere near as bad as he had been on Wednesday.
It is now Saturday. He has been in intensive care since Tuesday. We can't afford to keep him there. He is receiving the best treatment we can give him, but without knowing what's wrong we can't know if it's the RIGHT treatment. We will be bringing him home Monday, one way or another. (If only vet care weren't so expensive!)
In summary, has anyone seen these specific symptoms or combination of symptoms and recovery sequence? Is there something else we should be trying? Anything anyone recognizes? He's a great cat, and I'm really hoping he pulls through, but it's still so uncertain. If anyone has seen something similar it might help.

Tom and Cat said:

I know it's a long shot, but Thomas the 5 year old farm cat is very sick and I was hoping someone out there might recognize his symptoms.
The weekend was normal. A strange unneutered, unvaccinated cat has been showing up in my yard over the past month (I live in the country). I know the owner, so I caught the stranger on Saturday and returned him again. I saw Thomas in the yard chowing down on a bird when I got home. The next night I commented to my partner that tom's purr was broken. Normally Thomas starts to purr as soon as you touch him, but even a thorough snuggle couldn't get him purring. I noticed when I fed my cats Monday evening that Tom didn't eat, but sometimes my kitties catch their own food or sneak the dog's food, etc so I wasn't too worried. He threw up Monday night, a clear-ish watery vomit, and I assumed he had eaten something earlier that wasn't agreeing with him. My partner fed them Monday morning on his way out the door and didn't notice who ate what.
When I got home from work Tuesday evening, Tom was NOT himself. He had no interest in food and he was just laying on the bed. I knew something wasn't right and immediately suspected crystals (a urinary blockage), so I brought him to the emergency after-hours vet. He peed in the carrier on the way there. The vet found quite a high fever, felt his belly and mentioned there seemed to be fluid in his abdomin. She said he was a pretty sick kitty, but it didn't look like crystals. She put him on fluids and admitted him for the night to run blood and urine tests. I don't have the results, but I was told his white blood cells were extremely low, and his red cells were on the low side of normal. His bilirubin was high. He was yellow/jaundiced. There was bile in his urine(?). He was showing sugar levels consistent with diabetes or pancreatitis. She wanted to do an ultrasound, but we really can't afford it. The vet put Tom on some antibiotics and told us she would consult with other vets and specialists in the morning. This happens around midnight on Tuesday. Six hours after he was brought in. Since that point he has been receiving vitamins, antibiotics and antinausea medications through iv. 24 hours after he was brought in, I suggested trying a different antibiotic, since he was deteriorating. The vet added doxycilin(?). He has had blood work done every 24 hours since he was brought in.
His white cells recovered after 48 hours and have now been normal for 24 hours.
His red cells tanked after the first 24 hours. They stabilized and have shown modest improvement since but are still low. Same with his platelets. His fever went away after 48 hours. It returned 24 hours ago. The vet added a pain/fever medication she likened to aspirin that starts with an 'm'.
I visited on Wednesday and it broke my heart to see my sweet Tom so down. It looked like he was hallucinating. He had little interest in me, though he did seem to like gentle cuddling. Food repelled him. He was urinating on the blanket was was laying on. He did not look happy or comfortable.
Thursday my partner and I both went for a visit with the expectation he would need to be put down. His blood work was not looking good at this point- his red cells had crashed. But when we visited with him, He was acting like his old self. We knew he had to eat or be put on a feeding tube. So my partner syringe- fed him half a can of wet food which he didn't mind and kind of seemed to enjoy. He was literally jumping around (tricky when still hooked up to an iv). He was unquestionably feeling much better.
Friday I went in by myself. He passed the food we had given him as diarrhea. His fever was back, but he was still acting fairly normal. He was fed nearly a full can of food on Friday. He wasn't as active as the day before, but nowhere near as bad as he had been on Wednesday.
It is now Saturday. He has been in intensive care since Tuesday. We can't afford to keep him there. He is receiving the best treatment we can give him, but without knowing what's wrong we can't know if it's the RIGHT treatment. We will be bringing him home Monday, one way or another. (If only vet care weren't so expensive!)
In summary, has anyone seen these specific symptoms or combination of symptoms and recovery sequence? Is there something else we should be trying? Anything anyone recognizes? He's a great cat, and I'm really hoping he pulls through, but it's still so uncertain. If anyone has seen something similar it might help.

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Your cat sounds very sick.  I know you said you can't afford it, but i agree he needs an ultrasound.Professional vets can't diagnose him and sadly neither can we.  He could be bleeding internally, he could have cancer, he could have a liver disease, and pancreatitis is also possibly involved.   Imaging the inside of him is important to get a actual picture of his organs at this point.  The vets are throwing darts aiming for a hopeful bullseye and good luck, both of which may or may not happen.  You cats symptoms are consistent with a number of serious illnesses, that's why they want to do more advanced diagnostics.  It may be cheaper in the long run to throw one well aimed dart based on an ultrasound or xray that to trying different treatments.  It may also lead you to a diagnosis that will lead to palliative care which would comfort him.

Lastly, did they tap his abdomen to remove some of the fluid for analysis?

No update on his condition today yet but I'm going to visit him in a few hours.
No, they didn't sample the fluid. It seems to have disappeared, or is no longer concerning the vet, as she hasn't mentioned it since I brought him in. The problem is that she would like a barrage of tests done including the ultrasound and PCR and Coombs test. After re-examining his blood work and talking to an internal medicine specialist, I think she would prefer the PCR now, but without a psychic involved there's little chance there will be just one diagnostic test and each one is about $350 or more. It could very easily add up to thousands of dollars that we simply don't have. And there's a very real chance they still might not find out what's wrong. In addition it may be too late to do the PCR. I forgot to check if they had saved his original blood sample, but all the antibiotics that he is on will screw up the PCR results.

I would strongly recommend the ultrasound. At least if there is abnormal pancreatic issues it will be visible. It could be a viral infection that will take time to get over. The bloodwork is concerning and the fever would to me indicate some kind of infection. Is it possible the cat ate a plant or something that would make him sick? The doxy is a good antibiotic and works well. If you bring him home have them show you how to do sub fluids. Its a painless and easy way to keep him hydrated while recooperating. It would need to be done probably every 48 hours. its much cheaper than IV fluids but at least you can home nurse him.

They can prescribe pain meds to go home with you-buprenorphine works like a charm. if its pancreatic issues-its very painful and does cause vomiting/dia issues. There's no rhyme or reason why they get pancreatitis but its painful. Its important to send him home with supportive meds to help. anti nausea meds will also be needed. and appetite stimulant. sometimes they get a bizarre infection that takes time to get over. I would try to see if you can home nurse and see how it goes.

Sorry. I'm honestly just hoping someone will read this and say, 'hey that's exactly how my kitty was when he was suffering from such-and-such'. And yes, I realize all cats are different, and each sitution is unique. I'm just hoping.
Has anyone seen a cat with toxoplasmosis in the abdomin? I read an article on wiki vet that suggested some of the same signs. I know toxo more commonly affects the nervous system and respiratory system, but this one article mentioned that it depended on where the toxo infected what response the cat would have. It was very technical, so I didn't understand all of it, but I think it matched his signs. For some reason wiki vet won't let me read any more articles though...

foxxycat said:

I would strongly recommend the ultrasound. At least if there is abnormal pancreatic issues it will be visible. It could be a viral infection that will take time to get over. The bloodwork is concerning and the fever would to me indicate some kind of infection. Is it possible the cat ate a plant or something that would make him sick? The doxy is a good antibiotic and works well. If you bring him home have them show you how to do sub fluids. Its a painless and easy way to keep him hydrated while recooperating. It would need to be done probably every 48 hours. its much cheaper than IV fluids but at least you can home nurse him.

They can prescribe pain meds to go home with you-buprenorphine works like a charm. if its pancreatic issues-its very painful and does cause vomiting/dia issues. There's no rhyme or reason why they get pancreatitis but its painful. Its important to send him home with supportive meds to help. anti nausea meds will also be needed. and appetite stimulant. sometimes they get a bizarre infection that takes time to get over. I would try to see if you can home nurse and see how it goes.

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Thank you foxxycat. I'm thinking that bringing him home and nursing is exactly what is going to happen, and I'm sure I'll refer back to your post over the next week to reassure myself. I've never had to care for a sick cat before- my little ones have never had anything worse than crystals, or uri. You make it sound easy, so I'll re-read that for inspiration.

A PCR test should run well under $100 and antibiotics should have no affect on it if your cat is still ill. PCR testing amplifies Dna and is very sensitive.

yes the PCR test is a great tool to help figure out what is going on.

in 2012 I got to nurse a sick cat for the first time ever. I was scared. I didn't follow the directions. I made some errors but I learned. She was not able to be saved due to the anemia-it was an internal issue with her bone marrow not producing red blood cells. The PCR test helped tell us exactly what was going on-we did the ultrasound-came back normal. So at the minimum you would get a good snapshot of the structure of her cells and see what is working in her bone marrow and what isn't. Plus if I remember correctly the PCR test can also break down the DNA of cells to see exactly what is in the infection? or I could be wrong-but yes do it-the info would help figure out what the ending may be.

sometimes there is no rhyme or reason to illness.

It was scary my first time too. You will have tons of people here to help explain things to you. If I only knew then what I know now-but now we can help each other.

StephenQ said:

A PCR test should run well under $100 and antibiotics should have no affect on it if your cat is still ill. PCR testing amplifies Dna and is very sensitive.

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Ah, I think it's because I live in Canada that explains some of the cost difference. The test would have to be sent away, I think to the us. She did explain to me why it was so much. It was from reading various stuff on the internet that I assumed the antibiotics would muck things up. I was under the impression that as he reacted to the antibiotics, certain readings could be exaggerated and false positives/negatives could appear for specific conditions. Perhaps I'm wrong. I'm also from a fairly small city, so vets don't have as much experience interpreting these types of readings. As far as I know there are only general vets here, not specialized ones. I think part of the cost was assistance interpreting the results.

sounds like the PCR test may be sent to a university testing site-usually when its sent out-they will send an explaination for the test results-depending on the company-they usually do a good job of giving more information in regards to why some of the levels are the way they are-at least if you decide on Monday to do the test-its an option. The PCR test will tell us more than the ultrasound in regards to what infection etc is going on. The ultrasound is helpful if its liver or pancreatic issues-if the person doing the reading of the ultrasound has enough training-they should be able to detect abnormalities. The ultrasound is good for reading of foreign matter like cancer or objects in the body or in trying to gage the health of the organs-they are able to get snapshots of structural configuration of each organ-and while they are at it-I highly recommend that they ultrasound the heart as well as the other organs-but that's just my preference-your symptoms sound more of a bloodborn infection or something internal in the cells but sometimes we have cats who show odd symptoms and the vet doesn't check the heart in the ultrasound.

I also understand money doesn't grow on trees. I am not sure where you are located in Canada-and I know you are limited in vets but I wasn't sure how close you were to the US border. I really wish everyone had access to good honest vet care instead of vets who just want to rack the money because your heart is involved.

The minimum you can do is subfluids at home and syringe feeding. There is a website I will post-I know you don't have a CRF kitty but they have a whole page dedicated to trying to get kitties to eat-theres some info that I think would be beneficial to read to learn about home nursing care for our cats. Many of the meds mentioned in this site is also used offlabel for other illnesses. Cats are pretty resilant animals and if we can help nurse them through an illness it may be all they need. I wish we had a crystal ball to see what the future holds. but at least you can learn what to watch for, how to home treat and when to get the big guns involved -vets-

http://www.felinecrf.org/anaemia.htm explains about anemia

http://www.felinecrf.org/treatments_antibiotics_painkillers.htm for info about antibiotics-what to watch for-why they are given etc

http://www.felinecrf.org/diagnosis_test_ranges_factors.htm#factors_affecting_results this is about what the numbers mean in bloodwork etc-explains the dif in measurement from USA to other countries-

http://www.felinecrf.org/medicating_your_cat.htm   how to give meds and explains things related.

I think this site is a good one to start with in regards to learning what the meds do and things to watch for-I hope this helps figure out some of the problems.

Thanks so much foxxycat. I'm on my way for a visit and a talk with the vet, so I will know more about his progress. The vet tech this morning told me that he seems to be doing better-more social and energetic.

Just had a two hour visit with Thomas. He is doing wonderfully! His fever is gone again and his blood counts have stabilized and are slowly recovering. His white cells are now high and his red cells and platelets are low, but they have slowly come up over the last three days. Just as importantly to me he was acting like himself again. During my visit, he was talking, (Thomas has always been a VERY chatty cat) and he was purring and looking for pats and snuggles. He would eat a tiny bit on his own. One piece of kibble at a time if I gave it to him by hand. He would lick the wet food a bit. I fed him half a can through the syringe and he sulked a bit. (I consider it a good sign that he's feeling well enough to pout) He used the litter box twice, a pee and a poop.
Just this one day of hanging out with my beloved kitty back the way he used to be was so worth all the stress and expense this week. I've seen him suffering badly over the past week, but today I'm sure he wasn't hurting at all. The vet is becoming far more optimistic. Even though we still don't know what's wrong, it's looking like he might make it through. Oh I hope he keeps getting better!!!

It is most gratifying that Tom seems to be recovering.  I am a human physician in internal medicine, not a vet, but the elevated bilirubin and bile in his urine suggests he may have had an acute hepatitis.  However he has obviously been very sick and may have had a complicated illness with secondary hepatitis. The blood cell abnormalities may have been secondary to acute stress. 

I have a question and two suggestions:  Did the vet originally perform liver function tests?  If so - what did they show?   Can you repeat the bile in the urine (a cheap test ) to see if it has settled?  If you can afford it, can you ask the vet to perform liver function tests - and let us have the results?

Please give us the feedback.

With all best wishes,

Geoffrey

very good questions ^^^ Liver disease can cause some of the symptoms you are seeing. The key to healing the liver=FOOD! and pain meds. And sub fluids. SO keep doing what you are doing. Sometimes they get what is called fatty liver disease-its basicly the liver is a filter-the fat deposits break off and clog the filters-and cause the issues-upset stomach/pain/vomiting etc. the only way around it is to reintroduce food-either anti nausea meds and appetite stimulants or a feeding tube-takes a good month to get those values down to normal. Its possible there is an infection in the liver or elsewhere which is why the bloodwork is all over the place. And then trying to determine WHAT the infection is while supporting the body with food fluids and meds to keep him feeling well is another issue in itself.

I am so glad more vets are seeing things this way-in the old days-when a cat was ill they would PTS. Now its changing. Now we are trying to treat with home nursing care and just take it one day at a time. Just like people-how many times have we gotten ill and then had to take meds to get better-rest-food-liquids-meds-and we slowly get better. Its the same with our animals. Only its harder with them-they don't talk so we don't know whats going on unless we watch their body language.

Let us know how your boy is doing. The visit sounded like a really good one.

My old cat Floey when she is under the weather I have to hand feed her as well. Its nausea from the early kidney disease-raising the dishes up on a few books helped her tremendously. She is unable to be pilled so I can't give her Pepcid. I really wish I could-but it takes 3 people. My other two cats I can pill somewhat easily. Not Floey. Floey is a stubborn old lady and lets you know exactly what's on her mind.

Hooray! More good news about Thomas! I just talked to the vet about his urine analysis from this morning and all the worrisome findings from when he was admitted have resolved. No more bile, blood cells, weird proteins, ketones, bilirubin, and a normal pH. He is still on fever medication and definitely still fighting a fever, but things haven't spiralled out of control in his little body and there are definite signs of improvement. Also, he is eating and drinking on his own again! It looks like supportive medication and care might be enough. The vet says he's looking really good! I can't visit today, because it's Sunday, but she's pretty comfortable with sending him home tomorrow.
Thanks so much all of you for your support! It's really tough when one of our little ones is sick and just having a place to discuss it helps me from going crazy. Keep your fingers crossed, but right now things are looking good for dear Thomas!