What's killing Kim Chi?

Grateful for any ideas as to what is making our beloved Kim Chi sick. Our vet is at a loss!

We adopted Kim Chi and his brother at 3 months and they're now 6 months. Brother is a muscular teenager full of attitude but Kim Chi, although sweet-natured and responsive, is lethargic and underweight. We took them to the vet for their shots 2 weeks ago and were concerned that he was a little underweight (1.5kg) compared to his brother (1.9kg) at the time. Vet dismissed this and said the kitten was healthy. They share the same litter tray and food bowls.

We are 2 weeks down the line and Kim Chi's stomach has ballooned with peritonitis/ascites/edema (unsure the difference?). We took Kim Chi back to a different vet who ran an X-ray and some tests (both attached). Negative FIP result from the fecal sample but alarmingly high WBC and a slightly high temperature. We've been administering Augmentin (amoxicillin and clavulanic acid) twice daily for 48 hours and the peritonitis has not improved (may be worse). Breathing is normal and he's responsive and has a healthy purr when tickled. Appetite is reduced but he is eating and drinking occasionally.

Both cats are housebound and do not come into contact with other cats. Any thoughts on what's causing this? Xray and lab results below.

I'm so sorry you are going through this. I am going through digestive issues with my cat but she is 10 years old. She lost half her body weight in a year. We first did blood work and a urinalysis and treated for pancreatitis (which can be caused by the food they eat). Then after the 3rd visit to the same vet in a month that seemed to just be guessing and not plotting a course of action, we went to another vet for a 2nd opinion and he has been great. He sent us to an internal specialist for ultrasounds which ended up being inconclusive. Next step with the internal specialist was to biopsy the intestinal walls, but we opted to go back to the 2nd opion vet and just start treating for Irritable Bowel Disease (he said it's 80% likely IBD) and she seems to be responding to the treatment so far.

But my cat's symptoms were vomiting, diarrhea, lethargic, wanting to eat but wouldn't.

I went on Yelp and looked up reviews and asked friends for recommendations. Getting a 2nd opinion really helped me, and I recommend you do that too. If you call the 2nd vet and make an appointment, they will request all of Kim Chi's files and review them prior to your appointment. You can also look for an internal medical specialist as opposed to a standard vet.

Kim Chi is beautiful, I wish you two the best of luck. Digestive issues can be really tricky to diagnose.

Have they tried biopsying the inflamed tissues or anything? It seems like it would be good to see what's causing the swelling to see if that can be fixed. 

I've never heard of a fecal test for FIP all of the articles I've read about it say there is no definitive test for it. 

I have a cat with fluid in the abdomen. She is 13 and a senior citizen kitty. My vet took a sample of the abdominal fluid and did two tests on it. The first was observational. She put some on the table to see if it was "stringy" that would indicate a lot of protein and thus FIP. The other was to  "spin" the fluid ( I suppose to separate the elements in a centrafuge? not sure) to see what the fluid was comprised of. That test determines whether there is blood or urine in the fluid and the kind of cells at work. The vet specialist did the same and sent it to a board certified cytology lab which does a more thorough test to see what kind of cell activity is taking place.  That  will tell them if it is from FIP or something else. So yes it is more complicated that a simple test.  Inflammation response can cause the vessels to leak water basically and the abdomen and chest is where it can go. Same thing is happening to my 13 year old cat.

She is now on a combo of prednisone and trental (pentoxifylline) which is supposed to help the inflammation. I'm not sure it will. It's helped it keep from getting worse.

A 6 month old cat might be more difficult because of the small size. I have researched this until I can't keep my eyes open because both the regular vet and the cytology lab were a bit stumped. It wasn't necessarily cancer and it wasn't obviously FIP but the cytology vet wouldn't rule out either based on the cell activity.

I found an article on Little Big Cat on FIP which was the first to talk about this drug combo of predisolone and Trental.  www.littlebigcat.com/health/feline-infectious-peritonitis-fip

Anyway it also talks about how difficult it is to diagnose.  The condition results from a mutation in a coronavirus which is normally not a big deal. It is if it is FIP. Anything that makes the vessels leak is bad. VAsculitis is what they call it. I can't remember the source now, may have been the same site, but it was mentioned in one article that food allergy and intolerance may cause Inflammatory Bowl Disease too which can also cause some of the same symptoms. My kitty's belly still has fluid but it has not gotten worse after a week of lots of medication (she also has hyperthyroid condition). The special meds are for a month. If she responds maybe that's it for the drugs and then just the stuff for her heartbeat and thyroid. 

I'm so sorry for what you're going through.

The vet has requested a culture sample to see if it is a bacterial infection but I think a fluid sample (and drainage) is the next step. I've been dreading this as I imagine how painful it must be for the cat but gotta be done I suppose.

I spoke to a different vet about the fecal test for FIP and she said it often gives a false negative because the virus is only present in the abdominal fluid. This is my first encounter with FIP and it's a bit of a nightmare.

So sorry that you're having to deal with this nightmare. Testing the fluid in the body cavity is probably the next very important step to try. 

Our girl Francie keeps getting chest taps and thankfully the fluid is white and milky and not pink/red which would mean a higher FIP chance. Hoping the same for Kim Chi. Crossing my fingers for healing for the little boy so that he can sashay for many years to come. I hope they can find out what's wrong. I think they do a really good job of controlling the pain of having a chest tap if you have a good vet and vet tech doing the procedure. FIP is really hard to 100% diagnose.

GoldenGoose83 said:

 
The vet has requested a culture sample to see if it is a bacterial infection but I think a fluid sample (and drainage) is the next step. I've been dreading this as I imagine how painful it must be for the cat but gotta be done I suppose.

I spoke to a different vet about the fecal test for FIP and she said it often gives a false negative because the virus is only present in the abdominal fluid. This is my first encounter with FIP and it's a bit of a nightmare

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I watched my vet take a sample of Etta's fluid and it's a fine needle stick. So she seemed unaware of it. The vet specialist drained a portion of it a couple weeks ago (but not all due to electrolyte balance issues that can result if it all gets drained). I didn't see them take that. So I don't think that they really notice. The leaky vessels that cause it will continue to leak though and the fluid will build up again if the fluid continues to leak out. Regardless of the cause of it, it seems very stubborn and hard to correct.

Thanks for your kind words. The abdominocentesis was done this afternoon and it did seem to hurt a fair bit but Kim Chi cooperated better than I would have if the procedure was being done to me. My resolve broke though when the doctor showed me the bright yellow liquid. FIP as good as confirmed. They are administering some fluids overnight but I guess I have to man up and return in the morning to say goodbye and make the hardest decision for him. It's been a relief being able to chat to people on here. Lots of love and positive healing thoughts to Francie.

   Oh, NOOOO!! I am so, so very sorry for KimChi's entire family - my prayers and thoughts are with you during this difficult time. You have done all that can be done and I assure you that you will be giving him one of the most precious gifts possible tomorrow - the act of true, unselfish love. I have seen feral cats with FIP whom I couldn't catch & it is truly a sad, sad ending. Tomorrow, KimChi will leave peacefully and please know that even though your pain will be beginning, his will be ending. I, too, am in a tough spot because my disabled daughter's 18year old cat, Christy, stopped eating yesterday and the vet isnt available till tomorrow - Christy was a tiny, baby feral whose mother was poisoned & my daughter and I bottle-fed her from about 3-4 days old.....my daughter was a teenager recovering poorly from encephalitis and was extremely depressed, but beautiful little Christy gave my daughter the desire to live and get better. Christy is a family member, she is educated, too - some of my daughter's high school teachers allowed the kitten to be in their class!!!  At her last well check, the vet said that Christy was slowing down and if Heaven is kind, just wouldn't wake up some morning (my father died suddenly, in our yard, one night and it was such a blessing) so I was hoping we would get the same blessings for our little Christy, aka Kitty Princess Mao.Thank God for our TCS family of cat lovers who know and care    Susan

GoldenGoose83 said:

 
Thanks for your kind words. The abdominocentesis was done this afternoon and it did seem to hurt a fair bit but Kim Chi cooperated better than I would have if the procedure was being done to me. My resolve broke though when the doctor showed me the bright yellow liquid. FIP as good as confirmed. They are administering some fluids overnight but I guess I have to man up and return in the morning to say goodbye and make the hardest decision for him. It's been a relief being able to chat to people on here. Lots of love and positive healing thoughts to Francie.

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So sorry to hear it. When I saw the xray, FIP was my first thought, but we always hope that isn't the case! So sorry for you and for Kim Chi's cat family also.

Shoot.  I'm sorry to hear this. 

oh no, what awful news, I am sorry 

So very sorry for this news.

GoldenGoose83 said:

 
The abdominocentesis was done this afternoon.....the doctor showed me the bright yellow liquid. FIP as good as confirmed.....I guess I have to man up and return in the morning to say goodbye

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Hi GoldenGoose83.

General forums like this one are a wonderful starting point and first resource for average people to present problems and share experiences.

Where it comes to dealing with the critical issues of serious feline diseases though, many people find that the specialized online communities dealing with each specific disease/condition offer much more detailed - and often more informed and up-to-date - information and advice.

This is no wonder....after all, we expect much more informed information from our medical specialists than we do of our regular family doctors.

There are online groups dealing with almost every feline health disease/condition.....including FIP.

These groups have been running for years and have the collective knowledge and experience of thousands of people and their cats dealing with that disease. They are 'in the know' about the very latest i diagnostic testing and treatments as well as clinical trials of new treatments.

The FIP group has been active since 2002 and has seen 2500+ members and their cats. It's a very busy and active group.

There is an absolutely enormous amount of research currently underway towards an effective treatment for FIP - and these efforts have been ongoing for many years already. Huge sums of money are being and have been spent to date. There are (at least) two very large NGOs that are spearheading these funding efforts.

In 2013 a breakthrough was announced - you can read about it here: http://www.vet.cornell.edu/news/FIP.cfm    The same treatment concept that has been developed for HIV in humans is the basis for this discovery - the suppression of viral replication.

The most recent 'public news' about further developments can be found here (one of the two NGOs I mentioned): http://www.sockfip.info/

(If you want some sense of some of the number of studies already done by the other NGO, that's here:  http://www.winnfelinefoundation.org...logue=site-search&searchQuery=fip&wordsMode=0)

All of this is not meant to give you any false hope.

Twelve years ago I lost a very cherished cat partly due to my own ignorance of the resources which were then available online (and to an incompetent Vet). I wasn't even aware of the possibilities of second opinions. I was given one choice...one choice only. And, I had no time to assess what was happening.

If I were faced with your situation today, I would delay any irrevocable decision until I had presented Francie's case to the people in that FIP community and had heard what they would say on it.

It haunts me to this day that I was not afforded that opportunity.

If you wanted to consult the FIP group, their homepage is here: https://groups.yahoo.com/neo/groups/FIPCatSupport/info    Just click the purple + Join Group button there.

These groups were started in early Internet days when email was the common operating platform - most continue with email today. A new, dedicated email addy will help you manage the info flow best.

I wondered if you're in the UK - I saw your story on the UK forum as well. If so, don't dismiss any of this outright because of your location....see what the group might suggest.

I hope this may help your decision making.

catsknowme said:

 

   Oh, NOOOO!! I am so, so very sorry for KimChi's entire family - my prayers and thoughts are with you during this difficult time. You have done all that can be done and I assure you that you will be giving him one of the most precious gifts possible tomorrow - the act of true, unselfish love. I have seen feral cats with FIP whom I couldn't catch & it is truly a sad, sad ending. Tomorrow, KimChi will leave peacefully and please know that even though your pain will be beginning, his will be ending. I, too, am in a tough spot because my disabled daughter's 18year old cat, Christy, stopped eating yesterday and the vet isnt available till tomorrow - Christy was a tiny, baby feral whose mother was poisoned & my daughter and I bottle-fed her from about 3-4 days old.....my daughter was a teenager recovering poorly from encephalitis and was extremely depressed, but beautiful little Christy gave my daughter the desire to live and get better. Christy is a family member, she is educated, too - some of my daughter's high school teachers allowed the kitten to be in their class!!!  At her last well check, the vet said that Christy was slowing down and if Heaven is kind, just wouldn't wake up some morning (my father died suddenly, in our yard, one night and it was such a blessing) so I was hoping we would get the same blessings for our little Christy, aka Kitty Princess Mao.Thank God for our TCS family of cat lovers who know and care 

  Susan

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Thanks for sharing this beautiful story about Christy! It was so hard, but I'm glad we were able to be with Kim Chi in his final minutes and reassure him as he went to sleep.

I'm getting misty-eyed reading all these messages but I keep reminding myself how lucky we are to love and be loved by these special creatures. I'm glad your daughter was able to share her beloved kitty with kids at high school and find some joy. I wish Kitty Princess Mao an easy transition to her long sleep. The many years of love and happiness will outweigh any pain at the end.