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Etta got her 2nd blood test today to see if the thyroid medication was at the right level. She was at one full tablet of methimazole. She initially was at 10.4 on the scale for hyper thyroid and now is at 3. So now it is 1 and 1/4 tab twice a day. She's been perky, social, eating well. Fights me on the medication. Loves her catnip, feisty and her goofy self. The 2nd set of blood test was good on the kidneys, but show troubling changes in hemoglobin, drop in red blood cells and increase in liver enzymes. She had a 10% drop in red blood cells. It was 30 and now 21. So no she has to take Pet-Tinic to up her iron levels.
She had initially been into the vet and then a specialist because she had fluid build up in her abdomen. She got an ultrasound at the specialist and they sent some of her abdominal fluid to a cytology lab for analysis. The non specific finding in the fluid was that it was "modified transudates." It was a pretty non-specific finding showing some activity on cells like neutrophis, mesothelial cells and macrophages. It wasn't activity that suggested "neoplasms" (cancer) but didn't rule it out. It wasn't likely FIP but they wouldn't rule it out.
The ultrasound showed nodules on the omentum which could be cancer or irritation from whatever was causing her vessels to leak. The specialist suspects cancer and wanted to do an endoscopic biopsy ($3000). An open biopsy at the specialist would be $900 and at my regular vet $500. The only purpose would be to confirm or rule out cancer. I didn't want to do that and have her last weeks spent in pain from an open biopsy of her omentum (the fiberous net of tissue that holds internal organs together).
The specialist put her on prednisolone and pentoxifylline (trental or pentoxil) which is supposed to help blood flow more freely and make it less clotty and so less likely to leak and cause fluid build up. The prednisolone was for the inflammation evident in some of the interaction of the cells. I am at 2 weeks of 4 weeks of this combo of medication.
She also got atenolol for her fast heart beat.
I did learn a ton about effusions between those tests and now. There was an article on DVM360 from 2009 Cytology of Effusions that explained what modified tranudates means. Basically the protein is a little higher and the cell count is a little higher. The fluid is a little cloudy but fairly clear, sort of orange because of blood. The cytologist thought that it was evidence of maybe a past hemerorrage. And it's on its way to be "exudate."
At that time they did a therapeutic drain of most of the abdominal fluid and took out 1281 ML of fluid.
In these two weeks, she was getting more fluid in her abdomen but at a much slower rate. They removed 481 ML today. Not all of it so that it didn't screw up her electrolytes.
Her blood test wasn't so good. Hemoglobin low, liver enzymes went from 94 to 200 (but thought to be from the irritation of whatever is going on. Her red blood count is low. The good news is that her kidneys are good.
The cell activity is similar to what was in the cytology report but now there is "wall to wall cells" and it's milky colored and no longer clear.
My vet still thinks there is some sort of infectious thing going on because of the color of the fluid and the liver enzymes so she got a shot of covenia again.
The vet doesn't know. I think to see what the cells look like would take sending the fluids to the special cytology lab again to see if the cells are of a particular shape. The very helpful proceedings paper I looked at talked about how different forms of cancer have different characteristics in the cells that they see.
I don't have the report from my regular vet. The specialist gave me all the paperwork which was helpful in some of the research I've been able to do.
The pred and the pentoxil were compounded because pilling Etta is a challenge (and she's an easy cat). It's not super easy to get the liquids down her. I've taken to crushing up the atenolol and the methimazole and mixing with water and sucking it into a syringe to give her too because of her expert ability to spit out the pills. Tonight after crushing, I squirted out the dose of the pet tinic and then mixed and sucked it into the syringe so that she didn't have yet another medication to take.
Tonight she had 3 oz can of food with gusto followed up with a dessert of plain boiled chicken. It's snack time so I'll give her some Natures Variety Lamb which she enjoys. It's all a mystery. I thought I'd update. If you are interested in the article I can post the link since abdominal fluids have affected other kitties too that isn't FIP.
She had initially been into the vet and then a specialist because she had fluid build up in her abdomen. She got an ultrasound at the specialist and they sent some of her abdominal fluid to a cytology lab for analysis. The non specific finding in the fluid was that it was "modified transudates." It was a pretty non-specific finding showing some activity on cells like neutrophis, mesothelial cells and macrophages. It wasn't activity that suggested "neoplasms" (cancer) but didn't rule it out. It wasn't likely FIP but they wouldn't rule it out.
The ultrasound showed nodules on the omentum which could be cancer or irritation from whatever was causing her vessels to leak. The specialist suspects cancer and wanted to do an endoscopic biopsy ($3000). An open biopsy at the specialist would be $900 and at my regular vet $500. The only purpose would be to confirm or rule out cancer. I didn't want to do that and have her last weeks spent in pain from an open biopsy of her omentum (the fiberous net of tissue that holds internal organs together).
The specialist put her on prednisolone and pentoxifylline (trental or pentoxil) which is supposed to help blood flow more freely and make it less clotty and so less likely to leak and cause fluid build up. The prednisolone was for the inflammation evident in some of the interaction of the cells. I am at 2 weeks of 4 weeks of this combo of medication.
She also got atenolol for her fast heart beat.
I did learn a ton about effusions between those tests and now. There was an article on DVM360 from 2009 Cytology of Effusions that explained what modified tranudates means. Basically the protein is a little higher and the cell count is a little higher. The fluid is a little cloudy but fairly clear, sort of orange because of blood. The cytologist thought that it was evidence of maybe a past hemerorrage. And it's on its way to be "exudate."
At that time they did a therapeutic drain of most of the abdominal fluid and took out 1281 ML of fluid.
In these two weeks, she was getting more fluid in her abdomen but at a much slower rate. They removed 481 ML today. Not all of it so that it didn't screw up her electrolytes.
Her blood test wasn't so good. Hemoglobin low, liver enzymes went from 94 to 200 (but thought to be from the irritation of whatever is going on. Her red blood count is low. The good news is that her kidneys are good.
The cell activity is similar to what was in the cytology report but now there is "wall to wall cells" and it's milky colored and no longer clear.
My vet still thinks there is some sort of infectious thing going on because of the color of the fluid and the liver enzymes so she got a shot of covenia again.
The vet doesn't know. I think to see what the cells look like would take sending the fluids to the special cytology lab again to see if the cells are of a particular shape. The very helpful proceedings paper I looked at talked about how different forms of cancer have different characteristics in the cells that they see.
I don't have the report from my regular vet. The specialist gave me all the paperwork which was helpful in some of the research I've been able to do.
The pred and the pentoxil were compounded because pilling Etta is a challenge (and she's an easy cat). It's not super easy to get the liquids down her. I've taken to crushing up the atenolol and the methimazole and mixing with water and sucking it into a syringe to give her too because of her expert ability to spit out the pills. Tonight after crushing, I squirted out the dose of the pet tinic and then mixed and sucked it into the syringe so that she didn't have yet another medication to take.
Tonight she had 3 oz can of food with gusto followed up with a dessert of plain boiled chicken. It's snack time so I'll give her some Natures Variety Lamb which she enjoys. It's all a mystery. I thought I'd update. If you are interested in the article I can post the link since abdominal fluids have affected other kitties too that isn't FIP.