Advice On Course Of Action

obijkenobi

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Hi all,

Sadly, my first post on the forums is about the health of my little man Scottie. Scottie had a rough life before I adopted him. At some point along the way, he had injuries to his ears which led to him having curled ears, a scar at the base of his tail which has given him a bald spot, and his previous owner died and he had to be surrendered to the Humane Society. I don't know his exact age, but he's at least 8 and I've had him for a year.

I'm guessing because of how his life has gone he developed separation anxiety. I live alone and sometimes have to travel for work for a day or two, so he would be in the apartment alone (2 bedroom so plenty of room) and I'd come back to pee on the bed or couch even though I cleaned the box before I left and would have someone come feed him the second day I was gone.

Anyway, this is important because this led to a few things. He is very friendly with cats and about 4 months ago I adopted Zelda thinking he needed a presence when I was gone. After a week or so, they got along. Not super best friends, but they will sleep like a foot from each other with me on the bed.

Anyway, this month I had really long work days, had to travel, and did a horrible job cleaning the litter. Scottie peed outside the box twice, so I thought it was the separation anxiety + being a bad cat dad, but then I noticed he had been drinking less water and eating less food than normal. I thought he might have a UTI which could contribute to both.

I took him in for what I thought might be a UTI and the vet was immediately concerned about weight loss and wanted to do a full work up. He had lost nearly 2 pounds since he last came in (8 months or so). I'm not sure how quickly that had happened, but I knew he had been gradually losing SOME weight when I got Zelda because Zelda would eat his left overs (Scottie is a grazer).

More than $400 dollars for xrays and complete blood work and the vet told me his blood work was all fine and no UTI, but he had a lot of fluid up in his abdomen that obscured the organs there. She said it was probably cancer or FIP and that my next step was to pay another 400 for an ultrasound which would probably confirm either. She said I could either do than ultrasound or nothing and that he would probably decline rapidly. When I was silent because of the shock (she had spent 10 minutes telling me his blood work results one by one showing no issue, then BAM cancer or FIP are probably it) she said they could examine the fluids in his belly but that would probably not show anything.

I apologize that this is so long, but I am coming to my question. I haven't talked to that vet since. I have a vet tech friend who was hanging out with me the day before and whom got to see Scottie. I asked her what she thought and she asked if the vet had recommended appetite stimulates, diet changes or any meds to reduce fluids or examining the fluids themselves. The vet didn't mention any of that other than the fluid test which she immediately dismissed, I didn't even know they were options to be honest.

I changed his diet to Blue Buffalo wet food from Fancy Feast wet food and he immediately began eating that and drinking about as much water as he usually does. He's been on BB wet food for the past 3 days and its like his appetite is back. Its hard to gauge his energy levels because he was always a lazy cat, but he grooms himself and sleeps in his favorite spots. I can't really afford another $440 test right now, but should I ask for the vet about the other options or even for a second vet to look at his results?
 

jen

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Did she mention a test on the fluid in the abdomen or are you referring to the ultrasound? If the it is cancer or FIP, the outlook is grim unfortunately. Unless you wanted to pursue chemotherapy, you might only be able to treat the symptoms. I am not too hip on FIP so maybe someone else can give you some insight.

So increasing the appetite and getting the fluid out of his belly are the first two things on the agenda. Call the vet and ask about the fluid. Is there a medication he can go on to reduce it or would it physically need drained with a tube, is it going to just come right back (I have a feeling it will which is why the vet was hesitant to go further with anything).

Your tech friend is right, appetite stimulants would help. Canned diet is best. I feel like its a case of giving him whatever canned he will eat at this point. I don't feel like I was incredibly helpful so hopefully someone else will be along to help.
 
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obijkenobi

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The vet first pitched doing an ultrasound because the fluid was obscuring organs/potential cancer. That would cost $440, which I don't have atm because I literally spent that much on bloodwork/xrays. She said they could test the fluid itself, but she doubted it would show anything.

She never presented options to treat the symptoms. Scottie has always gotten wet food as a first option (I leave dry food for the cats when I go to work, but feed them wet food when I'm home) and occasionally gets bored of the flavor. This time I switched to a higher quality brand and flavor (Blue Buffalo).
 

jen

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Ok everything she did and said makes sense so far, but I find it odd she just said goodbye without a plan. Diet, meds, recheck in a month, ANYTHING. Now that you have processed everything maybe call in and ask what the vet recommends based on your budget.
 

Adelei

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The vet first pitched doing an ultrasound because the fluid was obscuring organs/potential cancer. That would cost $440, which I don't have atm because I literally spent that much on bloodwork/xrays. She said they could test the fluid itself, but she doubted it would show anything.

She never presented options to treat the symptoms. Scottie has always gotten wet food as a first option (I leave dry food for the cats when I go to work, but feed them wet food when I'm home) and occasionally gets bored of the flavor. This time I switched to a higher quality brand and flavor (Blue Buffalo).
So I've had one cat die (very, very quickly) from cancer and another die from kidney failure. I was able to keep the cat with kidney failure going for about 2 years after diagnosis by giving fluids through an IV twice a week and using appetite stimulants.

My opinion is that you should try to get the ultrasound done as soon as you can get the money together. Giving appetite stimulants to increase his appetite will help to a certain extent, but it's not going to cure cancer or FIP. And I'll tell you, with my girl, it also only helped to a certain extent. Even with the appetite stimulants, she'd constantly stop eating. Every time she'd stop eating or lose interest in a food, I'd have to switch to another brand or flavor (and she never went backwards and became re-interested in old brands/flavors we had previously tried.) Over the course of two years, we went through nearly every dry and wet food that was available at the time. It cost a lot of money, because sometimes I'd buy a bag of dry food and she'd eat one or two meals out of it and then lose interest.

I don't regret those two extra years I got to spend with her, but I just don't know that your case is the same. The appetite stimulant wasn't the only thing keeping her alive - the fluids twice a week was what her diagnosis required. If you don't have a diagnosis, you can't treat the illness. Giving appetite stimulants does help, but you're essentially treating one of the symptoms without knowing the cause. Even with the appetite stimulants, if you don't treat the underlying issue, he could still fade and pass away rather quickly.

My boy that died of cancer was probably more similar to yours. I found him as a stray, but he had certainly been a house cat at some point in time, because he came running every time he heard the can opener (and I never fed him food that required a can opener). The vet I took him to at the time estimated him to be around 3, but they weren't sure. He was diagnosed with abdominal cancer at the age of 9 and passed within a week of first showing symptoms. I feel bad that I didn't do more for him, but the doctors didn't believe that anything would extend his life beyond a few weeks. And to make matters worse, this was literally right after my dad passed away from colon cancer. We had just been through a month of sitting in hospice with my dad, watching him go through all these end-of-life things and now I was immediately watching my beloved cat go through the exact same things, but at an accelerated pace. I just couldn't bring myself to let him suffer the way my dad had suffered on chemo and radiation, especially if it wouldn't help much in the long run. My cat passed exactly 2 weeks after my dad's funeral.

Even as I write this, my heart is breaking again for my lost cats, so I feel for you. I hope you can find a way to help Scottie.
 

di and bob

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The ultrasound will only confirm what is wrong and either option doesn't sound curable with the symptoms present. No one knows how long he has, he may live for years yet. As long as he is eating, drinking, and using the litter box, I would just love him and make his life as comfortable as possible. You have already given him everything he wants when you opened up your heart and your home to him. He will forever be grateful. If you diagnose cancer/FIP, then what? Horrible expensive chemo and endless tests and pain that just prolong the inevitable? I for one would personally not want that, especially going through all that with out a cure, just getting a few more months of unending pain and being so scared. Let him enjoy what he life he has left. If he begins to decline again, take him to a different vet, you may want to research for one now, one that can give you a definite plan of action to work with. But in the meantime, just enjoy what time you have left. And know taht your love means the world to him, and he is receiving what that sweet boy deserves, love and a wonderful caring home.
I'll keep you all in my thoughts and prayers, I only wish the best for that precious boy. I pray he has many more years, and if not, a peaceful end. Take care my friend.....
 
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obijkenobi

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Thank you everyone. I will ask the vet about treating symptoms. Like I mentioned earlier, when I adopted him, he was already a senior cat, so in previous vet visits, I never had a good answer to questions about his long term behavior.

From day 1, his stool has always been on and off loose, but tests for that showed nothing. My plan, like its always been is to love him for as long as I can. If his weight drops to under 8lbs, gets to weak to get to his favorite sun spots, or stops asking for food, I will know its time.
 

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I want to just chime in with my experience with FIP. While mine is with the dry kind, not the wet (and the wet does cause decline faster), I feel like it might help with your situation.

Luna was my roommates cat but she was essentially everyone's cat because we all took care of, watched over, played with, etc. with her. She was always a bundle of energy and joy. She was SUPER food motivated and would literally steal food off your plate or the counter if you didn't watch her close enough. She would even get into the sink and go into the garbage disposal (with her head) to get food if it had not been run. With all of that, her lack of a normal solid poop was something we always (and the vets) attributed to her getting into food she shouldn't have. She consistently had soft or runny poops for months. And then one day, Luna just stopped eating.

My roommate took her to the vet who said she was running a fever (a seriously high one at 105.8, lethal being around 106.) and immediately put her on fluids. She had lost weight, which she was a small kitten to begin with. My roommate had lots of tests done, all of them coming back with nothing definitive. The vets diagnosed her with dry FIP based off elimination. Luna was put on antibiotics, prednisolone and something for her fever. The combination of all of this actually made her seem so much better we were almost convinced she couldn't have FIP. She gained A LOT of weight while on the prednisolone (one of the side effects is an increase in appetite, which is why I bring it up to you).

Luna eventually did die from this. Her body deteriorated very quickly towards the end. Her immune system couldn't fight off anything which made it hard on her. She was barely a year old.

Now, thats the long backstory of this. My advise to you is to get the fluid examined. Like Jen mentioned, talk to the vet to see if they can drain it. I don't want to get your hopes up, but there was a case on here where the vet was SO positive it was FIP but the examination of the fluid didn't have the markers for the corona virus (which is what causes FIP). Also talk to your vet about if prednisolone would be a good option for him. It will bring down the inflammation in his body as well as act like an appetite stimulant.

Lastly, my advise to you is if you feel like your vet isn't doing enough or you aren't comfortable, GET A SECOND OPINION! Scottie is a gorgeous kitty and even if someone else is telling you it's dooms day, another vet might have options that could help him.
 
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obijkenobi

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These are some of his fav sleeping spots. He hasnt slept on thr couch in a while, but that might be some of the cat urine cleaner I used because he peed there before I took him to the vet. I say that because Zelda used to like to sleep there tok, but doesnt much anymore.
 

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Plumeria

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I would go for the ultrasound when you get money together, or perhaps use CareCredit. Cats live 20 years, so at 9 years old, your baby is still middle aged. The ultrasound would help pinpoint the exact cause of Scottie's symptoms so your vet can come up with a course of treatment and hopefully a resolution. My Leroy passed away 3 weeks after his cancer diagnosis. He was 9 years old like your Scottie but declined rapidly from aggressive large cell lymphoma. If your Scottie has cancer, it could be small cell lymphoma, which would give him a much better chance of survival with cheaper oral chemo. But you don't know until the vet pinpoints exactly what he has. Whatever decision you make, good luck, and I'm sorry you and Scottie are going through this.
 
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obijkenobi

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The vet gave me some meds to boost his appetite and hopefully drain some of his fluids. I simply won't have enough money to spend the extra on testing plus treatment. That would be more than 1k at the very least.

Its tough. If it was something I knew for sure would be treatable and within a budget that I could afford if I tightened my belt, I would do it. But if to spend 1k to find out its something like FIP...would be emotionally and financially devastating. At least now if it is something like that, he won't spend the last bit of his life wasting away.
 
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obijkenobi

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So the meds worked for a bit. Scotties belly shrunk a little bit ans his appetite and increase. I went out of town for a day and came back to a cat that is asking for food and when I give it to him, he walks away. This is with him on appetite stimulates.

I will watch how he reacts the next few meal times since I don"t work today or tomorrow, but if he isn't eating by tomorrow, I think its his time.
 
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obijkenobi

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1.9 mg Mirtazapine. Its prescribed for once a day but after the first dose his appetite went back to normal for a few days. I gave it to him again this morning so we will see.

I will also try dofferenr flavored wet foods
 

Stinky15

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1.9 mg Mirtazapine. Its prescribed for once a day but after the first dose his appetite went back to normal for a few days. I gave it to him again this morning so we will see.

I will also try dofferenr flavored wet foods

Interesting. I haven't seen any recommendations for an every day dose, only 72 hr. and every other day. I have been giving my cat Mirtazapine for over 3 mos. His original dose was 3.75 every 72 hrs., but when he was on nasty Antibiotics I found that sometimes he needed a little more of it so I would give him half a dose after 48-60 hrs. or if it was 12 hrs. of time for a dose I would give him the full dose early. My Vet. gives me 15mg. pills which have been quartered and some of them are bigger or smaller. I would try some Baby food, Plain Chicken, Turkey, Ham or Beef whatever you think your cat might like. Make sure it has no onion/garlic. I found for a while he would eat that when he wasn't eating well. I always tried to get some regular kibble/cat meat in him so he got all the vital nutrients as well. I certainly understand your feelings about spending the money, I have spent several thousand and all I know is that he supposedly has no cancer, but he has swollen lymph nodes by his intestine which apparently is causing his Cobalamin (B-12) to be too high and making him not eat. He and I have been thru a lot. I think I would either talk to the Vet. again or possibly get a 2nd.opinion before I spent a lot of money.
 
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obijkenobi

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An update in Scottie B. It def feels like he has taken a turn for the worst. His belly is swollen again and while he drinks water, he has lost almost all interest in food. I gave him his appetite stimulate today after work (which he hates) and he has still shown no interest in food. He did eat some canned tuna, which is a food that he has gone wild over, but he ate very little. Maybe a teaspoon or two.

The most troubling part is he seems to have gotten to point where he has some issues moving around, probably from his belly size and not eating. He can still get tk his window perch and get with the bed with me, but he doesn't seem happy right now. In the morning I will schedule an appointment with the vet and see if they have any last meds recommendations. I am coming to grips that my little buddy might not make it to 2019, but I dont want to be selfish and keep him around if he is hating life and no longer eating.

The first pic is from him today and the second fron a few days ago. You can how his belly has gotten swollen from the sides. The third pic is from him begging for food in early June. The last one is from March with my exe's cat.
 

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obijkenobi

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Well, Scottie just peed on me this morning, which he has never done, so yeah
 
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obijkenobi

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Last update on this part of the forum...I scheduled Scottie's final vet visit for tomorrow. I almost lost it a few times at work and have definitely sobbed repeatedly at home
 
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