New Re-homed cat, very lethargic and non-reactive.

[ginny]

I'm so glad you posted!  I've been concerned.  It is worrisome why she isn't eating.  How long will they let her go without eating?  I know she's getting fluids and that's really good.  And so glad her temp is lower!  

Is she still having diarrhea or anything coming out?  I hope I don't upset you asking questions, I just wish there were something I could do to help figure out what is going on.  Could it be that she's pining for her owner?  I couldn't imagine giving one of mine away and not even caring what happened to them.  What could be done for that?  

I recall my Sammy being in the hospital about 6 months before he died and him just lying in the cage listless.  But I had had him for 13 years by that point and he did miss his lovely home.  I asked the vet to just send him home with me to die because that's what I thought would happen within a day or two judging by how he looked at the hospital.  But once I got him home he came to life again and ate and drank and sat by the front door looking out, visiting his old favorite napping places. He still had a lot of life left in him at that point.

I know his situation and Koi's is different but I so wish for the same positive outcome and many more years to come.  That she comes back to life again and eats and drinks.  She's such a pretty cat and looks very sweet.   I know you will keep us informed.  Hugs to you Mariel!  

 

[mariel]

Hi @Ginny  - you are truly  lovely, thank you for caring so much. 

I'm not sure how much longer they are going to wait for her to feed - all I know is that they did give her an appetite stimulant today, and have given her a variety of food to choose from, so hopefully once it kicks in, she will be enticed to eat. 

I am going to see her tomorrow... but I don't know if that will encourage her to feed, or feel any better, since we've not really bonded yet, I only had her for a few days, and she was sick all the time.. so I hope she doesn't associate me with anything negative... I'll be devastated if that happens. 

So many questions to ask the vet tomorrow!!!

Again - you are lovely, thank you!

Mariel

 

[ginny]

 
Hi @Ginny  - you are truly lovely, thank you for caring so much. 

I'm not sure how much longer they are going to wait for her to feed - all I know is that they did give her an appetite stimulant today, and have given her a variety of food to choose from, so hopefully once it kicks in, she will be enticed to eat. 

I am going to see her tomorrow... but I don't know if that will encourage her to feed, or feel any better, since we've not really bonded yet, I only had her for a few days, and she was sick all the time.. so I hope she doesn't associate me with anything negative... I'll be devastated if that happens. 

So many questions to ask the vet tomorrow!!!

Again - you are lovely, thank you!

Mariel

Aww thanks, yes I am concerned and I want her to be better!  I wouldn't worry about her associating you with negative things.  I've learned cats can be very forgiving especially if you give them their favorite treats or scratch them under the chin or just feed them on time.  I'm not sure they have the capability to be resentful or hold grudges the way humans do.  Who knows how a kitty's mind works?  It's a mystery.  So, the more you reinforce good things, the less they remember the bad, if they remember for long.  Take care!

 

[mariel]

Hi All

So - this mornings update from the vet. Koi was stable overnight, her fever didn't spike back, and she is taking the intravenous fluids well, used the litterbox a few times.

Still waiting on the results of the virus scans - but one of her other tests came back with a higher level of bilirubin than is normal,so, they have sent off for another test to check for possible pancreatitis.

She still isn't eating at all - and turns away from all the food that they offer her. The vet said that today they will up her dosage of anti-nauseant to see if that will make a difference, otherwise the next step is either syringe feeding or an esophageal tube - but they want to give her as many options to eat on her own first.

@Red Top Rescue - I did ask about the antibiotic, and they are not giving her Covenia. They initially gave her Amoxicillin, and then yesterday added on Neofloxin, just to cover all bases.

I am going to see her tonight though, so will send another update then as well.

Thanks all

Mariel

 

[aislinn]

Thank you for the update, Mariel. I am praying for little Koi. I feel like I know her, and this is so heartbreaking.

 

[ginny]

Hi Mariel,



I sure wish she'd start eating.  Did she ever eat at the shelter?  When will you hear about the test for pancreatitis?  Do they think it's fatty liver disease?

I'm so sorry!  Hugs to you.

 

[mariel]

Hi @Ginny

Just got back from the vets - no more answers so far. They have ruled out FIP, her viral tests were all negative. Still waiting on the results for the pancreatic enzymes, and they are running some other tests as well... I've sorted lost track of everything. 
She's still not eating anything. They're giving her one more day to eat on her own.. and then will decide from there. They just didn't want to give her the steroid which will stimulate her appetite now, in case it masks whatever may be causing the problem.

So... waiting again until tomorrow. 

When I went to see her.. she was totally non reactive. Didn't get up, we had the cage door wide open and she never stirred. Petted, stroked, scritched her... she barely registered it. You know how if you give a kitty a scritch they usually lean into you or respond in some way.. she's doing none of that. Even the vet thinks it's very odd, given the her fever came down to 38.5, she's taking the fluids well etcetc.. 

So.. we just don't know... and I can't keep her there much longer  

I'm in a catch-22 situation, if they suspect pancreatitis, and she doesn't eat, they will have to keep her there for at least another week to treat the symptoms and give her an esophageal tube to feed her. If it's not pancreatitis, they will have to run more tests to determine what it is.. and still keep her there for a few more days to manage her eating, still a feeding tube ...neither of which I can afford really..
I'm so upset that the adoption insurance doesn't cover this, it makes me so angry .. why?? wouldn't you provide the insurance for just such a thing???

The shelter put her on another policy - that will cover her up to $400... so, I can afford another day at least. 

Sry, don't mean to vent at you guys... I'm just stuck in a really terrible point right now, and either way, it's going to destroy me emotionally. 

I'm gutted 

 

[ginny]

It really is odd that she isn't reacting. But she wasn't when she was with you either. @Red Top Rescue what do you think?? Do they suspect neurological damage from the fever? Do you have Care Credit ? That could help tide you over a little. I would be angry too that the shelter is not going to cover but $400!!! That s Terriible. I think red top rescue mentioned to say no to any further tests didn't she? Hope she will be by soon to advise you because I don't know. Why won't she eat? Is it depression? What about those shots? How was she before the shots? I don't know Mariel. I would be gutted too

 

[ginny]

I hope you got my PM just now.  I'm wondering WHY aren't they feeding her?  Fluids aren't enough.  I'd be weak as water too if I hadn't eaten in days.  I think they are waiting too long on the food but I'm not a vet and it's just my opinion, but I'm sure they know about hepatic lipidosis.  I hope @Red Top Rescue  will be by soon to advise.  I tried to page her on my iPhone and I couldn't make her name blue.  So I got back on my computer, just now.  

 

[ginny]

@Denice  will you please advise?  Isn't it odd that they are waiting so long to feed her??  It's been days.  No wonder she's so weak.

 

[denice]

I have had a kitty that went into hepatic lipidosis, he did survive but it was a long recovery.  I personally would be pushing to start getting food in your kitty.  As long as foreign body ingestion has been ruled out then the important thing is getting food in regardless of what the underlying cause is.  With my kitty the underlying cause was undiagnosed IBD, he had actually been having severe flares for six years while I was vet hopping.  IBD is really difficult to diagnose and is actually a diagnosis by elimination, even a biopsy isn't 100 percent definitive in all cases.  When I finally found a vet that got him diagnosed and treated he was in hepatic lipidosis.  

 

[red top rescue]

I'm going to send you a link to my favorite vet's article regarding when they won't eat.   It is extremely informative and has saved several lives of cats whose owners chose the E-tube after they got over their fear of it by reading this article.  Humans think of "feeding tubes" as horrible end-of-life scenarios, but with cats it's ever so much better than struggling with them  to try to get down enough calories to keep them from going into hepatic lipidosis.  It gives them time to heal, and once they start eating with the tube in (they can do this, the tube doesnt go through the mouth!) then the tube can be taken out. 

http://www.iwillhelpyourcat.com/blog/2015/3/8/feeding-cats-that-wont-eat-at-all-pina-the-e-tube

As you will see in this article by Dr. Kris, the e-tube will allow you to bring her home, there will be no need to stay in the hospital, and she will be better off at home anyhow.  She doesn't have to stay at the vet once feeding is managed and the fever has responded to antibiotics.  She can come home and just go back to have blood drawn if she needs more tests. 

 

[red top rescue]

PS - I wrote the note above this morning but forgot to push SEND and I'm only ust now checking in on my laptop before going to bed (it's 4:20 AM here.    I guess that's why @Ginny is trying ti message and page me. I understand the vets wanted to wait and see if she responded to the antibiotics, but it's time to get some food in one way or the other.  If she still refuses to eat, I think you should go with the e-tube  now. BTW I am a "Senior" in the school of life and I don't stay connected with a smart phone and I don't text, so I will get messages here when I check in on the laptop so you can't reach me when I am not online.  I stayed up all night writing on TCS (and napped this afternoon).  Now it's time for bed again.  My cuddle cat is waiting.

Even when this cat feels better physically, the not eating could be depression from all that's happened to hee recently.  The feeding tube will solve the physical problem of not eating, and time and love can solve the emotional problem usually, although it can take a long time to connect with a Siamese who has been abandoned by that first owner.  Having a flat affect (i.e. not showing any response to anything)  Certainly being in a hospital is depressing for any of us!

As for the Pet Insurance not covering it, the same thing happened to me years ago so I totally hate all inurance companies.  I think they are deceptive and that "free insurance coverage" that they give to rescues and shelters to give their adopters does set people up for the "pre-existing condition" denial when you try to make a claim for ongoing expenses for something that occurred on the "free" policy.  You pay the premium and think you are covered after the 30 days, and then they have all kinds of loopholes.  Remember, what insurance companies want is to get your money and keep it.  They don't want to pay for anything if they can help it so they make it difficult to make claims.  I'm sure some are better than others.  That would be a god thread to start, comparing pet insurance companies.   DZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZ

oops, that was me literally falling asleep at the keyboard.  It's now 4:42 AM and I'm going to bed!

My wish is that they put in an e-tube and send her home with you. with feeding instructions as to how many calories you have to get into her daily.  Meds can go in the feeding tube as well, makes pilling your cat a non-issue.

 

[aislinn]

Oh Lord. Mariel, I'm praying for you and Koi.

 

[ginny]

In total agreement with all the above.  Please Mariel, don't let them go one more day without giving her food!  I can't believe they aren't even trying yet!   Not even syringe feedings!  Tell them to put the E-tube in and bring her home.  If it only takes 48 hours for hepatic lipidosis to begin, it is essentially their fault if it's happened already because they've waited so damn long to "see if she will eat".  That ain't happening!!  They should have known that when her fever came down.  Aren't they even concerned about putting her in hepatic lipidosis??? She's been there since Monday and it's now Thursday. I think they should have only given her 24 hours before inserting the E-tube.  God this is frustrating! 

Sorry for venting and getting angry. I'm not a vet nor a tech, but with all that's been said about hepatic lipidosis it's just frustrating that they are not being more aggressive to prevent this.  An abdominal Xray should have been enough to show an obstruction, if not that, then a CT would show it.  

 

[mariel]

Hi All

Just got this update - so, she ate a tiny, tiny bit last night, on her own. But, her temperature spiked again. The testing for hepatic lipidosis came back negative, so did the test for pancreatic enzymes. So, they've ruled out FIP, ruled out Pancreatitis, which means the amount of bilirubin in her blood and urine is probably due to some sort of ongoing chronic kidney condition? Sorry, I can't remember all the details as it was a lot to take in and I'm totally devastated. I am going there again this afternoon. Basically - this is something that she has had for a very long long time ( the vet puts her age at closer to 4 years - as there was a discrepancy on the adoption papers) - and I heard today from the shelter that they'd been in contact with the previous owner who said that Koi has always been a 'nibbler/fussy eater' - which probably means she's had episodes like these before, not eating due to whatever this condition is, but has been able to bounce back, so no one got her treated for anything. I'm trying to remember what he said about her kidney values - and how the urine output and the test numbers are at odds with each other and should not be showing like this (again, I apologise, it was such a lot to take in)...now though, whatever this latest episode is, she's not able to bounce back on her own since the accumulate damage is so great. (because the pancreas is normal, the bilirubin must be from blood cells destroying themselves due to infection/inflammation - something like that)

The options I have are limited - since there's really no way to manage her symptoms, without knowing what exactly the problem is and what they're trying to do (with the appetite stimulant, fever reducer etc) is not working.

The option to send her home with an eg tube is not possible - since the vet can't get any of her other symptoms under control, and if she goes home with her temp still rising - even if she feeds, it's still not fixing the underlying problem. The only way to help her is to basically keep her at the vets and manage the symptoms until they resolve (unlikely). So, I can keep her there for however much longer just keeping her comfortable and managed and hope she gets better on her own, or keep her their and they run more diagnostics (3D ultrasound, biopsies etc) and then maybe they can pinpoint the problem.

Thing is - I can't afford either of those, and even the vet said, given that clinically she's not shown any signs of improvement in the last 4 days, the prognosis either way is not good.

So.. everything is pretty much #@&%(#$ed

So, long story short - they don't know what is wrong, so they don't know what to do to 'cure' her - and everything they're trying right now is not working. I can take her home with a feeding tube and be back again when she relapses (which will be sooner rather than later since her temperature is already going up again) and then start this whole process over again... or keep doing tests until they figure out what is causing these syptoms, and manage her care in-hospital. But... more than likely, this is going to be a chronic, severe condition that will continue for the rest of her life.
So.. basically, it's been recommended that she be humanely euthanised.

I am going back there again just now to see her and the vet and makea decision. This is the worst

Mariel

 

[aislinn]

Oh, Mariel. I am so sorry to hear this. Poor sweet Koi. Poor you. My heart is with you.

 

[ginny]

I so wish @Red Top Rescue  could advise you before you make that decision.  Can't they put her on steroid to help the fever for a little while and send her home?  It sounds like they are just bilking you for money by saying they want to test test test.  Why is coming home with an E tube not possible?  They won't let you do that?  

 

[DreamerRose]

Mariel, I am so sorry. It sounds like the vets are at their wit's end and they are grasping at straws. It's so unfortunate that the shelter won't take any responsibility for this. Not to mention the previous owner. He or she had to know something was wrong. It could be the best thing is to visit her as you planned and say goodbye.

 

[mariel]

Hi @Ginny

I think they did try a steroid? I remember them mentioning something about that once they thought it may be related to pancreatitis.

I trust my vets - they have been so good to me in the past, so I know that they're not bilking me by doing as many tests as they can - they're really just trying to figure out what's wrong with her, and everything they are leaning to as possibility is coming up negative. I trust them because they are actually reluctant to go in for the 'big' tests - they don't want to start doing the $1100 diagnostics if they can try do whatever else they can first... so it's okay with them - they are absolutely doing the best they can (there are 3 vets that work in rotation and they all share each others knowledge and compare notes etc - so they're always relying on each others expertise to make sure nothing is overlooked).
The are totally okay with doing an eg tube - but if they just send her home with me, it's still not fixing the problem - especially now that her fever has started creeping back up, even while being on antibiotics, so, I can take her home, and she just relapses there and has to come back again.. or continues to just stay the same until the prescription runs out, and then the problem begins again? It's just tough to know what to do with her, because they don't really know what's wrong..

that's why this is so shitty



I think the biggest problem is - sending her home with a feeding tube would be fine, I'm more than willing to work with that, if that's all that she needed. If she was diagnosed with something that could be treated, at home, with a feeding tube, that would be something I can work with! Something I can actively do while she gets better. Problem is, she's not diganosed with ANYTHING - they cannot figure out what the problem is with the tests they've run so far. The only way to get an actual answer, is to do an Ultrasound, and a biopsy ( which combined will cost over $2000 - that I just don't have). And even still - IF that gave an answer, then there's still the rest of the vet bills that would go along with that. So just bringing her home, still sick, and feeding her through an eg tube isn't going to help her either - she's still going to be sick y'know? It's screwed up no matter which way you look at it.