Septic Arthritis or Mediated Polyarthritis?

[Mac and Cats]

Update on Molly: she had her follow up appointment today and the vet reported on what the radiologist's thoughts were. They also thought it was immune mediated polyarthritis. Her swelling has gone down 50% since we started the steroids. So they want her to continue until she is stable and then we will start tapering. The vet thinks that since immune mediated polyarthritis can be triggered by vaccines (ie. shots) and since Molly hasn't had any vaccines for several months, that it is very likely the Solensia or the act of injecting Solensia monthly caused this reaction. She is going to report it to the company. She said that since there is very little known there might be more reports coming in similar now, but we won't know for awhile. I really do believe Solensia improved Molly's life for a long while. But since we can't rule out if this is what caused her most recent ailment, we won't be moving forward with a 14th treatment. Molly is still acting normal, but I do think the swelling of her joints have gone down. Today was her last dose of antibiotics which I think is what has put her off of eating her pills on her own. I did get her to eat some of her pills this evening, but it took some treats and coaxing. Hoping we can get back to normal once she doesn't smell the antibiotics. I think she probably bit into one on accident and that is what has turned her off.

Unrelated, but my husband's grandmother died this evening. She was 93. Goodnight, Grandma Betty.

 

[DeesCats]

Thanks for the update on Molly and hope she continues to improve.

I'm so sorry for your loss of Grandma Betty, please accept my condolences for your family's loss.

 

[fionasmom]

That is good news about Molly! Vaccines can be another piece to this puzzle.

Grandma Betty lived a very long life and I hope that her passing was peaceful. I am sorry for your loss.

 

[alsmommy]

Thank you so much for sharing! My 19 year old cat has been getting Solensia injections for about 6+ months. On Friday (2/16/24), I noticed both of his hocks were swollen. I was able to get him into my trusted vet yesterday (2/19/2024) who did xrays and said he could tell the swelling was being produced from the ankle. He took fluid sample and has sent it off to the lab for testing. The preliminary diagnosis was septic arthritis, but honestly my vet wasn't even sure about that. I was confused as to why it would be both hocks at the same time. He started Clavamox last night while we wait for results. I wonder if it was in fact caused by the Solensia injection which was last given 2/5/2024. Please keep sharing any info you have as I'm still waiting for any results to help my old kitty.

 

[FeebysOwner]

I was confused as to why it would be both hocks at the same time.

I guess more to the point would be why not? The injection goes throughout the entire body, so if there is an impact, it could be anywhere, including multiple locations - perhaps the most 'vulnerable' locations?

 

[alsmommy]

I guess more to the point would be why not? The injection goes throughout the entire body, so if there is an impact, it could be anywhere, including multiple locations - perhaps the most 'vulnerable' locations?

I meant about the bacterial septic arthritis being in both hocks versus just one. Being the solensia makes more sense to me since it does go throughout the body.

 

[Mac and Cats]

Thank you so much for sharing! My 19 year old cat has been getting Solensia injections for about 6+ months. On Friday (2/16/24), I noticed both of his hocks were swollen. I was able to get him into my trusted vet yesterday (2/19/2024) who did xrays and said he could tell the swelling was being produced from the ankle. He took fluid sample and has sent it off to the lab for testing. The preliminary diagnosis was septic arthritis, but honestly my vet wasn't even sure about that. I was confused as to why it would be both hocks at the same time. He started Clavamox last night while we wait for results. I wonder if it was in fact caused by the Solensia injection which was last given 2/5/2024. Please keep sharing any info you have as I'm still waiting for any results to help my old kitty.

I absolutely will! Our vet said that when the immune mediated polyarthritis comes into play that it is usually all of the corresponding joints? Maybe ask your vet about that. We have a LOT going on right now with our pets (not just Molly), so I am so overwhelmed and could be misunderstanding or misremembering. Did they say it could also be immune mediated polyarthritis? Did they do x-rays? Please ask your vet about reporting it to the manufacturer. If they don't get reports, they don't know! So, every case like this may be important moving forward. I am really sad about not giving Molly the Solensia injections moving forward because they DID really help her for quite some time. Her swelling has gone down now with the steriods, but the vet said it probably won't ever go back to "normal". Would you mind giving me updates as you get any new information or just even reporting how your cat is doing? I don't mind if you report them on this thread so that other people in the future can also see.

When I was looking back for photos to send to the vet, I noticed swelling in a photo from even back in November, but I apparently didn't notice it back then. So, I think it was probably beginning stages. Hopefully, you caught it early. If the antibiotics don't work after a week they may want to consider that it is immune mediated polyarthritis and start steriods. At least, that's what happened with my girl. I truly hope you kitty improves and would love to get updates on your kitty once you have more information. Good luck to you!

Edit: So sorry, I see that you did get x-rays! Did they send them to radiology? Would love to hear the results on that if so.

 

[alsmommy]

I got the information back from the pathologist and my primary vet looked at the xrays that were taken. Altogether, they have determined that the hock swelling is not due to septic arthritis as they first thought. They have determined it is degenerative joint disease. When I mentioned the Solensia, he said that he believes the Solensia relieved my cat's pain enough so that he then overused his joints causing the inflammation. He does not believe the Solensia is a direct cause. Treatment for now is to discontinue Solensia, reducing his activity level, and using Onsior for inflammation.

 

[Mac and Cats]

I got the information back from the pathologist and my primary vet looked at the xrays that were taken. Altogether, they have determined that the hock swelling is not due to septic arthritis as they first thought. They have determined it is degenerative joint disease. When I mentioned the Solensia, he said that he believes the Solensia relieved my cat's pain enough so that he then overused his joints causing the inflammation. He does not believe the Solensia is a direct cause. Treatment for now is to discontinue Solensia, reducing his activity level, and using Onsior for inflammation.

Thanks for the update! I hope your kitty is feeling ok!

 

[Mac and Cats]

Thought I'd post a quick update. Molly seems to be doing just fine although, she is still walking on her ankles. I can't remember if I already posted that the vet thinks that issue is separate from the swollen joints. I suspect it may be because she felt better with Solensia and was doing more than she should have (mostly jumping off the bed instead of using the stairs) causing injury to those ankles. Unfortunately, I don't think there is much we can do about that issue and mostly everything I've read online says only surgery could possibly fix it. Anyway, her swelling seems to be getting better daily and she is acting herself. I do worry that once we finally ween her of the steroids that she will feel more pain from her arthritis. Only time will tell.

 

[Mac and Cats]

Molly's swelling has gone down significantly. We will be finishing out this week at 10mg of Prednisolone per day and then we will start the taper process of 5mg per day for 2 weeks and then moving to every other day. It's hard to tell in photos, but when I feel her back hocks, I can feel that the swelling has gone down a lot. She's still acting mostly the same. No change in behavior, eating, drinking or litter box habits. She is not very active in general.

One thing I noticed was that she seemed unsteady walking on our window sill to the window bed. She gets up to the window sill by using the kitty stairs to our bed and then from the bed to the dresser that is next to the bed and then from the dresser to the window sill that is right next to it. I noticed she was unsteady and paused to sort of recover her balance. I don't think it is anything neurological, I just think it's her arthritis and the smallness of the window sill making her feel like she's on a tight rope. There is nothing under the window to catch her if she falls and our windows are about 4-ish feet off the ground. Because of this, I went to home depot and bought a 9" wide board and cut it to the length of the window sill. I then screwed it directly to the window sill. I will be getting another board and staining/varnishing it to match our window sill so it won't look quite so out of place. Then I'll remove the current one and cut it to fit one of our other windows, that she sits in and do the same thing. She seems to walk more confidently with the new wider sill. It also allowed me to attach the window bed directly to the new board with hooks so that I can open the window all the way instead of needing to remove the cat bed in order to do so. My husband probably thinks I'm nuts, but it's not like this is the craziest thing I've ever done for the cats. So, maybe he has stopped questioning my sanity and has just come to terms with it.

 

[fionasmom]

My husband probably thinks I'm nuts, but it's not like this is the craziest thing I've ever done for the cats.

This is so kind of you to do for her.

 

[Mac and Cats]

I'm hoping someone can give me a reality check here. While Molly's joint swelling has gone down significantly, she is still having the issue with her front ankles (Carpal Hyperextension?). The vet said that they thought that was a separate issue and really didn't say much else about it. As I've said before, I suspect it is an injury from her insisting on jumping off our bed instead of using the stairs. Her ankles have been noticeably weak for at least a year, for example, her ankles will shake a bit when she is just sitting up right. She doesn't seem bothered by her current issue at all. It's probably more uncomfortable for me to look at than her. I found these ankle braces on Chewy and am thinking of getting them to see if they would help her. Am I nuts or is this reasonable to try? I would only leave them on her for 3-4 hours at a time and wouldn't leave them on over night like the directions say. I can always return them if they don't seem to help/work. Lay it on me, crazy to consider or reasonable to try?

 

[fionasmom]

I had a GSD with degenerative myelopathy and we had a house full of supports and a cart, so I certainly don't think that you are wrong to consider this. They are not that expensive, which is a good thing, and they are returnable. You might need to anticipate that Molly will think that they are beyond strange and won't even move once them are on. On the other hand, they may make her legs feel better and she may reason that out and be receptive to them. My experience with all of these orthopedic supports has been that you don't know until you try.

 

[Mac and Cats]

I had a GSD with degenerative myelopathy and we had a house full of supports and a cart, so I certainly don't think that you are wrong to consider this. They are not that expensive, which is a good thing, and they are returnable. You might need to anticipate that Molly will think that they are beyond strange and won't even move once them are on. On the other hand, they may make her legs feel better and she may reason that out and be receptive to them. My experience with all of these orthopedic supports has been that you don't know until you try.

Thank you, that's what I was thinking as well. I am fully aware that she may not tolerate them and it's extremely likely that she won't even allow me to put them on her, but she has surprised me before! I went ahead and ordered them since I had a couple gift cards from their deal last week anyway. If Molly doesn't murder me in the process of me trying to put them on her, I will report back!

 

[FeebysOwner]

Feeby was diagnosed with a hyperextended wrist. There wasn't much recommended, other than possible physical therapy, including acupuncture. and pain meds. That is when I started her on Solensia and the limp did disappear. However, at the same time, I set her up with makeshift steps (boxes big enough for her to rest on each step vs. those small cat stairs). And, she figured out pretty quickly that they were much better than trying to jump. We had to stop the Solensia, but she has continued to use the makeshift steps, and her limp hasn't returned.

The steps I set up are 6", then 12", and that has enabled her to reach the bed and the couch, which are her favorite hangouts. She has a similar set up for her patio perch, if she ever chooses to go back on the patio on her own.

 

[Mac and Cats]

Feeby was diagnosed with a hyperextended wrist. There wasn't much recommended, other than possible physical therapy, including acupuncture. and pain meds. That is when I started her on Solensia and the limp did disappear. However, at the same time, I set her up with makeshift steps (boxes big enough for her to rest on each step vs. those small cat stairs). And, she figured out pretty quickly that they were much better than trying to jump. We had to stop the Solensia, but she has continued to use the makeshift steps, and her limp hasn't returned.

The steps I set up are 6", then 12", and that has enabled her to reach the bed and the couch, which are her favorite hangouts. She has a similar set up for her patio perch, if she ever chooses to go back on the patio on her own.

Yeah, unfortunately we have a very small floor space around our bed, so there's not a ton of room to stick any that are larger. She does use them to go up on the bed with no problem. My husband says she uses them to go down and has seen her. Whenever I'm in the room though, she seems to jump off the bed instead of using the stairs. Right now they are at the head of my side of the bed so that I don't trip in the middle of the night. I just moved them to the foot of my side of the bed to see if that might help her. Maybe she thinks I am in the way when going down them. Hopefully I don't forget to go around them if I get up in the night.

I have been looking at getting her a ramp instead. Maybe that would work better for her?

 

[Mac and Cats]

Just wanted to give an update in case anyone is following along. The Solensia has totally worn off and unfortunately, it is completely obvious in the way Molly moves. She is doing ok, but she moves awkwardly and slow. I had reduced the Pred slowly and got down to 2.5mg/day and was a week away from reducing it to every other day. But the past couple days she has been off and her joints seem more swollen? The doctor said we could go back to 10mg for a month and then reduce again, so that is what I am going to do for now. There are a few places she likes to nap and I have a way for her to get up to all of them. We have two sets of stair cases, a step stool and I added a board to extend our windowsill so she can enjoy the window bed in our bedroom. I have another one I am staining/varnishing that I am waiting to dry and will add it to another window in another bedroom for her. She seems to feel much more comfortable walking on the window ledge with the extended board. She still seems to manage all of those places OK. Here is a video of her going up the stairs today. When she walks down the hall she seems to take a lot of breaks, but she manages.

Attached are some photos. Not of anything medical, just with Molly in them. Please don't judge our backyard! That is the photo that shows how I extended the windowsill. Last one is with the set of stairs I have for her at our bed.

Anyway, overall she seems to be doing ok and managing, but I can tell she has slowed down a lot since the Solensia has worn off. I'm super bummed because I don't feel like we can ever try it again, but I know it really did help her. Ultimately, I think it was probably the act of the injection that caused the swelling and not the Solensia itself. Our doctor did report it to Zoetis to be safe, but we haven't (and probably won't) hear anything back.

That's it. Nothing else to report. Have a great weekend!

 

[Mac and Cats]

Hi friends. I am back. Molly has been really struggling since I weened her off the steriods. I watched her walk today and she has significant limping. I ended up giving her Gabapentin again 8 hours from her first dose. She normally gets two doses twice a day 12 hours apart, but the doctor said we could do every 8 hours. The 8 hours is problematic because it means we do a 7:30am dose, a 3:30pm dose and a 11:30pm dose. However, I am usually asleep long before 11:30. So 3 times a day is not ideal by any means. I wasn't able to reach the vet today, but will call tomorrow morning to make an appointment. Here's my question: Do we try the Solensia again but maybe 6-8 weeks apart instead of every 4? Her swelling has gone down about 90% since we stopped and with the steriods. What would you do? Stop all together. She's acting normal in every other way except I can tell she is struggling and the past few days she's been eating less. I have been giving her some Cerenia every other day to see if that helps, but I really think it is just the pain. She even turned down some tuna today after a few bites. In years past she would eat everything I gave her. I think the worst case scenario if we try Solensia again is that the swelling comes back and then we know to stop period and start steriods again until it goes back down. What would you do if this were your cat? I'm not asking for medical advice and I will consult the doctor, but I'm not sure what the right thing to do here is. She is still going to the bathroom normally, although, she does have about 1/4 teaspoon amount of cat litter on her butt every time which tells me she's not able to squat like she use to. I want to get her arthritis friendly cat boxes, but we have a HIGH SPRAYER cat and we just cannot do low boxes because I can't prevent him from using them. What would you do? Should I just buy some rubbermaid boxes and cut them very low? Should I try Solensia again? I hate to see her struggle, but she isn't struggling so much I need to say goodbye to her (I don't think). I'm not sure what the right choice is here. I would love to hear your opinion. Thank you in advance.

 

[fionasmom]

Don't stop the gabapentin abruptly, even if you are considering eliminating it. If there is any way that you can give her a low litter box and prevent the guy who raises his rear end from using them, it would be worth a try.