Young cat in hospital with fever and vomiting

sweetleo

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Hi everyone, unfortunately my Leo has been sick the past week and a half and is now in the hospital. Some background on him, he has always had a sensitive stomach, in particular chicken gives him diarrhea. We feed him rabbit wet food with some dry to snack on between meals.

I’ll start from the very very beginning:
Around 4-5 weeks ago we attempted to transition him to lid turkey from the rabbit. He did well for almost 3 weeks but then started to get very runny foul diarrhea. Switched back to the rabbit, and he’s very picky about it and reluctant to eat it. At this point, we are just trying to get him to eat, so we try to give him a little lid salmon wet food. He throws it up, he doesn’t usually every throw up but not a big deal, we tried a few others. This kind of repeats for a few days, him snubbing food and us trying new things and him occasionally throwing it up. I also notice that he is hunched up and uncomfortable looking after meals, and I start to notice him hunching and sort of floofing up, like he is cold. We take him to the vet after 3 days of this, they don’t see anything of interest in the blood work and x-ray. We come back the next day, they take another x-ray. They see some gas and recommend probiotics. At this point he is pooping and peeing normally. He poops about once a day, sometimes it’s a little soft/runny. He throws up again yesterday, so we take him to the ER. This is a possible red herring, but my husband notices something in the vomit that looks sort of like a pale sunflower seed, and we bring it to the vet, thinking he could have worms or something. We get to the ER and they don’t seem interested in the puke, they do an x-ray and don’t see anything other than inflammation of his GI tract. They find out that he has a fever of 104.5, and they run a blood panel and see high white blood cells, eosinophils and i think basophils, she says that could be either allergy or parasites. The fever concerns her though and they still thinks it’s a possible foreign body, so they want to keep him overnight to give fluids, antibiotics, dewormer, and then do an x-ray in the morning to see if things are moving. This morning we call and they say he hasn’t eaten, which isn’t shocking because I’m sure he’s stressed, and that his fever went down overnight but then spiked this morning again to 104.5. They are going to start him on steroids for inflammation and keep him for another night most likely.

I just want to post to see if we are missing anything obvious or if anyone else has been in this situation.
 
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sweetleo

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Oh, forgot to say he is a week away from being a year old.
 

fionasmom

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I am sorry that you are going through all of this with your cat. Given his very young age, I am guessing that this is not something like cancer, but the part about the hunching caught my attention. Have they specifically ruled out pancreatitis? There are specific tests for this, not just the standard bloodwork, or a general assessment. An ER will only be able to go so far with a diagnosis, not because they are not competent, but that is not what they do. If this is not easily resolved, they don't have the specialists on staff to continue to work with the patient. Do they recommend an abdominal ultrasound? Do you have any suspicions of what kind of foreign object your cat could have ingested, depending on his lifestyle and propensity to eat objects....if this is the case?
 
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sweetleo

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Pancreatitis is something that was mentioned, but not really focused on. The main things they wanted to rule out were viral infection, ibd, and parasites. The foreign body thing seems to be ruled out, which makes sense to me. I’ve never seen him try to eat anything that wasn’t food and even then he’s picky. They did recommend a specialist for an ultrasound and a GI panel. They also said if the fever continues to do a full feline fever of unknown origin panel.

We picked him up today as they pretty much said they were out of things that they could do there that we couldn’t do at home. They said he seemed interested in food but was refusing to eat. Otherwise he was alert and vitals were good other than the fever spike. When we got home I put out his normal food with some pumpkin purée and carrot baby food on it and he ate a very small bit so I know he’s hungry. He seems fairly normal other than being exhausted.

His diagnosis was “vomiting, diarrhea, eosinophilia, leukocytosis/neutrophilis, and fever of unknown origin”. Under blood results it says “mild leukocytosis at 17.2, mild neutrophilia at 10.4, eosinophilia at 2.5”. For the x-rays, the only remark that seems important is “markedly thickened luminal edges of stomach and SIT”. I won’t get into all the meds they gave him while he was there, but they sent us home with metronidazole, prednisolone, clavamox, cerenia, and a probiotic (synacore, never heard of it). The prednisolone is going to be tapered off over 2 weeks. I also asked for a prescription for a hydrolyzed protein diet while I was there, just so I have another option for food that I know likely won’t give him an allergic reaction.

Anyway, sorry for the wall, just wanted to put all I know. I am a little bummed that this is seeming like something we won’t really know the cause of. I really hate the idea of my not even one year old cat having IBD, but I guess I can’t assume anything until I find a specialist.
 

fionasmom

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IBDKitties – Helping Save Lives…One Paw at a Time
This is a very comprehensive site about IBD which may help. If you can, I would go to the specialist, especially given the young age of your cat. If this can be resolved, he can get on with the remainder of his life without having recurrences of whatever is going on. They are telling you the truth; probably everything that is within their purview was done and they don't have the ability to do a deep diagnosis.
 
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sweetleo

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Thank you for the reply, I will make sure to do some reading on there.

Leo seems to be feeling a little better. The hypoallergenic kibble is a huge hit (RC hydrolyzed protein). The ingredients make me sad but I know it’s whatever he can get down and digest right now. I’d say he got atleast 100 cal in him yesterday. Unfortunately I don’t think he will ever touch the instinct rabbit wet/dry again, which is a shame because it seemed to be working for him. I have some ziwi peak rabbit and lamb, and also ordered some rawz rabbit/rabbit and pumpkin, so I’m really hoping one of those will work for him. Otherwise I’m not sure what protein to try next, I’ve been bribing him with tuna lately but I’m not even entirely sure that doesn’t upset his stomach. He hasn’t had a poop since monday which makes me a little worried, but he also has been running on empty lately. If he doesn’t poop by saturday I will call the vet and ask what to do. Another thing I noticed since starting all these meds, his red gums have completely gone away. I assume it’s from the steroids, but part of me is hoping that it’s from the antibiotics killing an infection, maybe bartonella?

Today the hospital called and apparently they did run a GI panel while he was there, and they informed me that the results were all normal. fPl was normal, cobalamin and folate were normal (folate was maybe on the higher end but still within reference range). The only things I noticed that were out of normal range, although I don’t know anything, were his amylase was low, and SDMA was high (but TT4 was normal). Assuming he stays stable, I will probably wait until his next scheduled vet appointment to ask about a referral to a specialist.
 

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Glad that things are looking up. Let him eat the food he wants for now and you can work on getting him to eat the other food as he recovers.
 
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sweetleo

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Just wanted to post a short update and some general questions. Leo has finished all his antibiotics and we are now in the process of tapering off the pred. Since starting the royal canin hp kibble, he has not had a solid poop. I also started introducing some rawz rabbit and pumpkin to his diet, but his poops got worse, so I decided to stick to the new kibble for a while. He is ravenous though and is eating probably 250-300 cal a day. Still having 1-2 very large soft poops a day though. I have been giving him proviable dc every night (spaced hours after the antibiotics). I am a little sad because for the most part his poops were ok before, he really only had diarrhea when he ate something that he was allergic to. That makes me very skeptical of the royal canin kibble. He has also had clavamox before and had absolutely no issues with his poop then.

I guess I just have a strong hunch that this new kibble is causing his diarrhea, but I really have no proof. Is having diarrhea through prednisolone common when there’s a food allergy? I know I didn’t slowly transition him, but I’ve honestly never had to with him when we found thighs that worked. My plan was to let him eat it for the next few days and if the poops don’t improve then I need to transition him back to the instinct rabbit kibble. Then from there I can try to introduce rawz rabbit and pumpkin.
 
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sweetleo

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Also, I was wondering if it’s possible to overdo pumpkin. After a day of feeding him the rawz rabbit and pumpkin (maybe half a can), and giving him a teaspoon of pumpkin before bed (with the probiotics), I noticed his poop was orange colored and kind of gelatinous the next day.
 

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Certain foods can influence the color and pumpkin can turn it orange and also cause diarrhea and looseness. I would cut back on it and see what happens. I am assuming that you are using only the Rawz Rabbit and Pumpkin canned food and not adding more pumpkin to his meals. That does not rule out the Royal Canin food though. You can eliminate both foods and see what happens but you won't know which caused it....not saying it could not be both of them. Watch for a change in stool color if you eliminate the pumpkin, and the gelatinous texture, so that you are sure that the food caused it. Rawz was not successful in my house, but I would assume that their foods are well balanced.
 
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sweetleo

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Just wanted to post a final update on here, Leo is back on his old food (instinct wet/dry kid rabbit), is done with all the meds, and is doing extremely well. He is eating more than ever (more than he ever did as a kitten) and is having normal poops. I always assumed he was a picky, slow eater, but I’m now realizing maybe it had to do with him not feeling well. He also completely stopped chewing wires, which I think was probably also related to not feeling well.

He has never been this healthy seeming, not even when we got him as a kitten, so I really think one of the meds he was on “fixed” something for him. I just wish I knew which one (antibiotics? dewormer?). But part of me also dreads that this might just be temporary. I am very worried about maintaining his good health. I have been doing all sorts of research on probiotics, digestive enzymes, raw feeding, but am terrified to add anything to his diet because he is doing so well right now. I guess I just need to relax and wait things out for now
 

fionasmom

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Thank you for the good news! Hopefully whatever worked will stay fixed for Leo.
 
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