# What else can cause pneumonia?



## cartoontan (May 16, 2010)

My cat has been diagnosed (with X-ray) with pneumonia for 2 weeks. We have carried out blood test to rule out FIP/FIV/FeLV and her other readings (kidney, liver) are fine. She does not cough nor sneeze and has no nasal discharged (nose is dry). We has just switch to another antibiotic as the previous one is not working, and without nasal discharged the vet cannot do analysis to determine the actual antibiotic to use.

I have 2 other cats at home and neither are sick (one of them occasionally shares food/water bowl with her). She is slightly less than 3 yrs old and does not go out of the house, but does roams in the garden for few hours a day.

She does not want to eat nor drink and has been on drips for a week. I have been force feeding her so far, but she is not really been fed the same amount as what she usually eat, and has lost 25% of her body weight already.

Any idea what else could be wrong?


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## laurief (Jun 22, 2008)

cartoontan said:


> My cat has been diagnosed (with X-ray) with pneumonia for 2 weeks.


I'm so sorry that your cat is ailing. The following link will take you to an article that you should read on pneumonia to get an understanding of the potential underlying causes, treatments, and therapies:

http://www.marvistavet.com/html/body_pn ... ement.html



> She does not cough nor sneeze and has no nasal discharged (nose is dry).


If she truly has pneumonia, you should implement the therapies recommended in the linked article to promote coughing.



> without nasal discharged the vet cannot do analysis to determine the actual antibiotic to use.


That's not correct. Your vet can perform a tracheal wash as noted in the article to identify the specific bacteria. Or your vet can employ the "four quadrant" antibiotic approach mentioned in the article.



> She does not want to eat nor drink and has been on drips for a week. I have been force feeding her so far, but she is not really been fed the same amount as what she usually eat, and has lost 25% of her body weight already.


A loss of 25% of her body weight in two weeks makes her condition critical, IMO. Why isn't she hospitalized? You need to discuss this with your vet immediately, because your cat could starve to death before her body has a chance to recover from the pneumonia. If there's some reason why she can't be hospitalized, then you need to assist feed her more and more often. If you can't get more food into her with assist feeding, she may need a feeding tube implanted to provide adequate nutrition until she recuperates. Starvation will shut down other critical body systems, so this isn't something that can continue.

You clearly are willing to invest the time, work, and money into your girl's recovery. She's a very lucky cat in that regard. But it sounds like your vet isn't doing all that should be done. You may need to consider getting a second opinion from a different vet, preferably a veterinary internist if you have access to one. Even if you can't bring your cat to a specialist, your vet could send the x-rays to a specialist and consult on appropriate treatment. You may need to become more proactive with your vet to get your cat the care she needs right now.

I wish you and your cat the best possible outcome.

Laurie


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## cartoontan (May 16, 2010)

Thank you for the link you have sent. However I don't think she can undergo a tracheal wash as it required anaesthesia/sedation, same goes for the feeding tube (I asked the vet about the feeding tube at the last consult). 

The reason why she is not hospitalized is because the clinic here are not 24 hrs. Meaning nobody is around once after office hours and I do not want her to be unattended for such long hours. Besides the extra stress of being in unfamiliar environment with other dogs/cats will not do well for her. I had brought her in once for "day-care" and she did not sleep and was staring with wide eyes are any movement the whole time (I kept visiting her to see how she takes to being hospitalized).

I convinced the vet to let me keep her at home and was taught how to change the drip/control the flow and how to flush it in case it gets blocked etc. In the beginning I was also asked to bring the cat back just for the vet to check on her condition of the drip. I guess they wanted to make sure I know what I am suppose to do. 

Yes, I know cats cannot go without food, I made the mistake in the beginning of the sickness and her liver reading was very bad. So after that I started force feeding her and a week later her liver reading is normal. She was also given Hepavite for 2 weeks (on alternate days) 

My other family can help monitor her and watch the drip, but they are unable to force feed her. I have been taking 1/2 day off work recently so she can be fed more times. Luckily my boss has been kind in granting all my leaves.

I will ask my vet about the 4 quadrant approach tomorrow when we go back for review. However it does seem that the current antibiotic is working as she seemed more alert these 2 days. She also has more strength to struggle too when being force fed. I hope that means it's a good sign. 

Will update again after the review.


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## cartoontan (May 16, 2010)

It seemed that the latest antibiotic is working. Latest x-ray showed that the lungs are much better and not that wet as previously.

However she still refuse to eat on her own, although she will drink water. I have managed to maintain her weight (2.7kg), hopefully will be able to make her gain back those lost weight soon.

It will of course be best she will start eating on her own.


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## laurief (Jun 22, 2008)

It's great that the antibiotic is working and her lungs are clearing up. Now to work on the appetite problem. The following links will provide you with a lot of tips and tricks to help get her eating again or to continue assist feeding her as long as she needs it:

http://www.felinecrf.org/persuading_cat_to_eat.htm
http://www.assistfeed.com/
http://www.yahoogroups.com/group/Feline ... ed-Feeding

One of the things you should discuss with your vet is appetite stimulants. You can read more about them at the first link above. I used cyproheptadine to help stimulate my CRF cat's appetite, and it worked well for him for quite a while. Your vet would have to write you a prescription for it, though. I do recommend starting cypro at a low dose (1/8 tablet once a day) because some cats have unpleasant side effects (agitation, howling, sleeplessness, high heart rate, etc.) at higher doses. If 1/8 tablet doesn't adequately stimulate appetite, the dose can be increased gradually from there.

Wishing you the best for your cat's continued recovery.

Laurie


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## cartoontan (May 16, 2010)

The vet did give her Steroids (something that starts with P) to stimulate appetite. I only bought 1 tablet (feed 1/4 alternate days) as I do not really like the idea of giving her these things, given the side effects and stuff.

Tonight I will be giving her the 2nd 1/4, not sure when I will see a difference. Until this morning, she is still not interest in food. She will sniff the food in the bowl and either move away or make a vomiting/gagging action but no vomit. 

I also tried a variety of food, am giving her canned wellness core, canned a/d, a powdered convalescent diet, baby food, boil chicken & soup, kitty milk etc. However I have problem finding nice baby food as most of the stage 2 food here are non meat base. Stage 3 food are too chunky. Only managed to find 1 flavour, pumpkin and beef. I just bought a pea and rice one since she sometimes like peas (before she was sick).

It is so tiring trying to find food that she will like.


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## CataholicsAnonymous (Dec 4, 2006)

In addition to force-feeding, you can give her Nutri-Cal or Nutri-Stat. It's a high-calorie supplement. If she doesn't want to lick it from the tube or your finger, you can paste it on her front paws or legs. Rare is the cat who won't lick it off.


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## cartoontan (May 16, 2010)

I bought Nutri-plus gel by Virbac, but she does not seem to want it. Even if I smear it on her lips, she does not really lick them off totally. She completely ignored them when I put on her paw, I had to swipe them off after a while. 

I think she is feeling nauseous, I saw Laurie's other post about lip-licking. She does that sometimes and will make a vomiting action when I place food in front of her.

I just googled and I think it the antibiotic (Baytril) that is making her nauseous. The pneumonia is showing improvement so I really want to complete the course in case it comes back. But then it's making her "sick" and not want to eat. This is so frustrating, seeing her so skinny and yet not eating.

I am not sure if the steroids are working or should I ask for cyproheptadine? If her appetite is really increased but the nauseous prevents her from wanting to eat, it is not worst for her?


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## laurief (Jun 22, 2008)

Unfortunately, you're between a rock and a hard place right now. Most antibiotics can make cats feel nauseous, and that nausea can last for a couple of weeks after you've finished the round of antibiotics. Right now your cat needs antibiotics to fight off pneumonia, and apparently Baytril is working, so you need to continue that until you are finished with ALL of the pills in the prescription. Ordinarily I would suggest asking your vet for a different antibiotic if the one you're using is causing nausea, but since you've already tried one antibiotic that wasn't effective and since the infective organism hasn't been identified, it's probably too risky to blindly switch her to a different antibiotic now. I think you're just going to have to ride this out.

That said, I am personally very reluctant to use steroids as an appetite stimulant, just because steroids are very strong drugs with potentially serious side effects. I avoid steroids unless they are absolutely necessary. Since cyproheptadine is, IMHO, a much safer drug, I would certainly try that first for appetite stimulation. HOWEVER, you MUST NOT quit steroids cold turkey. You MUST wean your cat off them gradually as directed by your vet. It can be very dangerous for your cat to suddenly stop giving a steroid. If you want to switch from the steroid to cypro, ask your vet how to make that transition safely.

For now, just keep assist feeding her as much as you can get down her daily to help maintain her weight and strength.

Laurie


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## cartoontan (May 16, 2010)

laurief said:


> Most antibiotics can make cats feel nauseous, and that nausea can last for a couple of weeks after you've finished the round of antibiotics.


A couple of weeks?? I was hoping she would feel better just a few days afterwards. 
There's about 6 more days to go, which means I have to be prepared for this "feeding ritual" to continue for at least 1/2 month.  



laurief said:


> HOWEVER, you MUST NOT quit steroids cold turkey. You MUST wean your cat off them gradually as directed by your vet. It can be very dangerous for your cat to suddenly stop giving a steroid.


She has just started steroids, 1/4 tab every alternate day. So far she has taken only 3 times, tonight suppose to be the last 1/4 but I did not give it to her as she kept gagging after taking the antibiotic. I was afraid another pill will cause her to throw up the antibiotic. If I just stop like that and forget about that last 1/4 tab, is it considered to quickly? Or should I further break the 1/4 into 1/8 and give her on alternate days to wean off? I don't think I want to continue with steroids anymore.

Not sure if I should start her on cyproheptadine as a side effect is increased heart rate. Before her pneumonia completely recovers, the increased heart rate might make her breathing more difficult. And I'm afraid of the possible "causing lethargy" effect. She is already quite lethargic right now, though slowly recovering. Should I wait till she finish her antibiotic then try cyproheptadine?


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## laurief (Jun 22, 2008)

cartoontan said:


> laurief said:
> 
> 
> > Most antibiotics can make cats feel nauseous, and that nausea can last for a couple of weeks after you've finished the round of antibiotics.
> ...


Not necessarily. It's just that some cats can have a lingering reaction to some antibiotics that MAY last a couple of weeks after the antibiotic is finished. It's certainly possible that your girl will recover her appetite quickly after finishing the Baytril. You'll just have to wait and see how she responds and do whatever you have to do to get food into her until she's eating on her own again, no matter how long it may take.



> She has just started steroids, 1/4 tab every alternate day. So far she has taken only 3 times, tonight suppose to be the last 1/4 but I did not give it to her as she kept gagging after taking the antibiotic. I was afraid another pill will cause her to throw up the antibiotic. If I just stop like that and forget about that last 1/4 tab, is it considered to quickly?


That's something you really MUST discuss with your vet right away. Steroids are nothing to screw around with.



> Not sure if I should start her on cyproheptadine as a side effect is increased heart rate. Before her pneumonia completely recovers, the increased heart rate might make her breathing more difficult. And I'm afraid of the possible "causing lethargy" effect.


Those side effects are unlikely to occur if you start her on a low dose of 1/8 tablet once a day. However, your vet may prescribe a higher dose of 1/4-1/2 tablet twice a day, and at that dose, side effects may occur. That's why I recommend starting at the low dose and seeing if that's enough to jump start her appetite. If 1/8 once a day doesn't do the trick, then you can increase the dose to 1/8 twice daily, or even gradually increase it more if necessary. You'll know if the dose gets too high for her because she'll start to become a bit agitated, restless, and/or vocal.

It's important to note that cypro doesn't stimulate appetite in all cats. It does work well for many of them, but not all. There's no way to tell if it'll work for your girl unless you try it.

Laurie


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## cartoontan (May 16, 2010)

Things does not seem to be too good.

Vet suspect Baytril may not be hitting the correct bacteria (there may be more that one bacteria affecting her) or the bacteria is getting resistive. The pneumonia had cleared up a bit while on Baytril, but had stayed that way without further improvements. Her fever came back. Consolation is her breathing is not getting worst and she still has the strength to push me away during feeding.

We have switch to another antibiotic (Vibravet) and she's back on her fever med again. She is getting more nauseous, will vomit/try to vomit every morning when I give her water. I have cut back on the amount I feed each time and increase the frequency so she will not throw up the food.

She had been wanting to go the the garden, so I let her out for short period as the weather was good. I hope that will make her feel better. She had also finally poo, after more than a week. Not sure whether to call it constipation or it is just because her intake of food is so little and mostly semi-liquid form.


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