# URI, kidney problems... HELP!



## Arkona (May 7, 2012)

I'm sorry for the long post, but I really need help and I think if I give as much information as possible you guys might be able to help me pinpoint the possible issues. I started writing this post yesterday before my husband took the cat to the vet. I will write a post with the vet's findings as a reply to this thread, but please bear with me because the vet didn't clear up much at all... I need some help and direction so if you can, please read both posts. Here it goes:

I adopted a cat from a rescue organization almost a month ago, and this cat is FULL of problems. Each time I think I'm starting to get a handle on one, another shows up. Now it's looking like she may have something much more serious than anything I thought… I am going to give you guys as much information about her as I can so you can help point me in the right direction. Sorry about the long post but every bit of information could be crucial.


Background: 
She was rescued from a shelter on the day she was going to be killed. She must have been about 2 or 2.5 years old. She was with a foster for 5-8 months before I adopted her. Her foster had 5 other cats. She is very small (the smallest adult cat I've seen) and non-confrontational. The cats were occasionally fed whatever commercial food was available, because the foster can't really afford the best food there is so they rely on donated food and money. They were mostly free-fed dry food (who knows what), and occasionally got canned food.


When I was about to adopt her, I was told she was 7lb. However, she clearly weighed less than that. When I took her to the vet the day after taking her in, they weighed her at 5.5. This makes me think she may have been 7lb when the foster first took her, or maybe he just didn't know. Either way, when I took her in I could feel her ribs, her spine, her shoulders, and her hip bones. VERY prominently. She is clearly underweight. She is a small cat and would weigh very little even at a healthy weight, however I would estimate "healthy" for her size to be about 6.5 or 7lb. 


She had recurring problems with a URI while at the foster home. When I took her in, she was just done with her antibiotic treatment. I took her to the vet and the vet said to watch for symptoms like runny eyes, sneezing, etc, and if nothing got worse then she probably wouldn't need to be treated. The reason I took her to the vet was because her breathing sounded weird, but it has since improved.


Her eyes have not been runny, nor has she been sneezing a lot (she sneezes occasionally) so she seemed to be getting better on that front. Some days she is very lethargic and just wants to sleep, and on those days sometimes her third eyelid doesn't close all the way when her eyes are open. I am not sure if that is a symptom of something.


She also came to me infested with fleas, which I got a handle on by the second day. She was quarantined to the bathroom and I was able to completely rid her of the fleas. 


Finally, when I took her to the vet, the vet pointed out she has a blackened tooth which may be dead and will probably need to be removed, but to give it a few months so she could recover from everything else that was going on, so as not to put her through too much at once. 

So it's been almost a month since I got her and took her to the vet. Her breathing improved, there isn't much sneezing, and her eyes aren't runny. The only issue with her eyes is that third eyelid thing. She is still underweight, but seems to have gained a little bit of weight. I can still feel all her bones but the shoulder and hip bones are less prominent. We have been feeding her commercial ground raw food. I have been feeding her enough for a 7lb cat because that is how much I think she should weigh. She has pretty decent appetite, and will generally eat all or most of the food I put down. Sometimes she refuses to eat her afternoon meal at the time that I put it down, however if I put it in the fridge and try again later in the evening or at night, she will eat it without a problem. So she's definitely eating enough.


She drinks a lot of water. She is always drinking from her bowl, even though her food has plenty of water. She drinks slightly less than when we first got her, but is still drinking a lot. My other cat who's on the same raw diet has not drank water in my presence since I switched her, because she gets enough moisture from her food. 


Well, over the past few days she has occasionally come down with a weird cough-type thing. It looks and sounds like she is trying to get a hairball out. But nothing comes out. We didn't think much of it, until today, my husband says she did the cough thing and her nose bled a little bit. We made an appointment with the vet right away and she will be there in a few hours. 


She also has been purring a lot yesterday and today. She is a big purrer, but she's been purring when just laying down by herself, very loudly. I'm afraid she could be in a lot of pain. She's been acting normally other than that, always wanting to be around us, playing when we try to play, and she keeps trying to make friends with my other cat, who so far is having none of it. 


Obviously she's going to the vet so we can determine what she could have, and I'll keep you all updated on everything but do you guys have any ideas, suggestions, experiences to share, etc? 


I keep thinking, if she is so underweight it could mean she wasn't eating properly either due to her URI or due to other cats stealing her food when she was free-fed at the foster home. If she wasn't eating properly, and went over a day without eating, she could have liver problems. I'm very concerned, and need all the help and support I can get from other people who love and understand cats.


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## Arkona (May 7, 2012)

OK so to follow up, my husband took her to the vet shortly after I wrote the post. I calmed down a bit and decided not to post it for that reason.
They did some tests on her and determined she probably has a tracheal infection resulting from her URI. They prescribed her antibiotics for that. They said the nose bleeding could have been due to her coughing too hard. They ran blood work on her, and I just got the call back from the vet this afternoon.

Now I'm freaking out again.

Her blood test came back with so many issues I couldn't even process all the information the vet gave me, I am going to have to call back and ask her about a lot of it again. But basically the gist of (some of) it is that her blood is very high in protein, except one specific protein (I forgot the name, but will ask). Her kidney is at around grade 1 kidney failure and can not process protein properly. The vet recommended a "low protein prescription diet" which of course I can buy right at the vet. However, I do not trust those diets. Cats are meant to eat meat, so how do I feed a cat a low protein diet, and wouldn't doing so only cause other problems? I need a lot of advice about this and may open a thread of its own just for this one specific issue. In any case, this helps explain why she drinks so much water, and maybe even why her pee is so stinky. 
I need help in understanding what to do to help her, how to feed her, and also I'd like to know what are possible causes of this. Could she have another disease that is the underlying cause?

The vet also mentioned her having problems with her immune system. She suspects FIV or FeLV, she doesn't think it's likely but it's possible she could have them. When I adopted her, I was *specifically told* by the rescue organization that she was tested for both and tested negative. Now the vet tells me her medical records from the rescue organization don't even mention such tests. I am extremely upset that I may have a FeLV cat, as much as I love her I would have never brought an FeLV cat into the house because I ALREADY HAVE A CAT and I don't want to get her sick. They were at the late stages of introduction so they've been together, meaning if it's FeLV it's likely my other cat could have it by now. FIV is much more manageable and it's possible to have FIV+ and FIV- cats coexisting so I am not as concerned if that's the case. 

So of course I asked them to test her for FeLV and FIV, the lab may even be able to do it using the blood samples they already have, so if that's the case I should have results in a couple of days (until then she will be quarantined again and kept away from my other cat). But I don't have money to test this cat for every possible disease the vet mentioned, let alone treat her, so I am at a loss for what to do and what to think… and what to do next, whether the results come back negative or positive.


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## rightsaidfed (May 31, 2012)

Wow. I don't even know where to begin. I think you should contact the shelter you got her from to warn them about all of the health issues that other cats may have been exposed to. I'd also warn the shelter about the particular foster she was with. If she was that obviously underweight and sick and went without treatment, who knows what the other cats in that household might be suffering from. 

I know that shelters and fosters mean well, but people need to know when to stop. It's possible that they're just overwhelmed at the moment and the foster keeps agreeing to take "just one more." 

You're doing all the right things as far as diagnosing what's wrong and trying to make her as comfortable as possible. 

I guess once you have the whole picture of what she needs as a full treatment, what she needs to keep her comfortable, and what you can afford, you'll have some tough choices to make.

Is your vet sympathetic? Is she willing to cut you a deal? Are there any funds in your area for people who can't afford ongoing treatment for their pets?

Hopefully once she starts to get better you'll find a treatment within your budget or find someone able to help contribute.

You really are an angel though adopting her on her last day an trying so hard to make her comfortable. Even if things don't go well, at least she'll know there was someone who cared!


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## minikin44 (Aug 25, 2012)

Wow...that shelter and foster sound like a train wreck waiting to happen. The foster must have noticed that she was unwell... and the shelter either didn't test her for FeLV and FIV or they lost the paperwork... either possibility is not great. As far as the prescription food goes, definitely don't let them give you prescription dry food. As for the wet, I'm not sure I have an educated opinion, but when I looked up the ingredients for c/d wet food (my middle cat had a urinary blockage) I was not impressed... I'm going to be asking my new vet what he thinks Tugs should be on, and I'll share the info with you if you'd like. Just a suggestion, add water to her wet food. It'll help increase her intake and maybe she won't have to drink so much or have such concentrated urine. I don't really have any other advice at the moment, but I hope she's FeLV and FIV negative and that it's just a kidney infection as hoofmaiden said, not kidney failure. It just occurred to me that with the black tooth, a tooth infection can spread to other parts of the body... perhaps it gave her a kidney infection? I would mention it to whatever new vet you go to, just in case.


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## Arkona (May 7, 2012)

I got her from a rescue organization, not a shelter. They are a network of fosters without a physical location, and they were the ones who rescued her from a kill shelter.

Her foster was fostering 6 other cats, and clearly he was overwhelmed. They did know about and treat her URI, and I was aware of that issue but they told me nothing about the dead tooth or anything else. They did tell me she was tested negative for FIV and FeLV, I'm very upset to learn there are no papers to show that so now she's being re-tested.


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## Arkona (May 7, 2012)

hoofmaiden said:


> Given the young age here, your vet should be suspicious of a kidney INFECTION, not chronic kidney failure. He should be following up on that and possibly putting her on some high powered antibiotics, not worrying about her diet.
> 
> I would ask for a referral to a vet school or local internal medicine specialist. Don't waste any more time/money w/ this vet.


Wouldn't they be able to tell from the blood work whether it's an infection or CRF? 

She's on antibiotics either way for the tracheal infection. Would that not be enough to cure other infections?


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## laurief (Jun 22, 2008)

Arkona said:


> Wouldn't they be able to tell from the blood work whether it's an infection or CRF?


That depends on exactly which blood tests were run. If it was a standard blood chemistry, then no, it wouldn't be able to differentiate between renal failure and a kidney infection. If the testing included a CBC, then infection would probably have shown up there. You need to go back to your vet and get copies of ALL lab results run on your girl (both current lab results and any other lab results run on her since you've had her). Once you get copies of all of her labs, post them here so that we can take a look. Perhaps we'll be able to point out issues that you should discuss further with your vet.



> She's on antibiotics either way for the tracheal infection. Would that not be enough to cure other infections?


Not necessarily. Each antibiotic only acts on certain pathogens. If she has a kidney infection, the antibiotic she's currently taking may or may not be effective against it.

Laurie


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## laurief (Jun 22, 2008)

BTW, you should go back to the rescue organization and ask them for the name of the vet who supposedly administered her first leukemia test. Even if the rescue lost her test records, the vet will certainly still have a record of the test. Get in touch with that vet directly.

Laurie


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## Arkona (May 7, 2012)

laurief said:


> That depends on exactly which blood tests were run. If it was a standard blood chemistry, then no, it wouldn't be able to differentiate between renal failure and a kidney infection. If the testing included a CBC, then infection would probably have shown up there. You need to go back to your vet and get copies of ALL lab results run on your girl (both current lab results and any other lab results run on her since you've had her). Once you get copies of all of her labs, post them here so that we can take a look. Perhaps we'll be able to point out issues that you should discuss further with your vet.


They are mailing out her blood work results. I'll keep you guys posted.


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## Arkona (May 7, 2012)

Trying to attach bloodwork results. Does this work?


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## minikin44 (Aug 25, 2012)

I don't know much about blood work on cats, but the fact that her white cell count is high would indicate that she's fighting an infection of some sort (at least it means that in humans). The creatinine and urea are indicators of kidney issues but I have no idea how to tell if that's infection or kidney problems. I think high protein is an issue with kidneys too. In anatomy class today, my professor said that proteins are normally too big to pass through the filtering unit of the kidneys but that if there is too much pressure then it can force the protein through. Amylase is an enzyme that breaks down amylose (a sugar) but I don't know what high levels indicate. Hopefully someone else will be able to give you more info, but at least now you know they posted alright.


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## laurief (Jun 22, 2008)

Oh, man! I don't even know where to start with that bloodwork. There's an awful lot of funky stuff happening there. If she weren't anemic, I'd even be inclined to suggest another round of bloodwork to verify the results. But with her anemia, every drop of blood is precious.

I am NOT a vet and NOT a hematologist, but I am willing to spend some time researching her blood values and see if I can come up with a list of things for you to discuss with your vet. Here's the website that I'll be largely using as my reference. You should spend time on this website, as well, going through the values and learning what you can about the possible causes of Amy's blood anomalies. Here's the link:

Broadway Veterinary Hospital / Laboratory Assessment Descriptions

If you click on the name of each blood value, it'll download a small informational page on that value.

It'll take me some time to work my way through these results. I'll try to post later tonight.

Laurie


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## Arkona (May 7, 2012)

I don't understand... where is all this coming from? Where is this CRF coming from? She's barely 3 years old! Why is she having all these problems?


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## laurief (Jun 22, 2008)

I don't have time right now to do more than a quick comment, but just at first glance, I'm inclined to agree with hoofmaiden that a kidney infection seems a lot more likely than CRF. Several of her blood values point to infection.

Laurie


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## Arkona (May 7, 2012)

laurief said:


> Broadway Veterinary Hospital / Laboratory Assessment Descriptions
> 
> If you click on the name of each blood value, it'll download a small informational page on that value.


Thanks for the resource. I don't know if this helps, but here are all her abnormalities and the explanations that website gives for each one:

LOW ALBUMIN
The Albumin level is low. Albumin is the main protein in the blood and is produced by the liver. Decreased albumin levels are most commonly attributed to either it being lost out of the body, a lack of production by the liver, over-hydration or laboratory error. Albumin is commonly lost through the gastrointestinal tract with primary GI disease, as with a hookworm infection, or through the kidneys, with disease that affects the renal filtration unit. Decreased albumin production can occur with end-stage liver failure, but this is rare. Over-hydration, such as during IV fluid therapy, occasionally can cause low albumin levels as well. The decrease in albumin should be interpreted with respect to the other lab values and physical exam findings.

HIGH GLOBULIN
The globulin level is high. Globulins are protein antibodies in the blood, which are part of the immune system. They are usually elevated due to infection or inflammation in the body. The most common infections causing this type of elevation are parasite skin infections, abscesses, Ehrlichiosis (in dogs) and FIP (in cats). Certain cancers, auto-immune diseases and even periodontal disease could also cause this elevation.

HIGH UREA NITROGEN
HIGH CREATININE
Your pet has azotemia, which is elevation of the kidney values; BUN and Creatinine. BUN, or blood urea nitrogen, is a by-product of protein metabolism and is cleared by the kidneys. If the kidneys are not working well, the BUN builds up in the blood, resulting in toxicity. A high BUN can lead to stomach ulcers, nausea and a loss of appetite. Creatinine is a normal muscle enzyme that is cleared by the kidneys also. It does not result in toxicity for your pet, but it is good monitor of kidney function. Once the creatinine level reaches about 10, we suspect total kidney failure is occurring. A normal BUN level is below 36 and a normal creatinine level is below 2.4. Very mild elevations in these values may only be a result of severe dehydration, more likely, these elevations mean your pet has Chronic Renal Insufficiency.

LOW CALCIUM
The calcium level is low, which is known as hypocalcemia. This is a rare and unexpected finding. It has the potential to be a serious condition. The most likely reasons for a low calcium level, other than being a lab error, are it being secondary to a low albumin (blood protein) level, hypoparathyroidism, ethylene glycol toxicity, renal failure, acute pancreatitis, intestinal malabsorption or hypomagnesemia.

HIGH AMYLASE
The amylase level, which is a pancreas enzyme, is elevated. Unfortunately, this enzyme is not reliable in cats, so this elevation has no significance.

HIGH WBC
The white blood cell count is elevated which most often indicates stimulation of the cellular immune system due to inflammation or infection. This value is made up of the individual white blood cell types: Neutrophils, Lymphocytes, Eosinophils, Monocytes and Basophils.

LOW RBC
The Red Blood Cell (RBC) Count is low. A low count is consistent with anemia. In rare cases, excessive fluid therapy could also cause this.

LOW HEMOGLOBIN
The hemoglobin level is low. Hemoglobin contains iron and is the main structure within red blood cells that carries oxygen from the lungs into the body through the blood. A low hemoglobin level could be seen with chronic illness, early or resolving anemia, as well as malnutrition (low iron levels).

LOW HERNATOCRIT
The hematocrit level is low. This means your pet has a low red blood cell count and is anemic. There are many causes of anemia. Some causes are from decreased production of red blood cells, as with chronic disease or bone marrow disease. Other causes are from loss of blood cells, such as with bleeding or a flea infestation or from hemodilution, which is seen with excessive IV fluid therapy. A final cause of anemia would be from destruction of red blood cells, such as with certain autoimmune diseases or blood parasites like hemobartonella. It is important for the underlying cause of anemia to be determined and treated. Hematocrit levels below 12% can become life-threatening.

LOW PLATELET COUNT
The platelet count is artificially low due to clumping of these cells, making it hard for the machine to accurately count the cell number. On visual inspection, the platelet count was adequate. This is considered a normal platelet count.

HIGH ABSOLUTE NEUTROPHILS
The neutrophil count is extremely elevated. This is one of the most important types of white blood cells in the body. It becomes elevated like this as a result of either inflammation, severe infection, or in rare cases, as a result of cancerous leukemia. This elevations indicates that the immune system is stressed and trying very hard to fight something off. The underlying cause of this elevation should definitely be diagnosed and treated.


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## Arkona (May 7, 2012)

laurief said:


> I don't have time right now to do more than a quick comment, but just at first glance, I'm inclined to agree with hoofmaiden that a kidney infection seems a lot more likely than CRF. Several of her blood values point to infection.
> 
> Laurie


Keep in mind she was also diagnosed with that tracheal infection and is being treated with antibiotics for it, so the blood values pointing to infection could be pointing to that, unless there is something that indicates a kidney infection in particular. 

However I am inclined to agree, because I find it very odd that she would have CRF at this age, I have not yet heard of CRF cats that young but then again I've only started researching this last week when I got that call from the vet. I also am of course hoping for something less extreme, and curable. 

Only a week ago I thought I had in my hands a cat that was sick and frail due to malnutrition, that I could bring back to health with a proper diet, exercise, and love. Now I'm having to come to terms with the possibility of her having a fatal, incurable, progressive disease with a number of terrible symptoms/side effects. 

I really appreciate you taking the time to help me. This is a really hard time for me, I am overwhelmed.


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## minikin44 (Aug 25, 2012)

From the descriptions you posted, it sounds like a kidney infection to me too. If I'm following it correctly, the kidney infection is causing the creatinine and urea levels in the urine, the white blood cells are present to try to fight the infection, and the kidneys are filtering out too much albumin, which is causing anemia and a calcium deficiency. Of course, I haven't finished my second anatomy & physiology course, and its about humans, but that's my partially-educated guess. Most kidney infections are caused by pathogens that make their way into the host by traveling backwards through the urinary tract (urethra to bladder, to ureters, to kidneys). As for a cause, maybe she could have picked up the germ from another cat that was at the shelter. Get your vet to test for a kidney infection, and if he/she won't do it, take your kitty for another vet for a second opinion.


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## laurief (Jun 22, 2008)

OK, I've spent some time on this tonight, but I need to go over it again tomorrow to see if my brain can make any sort of sense out of it all. In the meantime, I want to make sure you're looking at the same things I'm looking at so we're on the same page. There are a few additions and corrections you need to make to your list of lab descriptions that you copied and pasted above. In addition to the descriptions above, you need to download and read the following descriptions from that site:

Total Protein - high
Sodium - high
Neutrophils - high-mild
UA - Blood - cat
UA - Protein - +1 with normal to low SG & pH

There's a difference between neutrophils and absolute neutrophils. Amy's neutrophils are only borderline high. You downloaded the severely elevated neutrophils description. Let's not make things worse than they actually are. ;-)

I also urge you to carefully and thoroughly read the following web page in its entirety. It provides pertinent information relative to her urinalysis results:

Tanya's Comprehensive Guide to Feline Chronic Kidney Disease - Urinalysis

I'll post more tomorrow ...

Laurie


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## Arkona (May 7, 2012)

I haven't had time to read through that page yet but I will take a look tomorrow.

Her FIV and FeLV results came back negative, which is good news. The bad news is that over the past 2 days her appetite has decreased dramatically. She went from eating all of the food I was giving her (although not necessarily at the "right" times) to barely eating any. I'm at a point now where I'm just feeding her anything... because I can't leave the raw food sitting all day for her to eat, I've been leaving canned food with added water. If I'm lucky she'll spend 15 minutes nibbling on it, then she stops, and refuses to eat more, and there's still so much left.

Today I tried to give her raw food, I tried Wellness canned, she finally ate when I gave her Fancy Feast. But all she ate was half of a 3oz can, and not even the whole thing. When I am home I keep trying to get her to eat every 30 minutes, sometimes like I said she will nibble a bit but leaves most of the food.

She seems to be peeing less and less in her litter box, more and more at random places in the house. She threw up 2 days ago, and threw up again today. She's been lethargic and withdrawn. All she does is sleep. She's been a big sleeper this whole time (well, she's been sick this whole time!) but she usually showed interest when we were around. Now she just wants to be left alone, it seems. 

I still haven't been able to get in touch with the vet. I'm going to take her to a new vet as soon as I can, but I still want to speak with this vet more thoroughly now that I have a better idea of what's going on, but it's been hard to get a hold of her.


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## minikin44 (Aug 25, 2012)

I feel like her symptoms are progressing too fast for it to be "chronic" renal failure... but I'm not a vet. I hope whoever you find for a new vet is a lot more helpful and available.


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## laurief (Jun 22, 2008)

I'm sorry it's taken a few days to get back to you. I keep looking at her bloodwork and getting all confused, so I finally sat down tonight and made a spreadsheet of her blood anomalies and their most common causes from the Broadway Vet website. The spreadsheet is helping me organize my thoughts and show me which blood values point to which potential causes. But remember, I am NOT a vet and I don't work in any capacity within the veterinary profession. I'm just a logical thinker with a lot of experience taking care of a lot of sick cats over the decades. So take my insights and assumptions for whatever you may think they're worth. Hopefully, I'll at least help you identify topics to discuss with your vet.



Arkona said:


> when I took her in I could feel her ribs, her spine, her shoulders, and her hip bones. VERY prominently. ... She had recurring problems with a URI while at the foster home. When I took her in, she was just done with her antibiotic treatment. ... her breathing sounded weird, but it has since improved.


So, she was ailing, seriously underweight, and had been on antibiotics which likely upset her digestive tract. The antibiotics and/or the URI interfering with her sense of smell probably caused her to lose her appetite and/or she was not competing successfully for available food in the foster home.




> sometimes her third eyelid doesn't close all the way when her eyes are open. I am not sure if that is a symptom of something.


I suspect that is a symptom, though I don't know of what.




> She also came to me infested with fleas


Fleas, along with malnutrition, could easily explain her anemia, though there are a number of other potential causes for her anemia (auto-immune or bone marrow disease, among others).



> the vet pointed out she has a blackened tooth which may be dead and will probably need to be removed, but to give it a few months so she could recover from everything else that was going on, so as not to put her through too much at once.


I understand your vet's thinking, but if that blackened tooth involves periodontal infection, that infection could account for a number of her other blood anomalies, as well as cause damage to her heart and kidneys.

Regarding her diminished appetite - anemia, infection, inflammation, and antibiotics can all strip a cat's appetite ... and she's likely dealing with all of the above. You MUST get adequate food into her. You are correct not to worry about WHAT she eats. The primary consideration is making sure that you get as much food into her as possible. At this point, it sounds like you need to start assist feeding her to get enough calories into her each and every day. The following links will provide you with a lot of tips, tricks, and techniques to help you get nourishment into your girl:

AssistFeed.com: Advice to help a sick cat who will not eat
Tanya's Comprehensive Guide to Feline Chronic Kidney Disease - Persuading Your Cat to Eat

I certainly would NOT be giving her a low-protein diet at this point. In spite of the renal problem, she NEEDS high quality nourishment, and lots of it.



> She drinks a lot of water. She is always drinking from her bowl, even though her food has plenty of water.


That's most likely because of her kidney issue, which I think is most likely a kidney infection rather than renal failure. I think you REALLY need to talk to your vet about treating her for a kidney infection. Also, an x-ray would be advisable to check for kidney and bladder stones and to evaluate the size of the kidneys themselves.

Several of her blood values point to infection and/or inflammation, which, of course, may be occurring in multiple locations in her body. She may have a mouth infection from that tooth. She likely has a kidney infection. Blood in the urine may point to a UTI. She has the tracheal infection.

I would discuss all of these potential areas of infection with a vet and see if she shouldn't be on a much more aggressive antibiotic combination therapy.

I'll take another look at my spreadsheet tomorrow and see what else may jump out at me.

Laurie


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## Arkona (May 7, 2012)

Yesterday she barely ate, but at least she ate a little bit. Today she refused to eat AT ALL. She didn't even touch her WATER. I syringe-fed her but still, she didn't get nearly enough of what I think she should be getting in a day.

I took her to a new vet. He gave me an appetite stimulant so hopefully that'll help. He also gave her sub-Q fluids for her dehydration. He says there's no way of knowing right now what's causing the issues, but he mostly suspects FIP. A kidney infection is another possibility, however the antibiotics she's currently on for her tracheal infection should take care of that if that's the case. FIP is hard to test for, but I've decided to have them run a blood test for coronavirus. If she's positive for it that means she could have FIP, but not for certain as not all cats with this virus have FIP. However if she tests negative for it (unlikely) it would at least rule out that possibility.

Best case scenario right now is: she tests negative for corona, the issue is a kidney infection which the antibiotics will take care of in a couple more weeks, her appetite improves and she goes back to eating and we can start getting her on track to better health.

Pretty much anything else is pretty bad. Other possible things she could have are CRF or cancer. There are other possibilities, but it seems like regardless of what it is, it's fatal. We can't screen for every possibility. In just the 1 month I've had her, I've already spent close to $1000 on vet bills and medications for each of the many issues she has shown up with. I wish I had money to be able to figure out exactly what the problem is, but I don't, and it seems like no matter what it is, there is nothing I can do about it.

I have to take it one day at a time. I can't think about the future right now. I don't even know what's going to happen a week from now. Heck, I don't even know what it'll be like tomorrow. It's bad. Exactly ONE WEEK ago she had been fine (considering how she was when I first adopted her) other than that cough... I mean sure she had other issues but nothing that looked unfixable, let alone fatal. She played, she cuddled, she spent time with us, she ate and drank a lot. Now she hides and sleeps, doesn't drink or eat, doesn't use her litter box. She lost .4lb in only 3 days. It's all just going from bad to worse. Not in my worst nightmares could I have imagined anything like that...


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## minikin44 (Aug 25, 2012)

I am SO sorry you're going through all of this and that the poor baby is so sick  It really is a nightmare scenario... I guess all you can do is test for the corona virus and if it's negative give her a little time to see if her health will improve; then, if it doesn't, you may have to do the kind thing and end her suffering. At least, if this does turn out to be the end, she'll be lucky enough to have known love. In spite of all the nasty possible diagnoses, I hope she miraculously gets better, and soon!


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## Arkona (May 7, 2012)

Thank you. I hope so too. I will keep you guys updated...


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## Arkona (May 7, 2012)

It's so **** hard to swallow... how did I go from one day thinking CRF (which then sounded like pretty much the worst thing she could have) into FIP being the most probable possibility? If it's FIP, sources say she has days to weeks... a few more months at best. CRF is looking really good in comparison.


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## minikin44 (Aug 25, 2012)

Honestly I don't understand why the vet thinks she has FIP... what was his/her reasoning?


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## Arkona (May 7, 2012)

She still refuses to eat even though we gave her appetite stimulants last night. Now my other cat shows up with one eye mostly closed. Please tell me she didn't pass something onto her... I can't take this anymore.


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## minikin44 (Aug 25, 2012)

Hmm... I'd keep them separated. FIP is contagious (although I'm still unconvinced that the new kitty has FIP). The eye thing could be the beginning of a URI so just keep an eye on him/her and see if there is any sneezing, runny nose, etc.


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## laurief (Jun 22, 2008)

She also needs an abdominal x-ray to check for kidney and/or bladder stones.

There is no definitive test for FIP in a living cat, though there are tests that can strongly suggest that diagnosis.


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## laurief (Jun 22, 2008)

A mostly closed eye may just indicate that your other cat bumped or scratched her eye. It may also indicate illness ... likely herpes. It wouldn't hurt to mix 500 mg of L-lysine into each of your cat's meals once daily in case you do have a herpes flare-up happening in your household. L-lysine won't hurt even if herpes is not present, and it may help if it is.

Laurie


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## laurief (Jun 22, 2008)

Which appetite stimulant did your vet prescribe, and at what dose?


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## laurief (Jun 22, 2008)

Hoofmaiden, she's currently on an antibiotic for her tracheal infection that the new vet apparently said would also be effective against a kidney infection, if one is present.


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## minikin44 (Aug 25, 2012)

I'm not sure how the vet can say the antibiotic would definitely treat the kidney infection, seeing as if she has one, he doesn't know what she's infected with


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## marie73 (Jul 12, 2006)

My vets and the specialists were convinced that Cinderella had FIP, but it wasn't. I mean, it was pancreatic cancer, which is also terminal, but FIP gets thrown around alot when they can't get a definitive diagnosis.


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## Arkona (May 7, 2012)

minikin44 said:


> Hmm... I'd keep them separated. FIP is contagious (although I'm still unconvinced that the new kitty has FIP). The eye thing could be the beginning of a URI so just keep an eye on him/her and see if there is any sneezing, runny nose, etc.


FIP isn't contagious, the virus that causes it is, but it doesn't cause FIP in most cats. Amy was quarantined while we waited for her FIV/FeLV results, but I opened the house up for her again once those came out negative, until I heard about the FIP possibility last night. Amy is quarantined again. Not that it matters, because she's been sleeping in the closet all day not going anywhere, and because if she does have coronavirus it would have been transmitted to Liz by now anyway.

Liz's eye looks like it's swollen. It's not runny, there's no pus coming out, she's not sneezing and doesn't have a runny nose. If it doesn't improve soon we'll have it looked at. My husband thinks she just scratched it… it's happened before with the other eye although personally I think this time it looks a bit worse. In any case I will keep the L-lysine suggestion in mind if it's not better tomorrow. 



[quote=hoofmaiden;873017]
This really REALLY needs to get diagnosed. What is the vet actually DOING here? Is he not concerned?? You can have a belly tap done to Dx FIP if he actually thinks that's the problem. Has she had a urinalysis (sterile) done? If not, that needs to be done last week![/quote]

The first vet called me with her blood results exactly one week ago. She told me what they said, told me about everything that could possibly be causing the abnormalities, about all the tests that would have to be done to determine what she has. I would be spending thousands of dollars on tests alone just to get a diagnosis. Almost every possibility is very bad, and fatal. I had her re-tested for FIV and FeLV, for which she came back negative and it was a real struggle getting in touch with the vet to get those results and to have a conversation about what to do next.

So I went to another vet. That was yesterday. Between a week ago and then is when her symptoms really worsened so she needed to see a vet right away. The first vet finally called me back as I was on my way to the second vet and told me the same things again. I pressed her to help me find the more likely possibility so I would know what to do next but she continued to tell me the same things, mention the same things… everything was a possibility and she was stressing each possibility equally. She mentioned FIP, cancer, liver issues, kidney infection, CRF, etc etc. Once again, thousands of dollars just to find out what it is. When pressed the vet gave me no guidance, no ideal course of action, the best she had for me was to hospitalize her and possibly put her down. 

I got to the new vet and he examined her, looked at the blood work, said he thinks FIP is most likely. I asked him about all the other possibilities you guys and the other vet mentioned and he said they are all possible. However FIP is number one on his list. He told us about possible tests to determine FIP. It's an extremely hard disease to diagnose for certain and would take chest and abdominal x-rays, etc to diagnose. Over the course of a week alone I've already spent more on vets for this cat than I earned. So obviously I am not in a position to give her every test she needs to determine she has FIP beyond a shadow of a doubt, but I do want to know the real likelihood of it so I asked him to do the blood test for coronavirus. If she has coronavirus, with her current blood numbers it is highly likely that she has FIP. If she does not have the virus then it's not FIP and we can look at other things. That was my logic behind deciding to go with this test and not the others. 

She got a urialysis done with the blood work last Thursday, it's all attached to this thread. The vet also mentioned a urine test for cancer (or was it for something else?), however since she's now on antibiotics it would affect her results and they would not be accurate. I addressed the kidney infection possibility, told him which antibiotics she's on for her tracheal infection and he said they should take care of a kidney infection if she has one. I will get back to you all with the name and dosage of both the antibiotics and the appetite med.

Other than that, the vet gave her the appetite meds and subcutaneous fluids to help her feel better. However she only seems more uncomfortable now. Before she was hiding, tired, and not eating. Yesterday she just slept in the corner all day. Now she's doing all these things AND getting very upset if we try to touch her, growling and whatnot, and scratching when we pick her up to assist-feed her. She never did anything like that before so clearly she's become very uncomfortable after this vet visit.

I'm happier with the second vet. The people there were much more willing to get us an immediate appointment, the vet was more frank and to the point and willing to guide me a lot better rather than give me all the possibilities known to man without trying to help. He asked questions about her and was willing to tell me what he thought was most likely going on rather than try to get me to just give up OR to test for every single thing before saying anything. He also did things that were intended to give her some relief… they didn't work, but I don't think that's his fault.


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## Arkona (May 7, 2012)

marie73 said:


> My vets and the specialists were convinced that Cinderella had FIP, but it wasn't. I mean, it was pancreatic cancer, which is also terminal, but FIP gets thrown around alot when they can't get a definitive diagnosis.


So what happened after that? Were you able to treat her for it? What was the treatment?


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## Arkona (May 7, 2012)

Her antibiotic: Orbifloxacin, .6 milliliters per day

Her appetite pills: Mirtazapine 15mg, 1/4 tab per 72 hours.


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## marie73 (Jul 12, 2006)

Arkona said:


> So what happened after that? Were you able to treat her for it? What was the treatment?


No, sadly there's no cure, pancreatic cancer is just as terminal in cats as it is in people. She was with me only four weeks after my vet said she was ill. It was discovered from pre-dental blood work, which I'm so glad I had done because she probably wouldn't have come out of the anesthesia. At least I had another month with my sweet girl. (in my signature, she's second from the left)

[sorry to go off-topic/hijack]


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## Arkona (May 7, 2012)

Oh no 
The saddest thing about this is that it seems like no matter what she has, she won't be with us much longer. So even if I did have all the money to spend on the right diagnosis, how would it help?

I have changed my perspective a bit. I cried so much after the vet visit on Thursday night, I couldn't even sleep. I cried all day on Friday, even at work. When I came home she ate some tuna (hardly enough) and was a bit more responsive but still largely resigned to her corner in the closet and peeing on her bed, on my bed, etc.

We had to put her in the bathroom. When she's in the bathroom she will actually pee in the llitter box and not the carpet or bed. She was covered in her own pee and sweat because she has not groomed properly in days. 

All I had in my mind is that she will die before the weekend ends. I talked to her, I know sit's silly but I told her I'm going to get her all better but I need her to help me by eating and drinking. I don't care anymore that I will have to deal with litter box issues in the new house, i just need her to live.

This morning when I opened the bathroom door she got up to greet me. Poor baby is so thin she can barely stand and looks so shaky at times. But she ate and drank and had her peed in her box. She's still not eating or drinking enough but she is back like she was 4 days ago as opposed to the past 2 nightmarish days. I am so happy to see her recover even if it's just a tiny bit. She is sleeping on my lap right now. There is still hope.


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## laurief (Jun 22, 2008)

Arkona said:


> Oh no
> The saddest thing about this is that it seems like no matter what she has, she won't be with us much longer.


That isn't necessarily true! If she has bladder and/or kidney stones, those can be removed surgically. If she has a kidney infection, that can be cured with antibiotics. If she has some other bacterial infection, that can also be cured with the correct antibiotics. If she has hepatic lipidosis, that can be cured if you assist feed her effectively and adequately. 

There are, of course, ailments that can not be cured, but even many of them can be successfully managed for substantial periods of time, like CRF.

Your biggest problem is that you don't have a definitive diagnosis, so your vets are throwing generalized treatments at her in hopes that something will work. They're treating symptoms, not the unknown, underlying illness(es).

I will still urge you to have an abdominal x-ray done ASAP to see if there are stones and to evaluate the size of her kidneys. The weaker she gets, the poorer a surgical candidate she will be, if surgery presents itself as a curative option.

In the meantime, don't rely just on what you can convince her to eat on her own. You need to be syringe feeding her to get adequate nutrition into her. A starving animal can't heal.

BTW, "recommended" dosages of mirtazapine can REALLY weird out some cats. Her deteriorating behavior since receiving mirtazapine may be the result of too high a dose for her. If I were you, I'd cut that dose in half next time she's due for a dose and see how she responds to that.

Hang in there,

Laurie


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## Arkona (May 7, 2012)

Thanks. Her behavior began to deteriorate a few days before receiving the appetite pills, though...


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## minikin44 (Aug 25, 2012)

I don't know if you're religious or not but if it helps, I'm praying for her.


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## Arkona (May 7, 2012)

Thank you 

She's been doing a lot better this weekend. I'm glad for each day she is still alive and showing signs of progress.

Thursday and Friday I was coming to terms with the very real possibility that she wouldn't make it past this weekend. But here she is now, eating (still not enough, but it's something!) drinking, using her litter box (so long as she's in the bathroom, at least), even grooming herself a little bit (not much). We took her out of the bathroom and into our bedroom and she walked around a bit and didn't hide in the closet or under the desk like she was doing before. She's napping right now on top of the chair... which she hadn't done since her crisis began a little over a week ago.

We will put her back in the bathroom when we have to go to sleep so that she continues using her litter box and improving. Somehow, she seems to do better in there although she doesn't love being there by herself. 

She is skin and bones and I just hope that no matter what she has, her appetite will continue to improve so we can start getting her stronger and healthier. Tomorrow we will get her coronavirus test results and think about the next course of action.

Here is a photo of her drinking on my bed from earlier tonight, to cheer up this thread a bit.


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## minikin44 (Aug 25, 2012)

Aww she's still so beautiful! I'm glad she's eating better... hopefully she'll be eating a normal amount soon. I think it's a good sign that she's starting to groom again. Here's hoping the coronavirus test is negative and that it's something treatable!


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## Arkona (May 7, 2012)

Update:

She's still eating and drinking, almost like normal now. I might start trying to get her back into raw soon, because with raw she can eat smaller quantities and get better nutrition than canned. During this time we were really a lot more concerned over her eating at all than over what she was eating, and Fancy Feast seemed to do the trick. It also helps that I can leave it out a lot longer than raw.

She's still lethargic but she looks very interested when we open her can of food, she gets up when we open the door, etc. She's using the litter box but when I put her anywhere else other than the bathroom, she still pees on the carpet. 

Yesterday she walked around the room a bit and even jumped from the desk down to the floor. She plays a little when we try to play with her... she won't run around but she follows the toy around with her eyes and tries to grab at it.

Her blood test came back positive for coronavirus, which only tells us that she doesn't not have FIP... however doesn't confirm that she does, either. She also came back positive for toxoplasmosis, so we will be treating her for that now. Her antibiotic treatment should be over in a week or two, and she'll be on the toxoplasmosis medication for a while. We're keeping an eye on her and will follow up once treatment is finished, or before that if her condition worsens again.


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## minikin44 (Aug 25, 2012)

I'm glad she is at least a little better... Maybe getting rid of the toxoplasmosis will do the trick.


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## Arkona (May 7, 2012)

Things took a turn for the worse again. Amy was taking a step forward, but now she has taken ten steps back. The FIP possibility is looking more and more plausible now, given her unresponsiveness to her medications, how fast her condition is worsening, and the new symptoms she is showing.

The second-opinion vet was leaning strongly towards the FIP possibility. The first vet believes it's a possibility, as well. She has so many problems and they point to one immune system problem. It's not FIV or FeLV so FIP is another possibility. Furthermore, her bloodwork points to it as well. 

Amy can no longer keep her food down, so she has stopped eating and drinking altogether again. She hasn't truly been active since this whole crisis first started when I first posted this thread, she hasn't groomed herself, hasn't used the litter box properly unless she is quarantined to the bathroom.

Last night we let her stay in the bedroom again and as always, she peed all over the carpet, bed, etc. She also pooped and puked all over. It's not even frustrating anymore. We don't even mind cleaning up after her. It's just sad how helpless she is. 

She also seems to have developed neurological problems. She can no longer walk properly or even stand still, because she can't keep a balance, she just tips over. She has been a little shaky for a while, but now it's so bad she looks like a cat with severe neurological problems. And this all happened within the time span of a few hours.

For the past week/s I'd been hoping it wasn't FIP, but last night after the onset of these symptoms I revisited my "research" on FIP and it truly does look like the most likely possibility, especially given her albumin to globulin ratio which is at 0.26 (supposedly a value of 0.8 or lower means there is a 97% chance that the cat has FIP), and the recent neurological issues.

We have decided that the best course of action to take at this point is to put her down humanely. She is no longer happy or enjoying anything, she is just suffering and there is no hope for a cure. I'm afraid of prolonging her pain even longer. We've set up the vet appointment for Saturday, although if she continues at the current rate we may have to do it sooner. Things truly could not be any worse.


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## minikin44 (Aug 25, 2012)

I'm so sorry that things have turned out this way.  Poor baby girl... I don't quite know what to say. At least she was able to experience your love, and you'll be able to end her suffering in a quick, pain-free way.


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## Arkona (May 7, 2012)

Thank you. I appreciate all the help and support I got on this thread.

We had to put her to sleep a lot sooner than I thought. When I got home today, shortly after writing this post, she was doing much worse... 

RIP Amy. We loved you more than you'll ever know. We're so sorry this happened to you...


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## sunset97 (May 24, 2011)

I am so sorry for your loss.


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## laurief (Jun 22, 2008)

I am so very sorry for your loss of Amy. I was hopeful when she started to improve - hopeful that she only had one or more sources of infection that the antibiotics were successfully combating. But sometimes the supportive treatments only offer temporary improvement in how a cat feels, while the underlying disease continues to worsen. I so wish that hadn't been the case with Amy.

It's a very good thing that you euthanized her so quickly after her rapid deterioration. You couldn't have done anything more than release her from her painful body, and that's exactly what you did. Amy is free.

I wish you a peaceful grief,

Laurie


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