Cryptococcosis - Pandi's Story

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ruby6689

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PANDI'S STORY

I have been writing Pandi’s story as I could not find enough information or photos of what to expect during her diagnosis and treatment. I hope that it may be useful to other cat owners to have something to use as reference if their cat is ever unfortunate enough to contract this dreadful disease “Feline Cryptococcosis”.

Her journey started 19th April 2012.

April 19th - We noticed that Pandi was slightly lame in her right rear leg and on inspection I saw that there were a couple of small lumps on the scruff of her neck and also at the base of her spine. Andy took her to Richard our vet, as I suspected she had been attacked by our feisty little cat Misty who she did not get along with. Richard ran blood tests. Half the results came back that afternoon but we need to wait to get the full results.

April 24th - The results were in and reported that she had liver problems. As Pandi was 14 we agreed it was not really worth sending her to a specialist to have a scan. Richard suggested we try her on a two week course of the antibiotic Noroclav 50mg.

May 8th – The course of antibiotics had not helped although she was no longer lame the small lumps had spread and were now on her face, legs, tail and upper body. Her nose had swollen and she was sneezing badly and blood was visible. 

It was with a heavy heart we booked her in to be euthanized the following Saturday

May 12th – The day had come Pandi looked terrible, her sneezing had increased and there were bloody clumps of hair everywhere as she was scratching the scabs off constantly. I was starting to feel selfish and guilty about having left her this long, she was very unresponsive and eating only with a lot of coaxing and then only her favourite foods.

 

I said my goodbyes and sat in the carpark holding our two dogs while Andy

took her into the clinic.         

To my amazement Andy returned with Pandi and word from Richard that he thought he knew what she might have and that he wanted to try and save her! Even Richard was stumped for a while. In his twenty odd years as a vet he had only ever seen a couple of other similar cases. He thought it may be Feline Leprosy and asked for her to be returned on Monday for biopsies and more blood tests.

May 14th – By the time Monday rolled round it was inconceivable just how many more lesions had developed and how they had grown, 3 biopsies were taken and we took Pandi home to wait for the results.

May 16th – Pandi was not looking good and started smelling like road kill. I was starting to think we would loose her before a treatment had been prescribed. She was very weak and had to be carried to the toilet. She remained curled up and almost lifeless all day. I was coaxing her to eat and found that by putting the food on a raised platform she could manage a few mouthfuls without the constant sneezing that happened if she lowered her head. Large clumps of bloody sticky scabby hair littered her bedding and the surrounding area.

The results came back negative to Leprosy but positive to another rare fungal disease Cryptococcosis.  Richard got in touch with the Cryptococcosis specialist in Sydney and was advised it could be treated with special tailor made tablets. We were told the treatment takes about 18 months and decided that we owed it to Pandi to give it a go. We were worried that she was in pain but assured that she wasn’t, the lesions would be itchy but not painful which was a relief as we couldn’t bear for her to be in pain for that period of time.
 
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ruby6689

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May 18th – the tablets were ready and the twice a day administration would now begin. We were warned that we would see no improvement for about 4 weeks. What I didn’t expect was for it to get worse, and worse it did!

May 21st -


May 25th – Over the next few days we watched as the lesion grew and grew, they were now inside her ears, on her lip, on the edge of her eyes almost closing one and her claws were starting to fall out as the sores were taking over her paws well.

Tablet time takes the two of us as we cannot scruff her, the tops of the sores just peel off at the slightest touch so Andy has to ‘cuddle’ her tight while I tilt her head.

She bites my fingers each time so I have ordered a tablet popper from Ebay!

We had a very sick girl and it was heartbreaking to witness.

May 27th – 

 
   
 

May 30th - Pandi had a few hard lumps on her tail that were obviously bothering her, the only area she did not like me touching, so I very carefully cut them away over the period of the day to reveal infected sores, a mixture of matted hair, scabs and faeces had allowed no air circulation. I wasn’t sure if I had done the right thing but by the next morning they looked a lot better. 
 

jenwales

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Wow, I've never seen anything like that.  Poor Pandi!  I'm really interested in following the rest of her treatment.
 

tjcarst

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Are there recent photos?  May 30th was the last journal entry?  How is she now?  100% better I hope!
 
 
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ruby6689

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I am still updating her journey as she has still a way to go but her progress has been nothing short of a miracle. I will post more of her journey today. Thank you for your replies.

I apologise for the quality of some of the photos as I am just using my iphone and Pandi will not always stay still so some are a bit blurry. :pix:
 
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ruby6689

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May 31st – While Pandi still looked terrible there was a marked improvement, the lesion on her eye, though not pictured, had almost disappeared and she was walking around, wanting to go outside, toileting herself, asking for food and fighting me at tablet time (I never thought I would enjoy a swipe with a sharp claw but it was wonderful). She even sat on Andy’s lap as was her regular nightly routine.

  
 

June 5th – I had been away for 3 days and left Pandi in Andy’s capable hands and what a difference these days had made. The lumps were noticeably reduced and the lesions looking not as sore.

June 10th – Pandi back to ‘normal’ in her favourite morning spot. I have been constantly searching the internet for reference to Pandi’s condition and medication and came across a human reference for the tablets which also suggested the use of Clotrimazole cream. I had a tube of this cream which I had used on an infected finger, so I took the plunge and used it sparingly on the worst sores on Pandi’s head. I only put it in places I thought she could not lick.

  

June 13th – She has been off her food a bit the last couple of days and I was starting to worry that it was as a result of my self treatment of the Clotrimazole cream, had she managed to ingest some?

Her back is looking great now, the only ‘sores’ being the 3 biopsy areas which are healing nicely. This is an amazing difference from just a week ago. She has begun grooming herself again.


She is just starting to stop scratching her head and today all the lesions are dry for the first time, could my cream have helped? Her eyes are clearer as well and she is sneezing only occasionally.

 
  

June 14th – Still off her food, she would only be tempted by the cheese on her a cat smorgasbord in the morning and she did eat a little canned Salmon in the evening, I’m a bit worried.


June 15th -  Andy was greeted with a huge furball this morning, this could be the reason she was off her food. She then ate a big, for Pandi that is, meal of Salmon with gusto but threw it up within minutes. This is the first vomit she has had during her illness. I waited an hour then let her have a tablespoon of Salmon after her tablet which so far she has kept down. I think I might not feed her till after work today to let her tummy settle right down. Is this the correct thing to do?

On the good side every day she is healing, her back is looking great and even her head is now healing well. It seems the lesions are no longer itchy and she hasn’t really scratched for a couple of days now.

  
  
 
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ruby6689

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June 16th – We had to take one of our other cats, Mia, in for her annual vaccination so thought we would take Pandi along to show Richard how well she is now doing. She threw up on the way there and dirtied herself as we walked through the clinic door, typical Pandi making an entrance. Richard was pleased to see her and very happy with her progress. Richard made comment that her hair may never grow back, something I hadn’t considered. I have googled extensively and no where can I find progress records and pictures so I will have to wait and see. She will still be ‘beautiful’ to us.

June 18th   - it has taken a couple of days to get Pandi’s weight up but she is eating well again, Fresh Salmon and Roast Lamb did the trick! Meal menus are planned around Pandi’s likes, she has always shared our meal something our other two cats don’t do. She has also been sneezing a bit more the last couple of days but her skin is continuing to improve.

          
June 26th – The hair does seem to be growing back, very evident where the largest sore was on the top of her ear. She still has a few sores on her other ear as she has scratched them again. Her back is amazing, the lumps have reseeded and her skin is almost smooth with just a few small raised areas. Her eyes are also looking a lot clearer and the colour brighter. Her legs and paws look totally healed.

 

 2nd July – Pandi continues to heal but the days are chilly (winter in Australia), so I made her a coat which she loves, here she is sharing her ‘Dad’s ‘ lap with her rival ‘Misty'.

  

July 8th – A monumental day, the last of her scabs have healed. Her bumps continue to recede and her hair IS growing back. I am really happy with her face and head, her nose is still swollen and she continues to sneeze but no where near as bad as before and there has been no sign of blood coming from the nose for weeks. She is taking herself outside to sun herself and even ventured down to the garage to sit with her Dad.

  
 

July 17th – Pandi continues to improve

      
  

The dried scab shown next to the dollar coin came from the area on her ear, it was quite sizeable (the coin is 1" round) and I really didn’t expect her hair to grow back but as you can see there is only a small semicircle of hairless area here now.

  

I have also noticed that Pandi is no longer drinking water, she never did before, but was constantly drinking water earlier on with the disease. Her heart is also beating a lot slower. I guess these are good signs?

My only concern at the moment is her swollen nose. I will continue to monitor and photograph her to see if there is any improvement. Her sneezing is less each day, generally triggered when I put me hand under her chest to lift her up.

I am still feeding her on a raised platform (margarine container works well).


July 28th – Pandi visited Richard the vet and he is very happy with her progress. She has put on 600gms. Pandi will need to return in a months time for another blood test. We asked about the swollen nose but it doesn’t seem to be a real problem as she is not mouth breathing, it is probably scarring.

August 1st – Her hair is growing back really well now.

I noticed Pandi having a drink of water last night.

 
  

Her ‘Roman’ nose

  

August 18th – Still improving but still sneezing and drinking a bit of water.

Her skin is now smooth and all lumps receded. It is hard to believe how far she has come. Pandi has 100% hair coverage now it will be interesting to see if it all grows back as long and thick as it was before. There is slight change in fur colour in a couple of places. 
 

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I do like stories with happy endings. This is a fabulous report! Excellent information. Thank you very much for taking the time to give such a detailed, well illustrated report.
 

tjcarst

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Thank you for sharing.  I hope no one else's kitty ever gets this, but this may help save a life if they do.  There's treatment available, and now others know about it.

Glad that Pandi survived this awful ordeal.  Yay, Pandi!
 
 
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ruby6689

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Thank you, I still have one more part of her story to post, then I will just update if there is any noticeable changes.

 

I think the secret to her recovery is making sure the tablets are given as close to 12 hours apart as possible. Pandi has missed out on two only in her 5 months of treatment. I found these stuck to her coat, the cheeky devil spat them out!

 

Pandi is a well travelled cat, and has been caravaning four times since April. Her furry friends, Mia and Misty (cats) and Ruby and Rocky (dogs) have been boarded on these occasions and Pandi loves having us all to herself. Twice she has been in the vintage van at car shows and she has surprised many a looker who steps inside to view the van. 

 

Pandi's treatment is not cheap, the tablets have to be made for her and cost $285.50 for 3 months treatment then there's the constant blood tests and check ups. I have seen the tablets albeit 50mg available online somewhere in the States at far less cost but I was told they could not supply me here in Australia. I only looked it up because I found the exact same tablets my dog Ruby takes for $6.95 where as my vet charges $66! I buy these from the Chemist. I stumbled across this when I peeled the label off the vets tablets and found they were human tablets. 

 

Pandi is worth whatever the cost.

 
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ruby6689

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  Fur is growing back well.
 Her 'mate' Rocky has stolen her bed!

September 22nd – While Pandi’s fur continues to look better each day and her nose looks less swollen she has had a bit of a setback this last week. She has gone off her food again and is also looking very thin in the haunches.

She is suffering really bad sneezing attacks and her sneezes are wet.  Pandi’s right eye has also been weeping. She spent a day curled up in the middle of the lawn something Pandi has never done before so a visit to Nick the vet (Richard is on holidays) was warranted and blood tests done. The result was a secondary infection but nothing too bad. Vibravet 100 paste has been prescribed and we have started her on this. I’m feeling a bit concerned again.

September 25th – After 3 days of the new medication there has been a big improvement, Pandi’s appetite is back and she is much happier. Her sneezing has reduced immensely but there is still a slight discharge from both her eyes. Her coat is not looking the best, kind of ‘oily’ and messy. Not sure what that means.

The first photo was taken 2 weeks ago and the 2nd today.

   

October 10th – The secondary infection has cleared now and she is looking good, there is little evidence that she has had such a rough time, her nose swelling is continuing to go down and there are a couple of very small spots of bald skin which with her being long haired will not be noticeable once her coat is fully grown back.

PANDI TODAY I'm hoping there won't be any more setbacks to report and this is the end to PANDI'S STORY. I am blessed to have her today and hopefully for a long time to come.

 

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Thank you so much for posting Pandi's story.  My kitty Pumpkin is going through the same thing and it is heart breaking!  She was on Itraconazole for 7.5 weeks with no improvement.  It just keeps getting worse!  Today I started her on fluconazole...she just stopped trying to eat today.  I will try to raise her food, because she sneezes a lot when she tries to eat.  She has remained her sweet self.  I would also like to try the cream.  I think you said you think that really helped.  I wonder if it is sold in the states.  You have given me so much hope and a few great ideas...thank you again for documenting! 

Jennifer
 

happygirl90254

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I would also like to know how often you applied the cream?  Was it just one time or everyday?  I worry because my girl can lick all her lesions, but I want to do the most affective treatment.

Thanks Jen
 
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ruby6689

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Jen, I am so sorry that I have not replied before today. How is Pumpkin? Has the Fluconazole helped?

 

I only applied the cream once, I really think I should have used it more but I became worried that I was doing the wrong thing. It did seem to help. I wouldn't use it where it can be licked just to be on the safe side. Your vet may be able to advise if it is OK to use all over.

 
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ruby6689

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Well it's been a while and Pandi has been really well but only this week she has had a set back.

 

Her eye is weeping again and one side of her lip is swollen and there is a sizeable sore between her teeth and lip inside her mouth. Off to the vets again.

 

Pandi had another run in with her 'friend' Misty so I am hoping this is just a result of that. She is being treated for a secondary infection twice daily tablets of 50mg Amoxyclav for a week to see if there is any improvement.

 

The swelling does look to have gone down a bit, maybe this is wishful thinking, time will tell.

 

I am just dreading that it could be the Cryptococcosis returning. Her improvement was so great that she was taken off her tablets after 7 months. Blood test were run but the results were disregarded as they showed no change which there clearly was. We agreed to take her off her tablets and monitor her progress. Her nose will never return to normal and she still sneezes a bit.

 

 

 

Pandi must have overheard me booking her (for the first time since her illness) and her other furry friends in for boarding over this upcoming Easter weekend, maybe this is her ploy to come away again in 'her' caravan. It worked!

 
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ruby6689

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Looks like it's back to the Vets again, Pandi responded to the antibiotics and loved her trip away but the sore in her mouth has flared up again. Her nose is swelling even more and she is breathing noisily. She is also off her food again.

It's heart breaking to see her regress.
 
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ruby6689

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Today we got to se our regular vet Richard and he was very concerned at the growth inside Pandi's mouth, it is foul smelling and is covering all her top teeth. His first reaction was he thought it may be cancer.

 

Andy and I were devastated. Please, not now, not after how far we have come. I felt sick.

 

Richard examined her thoroughly and noticed that her nose swelling was soft and she wasn't in pain so he syringed it and found it to be full of puss. He has never seen this before so he put some on a slide and looked at it under a microscope. The Cryptococcosis is back. This at least gave us all some hope that the growth in the mouth may be lesions associated with Crypto. Pandi is showing no external signs and this is very different from her first bout.

 

The hand made mini capsule 30mg Fluconazole have been ordered again and after a few days on them Pandi will undergo surgery to her nose to remove the build up of puss. Fingers crossed my old girl will survive the surgery and hopefully be back on the road to recovery.

 

Cancer has not been ruled out at this stage, we will just have to wait and see if she shows improvement on the Fluconazole.

 

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Thinking good thoughts for Pandi and all of you!! What an ordeal your poor Kitty has been through. It is unfortunate you cannot get a script and buy the meds-other than the special ones - from a pharmacy /chemist. Good luck!!
 
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ruby6689

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Thinking good thoughts for Pandi and all of you!! What an ordeal your poor Kitty has been through. It is unfortunate you cannot get a script and buy the meds-other than the special ones - from a pharmacy /chemist. Good luck!!
Thank you jcat and Abisiobhan, I'm feeling a bit nervous at the moment about the surgery we should have her medication today sometime so at least we can get Pandi on her way. I am so afraid that she has developed cancer as well a her Cryptococcosis only time will tell.

I have researched for a cheaper alternative and it is not available here in Australia though I have found tablets o/s that I could divide up to the right strength. I am not sure how to go about getting them and there are so many warnings on the net about scam Chemist sites. I asked my vet if there was an alternative here but he said no.

Pandi has taken to sitting under the dining table the last two days, she always likes to be up high and 'went to ground' last time she was really ill. She refuses a lot of food but will eat when she likes what I am offering. She has always been a very fussy cat, what she likes today she hates tomorrow. The cat smorgasboard is back in play. I leave her 4 or 5 choices when I go to work and sometimes she eats sometimes she doesn't.

She was wormed while she was at the vets and I have used Revolution on her as well as the fleas are really bad. I don't know if I should have done this.
 
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