13-week-old Kitten Still Extremely Lethargic and with Tail Pain, 7 Days Post Vaccination

[kittenfriend]

I'm dealing with a perplexing and concerning situation with my kitten, who has been persistently unwell for a week now, ever since receiving vaccinations 7 days ago.

My kitten, upon returning home from the vet post-vaccination, was extremely lethargic and had a limp tail. Initially, I attributed this to a possible adverse vaccine reaction and assumed it would wear off. However, his lethargy has not improved over the past week. He only gets up to use the litter or eat a small amount of food before quickly lying back down. His overall level of activity is drastically reduced, and he shows no interest in play.

Five days post-vaccination, his condition seemed to worsen. He was not drinking or eating as much, was straining to defecate but was unable to have a bowel movement (I assume because of the limp tail), and looked extremely lethargic. I took him to the emergency vet. Labs were run, and x-rays taken. He was febrile, but his white blood cell count was normal. He demonstrated pain at the base of the tail. The x-ray read didn't show fracture but couldn't rule out lumbosacral trauma. Here are the fracture images:
Following the emergency vet visit, he received two enemas which resulted in a significant bowel movement, possibly indicating that constipation due to the inability to lift his tail might have been contributing to his overall discomfort. Since the emergency vet, he's been on corticosteroids, antibiotics, mirtazapine, and lactulose, without any improvement. They also gave him gabapentin and buprenorphine but I'm afraid to give it to him because they will make him even more lethargic.

Please help. It looks like we could be losing the kitten. He has lost like 15% of his body weight in the past week.. We're doing everything we can for him but all of this is perplexing to both us and the vets. He is so lethargic with zero interest in play. How did he potentially injure his tail - we were with him the whole vaccine vet visit and he never seemed to injure it, but was walking with a limp tail the same night (we reviewed our home cameras to be sure).

 

[iPappy]

I am so sorry your little kitten is having so many problems. Have you contacted the vet who initially gave the vaccine? Do you remember where they gave it?
You were with him during the appointment, was he wiggly enough that they had to restrain him in any way?
Would there be any way you could contact the emergency vet and tell them your concerns giving the gabapentin and buprenorphine? I don't have experience with buprenorphine, but I have given gabapentin and it seems to work for both pain and anxiety which might actually help him, if you can get it into him. It seems to be a pretty benign medication but I do understand your concerns with all this.
If you handle him, or pet him, does he show a pain response anywhere but at the base of his tail?
Give him a (very gentle) chin scratch from me.

 

[kittenfriend]

I am so sorry your little kitten is having so many problems. Have you contacted the vet who initially gave the vaccine? Do you remember where they gave it?
You were with him during the appointment, was he wiggly enough that they had to restrain him in any way?
Would there be any way you could contact the emergency vet and tell them your concerns giving the gabapentin and buprenorphine? I don't have experience with buprenorphine, but I have given gabapentin and it seems to work for both pain and anxiety which might actually help him, if you can get it into him. It seems to be a pretty benign medication but I do understand your concerns with all this.
If you handle him, or pet him, does he show a pain response anywhere but at the base of his tail?
Give him a (very gentle) chin scratch from me.

Thank you very much for the reply. I can’t contact the vet since it was at Banfield. However I’ve spoken to another vet at Banfield and they don’t really provide any additional information. The emergency vet was also perplexed at this case.

I did tell the emergency vet my concerns about the buprenorphine and gabapentin and they understood my concern. Those two meds are just for pain control so they’re not getting at the root of his medical issues.

I only notice pain at the base of his tail, when I lift it all the way up. But I don’t think it adequately explains his extreme and severe lethargy and lower appetite. I hope I can convey how serious I feel this lethargy is. It is everpresent and he only gets up to use the litter box, eat or drink a small amount, then goes right back to laying down. He has lost 15% of his body weight and I worry he’s not going to make it.

Thank you again for the reply and I’m eagerly awaiting more help.

 

[Furballsmom]

Hello.
It sounds to me like nerve damage, however it occurred. Is he pooping at all?

Can you handfeed him to help supplement his caloric intake?

I'm posting this link because the situations of cats having reactions is continuing, --whether or not this is specifically what's happening with your baby.

Clusters of suddenly sick cats roil some veterinary clinics

 

[kittenfriend]

Hello.
It sounds to me like nerve damage, however it occurred. Is he pooping at all?

Can you handfeed him to help supplement his caloric intake?

I'm posting this link because the situations of cats having reactions is continuing, --whether or not this is specifically what's happening with your baby.

Clusters of suddenly sick cats roil some veterinary clinics

Thank you very much for the reply. I also considered nerve damage, but I suspect a tail injury without nerve damage, as he does sometimes move the tail about halfway up and has pain at the base of the tail. His issue seems to be pain more than sensation issues. The base of his tail was also a little swollen per one of the vets. He also had no fracture which to me signifies there’s no compression on any of the nerves from a bone or anything.

Yes, I have been trying to handfeed him. I have also tried to use syringes but after giving him meds through them he has learned to hate syringes. I open a new can of wet food all the time to try to entice him to eat.

Thank you for the link. If there was no tail issue, I’d be certain that something like that (or perhaps an autoimmune reaction) was what is going on. However the tail in the context of else is seriously confusing and I can’t tell if it’s a red herring or one of his main issues. Thanks again for the reply. Everyone reading please chime in.

 

[Furballsmom]

Is he able to poop? Does his pain reaction seem to be improving?

Miralax often can have better results than lactulose.

Talk to your vet about the vaccine that was used, in relation to the information in the article. I strongly believe the lethargy/lack of appetite and the tail are two separate issues.

My vet gave me this method. Try using a narrow tongue depressor/popsicle stick that fits in his mouth. You can find different sizes and widths at hobby stores. Lift him up on a counter and scoop a little food on the end, and scrape that into his mouth. It's more effective than syringing.

 

[kittenfriend]

Is he able to poop? Does his pain reaction seem to be improving?

Miralax often can have better results than lactulose.

Talk to your vet about the vaccine that was used, in relation to the information in the article. I strongly believe the lethargy/lack of appetite and the tail are two separate issues.

My vet gave me this method. Try using a narrow tongue depressor/popsicle stick that fits in his mouth. You can find different sizes and widths at hobby stores. Lift him up on a counter and scoop a little food on the end, and scrape that into his mouth. It's more effective than syringing.

Thank you again for the reply.

He was actually severely constipated up until post vaccine day 6, and was straining to defecate with no bowel movements. That was one of the contributing reasons I took him to the emergency vet. They gave him an enema (and he actually required an enema the following day too) and he finally had a large bowel movement. Since then I've been giving him lactulose which has been helping, and he's been having very soft stools since then (that get all over his fur that we then have to clean, the poor baby). Thanks for the tip about Miralax, I'll ask the vet if we can switch to that.

I also agree with your gut instinct that the tail and the lethargy/low appetite are two separate issues. It definitely seems like two issues and that he's very ill/sick in addition to the tail issue. I wonder if both combined are what's making this extreme lethargy. I again want to stress how extreme the lethargy is - it looks like he's not going to make it.

I know he received FVRCP and FeLV vaccines but I'm not sure about the brand, but I will ask one of the vets tomorrow. I'm very curious to see if it was the version mentioned in that article. And if it is some reaction to the vaccine, what I can't understand is if he's experiencing an infection or some sort of autoimmune/inflammatory reaction to the vaccine?

Thanks for the tip with the tongue depressor. I will try that tomorrow. I feel so bad for him. I am trying to delay our next visit to the vet because he has been to the vet every day for the past 3 days including the terrible 12 hour emergency vet visit and I can tell how stressed and surrendered he is to these horrible visits where he gets poked and prodded.

 

[Furballsmom]

The thing about miralax is that it doesn't pull moisture from the rest of the body like lactoluse does. The dosage can be adjusted so that it works for his situation.

 

[kittenfriend]

I'm delighted to share an update on my kitten. Today, 8 days post-vaccination, he has shown a remarkable improvement. Quite frankly, the turnaround is as puzzling as the entire episode has been. He's been extremely playful today, chasing toys and displaying about 80-90% of his usual energy. With regard to the tail, he is now holding it up about 50-60% in the air, but occasionally gets it as high as 80%. One key change we made today was not administering mirtazapine, leaving him on oral antibiotics and a small dose of steroids.

We're extremely happy, albeit confused. Could it be that the mirtazapine was negatively affecting him, possibly contributing to his lethargy? I want to stress that the extreme lethargy was present before the mirtazapine was started, but today's significant improvement coincided with skipping the mirtazapine dose. While it's difficult to say if the mirtazapine played any role, it's something I wanted to share. His sudden turnaround is hard to understand, but we're overjoyed at his progress.

 

[iPappy]

I'm delighted to share an update on my kitten. Today, 8 days post-vaccination, he has shown a remarkable improvement. Quite frankly, the turnaround is as puzzling as the entire episode has been. He's been extremely playful today, chasing toys and displaying about 80-90% of his usual energy. With regard to the tail, he is now holding it up about 50-60% in the air, but occasionally gets it as high as 80%. One key change we made today was not administering mirtazapine, leaving him on oral antibiotics and a small dose of steroids.

We're extremely happy, albeit confused. Could it be that the mirtazapine was negatively affecting him, possibly contributing to his lethargy? I want to stress that the extreme lethargy was present before the mirtazapine was started, but today's significant improvement coincided with skipping the mirtazapine dose. While it's difficult to say if the mirtazapine played any role, it's something I wanted to share. His sudden turnaround is hard to understand, but we're overjoyed at his progress.

This is such a great update!! Whatever the cause, I'm glad he's behaving like a normal kitten again!
Everyone handles pain differently, I wonder if the pain from whatever was wrong with his tail did cause him to be very lethargic? I had an injury that was somewhat minor, but after a day or so the pain was bad enough that I didn't want to move and I didn't want to eat. It took another day or so to heal but the type of pain I was in really made me NOT want to do anything. Maybe it's the same for cats, especially with him just being a baby.

 

[Furballsmom]

So, as long as he poops normally, everything will be great!

You might get his health documents for your own file and make a note of the vaccine(s) brand/info, and see about hopefully avoiding that one in the future.