14 y/o cat with pleural effusion, advice?

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Ravynn

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Hi everyone, i'm coming here for advice from anyone that has dealt with something like this before or just any well wishes you can offer my girl, Kitty.

It all started, maybe, around October-December 2019 with Kitty getting very picky with her dry food. She's been picky her whole life with dry food and treats. She's never touched anything else, other than wet food. I thought maybe she was getting a sensitive mouth so tried her with easier to chew kitten chow (she needed the extra lbs, very small cat, around 5lbs). She ate this 2-4x a day, when she wasn't eating much other than treats/wet food.

Then came along February 2020. Honestly, this could have started back when I got her a new heated bed November 2019 and I would see her lay on the tile floor because I thought she was cooling off from being too warm. Who knows. :( In February I noticed her sides going in and out more than i've noticed before. Never thought too much of it because she's small. Then I started noticing her sitting in the "sphinx" position and she didn't have as much energy. February 29th 2020 I noticed her breathing through her mouth after physical exertion. I wasn't able to get her to the vet until March 6th 2020 due to the weekend/work.

Vet told me her lungs sounded clear and that it doesn't sound like she has a heart murmur. Immediately I was told to bring her to the other vet that had diagnostics. She got an xray. The vet showed me the xray and there was fluid in her chest cavity going down into the abdomen, mostly in chest. Couldn't see her heart or stomach. Her lungs were completely clear.. no abnormal growths in the areas you could see. I asked if furosemide would do anything and he said he wouldn't be against trying it. He didn't really tell me what he thinks it could be and told me if the furosemide doesn't work in 3-4 days then I should put her to sleep. Doesn't think a chest tap would be a good idea because she's too worked up (she will bite/scratch if she's scared) without sedation and doesn't think it's a good idea to put her to sleep to do a chest tap because she might not wake up.

So basically I have no idea why this happened, what caused it, and no one told me to do any follow up to see how she's doing. :( The visit was rushed as well since they were really busy. I feel kind of hopeless with not a lot of info from the vet.

The good news: she's been eating lots (even if it's only temptations and wet food), drinking lots, still cleaning, coming down the stairs to see us, peeing/pooping. She started furosemide yesterday, the 6th, at 4pm and by 4am she had peed 10 times and has peed 5 more times since 5am this morning (7th) on her second dose of 0.5ml of furosemide twice a day. Her breaths per minute were 36 while resting before the vet and today they are 28-29 per minute while resting and she is no longer open-mouth breathing after physical exertion.

I've ordered Rutin since I have no idea what kind of fluid is in her, so maybe it's heart related build up or chylothorax? The only weird thing today is that after doing certain activities she has small sneezing fits with nose twitches like something is tickling her nose, which didn't happen before the vet yesterday.

Most of this is just venting... but would love if anyone could give me some well wishes for my little girl or any suggestions to make her more comfortable. Thank you.
 

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FeebysOwner

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Hi. I think it would be worth it for you to get a copy of all her records and perhaps see another vet - possibly one who specializes in internal medicine. While the furosemide may be helping to reduce the fluid - which is good - it certainly doesn't do anything to help explain what is causing the fluid build up. Any time a vet's answer is to put a cat to sleep is the time to look for another vet that isn't so quick to suggest that as a resolution.

I would also find out if a small dose of Gabapentin might be enough to calm her for the needle aspiration procedure, without compromising her breathing.

Btw, although no absolute, I do know in humans who have breathing problems that coughing is common. Could the sneezing you see her doing actually be coughing?
 
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Ravynn

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Hello! Welcome!!

In my opinion eating wet food is a very good thing. Can you weigh her to keep track and see if she starts to lose weight?

Just in case, is there any other vet you could talk with? This could help

Find a Veterinarian and Practice | The Cat Community
Yes, I can weigh her. Thank you for the reply!

Hi. I think it would be worth it for you to get a copy of all her records and perhaps see another vet - possibly one who specializes in internal medicine. While the furosemide may be helping to reduce the fluid - which is good - it certainly doesn't do anything to help explain what is causing the fluid build up. Any time a vet's answer is to put a cat to sleep is the time to look for another vet that isn't so quick to suggest that as a resolution.

I would also find out if a small dose of Gabapentin might be enough to calm her for the needle aspiration procedure, without compromising her breathing.

Btw, although no absolute, I do know in humans who have breathing problems that coughing is common. Could the sneezing you see her doing actually be coughing?
It doesn't sound good but i'm in Canada living in a rural area and there's currently only 2 vet practices here, both the same "company" with a handful of vets going back and forth between the 2. The one I went to without diagnostics (this vet was nice in explaining the possibilities and sympathetic but still mentioned putting her to sleep...) is the one that referred me to the other practice with diagnostics ASAP. I don't think we have any specialists here. I'm also nervous about the money aspect of it, as it was $325 CAD just to get this information.

The vet that did the xray is one that my sister has dealt with a long time ago with her elderly cat that was getting abscesses and seizures (if I remember correctly). I was quite disappointed when I realized he was the one that did it as he manhandled my sister's 18 y/o cat that was flying around on the table... he doesn't have any "bedside" manners, imo. :(

You know when you're about to sneeze but it doesn't happen and instead just tickles your nose? That's what it looks like is happening, then she will do one sneeze or a few small ones, sometimes not.
 

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Are there any vet universities around that your vet could consult with? They do this in the US, but I don't know about Canada. Even a specialist in another location might be able to be consulted from afar? The idea would be to find someone who could look at the results and perhaps see something not being seen by the vets you have dealt with so far. Plus, they may be able to recommend some sort of mild calming agent that wouldn't be as risky to administer for the needle aspiration.

About the sneezing, I am not sure. That should be something you could ask your vet about to see if they think it is related. Getting it on video to show the vet might be an idea too.
 
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Ravynn

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Are there any vet universities around that your vet could consult with? They do this in the US, but I don't know about Canada. Even a specialist in another location might be able to be consulted from afar? The idea would be to find someone who could look at the results and perhaps see something not being seen by the vets you have dealt with so far. Plus, they may be able to recommend some sort of mild calming agent that wouldn't be as risky to administer for the needle aspiration.

About the sneezing, I am not sure. That should be something you could ask your vet about to see if they think it is related. Getting it on video to show the vet might be an idea too.
I'm not sure, I haven't really heard of that here, the nearest school for anything vet related is 5+ hours away. I'm definitely not putting her down so soon if the furosemide doesn't make a huge difference, I really don't know what i'm going to do. The vet is open on Monday so I will call then to ask about the sneezing and taking a video is not a problem but wouldn't be able to get back in until Wednesday.
 
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Ravynn

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I'm going to run a humidifier for her just in case, the house is very dry to begin with. Hopefully it helps even if it's just a little bit.
 
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Ravynn

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Did they do any blood tests or panels?
No, they never even suggested it. She was very worked up with her tongue hanging out after the xray (didn't do that at home) though so it probably wasn't a good idea at the time regardless.

An update: the sneezing is almost completely gone, I wrote that long email about the sneezing so I guess i'll send another to update them when they read it tomorrow. She's doing even better today with her energy and I can't even notice her sides moving from breathing now. Depending on how she does this coming week with the furosemide (she's obviously doing good!), i'm thinking about getting another xray to see how the fluid is doing and if they can see and hear her heart this time. I will request a specific vet this time, definitely not seeing the other one that did the 1st xray. :/
 
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Ravynn

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Her breaths per minute were 36 when laying down but awake on Friday and today they are down to 23 breaths per minute when starting to fall asleep (which she can finally do now!!). :yess:
 
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She's truly done a 360. She has more energy than she's had in months, running up/down the stairs, jumping on the beds and sleeping on them, laying on the floor with her legs up cleaning herself, playing with me when I put my fingers under the blanket... :hearthrob:

I'm so ecstatic, as I know most people don't see their cats do so well after being diagnosed with fluid in the chest. I really hope the underlying issue is something medication can control...
 
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Ravynn

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Finally having a snooze in her favorite position. She's catching up on all that missed sleep... will update if anything changes.

IMG_20200309_121513692_2.jpg
 
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Ravynn

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She's acting more like her old self everyday. Bpm still 23. Made an appt for next Wednesday with the "cat man" vet. I can't feel her left rib/diaphragm distended anymore... lots of fluid must of left.

I picked up some prescription hill's diet urgent care wet food. She's picky so I still have to mix it with fancy feast chicken and liver but she's eating that good. She's playing even more and attacking me... got scratches all over my hands. She's silly!
 
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