- Joined
- Mar 5, 2018
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- Purraise
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Hi all.
This post does not contain any questions because at this point I am frankly out of questions. I spent the last three weeks digging the internet for answers and possible questions. I'm posting this mostly as a method to vent. I also hope that someone who reads this might actually figure out a smart question to ask, or might have a helpful hunch.
Silvester is a 9 years old male who we got from a vet clinic when he was a few months old. Since then he never went out of the appartment, except for minutes when he would accompany me on the stairs. We had another cat, 2 years older, who passed on December 5th, after what we assume it was undiagnosed diabetis. That is a story in itself, but the only part relevant here is maybe that they had both received Drontal at the time, as she was suspected of tapeworm - even though she never ever left the appartment. They were not very close, but I guess he might have been stressed out even before we noticed she was sick. He certainly was not good in her final days, when we stayed locked with her because he started being aggressive towards her, but he seemed to have passed well over the event.
He was a bit fat and had a history of regurgitation and hairballs, but it was not really possible to monitor his eating while we had both. So we started to monitor just after that, and also raised his boll to prevent regurgitation. He was eating a bit less than what the normal was for his weight, but over the 2 months since he only lost 0.5kg out of the 6kg he had. So nothing to worry about, maybe.
He seems to be somehow related with norwegian forest cats, if you search for a black and white norwegian forest cat, they look identical. He had a history of hairballs, but we never really treated it - except for growing some cat grass which he would really enjoy - we just assumed it was normal given the longer hair.
Fast forward to Friday, the 9th of February. When we came back from work, around 19:00, we noticed he had some clear vomits(no hair or food in them) . We went out that night, blaming a possible hairball that he was trying to get out. The next day he vomited again a few times, just white foam, and he wouldn't eat. We took him to the closest vet, who said it was pharingitis and shot him some antibiotics, antivomitive and vitamins.
Some hours later he wouldn't pee or eat and look generally bad, so we took him to an emergency clinic. They made a emergency ultrasound (everything looked fine). Their primary concern were the kidneys, so the only blood tested BUN - 19.9 and CREA - 1.2. All fine. They hidrated him subcutaneous and made some blood tests. They sent us home with instructions to continue the treatment of the original vet.
2 days later we concluded that the treatment does not help. Still vomiting, although more rarely if I remember correctly. Still not eating. Drinking water and peeing were fine, but no defecation. We took him to the emergency clinic again and from here on we only went there.
They admitted him that day, Monday the 12th of February. They made another ultrasound, an xray and blood work and checked his mouth. Turns out there was a bad tooth, but not infected. The ultrasound revealed nothing, as the bloodwork (ALT, CREA, ALB, GGT and TP all within normal limits; low BUN - to be expected without food). The xray revealed gas in his intestine, according to the vet. He showed us the small intestine/L5 ratio and pointed out that it is not yet 1.6 but it is still high and he suspects intestinal blockage. They would keep him overnight on IV and if things don't change in 12 hours they would recommend exploratory surgery - which we agreed and they did the next day. (still not sure that 1.6 has any relevance, I only found it associated with intestinal blockage with dogs, not cats).
They found no blockage. Removed the tooth( "I tried to clean it but it just fell") Cleaned some dried up poop from the intestine, noticed an irritation of the small intestine, a slightly fatty looking liver ( "but nothing to worry about, given he is overweight") and slightly inflamed mesenteric glands ("nothing to worry about yet, probably there is an infection in the small intestine which caused this"). Said that by itself nothing explains not eating, but maybe there was a combination of tooth and infection. "let's give it 2 more days and then we'll put a feeding tube".
We suggested them to perform an endoscopy when putting the tube. We were afraid of esophagitis which is a contraindication to e-tubes and also wanted to check the upper part of the GI. 2 days later, on the 15th, he was still not eating, but otherwise recovered after the surgery. Nice energy levels, drinking water, they said he's probably not eating because of the clinic environment. They gave him some mirtazapine on the 14th, and sent him home on the 15th with ronaxan, metronidazole and ezomeprazol. They said they would give him few days at home.
2 days later - energy levels still good, but not eating. Interested in food, licking his mouth and paws when we would put it there, but not touching it on his own. Beeing Saturday, they said they would give him the second dose of mirtazapine(apparently that's when it become most effective) and perform the endoscopy and place the feeding tube on Monday if there is no change. The only change was that he got 3 pieces of dry food by himself on Sunday.
Monday, the 19th of February, they performed the endoscopy and put in the feeding e-tube. They found a 7-8 cm hairball in his stomach which was blocking the entrance to the small intestine(the pilorus) and removed it. They said the stomach was irritated where the besoire was sitting. They did not take any samples for biopsy as they found nothing of interest. The sphincter was "pink", which they said it was to be expected given the circumstances. They sent him home the next day, with sufalcrate, ronaxan and famotidine. They only told us they tested his ALT levels, for a potential hepatic lipidosis, but they were normal. Told us we can give all the medication together, when we feed him, so it is easier for us.
This time the recovery of the energy levels was longer. In the first few days he would hide a lot and only move to pee and defecate. But he became constipated. Finally we realized that giving sucralfate with famotidine and food makes no sense, so we started sucralfate 1hr before meal - which promptly triggered vomiting after the first 2 sucralfate doses. Without sucralfate in his system his energy levels started growing and the constipation became milder, so we removed him of sucralfate. 9 days after the endoscopy he was off all medication, we got him from 6 to 3 meals per day, he was peeing a lot and pooping regularly. The pooping still seems to indicate constipation (small 2-3cm pieces and sometimes quite thick). During all this time he had some trouble breathing, with some wierd irregular snorting when he stays in relaxed positions, both asleep and awake. Quite scary when he slept, as sometimes it seemed he'd briefly stop breathing during the worst of it. It got better and better as time passed, but they had no idea what was causing it upon physical examination. Also he is lip smacking a lot and swallowing what appears to be saliva.
Finally on the 28th of February, he was prescribed medrol, with the indication that if he starts eating we should announce them immediately so they tell us how to decrease the dose to stop it. They also told us that given he did not eat yet, they now think he had hepatic lipidosis all along and the hairball might have formed because there was no transit. We did not give him medrol immediately because we were concerned. Not necessarily of the side effects, but on the good ones too. If he has lymphoma, which in my opinion is not off the table, we don't want to prolong the unavoidable, and medrol would actually help against lymphoma. The vet said he does not think he can have lymphoma.... but steroids are such a 'fix it all' drog that we're afraid we might not know what's was wrong. Anyway, Silvester solved one problem by taking his first 3 pieces of dry food the very next day.
Today we "celebrate" 2 weeks with the feeding tube on. For 5 days now, he had 3-8 pieces of food per day. His energy levels are very high, I'd say as high if not higher than before this started. However, he did vomit twice in the last 5 days, each time before meal. He is very interested in food, smelling all the plates, waiting at the kitchen door, coming to us and sniffing when we eat. But he won't take anything except those few pieces, and those usually if it happens that we do petting near the boll of food. We tried any possible kind of food. He also does not drink, but I suspect it is fine giving he's on liquid diet. Lip smacking is still there, albeit more rare. The snorting is still there, but milder. He seems to really enjoy tube feeding. When he is hungry, sometimes he just goes to the designated feeding place and waits.
Our problem is that hepatic lipidosis doesn't really make sense. His ALT levels were always normal, he did not develop any jaundice, he did not throw up at all in the first few days of tube feeding. Basically the only things that fit are that he had a period of anorexia and that now he's not eating. But we also can't think of anything else that might make sense.
Now he is as active as he ever was. Except for the unexplained snorting and for the lip smacking, he seems a perfectly normal cat who just won't eat. We're not sure how long we can go on like this or what we should do next. At this point, it seems we're just waiting for something to happen, and we feel it might be a while before it does. It all feels very frustrating.
This post does not contain any questions because at this point I am frankly out of questions. I spent the last three weeks digging the internet for answers and possible questions. I'm posting this mostly as a method to vent. I also hope that someone who reads this might actually figure out a smart question to ask, or might have a helpful hunch.
Silvester is a 9 years old male who we got from a vet clinic when he was a few months old. Since then he never went out of the appartment, except for minutes when he would accompany me on the stairs. We had another cat, 2 years older, who passed on December 5th, after what we assume it was undiagnosed diabetis. That is a story in itself, but the only part relevant here is maybe that they had both received Drontal at the time, as she was suspected of tapeworm - even though she never ever left the appartment. They were not very close, but I guess he might have been stressed out even before we noticed she was sick. He certainly was not good in her final days, when we stayed locked with her because he started being aggressive towards her, but he seemed to have passed well over the event.
He was a bit fat and had a history of regurgitation and hairballs, but it was not really possible to monitor his eating while we had both. So we started to monitor just after that, and also raised his boll to prevent regurgitation. He was eating a bit less than what the normal was for his weight, but over the 2 months since he only lost 0.5kg out of the 6kg he had. So nothing to worry about, maybe.
He seems to be somehow related with norwegian forest cats, if you search for a black and white norwegian forest cat, they look identical. He had a history of hairballs, but we never really treated it - except for growing some cat grass which he would really enjoy - we just assumed it was normal given the longer hair.
Fast forward to Friday, the 9th of February. When we came back from work, around 19:00, we noticed he had some clear vomits(no hair or food in them) . We went out that night, blaming a possible hairball that he was trying to get out. The next day he vomited again a few times, just white foam, and he wouldn't eat. We took him to the closest vet, who said it was pharingitis and shot him some antibiotics, antivomitive and vitamins.
Some hours later he wouldn't pee or eat and look generally bad, so we took him to an emergency clinic. They made a emergency ultrasound (everything looked fine). Their primary concern were the kidneys, so the only blood tested BUN - 19.9 and CREA - 1.2. All fine. They hidrated him subcutaneous and made some blood tests. They sent us home with instructions to continue the treatment of the original vet.
2 days later we concluded that the treatment does not help. Still vomiting, although more rarely if I remember correctly. Still not eating. Drinking water and peeing were fine, but no defecation. We took him to the emergency clinic again and from here on we only went there.
They admitted him that day, Monday the 12th of February. They made another ultrasound, an xray and blood work and checked his mouth. Turns out there was a bad tooth, but not infected. The ultrasound revealed nothing, as the bloodwork (ALT, CREA, ALB, GGT and TP all within normal limits; low BUN - to be expected without food). The xray revealed gas in his intestine, according to the vet. He showed us the small intestine/L5 ratio and pointed out that it is not yet 1.6 but it is still high and he suspects intestinal blockage. They would keep him overnight on IV and if things don't change in 12 hours they would recommend exploratory surgery - which we agreed and they did the next day. (still not sure that 1.6 has any relevance, I only found it associated with intestinal blockage with dogs, not cats).
They found no blockage. Removed the tooth( "I tried to clean it but it just fell") Cleaned some dried up poop from the intestine, noticed an irritation of the small intestine, a slightly fatty looking liver ( "but nothing to worry about, given he is overweight") and slightly inflamed mesenteric glands ("nothing to worry about yet, probably there is an infection in the small intestine which caused this"). Said that by itself nothing explains not eating, but maybe there was a combination of tooth and infection. "let's give it 2 more days and then we'll put a feeding tube".
We suggested them to perform an endoscopy when putting the tube. We were afraid of esophagitis which is a contraindication to e-tubes and also wanted to check the upper part of the GI. 2 days later, on the 15th, he was still not eating, but otherwise recovered after the surgery. Nice energy levels, drinking water, they said he's probably not eating because of the clinic environment. They gave him some mirtazapine on the 14th, and sent him home on the 15th with ronaxan, metronidazole and ezomeprazol. They said they would give him few days at home.
2 days later - energy levels still good, but not eating. Interested in food, licking his mouth and paws when we would put it there, but not touching it on his own. Beeing Saturday, they said they would give him the second dose of mirtazapine(apparently that's when it become most effective) and perform the endoscopy and place the feeding tube on Monday if there is no change. The only change was that he got 3 pieces of dry food by himself on Sunday.
Monday, the 19th of February, they performed the endoscopy and put in the feeding e-tube. They found a 7-8 cm hairball in his stomach which was blocking the entrance to the small intestine(the pilorus) and removed it. They said the stomach was irritated where the besoire was sitting. They did not take any samples for biopsy as they found nothing of interest. The sphincter was "pink", which they said it was to be expected given the circumstances. They sent him home the next day, with sufalcrate, ronaxan and famotidine. They only told us they tested his ALT levels, for a potential hepatic lipidosis, but they were normal. Told us we can give all the medication together, when we feed him, so it is easier for us.
This time the recovery of the energy levels was longer. In the first few days he would hide a lot and only move to pee and defecate. But he became constipated. Finally we realized that giving sucralfate with famotidine and food makes no sense, so we started sucralfate 1hr before meal - which promptly triggered vomiting after the first 2 sucralfate doses. Without sucralfate in his system his energy levels started growing and the constipation became milder, so we removed him of sucralfate. 9 days after the endoscopy he was off all medication, we got him from 6 to 3 meals per day, he was peeing a lot and pooping regularly. The pooping still seems to indicate constipation (small 2-3cm pieces and sometimes quite thick). During all this time he had some trouble breathing, with some wierd irregular snorting when he stays in relaxed positions, both asleep and awake. Quite scary when he slept, as sometimes it seemed he'd briefly stop breathing during the worst of it. It got better and better as time passed, but they had no idea what was causing it upon physical examination. Also he is lip smacking a lot and swallowing what appears to be saliva.
Finally on the 28th of February, he was prescribed medrol, with the indication that if he starts eating we should announce them immediately so they tell us how to decrease the dose to stop it. They also told us that given he did not eat yet, they now think he had hepatic lipidosis all along and the hairball might have formed because there was no transit. We did not give him medrol immediately because we were concerned. Not necessarily of the side effects, but on the good ones too. If he has lymphoma, which in my opinion is not off the table, we don't want to prolong the unavoidable, and medrol would actually help against lymphoma. The vet said he does not think he can have lymphoma.... but steroids are such a 'fix it all' drog that we're afraid we might not know what's was wrong. Anyway, Silvester solved one problem by taking his first 3 pieces of dry food the very next day.
Today we "celebrate" 2 weeks with the feeding tube on. For 5 days now, he had 3-8 pieces of food per day. His energy levels are very high, I'd say as high if not higher than before this started. However, he did vomit twice in the last 5 days, each time before meal. He is very interested in food, smelling all the plates, waiting at the kitchen door, coming to us and sniffing when we eat. But he won't take anything except those few pieces, and those usually if it happens that we do petting near the boll of food. We tried any possible kind of food. He also does not drink, but I suspect it is fine giving he's on liquid diet. Lip smacking is still there, albeit more rare. The snorting is still there, but milder. He seems to really enjoy tube feeding. When he is hungry, sometimes he just goes to the designated feeding place and waits.
Our problem is that hepatic lipidosis doesn't really make sense. His ALT levels were always normal, he did not develop any jaundice, he did not throw up at all in the first few days of tube feeding. Basically the only things that fit are that he had a period of anorexia and that now he's not eating. But we also can't think of anything else that might make sense.
Now he is as active as he ever was. Except for the unexplained snorting and for the lip smacking, he seems a perfectly normal cat who just won't eat. We're not sure how long we can go on like this or what we should do next. At this point, it seems we're just waiting for something to happen, and we feel it might be a while before it does. It all feels very frustrating.
