Cat severely lethargic but vet can’t figure out anything physically wrong

Pianistbarista

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Apologies in advance…. This is long, but I’m desperate.

About 3 weeks ago, we noticed our 12 year old cat, Loki, acting very lethargic and moving around slowly. Took him to the urgent care vet and they tested his urine, then diagnosed him with a UTI. They did a full body xray and found no blockage, so they sent us home with clavamox and orsion. For a few days, he seemed to be getting better, but then lethargic again. Took him back to the urgent care vet and they did blood tests- everything normal except for elevated liver values, so they sent us home with supplements. Our home vet suspected pancreatitis, so she prescribed cerenia and mirtizapine.

A week later things had still not improved, and he was starting to eat less, so we took him to an ER that had an internal medicine specialist and they redid blood tests, urinalysis, and did an ultrasound. They found nothing out of the ordinary except his white blood cell count had risen, and an outside lab confirmed it was increased neutrophils, confirming there was inflammation somewhere in his body. His pancreas and intestines were mildly inflamed, but nothing serious. They suggested we stop all meds and see how he does. This was last Wednesday.

He hasn’t gotten better. He’s hardly moving around and lays on the same spot on the couch. He’ll walk a few steps and then stop and lay down again. He’s still eating very slowly, and mostly lick food off my hands. He uses the litter box once a day- that’s all he seems to have the energy for. The ER vet suggested this might be something neurological, but MRIs are terrible expensive, and we don’t want to put him through more invasive tests. He’s also not showing any neurological signs other than lethargy and mobility. We do have pet insurance.

Our family vet prescribed us onsior to get through the weekend, but it doesn’t seem to have helped. We’re taking him to her tomorrow to do chest X-rays, since that’s the only thing we haven’t tried. I’m heartbroken and feel powerless, and don’t know what to do. His quality of life is poor right now, but I hate even thinking of saying goodbye without knowing what’s wrong.
 

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Furballsmom

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Hi, is he an indoor only cat? Could he have eaten something he shouldn't have, even though nothing showed in blood tests?

If outdoor, could he have gotten injured (ie; tying to the neurological idea)?

Are you handfeeding him as much as you can?
 
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Pianistbarista

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Hi there,

Thanks for responding. He is strictly indoor. No idea what he could have gotten into - we have plants but I’ve made sure all are cat friendly.
I’m hand feeding him two pouches of tiki cat mousse every day, and usually one or two churu treats. His abdominal scan didn’t show anything alarming besides mild inflammation.
 

silent meowlook

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Hi. I am sorry your cat is going through this.

Is there anything in your house? Plants? Essential oils? Air fresheners? Anyone in the house take medication? Topicals? Anything you can think of? Does he go outside? Do you have other pets? Can you post the blood work?

I am not a vet. Just trying to help you come up with some answers.
 
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Pianistbarista

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Hi. I am sorry your cat is going through this.

Is there anything in your house? Plants? Essential oils? Air fresheners? Anyone in the house take medication? Topicals? Anything you can think of? Does he go outside? Do you have other pets? Can you post the blood work?

I am not a vet. Just trying to help you come up with some answers.
 
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Pianistbarista

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Hi. I am sorry your cat is going through this.

Is there anything in your house? Plants? Essential oils? Air fresheners? Anyone in the house take medication? Topicals? Anything you can think of? Does he go outside? Do you have other pets? Can you post the blood work?

I am not a vet. Just trying to help you come up with some answers.
We do have a few plants, but I’ve made sure all are cat friendly. He’s indoor only. No air fresheners or essential oils. We do have Feliway multicat and introduced a new cat to our family in early February.
I’ve attached his med record from ER visit, which include their findings and blood test.
 

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stephanietx

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I'm so sorry you're having to deal with this. I have no words of wisdom for you, but hope the vet can figure it out.

Oh wait! What about his B12? Did they check that? I would ask for a B12 shot even if his numbers are "good" to see if that gives him a boost.
 

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They checked he teeth? Does the pet insurance at all cover an MRI?
 

silent meowlook

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I’m assuming he has been tested for FELV and FIV prior?
It could be intestinal lymphoma, but that doesn’t explain the elevated liver values prior. Did they mention how his liver looked on ultrasound? If his appetite was decreased the liver values can sometimes go up.
He looks like he feels bad in the picture. You may want to seek a different specialists opinion. One not affiliated in any way to the other.
 
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Pianistbarista

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I’m assuming he has been tested for FELV and FIV prior?
It could be intestinal lymphoma, but that doesn’t explain the elevated liver values prior. Did they mention how his liver looked on ultrasound? If his appetite was decreased the liver values can sometimes go up.
He looks like he feels bad in the picture. You may want to seek a different specialists opinion. One not affiliated in any way to the other.
He was tested for all that as a kitten, and vaccinated for all the things. They said his liver looked normal.
We’re taking him in to our family vet today- she actually hasn’t seen him since all this started- and getting chest rads. The painkillers (onsior) don’t seem to have helped him 😢
 
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