Hey all, new to the forums...I've seen a lot of helpful stories, and I want another take on what's going on with my sweet girl.
She was a street rescue at 4 months, and is now 4.5 years (indoor-only). She was diagnosed FeLV+ on 9/1/2017 (SNAP test only) when I took her to a new vet (we had to evacuate after a hurricane, and I wanted her looked over since she developed a sneeze.)
On 10/30, I noticed she hadn't touched her food all day, was very lethargic, and wasn't interested in playing, treats, or water so I made an appointment with her vet for 10/31. There was no litterbox output on 10/30 or 10/31. She got a Covenia shot, a B12 shot and instructions to monitor for food intake. She'd lost a pound from her September check-up. I worked from home the next day, where we got some small urine output, but it was unusually dark. After talking to her vet, I took her to an animal hospital for a blood draw and urinalysis. They also gave her Cerenia for nausea, added Orbax and Mirtazapine (given two hours later, at home) for appetite stimulation. She drank a little bit, but was still lethargic and not eating.
By Saturday, 11/4, she was dehydrated, and not moving at all, so I took her back to the animal hospital. They gave her another Cerenia injection and sent me home with subcutaneous fluids. She perked up a little after the first administration, but was down again by Monday. She smelled food as I tried an assisted feed and dry heaved, so I took her back to the animal hospital, saw a third vet who broached whether this was her FeLV killing her. He hadn't looked at her lab work, so I pulled it out. Her WBC and RBC are in range (WBC is on the high end of normal), but her liver enzymes and bilirubin are out of whack (AST is 908, ALT 2070, Total Bilirubin 0.9, WBC 15.4). She was down another pound (from 8.13 to 7.12 lbs in about 5 days). He sent us home with another Cerenia shot, a new antibiotic (Zenequin) and instructions to continue fluids and monitor for three days.
I called my regular vet this morning to fill her in on what all has transpired this weekend, and to say that I still don't have a diagnosis and I'm not really happy with the "wait and watch" approach while my cat basically starves to death. She's referred me to a specialist (internal medicine), for tomorrow morning. At this point, my big fear is that the lack of food is causing hepatic lipidosis, or some other complication that /could/ be treated and keep her quality of life high for another year or two, at least.
The questions I'm posing to anyone out here are 1) What bases do I need this new vet to cover, besides getting a diagnosis as to the cause of elevated liver enzymes and anorexia? 2) Has anyone been through something like this, and can you give me some insight as to outcome or treatment plans that you tried? 3) Should I have the specialist confirm FeLV through blood work rather than relying on the SNAP test results? The hospital vets don't seem to be focused on palliative care, or on getting her to eat, just on either getting her to take an antibiotic or putting her to sleep, which seems a drastic swing 4) At this point, should I consider an at-home feeding tube to get her strength back? There have been moments during the past week where the fluids have kicked in, or she's nibbled some food and started to come back to "her old self", which makes me think that recovery could be possible.
She was a street rescue at 4 months, and is now 4.5 years (indoor-only). She was diagnosed FeLV+ on 9/1/2017 (SNAP test only) when I took her to a new vet (we had to evacuate after a hurricane, and I wanted her looked over since she developed a sneeze.)
On 10/30, I noticed she hadn't touched her food all day, was very lethargic, and wasn't interested in playing, treats, or water so I made an appointment with her vet for 10/31. There was no litterbox output on 10/30 or 10/31. She got a Covenia shot, a B12 shot and instructions to monitor for food intake. She'd lost a pound from her September check-up. I worked from home the next day, where we got some small urine output, but it was unusually dark. After talking to her vet, I took her to an animal hospital for a blood draw and urinalysis. They also gave her Cerenia for nausea, added Orbax and Mirtazapine (given two hours later, at home) for appetite stimulation. She drank a little bit, but was still lethargic and not eating.
By Saturday, 11/4, she was dehydrated, and not moving at all, so I took her back to the animal hospital. They gave her another Cerenia injection and sent me home with subcutaneous fluids. She perked up a little after the first administration, but was down again by Monday. She smelled food as I tried an assisted feed and dry heaved, so I took her back to the animal hospital, saw a third vet who broached whether this was her FeLV killing her. He hadn't looked at her lab work, so I pulled it out. Her WBC and RBC are in range (WBC is on the high end of normal), but her liver enzymes and bilirubin are out of whack (AST is 908, ALT 2070, Total Bilirubin 0.9, WBC 15.4). She was down another pound (from 8.13 to 7.12 lbs in about 5 days). He sent us home with another Cerenia shot, a new antibiotic (Zenequin) and instructions to continue fluids and monitor for three days.
I called my regular vet this morning to fill her in on what all has transpired this weekend, and to say that I still don't have a diagnosis and I'm not really happy with the "wait and watch" approach while my cat basically starves to death. She's referred me to a specialist (internal medicine), for tomorrow morning. At this point, my big fear is that the lack of food is causing hepatic lipidosis, or some other complication that /could/ be treated and keep her quality of life high for another year or two, at least.
The questions I'm posing to anyone out here are 1) What bases do I need this new vet to cover, besides getting a diagnosis as to the cause of elevated liver enzymes and anorexia? 2) Has anyone been through something like this, and can you give me some insight as to outcome or treatment plans that you tried? 3) Should I have the specialist confirm FeLV through blood work rather than relying on the SNAP test results? The hospital vets don't seem to be focused on palliative care, or on getting her to eat, just on either getting her to take an antibiotic or putting her to sleep, which seems a drastic swing 4) At this point, should I consider an at-home feeding tube to get her strength back? There have been moments during the past week where the fluids have kicked in, or she's nibbled some food and started to come back to "her old self", which makes me think that recovery could be possible.
. This happened to one of my cats. WHY he stopped eating in the first place we never knew...he just did. But it turned into H/L and he got a feeding tube. I think oftentimes there is no real clinical reason why they stop eating, but once H/L begins, then you've got a problem until their livers get in check again.
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Let us know what they say after more tests are run.
You are right on with everything I have read from you so far. 
to you Shar371.
