Lung Problems, Is The Diagnosis Correct?

[FeebysOwner]

But he did have FeLV injected to him, twice (talking about vaccinations). Maybe they caused the infection?

I don't know if the vaccination can cause it or not. I do know that the vaccination is not 100% effective in preventing a cat from getting FeLV.

What made you think that this is FeLV or FIV? It could also be FHV or FCV.

I focused in on FeLV and FIV only because I found no information anywhere that suggested using Zylexus as a immno-stimulant for FHV or FCV. But, that doesn't mean that vet's don't use it to try to boost the immune system for cats with these viruses as well; and perhaps that may be a more preferred treatment in Turkey, as opposed to the US.

Was your cat ever vaccinated for FHV or FCV? Did the vet ever suggest a PCR test for any of these viruses? I believe they can be confirmed through a PCR even if Count received vaccinations for them, although as with most tests it is not fail-safe.

 

[Count]

I don't know if the vaccination can cause it or not. I do know that the vaccination is not 100% effective in preventing a cat from getting FeLV.



I focused in on FeLV and FIV only because I found no information anywhere that suggested using Zylexus as a immno-stimulant for FHV or FCV. But, that doesn't mean that vet's don't use it to try to boost the immune system for cats with these viruses as well; and perhaps that may be a more preferred treatment in Turkey, as opposed to the US.

Was your cat ever vaccinated for FHV or FCV? Did the vet ever suggest a PCR test for any of these viruses? I believe they can be confirmed through a PCR even if Count received vaccinations for them, although as with most tests it is not fail-safe.

He was vaccinated for FHV and FCV too. He never even mentioned that tests existed for confirming these.
Here is a paper on effects of Zylexis on FCV: Protective effect of the paramunity inducer Parapoxvirus ovis (Zylexis®) in kittens experimentally infected with Calicivirus (strain FCV-KS 20)

 

[white shadow]

I don't know if the vaccination can cause it or not.

Well, it can not "cause" any infection. Period.

Inserting FeLV and FIV into this is unwarranted.
.

 

[FeebysOwner]

Well, it can not "cause" any infection. Period.

Inserting FeLV and FIV into this is unwarranted.
.

Sorry, just trying to help. I don't think I am doing anything but giving Count additional information to help him digest possibilities. Your remarks are unwarranted as well, and are certainly not of a helpful nature.

Count , if you feel like white shadow , I apologize.

 

[Count]

Sorry, just trying to help. I don't think I am doing anything but giving Count additional information to help him digest possibilities. Your remarks are unwarranted as well, and are certainly not of a helpful nature.

Count , if you feel like white shadow , I apologize.

I know that you are just trying to help, and appreciate it. It is a good idea to consider every possibility, even though I don't think it is FIV or FeLV. FHV and FCV seems more likely.

 

[Noirele]

The fact that no bacteria were found in the nasal swab doesn't mean it's a viral infection. I mean, he was taking antibiotics, which could mask bacteria and give false negatives

 

[FeebysOwner]

I know that you are just trying to help, and appreciate it. It is a good idea to consider every possibility, even though I don't think it is FIV or FeLV. FHV and FCV seems more likely.

Thanks, I am glad you don't feel as if I am making unwarranted comments, and at least I am trying to help.

I am sure you are correct about the type of virus to could be, you would know better than I with all that you have been through. And, since Zylexis is an immno-stimulant, there wouldn't seem to be any reason why it couldn't be used as a way to boost a cat's immune system, regardless of the virus.

You could at least ask the vet about PCR testing for FHV and FCV, and see what he says.

 

[Count]

The fact that no bacteria were found in the nasal swab doesn't mean it's a viral infection. I mean, he was taking antibiotics, which could mask bacteria and give false negatives

Actually, we waited 7 days after his last antibiotic to do the test. So it shouldn't effect the results. We started antibiotics again after taking the sample, while waiting for the results.

 

[She's a witch]

The fact that no bacteria were found in the nasal swab doesn't mean it's a viral infection. I mean, he was taking antibiotics, which could mask bacteria and give false negatives

to add to that, I am thinking it could also be fungi or mycoplasma, or as mentioned already - parasites (lungworms - I don't think that one dose of spot-on dewormer would treat this, toxoplasma), I would check that as well. And also - I am not an expert but I am not sure if the nasal swab is enough to check bacteria in the lower airways, my cat was to have a bronchial fluids checked for bacteria with her lower respiratory disease. But this is obviously more invasive.

I don't want to scare you but I think I would actually do echo cardiogram now as heart disease can also cause some of his symptoms (mainly coughing). It was actually suggested to me at the first sight of my cat's lower airways troubles.

Regarding FIV/FELV, I think it is a good practice to have all cats tested when a cat is adopted/bought, in fact, in was a standard test in the foster home from where I adopted my cat, I would imagine breeder would do the same; if a cat was not tested for these, I would certainly ask for this test at the first sign of any health troubles.

I don't understand why the vet would not take a proper x-ray at this point.

I would also ask his breeder for a full medical history and any tests of Count's parents, and ask if they have had any outbreak in the cattery, including herpes and calici viruses, and lungworms, or anything else, you never know how things connect. They should be helpful, after all this was their kitten at some point, and his health is at risk now.

How is Count anyway? Is he eating, coughing, sneezing? Fingers and paws crossed that it will end soon and he'll get back to enjoying his kittenhood!

 

[Noirele]

Actually, we waited 7 days after his last antibiotic to do the test. So it shouldn't effect the results. We started antibiotics again after taking the sample, while waiting for the results.

That's good, but I'm not completely sure it's enough time. When we were supposed to do a bronchoscopy, the vet told us we should have waited at least 15 days!

 

[Count]

How is Count anyway? Is he eating, coughing, sneezing? Fingers and paws crossed that it will end soon and he'll get back to enjoying his kittenhood!

He looks better. His appetite is back and he is less lethargic. Coughing completely stopped for now, and sneezing decreased. That being said, these improvements happened before, then he became worse. So I would not say he is better for sure.

That's good, but I'm not completely sure it's enough time. When we were supposed to do a bronchoscopy, the vet told us we should have waited at least 15 days!

And also - I am not an expert but I am not sure if the nasal swab is enough to check bacteria in the lower airways, my cat was to have a bronchial fluids checked for bacteria with her lower respiratory disease. But this is obviously more invasive.

Good to know. Vet said this means for sure that there is no bacterial infection. It makes sense to take fluid from lungs but I'm not sure if this vet does that. I would probably have to go to an animal hospital for that, which I am considering.

I am thinking it could also be fungi or mycoplasma, or as mentioned already - parasites (lungworms - I don't think that one dose of spot-on dewormer would treat this, toxoplasma), I would check that as well.

How would WBC react to lungworms or mycoplasma? Does the xray look like these are possible?

I don't want to scare you but I think I would actually do echo cardiogram now as heart disease can also cause some of his symptoms (mainly coughing). It was actually suggested to me at the first sight of my cat's lower airways troubles.

Since coughing stops for a few days then starts again, and since there is not much of a breath shortage, I don't think it is a heart diesase. That being said I want to check him for HCM anyway due to his small size, so I will have a echo cardiogram at some point. I might do it at the same time if I go to an animal hospital, to save a trip, and make sure.

I would also ask his breeder for a full medical history and any tests of Count's parents, and ask if they have had any outbreak in the cattery, including herpes and calici viruses, and lungworms, or anything else, you never know how things connect. They should be helpful, after all this was their kitten at some point, and his health is at risk now.

I will not talk to the breeder yet, because I want to get some sort of reimbursement from her, and before letting her know that the cat is sick, I need to make sure of the sickness. But I do have the phone number for Count's veterinarian that the breeder went to. I will call them tomorrow, not tell why I'm calling and just ask for his medical history, maybe she knows something.

What do you all think? Should I try changing vets again and go to an animal hospital instead of a clinic this time? There are three of them about an hour away, so they are not very close, but maybe it is necessary. I have my car back, and I took a small loan to pay for his treatment, so money and car issues are not a problem for now (but obviously I don't want to waste any money).

 

[FeebysOwner]

Is it possible to call the ones you are thinking of using, and ask them if you can provide them with a full set of records would they be willing to provide a consult? I am guessing that a consult would still cost you, but less than actual vet visit? Besides, you could compare the advice they provide via consult and perhaps get a feel for what you would be most comfortable with in term of their recommendations/suggestions? I don't even know whether that is possibility in Turkey...

Count is so lucky to have you!

 

[white shadow]

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Count - do these hospitals have websites? ......can you post links?
.

 

[Count]

Is it possible to call the ones you are thinking of using, and ask them if you can provide them with a full set of records would they be willing to provide a consult? I am guessing that a consult would still cost you, but less than actual vet visit? Besides, you could compare the advice they provide via consult and perhaps get a feel for what you would be most comfortable with in term of their recommendations/suggestions? I don't even know whether that is possibility in Turkey...

Count is so lucky to have you!

If I decide to go, I will call them in advance and ask for that, but I highly doubt that they offer such service. I haven't heard of something like that here.

.
Count - do these hospitals have websites? ......can you post links?
.

Only one of them has a website for some reason (even the small one man operation clinic that I first went to had a website). They do however, have reviews and pictures in google maps and Instagram. I will post all of them. Keep in mind that these will be in Turkish so you will need to use a translator.

I ordered these in the way that I most likely see my self going for one reason or another.
1. Empati Akademi Animal Hospital
Empati Akademi Hayvan Hastanesi – Türkiye'nin En Büyük Hayvan Hastanesi
Google Maps
EmpatiAkademi Hayvan Hastanesi (@empatiakademi) • Instagram fotoğrafları ve videoları

2. Istanbul University Animal Hospital
NO WEBSITE
Google Maps
NO INSTAGRAM

The third one seems to be closed based on a recent forum post I saw somewhere, so I'm not listing it.
There are however animal hostpitals that are farther away but not impossible to go to (2-3 hours). I listed them below, but I don't think it makes much sense to go to these.

3. Fatih Animal Hospital
Fatih Hayvan Hastanesi – Dostlarınızın Sağlığı İçin Buradayız
fatih hayvan hastanesi - Google Search
İstanbulfatih Veteriner (@istanbulfatihveteriner) • Instagram fotoğrafları ve videoları

4. Anatolia Animal Hospital
Anatolia Hayvan Hastanesi
Nurettin Ali Berkol Sok. No: 43 Şaşkın Bakkal Suadiye / Kadıköy / İstanbul - Google Search
Anatolia Hayvan Hastanesi (@anatoliahayvanhastanesi) • Instagram fotoğrafları ve videoları

5. İstanbul Animal Hospital
Anasayfa - İstanbul Hayvan Hastanesi - 7/24 Hizmet
NO REVIEWS ON GOOGLE
İstanbul Hayvan Hastanesi (@istanbulhayvanhastanesi) • Instagram photos and videos

Just for reference, this is the vet that I went to last time:
O2 veteriner
Google Maps
Oksijen Veteriner (@o2_veteriner) • Instagram photos and videos

 

[She's a witch]

any of these is a cat vet only?

 

[Count]

any of these is a cat vet only?

No. I don't think such place exists in İstanbul unfortunately.

 

[She's a witch]

What do you all think? Should I try changing vets again and go to an animal hospital instead of a clinic this time?

This must be so difficult and I feel for you. Personally I think I would not stop till all diagnostics options are done, which unfortunately would mean lots of tests (and money...) only to rule something out... I am not a fan of implementing a strong medicines hoping it will change anything (I call it dr House method, so common in vets all over the world). I've seen/heard enough not to trust the vets that make a diagnosis based on their experience only, especially if these are vets that don't specialise in cats, the animals are so different. So provided that you can find the really good diagnostics options + competent and compassionate vet, I think I would take my cat to some place else. In your case I would actually try to find some cat/animal pulmonologist and/or great radiologist. Of course and if possible, I would start with the consultation only with the results that you already have, but in my opinion you may not have a really good x-ray pictures to start with (most recent and taken from 2 or 3 sides as mentioned already). Can you maybe find a local Turkish forum with experienced cat lovers/foster homes/breeders that would recommend a really good place? Good, recommended vet place is a must in my opinion. Even if you won't be able to get them review the tests first, I would start with the phone conversation to see if the person has any fixed ideas on what is happening or is flexible.

Having said that, if you say that Count is better now, I probably would wait to see if he indeed improved or not. But this is a risk, since his improvement might be an effect of steroids (I think he got them?) or other meds and his true condition may be "covered up". I understand he is off any medications at the moment?

If Count won't get better though, regardless if you decide to change the vet or not, I would discuss with the vet the following tests:
- x-ray with at least 2 different positioning
- full blood tests run, including CBC (with eosinophils), but also possibly chemistry panel and ionogram
- fecal test to check for lung worms eggs (although they should be visible on good x-ray)
- possibly PCR panel for upper respiratory diseases in Idexx laboratory if it's available (the sample can always be sent to their lab in Germany)
- FIV/Felv tests just to rule this out - they make any infection more difficult to heal
- I think I would also like to have ruled out the following: toxoplasmosis, mycoplasm, bordetella, asthma/chronic bronchitis

These are my ideas only based on my cat's diagnostic history and my own research into lower respiratory diseases (and chronic, not acute, as it is my cat's case), and by all means it is complete and I don't know to what extend would that be relevant to your cat's conditions - I am not a vet. That's why it is so important to find a truly competent vet with whom you can talk freely and suggest anything.

 

[Count]

It's nearly 5 am right now here, and I'm still awake because I can't stop thinking about the situation. I really don't know what to do. My instinct tells me to take him to the hospital, and at least talk about the tests we've already done, and maybe do a test or two if necessary, on the other hand, I don't want to waste money, I may need that money for further treatment. I just want my cat to be healthy, why is this so hard? He is my only friend keeping me from taking my own life, and I don't want to lose him. I don't know if I could handle something like that, if it were to happen while I'm still depressed. I need to do everything that I can do to make him better. I'm just not sure if the better option is to save the money for further treatment, or try another vet, and get proper diagnosis this time. I feel like the latter is better, but I'm not sure.

Sorry for rambling, I just couldn't help it.

Thanks for the advice She's a witch . I will think about all of the tests you mentioned individually and do them if it makes sense financially.

I will keep all of you updated as things develop, if I go to the hospital tomorrow, I will post about it. Otherwise I will post when something new happens.

 

[FeebysOwner]

Sorry you're going through this. All the information you have gotten is good because it helps you go through thought processes you might not otherwise have done. But, the end result is you have to go with your gut - the only difference in your case is you are working with your gut after being very, very informed and educated. That counts for a lot. If I were Count, I would trust you. Please keep talking to us.

 

[Count]

Prepare for a long reply.

I went to the animal hospital today. After a stressful (for the cat) 30 km drive, we were there.

I went inside and talked to the receptionist, and I was really surprised by how serious they were, about the paperwork, making an appointment beforehand etc.. It was like real hospital, which is a good sign in my opinion. I was asked to fill out some paperwork for the first time and 10 minutes after they called me for Count's exam.

The vet started by asking about the problem, which I responded with it is a long story (as you all know), and surprisingly she was willing to listen to every treatment and diagnostic Count went through. She also heard of the breed (maine coon), which was a surprise. After about 10 minutes of talking, she examined Count. She did hear lung problems, and also noticed that the heart felt a bit large. Otherwise everything seemed normal. He gained 200 g since he was last weighed, and his fever was normal-ish.

She looked at Count's earlier blood tests, and she said that the blood tests indicated an infection, and was surprised that there was no bacteria found on the nasal swab. She asked about how the sample was taken, and after learning that it was just a booger hanging out from his nose, but the swab wasn't fully inserted, she said that that test doesn't mean anything, because there wasn't enough sample taken.

She also looked at Count's earlier xray, noticed the problems, but took another xray because it was dated. They took xrays from 2 angles.

Spoiler: Xray Pictures

There were four conclusions made from these:

1. He still has heavy problems in his lung, but the amount decreased
2. There are no lungworms (no fecal test done though, take it with a grain of salt)
3. There is blockage in his intestines. This is also putting pressure on lungs and heart.
4. His heart is too large and putting pressure on his lungs.

Based on these results, we started about treatment. As you can see, there are three problems. We decided to wait a week before prescribing medicine for his intestine blockage because she thinks that the blockage may be a side effect of the heavy medications that were used before. We decided to wait on the heart issue as well because after the pressure from his intestines is gone, it may look normal in an xray. Doing an echo cardiagram costs a fortune too.

As for the main problem, we decided to not do the second and third zylexis shots, since she thinks that it is unnecessary. I will also stop giving theophylline and methylprednisolone. I forgot to ask about virgin olive oil and black cumin oil. She prescribed other medicines which I will get to in a second. I am also supposed to check his heartbeat in a few scenarios, and check if he has any problems with using the toilet.

As for the prescription, I am supposed to give Count 2 medicines orally, and 3 medicines using a nebulizer. Since I cannot put a mask on a cat, I had to make a makeshift enclosure.

The medicines are: (per day)

• 40 mg Azithromycin (pill)
• 1 cc Interferon alfa & isotonic mixture (mix with food)
• 2.5 mg Salbutamol (nebulizer)
• 0.5 mg Budesonide (nebulizer)
• 0.5 cc of something called Genta (nebulizer)

She said that she will call in a few days to check Count's situation. Otherwise she will see Count next week.

What do you think of these? Is Count getting a better treatment here?

(Count is really tired after the vet visit)