Need Advice For My Cat's Condition

MeongCat

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Hello everyone, this is my first time posting anything in this amazing forum after being a silent reader for a long time^^

I have a 9 y.o. male cat. He was diagnosed with elevated ALT last month and got re-checked 2 days ago, after 1 month in Samylin, and still get his ALT higher than normal range (294). The vet told me to change his supplement with Zentonil. But he vomited not long after taking it and it happened not only once but twice which makes me think to switch back to Samylin because he seems to fare better with it (not drooling anymore, more playful and social, etc though it only brought down his protein level but not really his ALT level).

My questions are:
1. Should I ask the vet to switch back to Samylin? Since today he starts to drool again which hasn't happened until he got his supplement switched 2 days ago not to mention, he never vomited after taking Samylin.

2. ‎I'm thinking of giving my cat Milk Thistle as additional supplement BUT it's impossible to import animal's supplement into my country so I'm thinking of giving him a human's milk thistle (ofc I already mentioned this to the vet and he said go ahead even though he never really tried it)... So, I'm wondering if human's milk thistle is safe for cat in lower dosage? If so, what ingredients should I watch for?

Another question:
3. My cat is not a very good patient. He always gets scared, pooped, peed, and acts aggressive anytime I take him to the vet office. 2 days ago when he had his blood work test done, he needs to be handled by 3 assistants. The (bad) thing is, the vet told me to get out of the examination room since my existence will encourage him to be more explosive and all. So, after we got home, I can't really examine him because he doesn't want to get close to me, which is pretty unusual since he always asks for cuddles once we reached home after each vet visits.

Yesterday, after he opened up more and I can inspect him closer, I realized that his nose looks abnormal (a little crooked). I don't know if it's broken or anything but when I tried to touch the parts of/near the nose bridge, he didn't avoid it and it feels hard like bones, unlike swellings.

I already asked the vet if he ever bumped into the walls or fell from the examination table when handled which ofc they answered no. Aside from his abnormal nose (which he didn't have before going to the vet office) he doesn't show any other abnormality or symptoms (like panting or hard time breathing). Still, I'm worried. What could possibly happen to him? Does it seem like he broke his nose? Or could it be his nose is swollen because of allergy to his new supplement, since he vomited twice after all? It's already past 24 hours since his last Zentonil but I can't see any improvement on his nose though.


Sorry if I can't explain his condition really well and wrote too long. I'm really scared if I brought him unnecessary pain if it's really because of the way the assistants roughly handled him on his blood works test.

Thank you for any advice you can give!


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duckpond

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he is a pretty boy, bless his heart. I dont really know anything as far as advice to give you. I think i would have had a hard time going out of the vets office while they are taking care of him. maybe they should be giving him a light tranquiler before they work with him? something just to take the edge off?

The only advice i really have is that if you are not happy with your vet, either the way he is taking care of your cat, or the way he works with you, i would see about a second opinion.

I will keep you guys in my thoughts and prayers. Do keep us updated on how he is doing. Im sure you are scared for him. I will worry with you.
 

mrsgreenjeens

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I would definitely discuss with the Vet what is happening with the new medication and ask if there is anything else to try. Maybe there is yet another drug besides going back to the Samylin. When my girl's ALT rose, we tried Denamarin, which contains both Sam-E and Milk Thistle. It may not be available in your country, I just don't know. I think as long as you aren't given a drug that already has Milk Thistle in it, it should be ok to use human milk thistle, and I would look for a product that is just that, no additives. BUT, you will need your Vet to tell you how much to give, IMHO. He needs to research it and let you know how to give it. Are you able to pill him? I think milk thistle and/or Denamarin are supposed to be given on am empty stomach, so mixing with food may not be a good option.

As far as what happened to his nose, while you are talking to him, ask what could have happened. Send the pictures. Ask if it could be the other drug, or if he could have hurt himself during the exam.

Has it been determine WHY your guy has raised ALT? Has he had any antibiotics? That's the first thing our Vet did was give our girl antibiotics and that helped immensely. Caused the ALT to drop a few hundred points.
 
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MeongCat

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he is a pretty boy, bless his heart. I dont really know anything as far as advice to give you. I think i would have had a hard time going out of the vets office while they are taking care of him. maybe they should be giving him a light tranquiler before they work with him? something just to take the edge off?

The only advice i really have is that if you are not happy with your vet, either the way he is taking care of your cat, or the way he works with you, i would see about a second opinion.

I will keep you guys in my thoughts and prayers. Do keep us updated on how he is doing. Im sure you are scared for him. I will worry with you.
Thank you!!:happycat: Actually I mentioned about using tranquilizer to my vets, but every single of them told me that they're worried if it'll burden his liver all the more :(

Oh, I forgot to mention that I already see 3 different vets for him (though the latest two come from the same vet clinic with different practice schedules: one of them is the male vet who gave him samylin, who didn't shoo-ed me away when he was handling him, then the other one is the one is a female vet who changed it to zentonil for the last few days and handled him in his latest blood work test).

I'm actually happy with my 1st vet (the one from different clinic) but it's really too bad that the clinic seems to focus more on dogs as they don't sell medications/supplements/special diet foods for other animals than dogs. I also called for some other (4 of them) but they either didn't have specific medications for cats or they don't restock it because of the new custom in my country that makes it harder to import medicines/supplements aside from ones for human use.

Though he's only one among other animals I rescued but he's very important to me. He almost died twice: when he was a kitten and once when he was 1 year old, despite all the antibiotics, medications, and how hard I work together with the vets. That's why I really am scared when I got back his test result (and the 2nd one is not any better).

I definitely will keep you updated. And thank you so much, that really means a lot for me!:lovecat:


I would definitely discuss with the Vet what is happening with the new medication and ask if there is anything else to try. Maybe there is yet another drug besides going back to the Samylin. When my girl's ALT rose, we tried Denamarin, which contains both Sam-E and Milk Thistle. It may not be available in your country, I just don't know. I think as long as you aren't given a drug that already has Milk Thistle in it, it should be ok to use human milk thistle, and I would look for a product that is just that, no additives. BUT, you will need your Vet to tell you how much to give, IMHO. He needs to research it and let you know how to give it. Are you able to pill him? I think milk thistle and/or Denamarin are supposed to be given on am empty stomach, so mixing with food may not be a good option.

As far as what happened to his nose, while you are talking to him, ask what could have happened. Send the pictures. Ask if it could be the other drug, or if he could have hurt himself during the exam.

Has it been determine WHY your guy has raised ALT? Has he had any antibiotics? That's the first thing our Vet did was give our girl antibiotics and that helped immensely. Caused the ALT to drop a few hundred points.
You're right, most medications and supplements for animals are not available in my country. I contacted the vet twice and asked about other alternatives like Denamarin for my cat but the clinic only sell Samylin and Zentonil Advanced. Both have Sam-E and Silybin (some part of Milk Thistle extract?) but strangely, my cat only negatively reacted to Zentonil. Both of them have: 75 mg SAMe + 10 mg Silybin + Vit E + Vit C and 100 mg SAMe + 25 mg of Silybin respectively, and the vet think it's okay to add a little more Milk Thistle though he didn't really say the exact dose because there aren't Milk Thistle for animal use in this country. I'll try to communicate more about it since there are limited choice of human Milk Thistle too since I also heard that too much of Milk Thistle could cause a diarrhea on cats.

After one month in Samylin I think he got used to it because it gets easier to pill him each day. The only problem is, I gave the supplements after eating because the vet told me to do so. He was kind of impossible to pill unless I get some treat for him to nibble after pilling, I wonder if that's acceptable?

Thank you, now I'm sure I had to give him the supplements before eating. I always thought it was strange to hear how the vets here told me to always give the supplements after eating even though AFAIK it was better to give him the supplement at least one hour before eating or two hours after eating for optimal absorption (from what I read on how to administer those supplements). I will ask the vet further about this.

When I contacted the clinic yesterday, the female vet who handled my cat already took her paid leave until next month so I kinda talked to another vet who saw the pics I sent and the assistants who handled him and they said that he didn't bumped on anything, neither fell from the examination table which I had a doubt about it (because I was asked to leave the examination room when he was handled and can heard how crazily chaotic it was from outside). I know how aggressive and scared he is since previously I saw him fell off from a much wider examination table twice in the 1st clinic where he was diagnosed with elevated ALT :( About the meds, the vet was puzzled because she never saw any adverse effect from zentonil on other cats but she also told me to stop it for a while and see if there is any improvement on his nose (36 hours after his last Zentonil, still crooked, didn't see any improvements).

Now that you reminded me of it, the vet prescribed him Samylin (then Zentonil) without doing further examinations (because the rest of blood works don't really had a problem except the RBC, HGB, and HCT which highly affected by stress, they said). I will also ask the vet more about this.

May I ask how high your girl's ALT was? I know that there are some cats who gets as high as 1.000 but only 294 on my cat is enough to scared me to no end.

Thank you very much for your advice!:heartshape: For now, I will try to contact the vet and hopefully he will give me a way to make him better.

Sorry for the long post :worship:
 

mrsgreenjeens

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It's been a few years since we lost our old girl (NOT to liver disease), but I think when her ALT went up, it would go into the 400s.

You didn't mention RBC, HGB and HCT being off. Are they LOW? Do you have the numbers? You mentioned he almost died when he was younger. What happened? I'm wondering if this can be related. Does he go outside? Has he been vaccinated? Sorry to ask all these questions, but now there are new things in the mix so the wheels are turning in my brain.
 
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MeongCat

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It's been a few years since we lost our old girl (NOT to liver disease), but I think when her ALT went up, it would go into the 400s.

You didn't mention RBC, HGB and HCT being off. Are they LOW? Do you have the numbers? You mentioned he almost died when he was younger. What happened? I'm wondering if this can be related. Does he go outside? Has he been vaccinated? Sorry to ask all these questions, but now there are new things in the mix so the wheels are turning in my brain.
Oh my... that's a high number. Sorry if I reminded you of such unpleasant experience :( (of when your baby girl fell ill). I'm glad to hear she recovered from that and lived a full, happy life until she grew old with you.

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Every single vet I met told me that those three indicators are high because he was in extreme stress when the blood drawing occurs.

That happened when he was still a kitten (a few weeks to a month old, as the vet assumed). He was very thin, severely malnourished, and weak because he was left by his cat mother/someone dumped him in an abandoned house near my house. His other siblings didn't make it and he had a cat flu and an unstoppable diarrhea that went for a month before it finally stopped. He was severely dehydrated and lost so much weight from his tiny-thin body. I forgot what the medications the vet gave me, all I remember is how I had to syringe feed him food and drink every few hours and how the vet refused to deworm him until he reached a normal weight because he was too young at that time.

The second time happened when he was 1 year old, after my family moved to a new home. He caught FUS and despite all the antibiotics and medications the vet gave him, he still can't pee. Most clinics (at least ones I knew and contacted) don't have catheter for male cats at that time so the vet had to drain out the urine via syringe. What made it worse was he refused to eat and drink. He was very aggressive that the vets couldn't force feed him and had to sedate him when it's time to extract the urine. 3 weeks later, he still can't pee by himself, his muscle wasted, he can't walk, and he can't even lift his head. The vet gave up on him but refused to ease his pain. I went to other vets to no avail, until I met an eccentric one who gave him Enatin (a herbal human's medication for Calcium Oxalate Crystals). Because he was too weak to bite (he can't move his legs), I finally able to force feed & gave him the meds. A week later, he showed some improvements, he can pee little by little (I helped him with a washcloth to stimulate his peeing just like how a mother cat does). So I continue to give him Enatin until he was finally able to pee by himself (just like how the eccentric vet told me to).

He still can't walk until 3 months after he gradually recovered, idk why. The vet told me that maybe it was related to the sedation because his liver was getting bad after he refused to eat and drink for a long time. He was puzzled but then taught me about hydro-therapy, so I bought a baby pool, massaged him daily, and trained him to walk in the water, until slowly he finally able to walk again.

In the past he was and inside-outside cat because my mother refused to let him in 24/7 but after the 2nd time he got sick and she saw me getting stressed over it (losing hair, weight, often feel sick and vomit without reasons, aside from my psoriasis flaring up), he became a 100% indoor cat.

About vaccination... he never had one. I wanted to but I got really afraid when the vet mentioned about any possible side effects of it (even though I know they very rarely happen). His past record made me scared of everything, even for the supplements he had now.

Today I went to the vet, since my cat's nose is getting better after abstaining from Zentonil, the vet told me to change back his supplement into Samylin and to try administer it after a period of fasting (in the morning, an hour before eating). If after a month his ALT doesn't get better, he will do a further check ups and reschedule his vaccination date (he compromised after I asked him not to vaccinate my cat before his blood test result is better). I forgot to ask about Milk Thistle so I'll do it when I bring my hedgie this Saturday.

Once again thank you for your response and for reading my uselessly long post :worship:
 

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Wow! He (and you) have really been through the wringer.

I'm so glad that his RBC, HGB and HCT are on the HIGH side vs low. I was worried there for a minute, but no longer. Your Vet is right in that these numbers can rise due to stress, and obviously your little guy gets extremely stressed out during his visits. Dehydration can also cause a rise in these numbers, in case he doesn't drink much or eat wet food.

All my questions earlier were based on him possibly being anemic, which obviously is NOT the case since his numbers are high rather than low.

So is that "eccentric" Vet still around? Maybe he can figure out what's happening now with your guy. He sounds great!!

Hoping the new regime of giving the Samylin without food does the trick. :crossfingers:
 

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When my cat was in Fatty liver his ALT went up to almost 1300. His reading is high but not to the point of being a marker for serious illness. Hopefully after a month his reading will come back down. If I remember correctly normal is below 100.

An injury can cause a temporary slight rise in the ALT.
 
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MeongCat

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Wow! He (and you) have really been through the wringer.

I'm so glad that his RBC, HGB and HCT are on the HIGH side vs low. I was worried there for a minute, but no longer. Your Vet is right in that these numbers can rise due to stress, and obviously your little guy gets extremely stressed out during his visits. Dehydration can also cause a rise in these numbers, in case he doesn't drink much or eat wet food.

All my questions earlier were based on him possibly being anemic, which obviously is NOT the case since his numbers are high rather than low.

So is that "eccentric" Vet still around? Maybe he can figure out what's happening now with your guy. He sounds great!!

Hoping the new regime of giving the Samylin without food does the trick. :crossfingers:
:bawling: Those times were like a nightmare for me. That's why I really don't want to see him sick/suffer anymore or at least not this soon.

Sorry for replying late, I was busy taking care of my very uncooperative hedgehog who was on hunger strike and keep refusing to be fed :(

Yeah... my cat was visibly upset and stressed, that I feel really guilty every time I brought him to the vet, like... I'm doing it for him while in the same time I betrayed him.

Now that you mentioned it, the vet asked me about his water consumption too which I don't think was a problem since I often see him drinking from his fountain (I work at home and change the water + wash it every 2 days/3 days-MAX). He also does his bathroom business normally. His diet contains of wet food and dry food, but the vet told me to cut the wet food (chicken breast and gravy) temporarily as she deemed it too high of protein and can potentially add more waste products for the liver to work on.

About that 'eccentric' vet, I haven't see her for years. I heard that she started her own clinic in her house but I still can't find her exact address despite asking around in the local forums.

Thank you! I really hope it does work, since the vet already said that there'll be further examinations once there isn't any major changes in his blood test result. Tbh, that fact didn't really assure me, seeing how limited our choices of medications and supplements here.

Good news about milk thistle, though it's impossible for me to import by buying it online (as how I phoned and mailed the customs, who said that it'll be destroyed on the border OR be sent back), coincidentally my uncle is going to US in a few days and he said that he'll buy me the one specially designed for cats! :happycat: So I don't have to worry about over-dosing or poisoning him with human medications!

When my cat was in Fatty liver his ALT went up to almost 1300. His reading is high but not to the point of being a marker for serious illness. Hopefully after a month his reading will come back down. If I remember correctly normal is below 100.

An injury can cause a temporary slight rise in the ALT.
Whoa, 1300?? OMG, that's a ridiculously high number!!:( I never thought Fatty Liver can affect ALT that much. Gosh. Now I'm wondering if his previous history of not eating and losing so much weight in a short time when he got FUS could affect his liver now.

Yeah, the vet told me not to over-worry things, that though his ALT is almost thrice the max number, it was not that high, not to mention he shows no other symptoms aside from his blood test results and it was caught pretty early.

Thanks!! I really hope his reading will come back down soon so I don't really have to add more stress into his life by bringing him to the vet this often anymore (at least not until his half a year check ups).

And about liver injury...:( the vet said that it's a possibility, but I really hope it wasn't that and even if it's that, I hope my cat can recover from it.
 
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MeongCat

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Been so long since my last update...

So, there were ups and downs in my cat's condition these few months. Since his bump is getting bigger and starting to hurt, the vet injected an antihistamine and meloxicam to control his inflammation. So... a few days after the Meloxicam injection, my cat went for another blood test to schedule a dental cleaning as my vet is very concerned about his broken canine and his ALT showed up to be 4 times higher than the upper ALT limit (while his AST almost 4 times higher than the upper limit). I'm really mad at the vet who injected the Meloxicam as it does nothing to my cat, neither controlling the swelling nor the fever and also made him not viable for a much needed dental cleaning :frustrated:

After going back and forth for vet visits (as the swelling on his face didn't get better and the vet office or the animal hospital didn't have the xray machine specifically made for head xray), finally the swelling on his nose burst open with a little pus and a lot of blood in it. It smells, I freaked out, I brought him to the vet, and after the vet can do nothing since my cat is getting crazy and his tongue turned blue when handled, I got home and treated his wound per the vet instructions. He was prescribed Metrodinazole for a week, twice a day (forgot how many mg(s) since the vet is being careful with his liver condition too). To be honest, I'm very confused on how the previous blood works never show a sign of infection despite the growing lump which contains puss on his nose.

After starting the antibiotic, I noticed that there were tapeworm eggs on his backside, I wiped them off of his butt and brought the sample to the vet and the vet prescribed him Drontal cat (praziquantel 20 mg and pyrantel pamoate 80 mg) but told me to finish the antibiotic first before giving it to him. Few days after the antibiotic I noticed that the number of eggs is getting higher and higher despite how I always clean his litter box every time he pooped and clean his bedding whenever I saw an egg dropped. He has no flea and I always checked his fur for eggs too. Despite my worry, I followed my vet advice anyway and finally finished the antibiotic regime a few days ago. Phew.

The vet told me to continue his liver therapy (with Samylin and Milk Thistle) for a few days before I can give him the Drontal.

Regarding this, despite the fact that he's fine when he got Drontal few years back and how Bayers & my vet told me that it's okay to give him it for the worms, I'm scared that his tapeworms infection is too heavy that the dead worms will obstruct his intestine and he can't handle the parasite die off symptom. Not to mention, few days after finishing the antibiotic I noticed that he became a ravenous eater but also lethargic, which maybe was caused by his worm infection as I find more than 12 eggs per day on his bedding and his poop.

I'm very scared and confused on what to do now. The vet told me that it's okay to give him probiotics (NOW Foods 25 billion), he also told me to deworm him but he's being vague on which should come first and later. I wonder if it's okay to give him probiotics and the dewormer on the same day? Or should I bring him to the vet first and take another blood works so I know better about his condition before I do anything? I don't know if the infection is back or something but last night he's very cold and his heartbeat slowed down and when I asked the vet and he told me to keep him warm and gave him some food, he got much better and acted normally until now.
 

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I think the probiotic and the dewormer will be fine on the same day, maybe one in the morning and one in the evening. or at least not right at the same time, incase he throws up? He really sounds like he needs the dewormer medication. I think that would be my first priority. Use the deworm medication, and if worse or not better in a day or so then take him back in.
Best of luck to your guy, i will keep him in my thoughts!
 
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MeongCat

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I think the probiotic and the dewormer will be fine on the same day, maybe one in the morning and one in the evening. or at least not right at the same time, incase he throws up? He really sounds like he needs the dewormer medication. I think that would be my first priority. Use the deworm medication, and if worse or not better in a day or so then take him back in.
Best of luck to your guy, i will keep him in my thoughts!
Thank you!! After reading your thought, I've decided to give him the Drontal first and the probiotic later. So far (since more than a hour ago) he didn't show any bad reaction to it either by vomiting or rapid breathing or rashes or anything, he still acts like the same old cat.

I'll be watching him closely for this 24 hours and hope that he won't show any bad reaction or acting too lethargic because of the dewormer. I'll also give him more wet food in water to entice him to eat and/or drink just in case he doesn't have any appetite or too lazy to drink. I will also clean the bedding, his sleeping spots, and most importantly his litter box to reduce the chance of reinfection. I also wiped his body and backside with warm towel as I'm worried there'll be some eggs attached onto them (still wondering if that's okay since he really really hates it when I do that).

I always think too much when it comes to my cat and scared of doing anything even with the smallest risk even though I know it's for his own good and the risk . Thank you very much for giving the push I needed!
 

duckpond

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Glad you gave the medication, and did all of the cleaning! I think this will go a long way to making him a healthier and happier cat! Do keep us updated on him!
 
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MeongCat

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Glad you gave the medication, and did all of the cleaning! I think this will go a long way to making him a healthier and happier cat! Do keep us updated on him!

Thanks!!^^ I will!


So... It's pretty early (?) but I've another update on him... After a few hours on Drontal, he didn't really shows any bad reactions to it, he even became more active than usual and I didn't see a single proglottid/tapeworm segment crawled from his backside.


After it passed 12 hours since I administered the dewormer though, he became very sleepy, didn't react much when called (except to the snapping sounds of canned cat food), and keep twitching his legs and whiskers like a cat in his REM sleep (not when he's completely asleep and entered it gradually but rather every single time when he started to fall asleep/dozed off which is very often since he seems to be extremely sleepy last night). I'm worried if it's some kind of mini seizures but I can't bring him to the vet since there aren't 24 hours vet clinics nearby so I decided not to sleep and watch his vitals every hour.

His vitals average when he's sleeping, aside from his temperature which I can't really check with a digital temperature insert, are as follows: BPM : 109 (I used stethoscope), Respiratory/min: 24, skin elasticity: ok, gums pink and CRT: 1 second. His respiratory varied between 20-29. His BPM though, it went as low as 98 to 122. Is it normal? The vet told me that the slowest is 100 when a cat sleep and not to worry about his 98 but from what I read <100 is too slow, even from a sleeping cat. His limbs aren't cold and he still eats as usual every time he woke up (he's on Royal Canin Hepatic and I give him a little wet food with water few times a day). Later on I noticed that his twitching is lessened.

Now...

24 hours after Drontal, he pooped. From what I saw, it's his normal poop minus the usual stinkiness and proglottids of the tapeworms. Actually this confused me. Doesn't cat passed dead tapeworms after deworming protocol? Is it normal to find nothing on his poop after a dewormer? But I've made sure to give him the Drontal right after he did his stinky daily 'business' yesterday's morning since I don't want to risk him being constipated after being dewormer which happened when he passed some dead roundworms after two days producing nothing.

I really want to bring him to the vet to check about his continuous twitching last night but today is Saturday which means the vet clinics I know are packed (much much more than weekdays) and I don't want to risk him being hypoxemic again with the stress of the car-ride plus the long waiting time/noise/smell and handling in the vet office. He got hypoxemic twice in a row when I brought him to the vet last month. That it made the vet stopped everything he was doing and instructed me on how to treat his wounds and check his vitals at home and to keep him updated with my cat's condition. The earliest house call (to check his full blood count and blood chemistry) is available on Monday. He no longer twitch when he sleeps right now. And when he's awake, he's acting as he usually is + he's eating fine. Should I risk and bring him to the vet?
 
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MeongCat

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........ since I don't want to risk him being constipated after being dewormed* which happened few years back, when he passed some dead roundworms after two days producing nothing.
 

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If he is acting fine, eating, drinking, pooping, and not twitching or anything else i would just watch him close. It can happen that they get constipated if the worm problem is massive. But often they die off and just get digested, or popped out. I would watch close, if he seems sick then take him in. if he seems ok i would not stress him with it. If you are still worried next week you can have him checked?
 
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MeongCat

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With my pets!
If he is acting fine, eating, drinking, pooping, and not twitching or anything else i would just watch him close. It can happen that they get constipated if the worm problem is massive. But often they die off and just get digested, or popped out. I would watch close, if he seems sick then take him in. if he seems ok i would not stress him with it. If you are still worried next week you can have him checked?
Thanks. I will watch him closely as much as I can (as he's sleeping in my room and I don't really let him do any rigorous activities today and tomorrow). He's still eating and drinking and acting normal, he pooped this morning as he always does (once a day). He doesn't twitch anymore when he fell asleep (from what I observed) but I still don't know if it will happen again tonight, hopefully not. I hope he can pass the worms safely tomorrow.

I will give him a full check up with the vet once Monday come (blood test too as it's also time to check how his liver is working). Tbh, I'm really scared if his results are worsening because of the complications of his health issues but still... I'd rather know than being clueless about it. I hate how good he is at masking his illness(es) that I sometimes wish he whines as much as my other cat who whines over everything.
 
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