Mystery Sickness in Cat
June 14, 2011 6:30 AM   Subscribe

Cat has raft of weird symptoms, isn't improving, vet is nonplussed.

This isn't my cat, and therefore I do not have photos. Sorry guys. Suffice to say that although Josie is not mine, her Mom is my friend, and things are getting weird.

So late last week was when Josie's behavior seems to have altered - didn't greet Mom at the door (but was sleepy and happy to be petted, showing her belly, etc). On Saturday morning, very early, Josie was found in the closet, which is not normal, and she was weak and not unresponsive, but clearly in distress. She was taken to the vet and had a fever of 104. Bloodwork was normal. CBC, urinalysis showed no bacteria or reasons for the fever, so idiopathic/fever of unknown origin. She got sub-cu fluids and stayed overnight at the vet, where she did urinate. She didn't rest because she's *extremely* high strung, and really more or less hates anyone who is not her mom.

After she came home on Sunday, she didn't eat, drink, or use the box. Monday morning, which is when I was called on the scene for moral support, same thing. Throughout the day on Monday we offered her chicken broth, crunchy food that she likes, cat treats, and wet cat food to no avail. Finally around 2pm we resorted to restraining her and feeding her with a syringe. Probably she got 1.5 teaspoons. At this point b/c of nonuse of the litter box, we took her to the vet. At this visit there was no fever (temp of 102). She got a shot of antibiotics, and some more sub-cu fluids. The vet was concerned about the non-elimination, palpated her bladder, and stimulated her to urinate, which she did (in her carrier, sadly, and on herself, sigh).

After all that excitement, Josie went under the furniture and has more or less stayed there. Water and a selection of food were on offer, which she did not express interest in. She's not groomed herself or used the box. The vet doesn't have a lot to offer in the way of what the fuck is going on. Taking her to the vet's is so, so stressful that just taking her there for observation is a terrible ordeal.

Additional information:
Until recently two other cats were living with them, cats that unbeknownst to Josie's mom hadn't been vaccinated or otherwise treated before coming into the home. This is a source of conversation with the person in question, but it's done. Josie was tested for FIV/FLV and it came back negative. Helpfully she's also got fleas from these other cats, but according to the vet she is not anemic and she doesn't have any flea-borne parasites.

I'm up for anything. I'm worried about Josie getting fatty liver disease. How long can this idiopathic lethargy go on? Have you seen this before? are there questions we should be asking that we're not asking? I'll be watching to respond if there are further questions.
posted by Medieval Maven to Pets & Animals (32 answers total) 1 user marked this as a favorite
Get a referral to an internist.
posted by TheBones at 6:44 AM on June 14, 2011

Definitely another vet. How old is Josie? Depending on her age, cancer would be on my list (among other things). She needs to be force feeding Josie at home. They can only go for about 2 or 3 days before trouble starts.
posted by bolognius maximus at 6:51 AM on June 14, 2011

Josie is five years old. Being at the vet with her, I think they are good vets. Money is going to be a concern at some point, but if they don't have a referral to an internist, I'm about to suggest that she bring Josie up to see my vet, who's great, but it may just be $100 to say that we don't know what is wrong.
posted by Medieval Maven at 6:53 AM on June 14, 2011

Is it possible to find a mobile veterinary service since Josie gets so stressed about things? Some vets do do house calls. But really, despite the fact that she gets stressed out, she needs to be seen. Can your friend take her to UGA Veterinary School? If she went there, they would be able to direct her to the right specialist.
posted by bolognius maximus at 6:54 AM on June 14, 2011

There are obvious signs of hepatic lipidosis, jaundice being the most noticeable. If the cat is not eating, then an esophageal feeding tube may need to be placed. I would bring this up to the vet sooner rather than later because hepatic lipidosis is BAD.
posted by TheBones at 6:56 AM on June 14, 2011

Has the cat vomited lately? Is she prone to hairballs? Has the vet done an X-ray? The only time this happened to my cat (though not sure about the fever) was when she had a massive hairball she couldn't vomit up. She stopped eating and drinking--I guess she knew nothing was getting through--and so stopped using the litter box and got really lethargic.

The vet used an x-ray to diagnose the blockage and see how far along in her system it was, forced a ton of that malt-flavored hairball remedy down her throat, and sent us home, saying it would come out one end or the other. That afternoon, it came out the front end in a violent and grand shower of malt hairball remedy and she was almost immediately better after that.

I'm sure other people will come in with more likely (and more serious) scenarios, but that was my experience with similar symptoms. She just had a terrible tummy ache.
posted by BlooPen at 7:00 AM on June 14, 2011 [1 favorite]

Of course not eating is most likely a symptom of an underlying problem. Ask for a referral to see an internal medicine specialist and don't waste your money on an RDVM (some RDVMs are good, but most are not).
posted by TheBones at 7:01 AM on June 14, 2011

So they gave her a shot of antibiotics but didn't send her home with more antibiotics? That's interesting to me, although I could just be ignorant.

If it were me with one of my fosters, I would probably crate her with a tiny litter box (you could do it in a bathroom -- so that I could see exactly what, if anything, was coming out of her. And then I would ask the vet to teach me how to give sub-q fluids (it's very easy, and they will sell you the supplies for about $15) -- and then I would give her fluids twice a day, and force feed her baby food meat (just meat and broth) -- at least a jar a day, preferably 2. She will hate you for doing it, but 99% of mine loved me again once they recover.

And I would do that for 3-7 days, and see if a) she randomly gets over whatever it is, or b) my 'spidey senses' start to go off -- at which point I'd figure out how much I was willing to spend and check with the vet again.

If you decide to do any of the above, you can memail for more info if you want.
posted by MeiraV at 7:04 AM on June 14, 2011

My cat has had this particular flavor of "mystery sickness," except it was actually a mysterious intestinal blockage. Did the vet take x-rays to see if this was potentially the case?

If you suspect a blockage, force feeding her is going to do more harm than good. IV fluids and internally administered lubricant worked for my kitty, but in serious cases intestinal obstruction requires surgery. And if surgery is necessary it is better done sooner rather than later, when the cat will be even weaker because of the whole not eating-not pooping ordeal.
posted by lydhre at 7:20 AM on June 14, 2011

OK, so blockage is moving up on my list. She has not vomited, for what it's worth. Anything else that would be a good clue? She is NOT straining or even attempting to use the box.
posted by Medieval Maven at 7:23 AM on June 14, 2011

Yeah, mine didn't attempt the box, either. If it's a blockage, she probably cleaned out the rest of her poo the last time she used the box. If nothing else has made it past the blockage, then she wouldn't have anything else to poo--hence no attempting to pass anything.

It could be something other than a hairball, too--any ideas if she ingested a ribbon, rubber band, or anything like that? Those things are really serious because they can get the intestines messed up, so I'd ask for an X-ray right away even if the cat freaks out about going to the vet.
posted by BlooPen at 7:28 AM on June 14, 2011 [1 favorite]

I know this doesn't address the main issue, but if a blockage as a source of the problem is eliminated, ask the vet for Valium. I had a cat who wouldn't eat and my vet put her on valium to stoke her appeitite and it worked really well. All of a sudden a kitty I had been force feeding (a couple of cc's every other hour, misery) for a almost five days started eating on her own. Once she started eating on her own, she no longer needed the drug, I think I gave it to her three days max.
posted by stormygrey at 7:40 AM on June 14, 2011

Nthing internist. Not eating is very bad, not using the litterbox is even more bad. I don't want to frighten you, but this must be taken care of, like yesterday. Cats don't let you know they're sick until they're very, very sick, so it's likely that Josie has been semi-ill for some time, and sometimes it's impossible to get them well again if they're too far gone (this happened to me recently and we're mourning the loss of our Woody).

The question you need to be asking right now is, "Which internist do you recommend, and will you please let them know we want Josie to be seen today?"

Internist. Now.
posted by cooker girl at 7:43 AM on June 14, 2011

This happened to my beloved departed kitty many years ago. I took her to the vet, the vet x-rayed her and determined that she was severely constipated, the poor thing. The vet said that cats will sometimes eat bones either out of the garbage or from prey and those bones can cause obstructions. Anyway, after an enema (so undignified) and an overnight stay (the horror), she was as good as new.
posted by Maisie at 7:53 AM on June 14, 2011

I know a very good cat specialist in the Atlanta area, if you want a recommendation. Memail me.
posted by Eyebrows McGee at 8:02 AM on June 14, 2011 [1 favorite]

Definitely another vet / internist. Like mentioned previously, a cat that is letting you see that it's sick is already very sick, as they are the master of disguise.

You said your vet was concerned with all that was going on, but what was recommended for follow up? I'm confused - did they just throw their hands up and send you home? Although hanging around for observation is stressful, it might give your vet a hint or two, and if something does go wrong that requires immediate treatment, they're already there to do it.
posted by cgg at 8:14 AM on June 14, 2011

This happened to my cat while constipated, too. But definitely keep escalating until you get some sort of answer. There's no reason for poor Josie to suffer.
posted by PhoBWanKenobi at 8:15 AM on June 14, 2011

@cgg - in retrospect thinking about yesterday, I wish they would have pushed harder for the xray, as I think that's looking more and more like what she needs. Her lack of fever and generally the fact that she's alert just don't jive with the fact that she doesn't want to eat or do anything. The antibiotics were given on the chance that she just had a lowlevel infection that was making her feel bad but wasn't really showing up in bloodwork.

She was fed with a syringe a little while ago and has cleaned off her face and paws from that and seems to like the food even if you have to make her eat.
posted by Medieval Maven at 8:21 AM on June 14, 2011

The basic answer is going back to the vet and being more assertive about getting a plan of action for the cat's symptoms, or trying a different vet.

Also, a caution from my years of caring for renal failure cats: if you decide to force feed the kitty by syringe, be careful because, if not done correctly, you can cause her to aspirate the food (which may result in pneumonia); also, force feeding can give cats a strong aversion in the future to eating the food that has been force fed (for example, if you've pureed the cat's normal favorite food to use in a syringe) that is difficult to overcome when the current inappetance has passed.

Be careful of feeding chicken broth if it's commercial canned product. The onion, garlic, and salt in it are bad for cats. (If you made your own broth at home without onion and garlic then nevermind.)

Good luck to your friend's cat. I hope your friend finds someone who can properly diagnose the poor thing.
posted by aught at 8:28 AM on June 14, 2011

Thank you everyone.

At this time, the plan for Josie is that an appetite stimulant will be administered, and then if that does not work and get her interested in something by 3pm or so, then she will visit my vet, who is not in the biz of acting like you're a crazy cat lady. Her medical records will come with her when she sees my guy.

We have offered broth but she's not really been interested, but I hadn't thought of the onions in the broth as being a problem (I mean, I know that there is onion typically in broth . . anyway) - the soft food she's getting via syringe she actually seems to want to clean up and eat once she's gotten a little, but it's new food to her that is not what she typically eats. It's high quality canned that I had left over from when we fed our neurotic beasts that stuff.

Thank you all so much for your responses. Keep them coming, and I'll let you know how Josie does.
posted by Medieval Maven at 8:52 AM on June 14, 2011

Also, have you tried meat-flavoured baby food? Nothing with onions or garlic, but it's a sure bet with most cats. Smudge some on her mouth and paws... she will probably lick it off.
posted by cgg at 9:10 AM on June 14, 2011

If she is impacted or has a foreign body or blockage, continuing to feed her will make things worse.
posted by TheBones at 9:45 AM on June 14, 2011 [2 favorites]

MeiraV: "So they gave her a shot of antibiotics but didn't send her home with more antibiotics? That's interesting to me"

There is a new-ish timed-release injectable antibiotic. One injection is a full course of antibiotics. GREAT for cats, who are so bad at taking pills.
posted by galadriel at 10:09 AM on June 14, 2011

Yeah, I agree with TheBones and others. If it's a blockage, she doesn't need anything else in her stomach right now. She's not going to be worse off for not eating (no more than you would be if you didn't eat a regular meal when you felt sick), but she may be worse off as a result of the force feeding, so I'd stop attempting that because it's probably not helping and may be hurting her. The not-eating is not the problem. It's a symptom. And if she has to have surgery, you don't want any more food in there anyway. Plus, NO BROTH--onion/garlic isn't just distasteful to them--it's a toxin.
posted by BlooPen at 10:38 AM on June 14, 2011

Sounds like a blockage to me, too.

I don't think she is in serious risk of liver shutdown as she just had sub-cutaneous fluids yesterday, right? So if you end up going to the vet this afternoon, have them check for the blockage, but don't panic.
posted by misha at 12:43 PM on June 14, 2011

N-thing blockage. My cat used to get what is called "mega-colons". Whenever that would happen, he holed up somewhere, was nonresponsive and refused to eat. Eventually we had to give him a medicine called "propulsid" to facilitate colon movement.
posted by pushing paper and bottoming chairs at 5:11 PM on June 14, 2011

If she's not drinking or urinating either, make sure it's not crystals. I had similar problems with my beloved Firstborn Son kitty some years ago, and it turned out he had a urethral blockage so bad that they couldn't even get a catheter up there and had to operate. He's fine now, though. But yeah, VERY good idea to take him to a different vet. Sometimes that is necessary.

Much luck to poor Josie...
posted by Because at 5:13 PM on June 14, 2011

Hi everyone.

I'm just getting home, but I wanted to update you on Josie, since you were all so nice to share your experiences with your pets.

Today we took Josie to a different vet, the vet that sees my cats. They sedated her and did x-rays. Josie had significant amounts of fluid outside her lungs and in her abdominal cavity. The most likely diagnosis is leukemia, but none of the alternate diagnoses carry a great survival rate, either. The only way to find out if it is leukemia is if they do a biopsy or cat scan. Since Josie is a very bad candidate for chemotherapy (the stress that she is under due to vet visits is just not something you can understate), confirming leukemia would only confirm the inevitable, that Josie needs to be allowed to pass on.

So in the morning tomorrow I will go with her and we'll see this crazy sweet cat, who loved to hear her mom sing and who didn't love any one else at all on earth, off to the other side. Thank you again for sharing your answers and I hope they help someone else along the line.
posted by Medieval Maven at 8:04 PM on June 14, 2011

Poor Josie. So sorry to hear it's not better news. Please pass our condolences along to her mom. It's so hard to lose a special kitty :(

posted by BlooPen at 8:35 PM on June 14, 2011

Oh god, I'm so sorry. My love to you, your friend, and Josie.
posted by PhoBWanKenobi at 8:39 PM on June 14, 2011

My thoughts are with you and your friend and Josie. She sounds like a really special kitty.
posted by kathrynm at 4:07 AM on June 15, 2011

Rest in peace, dear Josie. She was lucky to have you and your friend to take such good care of her.
posted by polyester.lumberjack at 1:39 AM on June 16, 2011

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