Help desperately needed with older cat, please!

Re: Help desperately needed with older cat, please!

Mark Hedberg — Tue, 09 Oct 2012 20:07:49 GMT

Well, if she's not happy with her own vet, it's time to refer. I don't suggest that people change vets at the drop of a hat but if she feels she's not getting the right treatment it's not helpful for anyone.

But we're just guessing, based on little snippets of history - sorry!

Re: Help desperately needed with older cat, please!

Ellisonia — Tue, 09 Oct 2012 19:22:46 GMT

Thanks Steph-As far as I know bloodwork I mentioned earlier ( first post) was early the same week ( at normal practice) but outside lab. Oh! I've also just remembered she was given an immunosuppressive dose of Dexadreson then as well-not a great fan of steroids myself and must make more enquiries as to why this was given. A lot of drugs in a short space of time-Convenia and Laurabolin a few days earlier.

Owner would certainly be willing to do all in order to save this little one but for some reason vets are very resistant to doing any tests....Hmmm. Only putting incredible pressure to PTS even though they don't know what wrong with her.!! Feel they couldn't be bothered and writing cat off due to age. Owner has requested a full work-up in order to make an informed decision.

Nearest referral centre is miles away (4 hours) unfortunately, so best bet for now is moving to another practice. Hopefully vet there will be more pro-active.

Will be speaking to her later so will update you all.

Again may thanks everyone! Keep the ideas coming.

Re: Help desperately needed with older cat, please!

Steph Worsley — Tue, 09 Oct 2012 18:22:28 GMT

Ok my first steps would be:

repeat full hematology, biochemistry, T4, fPLI, fTLI all sent to an external lab (don't know how recent the recent bloods are or where they were performed)
DV/R lateral thoracic radiographs (inspiratory), lateral abdo radiograph. ]
abdominal ultrasound by an experienced ultrasonographer

Low albumin could be causing the ascites, I would also want the fluid sent of for full cytology.

You don't say if the O is in the position to have the cat referred as this is an option?

Re: Help desperately needed with older cat, please!

Ellisonia — Tue, 09 Oct 2012 16:29:28 GMT

Yes, the same thing struck me Karen though I'd have thought that would have been detected by the OOH vets? Fairy sure she said there was also blood in the urine sample as well. I've even wondered about it starting off a type of peritonitis. Not seen a case to date (uroabdomen) so unsure how it would all match up with the fluid analysis really. I know owner had all the recent bloodwork with her at vist plus the cysto result.

However, in view of history and recent bloods/fuid analysis. I'm also wondering about pancreatitis/cholangiohepatitis as well.

Re: Help desperately needed with older cat, please!

KarenVN — Tue, 09 Oct 2012 15:57:21 GMT

So the cat seemed okay until it had cystocentesis and now is ascitic, is it possible the cat has a uroabdomen?

Re: Help desperately needed with older cat, please!

Ellisonia — Tue, 09 Oct 2012 15:57:12 GMT

I agree and the sooner the better for all concerned especially this little cat. Owner is very upset and just wants to have a realsitic overview of how treatable all this is and is frustrated by the 'vet' who appears to have dismissed any options other than PTS. Think at one point he thought it was his kidneys!!!

Re: Help desperately needed with older cat, please!

Mark Hedberg — Tue, 09 Oct 2012 15:38:02 GMT

Ok, good luck! Long as someone's on the case. :)

Re: Help desperately needed with older cat, please!

Ellisonia — Tue, 09 Oct 2012 15:26:52 GMT

Thanks so much for your reply Mark. However, the ER vet ruled out heart problems as a cause. Apparently heart sounded OK. Also heart disease would be more likely to be a transudate than an exudate. I realise also that BP might have peaked at some point, so causing the detachment. I think the FIP diagnosis was most likely based on the fluid analysis and the mistaken belief the cat came from a multi-cat household, which isn't the case at all and additionally the blindness, though this is more common with dry-FIP as opposed to wet, I would have thought.

Off case though cat was behaving normally until a few days before the onset then became more lethargic and stopped eating. Had a cysto a few days earlier and practice vet hadn't noticed any build-up of fluid at this point, even though my friend has said ( in hindsight) she now believed she noticed he looked 'rounder' the day before. However, she's adamant ascites didn't come on suddenly.

Think she should move him. Looking around at alternatives now, I believe.

Re: Help desperately needed with older cat, please!

Mark Hedberg — Tue, 09 Oct 2012 15:08:10 GMT

Please be very very careful with fluids; ascites can be a sign of heart failure in cats. Retinal detachment can be caused by high blood pressure, which is also a symptom of heart disease. It's worth rechecking the blood pressure a few times to get an average; especially if you have ascites present. (I know you said it was normal, just worth rechecking in light of the retinal detachment.)

Please note that I haven't examined your cat and I don't know more of the history but this would be my first suspicion, especially with the history of the heart murmur.