Questions for those who have experience introducing cats? (old question) July Walnut health update!!!

[sonnyjane]

@mom2rtk @SaintsManiac

Thanks for your words.

So Walnut has been to three vets at this point. First vet was our original, then we switched to cat only hospital. He was also seen by an internist at MedVet (where second ultrasound done and pronounced no diseases). Then we've been bringing back to Cat Hospital.
Cat Hospital was really only going on the ultrasound, blood work and exam results from both previous hospitals. All of this started right after Christmas.

When we brought him in Friday because he was starting to really not eat, he checked out perfect onl physical exam, Vet did say she felt poop, so he may be constipated and to keep eye on. He pooped as soon as we got home, so we thought okay. Hard, but decent size. But then all weekend he still wouldn't eat. So we went back last night and all that happened.

So overnight he never pooped. He did go and start eating crunchies on his own and some wet food, but not normal. He's still wide eyed and barking at birds.
Called vet and told to bring him in.
But now they don't think fatty liver. His blood work points to liver inflammation (can't rule out a cancer, but based on previous ultrasounds there were never any liver findings) but rules out the fatty liver - she thinks he's having another pancreatitis flare and it's affecting liver. Also causing the constipation which is causing him not to eat.

So he's at hospital right now, getting another enema, treatment for flare including low-dose steroid and something for liver. And another enema. This time it's a more aggressive one as the one they did last night was modified. We are waiting for a radiologist to review his abd x-ray and they are talking about another ultrasound. We just did 2 in a matter of 4 weeks!!! They will call us later today for updates. I'm just sitting numb on my couch, waiting for more bad news. He's so happy too, like he thinks he's doing great!

Please keep in mind also that most cats aren’t big fans of car rides or vet visits. Even without being on any medication, being poked and prodded Can cause cats to act abnormally. I know you need a diagnosis but it seems everyone is telling you very different things. I’m not a vet but I do have a lot of experience with animals and I wonder if we need to let him settle down a little bit, both to improve his health and make sure that the doctors are working off of the proper symptoms?

 

[Farro]

I realize cats dont like going to vet but I cant treat these problems at home. It's not stress, its physical. I only bring him when its serious, as now.

 

[lisaviolet]

I realize cats dont like going to vet but I cant treat these problems at home. It's not stress, its physical. I only bring him when its serious, as now.

Farro,

No one is saying don't take Walnut to the vet, to get a handle on what is impacting his well-being and health.

People are only talking about *trying* to be conscious of the balance between finding out what is wrong and making sure the stress of vet visits/procedures isn't in itself impacting his health/well-being - beyond any diagnosis. And producing stress symptoms that are not relative to the actual medical issue at hand.

On a good day it is a difficult balance. But on days when we are beyond stressed because there is no diagnosis and our pets are suffering, on those days it is almost impossible to even think clearly, beyond focusing on getting concrete answers. We all understand.

 

[Farro]

Farro,

No one is saying don't take Walnut to the vet, to get a handle on what is impacting his well-being and health.

People are only talking about *trying* to be conscious of the balance between finding out what is wrong and making sure the stress of vet visits/procedures isn't in itself impacting his health/well-being - beyond any diagnosis. And producing stress symptoms that are not relative to the actual medical issue at hand.

On a good day it is a difficult balance. But on days when we are beyond stressed because there is no diagnosis and our pets are suffering, on those days it is almost impossible to even think clearly, beyond focusing on getting concrete answers. We all understand.

I understand that. But we are dealing with life/death at the moment and it doesn't matter if he likes the vet or not, he has to go. Pancreatitis, liver inflammation, constipation and not eating. I don't have the luxury to see if things calm down as he calms down unfortunately.

Anyways, no poop yet today. They are starting steroids, liver meds, motility drugs and who knows what else. Going to get him in a little bit, only to call them tomorrow to tell them no improvement i'm sure.

I tell myself people have it worse, and they do. But this fear, feeling sick in the pit of stomach and waiting for the grief all over again. We just did this 3 months ago when Cashew died. I don't know how much we can take!!!
It's not the vet's fault. It's nobody's fault. But I really want to explode.

I'm just angry and sad. Be okay eventually. I was on the phone with vet getting an update and she tells me everyone is taking pictures of Walnut right now. I'm like why? She said oh, he's so drugged he looks adorable. I laughed, but honestly that annoyed me.

I'm going in and asking what is the next step. Enough bringing back and forth. Let's get this poop out, even if it means a manual extraction.

 

[belleatdisney]

I have dogs not cats but I think for your peace of mind you need another opinion from a different practice if things haven’t improved.

I feel so bad for you. The roller coaster of not knowing and anticipating grief is really hard.

I hope walnut pulls through.

 

[mom2rtk]

I'm just angry and sad. Be okay eventually. I was on the phone with vet getting an update and she tells me everyone is taking pictures of Walnut right now. I'm like why? She said oh, he's so drugged he looks adorable. I laughed, but honestly that annoyed me.

That's incredibly inappropriate. They are not treating your pet seriously or respectfully. I know you can't run up and grab him and go home, but honestly, I'd be looking for a new vet at the first opportunity.

 

[sonnyjane]

I understand that. But we are dealing with life/death at the moment and it doesn't matter if he likes the vet or not, he has to go. Pancreatitis, liver inflammation, constipation and not eating. I don't have the luxury to see if things calm down as he calms down unfortunately.

Anyways, no poop yet today. They are starting steroids, liver meds, motility drugs and who knows what else. Going to get him in a little bit, only to call them tomorrow to tell them no improvement i'm sure.

I tell myself people have it worse, and they do. But this fear, feeling sick in the pit of stomach and waiting for the grief all over again. We just did this 3 months ago when Cashew died. I don't know how much we can take!!!
It's not the vet's fault. It's nobody's fault. But I really want to explode.

I'm just angry and sad. Be okay eventually. I was on the phone with vet getting an update and she tells me everyone is taking pictures of Walnut right now. I'm like why? She said oh, he's so drugged he looks adorable. I laughed, but honestly that annoyed me.

I'm going in and asking what is the next step. Enough bringing back and forth. Let's get this poop out, even if it means a manual extraction.

Maybe I’m not reading correctly but it seems like the liver and pancreatitis issues are the things that the vets are giving mixed messages about? The only thing you know for sure is that he is constipated and not eating normally, is that correct?

 

[SaintsManiac]

Oh no ma’am. I would have gone off if they said that to me on the phone.

 

[TipsyTraveler]

Maybe I’m not reading correctly but it seems like the liver and pancreatitis issues are the things that the vets are giving mixed messages about? The only thing you know for sure is that he is constipated and not eating normally, is that correct?

An enlarged pancreas can affect the liver by causing a bile duct obstruction, so both organs can be affected even though the liver would be functionally fine if it weren’t for the primary issues of the pancreas. I have no idea if that’s what the vet is saying is going on, but maybe that’s why both are being discussed?

@Farro , the list of possible causes for icteric blood serum is lengthy and will unfortunately take quite a bit of sleuthing to pinpoint. All the time and diagnostics and money spent will be frustrating, no doubt, but it’s just part of the process. Each disease they can rule out puts them closer to a definitive answer. The end result may be a relatively simple fix or it may be bad news, there’s no way to know at this point. I think you said he’s still bright and active? That’s a very good sign that’s it’s okay to keep pursuing a diagnosis, IMO. Good luck.

 

[Farro]

An enlarged pancreas can affect the liver by causing a bile duct obstruction, so both organs can be affected even though the liver would be functionally fine if it weren’t for the primary issues of the pancreas. I have no idea if that’s what the vet is saying is going on, but maybe that’s why both are being discussed?

@Farro , the list of possible causes for icteric blood serum is lengthy and will unfortunately take quite a bit of sleuthing to pinpoint. All the time and diagnostics and money spent will be frustrating, no doubt, but it’s just part of the process. Each disease they can rule out puts them closer to a definitive answer. The end result may be a relatively simple fix or it may be bad news, there’s no way to know at this point. I think you said he’s still bright and active? That’s a very good sign that’s it’s okay to keep pursuing a diagnosis, IMO. Good luck.

Yes, triaditis. Hes on 9 medications. If he poops and starts eating next 24-48 hrs things are good. If not will probably get feeding tube or syringe feeding and a manual evacuation of poop.

Being he had normal ultrasound two weeks ago they feel tumors or something like that unlikely. As well nothing like that on x-ray.

 

[TipsyTraveler]

Yes, triaditis. Hes on 9 medications. If he poops and starts eating next 24-48 hrs things are good. If not will probably get feeding tube or syringe feeding and a manual evacuation of poop.

Being he had normal ultrasound two weeks ago they feel tumors or something like that unlikely. As well nothing like that on x-ray.

Yeah, that’s a tough one to get sorted out and ultimately it may come down to managing symptoms as opposed to curing a cause.

 

[Farro]

Yeah, that’s a tough one to get sorted out and ultimately it may come down to managing symptoms as opposed to curing a cause.

So he started with first ultrasound showing inflammed cecum and mildly inflamed pancreas. Put on flagyl and panacur. 2 weeks later was in ED for something that turned out to be nothing, but ultrasound there showed all clear. Their internist said to stop all meds early.
Vet today said possibly stopped too early and inflammation came back worse.

They think cause of everything IBD. If can get him better he may be on low dose of flagyl for good. Unless diet change works.

 

[TipsyTraveler]

So he started with first ultrasound showing inflammed cecum and mildly inflamed pancreas. Put on flagyl and panacur. 2 weeks later was in ED for something that turned out to be nothing, but ultrasound there showed all clear. Their internist said to stop all meds early.
Vet today said possibly stopped too early and inflammation came back worse.

They think cause of everything IBD. If can get him better he may be on low dose of flagyl for good. Unless diet change works.

There’s likely to be some trial and error before they hopefully figure out what it takes to keep him stabilized. I’d try to leave decisions about medicines and diet changes to one internist only, if possible, whichever knows his case best.

 

[KayaWildfire]

So he started with first ultrasound showing inflammed cecum and mildly inflamed pancreas. Put on flagyl and panacur. 2 weeks later was in ED for something that turned out to be nothing, but ultrasound there showed all clear. Their internist said to stop all meds early.
Vet today said possibly stopped too early and inflammation came back worse.

They think cause of everything IBD. If can get him better he may be on low dose of flagyl for good. Unless diet change works.

IBD is horrible to deal with, I'm so sorry this is happening to you. Our current cat has IBD and she had horrible uncontrolled diarrhea for months. Flagyl didn't touch this. She was super sick. Thankfully, she is well managed on just diet now and we are officially one year free of any and all diarrhea. I hope things improve for you.

 

[Farro]

No poop overnight. He still seems so drugged out from everything he's on plus the sedative from the enema yesterday. Hard to tell if still just drug haze or feeling sicker.

If no improvement today, tomorrow will be a hard discussion with our vet.
He's only 5 so we want to do feeding tube and manual extraction, but if he's too weak or too sick for anesthesia, we need to decide if it's time to let him go.

Also emotionally and financially we are drained. Cashew was about $8,000 to try to save and Walnut is already over $4000. But if they think we can still save Walnut, we will try anything.

Walnut.

 

[SaintsManiac]

Are they sure it's poop and not hairball related? I only ask because I just spent $2000 for my cat to have hair surgically removed from his intestine. They could not tell what it was until they opened him up.

 

[Farro]

Are they sure it's poop and not hairball related? I only ask because I just spent $2000 for my cat to have hair surgically removed from his intestine. They could not tell what it was until they opened him up.

They say poop from x-ray. And the ultrasound from 2 weeks ago showed nothing. And she last night she said they can finally feel it softening, he just isn't pooping it out. He did do the poop stance in the litter box at least, before he wasn't even trying, so something is happening. Just too little too late I'm afraid.

He looks like he's sleeping with his eyes open! I just can't believe it. Even just yesterday morning he was lying on top of us, purring, then looking out windows at birds. My Walnut, I love his meow, he's so talkative. I'm going to miss hearing him so much.

 

[belleatdisney]

They say poop from x-ray. And the ultrasound from 2 weeks ago showed nothing. And she last night she said they can finally feel it softening, he just isn't pooping it out. He did do the poop stance in the litter box at least, before he wasn't even trying, so something is happening. Just too little too late I'm afraid.

He looks like he's sleeping with his eyes open! I just can't believe it. Even just yesterday morning he was lying on top of us, purring, then looking out windows at birds. My Walnut, I love his meow, he's so talkative. I'm going to miss hearing him so much.

 

[belleatdisney]

Sorry I hit post too quickly above.

I am not familiar with cats but...

Are the vets saying this is critical? I don’t understand feline diseases but gosh he got bad so quickly. Can you get another opinion?

I hope he gets better.

 

[Farro]

Walnut back in with vet. Too sick to go under anesthesia for clean out/feeding tube.
Medications to treat inflammation don't seem to be working.
Trying mild sedation and one more enema and clean out to see if it helps him turn the corner.
If no poop today after enema and still no improvements, will be put to sleep tomorrow.
If poop today from enema, but not able to product any tomorrow with no improvements will be put to sleep Saturday.

Now thought process is that being Cashew's pancreas was attacked and inflammation all over and now Walnut's liver attacked and inflammation all over - FIP presenting in an untypical fashion.