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Francesca | 4 months ago
I Have A Very Special And Painful Case I Need Help With, I Have Tried Several …

I have a very special and painful case I need help with, I have tried several different veterinarians with no diagnosis or prognosis so far. It may be a long shot, but I was hoping you could help me shine a light on this.

In April I found an extremely skinny stray cat and took him in. I first thought he was malnourished from lack of food for being in the streets, but 4 months in his case keeps unfolding.

He is likely older than 15 years old, but he’s a happy cat with a lot of energy and mobility. He weighs 3kg but he’s a big cat, you can feel every single bone in his spine, although you can’t see them that easily because he has long hair. He’s completely affectionate, loves to be pet, and asks very politely for attention and food all the time.

All we know about his past is he is neutered, he had some teeth surgically removed and he tested negative for FIV and FeLV.

He had a huge appetite when I first took him in, he would eat 100g of food in one meal and ask for more right after. He would sometimes ‘cough’, it sounded like he was choking on some kind of fluid, it doesn’t happen in sequences, but it happens almost every day until today.

He always drank LOTS of water and produced a lot of urine as well. His feces at the beginning were really solid with some mucus.

After a month, he continued to eat plenty and hadn’t gained any weight, that’s when he started to throw up. It started happening a few days a week, usually after spending several hours without eating he would throw up a clear frothy fluid with no content, and then it progressed to twice every day regardless of when he had eaten.

We suspected it could be diabetes or hyperthyroidism, but the labwork didn’t confirm either, it showed regular kidney function with small liver function alterations.

We then introduced prednisolone (2,5mg/day) and changed his diet from a mix of natural home-cooked protein, hypercaloric wet food, protein supplements, and dry food to exclusively Royal Canin Hypoallergenic while waiting for Royal Canin Gastrointestinal Hydrolyzed Protein to arrive in Brazil, keeping Omega 3 (fish oil) 500mg/a day in his diet.

Vomits went away for a while. He kept drinking lots of water and peeing a lot, but his feces got softer (not liquid).

He had periods where he lost his appetite, which we treated with mirtazapine, he reacted after 6 days.

We performed an ultrasound and discovered that basically all his internal organs were compromised. He has severe alterations everywhere. Still, the best specialists I could find couldn’t tell me what was causing it and offer a course of treatment that didn’t involve opening him up to collect tissues for a biopsy.

I personally think it is absurd that a doctor could look at this frail elderly cat who obviously can’t resist anesthesia without serious risks and say that surgery is the only way to go, all to find out for sure if we’re dealing with a lymphoma or an infection. I’m looking for someone to advise me on the most effective course of action. Of course, I aim to reverse his condition, but I understand that given his age and how advanced it is, it might not be an option.

He is currently at 3kg, eating exclusively Royal Canin Gastrointestinal Hydrolyzed Protein with fish oil, and taking prednisolone every day for a month now. His appetite is healthy, he still drinks a lot, pees a lot, and poops regularly but softer. He eats an average of 5 small meals.
Vomits are back down to a few times a week, usually early in the morning before his first meal, and always a clear liquid. He goes and eats right after throwing up so I get the impression he is not nauseous.
He doesn’t seem to be in pain overall.
He’s not gaining any weight regardless of all my efforts.

That is why I’m giving this a shot and trying to get your attention. I hope you have more resources and knowledge that could help me figure out appropriate next steps to give this little guy the best fighting chances I can.

On this link you’ll find a translation of his bloodwork and ultrasound. I had chat GPT translate it for me so forgive me if there are errors.
Link: https://docs.google.com/document/d/1yqcen-TYzyvfBYU-J4t1tCHola1E2otDGDa1H7V032Y

I appreciate any support you can lend me, his name is Valentim which means brave and strong, and I want him to win this fight.

1 Response

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  1. Krista Magnifico

    Hello,
    It sounds like you have done a pretty thorough work up. The places I think that you should look into are;
    Repeat the blood work. It sounds like hyperthyroidism. I always check a free T4 on top of the thyroid T4. I also check a urine. If you haven’t sent a fecal to the lab too.

    After that the ultrasound and X-rays are where I look.

    You are still at the place where the diagnosis is eluding you. That’s where you need to focus.

    PS. Just for the record I don’t love starting pred until you have a diagnosis. It can obscure your diagnostics.

    Good luck. I hope this helps.

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Lisa | 4 months ago
My Cat Is 1 Years Old Lillyanna Is Laying Around And She Is Not Eating What Do …

My cat is 1 years old Lillyanna is laying around and she is not eating what do I do?

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  1. Krista Magnifico

    Hello,
    If you think that your cat is not acting normally please see a veterinarian. At least have an examination done. Maybe it can be as simple as trying an antibiotic. But please see a vet.

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Lisa | 4 months ago
My Cat Is 1 Years Old Lillyanna Is Laying Around And She Is Not Eating

My cat is 1 years old Lillyanna is laying around and she is not eating

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Elaine | 4 months ago
Anna Is Turning Her Nose Up At Both Wet And Dry Food. When She Does Eat (…

Anna is turning her nose up at both wet and dry food. When she does eat (with aid from appetite stimulant prescribed by vet) her stools are normal. She drinks/pees normally and is playful. She’s taken to sleeping under my bed rather than up with me but maybe it’s cooler there? It has been very hot here this summer. Less eager to go exploring on harness/leash in fenced in yard/garden but may have issue that I tell her not to eat the grass (have organic grass inside for her but she wants the outside stuff that has Creeping Jenny in it -toxic to cats. Grass eating only started a few months ago and she eats it & throws up a small amount of clear fluid with the grass in it). Got 2 vet opinions regarding Anna’s refusal to eat (I have tried everything from raw to cooked and every prepared wet & dry food off shelf to no avail). Anna will eat some Temptations Mixups BBQ flavor. Weight fluctuates between 6.7 and 7.7lbs. A “normal” Siberian female her age is 10-15lbs. (Anna does have very mild gingavitis & plaque but vet said this wouldn’t be reason for not eating.)

Both vets recommended an ultrasound of her abdomen but as a retiree the $500-$700 is a big chunk of change. Mostly, as a Cat Mom of many years my gut tells me something else may be the culprit for Anna not eating. She has been “flicking” her tongue over her nose more often (she has no upper respiratory issues says both vets). And, to me, the right side of her mouth seems to be looking different than the right side lately. It reminds me of my Nana who had Bells Palsy and one side side of her mouth “drooped”. I will see if I can post an upclose picture below of her right side (photo left) mouth.

Was intrigued with your video of polyps in cats and would love to know if maybe a change in Anna olfactory senses might be tied to her disinterest in eating? She doesn’t snore, btw.

Thank you!

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  1. Elaine Post author

    Here is a picture of Anna from February before the eating issues began. Her mouth on her right side (left in photo) looks different to me, ie not drooping like it is now.

  2. Krista Magnifico

    Hello,
    My recommendation is to have a blood work panel done. It should include a full chemistry a cbc, fecal, urine and thyroid. At my clinic this is about $200. An abdominal ultrasound is about $350. I think that these are imperative to figure out what’s going on. And hopefully be able to start a treatment plan for. I doubt it’s a polyp. Use your resources elsewhere. I also think it’s perfectly acceptable to see if you can find these cheaper elsewhere if you are unable to afford them with your vet.

    Good luck

    1. Elaine Post author

      Thank you, Doc. My vet did a “pre-op” panel and everything was normal except:

      Total protein: 5.9 (6.3-8.8 normal)
      Globulin: 2.6 (3.0-5.9 normal)
      Alp: 11 (12-59 normal)

      The ALB/GLOB ratio was slightly high at 1.3 (normal 0.5-1.2)

      The neutrophils were slightly low but the vet said it was probably due to the stress from the visit. (The vet gave me deworming for both kitties, too)

      Because Anna doesn’t have diarrhea and a mildly decreased appetite (and holding her weight level) the vet said we could hold off on the US. But the past few days (without the appetite stim) Anna is again not eating well (treats, some yogurt, a few licks of wetfood & a few dry kibbles) I called and they are going to put me in touch with a “traveling” ultrasound doc who charges $300-$350 and uses different hospitals to do the US. Still awaiting a call back.

      Is this now an “emergency”? I am so worried about Anna…

      Thank you for your input. Muchly appreciated!

      Lynn

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laura | 4 months ago
I Am Concerned About My Elderly Dog Who Has Started Sleeping All The Time. She Only …

I am concerned about my elderly dog who has started sleeping all the time. She only gets up to eat and go to the bathroom. Sometimes I think she is dead because she sleeps so long and so soundly. When she gets up she seems ok. Just wondering if this is somethings I should be worried about. I would say she sleeps like 22 hours a day.

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  1. Krista Magnifico

    Hello,

    You are the person who knows your dog the best. If you see a change in him then please reach out to your vet. I think an examination and some blood work are indicated.

    Hope things go well.
    Dr Magnifico

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Paula | 4 months ago
Hi Dr. Magnifico, Thank You From The Bottom Of Our Hearts For Your Help With Our …

Hi Dr. Magnifico,

Thank you from the bottom of our hearts for your help with our baby Percy last week. He perked right up after the Subq fluids and is doing well. I wanted to ask you how many times is best to feed him since he is a kitten? Don’t want to overfeed him or underfeed him. Also, since I rescued him from the rescue I volunteer with ( AARF) they will be doing his neutering on 7/30. He will be 3.5 months then. He was born on April 11th 2024. I’m still nervous because he’s so young and little and just want to do the right thing and for it to be safe for him. How young do you neuter boy kittens if I came to you? My kitten that I rescued in 2005 from Defender’s of Animal Rights was already spayed when I got her and she was just a little thing. I know with male kittens you have to wait longer. Thanks so much for your advice.

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  1. Krista Magnifico

    Hello!
    I am so happy to hear that Percy is doing well.

    I think that feeding three times a day is fine. I will admit that with my kittens I leave out dry kitten food and offer a half a 3 oz can every 12 hours.

    I also think that neutering at 3.5 months is fine. I have done it many times. If able I prefer to neuter at about 6 months old.. But I understand why the rescues prefer early., You will have to discuss with them,

    Thank you for all you do to help these animals who need us.

    take care
    krista

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Stina | 5 months ago
My Cat Has Been Excessively Licking Herself On Her Back Side, Around The Tail Area And …

My cat has been excessively licking herself on her back side, around the tail area and on her paws. So much so that now she has a bald spot on her rear end. This has been going on for a week now, from what I have noticed. I have tried brushing her to look for flea evidence but I have had no luck. She also doesn’t let me see her paws. She has been eating fine and nothing has been different in the home like food wise or litter wise. She occasionally goes out side just onto the deck but not lately due to the heat. What could this be? None of my other cats are showing the same behavior. Do I need to get her seen?

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  1. Krista Magnifico

    Hello,

    anytime I see a cat with itching at the base of the tail I do two things;
    1. put a good, safe flea and tick medication on, I like Revolutions, but Frontline is also good.
    2. I check the anal glands

    the other thing I do is look for any signs of trauma around the area.

    In some cases cats have a hyperesthesia complex. This is something to talk to your vet about
    see more about this here; https://www.webmd.com/pets/cats/what-is-hyperesthesia-in-cats

    I hope this helps

    1. Stina Post author

      What if she has a flea collar on? As for the glands I don’t know what I’m looking at or for. Do you think she should be seen by the vet?

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Skyler | 5 months ago
I Have A Male Orange Cat Who Has Been In And Out Of The Vet For …

I have a male orange cat who has been in and out of the vet for urinary troubles.
Three weeks ago I took him into the emergency vet for what seemed to be a UTI, he was constantly trying to urinate only producing small amounts. I panicked because two years ago he experienced a total blockage.
The vet three weeks ago told me he was not blocked and had no crystals and sent me home with gabapentin.
Three weeks later he experienced an actual blockage. Again I took him to the vet, they unblocked him, flushed his bladder and told me this time he had a ton of crystals. They sent him home after about only an hour of being there. Two days of him being home he blocked AGAIN and I had to repeat the process. This time he came home with a catheter that I had to monitor. I took him back in the next day and they monitored him all day, then proceeded to call and say they would like to send him home with another catheter. I opted to have him stay at the vet overnight and he was sent home with no catheter the next day. I picked him up yesterday afternoon and he was just kind of dribbling urine and squatting around the house. At least this time urine was being produced, just not many strong streams.
Today he is acting normal until he urinates and then he feels like he has to keep going. He does that until he falls asleep. Then the process repeats.
He is currently taking Gabapentin, Prazosin, Zeniquin and he just finished his last pill of Onsior. He is also strictly eating OTC urinary wet food.
I’m just wondering if this is normal behavior after having being in and out of the vet so much within the last few weeks. He isn’t blocked up but he’s still trying to urinate often in and out of the litter box, producing some urine. He is able to drain his bladder, it just takes some time. I’ve dropped about $2500 so far and am so worried this isn’t going to get better soon. I’m sorry this was such a long post, I just need some help. I like my vet it just seems like there is more to do. Thank you in advance.

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  1. Krista Magnifico

    Hello,
    I would recommend the following;
    1. send a urinalysis to the lab for analysis
    2. take an xray of the bladder to make sure there isnt a bladder stone
    3. i recommend in hospital iv fluids for 3 days to flush the bladder
    4. long term analgesic therapy. I like gabapentin
    5. a canned food urinary prescription diet

    best of luck

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Maryam | 5 months ago
Hello All, Writing In With An Agonizing And Drawn Out Struggle With My Cat Petra.. I …

Hello all,
Writing in with an agonizing and drawn out struggle with my cat Petra..

I rescued a feral kitten in 2022 who developed cryptococcosis the following year – confirmed through a biopsy.
She has the cutaneous and nasal form, and while we tried itraconazole for a few months, it did devastating damage to her nose.
Vet switched her to fluconazole 37.5 mg (at that time my cat was just over year old and weighed 3.5 kg) once a day… and the symptom relief was remarkable!
Within a month, her nose was much less inflamed and starting to look “relatively normal” again, and best part was she was no longer having difficulty breathing, no stertor or mouth open.
Her many crusty skin lesions and nodules under the skin cleared up miraculously!

But, the success was short-lived, because a couple of months later she developed a big bulge on her abdomen/side under the skin – which eventually erupted. She had had several of these nodules and lumps, that ulcerated last year but the fluconazole seemed to clear them all up. Until now. I was so disheartened, to say the least.
The crater-like ulcer got infected and our vet (RCVS licensed in UK) decided surgery was the best option.
We did this, and the vet found more ulcers which needed to be removed to patch up the skin. It was a horrific looking surgery aftermath when she came home.

Petra required to wear a cone for 3 weeks after her surgery so she couldn’t touch her healing wound. It got infected anyway, and this increased her “cone suffering” duration.
The impact of many vet visits, surgery, and follow ups while the vet checked if the wound was healing and if the stitches could be removed, was quite an ordeal for Petra.
She gets very stressed and is difficult to put in a carrier. I feel that the stress of cone duration + all the vet trips triggered an inflammatory response in her and her nose started showing signs of the fungus again. Inflammation, distortion and worst of all the stertor was back.

The vet increased her fluconazole dose to 75 mg a day (37.5 mg morning, 37.5 mg evening). This had no noticeable effect and her nose got more inflamed as each day went by. 2 months later and her nose is worse than ever and the tip is so inflamed. With the loss of scent and ability to breathe sufficiently, she’s become reluctant to eat more than half a tin of food a day. Sometimes all she will eat is half a tablespoon and then runs off, upset.

Petra’s vet wants to put her on a maximum dose of 150 mg of fluconazole, daily, before assessing her quality of life and potential euthanasia.
I decided to try homeopathic remedies first, while continuing 75 mg a day of fluconazole) but it doesn’t appear to be helping 3 weeks in.

I’m concerned about continuing vet interventions, because Petra is so stressed by them, and at 150 mg a day she will need to see the vet frequently and likely need blood tests. At 150 mg a day, it’s also a non sustainable chunk of my monthly expenses (taken from diminishing savings), and she is not my only cat or responsibility… this could go on for years..

If she has no positive response (symptoms relief) at 150 mg, the vet is out of ideas other than euthanasia. I live in Bahrain and the options for treating this fungus are very limited.
They have not seen it in over 40 years of vet practice, so this is a first time.

I love Petra and it’s been hell witnessing her struggle to breathe for over a year. That’s what makes me panicky and consider quality of life, if she cannot be cured or brought to a level of management where the fungus doesn’t impede her breathing.

I need advice from a community of animal lovers, vets, who can also understand and take into consideration her temperament and adverse reaction (inflammation) to vet visits.

I was really hoping the homeopathic medicine would help and the practitioner I found has many years of successes working with animals. It’s either the wrong remedy, or just going to take a long time. In the meantime, in my opinion, my cat is suffering and struggling. She takes gasps of air every so often and her mouth is slightly open while she makes a snoring sound as she tries to breathe through her blocked airway. She has lost weight as she eats much less now. She was 4.7 kg in April before her surgery. At the beginning of June she was 4.5 kg and now she is closer to 4 kg.
Also within the last 2 months, her eyes have gotten affected by the nodules. One above her right eye, under the skin and affecting the bone. The other is in her left lower eyelid.
During this whole ordeal, her right lymph node under her jaw has been the size of a golf ball.. and the left one also swelled up a few months later. But that side seems to have gone down.

Any help or advice on what to do.. would be very much appreciated.

Pics from most recent (today June 3rd 2024) to last year before fluconazole and way before, late 2022, when she was a kitten.

5 Responses

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  1. Krista Magnifico

    Hello,
    I am so sorry to hear of your frustration over your cats case.
    I am not able to give much advice on this case with specific details to treatment but I will add that I think seeing a feline practitioner (someone who just sees cats) and see if they can help.
    I am sorry but I cannot advise a homeopathic vet on this case, it is too far advanced.

    I wish you the best of luck

    1. Maryam Post author

      Thank you, Dr. Magnifico,
      I have agreed to up her dose to 150 mg of fluconazole and it’s been a week with no improvements so far – except I noticed her drinking more water. Living on a small island, we don’t have any feline only vets, every vet here sees both cats and dogs. I really don’t want to elect euthanasia (which the vet said is an option) and the other end of the spectrum is my fear that she will suffocate eventually. It’s been so painful watching this unfold. Thank you for responding, about homeopathy. It is an added cost and couriers to get the medicine in. I have been desperate.

  2. Shiria

    Hello,
    I’m so sorry to hear that your cat is so unwell. I’ve luckily never seen ryptococcosis, but if it is treated with itraconazole or fluconazole, maybe ketaconazole is an option to try, too?
    Thank you for trying so much for your cat and not giving up on her. You are both amazing.
    Shiria

    1. Maryam Post author

      Hello Shiria, thank you for your kind comment. Petra is amazingly resilient.
      Animals take on suffering without complaint so I don’t know if I’m doing the right thing at this point, if she won’t get better. I’ve read about ketoconazole but it seems like the least helpful of the two azoles for this condition, and it seems like it has more adverse effects too. I will look into it, though, I don’t know if I’m doing the right thing for her as she struggles to breathe and trials take time. It hurts to think of putting her down and it hurts to see her suffering without knowing what will help, or if anything will. At a certain point I ask if it’s selfish to keep her alive & suffering in the hopes something will help, over a year on.

  3. Maryam Post author

    Hello. An update for anyone in the future researching on behalf of their pet who develops this fungus.
    A cure is possible, some cats respond very well to anti-fungal meds. My Petra did not. Initially, her nose cleared up very well and she could breathe much better, but the fungus returned with a vengeance a few months later.

    She has been on Fluconazole for 11 months total:
    (37.5mg – 75mg), and on 150mg for 3 months. 2 months into the higher dose, I found her with anisocoria (one pupil very dilated). It went away and came back over two days. One of her eyes is droopy (Horner’s syndrome). Yesterday I found blood smeared on her paw and couldn’t find a wound.

    I took her to the vet, who opened her mouth and discovered the fungal growths are pushing through her soft palate (roof of mouth) and causing anatomical separation. Her nose is swelling up considerably and distorting again. It began regressing 6 months ago but was relatively stable, but now it’s increasing in size and doubling almost overnight. She has lost 1 kilo. The vet has recommended euthanasia, unequivocally. Petra is struggling to get air in, and while we hoped for a cure (with medication) that is not happening. It’s cruel to continue with no hope of quality of life and only more suffering, and the outcome if left would be suffocation.

    We have decided to let my sweet girl go, while she is still mobile, eating, before she suffocates to death.

    It’s been so traumatic, to witness this and I want to send good vibes to anyone in the future who is struggling with the same disease (mainly the nose – which causes so much suffering).

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Jenn | 5 months ago
My Dog Has An Aggressive Retrobulbar Mass. He’s Been Doing Okay With Gabapentin. But Today …

My dog has an aggressive retrobulbar mass. He’s been doing okay with gabapentin. But today he seems to be having trouble breathing and is bleeding from his nose. Will he be able to make it until tomorrow when we can go to our vet if it’s time to say goodbye?

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  1. Krista Magnifico

    Hello,

    I am so sorry to hear about your pup. I will be at the clinic early today if I can help.

    Dr Magnifico