Hello all,

I posted on here earlier this year asking for some advice about my cat who had a very advanced cryptococcosis infection.
Her right lymph node (submandibular) was swollen the entire time, and the left one but to a lesser degree.

She developed anisocoria and horners syndrome, droopy right eye, and she had a mass that felt like bone on top of her eye.
The anisocoria disappeared after 3 days and her pupils were entirely normal again.

Things escalated last week. Her nose has always been blocked, to various degrees, since she developed the symptoms, 1.5 years ago, but it seemed like she was able to get enough air in with some gasping and mouth breathing. I didn’t know how comfortable she was, but I had to try the last recommendation the vet suggested: 150mg of fluconazole a day. She was on this massive dose for 3 months. (4 kg cat)
Previously, she was on 37.5mg for 6 months, her nose and lesions cleared up and she was able to breathe again (most importantly!)
But, in March, a big lump (cryptococcosis mass) exploded into an abscess. It wouldn’t heal. The vet performed surgery to remove it and other lesions nearby. It was an eyesore, I felt so bad for her. She had a cone on for nearly 3 weeks because the suture area got a bit infected. Raised her fluconazole dose to 75mg a day.

Last week, her nose got much more inflamed and distorted very rapidly. It began bleeding and ulcerating, drying up and then bleeding repeatedly.
She looked so uncomfortable and basically slept all day in various positions to keep her head elevated. When near me or when sleeping with me at night, she’d clamp onto my arm or neck with her teeth to keep her mouth open so she could breathe and fall asleep. I can’t fathom how difficult it was to sleep having to make a conscious effort to get air in through her mouth. I understand cats are not “mouth breathers” and can’t fully relax that way.

I took her in to see her vet, 11 days ago, after noticing blood on her paw, and no wound. The vet looked inside her mouth and looked said the fungus was pushing through her soft palate (roof of mouth) into her front teeth. She recommended euthanasia and said she was not going to “get better” in her professional opinion. And that my cat was suffering and it wasn’t ok, I asked outright if her quality of life was ok. She said no. My cat had lost 1 kg since her last visit. This also factored into the vet’s recommendation.

The vet was ready to put my cat to sleep at the time of our consult, but I requested some time to digest and take her home to say goodbye.
Then, 4 days later, I took her in for euthanasia. I wish I had canceled. Am I wrong to feel that she should have died on her own terms?
What she had was like a breathing disability, in other ways she was a strong and vital cat. She was still eating, though appetite decrease by 30 or 40%.
Why did her nose not clear up (while the cutaneous lesions cleared) and in fact get worse after 3 months on a higher dose?
I’m so devastated and confused and wish I could have done more to save her life.
I felt selfish for letting her live this way, knowing there was no hope and I’d just be prolonging the inevitable (probably suffocation).
I am in so much pain recollecting what’s happened.

I wish I had kept her at home and only taken for euthanasia if she had collapsed and refused to eat. Taking her in to have her put down when she still asked to be fed, showed playfulness in some moments, trotting around when it was food time, it felt hasty but also inevitable. I felt I was saving her from experiencing more suffering as the fungus grew.
But, I will never know how it would have gone if I left her. Maybe nature would have performed a miracle, and she would heal, or she would die without my intervention and without pain (like a quick heart attack). I feel so terrible for having made the choice to snuff out her little life when she was still very strong.
She fought the sedative the vet gave, they took her back to insert a catheter and didn’t bring her to me until 40 mins later, saying she was fighting the sedative.
It pains my heart thinking she was in terror during her last hour on earth. When they carried her in, sedated, she looked absolutely petrified and braced. I could see her spirit fighting with all its might.

The vet told me that she had a more thorough examination of her nose and that the masses had hardened/were like concrete all through her nasal airway and that she was breathing through a “pin prick” hole. She said she was never more certain that euthanasia was the right choice.

I am so heartbroken. I still feel like I took her life away too early. Why should it be up to me? I can barely trust myself now.

Hello, firstly thank you for making this site and sharing your message and trying to help both Vets and pet owners do better by and for their sake.
The cold weather in Oregon is setting in, I attached some photos I hope help. I’m trying to figure out the best way to identify and treat this issue.
The following are my observations of the marks located at the base of the tail areas side and underside only, surface level circular with some being slightly more crater like. Hair loss and area effects remain the same after what feels like over a month already. Plasma is typical puss in 2 or so spots, no swelling since first observed till present day, skin near effected area looks okay, over grooming of the area likely but not believing this is a source of pain. We live in a farm setting he is a stray I will watch over like my own and treat as such, I’m not against funding anything from big or small for his care but he’s strictly outdoor hunter and sometimes I wont see him for days. Would be most appreciative to any insight in what this might be or how I can help, likewise if there is a wound spray or dewormer I could purchase he is 100% outdoors and I see no signs of worms but he drinks from bird bath dishes. He will allow me to handle him but only so much I’d be much more worried when his patience runs out. I’d say he weighs about 15 pounds and overall health and appearance / dental is amazing. I always offer him a safe clean area and access to the property I will be buying a breakaway collar with a GPS tracker for him, he’s a farm cat my neighbor and me watch after. Would this be something to just give more time to mend? or should I step in and apply or seek help. Thank you! I will 100% be doing a donation, really wish more Vets were like you or highlighted in the community.

EDIT, the donation link via paypal says this is indelible, you can click 1-2 photos below that say Ads to be redirected to those to donate, if you have a place in mind please add it to the response I’d be happy to donate to your place of choice.

Hi, I have a male cat (Mugzy) less than 2 years old with a broken / dislocated right hind leg, he was probably hit by a car. After his injury he was removed from a colony and taken to a vet. digital scans were taken of his leg. Aside from this injury he appears to be in good health. The injury occurred approximately 2 months ago and he had gone missing for 1 month before he reappeared. The veterinarian recommended the leg be amputated at the hip. He has good blood circulation in his leg and foot and is coping well despite his injury. My question is can surgery restore partial mobility to his leg as an alternative to removing his leg ? See pics. Appreciate your opinion. John

Hi my cat went to the vet a couple weeks ago and noticed a scratch with a small bald spot as soon as I got home now he has a huge spot with scratches can anyone please identify what is could be ?

[Very Urgent] Advise on Cystotomy vs PU

My 8 year old cat (male, neutered, American short hair) was diagnosed with bladder stones and underwent a cystotomy in February 2024 to surgically remove the stones from the bladder. Unfortunately, the surgeon left behind 3-4 stones in the urethra during the surgery, which were later pushed back in the bladder. These stones blocked him again in May 2024 – he was unblocked via a catheter and the stones were pushed back into the bladder during catherization. He again got blocked a couple days ago and has been unblocked again via catherization with the stones pushed back in the bladder. The X-rays do not show formation of new stones in the last few months and the urinary analysis do not show any crystals.

We are considering three surgical options to remove the sones now: 1) cystotomy 2) PU 3) Cystotomy + PU. Please see X-rays after the cystotomy in February, the one from May and the one from last night and advise on the best course of treatment

Should my 15yo cant perform nasal polyps removal operation?

Good Afternoon Doctor.
I came across your Youtube video that you are performing Nasal Polyps removal operation to young cat.
My question is should my 15yo cat young enough to receive this operation.
Currently he is on Steroid and Yuan Bio medication but it is starting to wear-out.
Those medication worked great for the first month but now he is having discomfort in respiratory again.
My cat is not young but I would like to maintain the QOL of the cat and wanted to know if this helps.
If so, what will be the rough estimate and how long does she might have.
I know this is hard to speculate without actually seen the cat but just a ballpark will be appreciated
Thank you

T

Hi Krista,
We had adopted two month old American Short Hair and got them all vaccinated at Petco plus got them Spayed/Neutered.
One of them, 2 years old Riley had a runny nose(Green Mucus) right from the beginning and later on the Vet at Petco mentioned that she has a Polyp and can’t be treated at their facility.
I need your help to find a vet that can perform Polyp removal surgery on my 2 year old female American short hair cat near Chicago, IL
It seems Riley has a very large Polyp or some type of mass that’s blocking her airway and food pipe; the vet tried to insert a tube for breathing and it couldn’t go through due to a large mass that is blocking it.
This Vet @ Westchester Animal Clinic in Porter, IN recommended a Specialist and is not optimistic that this polyp or mass can be removed through surgery and was proposing Euthanizing as an option which we didn’t agree.

My cat had some secretion on his bum opening and it was definitely that anal sac smell I’ve experienced before. I’ve wiped it off, but wonder what to do if it persists, do I need to express them?

This just happened today and I haven’t noticed the smell or any issues until now. I’m hoping I just caught him after using the bathroom or something and he’s able to resolve it on his own but want to be ready if he can’t.

I have two cats so I didn’t notice my cat is not eating. He’s very skinny. He refuses his favorite foods. He’s drinking water. He’s greenish looking poo around his anus. Old and dry. I tried to clean it.

We are on one income and cannot make it to the vet. What should I do?

A question for Krista Magnifico:

Hello! Hoping to get some advice on recommended next steps for my cat, Sammie, who is being evaluated for IBD vs. small cell lymphoma.

Sammie is 17 years old and is overall quite healthy! Throughout the time I’ve had her, she’s had a history of vomiting a ~once per week or two (sometimes more frequently). Vomit is usually clear, foamy. No other GI issues or health issues otherwise. She is active and energetic, and has not had any health issues until ~1 month ago when I noticed she stopped eating as much as she previously did. She stopped eating her dry food altogether, and seemed to become quite picky with her wet food. I initially thought her teeth may be bothering her because of the avoidance of dry food, so I brought her to the vet.

Vet found that she had lost a couple of pounds, unintentionally. Based on presenting symptoms, vet thought she might have a GI pathology so ordered an abdominal U/S:

Ultrasound, Abdominal Study Outcome:
Kidneys: overall normal size but mild reduction in detail and small mineral foci. Trace pylectasia noted w/out ureteral disension.
GI: Avg SI thickness normal. Mild corrugation is noted in some regions and some ileus (luminal fluid distension up to 4 mm w/ reduced
peristalsis) noted w/out obstruction. No discrete abnormalities appreciated throughout the small intestines.
Caudal abdominal nodes are prominent to mildly enlarged and rounded w/ smooth texture. One irregular cystic structure noted near right
kidney. The mesentery around the ileus segments is mildly hyperechoic.
A:
Intestines most consistent w/ enteritis
Nodes: r/o reactive vs other
Cystic strucure: r/o benign mesenteric vs inflamed node
Kidneys have evidence of chronic disease.

Here are her prior labs:
PRIOR LABS:

7/15/24: Wt loss 0.28 lb; PCV: 40/7.6; Chem18: BUN 41, creat 1.7, K+ 4.3, phos 4.2
U/A: USG 1.019, pH 6.0, rare wbc/rbc; no bact/cryst; cobalamin: 437; folate: 11.2

2/13/24: Wt loss 0.8 lb; CBCcomp: hct 44, diff wnl (clots in sample; rec. resubmit)
Chem25: BUN 40, creat 1.3; T4: 2.8; SDMA <10
U/A: USG 1.025, pH 6.0, rare wbc, no rbc/bact/cryst, rare fine gran casts.

1/19/23: Wt loss 0.4 lb; CBC: (hct 40, diff wnl); Chem25: (BUN 32, creat 1.3)
T4: 1.8; U/A: USG 1.051, pH 6.5, 1+ prot, rare wbc, no rbc/bact/cryst

11/19/21: CBC: (hct 46, diff wnl); Chem: (BUN 34, creat 1.5); T4. 1.9; DGGR lipase 9
U/A: USG 1.053, pH 7.5, rare amorph. crystals, no wbc, no rbc

6/17/22 Wt loss 0.16 (as desired); USG 1.040; SDMA: 11

Most recent A&P:
A:
1) Intestines most consistent w/ enteritis (IBD vs SCLSA); ileus likely cause of decreased appetite.
2) Nodes: r/o reactive vs other
3) Cystic strucure: r/o benign mesenteric vs inflamed node
4) Kidneys have evidence of chronic disease ; in keeping w/ previous lab findings.
P:
1) Rx: metoclopramide 5 mg: 1/4 tab po every 8-12 hrs.
2) Continue vit B12 as Rxed.
3) picked up Mirataz but hasn't started it yet. Rec. give. metoclopramide for 2-3 days and then if not improved appt, start Mirataz.
4) to consider presumptive pred tx vs ex-lap for biopsies.

Sammie is seeming to eat better with the metoclopramide.

My question:
Is pusuing an ex-lap for biopsy recommended vs. empiric tx for IBD with steroids vs. empiric tx for SCL with steroids + chlorambucil.

Thank you!!!