Colin to Dr. Krista : May I pick your Brains?

Dear Dr. Krista,

I’m writing to ask your advice about a stray cat I found last month. See images attached.

But first I want to thank you for the polyp videos you made, which were refreshing, as well as impressive.

One of my strays was snoring, so I was eager to pluck out a polyp hiding behind his soft-palate. (He didn’t have one, but I’m gratefully alerted for the future.)

Last month I found a stunted stray ginger cat outside a 7/11 in North Thailand, where I’m a self-financed Christian missionary.

Can you help me diagnose, and treat the problem?

At first I thought it was simply FVR / Calici and chronic snuffles.
But when I opened her mouth, she had only 4 teeth in her head!

Yes, she had calici tongue-ulcers, but little sneezing, no ocular discharge, and has been eating like a horse from day one. She’s happy and bright in herself, apart from the ugly sore nose.

Her mandibular Ln were big and hard, so I put her on antibiotic tablets, with a little dexamethasone (actually 2.5mg Prednisolone tab. daily.)

Then after a week or so I sedated her, and examined her mouth more closely, no observable polyps (drat!) but one of her molars was loose and covered in calculus, so I pulled that one out, and cleaned up the remaining molar and two premolars, otherwise the poor thing would have zero teeth.

There was of course gingivitis and pharyngitis, but pink, not red like “dragon-mouthed cats” on dcf.

For the last month I’ve given her a course of floxacilin (30 days) with amoxycillin, and tried all sort of creams on her nose and lower eyelids which. as you can see, are raw and sore.

Her Ln are almost normal now, +but that nose is no better+, and she tries to rub as though it is itchy.

(I made up creams mixing; 10% flours of sulphur, betamethasone, ivermectin, and vaseline)

There’s a temporary lessening at best, but no lasting improvement.

So what is your differential for her?

In NZ where I locummed, cat leprosy was common (Mycobacterium from mice and voles) so that was my diagnosis, but the floxacillin has made no impression.

I’ve trimmed her claws and taped her fore paws to stop her making her nose raw.

I’m stuck, and thought of asking you Doc.

I’d guess she’s 3-4 years old, confident, unvaccinated, entire, lived wild all her life eating left over fast food, and possibly DCF from neighbours.

Since October I’ve been feeding her raw chicken frames, tinned sardines, vitamin syrup, and no DCF.
She loves raw chicken :), and eats whatever I put in front of her and still looks for more.

Apart from her nose you would not think she was ill in any way.

Thanks for your advice.

Colin

PS. For some reason, Depo-medrone has been taken off the market here, not even local vets can get hold of it.

Colin Melbourne English missionary in Asia
https://www.born-again-christian.org/news/
https://www.born-again-christian.org/news/ไทยคริสเตียน/
https://www.born-again-christian.info/aboutus.htm
https://www.born-again-christian.com (Asian languages)

Hi Krista,

I discovered your YouTube videos yesterday and found your advice on cat care incredibly helpful. My wife and I are caring for our 18-year-old Birman cat, who is in stage 4 kidney disease with significant muscle loss. She’s also struggling with constipation and has other health issues, including high blood pressure and a heart murmur.

Currently, we’re feeding her a mix of wet food (chicken broth, chicken, pumpkin, and egg yolk), and providing SubCut fluids (50ml/day), along with the following supplements:

– Epakitin (0.5g/day)
– Pet-Tinic (2ml/day)
– Lactulose (3ml/day)
– Phos-Bind (0.2g/day)
– Potassium chloride (0.19g/day mixed in the broth – though we’re concerned she’s not getting the full amount since she’s unable to finish the broth).
– In addition, she’s on Amlodipine (0.25ml/day) to manage her high blood pressure.

Despite this, her weight has decreased significantly over the past year. She was once 3.3kg, but a year ago dropped to 2.5kg, and three weeks ago, it dropped again to 1.8kg, despite our best efforts to feed her.

A week ago, we had an enema done at the vet, which relieved some diarrhea, but there was still hardened stool near her anus. We’ve been massaging her abdomen and anus daily to stimulate defecation, and were able to help her pass a large, hard stool last Wednesday. Since then, she’s only passed small amounts of stool – mostly liquid or dark – and has had a lot of difficulty.

Today, we used a Pedia-Lax suppository (1ml), and after about 30 minutes, she passed a larger stool with dark liquid diarrhea. The stool was slightly hard, dark, and very smelly. She’s now very exhausted and resting, but did purr a bit before falling asleep.

For hydration, I gave her 10ml of SubCut fluids before the suppository to prevent dehydration. We’ve seen three different vets, but none have been able to provide lasting relief.

We’re reaching out for advice on whether we’re on the right track and if there’s anything else we can do to help her feel better and poop more easily. Any suggestions, given the circumstances, would be greatly appreciated.

Thank you so much for your time and any guidance you can offer.

Warm regards,

Joel and Sonia

My senior, male, neutered, diabetic nebelung cat is experiencing constipation, I had recently slowly changed his diet to a raw based diet from royal Canon diabetic pouches,, as i was put off from the vet scientific diabetic diets in the end due to one day reading the ingredients and seeing that my cat was needing something more or potentially he was lacking something, I say this as he was starting to mirander outside like a Billy goat eating all the graass that he could in our backyard. Coincidently, Boof started flickng his head and scratching at his ears, the next day after noticing his discomfort and that he still hadn’t defecate (day 3) i took him to a neighboring vet as our usual vet was fully booked out, I could see crusty brown specs in his ear and a discharge, the vet I took him to gave, me pmp drops to administer 3 drops per ear twice daily for 7 days. She didn’t want to try to much else due to him being a diabetic and also a new patient,
One day later when I was cleaning boofs bedding a spider
Like bug had come out onto our carpet,
I took a photo of it,
It’s definitely some type of tick not sure if it cpmr from out of his ear or if it has anything to do with his constipation.
Boofs appetite has been great this whole time aswel.
Although after eating I have noticed him somewhat whining ND groverling like his pain 🙁
He also vomited twice after having dinner. (biley foaming substance liquid)
On day 5 I took vet into out normal vet who assessed him, she gave him a 24hour anti nausea injection, and assessed him, she said to resume giving lactolose maybe a little bit more and aswel with the subcut fluids,

And still nothing,….

The vet called today to see how Boof was I explained to her that he wants to go to the toilet but just can’t, and his looking pretty squeamish again,
She explained to me that because of it being 6days now with no bowel movements that it can get Boof pretty sick potentially, she explained that instead of taking a stab in the dark and guess that they would breed to take xrays ect bloods and mannualyl remove all feces that’s stuck in him and it would cost $800. Due to Christmas coming up and the overall rise in the cost of living and the renting crisis here, I am just stuck for money at the moment that kills me to say, I have tried vet pay with. No luck…

Is there anything I can try at home please, it’s not at all a situation where I don’t want to pay anyone, it’s by far the opposite and I’m hoping that a friend of family member will reply to me after asking for a lend, which I never do, and I never would expect or be suprised if anyone can help,
My boy means so much to me,
I just gave Boof a 5ml enema of lactulose and more subcut fluids
Is there anything more that I can do please 🙁 🙁

My cat got a large lump under his jaw that formed over night. The vets are closed and the emergency vet is too far and expensive. My parents say they will take him monday but is it safe to leave it untreated for two days? *edit, i should mention the lump is large and does not seem to be causing pain, he is acting normal anyway. I cant tell if its warm or not thou

I’m saving a small 8-10 week kitten. We found her while we were walking our neighborhood, she was crying for help on the side road/gutter. She has a hurt right leg. We have caught her and made sure that she was alone…we visited her for about 1 week (feeding and winning her trust) and new we had to help her ASAP. We got a trap and trapper her and took her home. We don’t have much money since I have already saved two other feral kittens in the neighborhood and kept them both. I won’t get into that since that is not my purpose on here. But we have taken Lola (the new found kitten) to get x-rayed and started her shots. I’m at my wits end because we took her to AM/PM Vet to get the x-ray and they simply said that she has no broken leg and that more than likely she would need the leg amputated but to give her two weeks. They did not offer any advice what to do. So, we took her back and this time they (another vet at AM/PM) said that it was a mis diagnosis. I have been spending lots of time with Lola and massaging her leg and I think she has been able to move it more than when we first brought her home. She is totally comfortable with us at home now and I think she is healing but I’m not sure if what I am doing is causing more harm. I’m doing my best to keep her confined in a cage, but I do take her out to bond with her and play and massage her leg. So today, I saw your video putting a splint on Penelope and I think that is what I should do also. I believe the symptom you mention is possibly what Lola is experiencing. Should I take her to another vet specialist who can give hopeful advise? Can you please give me advise on: What to do and What Not to do? I’m doing the best I can but finding it difficult because I have saved two other cats (Mango is 3 years now and MaeLa is 8 months – they were both feral kittens when I saved them. It has been two weeks now and I know time is of the essence to help Lola with her leg. Please help me with advice from your experiences.

8 week old female kitten not defecting properly….several days. My 21 year old daughter (away at college) just got a kitten last Tuesday. She noticed the kitten wasn’t pooping but the kitten was trying but either nothing was coming out or a piece was stuck in and hanging of her rectum. Sometimes my daughter returns to the room where the kitten is and finds smears of poop. he took her to the ER and they gave the kitten an enema… which sort of worked a bit and the kitten did go on Friday (the day after). They wanted to do more such as an X-ray and give fluids but the cost was so high my daughter didn’t want to do that. Since then, the kitten is trying to go anywhere and everywhere but nothing coming out. Occasionally some poop smears are found. Thus far the kitten has been in decent spirits…. playful a bit and eating wet food (with a little aded water). Of course, I’m sure this will change fast. Last night the kitten tried to poop while sitting on my daughters lap. 🙁
We have an appt. on Tuesday afternoon at a local vet whom I use for my cats and I trust….. I’m worried we can’t wait til then to get her checked. Any suggestions on what could be going on? I’m worried its something more serious. Thank you so much for your consideration!!!

What is the cost to remove polyps in a cats nose ?

Hello all,

I wanted to follow up on my question about Mercury from two months ago. He had been suffering from recurring urinary blockages, and after several ER visits, I scheduled him for a PU surgery at The Bridge Clinic, a non-profit vet hospital in Bensalem and Philadelphia. The surgery was done on Aug 14th, and the surgeon recommended doing the PU first to see if the stones would pass naturally, which they did. The surgery cost me $1,181.

Unfortunately, the issues didn’t end there. Mercury seemed to recover for about three weeks, but then he started frequenting the litter box and peeing only small amounts, sometimes not at all. He also began peeing outside the litter box and seemed very uncomfortable, especially at night, so I took him for a follow-up on Sep 12th. An X-ray and urinalysis were negative for stones or infections, but crystals were found, leading to a diagnosis of FIC/FLUTD. They suggested Gabapentin for pain and more water fountains and litter boxes (this visit cost $191).

Despite following their advice, Mercury’s issues persisted, so I scheduled another appointment on Sep 19th. The vet confirmed FLUTD and suspected a possible infection at the surgical site, so he received a Convenia and Buprenorphine injection (visit cost: $134). Still, no improvement.

I then took him to his primary vet at Telford on Oct 3rd, where they suspected a different bacterial infection and prescribed Clavamoxin, though I declined a urine culture due to cost (this vist was $170). I also put him on a strict urinary diet (he was on dryMetabolic Urinary food and regular wet food which I diluted with water). He showed some improvement, but then, last Monday, he seemed blocked again. After giving him Amitriptyline, he was able to urinate, and Telford said their only recomendation is a urine culture, and they don’t have any time to see him that week, so I reluctantly agreed to. (Urine culture + 7 Amitriptyline + 14 Clavamoxine was $323), today the results from the culture came back clean, meaning I spent $273 for nothing.

What’s frustrating is that I haven’t spoken to the vet directly since the first visit, only through techs and nurses, and I’m running out of time and money. Mercury is still in pain and struggling to urinate, and I don’t know what else to do.

So if you have any insight or recommendations to what I should do next please let me know because I am at my wits end and have no idea what to do. (I’ve attached the visit’s summaries and the receipt from my last time at Telford to this post)

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.

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?