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.

7 MONTHS LATER MY CAT IS SLOWLY CHOKING TO DEATH !
I posted this 7 months ago : My rescue cat of 5 years is showing all the symptoms of Nasopharyngeal Polyp. He is my everything!
OH please I am begging for help here ! I am disabled and he is the center of world . I am on the south west coast of Washington State, my rescue cat Kiki presents with all these symptoms ( I come from a family of RN and Bachelor in Nursing ) I have called vest around here and ALL of them say they do not do this surgery because they dont have the scope, or they will not even discuss possible price or treatment without me coming in and the vet seeing them. They say they will diagnose and refer me to a specialty clinic not far away . The specialty clinic gave me a quote of $3,500-$5,000 !! If this is even what is wrong with him . I am devastated that no one will even discuss this with me without paying for a vet visit. It looks like i could spend hundreds in visits before i can find someone who is even willing to think about this surgery without referral to the very expensive specialty place . PLEASE HELP I CANNOT AFFORD THAT MUCH !! Meanwhile my poor sweet Kiki is slowly getting worse. I dont know what to do anymore !!!!!!!!

UPDATE : PLEASE PLEASE I AM ONCE AGAIN BEGGING FOR HELP !! My cat displays all the symptoms of this I do not have a lot of money . i can come up with a few hundred dollars but no where does this surgery without a scope or it being a specialist . I keep being quoted THOUSANDS OF DOLLARS to have it removed ! I have called and called and called vets around here and either they dont know what I am talking about or they will only refer me to a very very expensive specialist ! I asked for help months ago and finally chatted with you and all you told me was keep calling vets in my area and asking . I have over and over , I am watching my cat slowly choke to death more and more each day ! this is a nightmare ! I dont have $3,500-$5,000 that they are telling me it will cost ! Why can you do this for so little and no one else can ? PLEASE I AM BEGGING YOU !!! ANYONE PLEASEEEEEEEEE HELP !!!!!! He is choking to death !

Does Reflux in premature kittens exist?
I’m asking because we got 4 tiny premature kittens yesterday with their mother. She didn’t have milk when the were born, so the little ones were bottle fed/syringe fed the 2 days before they came to us.. However since she still showed interets in her babys they stayed with her. They had around 70gram according to their owner. When they arrived, they were cold and crying. One died a few minutes after they arrived, despite slowly warming up. It had tiny bits of milk in its nose.
(they were fed ca. 60 minutes earlier)

When they were finally warmed up two were drinking, one was fed with a syringe. All were urinating normally, one had a bit of bowel movements (yellow and soft). I placed them to their mother who was very worried about her babies and cuddled around them immediatly. She had a heat pad below her box to help keeping the temperature. She was extremly nervous, so I left her alone for the time being.
When I looked after them for the next feeding, the second one was dead. Milk around nose and mouth. I checked for cleft palate, but there was none visible.
The other two also showed no signs of a cleft palate. However, they felt cold again despite lying on their mothers belly.

I warmed them up again and this time I didn’t put them back – as it seemed that the despite mother and heat pad below they could’t keep their temperature. So they stayed in the box we use for raising kittens.

One was drinking, one was not. The none drinking was tube fed. When I looked after them a ca. 15 minutes later the non drinking one hat milk running out of its nose and mouth. I cleaned it immediatly and it started breathing again – but I guess it still got something in its lungs, as it died a few minutes later.

The remaining one was now warm, still urinating normally and drinking. But it couldn’t settle down. It was always crying and seemed restless. The next two feedings went normally – as dfar as that is possible with such a tiny one. When I wanted to feed it in the late evening I found it dead – a bit of milk running out of nose and mouth. It was the smalles one of them with only 67 gram.

I’m very worried that I did something wrong… They were not the first babys I bottle fed (or syring fed/tube fed). But it’s not like I’m very experienced… Usually the ones I get are at least full term… I only had one premature Baby before, that also died after 2 days. It had only 53 gram when being born – but it was with me since birth.
None of the babyies I cared lost as much milk through their nose – and especially not their mouth. The only ones that did this, had a cleft palate. The healthy babys may choke at some milk at the beginnig when they try to figure out the bottle – and may show a bit milk at their nose when doing so – but they never showed those problems. They were fine later,

These ones died more or less immediatly after I took them in – and that’s why I’m asking myself, if I did something wrong – or if I should do something different next time – as all of them showed milk at nose and mouth. The third one looked like it had spit our everything it drank earlier and the last one also had more than just a drop outside of nose and mouth. I only fed tiny amounts – ca. 1ml each feeding, to get them started, was that still too much? The previous owner said nothing about problems with feeding – and I used the same milk as them.

It seemed all aspirated milk because it came back out of their stomach (reflux).
I know reflux is not unusual in human preemies – but what’s with cats and is their a way to avoid that? (If that’s the reason for their problems at all). But if not why came the milk back up?

My cats always choke on hairballs in their throats (without vomiting) so I would prefer (if available online/in your local store) a dry cat food brand that eliminates/controls the hairballs in my cats’ throats in addition to the food being completely FREE of BY-PRODUCTS because 2 of my 3 cats have suffered from Meow-Mix (which contains by-products).

King Charles got excited and started choking, I had to pull his tongue from the back of his throat and he sometimes starts snorting when breathing what should I do