Hi Krista
My almost 11 year old MC Potcake (who has too many beings lipomas to count) recently had his senior blood work and urinalysis – everything was normal except an elevated ALP.

The urine was a free catch sample at 4 pm and it was very dilute. This prompted me to remember that he has been drinking a little more (summer) as well as eating a lot of watermelon – and to remind me that he has also had an increased appetite over the last year. I did a specific gravity on a morning urine sample after he had no access to water overnight and he was able to concentrate his urine at 1.025

He has chronic seasonal allergies so his inner thighs have a dark pigment change – this has been present for years – there are no other derm changes and I don’t see a pot bellied appearance but the vet is considering Cushing’s. They suggested an abdominal ultrasound first followed by a low dose suppression test. I would rather do the dex test first before an ultrasound. I’m not sure that I’m convinced that Cushing’s is likely but something may be going on.

Of more concern is that this previously healthy dog coincidentally, a few days after the blood work, had an episode of vertical nystagmus and ataxia – very brief – less than 30 seconds. He’s been fine ever since but its only been a few days – I have been told that vertical nystagmus is less common with Senior Vestibular disease and possibly more likely a central lesion.

any thoughts that you have would be appreciated !
Pam

My dog had been having issues with diarrhea, regurgitation, and vomiting. I need help please.

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.

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!!!

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.

So my cat was diagnosed with upper respiratory about 4 months ago. Well he has been sneezing ,sounds nasally and , boogers just in the nasal area and the culture came back with pseudomonas well he is still lethargic and now won’t eat or drink now. He has been on orbax, nose drops, intrafungal medicine. Also he has a constant fever of 104°F. I am taking him to the vet tomorrow but wonder if it could be polyps? Pancreatitis?

My 1 year old dog (1/2 lab, 1/4 German shepherd, 1/4 boxer) has a large, perfectly round red bump on her face. I have researched and see potential answers but we are currently out of town and cannot take her to the vet yet. She is very important to me so of course I am concerned, but I would like opinions on whether I should be panicking as much as I am according to the photos I provide. Some articles say cancer, others say histiocytoma.

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.

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.