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)

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 5 yr old cat has been home one day following an overnight stay at the vet for blockage of urethra for crystals. He was given what seemed to be the appropriate treatment of catheter, steroids, antibiotics and a X-ray. He has come home on a five day supply of steroids and diet food. I was expecting my cat would just be “fixed” and back to normal. But he is not back to normal by any means. He is very weak and subdued. This is a normally very active , mischievous cat. My question is this normal response after having been thru this ordeal ? He is eating and drinking well. He is peeing but very little. Often but small amounts. He does not seem to be in pain like prior to treatment. He will go and just lay in the litter pan. It almost seems he is too weak to get out. But he does get out. I’m assuming he might be just like a human with a uti , in that he feels he has to go pee all the time . They did send him home having had a long acting antibiotic. I don’t know if that can make him feel bad. He does seem to be in the side of improving , but very slowly. Is this normal? It’s the weekend here so I can’t call the vet with my questions. I have a great vet group , although I have never seen the vet who took care of my cat before and am disappointed I was not given more post care instructions on what to expect.
Thank you
DWS

My 11 month old has thrown up a small amount of clear foamy liquid twice. She did the same thin about a week ago. She’s behaving like normal with exception to food. She’s not hungry for her food first thing in the morning (but will beg for everyone else’s) she’s always been a very enthusiastic eater. She’s also been whining off and on. I thought it was a new signal to go out because it’s very intermittent, but that doesn’t seem to be the case. I’m going for indigestion maybe? She prefers to rest in her crate now (before it was anywhere I am). She’s a bully breed and a puppy so I’m hoping it’s simple and not something she got her lips on. Maybe I should run her to the vet? I just hate to waste their time if it sounds like I’m overly worried.

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!!!

Hi. I have an almost 6 year old lab who keeps vomiting when she eats or drinks. She is otherwise happy and doesn’t appear to be in any pain but does appear to be losing weight (she’s a heavier build). She wants to keep eating and drinking though and not having any other problems. Is there something I can give her to resolve the stomach issue or could it be something more serious?

This is a lot to digest. We have a 15-year-old dog that has been on meds for congestive heart failure. He was doing fine until…the other day he apparently got into the trash and ingested a paper towel with meat gravy. For the past 24 hours he has been vomiting up food he ate after the ingestion so we obviously have not fed him further. He has been drinking water regularly throughout the day and night but vomiting it up at times as well. I have discontinued giving him water so the vomiting doesn’t dehydrate him. He did vomit up part of the paper towel but now we believe there may be a piece in his digestive tract too. He is resting now but has been very lethargic as one might expect. Not interested in eating, vomit is a combination of yellow and clear. One earlier vomit was very brown and “pudding” consistency. Since then mostly watery. Our vet is in surgery and is unavailable for the entire day, The main question is how dangerous is the paper towel if in fact it is lodged in the digestive tract? Will it degrade fast enough to allow water first and then food to pass. Our vet said the dog’s age and heart condition preclude any surgery. We are at a loss as to what, if any steps are available to us. He is not in immediate distress but is clearly in need of something.

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! I was listening to a lecture on animal nutrition, and it brought up the topic of grain-free diets. I used to feed my dogs the blue wilderness grain free diet. But is grain free safe for my dog? Should my dogs have grain in their diet? They are currently eating team dog and that has grains in it. Thank you!

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