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 took my German Shepherd Diesel to a small airport near my house that is all desert (southern Nevada) on 8/17/2024.
He was running and chasing rabbits and was just fine. He is a very healthy dog, 8 years old, and has never had any health issues, not even hip dysplasia. He doesn’t have the common sloping back/angulation in GSDs, but a straight back, which is probably why he doesn’t have hip dysplasia. Anyway, today and yesterday, he started showing signs of limping on his rear right leg, which was much more visible today. He is hardly putting any pressure on the foot, often lifting it up. I gave him some carprofen for pain and inflammation. I trimmed his nails, because they were a little long and it looked like they were pushing up his toes and could have been the source of discomfort. It didn’t seem to help. Since we were in the desert, I checked for any injuries from the rough terrain and for cactus needles. No sign of any, but I am still very concerned. What should I do?

Hello

My name is Parham Parsa, I found your page on youtube and have read your blog, and for once I saw someone that is actually talking about blocked cats and is raising awareness to this issue and I wanted to thank you for it.

My cat Mercury (4.5 years old, 18lbs) is currently in the hospital for another urinary blockage and I genuinely don’t know what to do, this is his third visit, first time he got blocked was about a year and half ago and he was on the death’s door, his blood work was extremely elevated, he was lethargic and in visible pain. His regular vet unblocked him and transferred him to a vet hospital for further care, this visit cost me about $5K, and after that he was put on a strict urinary diet. Second time was 3 months ago where we noticed him being in pain and struggling once again and we took him to an ER vet and he was unblocked again, despite my persistence of leaving the his urinary catheter in, they took everything out, and send him home that very night, thankfully he remained unblocked until last night. His vet told me that since he is keep getting blocked he should just get the PU surgery and all but refuse to see him, so I took him to the Metropolitan vet hospital and their estimate for getting him unblocked and doing the PU surgery was 7-8 thousand dollars which is wildly out of reach for me at the moment. After reading your blog I have decided that if I find a second job I can afford to have him unblocked and kept in the hospital for observation for a night or two but I don’t know what I can do after that. If you have any suggestion regarding an affordable PU surgery or any other suggestion I am all ears. I’m really sorry for the long email, and looking forward to hearing back from you.

I just got off the phone with his vet at Metropolitan and after they took some X-Rays they saw some large stones in his bladder which they suspect could be the reason for his repeated blockages, and recommended a cystotomy and they said that the balance would stay at 7-8 thousand dollars. As of now my plan still remains to have him unblocked and watched for couple of days but I don’t know what I should do next.

PS.. I have attached a couple of pictures of him to this post. He is genuinely the sweetest and the friendliest cat I have ever met and the idea of me having to say goodbye to him just because I can’t pay for his treatment is is something I cannot imagine.

My Dog cannot walk .Her left leg has not been working properly.It’s too week.I search everywhere the symptoms I might feel like its IVDD.She was trying to wake up but she can’t.Her weight is too heavy like 35-40kg. german shepherd. please help

Intermitent Limp

Hello, one of my dog has a limp on her hind right leg that only occurs minutes after she gets up after lying down for a long period of time.
When she gets up her leg won’t touch the ground while standing up or walking.
In just a few minutes, she’ll touch the ground again, run, and jump with no sign of pain, but every time she gets up it’s the same thing, several times a day.
I’ve squeezed her leg all the way, and moved it around and she shows no pain or injuries,

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.

Anna is turning her nose up at both wet and dry food. When she does eat (with aid from appetite stimulant prescribed by vet) her stools are normal. She drinks/pees normally and is playful. She’s taken to sleeping under my bed rather than up with me but maybe it’s cooler there? It has been very hot here this summer. Less eager to go exploring on harness/leash in fenced in yard/garden but may have issue that I tell her not to eat the grass (have organic grass inside for her but she wants the outside stuff that has Creeping Jenny in it -toxic to cats. Grass eating only started a few months ago and she eats it & throws up a small amount of clear fluid with the grass in it). Got 2 vet opinions regarding Anna’s refusal to eat (I have tried everything from raw to cooked and every prepared wet & dry food off shelf to no avail). Anna will eat some Temptations Mixups BBQ flavor. Weight fluctuates between 6.7 and 7.7lbs. A “normal” Siberian female her age is 10-15lbs. (Anna does have very mild gingavitis & plaque but vet said this wouldn’t be reason for not eating.)

Both vets recommended an ultrasound of her abdomen but as a retiree the $500-$700 is a big chunk of change. Mostly, as a Cat Mom of many years my gut tells me something else may be the culprit for Anna not eating. She has been “flicking” her tongue over her nose more often (she has no upper respiratory issues says both vets). And, to me, the right side of her mouth seems to be looking different than the right side lately. It reminds me of my Nana who had Bells Palsy and one side side of her mouth “drooped”. I will see if I can post an upclose picture below of her right side (photo left) mouth.

Was intrigued with your video of polyps in cats and would love to know if maybe a change in Anna olfactory senses might be tied to her disinterest in eating? She doesn’t snore, btw.

Thank you!

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 cat has been excessively licking herself on her back side, around the tail area and on her paws. So much so that now she has a bald spot on her rear end. This has been going on for a week now, from what I have noticed. I have tried brushing her to look for flea evidence but I have had no luck. She also doesn’t let me see her paws. She has been eating fine and nothing has been different in the home like food wise or litter wise. She occasionally goes out side just onto the deck but not lately due to the heat. What could this be? None of my other cats are showing the same behavior. Do I need to get her seen?

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.