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Cat not doing well.

Species: Cat
Breed: Oriental Shorthair
Age: 1-2 years
Hi Dr. Marie,
First I want to say I love your page on Facebook and I am a big Fan of yours – so I'm hoping you can give me some advice/and perhaps a different perspective / viewpoint to see if there is perhaps something that I may have overlooked or missed that could help my little boy Stanley – he is a 1-1/2 yr old neutered Oriental Shorthair, who has had some very tough obstacles to overcome right from day-1 – Just to give you some background –According to Stanley's breeder, his Mom had an emergency C-Section and he was the only one of littler who survived, they thing cause he was so tiny, the smallest one - and it was touch & go for him and he almost did not live. By @ 8 wks still so very tiny and not eating enough and had to supplement his diet w/formula. I finally got him July 2010 @ 4-1/2 mths old weighing only 3-1/2 lbs. After having him just a few days he ended up having diarrhea – I started to think he may have caught something from one of my other cats (I have an older 13-yr old girl, Chinagirl– and 2 other kittens (Madeline & Oliver) that we got 2-mths prior to getting Stanley– unfortunately unbeknownst to us Oliver came to us having Tritrichomonas foetus which was first misdiagnosed as being Giardia, & later we found out he had herpes & calicivirus, and corona virus, plus at the age of 6-7 mths Oliver had Juvenile Periodontits Disease (the advanced 3-4 stage) along with Stomatitis –diagnosed by a Board Certified Vet Dentist – who was already treating Chinagirl for advanced Stomatitis requiring all her teeth to be extracted – and when the Vet Dentist cleaned Oliver's teeth she had to extract 1/2 his new Perm Teeth. Back to Stanley, we did not know Oliver had Tritrich until months after getting Stanley - so unfortunately all my cats got it w/the diarrhea– it took a lot of work & research to finally get the Tritrich under control – and under our Vet's care back in Nov 2010 we treated them all with Ronidazole (extremely toxic) (also according to Dr. Jody Gookin's research and recommendations) –at first seemed like they were finally cured, but then a couple weeks later Oliver & Madeline had diarrhea again! Ugh!! And seemed they were all taking turns vomiting just like they did before the Ronidazole- so their digestion is still an issue - Although Stanley & Chinagirl stools are solid (almost too hard). But just because China & Stanley did not have diarrhea doesn't mean they don't have Tritrich - we're assuming if one still has it, they all do? But rather than retreating them all again with Ronidazole we opted to find alternative remedies/solutions to ease digestive & diarrhea & vomiting symptoms – One way to help them is to find high quality easy digestible single protein food. Ironically though, by trying different foods in hopes of finding the best one I was inadvertently kept the tritrich symptoms going – so in effect by constantly trying & switching foods I was exacerbating Tritrich – so we now feed Evangers & Weruva can food and Evangers dry along w/giving them Purina Forti-Flora and L-Lysine –maintaining this diet w/ no deviating has made them all better except for Stanley. Stanley still has digestion problems w/ vomiting and has been battling Tonsillitis since Mar 2011 – He’s been on so many different antibiotics to no avail – his tonsillitis keeps coming back which causes him to cough and gag. He still vomits frequently almost daily sometimes – and we found when he starts gagging/coughing and trouble swallowing it seems we immediately feed him Baby Food Turkey Beech Nut which make him feel better immediately – quiets his cough and soothes his throat. But so our Vet told us since we tried so many different antibiotics that should have cured tonsillitis but instead all failed that we should consider surgery – but there has been no real discussion as to WHY is he's having Tonsillitis? But so before we opted for Surgery we gave it one last non-surgical try and gave him a Steroid Shot this past August 2011– but a couple days after being at the Vet and getting the shot Stanley ended up getting really really sick with bad URI –took him back to Vet and gave him Clavamox which he never had before. He started to improve but then all my other cats started getting realy sick –and Oliver got it the worst super high fever and couldn’t breathe thru his nose & struggled for each breath - We rushed him to the Vet – we did a swab and ran a PCR test for all possible URD –it came back Positive for Herpes, Calcivirus and Mycoplasma Felis - so starting Sept 9 we started all my cats on a 21-28 day treatment of Doxycycline– but Stanley seemed to vomit much more almost once or twice a day immediately after eating a big meal – so we lowered his dose of Doxy and started giving him frequent small meals which seemed to help and he'd go 2-3 days before vomiting – usually because I possibly let him eat too much –
So this gives you a pretty good background on Stanley – and here’s the problem – he vomits frequently and cries when he goes to use the litter box – and I really haven't seen him have a bowel movement but I keep seeing these very small very hard stools in the litter and since I see the other young cats stools are large and more normal I'm thinking he's having a problem with having hard stools – and his tonisillitis is back again with vengeance – so my question is could this be a form of stomatitis? Could he have gotten this from the other cats with stomatitis? And we know they all were infected with Calicivirus which I believe is somehow connected with Stomatitis? And why does he cry when using the littler? He doesn't moan, he just meows like announcing or could be crying, not sure? But still haven't seen him have a bowel movement so not sure but pretty sure his are hard little stools. Could this be causing the frequent vomiting? And he doesn't eat much dry so why would he have small hard stools? What would cause this?

I appreciate any insight or suggestions you can offer or offer a different approach I can maybe take with Stanley –like what tests should we should ask for? Thanks so much, and sorry for being so long winded.


Online vet, Dr. Marie

Dr. Marie replied:

Wow, poor little Stanley has been through so much.

It sounds like your vet is doing all of the same things I would. I'm not likely to be able to give you any miracle answers here, but let me give you a few thoughts on his issues.

I'm really suspicious that there is a serious underlying problem with Stanley. It's possible that he has an underlying viral problem. One of the things I would be concerned about is FIP. FIP is sometimes a difficult disease to diagnose. Has Stanley had a complete blood chemistry profile done at any time? Usually cats with FIP will have a low Albumin-Globulin level. If I see this, then I will sometimes run a test called a FIP end point titer. The problem is that there is no test that tells us 100% if a cat has FIP other than doing biopsies, or sometimes evaluation of fluid if there is any. If FIP is present then there is unfortunately no cure for it.

FIP can cause all sorts of symptoms. It may be an explanation for the litter box issues as it can cause problems with the intestines.

Another thing I would look at would be the possibility of a liver shunt. A cat with a liver shunt will just not grow as well as normal cats and can have all sorts of problems. This can be hard to test for as well. Often cats with liver shunts can still have normal blood levels for their liver enzymes. One test that could tell us possibly if there is a liver shunt is to do something called a pre and post prandial bile acid level. If there is a liver shunt, some cats can get better with surgery, but it is a risky venture.

This would be where I would start. This is a really complicated case. If you really wanted to get down to the bottom of things you could consider asking your vet to refer you to an internal medicine specialist. They may be able to get you a diagnosis. However, if you do this, be prepared to spend more money on testing.

I wish I had a more concrete answer for you. I feel really bad for your situation!





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Disclaimer: Although Dr. Marie is a qualified veterinarian, the information found on this site is not meant to replace the advice of your own veterinarian. AskAVetQuestion.com and Dr. Marie do not accept any responsibility for any loss, damage, injury, death, or disease which may arise from reliance on information contained on this site. Do not use information found on this site for diagnosing or treating your pet. Anything you read here is for information only.

Customer reply:

Dr. Marie,
Thanks so much for your information - To answer your question, 'no' he has not had complete blood chemistry profile done - I will definitely ask my Vet to do this. As I'm sure this will be the best starting point. I was just kind of hoping you might suggest a Thyroid problem - because that would be treatable - but deep down I was so afraid you may say FIP - OMG that is an awful disease and causes such suffering from what I've heard - I'm guessing you suggest FIP because we know Stanley has Coronavirus? The liver problem doesn't sound much better either- I'll have to research Liver Shunt because I have never heard of this. I pray he doesn't have either -And just really afraid if turns out to be FIP at what point do we know for certain - what are the tell-tale signs before the disease really progresses so we can maybe catch it before he suffers? Thank you again so much, I greatly appreciate your insights and sharing your thoughts for my little Stanley. I'll keep you posted. Best, Ellen


Online vet, Dr. Marie

Dr. Marie replied:

Thanks for the kind feedback you sent Ellen.

A thyroid problem is something we only see in older cats. It would be extremely unlikely in your guy's case.

My suggestion of FIP is really only a guess, and hopefully a wrong one. FIP can cause multiple problems, infections, intestinal issues, and more. I have it on the list of rule outs for any young cat that has been chronically sick. It's really hard to ever say for certain if FIP is there. There are no exact "tell tale" signs, but abdominal fluid is a common one though. If he starts getting a big belly then your vet will tap it to see if there is fluid there. If there is fluid in the abdomen at all then this can be tested for FIP. But, if an end point titre is done and the results are positive at a very high dilution (your vet will know what this means) then it is very suggestive for FIP.

Feel free to post back if you have more questions.

Dr. Marie.



Customer reply:

Hi Dr. Marie,
I just wanted to give you an update on Stanley. I took him to the Vet last Friday afternoon for a complete check and to also draw blood to get a complete panel on him. I ended up seeing the newest Vet of the practice that I go to (the Vet I usually see was not available)-But in a way I'm glad - it was good having a fresh pair of eyes reviewing his case. He was able to review his case history/ file, and we talked and he really listened to me too which I appreciated (of course I asked him about Liver Shunt and FIP) - Here's what saw and what he thinks - in reviewing his file/history and giving him a thorough exam:
1) definitely swollen tonsils – his Tonsillitis is back! (not sure why)
2) gums / teeth look fantastic – nice pink – no redness at all! Great gums!
3) everything else looks great in his physical exam – even his stools are soft - whereas I thought he could be very constipated – but not the case from what he feels.
OK – Here's his evaluation.
A.) He doesn't feel it can be Liver Shunt because his growth would have been very stunted (not by weight but rather by skeletal size)-& even though he's very skinny/ boney - he pointed out his skeleton is fully developed and lanky of normal size, plus he pointed out yellowing is usually seen which he doesn't have. So I was happy to hear this as I’m you are too – as I know it’s hard for you because you can’t see him in person to assess his size.
B.) Regarding FIP, even though he has coronavirus he just doesn't think the signs are really pointing him in this direction. He wasn’t really very specific on this point.
C.) Regarding Crying at the little box – He said perhaps he was a little constipated at one point to cause him discomfort and pain enough to cry at the box – but can’t really explain it because his stools feel fine – And regarding Vomiting, it does not appear to be caused by constipation since he is not right now. But suggested I add a little metamucil to his food (& explained how to & that it could help his digestion) –
But for right now he’s asking me to not leave food down for my cats so Stanley can’t keep eating- and only feed Stanley very tiny portions at a time several times a day, and we'll see if this helps.
RE: Treatment: for his Tonsillitis he gave him a 2-week acting Steroid shot to counter the inflammation and pain, and start him back on Clavamox again for two weeks (antibiotic he said is given as a precaution because the steroid lowers his immune system which puts him at risk since he has an infection with the tonsillitis and we don't want him to get sick or should I say sicker).
Results: His blood work the next day came back Perfect!! everything well within the normal ranges –
And with feeding him tiny meals this past week he hasn't vomited - only once when I forgot to pickup dry food and he definitely ate too much! and his bowels do seem normal - and a week later we can tell his throat is definitely feeling better! (I'm thinking his sore throat contributes to his vomiting! but that's just my opinion) This little boy definitely his high energy and loves playing and obviously eating is not an issue - I truly think he'd eat himself to death!! Yet he's so skinny! weird - I'm thinking part of the problem is he truly cannot sense when he's full or had enough food! He still announces when he goes to the bathroom - and that still has me puzzled - but he doesn't really seem to be in pain.
Summation: My only fear at this point is after the steroid wears off and has finished his antibiotic that his tonsillitis will still be there! I just wish I knew what is causing his tonsillitis? and do you think if it’s still swollen and keeps coming back that this could this be the beginning of Stomatitis? and taking him to a Vet Dentist? or should we think about having his tonsils removed? Would love your thoughts on that. I found this great website about FIP and Stomatitis by Dr. Addy (http://www.dr-addie.com/stomatitis.html) and I definitely learned a lot from this site and their ebooks and was wondering if you had heard about this site and what you thought. Thanks again so much. Best, Ellen


Online vet, Dr. Marie

Dr. Marie replied:

I'm very glad to hear that he is improving! If you find that the problem comes back again after he comes off of the steroid then it's possible that Stanley has some type of auto-immune condition. If this is the case he may need to stay on a tiny dose of steroid long term. Ultimately to get a diagnosis, a biopsy of the tonsils might help, but he'd need to be under an anesthetic for this.

I haven't seen that website that you mentioned, but after a brief look it looks like it's got a lot of good information.

I hope things continue to look up!



Customer reply:

THANK YOU!


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Dr. MarieDr. Marie is a veterinarian who practices in a busy animal hospital in Ottawa, Ontario. She created Ask A Vet Question as a resource for good, accurate veterinary advice online. Dr. Marie treats dogs, cats, hamsters, guinea pigs, and rats. She has been a vet since 1999.

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