Anaphylactic shock in cat--what next?

[Zai]

Hello all,

I stumbled on this forum and found such professional and measured responses on it that I thought I would share with you what happened to my cat last week. I would be grateful for any advice or tales of similar experiences you might be willing to share.

I have a 13 month old 4th generation female tonkinese called Isis (aka, Zai). The other day, she was getting her boosters for Flu& enteritis + Rabies. Luckily, I live 5mins away from the veterinary practice, and when I let Isis out of her carrier once we got home I noticed she was itching the site of the injection. Nothing abnormal so far, and I was preparing to go out shopping (when she was younger I used to watch over for a while after her vaccinations but was not about to do it this time since she had always been fine). However, in less than a minute, her itching became crazy, she was frantic,biting her paws, and scratching her ears and eyes furiously. Next she became very agitated and began to run around the room as if trying to escape the itchiness, and the running soon turned into crazed galloping. By then she was howling as she ran around. Clearly something was very wrong and I phoned the vet to inform them I was on my way back--it was closing time for them. By the time I had put the receiver down, i.e less than a minute later, things had got worse: Isis's face had swollen up into what resembled a puffy caricature of herself, she had vomited on the floor and was vomiting again from the top of a wardrobe off which she proceeded to hurl herself in a panic, and started having diaorrhea everywhere. I just about managed to get her into her carrier and took her immediately to the vet's. By the time we got there she was gasping for air, despite my having sprayed salbutamol into her carrier bag. Luckily, fast acting steroids did the trick, as well as a sedative, and the vet observed her for an hour before agreeing to let me take her home, under close observation, with his number to phone in case anything went wrong again.

Obviously, I am unwilling to ever vaccinate Isis again due to how violent this anaphylactic shock was...if the different phases came on that quickly the 1st time, I dread to think how drastic a second shock would be.

However, she is an indoor-outdoor cat and her booster for leukemia were supposed to be due in January. Turning her into an indoor cat is not an option for me.

More background:
--she has allergic asthma which we medicate with inhaled steroids and salbutamol when needed.
--2 days ago, she sniffed some crushed walnuts and within seconds started itching all over, her skin was rippling, and she was becoming agitated again. I contained her in the bathroom so as to be able to catch her in case it degenerated into a shock again, but luckily after 5 minutes the symptoms subsided
--she was stung by bees twice in the garden as a kitten, and both times considerable swelling ensued at the site of the sting, but nothing beyond that
--she threw up when we fed her an egg, which we have never done again since.

So as you can see this precious little miss whom I love to bits (she is the most quirky and adorable character) is very sensitive to allergens.

What should I do about future vaccinations? Every 3 years under closely supervised conditions? De-activated vaccines? Or nothing at all?

Thank you so much for taking the time to read this.

[sugarcatmom]

Originally Posted by Zai

What should I do about future vaccinations? Every 3 years under closely supervised conditions? De-activated vaccines? Or nothing at all?

If Isis were my cat, I would never vaccinate her again. Actually my own cats have only had their kitten series for FVRCP (no rabies, no FeLV vax) and that's all they'll get. Ever. I think we are way over-vaccinating our pets and it's actually causing more health problems than it prevents. Your kitty likely has enough immunity from the shots she's received already but if you're in doubt, you could always have titres done (although again, even if her titre is low I personally wouldn't revaccinate).

Just an aside, what does Isis eat? Diet can play a role in immune system stability and I'm wondering if there might be something in her food that is pushing her to be hyper-responsive to things in her environment.

[Zai]

Hi, thanks very much for responding. My instinct is the same, I don't want to vaccinate her again and like you, I suspect the vaccination schedules we are given have a lot to do with how many vaccines pharmaceutical companies wish to sell.

I too have been wondering since this episode whether the powdered egg contained in her food could be a culprit. After the shock, I stopped feeding it to her for a while just in case she is allergic to egg proteins, a known allergen from what I understand. But all dry cat food has powdered egg in it. :-(

Her wet food is Applaws canned chicken, and her dry food is mainly Sanabelle, a brand which she seems to love, as well as Orijen or Applaws from time to time for more variety... I am at a loss to think how to feed her healthily and affordably if I am to start avoiding all traces of eggs.
Luckily I had told the vet about my suspicion concerning eggs and when he spayed her he changed the anaesthetic protocol to avoid using a drug with traces of egg in it. Unfortunately, I think both he and I forgot about the whole egg question mark for the vaccination... :-(

Do you know whether there is an allergy test available for animals? Though I am reluctant to take her yet again to the vet's poor thing, it's been one thing after another recently!

Thanks for your help!

PS: Isis needed the rabies vaccination because she lives, like me, between France and England so it was a requirement in order to travel... :-/
PPS: read 'reluctant to take her to the vet yet again just yet'...I am a firm believer in taking animals straight to the doctor as soon as I suspect they might be unwell, don't get me wrong! It's just that the poor thing is still quite stressed by her ordeal and hides from me if she thinks I might be getting her carrier out, something she never used to do before the incident.

[sugarcatmom]

Originally Posted by Zai

But all dry cat food has powdered egg in it. :-(

I would stop feeding her dry food if you can. Cats should ideally only eat wet food, for reasons you can read about here: www.catinfo.org

Originally Posted by Zai

Her wet food is Applaws canned chicken, and her dry food is mainly Sanabelle, a brand which she seems to love, as well as Orijen or Applaws from time to time for more variety...

If I'm reading the Applaws website correctly, their canned products aren't nutritionally complete and should only be fed as a treat (no more than 10-15% of the cat's diet). Can't find anything regarding the Sanabelle food online.

Would you at all be interested in feeding her a raw diet? That way you'd have total control over what goes into her food. Takes a bit of research to make sure it's adequately balanced, but it really is the ultimate healthy cat food if done correctly. If that isn't an option, I truly think she would benefit from 100% wet food. You can leave it out for free-feeding as well, it doesn't go bad like you think it would as long as you toss whatever is left after 12 hrs.

Originally Posted by Zai

Do you know whether there is an allergy test available for animals?

There are, but I don't know if they'd be helpful in your situation. You can get skin tests done for environmental allergies (which can be valuable), and some companies offer blood tests supposedly to determine food allergies, but those are completely unreliable in cats and I wouldn't waste your money. For food allergies, really the only way to figure them out is by doing an elimination diet. Switch to a novel protein source like venison or rabbit, something the cat has never had before. I would eliminate all carbohydrate sources except maybe some low-glycemic soluble plant fibre like zucchini or lettuce. Feed that exclusively for at least 6-8 weeks, then slowly start adding in other protein sources and wait to see if there's a reaction. Not sure what's available in Europe but here there are some pretty decent pre-made frozen raw diets, although making your own would be the cheapest option.

As for the rabies vaccine, is there anyway you can get a medical exemption from the vet? Here, a vet can write a letter saying the cat has been vaccinated in the past, but that due to a medical condition, he can't be vaccinated again. Sometimes titre tests are also sufficient. But again, I have no idea if that's an option for travelling between countries in Europe.

[Zai]

Thanks very much for all your advice. Her main diet is the dry food, with a small portion of wet food daily, and regular treats of chicken (raw or cooked), red meat, and white fish. I don't think I can switch her to an all-raw diet only for logistical reasons, and a couple of doctors have told me that it is very unlikely she is allergic to something in her food since she doesn't seem to react to it as directly as say, dust, or other things. They have told me that if she is getting daily doses of an allergen either she would build up immunity to it or it would trigger stronger reactions, so either way it would not be the main culprit. If her hypersensitivity persists however, perhaps that will be the only resort, perhaps the allergy test you mention could enable me to rule out the egg allergy...

I was wondering whether the steroids I give her (inhaled) to treat her asthma could be modifiying her immune response to things?

I am also wondering whether I should get a child epinephrin pen or something, in case one day she goes into shock very suddenly again and I don't have a vet as close to home (I'm thinking bee stings and other potential allergens she might develop a reaction to...).

Is there any way I could make my post more 'visible' on this forum? I'm very grateful for your help Sugarcatmomma, but I was wondering if anyone else on this website has had a similar experience? If so I'd love to hear from them!

[sugarcatmom]

Originally Posted by Zai

I don't think I can switch her to an all-raw diet only for logistical reasons,

What about canned food then?

Originally Posted by Zai

and a couple of doctors have told me that it is very unlikely she is allergic to something in her food since she doesn't seem to react to it as directly as say, dust, or other things.

But it could be a cumulative effect, like the straw that broke the camel's back. Immune system balance is a "whole body" issue, and diet plays a big role. The over-processed denatured proteins in kibble can cause the body to think it constantly has to defend against foreign invaders. So maybe dust or vaccines wouldn't normally be a big issue, but when combined with constant exposure to a species-innappropriate food source, the hyper-vigilant immune system becomes overreactive.

Originally Posted by Zai

perhaps the allergy test you mention could enable me to rule out the egg allergy...

The only way to rule out an egg allergy is to eliminate it completely from her diet. There is no other reliable test for food allergies.

Originally Posted by Zai

I was wondering whether the steroids I give her (inhaled) to treat her asthma could be modifiying her immune response to things?

I really don't know, but again, I see this as a more systemic issue. There are some vets that specialize in holistic allergy treatment, not sure if that's an option where you are.

Originally Posted by Zai

I am also wondering whether I should get a child epinephrin pen or something, in case one day she goes into shock very suddenly again and I don't have a vet as close to home (I'm thinking bee stings and other potential allergens she might develop a reaction to...).

Some people keep Benadryl on hand in case their pet has an allergic reaction. May buy you some time while you're trying to get Isis to a vet.

Originally Posted by Zai

Is there any way I could make my post more 'visible' on this forum?

I guess just keep bumping it up with posts. Things kind of ebb and flow here, so sometimes it's rather quiet. Could also be that nobody else has dealt with your issue.

[sugarcatmom]

One thing I forgot to mention regarding her asthma is the potential for cat litter to be a problem. Does she go to the bathroom inside or out? If you do use cat litter, what kind is it? Dusty clay litters, especially if they are scented, are infamous for causing respiratory issues in cats.

[Zai]

Thank you Sugarcatmom, I think you may well be onto something with the systemic issue being linked to food, it makes absolute sense and I think I probably need to rethink her whole nutrition.

Her return of asthma coincided with her moving back with me to the UK where (contrary to France) we have carpets in the flat. She also goes out a lot less here and seems to prefer to use her litter box (I imagine for territorial reasons, we don't have our own garden here so she is not in "her territory" when she goes out), so the litter was the first thing that sprang to mind. She used to use "cat's best öko" litter, which is a pine-based clumping litter. Not too dusty, but reasonably dusty. I stopped that litter since I realised pine is also an allergen, and tried just about everything else under the sun. I quickly realised that clay litters, especially the clumping ones, were horribly dusty as well as extremely unhealthy, I used one for a day and then decided it just didn't feel right plus was dustier than I expected. In fact, all the other litters I tried were dusty, even the non-clumping ones, so I tried paper pellets, but she refused to use those. She had been pretty good about changing to the other stuff but paper was an absolute no-no. So the compromise we've reached and which seems to work is wood pellets: although it is pine so still potentially allergenic to her, she likes the smell and is happy to use them. Also, the pellets are very big so hardly dusty at all, and I clean the litter almost daily so that there is no accumulation of sawdust at any time... hard work but worth it!

Thanks for your help, I really appreciate it.

[sugarcatmom]

Originally Posted by Zai

So the compromise we've reached and which seems to work is wood pellets:

I'm a fan of the pellets myself, although you're right about not all cats liking the texture. I use a blend of paper and pine, and the dust is almost non-existent, which is great cause I'm the one in our household with asthma!

Glad to help, and I hope you get to the bottom of your kitty's issues. She looks like such a beautiful cat!