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  #31  
Old December 1st, 2009, 11:46 PM
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Good to hear Mikey is feeling better already You are right definately don't change anything until after the next lab report.

For McKinley's transition off dry food here are some tips http://www.catinfo.org/#Transitionin...o_Canned_Food_

I know I can speak for sugarcatmom and myself in saying you are very welcome we are just glad Mikey is on his way back to being himself
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  #32  
Old December 2nd, 2009, 08:42 AM
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Thanks for the food transition tips...I'm excited to try this but want to be careful about it. I would love to have the supplement mix, trying to do that myself is time consuming (I even had to crush the pills myself) and worrisome because I'm not sure of exact conversions.

We got the rest of the urine results back, no more blood in the urine, still high white blood cells (fighting infection?) and some dead cells that the doc said were from the bladder flushing out. No indication of continued inflammation too.

Mikey was SO good yesterday and this morning until noon, then he started crashing again...I feel like I'm on a roller coaster. He ate really good (K/D) all yesterday and today until noon, now won't show interest in anything. I'm currently waiting on my chicken to finish slow cooking to mix with the pumpkin and supplements I put together following the recipe on the Feline Futures website. I'm so hoping that will entice him to eat.

Is it normal for a cat to fluctuate like he is? He feels better for a while then crashes back down to feeling crummy. The thing keeping me sane is that every time he seems better, the duration of 'betterness' lasts a little bit longer. I wish I could magic away his pain.
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  #33  
Old December 3rd, 2009, 01:51 AM
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What symptoms is he showing when you say "crashing"?

Has Mikey been to the litterbox?

How did Mikey react to the cooked chicken? Has he eaten some?
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  #34  
Old December 3rd, 2009, 07:49 AM
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Yes on the litterbox trips, both kinds. We keep him separated from his sister about half the day to monitor that. He doesn't seem to be straining or 'worried' when using the litter box either, to date.

Crashing-he seems like he's getting better, purring, wanting to be petted and snuggled. He'll play a bit, move around, etc. Then all of a sudden he starts withdrawing. He moves further away from us, doesn't want to be touched, then wedges himself behind/under things. His tails starts twitching and he won't eat. This has happened four times now. Each time he's 'better' for a bit longer time and the 'crashing' doesn't last as long or seem quite as bad. But it's still scaring me. I'm so afraid we're missing something. Is it normal (let's say it's FLUTD and not Kidney disease) for him to take this long to heal? He's still a bit weak and wobbly and his hind legs especially seem just a tiny bit funny when he walks. Also, when he's sitting on his haunches or sitting with his head up, he has this odd little waver to his head. It's a tiny, almost imperceptible, back and forth movement.

He did eat the chicken breast. He's also eating the pumpkin/chicken recipe from Feline Futures. I used the supplements that I had from the last time I was cooking for him. I'm putting lots of water in it, too, when he eats to make sure he stays hydrated. That said, he just ate a couple of bites, then went and drank a bunch of water from two different water bowls-I'm not sure if this is a good or bad thing.

Overall, he does seem better, but it's not a steady incline of improvement, it's a huge rollercoaster and it's freaking me out that I'm missing something, something important!
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  #35  
Old December 3rd, 2009, 08:13 AM
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Poor kitty.

Is it possible that he is getting into some toxins?

Here is a great link to explain reading cat's blood work results:

http://www.sniksnak.com/cathealth/labreports.html
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  #36  
Old December 3rd, 2009, 08:42 AM
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Thanks for the link to the website, I'll check it out.

I can't think of any way that Mikey could be getting into toxins now. He's a huge plant chewer-but he hasn't chewed on anything in at least a couple of weeks. We take them outside to 'play' in our yard and a couple of weeks ago my husband 'lost' Mikey for a bit (not a good day for him). Mikey was outside in very hot weather and absolutely could have gotten into all sorts of toxins, including weird plants and even a snake bite (this is Thailand after all). We saw no marks no him, no vomiting, just lots of open mouthed panting. I'm not sure how much this could play into his current state.

As I write this, he is currently once again 'withdrawing' and hiding in the back room behind the ironing board.

The more I research, the more I'm wrecked with guilt. I had Mikey on a primarily dry kibble diet (grain free and high quality, but still dry) AND then I started feeding him loads of crappy, total fish based Thai wet cat food...the two worst things you can do for a cat to contribute to urinary problems. I'm an idiot. Lesson learned, I just pray it's not too late...
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  #37  
Old December 3rd, 2009, 09:35 AM
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Don't beat yourself up about the kibble Many, many people, including me, put our trust in the pet food industry. It just makes me angry when vets are not educated enough to advise people on good feline nutrition.

Open mouth breathing could be a sign of asthma, blocked sinuses, heart disease or other lung ailments such as chylothorax. Has the vet x-rayed your cat?
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  #38  
Old December 3rd, 2009, 04:00 PM
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MnM,I am so sorry you are still having issues with Mikey,we all get guilt feelings when our animals get sick,feeling we have not done enough or done something wrong.
I feel you are doing everything possible for Mikey,seeing you are living in Bankok,and not having the food choices we have here.
I can justhe'll get better very soon,from whatever ails him
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  #39  
Old December 4th, 2009, 04:27 AM
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Mikey was GREAT this morning, drooling, purring, kneading, etc. He's again been okay this afternoon. Not as bad as before, but still not back to normal. I find myself wondering if it's because his insides are still in chaos that when he eats, it causes pain and discomfort. he stops eating, feels better, so starts eating again...then feels slightly uncomfortable again?

He for sure eats more in the morning before noon than he eats after that. Now it's just some licks and nibbles.

Overall, still on the mend. Can it really take THIS long to heal from FLUTD? I can't find a recovery time anywhere online. I'm still hopeful that Monday's blood/urine tests will indicate progress towards complete recovery. Maybe I'm naive!

He's at least letting me lay next to him now without moving away, so that's progress!
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  #40  
Old December 4th, 2009, 07:03 AM
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I'm wondering if there might be some pancreatitis issue going on here. It can be tricky to diagnose, and while there is a blood test (fPLI) which is helpful, I'm not sure how available it is in Bangkok. Something to keep in mind maybe. In the meantime, I'm so glad Mikey is doing better!
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  #41  
Old December 4th, 2009, 07:41 AM
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Interesting that you would say that...what makes you wonder about pancreatitis? When we did the zillion tests a year and a half ago because of unexplained weight loss, Mikey was diagnosed with pancreatitis. Though the docs kept thinking there must be something else coming on. He was put on metranidazole and immediately gained weight (actually, the only time he gained weight was on the antibiotic, he only maintained weight off of the med).

Could this be an issue right now? Would FLUTD make the pancrease react? I'm so confused!
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  #42  
Old December 5th, 2009, 07:54 PM
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So an update on Mikey-

Overall he seems better-he's is acting much like his old self again. Although he appears to actually be getting weaker (shaky legs front and back, difficulty retracting his claws, that kind of thing).

He's eating well, drinking some, going to the bathroom, purring...so on one hand I'm staring to feel hopeful. But then my husband says he suspects elevated Creatinine is the cause for the muscle weakness...so spiraling back down I go.

I just wish I had a vet here that I completely trusted-could this current muscle weakness be from the elevated Creatinine levels from before, but he could actually be getting better?

Our appt is tomorrow with blood results likely back on Wed night our time. I'm back to being very scared.
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  #43  
Old December 6th, 2009, 12:35 AM
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MnM, I have no answers for you but just lots of

Sugarcatmom and Growler should be here soon to give you some advice.
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  #44  
Old December 6th, 2009, 12:57 AM
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Quote:
Originally Posted by MnM View Post
could this current muscle weakness be from the elevated Creatinine levels from before
It's very unlikely the creatinine would cause it, crf cats with muscle weakness is usually caused by: anaemia, high phosphorus, low potassium, constipation, hypertension, arthritis, metabolic acidosis, diabetic neuropathy, or heart problems.

How much is Mikey eating? Does he look like he's lost weight?

for the blood results & the appt
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  #45  
Old December 6th, 2009, 01:13 AM
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He's eating actually really well! If anything, he's gaining weight!

He responds to being petted, is constantly rubbing his chin up against stuff. But his legs are shakier today than yesterday. I also have heard his joints 'cracking' a few times which I've never heard before. He doesn't seem to be in pain, though. He is doing A LOT of stretching. Even when he was just sitting, he'll suddenly go to walk and stop and stretch. He also lays down oddly, curling his right paw under then slowly dropping his body down, then stretching his legs out in front-which is not how he normally lays down.

We're trying to move his appt up to tonight, that way it's one less day to wait on blood tests.
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  #46  
Old December 6th, 2009, 01:32 AM
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Good news on the eating/weight gain

Mention it to the vet when you see him, it may just be some joint stiffness/trying to get comfortable possibly a bit of normal aging arthritis what with the cracking sounds, you can always try supplementing with something like Glyco-Flex II that has green lipped muscle, glucosomine & msm in it.
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  #47  
Old December 6th, 2009, 01:54 AM
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Glad to hear that Mikey is eating well.

The joint 'cracking' could very well be age related arthritis. :sad:

This is what I am wondering about ...

Quote:
He is doing A LOT of stretching. Even when he was just sitting, he'll suddenly go to walk and stop and stretch. He also lays down oddly, curling his right paw under then slowly dropping his body down, then stretching his legs out in front-which is not how he normally lays down.
As we all know, cats are so very good at hiding everything and, to me, that sounds like he is in pain. :sad:
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  #48  
Old December 6th, 2009, 04:58 AM
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I'm in agreement that I don't think this is age related...it is definitely out of the ordinary behavior and increasing day by day.

He's in the 7th hour of no food now so we can do the blood test tonight, he's not thrilled about this-which is a good thing I think. He's right now playing with my husband and his favorite long piece of ribbon.

...which didn't last long because he suddenly seemed to feel pain and halted his playing. It seems to be primarily his back right leg now, but all of his legs are wobbly and weak.

I can't believe I have to wait two days to get blood test results! This is killing me!
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  #49  
Old December 6th, 2009, 09:05 AM
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Back from the doc's...I still feel as lost as I did before.

The doc said he had a type of 'strain' in his right back leg and one in his right front leg. This he was worried could be caused by 'rubber bone' which is a problem with kidney disease...and it's not 'fixable'. So they x-rayed him while I quietly cried. Not rubber bone-so that's some decent news I guess.

His urine isn't as great as we'd like: USG fell to 1.026 but the doc said that could be because of the Leuco which is still at 3+.
Ph 6
Protein 1+
Bilrubin 1+
All else negative or normal.

The vet said tomorrow we should get the blood tests except for the fructosamine that we're having done, that will take a week (sigh). The vet is now leaning more towards diabetes than kidney disease. And then he suddenly starts saying something about the pancreas. I tried to figure out if he does have pancreatitis (which he did have before a year and a half ago) could THAT lead to diabetes and then the muscle weakness that he's experiencing now? And if so, if we can get the pancreas under control, would the diabetes regulate itself so he could lead a normal life? And sugarcatmom already brought up the pancreas...why?

I've been spending all my time researching (or trying to) kidney disease and FLUTD. Now I have to turn to diabetes and pancreatitis...maybe. I'm so scared that there is something happening that we're missing and he's going to slip away or have permanent, irreversible damage. I did get some electrolyte powder from the doc today to try and see if that helps with the weakness (it's orange flavored so I'm going to try and find it w/out flavor tomorrow). The doc could tell that there was significant muscle weakness and that the damage was caused because of this muscle weakness.

I am so frustrated and scared.
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  #50  
Old December 6th, 2009, 11:53 AM
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Quote:
Originally Posted by MnM View Post
I tried to figure out if he does have pancreatitis (which he did have before a year and a half ago) could THAT lead to diabetes and then the muscle weakness that he's experiencing now? And if so, if we can get the pancreas under control, would the diabetes regulate itself so he could lead a normal life? And sugarcatmom already brought up the pancreas...why?
Pancreatitis and diabetes frequently go hand-in-hand, yes (the pancreas is where insulin is produced). The reason I was wondering if maybe Mikey had pancreatitis was because of his waxing and waning symptoms that seem to correspond with eating, plus his periodic hyperglycemia. Since cats more commonly develop chronic pancreatitis (as opposed to the acute form), and may have periodic symptom flare-ups throughout their life, I think the fact that Mikey has had pancreas issues in the past is a big clue here.

Hard to say what the connection would be with the muscle weakness. Pancreatitis can result in electrolyte imbalances, which may be a factor. Pain can manifest as a stiff gait or odd positions while lying down. Diabetic neuropathy usually develops after pro-longed hyperglycemia, so hopefully the fructosamine results shed some light on whether that's an issue.
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  #51  
Old December 6th, 2009, 03:56 PM
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MnM,I let our kitty-experts do the advicing,I just wanted to say,I feel for you and hope you and Mickey will get some definite answers very soon
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  #52  
Old December 6th, 2009, 07:07 PM
MnM MnM is offline
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Thanks everyone for the positive thoughts and kindness. It helps.

Sugarcatmom-I am more and more wondering about the pancreas too. Unfotunately, the doc said they do not have the test here in Thailand (but at least he knew what the name of it was!). All of the sites I have read, though, say it's almost always characterized by a decrease in appetite. This is definitely not Mikey. However, last time when they did diagnose it (based on an ultrasound), Mikey was actually begging for people food-jumping on the counter and ripping open pizza boxes which was NOT him at all, refusing to eat his dry kibble. I always thought he was trying to eat something/anything that would make him feel better-like he felt bad and was trying to find that magic thing to make it go away. Again, I was feeding him some crappy Chinese Whiskas fish packets because he had struggled with constipation once, so I was supplementing his dry kibble with one packet a day(we lived in China at the time). He lost over 2 pounds, but gradually over the course of three years so it wasn't really noticeable/worrisome until he fell under the 8 pound mark. Then they gave us metronidazole and the ONLY time in a year and half that he has gained weight was the two times he was on that med (gained 1/2 pound in ONE week when he first started it).

All night last night I woke up to Mikey wanting to snuggle, but I could hear his joints cracking-which is breaking my heart. WHAT IS GOING ON???

The doc should call tonight with his blood test results-minus the fructosamine. I'll continue to give him the electrolyte powder and see how that goes.
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  #53  
Old December 6th, 2009, 09:17 PM
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I would suggest an abdominal ultrasound that way they can check the pancreas, kidneys, intestines and bladder all at the same time & ask them to take a quick peek at Mikey's heart since you're already there & then they can rule out or confirm everything all at once.
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  #54  
Old December 7th, 2009, 08:00 AM
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So the vet called with the blood test results, then we went in to the vet to talk about them because we were so confused...we spent over an hour discussing things with him (which we were not charged for, pro for Thailand). Unfortunately we're still just as frustrated and scared (con for Thailand).

So here are Mikey's latest blood results (Potassium we'll hopefully get tomorrow):
BUN 28 (down from last time from 30.2) [norm 7-26]
Creatinine 2.07 (down from 2.4) [norm .4-1.8]
SGPT/ALT 56 [norm: 5-60]
ALK.P 29 [norm 3-60]
Albumin 2.92 [norm 2.4-4.3]
Calcium 10.9 [norm 9.6-11.6]
Phosphorous 4.27 [norm 2.5-6.2]
Total Protein 7.2 [norm 5.8-7.9]
The doc must have called in a favor because the fructosamine also came back while we were meeting with him-290, well within normal range.

So no diabetes, and the kidneys are looking better and better (right?) Phosphorous levels are great (am anxious to hear the potassium). So why the heck is my cat losing muscle/having front and back leg weakness? His joints are clicking more and more...what could be causing this?

The doc wanted us to start subQs again, but we questioned why. Mikey's hydrated, urinating normally, why would we give him 200ml a day? I said unless it will fix the muscle weakness problem, I'd rather not. He sent us home with a calcium supplement and a 'come back on Sunday and if he's not better we'll do an ultrasound'. Sunday is a LONG way from now.

As a side note, we went ahead and had McKinley's blood drawn for a check up as well. HER creatinine came back high at 2.17 (higher than Mikey's is now) but her BUN was only 16. Her SGPT/ALT was 115 (high) and her ALK.P was 89 (high)...he wanted us to start giving HER subQs! I feel like I'm pounding my head against a wall.

We did try and push the pancreatitis theory-but Mikey doesn't exhibit a single symptom...though when we was diagnosed with it before he had zero symptoms except weight loss as well. The problem is the food I'm feeding him is a recipe for kidney problems (lots of pumpkin) and for pancreatitis, this is supposed to make it more inflamed right? HELP! Could pancreatitis cause Mikey's muscle/bone/weakness?
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  #55  
Old December 7th, 2009, 11:29 PM
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Here is an article wrtten on pancreatitis written by a vet.
http://www.manhattancats.com/Article...itis_test.html

As I mentioned earlier if it was my cat I wouldn't wait for Sunday I'd book the ultrasound appt The ultrasound will also check on the kidney stones you mentioned in the first post. Depending on the type & severity of the stones it can cause acute kidney failure which is reversible when treated promptly & correctly.

A few months ago Duffy had an ultrasound to rule out pancreatitis, check the condition of her kidneys and the severity of her heart murmur, all of which were normal/or better than expected but the vet did find some inflammation in her intestines which explained the symptoms Duffy had been showing (sudden onset vomiting, straining to poop, diarreah, bloated doughy feeling abdomin, lethargy, depression) - IBD with previously suspected but now known specific food triggers. http://www.manhattancats.com/Articles/IBD.htm

Was there a FIV test done at any point?
http://www.manhattancats.com/Article...ency_Virus.htm

The numbers look quite good obviously high on BUN & creatinine but not by very much. McKinley's numbers show raised liver enzymes plus the creatinine however if the blood sample was haemolysed the ALT will appear falsely inflated.
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Last edited by growler~GateKeeper; December 7th, 2009 at 11:36 PM.
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  #56  
Old December 8th, 2009, 09:26 AM
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Thanks for the advice growler-it was the catalyst that pushed me to work HARD to get in to see the only cat specialist in all of Bangkok. She only sees patients on referral after they've been to one of the recommended vets and she's only available from 7:30-3:30 on Tues and Thurs and this coming Thurs here is a holiday...so at 1pm today I started the ball rolling (why I waited so long is something that will haunt me). Very long story short-my secretary is my hero. She had a friend who had a friend who was a doctor at the university hospital where the specialist worked. The woman who was near impossible to get an appt with I saw within a couple of hours. I spent 5 hours there, saw 5 different doctors...and walked away with a diagnosis of Progressive Polyarthritis. It makes me sad-but I'm hopeful that they are wrong and Mikey can make a full recovery. He will start taking glucosamine and he's on some pain killers temporarily. He already seems better (pain killers?) but they said it will take up to 6 weeks to see the glucosamine and how much cartilage can be regenerated. Their fancy schmancy x-rays showed he's lost all cartilage in the back hock joint and much in the hip.

So the entire vet visit (5 hours, 5 docs, x-rays, some blood work) cost me around $25USD...the glucosamine? Over $50USD! Thailand is so interesting.

I have just gotten home, exhausted and emotionally drained so haven't even begun to learn about the 'new' disease my boy has. Or about the Meloxicam he's taking for pain (.15 mg today, tomorrow, then e/o day for a week). The box said for dogs, but the vet said it was approved for use in cats in CA...not US.

What still continues to baffle me, is how quickly this came on. I always thought arthritis was a slow progression towards worsening...my boy went from fine to all cartilage gone in his hock joint and other joints looking bad in less than a week! I will probably feel more sad tomorrow, but right now, I'm relieved to have a diagnosis and treatment.

FYI-Mikey is digging the raw food, I added brown rice b/c my other vet was freakin' about the kidney issues. This vet said 'pooh' to the creatinine and BUN...high'er' but not HIGH she felt. Next time no brown rice I say!

Any thoughts or advice would be appreciated. Again-you all have been an invaluable resource. My husband calls you my 'peeps' now: "you writing to your peeps?". Thanks so much for being there.
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  #57  
Old December 8th, 2009, 10:20 AM
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I don't know how similar it is, but my sister's dog got this diagnosis a couple of years ago. She says that acupuncture has completely changed his life. When it hit his spine, their vet told them that he may not have much longer, but in the month or two of acupuncture, she says he's no longer exhibiting pain at all. It might be worth looking into - seems like something that might be available there. It's called Eastern medicine, right?
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Old December 8th, 2009, 05:30 PM
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Originally Posted by MnM View Post
I spent 5 hours there, saw 5 different doctors...and walked away with a diagnosis of Progressive Polyarthritis.
At least you have something to go on now.

Quote:
Originally Posted by MnM View Post
I have just gotten home, exhausted and emotionally drained so haven't even begun to learn about the 'new' disease my boy has.
I did find some info on how it might be related to a retrovirus called Feline Syncytia-Forming Virus (FeSFV), and how that virus might have a tenuous connection with FLUTD, which I thought was rather interesting.
http://www.familyvet.com/Cats/Imune.html

Quote:
CHRONIC PROGRESSIVE POLYARTHRITIS

Progressive polyarthritis is a disease characterized by joint damage in young or older cats. While this is considered an immune mediated disease, there may be a link to feline leukemia virus and its relative, Feline Syncytia-Forming Virus. (FeSFV) All cats with the disease have been found to be positive for FeSFV and over 60% are positive for FeLV. Immune complexes (clumps of antibodies and antigens) related to these viruses seem to be involved with causing the damage related to the disease.

There are two classifications of the disease; a surface inflammation of the bones and joints most common in young male cats and severe joint deformity most often seen in older cats. Besides damage and inflammation of multiple joints which gets worse over time (hence the name), clinical signs include fever, weight loss, loss of appetite, muscle wasting, lameness and joint swelling. Diagnosis is based on history, clinical signs, physical examination, X-rays, joint fluid cytology, blood counts and serum chemistries. Most cats get worse with time but can be maintained with early and aggressive therapy.

TREATMENT OF CHRONIC PROGRESSIVE POLYARTHRITIS

Cats positive for feline leukemia will often respond poorly to treatment. FeLV negative cats can do well on prednisolone therapy alone or combined with azathioprine and cyclophosphamide. Adequan, Cosequin or Synovi-Cre may also be helpful but little research has been done as to their effectiveness.

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Originally Posted by MnM View Post
Or about the Meloxicam he's taking for pain (.15 mg today, tomorrow, then e/o day for a week). The box said for dogs, but the vet said it was approved for use in cats in CA...not US.
Careful with this (also known as Metacam). It's actually not approved for oral use in cats in Canada either, only as a one time post-surgical injection, and it has been implicated in causing or exacerbating renal failure. I realize there's a quality of life issue where chronic pain is concerned, and Metacam can really help some cats. Just keep a close eye on Mikey's kidney values with regular check-ups. I also second rjesak's recommendation to try acupuncture.

Good luck!
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  #59  
Old December 8th, 2009, 06:21 PM
MnM MnM is offline
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Thanks for the info and thoughts!

I will definitely see if I can find an animal acupuncturist here...easy to find for humans, not sure if they've progressed to animals yet. I do like that idea.

I will tread lightly with the pain med...he gets one drop today and then we move to e/o day. I'd like to stop it asap, but also don't want him in pain. I'm wondering if there is another option that has less scary side effects? My husband read something about aspirin?

He's supposed to rest and take it easy too, problem with the pain med is he's feeling better so not resting (went up and down the stairs 3 times last night for no apparent reason. I don't give him his second dose until late tonight...so we'll see.

I'll keep you all posted. I can't tell you how much I appreciate your help and ideas. We are collecting ALL of his paperwork/x-rays to make an appt in Seattle with someone to get another opinion, too. I again can't believe that he went from fine, to no cartilage in less than a week and it happened right after he began to improve from the FLUTD...there just has to be the connection. Thanks-at work trying to do some massive catch up!
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  #60  
Old December 8th, 2009, 07:39 PM
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sugarcatmom sugarcatmom is offline
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Quote:
Originally Posted by MnM View Post
I will tread lightly with the pain med...he gets one drop today and then we move to e/o day. I'd like to stop it asap, but also don't want him in pain. I'm wondering if there is another option that has less scary side effects? My husband read something about aspirin?
I wouldn't use aspirin. Cats metabolize it very slowly and it's too easy for it to reach toxic levels. It won't provide enough pain relief at the low dose you'd have to use.

Not sure how available something like Buprenex (aka Buprenorphine) is in Thailand, but that one tends to have less noxious side effects than most other pain meds, although it can make some cats rather dopey. It's also really expensive (here, anyway).

Other than that, a low dose of Metacam with regular monitoring might be your best bet.

Other supplements along with the glucosamine that could be worthwhile are MSM, chondroitin, green lipped mussel, and omega3 fatty acids (in the form of fish oil).

Some info on chronic pain management: http://www.vasg.org/chronic_pain_management.htm
And a great site with info on arthritis: http://www.harpsie.com/arthritis.htm
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