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Old 11-17-2005, 08:40 AM   #1
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question for people who know cats

Have a cat that who lately has been in and out of vets offices, hospitals etc, thought Id see if this rings a bell with anyone here.

Cat is 12 years old going on 13. He has history of renal failure but that was earlier in life, seemed to have subsided and when signs are evident we have medication for it which helps.

Started a few weeks ago. He has been not himself, not meowing, lethargic, stopped eating, seems to be in discomfort when he lies down, or walks, doesnt greet at door anymore, just acting differently.

After exhaustive bloodwork, xrays, ultrasounds and ct scan, here is what they found. Initially urinary tract infection. After trying 2 types of antibiotics we were told to take him off because they didnt seem to be agreeing with him. Found out infection was e-coli type. took him to see cardiologist and an internal specialist. Xray revealed a mass on his lung. Nothing else found other than the mass. Ultrasound and CT scan found nothing that would indicate why he has stopped eating or would be in pain. Intestines, liver, kidneys, colon everything seems to be fine. Just the mass on his lung. This has been there for 2 years and has doubled in size in 2 years. It appears localized and not spreading or increasing at fast pace. Bloodwork, everything appears fine, they even checked his larynx to see if there was blockage, nothing.

Question is - what could be causing him not to eat - we just cant figure it out. We have tried everything and nothing seems to work. Will removal of the lump make all that go away, or is something else going on? maybe he is just upset with all the poking and prodding. Maybe he just isnt feeling well. He is not coughing, sneezing, breathing heavy, nothing to indicate anything like that.

Does this ring a bell of wisdom with anyone who has cats?

Right now we have appetite stimulants, we have dietary food, we have veggie in tube to force feed, we have some pain medication in case he is in pain and discomfort, we basically have pills up the wazoo...

Any ideas?
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Old 11-17-2005, 09:39 AM   #2
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I would be inclined to think he is not eating because the lump on his lung is causing him discomfort. The first reaction animals have with pain is to stop eating. I just had my 14 year old dog put to sleep because she had a mass on her spleen (sp?) and she had stopped eating. It was hard for me to make that decision but I did not want her to suffer.
I hope your cat gets better and best of luck.
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Old 11-17-2005, 09:56 AM   #3
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we were told by all specialists that there experience with this type of lump, the cat shouldnt be in pain or discomfort, esp since he has had it for awhile. They dont see any trouble with removing the lump but cannot tell us that by removing it will make him better. You just dont want to put cat through any more than absolutely necessary...Id hate to cause him more pain if that is what he is in, noone seems to know and they all seem to conclude that he shouldnt be in any.
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Old 11-17-2005, 10:53 AM   #4
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My act stopped eating because he caught feline hepatitis. They gave him some medicine and he got better.
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Old 11-17-2005, 11:10 AM   #5
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My job is so frustrating sometimes esp in cases like this - it would be so nice if we could talk to them to ask them where they hurt, how they feel etc.

I think the mass could be part of it, esp if it is larger than it was previously. I'd also be interested to know his kidney values, the docs may not think they are 'that bad' but I've found that many cats appetites decrease when their phosphorus level goes above 5.5. Have you tried an antacid like Pepcid AC (famotidine)? Cats with kidney issues can have problems with excess stomach acid production, and sometimes an acid reducer will help their appetite.

Cats can feel surprisingly bad with a bladder infection - did they get him back on antibiotics once they knew for sure what he had? The longer they have an infection in their bladder, the more at risk they are for the bacteria going up the tubes to the kidneys, causing a kidney infection, and making them really sick.

You've been through alot, sorry you haven't gotten any good answers - unfortunately that is often how it is in medicine
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Old 11-17-2005, 11:33 AM   #6
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he has seen so m any vets and specialists and has had all his bloodtests etc done, I will check the level results when I get home to see if it give phospherous level reading. I know his other levels, compared to his previous tests were pretty normal, but at this point I really really appreciate a bit of information that we can look for. Its frustrating when every single doctor tells you everything looks normal. You pay for all these tests thinking maybe they will find the cause, but nothing.
Strange that all of a sudden the mass would make him turn on a dime so top speak, there was nothing subtle to pick up on, it was an overnight occurence and ever since he doesnt come around. Thanks for the info, and if you dont mind I will come back tomorrow once I look at his blood result sheet and let you know if it is perhaps high as you suggest.

Thanks so much, I hope I find this and it explains everything, somehow I dont think it will, but it would certainly be nice to have an actual answer.

The surgery costs quite a bit of money, but it is only money. If someone could tell us it will help. If someone could tell us it would prolong his life. I dont think we would have qualms about it. But if we put him though the grief and if gives or improves nothing, then Im not so sure we could go through with it. The only thing it would do is give more pain.
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Old 11-17-2005, 11:36 AM   #7
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I would echo what Bonosloveslave said about the lack of appetite potentially being tied to the kidney issues; to my knowledge renal failure doesn't actually reverse (BLS weigh in here?), so given he had some kidney insufficiency earlier in life, I would suspect that it may be the culprit.

One thing I have also seen is kidney values looking better than they really are due to hyperthyroidism, which can sometimes "mask" renal failure. Has your vet looked at/ruled out hyperthyroidism?
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Old 11-17-2005, 11:48 AM   #8
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and yes once they founf the urinary tract infection to be e-coli, they switched the antibiotic that we had to give him. BUT, after about 4 days on giving him, he didnt seem to be getting any better or different, so back to vet we went, and she told us to stop the antibiotic and wait for utlrasound and ct scan results to see if something was going. but that found nothing other than the lump on his lung. His renal failure hasnt creeped back on him for awhile and they did check and it all seemed to be ok back there. And they did say that for a cat who was disgnosed with renal failure before, the levels look ok and dont indicate that there was any indications with respect to that.
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Old 11-17-2005, 11:50 AM   #9
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Quote:
Originally posted by Catlady
I would echo what Bonosloveslave said about the lack of appetite potentially being tied to the kidney issues; to my knowledge renal failure doesn't actually reverse (BLS weigh in here?), so given he had some kidney insufficiency earlier in life, I would suspect that it may be the culprit.

One thing I have also seen is kidney values looking better than they really are due to hyperthyroidism, which can sometimes "mask" renal failure. Has your vet looked at/ruled out hyperthyroidism?
Internal specialist mentioned possibility of something masking but I dont know if that was the term he used. But I will write it down and ask.
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Old 11-17-2005, 11:57 AM   #10
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good luck and please come back and let us know what you learned...

here are some kisses and hugs for sick kitty from me
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Old 11-17-2005, 10:40 PM   #11
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If they actually cultured e-coli and has not been treated for that, they need to try something else or another route to get on top of it. If they did not perform a culture on the urine and just *think* it is e-coli, they need to attempt a culture and sensitivity - where they find out what species of bacteria it is, as well as what antibiotics it is responsive to. Most e-coli infections will respond to an antibiotic called Baytril/enrofloxacin. If he has been on this orally and potentially had stomach upset, it comes in an injectable version that cats rarely have GI upset with when given under the skin. Even if this is not the biggest issue with his appetite, there is still the worry of progressing to a full blown kidney infection if he does not get the proper antibiotic for it. On my cats when we get a positive culture and we know they have kidney issues, I never do less than 4 weeks of antibiotics, and always reculture 1 month after they have finished antibiotics to make sure the infection is totally gone.

In regards to the lump in his chest, something to keep in mind is that cats, as a species, are genetically programmed to hide problems for as long as possible. If they show signs of weakness/illness in the wild, there are many creatures bigger than them who would eat them for lunch. If it is bigger now, he may just be at his breaking point where he can't hide that he doesn't feel well. That said, there are no guarantees that removing it will put him back to normal again. Hard choice, I know

But yes, let me know if you have the numbers for his most recent kidney values - and CatLady is right - generally once they show signs of kidney disease, it gets worse over time
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Old 11-18-2005, 08:07 AM   #12
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They did urinalysis and they waited for culture and found bacteria to be e-coli. They prescribed Zenequin for it. We took him off but he is back on again.
The blood work shows elevated Amylase, Urea and Creatinine but they keep stressing that they arent at levels that they would say are critical or high. His Potassium level is 5.0
amylase is at 2324, indicates normal range is 300-1400
urea is 11.5
creatinine is 218

When he was first diagnosed with CRF, his levels were higher. They never prescribed anything for him at the time other then change his food to the low-protein calorie reduced diet formula. SO he has never had anything medicinal for it. Even now with knowing his hitsory and his blood results they still do not speak of this as source of ailment. Ultrasound is usually a telltale sign of pinpointing something like this from what Ive read, and his ultrasound showed nothing abnormal. His blood counts are normal as well.

I am calling specialist and the vet the find out about getting 2 tests done - a t-4 test and a reticulocyte count test. The other thing I am curious about is if he has acid buildup in stomach causing discomfort. Found some information that some vets suggest Pepcid AC which is people pills so that is wierd but something Id like to look into as well.

Do these make sense at this point to test or witll they not show us anything substantial to help.
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Old 11-18-2005, 12:10 PM   #13
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one more followup
I just spoke to the specialist at emergency hospital and he says that the levels on the blood work, although elevated are really not that high to point to the reanl failure being a problem at this point. He says the levels should be much higher. I asked about stomach acid and further blood tests, and he said that stomach acid is a later sympton and again his levels would be alot higher so he doesnt even see that as something to look at but he did say we could do another blood test to compare the 2 to see if his levels have gone up?

Gosh, and here I thought maybe I had an answer for his behaviour, but we seem to go around in circles. They seem stuck on the lump on his lung and dont appear to be worried about anything else.
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Old 11-18-2005, 04:43 PM   #14
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IMHO, you should do the t-4; if they haven't ruled out hyperthyroidism those renal values you're getting could be way off.

Bonosloveslave whadda you think? Have you seen hyperthyroid mask renal failure before?
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Old 11-18-2005, 08:45 PM   #15
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An overactive thyroid yes can cover up kidney disease - though far and away the most common sign of thyroid disease in cats is a large appetite but losing weight. Not all cats read the book though, and it never hurts to check in an older cat.

I have seen quite a few cats with early kidney disease eat much better after getting antacid - we usually use Pepcid AC, average sized cat gets 1/4 tablet every 12-24 hours. If he has never had it, definitely wouldn't hurt to try. The kidneys normally play a role in regulating how much stomach acid is produced. When they are not working like they should (regardless of the stage of kidney disease), the stomach left to its own devices tends to produce way too much. This can make cats prone to nausea or general inappetance, sometimes ulcers. There are no side effects to the Pepcid AC, no significant interactions with drugs so I would start him on it if he hasn't been on it already. Cats will also tend to feel nauseous when their kidney values are high - but these are 2 seperate mechanisms that can make them feel icky.

Zenequin is very close to Baytril so that is good, it is even less likely to cause stomach upset.

You're in Canada right? They measure the values differently so I'm not sure how to interpret those numbers without the normals - i think I can find them online somewhere. Did they check his Phosphorus level recently?

We usually only think about doing a reticulocyte count when they are anemic, so if no one has mentioned him being anemic, I don't think that would be too helpful.

One other test that may help, if it has not been done, is a TLI/cobalamin/folate level. This is a blood test that can let us know if the GI signs are coming from the pancreas and/or intestines. If their pancreatic enzymes are elevated (TLI), even if the pancreas looked ok on ultrasound, that says they are in the midst of pancreatitis and affected as he is, likely would need steroids to get over the hump. It also lets us know that he is going to be more prone to episodes in the future. The other things are vitamin levels, if they are low we know they at the very least need to be supplemented - but that there is intestinal disease going on that may need to be addressed. If all normal then that is probably not the problem area.
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