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Dr. B.
Dr. B., Cat Veterinarian
Category: Cat Veterinary
Satisfied Customers: 20277
Experience:  Small animal veterinarian with a special interest in cats, happy to discuss any questions you have.
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My 10 month old female cat was recently diagnosed with FIV+,

Customer Question

My 10 month old female cat was recently diagnosed with FIV+, she's on prednisolone twice per day. Friday she took a turn for the worse...too weak to walk and is gulping every few seconds. Won't eat or drink
Submitted: 2 years ago.
Category: Cat Veterinary
Expert:  Dr. B. replied 2 years ago.
Hello & welcome, I am Dr. B, a licensed veterinarian and I would like to help you with today. I do apologize that your question was not answered before. Different experts come online at various times; I just came online, read about your wee one’s situation, and wanted to help.
Again I do apologize that my colleagues could not aid you sooner, but can you tell me:
Why has your cat been put on steroids specifically?
Are her gums pink or pale/white? Moist or sticky?
If you press on her belly, does she have any discomfort, tenderness, or tensing?
Could she have eaten something she should not have (ie bones, toys, string , plants, chemicals, etc)?
Has she had any diarrhea?
Are her stools black?
Any vomiting?
Customer: replied 2 years ago.
Good Morning Dr. B - I'm grateful to finally have someone with which to discuss Maui's condition. I can answer yes to the diarrhea and vomiting (each for at least 24 hours) and it's likely she does have a tender stomach because she moans when I pick her up. I believe the veterinarian that diagnosed her FIV said the steroids were for the inflammation. She is very weak in her rear legs and has to really work not to fall. She only goes short distances before needing to rest. I really don't want to put the kitty to sleep, I'm trying ascertain whether she is at the end of the disease and suffering
Expert:  Dr. B. replied 2 years ago.
Thank you,
I have to say that I am quite concerned about Maui and her current state.
Just further to getting a clear picture of her situation, are her gums pale?
Did she have the vomiting/diarrhea before the steroids were given?
Any black feces? Or does she vomit coffee ground like material?
Customer: replied 2 years ago.
Unfortunately based on where she's currently hiding I won't be able to answer the question re: her gums. No diarrhea or vomiting before the steroids but she did have what appeared to be an upper respiratory infection. If I'm accurate ...she is vomiting clear liquid. Her stool has always been the appropriate color
Customer: replied 2 years ago.
Are you still reviewing Dr. B?
Expert:  Dr. B. replied 2 years ago.
No worries,
When she is out next, we would want to take a peek. The reason I was asking about gum color is because we can see FIV invade the bone marrow and cause anemia. And a drop in red blood cells in circulation can cause weakness, lethargy, deterioration, changes in breathing rate, and wobbliness.
And I do have to note the episodes of going a short way before needing rest you mentioned make me concerned that this could be related to her not having enough oxygen in circulation (due to too low red blood cells to carry it) to feed her tissues and therefore she becomes easily winded. But after she takes a break, the oxygen level raises, she can continue until the same happens again. So, I would just be wary that we may be seeing anemia causing that side of her signs.
Otherwise, I have to say that I am concerned the steroids may also be an issue. As I am sure you can appreciate, FIV+ cats tend to have very weak immune systems (just as HIV people do) and can be highly at risk of catching GI bugs (bacteria, viruses, etc). As well, while steroids can be used to treat inflammation (and stimulate red blood cell levels), they can dampen the immune system. And this could increase the vulnerability of an FIV+ cat to catch those GI infectious agents even more. And I would be more concerned that is why we have the GI signs (and thankfully if she has no black feces we don't have to be as worried that the steroids have caused bleeding in the gut to cause all her signs).
Now considering all you have told me, we need to tread with care. If she has anemia, then her prognosis will be poor. Still, we can try and address those new GI signs. The gulping is a sign of nausea, even when she is not vomiting. Now I will note some supportive care we can try for her, but with her being immunosuppressed and therefore this carrying a high risk of infectious agents, I would note that she may need to see her vet for at least antibiotics but possibly fecal testing.
Now if she is vomiting but hasn't just done so, we can try to settle her stomach at this point with an antacid. There are a number of antacids that are available over the counter and pet friendly. I would advise only treating with one, but the ones I tend to recommend are
* Pepcid (More Info/Dose @ http://www.petplace.com/drug-library/famotidine-pepcid/page1.aspx#.VGJLgsn9XPg) or
* Zantac (More Info/Dose @ http://www.petplace.com/drug-library/ranitidine-hcl-zantac/page1.aspx)
* Tagamet (More Info/Dose @ http://www.petplace.com/article/drug-library/library/over-the-counter/cimetidine-hcl-tagamet)
We tend to give these 30 minutes before offering food to give it time to be absorbed.
Otherwise, once that has absorbed and if she is more steady on her stomach, we can then tempt her with a small volume (a tablespoon worth to start) of a light/easily digestible diet. Examples of this would be boiled chicken, boiled white fish, scrambled eggs (made with water and not milk), meat baby food (do avoid the ones with garlic powder in the ingredients) or there are also veterinary prescription diets that can be used in cases of gastroenteritis (ie Hill’s I/D or Royal Canin’s sensitivity). Now if she can keep the small amount, she can have a bit more after 30 minutes. And as she keeps it down, she can have a bit more and so on. The aim of these light diets is that they are easy on the compromised GI and tend to be better tolerated. This means less vomiting but also increased nutrient uptake and therefore less diarrhea.
As well, do keep an eye on her water intake as profuse vomiting and diarrhea can quickly dehydrate a cat(and dehydration will make them feel worse and complicate their situation). If you are concerned that she is becoming dehydrated, you can try an encourage her to drink but offering fresh water or even low-sodium chicken broth. You can offer her Pedialyte but do not try to syringe feed it because syringing fluids to a vomiting pet is contraindicated since we don't want to cause further vomiting.
Furthermore, it'd be ideal to assess a hydration status at this stage. To check this and make sure she is not becoming dehydrated there are a few things we can test at home. One is whether the eyes appear sunken, if the gums are tacky instead of wet/moist, and whether she has a "skin tent" when you lift the skin. To see how to check these parameters for dehydration, you can find a wee video on this (http://www.ehow.com/video_12232503_dog-dehydrated.html). They do show these signs on a big dog, but the tests are the same on any animal. If you are seeing any signs of dehydration already, then that would be a red flag to have her seen urgently by the vet before this gets any further out of control.
Further to this, once her vomiting is settling you can consider trying her on a cat safe anti-diarrheal. As I am sure you appreciate, these would not be a cure if her diarrhea is being caused by an infectious agent (ie bacteria will require antibiotics, parasites or protozoa will require anti-parasitic treatment, etc). Still it can slow the diarrhea to aid the body to absorb more water/nutrients then it would have if the diarrhea were unchecked. Furthermore, these treatments will coat the GI and could just settle the GI upset. In regards ***** ***** options for your wee one, the one we most commonly use is
Kaolin/Kaopectate (More Info/Dose @ http://www.petplace.com/drug-library/kaolin-and-pectin-kapectolin-k-p/page1.aspx) Furthermore, Propectalin or Protexin Pro-Fiber (which is available OTC at vets, pet stores, even Amazon) would be other options. All will slow diarrhea and the las 2 have the bonus of providing support to the delicate good bacteria of the GI. So, you can consider trying these as a short term means of trying to soothe her upset GI. (And do make sure to avoid Pepto Bismol or Loperamide/Immodium with her since these can be harmful to cats).
Overall, we have a few different issues bombarding Maui just now. I would advise the above supportive care for her GI signs, but since she is immunosuppressed due to her FIV, we'd want to make sure no infectious agents are causing her signs or that we are treating those too. As well, and more worryingly, we need to keep an eye on this deterioration and slowing she has been showing. So, when you can, do check her gums. If she has anemia, then we may be in a situation where this has become terminal. But if she does not (and the signs are related to the weakness of dehydration/lack of nutrients), then we may be able to address this, settle her signs, and help her recover.
Please take care,
Dr. B.
Expert:  Dr. B. replied 2 years ago.
PS- I do apologize that I needed a few minutes to write everything I was concerned about with Maui and how we can help her. I hope my thoughts are helpful for you.
Please take care,
Dr. B.
Customer: replied 2 years ago.
Sadly...I didn't mention prior to confirmation of FIV, she did test positive for anemia. How could a cat this young (10 months) have such a full blown case of FIV already?
Expert:  Dr. B. replied 2 years ago.
Hi again,
That is a shame that she was and it does even more increase our concerns for Maui. In regards ***** ***** virus and its causing disease for her, viruses know no age and can cause disease at any point. It is just the same with AIDs in children. And I have to note that how fast it causes severe disease will vary because FIV does have a number of strains. Some are quite mild and cats live with them for years, but other strains are very virulent, obliterate the marrow early on, and trigger full blown FAIDS (feline AIDs) in cats much more quickly.
So, in this case, I am very sorry to say that I am concerned that she has a virulent FIV strain and that it is wrecking havoc on her poor body.
Please take care,
Dr. B.
Customer: replied 2 years ago.
I appreciate your concern Dr. B and you've been helpful. Thank you
Expert:  Dr. B. replied 2 years ago.
You are very welcome, my dear.
Please do let me know how Maui gets on with everything,
Best wishes for her,
Dr. B.
Expert:  Dr. B. replied 2 years ago.
Hi,

I'm just following up on our conversation about your pet. How is everything going?

Dr. B.

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