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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Cat Veterinary
Satisfied Customers: 25668
Experience:  University of California at Davis graduate veterinarian with 44 years of experience.
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In September we rescued some kittens and brought them into

Customer Question

Hi there, in September we rescued some kittens and brought them into my mother's place until we can bring them to our place. They are now 9 months old. The female has not been herself the last few days. Her symptoms are a rather strange mix. She is not playful like she normally is. She is more frequently licking and grooming herself and scratching herself. She has on several occasions coughed like maybe she has a hairball but doesn't vomit anything up. And her third eyelid is a little more visible than normal. Any ideas?
Submitted: 1 year ago.
Category: Cat Veterinary
Expert:  Dr. Michael Salkin replied 1 year ago.

I might conjecture that all of Creme's symptoms represent a hypersensitivity reaction - most likely to environmental allergens such as pollens, molds, dust, and dust mites, etc. Coughing is pathognomonic (particularly indicative) of feline asthma. I also see coughing with feline herpesvirus (FHV-1) infection but asthma and pruritis (itchiness as evidenced by her licking and scratching) are more likely to represent hypersensitivity.

Please respond with further questions or concerns if you wish.

Customer: replied 1 year ago.
I agree - I thought maybe it could be an allergy. Thing is - her environment really hasn't changed. She has been in the same place since September. And I wouldn't have thought it would cause her to become lethargic. The cough seems to be more consistent with trying to unsuccessfully expel a hairball.
Customer: replied 1 year ago.
Would this make sense if her environment hasn't changed?
Expert:  Dr. Michael Salkin replied 1 year ago.

It can, yes. Remember, it can take some time to be sensitized to an allergen. I always remember my mother telling me that she didn't have allergies until she was in her 30s. I should have been so lucky...

Remember, hairballs cause gastrointestinal symptoms - vomiting, regurgitation, salivation. Coughing is a respiratory symptom. There is some overlap because ingesta can irritate the oropharynx and result in coughing. Please continue our conversation if you wish.

Customer: replied 1 year ago.
She has been eating more grass I would say than usual which I am thinking may have somewhat of an obstruction. But if it's an environmental allergy - is there anything that can be done? Could that also cause that 3rd eyelid to be more prevalent?
Expert:  Dr. Michael Salkin replied 1 year ago.

Eating non-digestible greens suggests gastrointestinal distress. It's of evolutionary benefit because it usually results in vomiting which empties the stomach of infectious agents and nondigestibles.

A glucocorticosteroid such as prednisolone might be prescribed for seriously allergic cats - particularly if asthma can be confirmed. 3rd eyelid prolapse can occur with conjunctivitis, as a protective device over the cornea, secondary to interruption in the sympathetic nerve chain, and is conjectured to arise in cases of infectious diarrhea (Haw's symdrone - both 3rd eyelids would be prolapsed).

Customer: replied 1 year ago.
One more thing, I do remember that I took her to the vet the day we brought her in because she had not been eating much outside and while I wasn't able to observe her outside grooming herself more than usual or scratching or coughing, she was more lethargic and the 3rd eyelid was showing more than usual like now. I took her to the vet and he prescribed an antibiotic and she got back to normal. Perhaps a chronic infection?
Expert:  Dr. Michael Salkin replied 1 year ago.

FHV-1 is the most common of the infectious agents which essentially stays with a cat forever. It can come out of its carrier state at times of stress. It doesn't respond to antibiotics, however, but does to the tincture of time. I can't incriminate FHV-1 in itchy skin, however.

Customer: replied 1 year ago.
One other possibility struck me. My mom has another cat that is on hyperthyroid medication. She gives her methimazole in a pill pocket. I asked my mom if it is possible that Creme might have eaten her cat's medication. She said she didnt think so, but that it is possible. I read about the side effects and itching of skin and nausea are definitely side effects. Not sure about the eyelid though. What do you think if she did eat the pill and possibly on more than one occasion is this consistent with her symptoms? And how long now will it take to clear her system? Any other potential damage?
Customer: replied 1 year ago.
She licks her lips a fair bit - that's why I suspect nausea too. The dose was 5mg.
Customer: replied 1 year ago.
I sent out another question as I see you are offline.
Expert:  Dr. Michael Salkin replied 1 year ago.

Methimazole can cause facial pruritis but the incidence of this is reported at just 2-3% with the majority of cases afflicted within the first 3 weeks of treatment. In another study an incidence rate of up to 15% was reported.

Customer: replied 1 year ago.
Could i mix activated charcoal with her food to absorb it if it is in her system? like a quarter teaspoon or something like that?
Customer: replied 1 year ago.
Any possible long term danger to her? I can't imagine it would be too bad if the other cat takes it regularly.
Expert:  Dr. Michael Salkin replied 1 year ago.

I believe the benefit to risk ratio is far too low to be dosing with activated charcoal. Simply making sure it couldn't happen again is curative. This drug's half-life is only 2.3-10.2 hours and there's usually a 1-3 week lag time between starting the drug and significant reductions in serum T4 (total thyroid hormone).

Customer: replied 1 year ago.
okay that is very helpful - so no significant danger to kidney or liver? what is T4?
Expert:  Dr. Michael Salkin replied 1 year ago.

Correct. As stated above T4 is the abbreviation for total thyroid hormone (in a cat's serum).

Expert:  Dr. Michael Salkin replied 12 months ago.
Hi Jonathan,
I'm just following up on our conversation about Creme. How is everything going?
Dr. Michael Salkin

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