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Dr. B.
Dr. B., Cat Veterinarian
Category: Cat Veterinary
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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 cat went to the vet about a week and a half

Customer Question

My 10 month old cat went to the vet about a week and a half ago due to swollen tonsils and other lymph nodes in groin and behind knees, as well as lack of appetite. The vet thought everything pointed to FeLV or FIV so we ran blood work and did chest xray. He also prescribed doxycycline. The next day the swelling in the tonsils was completely gone and his appetite was much better so I got another weeks worth of antibiotic. All his blood work came back perfect and negative for FeLV and FIV. He's acting completely normal and eating well, however, I'm still very concerned because the nodes in his groin and behind the knees are still swollen. He's also exhibited strange behaviors such as increased thirst and eating cat litter! He's also extremely itchy and scratches himself constantly. He has multiple raw wounds on his back from scratching himself so hard. I guess I just want to know if any of these issues are related and what is possibly wrong with him.
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:

Did the blood work show that Henry had anemia (low red blood cells) or iron deficiency?

Was he tested for feline infectious anemia?

Have they taken samples from the lymph nodes for analysis?

When did the itchiness start relative to his other signs?

Any plaques or odd patches/masses on the skin?

Customer: replied 2 years ago.

When I called my vet to get results from blood work they told me everything looked great. I didn't ask about anemia but I hope that is something they would've mentioned if they saw it in the blood work. His gums aren't pale or anything either. He was not tested for feline infectious anemia. One of the lymph nodes was aspirated to be sent in pending the blood work results and after he responded well to antibiotics my vet said there was no need to send it in.

Looking back I think the itchiness started around the same time as the swelling of his nodes. When he first became ill I noticed crusty scabs on his neck and back but I just assumed they were from playing too rough with his brother. After being put on the doxycyline however, they seemed to clear up right away, perhaps they were infected? Anyways, they cleared up very nicely for a few days and now in the last day or two he's been constantly licking and scratching himself and he has several raw patches on his back.

His symptoms are all so random I'm not sure if they can be related in any way. He still has about a weeks worth of the doxycycline left.

Expert:  Dr. B. replied 2 years ago.
Thank you Amanda,

I agree that Henry's signs are quite vague and don't come together nicely to give us an easy diagnosis. Still, we do need to think about a few different issues and approaches to this situation.

First, I too would hope that they would mention anemia if it were present, but if he is eating litter I would just double check with them whether he was or not. The reason is because litter eating is often a sign of pica-ism and this can be triggered by anemia and/or iron deficiency. Therefore, we would just want to double check based on that sign. (And I would note increased thirst could also be a feature, but could also be a side effect of the inflammatory process ongoing in his body).

If that is normal, then we'd have to question if the eating of odd items and drinking may actually not be health related but instead behavior related. We can see compulsive behaviors in cats that are struggling with an issues they cannot control. And if he is intensely itchy and cannot seem to every soothe that itch, he could potentially develop either of these as a displacement or compulsive behavior. So, they may be side effects of the bigger issue.

In regards ***** ***** larger issues, we need to consider the skin signs and the elevated lymph nodes. Now we always have to be wary that enlarged lymph nodes can be a sign of cancer (lymphoma or leukemia) even in young cats. That said, lymph nodes commonly enlarge in responds to allergic or inflammatory reactions. And if there is one in the skin (that is making him itchy) then that would in theory potentially trigger an increase in the size of all those lymph nodes. So, we need to consider that as well. And just to note, the scaling that settled with the antibiotics was likely a bacterial collarete or mild infection.

With all this in mind, I would advise it ideal to have some lymph node aspirates or a biopsy taken for analysis. This way you can determine if we have a lymph node based cancer worry or if we have a cat that has a major allergic skin disease that has his immune system totally overstimulated. Otherwise, depending on your vet's exam and blood test findings, you may want to discuss a trial on antihistamines or steroids to see if this settles either the itching or lymph node size.

Overall, Henry's signs are quite complicated. But if he has been itchy from the start of his glands being all elevated, it is possible that he is actually reacting to something he is allergic (ie pollen, food protein, dust mites, literally anything) to and this is triggering all of his signs. So, it is worth checking to make sure we can rule out anemia, and then discussing/testing to see if the lymph nodes are reacting to an inflammatory skin issue or if we do need to be worried about something more sinister.

I hope this information is helpful.

If you need any additional information, do not hesitate to ask!

All the best,

Dr. B.


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