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My kitten is hallucinating what appears to be. She looks all…

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My kitten is hallucinating what...
My kitten is hallucinating what appears to be. She looks all around as if there is a fly around. She has been administered the meds as shown in the pic here around 5 hours back. These meds are in response to her enlarged kidneys and a suspected FIP.
She has not been eating and refusing to take meds past 2 weights and lost 200 goms. currently at 1.810 kgs. Could this be a reaction to any of these meds ?
Please advise.
Submitted: 1 month ago.Category: Cat Veterinary
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Answered in 1 minute by:
3/19/2018
Cat Veterinarian: Dr. Michael Salkin, Veterinarian replied 1 month ago
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Cat Veterinary
Satisfied Customers: 33,258
Experience: University of California at Davis graduate veterinarian with 45 years of experience.
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Cat Veterinarian: Dr. Michael Salkin, Veterinarian replied 1 month ago

I would incriminate the tramadol although it's important to recognize that FIP can invade the central nervous system. Please stop administering all drugs for the next 24 hours and let me know if you see a change. (Berlex is sotalol which wouldn't be given to Oggy. Please clarify.)

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Customer reply replied 1 month ago
Will wait as suggested for the Tramadol effect to wear out. Vet gave Tramadol for pain relief coz she seemed to have abdominal discomfort while palpitating.What can be a safe substitute of Tramadol for a 6 month cat for pain relief? What should be the dosage?Berlex is a vitamin B-complex related injection given as supplement coz Oggy's is eating very less.
Cat Veterinarian: Dr. Michael Salkin, Veterinarian replied 1 month ago

Another narcotic such as buprenorphine dosed at 10 - 30 micrograms/kg (0.01 - 0.03 mg/kg) into the mouth every 6-8 hours. Nonsteroidal antiinflammatory drugs (NSAIDs) aren't the best choice for visceral pain. Thank for the information concerning Berlex. Please continue our conversation if you wish.

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Customer reply replied 1 month ago
Thank you Dr. Michael.Oggy is eating very less, hardly few tbps a day. She seems to be wanting to eat food but after smelling it she doesn't eat more than 1 tbps. I've been trying different flavors of cat wet & dry food, raw & boiled meat & fish, haven't had much success yet. I also gave antacid but that didn't help. Any sugggestion of what could we potentially look at to figure out why's she eating so less?I am thinking if we can give her a appetite stimulant (link below)? if yes, what'll be dosage & frequency?https://www.1mg.com/drugs/practin-4mg-tablet-135932
Customer reply replied 1 month ago
This is the same kitten's treatment you were guiding us with via the following thread :https://my-secure.justanswer.com/question/index/91a48116a6424721a7d4f8c1a8d942c2?continueTheConversation=False&comingFromAdservEmail=False&ratedThroughEmail=False&rating=0&paymentType=Unknown
Cat Veterinarian: Dr. Michael Salkin, Veterinarian replied 1 month ago

The appetite stimulant of choice for cats is mirtazapine dosed at 1/4 of a 7.5 mg tablet (1/8 of a 15 mg tablet) every other day. I can't imagine that such an ill cat (FIP is likely) would be appetent and you can't fix these cats...

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Cat Veterinarian: Dr. Michael Salkin, Veterinarian replied 1 month ago

Thank you. I remembered Oggy but forgot that I put more emphasis on lymphoma than FIP. Mea culpa.

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Customer reply replied 1 month ago
but we have no tests here for further diagnosis. Also, do you think an immunostimulant may help in her case ?
We really want her to live n live well.
Cat Veterinarian: Dr. Michael Salkin, Veterinarian replied 1 month ago

We don't have a specific diagnosis and so I can't know if an immunostimulant would be of value.

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Customer reply replied 1 month ago
Would it harm if not help ?
Or what could we use in general to boost her immunity - perhaps it could help fight off something ?
Cat Veterinarian: Dr. Michael Salkin, Veterinarian replied 1 month ago

There are no over the counter immunity boosters that have any scholarly studies showing that they do as they purport to do. I don't believe that any would be harmful, however.

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Customer reply replied 1 month ago
Oggy's stomach seems to be bit bigger/larger/distended although she's still skinny & her weight is 1.8kgs. Not sure if this has anything to do with the fluids (80ml) we've been giving her for past three days. Could fluids cause stomach to be bigger?Can this be due to liquid formation in the abdomen due to wet fip? How can we diagnose it? What symptom should I watch out for?Can ultra sound clearly show fluid build up in abdomen region?
Cat Veterinarian: Dr. Michael Salkin, Veterinarian replied 1 month ago

Yes, but there's likely to be inflammation (peritonitis) that's encouraging those fluids to find their way into the abdomen. The peritonitis can arise secondary to infection (FIP or bacterial infection), neoplasia such as lymphoma, or hypoalbuminemia (a lack of the large protein albumin which is needed to keep fluds inside vessels and out of "third spaces" such as the abdominal cavity). A small amount of the fluid can be needle aspirated and analyzed for its physical qualities and cellularity which then gives us an idea of why it arose. Yes, ultrasound would see fluid easily.

It doesn't sound as if you're going to win this battle.

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Customer reply replied 1 month ago
I have been thinking that until I get to the abdomen ultrasound, would a pot belly & muscle loss be a side effect of prednisolone.
She is currently at 5 mg (2.5 mg morning & 2.5 mg evening) on a 1.7 kg weight past 4 days - to be weaned off to 2.5 mg per day next 4 days.This warrior will fight the battle nevertheless :-). I have to admit that I am ever so grateful to you for being patient and responsive. Thank you for being there !!
Cat Veterinarian: Dr. Michael Salkin, Veterinarian replied 30 days ago

Yes, but those are chronic administration of prednisolone changes and cats are more resistant to those changes than dogs in any event.

You're quite welcome.

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Customer reply replied 29 days ago
Was reading about cholagiohepatitis. Do you think it can be a case with Oggy? How to diagnose it?
Cat Veterinarian: Dr. Michael Salkin, Veterinarian replied 29 days ago

Probably the most common liver-related disorder in cats. Ultrasound/ultrasound-guided biopsies.

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Customer reply replied 29 days ago
Any blood test that can help detect it? is elevated ALP a result of this?
Cat Veterinarian: Dr. Michael Salkin, Veterinarian replied 29 days ago

Both ALT and AP are expected to be increased but there's no specific test for it.

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Customer reply replied 27 days ago
Got blood test & ultra sound tests done yesterday. could you review the attached reports.
Cat Veterinarian: Dr. Michael Salkin, Veterinarian replied 26 days ago

Sorry for the delay. I was hiking up and down a mountain.

Severe nonregenerative anemia - an anemia typical of chronic inflammatory disorders

Bilirubin and AP significantly elevated - not specifically indicative of any one particular disorder but liver/biliary tree-related

I don't see an ultrasound report.

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Customer reply replied 26 days ago
The vet did not do a full fledged ultrasound. He wanted to check for accumulation of fluid as he felt her stomach was a little bloated. He said he could not see a fluid - or if there is it is insignificant at present. He did see 1 patch of fluid but that he said could also be the gall bladder.We started her on an iron supplement & doxyciline along with prednisolone. We have a reduced dosage of prednisolone at 2.5 mg per day.Is a blood transfusion in order ? Or we wait and watch for the iron supplement to take effect ? Given her weight & condition would she able to take a blood transfusion.
Cat Veterinarian: Dr. Michael Salkin, Veterinarian replied 26 days ago

Thank you for the additional information. Blood transfusions for cats are considered at a hematocrit (PCV) of 15 or less; however, her anemia is nonregenerative; in other words, she can't replace the red blood cells she lacks efficiently and so a transfusion would only be a temporary fix. Iron and vitamin B12 supplements aren't very helpful for nonregenerative anemias because those building blocks for red blood cells aren't lacking in nonregenerative anemias.

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Customer reply replied 26 days ago
Any treatment possible to address non-regenerative anemia ?
Customer reply replied 26 days ago
Also, the blood sample had to be taken from the jugular vein. Is it possible that these values will vary under stress ?
Cat Veterinarian: Dr. Michael Salkin, Veterinarian replied 26 days ago

Treatment is addressed to the cause.

The white blood cell count can increase due to stress but stress doesn't reduce the red blood cell count.

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Cat Veterinarian: Dr. Michael Salkin, Veterinarian replied 25 days ago

There is no requirement for vitamin C in cats as they can manufacture their own and there's no evidence that vitamin C is of value when addressing FIP.

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