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My cat (female, spayed) is 13 years old. Last week she

My cat (female, spayed)...

My cat (female, spayed) is 13 years old. Last week she suddenly stopped eating. We took her to the vet, they did tests and everything came out okay. No diabetes, no cancer that they can tell, no kidney disease. They sedated her and did an x-ray and looked down her throat. No masses seen on x-ray, but she has two very angry looking red spots on each side of her throat. They don't know what it is, and suggested we put her down. We didn't want to at that point, so they gave her some pain medication, appetite stimulant pills, anti-nausea shot and fluids. This was Friday. That night she ate about 1/3 can of wet food on her own. We've been giving her pain meds (liquid squirted in mouth), and fluids at home. She ate pretty well yesterday, and some this morning, but now she acts hungry but won't eat when offered food. Sorry for the long story. I appreciate your help!

Veterinarian's Assistant: I'll do all I can to help. This sounds like it might be serious. I'll let the Veterinarian know what's going on ASAP. Is there anything else the Veterinarian should be aware of about your cat?

Well, looking back it seems like she maybe has been eating less for several months. I was concerned enough about her weight loss that I started monitoring it at home. She was about 8 lbs. mid-February, about 8 lbs. mid-March and then 6.4 lbs. last Thursday when we brought her in.

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Customer reply replied 3 months ago
Also the vet said her teeth looked fine except one back molar is brown and she didn't know what that could be.
Customer reply replied 3 months ago
Her activity level is pretty much normal, for her, being 13 years old. It just seems like it she wants to eat, but it hurts her.
Answered in 2 hours by:
3/26/2018
PitRottMommy
PitRottMommy, Veterinary Nurse
Category: Cat Veterinary
Satisfied Customers: 12,188
Experience: 15 yrs experience in vet med, 8 in emergency med. Founder of a non-profit animal rescue
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Hello, JACustomer. I have been a Veterinary Nurse for over 15 years and would be happy to help you today. I'm reviewing your question right now.

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Can you share pictures of the bloodwork results?

Is she drinking well currently?

What medication is being given?

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Customer reply replied 3 months ago
Thank you for getting back to me. When we first brought her in, on March 21, they gave her an appetite stimulant, Mirtazipine, to be given 1/4 of a 15mg tablet every two days. She had doses of that (3.75 mg each) on March 21, March 23, March 25 and is due her last dose tomorrow, March 27. On March 22 we brought her in for her x-ray and throat probe. That day they gave her the pain med Buprenex and sent us home with 6 more .1 ml doses to be given every 8-12 hours. She got her last dose of Buprenex the evening of March 25. On March 23, we brought her in and she got a shot of Cerenia anti-nausea, and subcutaneous fluids 150 ml. We are continuing her sub-q fluids at home, giving her 150 ml each time on March 24, 25 and today, March 26. I brought her in today, March 26 for a second shot of Cerenia, and also got some Cerenia tablets to administer at home.The evening of March 23 is when she actually started eating again on her own. She ate about 1/3 can wet food that evening and about 1/3 can total on March 24. Then on March 25 she stopped eating on her own although she acts hungry. We've been giving her Kitten Milk Replacer by syringe since late yesterday March 25.No, I haven't seen her drinking on her own. She does seem to be using the litterbox.I'm attaching her bloodwork results and the picture of her throat. I really appreciate your help.

Ouch! Her poor mouth. Has this area been rechecked since the original pics were taken? Have they discussed the potential of stomatitis?

I'm glad to hear that you're using KMR, as this can be one very useful food option for cats who are limited in what they will intake. Have any pureed baby foods been tried yet? Has your vet discussed using any oral rinses or water additives? Any recheck bloodwork to ensure the liver is still doing well? Any discussion on medications to help bring down the oral inflammation, such as steroids? Have they talked to you about starting lysine, for good measure, as well?

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Customer reply replied 3 months ago
No, the vet did not discuss any potential causes for the sores. I googled "throat sores in cats" after we saw the picture and I read about stomatitis, and I know it can't be ruled out, but she has not had any drooling or bad breath. And the vet said her teeth looked pretty good overall. I mentioned I brought her in for a Cerenia shot this morning. This afternoon she is eating on her own again--I offered her some beef baby food and that really got her attention! It seems now the issue with her not wanting to eat may be more due to nausea than throat/mouth pain so we plan to continue with the KMR, baby food and sub-q fluids until we can get an appointment with a specialist.I forgot to mention, about the time she stopped eating last week, I noticed she was having some goopy discharge from her right eye. It sort of comes and goes, right now her eye looks pretty clean.What is lysine given for? You have been wonderful!

Let me give you some information on what may be potentially causing this and how I'd address it if this becomes a recurring problem for her.

1) Stomatitis. Talk to your vet about a course of antibiotics like clindamycin, oral coating medications like sucralfate slurry, dental cleaning (clearing away the bacteria can help greatly), dental rinses like CET aquadent, etc.

2) Herpes (which could explain the eye gunk). Consider starting lysine daily from this point forward. Oral ulcerations are common with this condition and can be latent for years before problems occur.

I hope this information has been helpful. I will be standing by if you have other questions. Let me know if I can help further. Also, before signing off today, please take the time to use the star rating system at the top of the page to leave a rating for me (bottom of the page if using the app). A 5-star rating is appreciated as top-notch answers are my focus. If you feel you have received anything less, please reply so that I may help until you’ve received the assistance you need. Until you issue a rating, the website will not compensate me for helping you. You will still be able to chat with me even after issuing a rating at no further charge on this thread.

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Customer reply replied 3 months ago
Hi--I just talked to the vet. She and her boss believe my cat is in end stage kidney failure. She said when they tested the blood they drew on March 21, the kidneys looked fine, but when they sedated her on the 22nd for the x-ray/throat check, they drew more blood and that's when they saw something that indicated kidney disease. I may have misunderstood, but I thought she said that whatever they saw in the second test indicated the kidney disease was so bad it actually depressed the other markers they look at.We are going to get an antibiotic shot for the cat tomorrow, and continue with the fluids, KMR, baby food/soft food and see how it goes. Maybe it is her kidneys but it's just unfortunate that the vet told us they were okay at first. Is there anything you see on the blood work to indicate kidney problems? I'm not sure, but I don't know if the results I sent you include the second blood test they did.Just looked--looks like the second blood test was an SDMA test? Can you tell me anything about how that works versus the standard kidney evaluation tests? I will ask for the SDMA results tomorrow.Thanks again.

Kidney problems can definitely cause ulcerations in the mouth. My question would be why this would have started before her kidneys were showing problems. I'd ask for a copy of that bloodwork, if possible. Nothing on the bloodwork you provided suggests that her kidneys are failing.

The SDMA specifically checks how the kidneys are functioning. It's more specific than factors on bloodwork, such as creatinine. The SDMA tends to be less likely to be falsely swayed by age, body condition, stress, etc. where bloodwork often can. What was the SDMA result, do you have a copy to share?

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Good morning, JACustomer. Checking in. How is your companion doing today?

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Customer reply replied 3 months ago
About the same. Gave her fluids and KMR early this morning, then about 3 hours later offered her some baby food which she licked off my fingers, about a tablespoon total. Will offer her baby food again in about an hour. Thanks for checking!

Sure thing. Keep me posted on your progress. I'm rooting for you guys!

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Customer reply replied 3 months ago
I'm attaching her complete record. The SDMA results are on page 3. We talked to the senior vet when we were in this afternoon, and I guess it helped us accept the diagnosis after seeing the actual SDMA findings and her explaining about the SDMA being a specific test for kidney disease, and how the regular bloodwork findings can be skewed based on body weight. I'd still like to hear your thoughts on her test results. Thanks.

Based on the symptoms you've shared, I do think that kidney disease is likely. I don't think there is anything wrong with continuing to try at home. So long as she's eating and responding to therapy, her quality of life should be sustained. I do think it would be worthwhile to have a urinalysis/xrays performed to ensure that she doesn't have other contributing factors since she's had urinary crystals in the past. My gut feeling is, though, that she likely does have kidney disease and the SDMA results are not incorrect. If she continues to improve with home treatment, especially fluids, her SDMA result should be rechecked in 2-4 weeks. IV fluids and hospitalization should be considered, as well.

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Customer reply replied 3 months ago
Thank you.

You're very welcome. Best of luck to you both. Please let me know if I can help you further in the near future. Don't forget to rate today, before signing off, so that the website compensates me for helping you.

PitRottMommy
PitRottMommy, Veterinary Nurse
Category: Cat Veterinary
Satisfied Customers: 12,188
Experience: 15 yrs experience in vet med, 8 in emergency med. Founder of a non-profit animal rescue
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Hi,
I'm just following up on our conversation about your pet. How is everything going?
PitRottMommy
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Customer reply replied 3 months ago
We had her put to sleep on Saturday. I appreciate your help though. Thanks.
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