Oscar in Aus not well

http://felinediabetes.com/FDMB/viewtopic.php?f=28&t=30543

Hi All,
Well we were doing really well and BG is still really good 60-110 but Oscar has become listless and looks thinner but his major problem is shortness of breath the last week or so. We are off to the vet today, he doesn't really like the 3 hour round trip but it is getting more prevalent so I am hoping they have some suggestions. Maybe he just needs a course of antibiotics (I hope). Is this a problem anyone has had with a sugar cat in remission before? He also has been licking himself more than normal, he is a bit of a OCD preener in general anyway.
I probably will have been to the vet and back by the time most of you see this (time diff) but any thoughts would be gratefully received. He was doing so well before this?
Also weather is getting hot and due to unusual rains a bit sticky so I thought maybe weather may be the cause - we shall see.
He's been eating FF and occasionally a little diabetic dry ( I can leave it down longer - due to summer fly probs) We are having a bit of trouble with grasshoppers as well which he does eat a few???
Anyway enough woes for now. Hope you are all doing well.
Cheers Joan :sad:

 

Asthma could be the problem....in which case you need to really look at what kind of meds they prescribe; inhaled are much better and will have less of an impact on his diabetes. Hopefully whatever it is will be easy to treat...let us know ok?

Jen

 

Thanks Jen,
Does that mean there is an inhaler type for cats? I think they will look to Predislone - which I dread as it is bad for the liver etc. But I will ask about asthma meds.
Thanks for the thoughts. A problem shared is always a little lighter.
Cheers Joan

 

Hi Joan,

Sorry to hear that Oscar is not feeling well. Paws and fingers crossed that it will be an easy fix.

 

Yep there is an inhaler for cats. Aerocat it is a little mask that fits over their face...Traci & Boomer here has a new kitty that has asthma and she use it for Merlin. But for the life of me I can't remember the meds but you could send her a PM and ask.

Mel & Max

 

There is a website with all the info you need

http://www.fritzthebrave.com/

 

Thanks Folks.
That's great I can read up before heading down to vet this arvo.
I will report back later.
Cheers Joan

 

Hi Joan ! It's nice to see you here --- but I wish it was not b/c Oscar is not feeling well.

I hope the vet figures out what is going on.

Besides the asthma that has been mentioned above, I would suggest asking the vet to do a thyroid panel and also to rule out any heart disease ( heart issues can be a part of hyperthyroidism or, of course, a separate health problem)
They both can cause the symptoms you are describing.

I grabbed a quick link for you that has a chart on symptoms. Not all cats present in the same way, but you can see that the symptoms you mentioned of shortness of breath, weight loss, coat issues, lethergy, etc... are all a part of that condition. Certainly worth doing the bloodwork for that imho. btw-- it is a very treatable illness.

http://www.peteducation.com/article.cfm ... 30&aid=218

I' m sorry I missed your previous update. Thank you for linking it. I'm glad to read he is still OTJ. I send best wishes that whatever is going on is found and successfully treated !

 

Hi All,

Thanks for the extra info Cheryl.

Well Oscar got a bit worked up yesterday and when he presented to the vet he had a rapid heart rate and breathing, hence she said it's hard to tell. His chest was clear and temperature normal, eyes bright as he had worked himself up and so the prognosis was a bit hard! However he has started a course of antibiotics and some anti-inflammatory med (can't have steriod whilst on anitbiotics-she said). She took blood and will send it to the city for analysis and I will try to get a urine sample today and test with the multistix for blood. So nothing really to go on yet but whe will do an Xray if it continues, I will have to travel a bit further to their other clinic for that - but that's OK.

Of course on the way home he chilled out and went to sleep - go figure!!!
At least he is better in the car these days and wanders around - he used to go berserk!

The best thing is knowing you guys are there at the other end, really rallied yesterday - thanks.

Talk soon.
Cheers Joan

PS Nice to hear from you Cheryl - I will always feel a bond with you after our Saturday afternoon with Oscar's Insulin drop (some months ago).

 

Keeping Oscar in my prayers. I think an xray would be very helpful.
jeanne

 

I am glad you guys made the trip in to see the vet, but sorry that Oscar is not feeling well and doesn't sound like he was happy about the trip!

I hope the a/b help some, and that you get good results on the b/w.
I am not sure but don't Xrays help with the dx for asthma? You could ask your vet about it.

 

Joan, you made the staement:
"can't have steriod whilst on anitbiotics-she said"
I Googled and using both together is common in both humans and animals. Just yesterday my Dr. prescribed both oral steroids (Pred) and an oral antibiotic.

 

I'm glad he has become such a good traveler.

worried that he is so symptomatic.
do you know if vet included thyroid panel w/ the b/w ? maybe call and see if there was enough blood taken to add it to the tests if she did not already order it.



Joan, I feel the same connection. ;-) what a day that was !
scritches to Oscar for me cat_pet_icon

 

Hi Joan

Cheryl alerted me to your post. Is your kitty feeling any better? From what I can gather from your posts, your vet didn't do a chest x-ray. Is there a vet close to you where you can get an x-ray? A large animal facility would be able to do that as well --your regular vet could 'prescribe' an x-ray and they could do it.

I'll be honest with you. I think it is unlikely that antibiotics will fix this. I don't know if your cat has a primary respiratory disease (asthma) or is in congestive heart failure-- an x-ray is the ONLY thing that will tell the difference and your vet didn't do one. I would ask your vet tomorrow for a prescription for furosemide to keep at home for emergency use. It is a drug used for congestive heart failure. It is not ideal to do it this way, but if the only vet you can see is 3 hours away, starting oral furosemide during a crisis may help him make it to the vet in case of emergency. Your vet can explain the guidelines for its use. This is a human drug that you can get from your local pharmacy.

It is also possible that your cat has asthma. I would look to order the AeroKat device to have on hand, again because of the distance you live from the vet and the fact that you don't yet have a diagnosis. Your vet can prescribe albuterol (I think the other generic name is salbutamol? something like that), an inhaled medication used in asthmatic crises.

It also sounds like your vet prescribed an NSAID, probably Metacam? I am not sure why. I would question this treatment in the future, if it's offered again.

If you are in a heartworm endemic area, your kitty should have (drumroll please) a chest x-ray to look for lung damage and blood tests for heartworm (both an antibody and an antigen test). Blood tests in cats with heartworm may be negative during certain stages of the disease and are not entirely reliable. People who live in heartworm-endemic areas, actually everyone who lives in an area with heartworm, IMO, should have their cats on Heartgard or a similar product. Heartworm causes respiratory disease in cats and sudden death, and the prevention is simple-- a small amount of dewormer every month.

Let me say a few things, generally speaking, because they come up a lot in posts dealing with cats with breathing problems:

-- Heart disease in cats must be diagnosed by echocardiogram. There is no other way to determine if a cat does NOT have heart disease. X-rays, listening, the absence or presence of a heart murmur, none of these things can determine the status of heart disease in cats.

-- X-rays will show if a cat has congestive heart failure (CHF). This is a consequence of heart disease. Listening to the cat with a stethoscope should never be the basis of diagnosis. A clear-sounding chest does not mean a cat does not have CHF, heart disease, or asthma. If your cat has breathing problems and the vet says s/he listened to the cat and it's all clear, no heart problems, ask for a chest x-ray anyway. I know of more than one cat that has died because the cat was determined to be ok based on auscultation so this is particularly frustrating to me.

--- X-ray, x-ray, x-ray cats with breathing problems. Always. No exceptions.

--- Cats who are having trouble breathing and may be in CHF should not get a steroid injection (treatment for asthma) until a chest x-ray proves that they are not in CHF. The exceptions of course are cats with properly diagnosed other issues like heartworm or asthma, or who have had a recent echo that shows no heart disease.

--- Steroids are a wonderful, lifesaving treatment for cats with asthma and other types of respiratory crises related to lung disease. Steroids also can induce, worsen, or prolong CHF in cats who are having heart-related problems.

Joan I hope none of this applies to your guy and he does well on the antibiotics. I would get the furosemide and albuterol to have on hand, given his history and your distance from veterinary medical care.

Please keep us posted.

 

Firstly, sorry I haven't posted in the last few days things have been hectic - not because of Oscar - just lots happening. I spoke to the vet on Monday when the blood results came back and she said it didn't really show anything. So I have booked an Xray at the other clinic (bit further away) on Friday so I will know more then - I hope.
There is more than one vet at the practise and the one who took the blood I feel has less expreience than the one that dealt with Oscar's diabetes. Unfortunately although I discussed him with the better one she won't be on when I go Friday the young one will be. I will keep plugging away as I feel deep down that it is heart related so we may need the echo. They have 2 clinics and it is the main one that seems to have all the equipment. But they are better than the horse vets we have had to deal with in the past. Will they need to sedate Oscar for an Xray?
Interesting about the comment with regard to steroids and anitbiotics - you are right I have asthma meds (steroidal) and still have antibotics. I will ask?
Meanwhile I don't feel Oscar has responded to any of it, he still seems tired and his breathing is more rapid than normal. Not panting which the vet seemed to think would be happening if something was wrong! Still he is eating and not in any pain so that's good.
I will check my post for any hints tomorrow night before going down Friday. Thanks for the already received ideas as I will ask about furosemide and albuterol to have on hand while I'm down there.
Thanks again to all of you for being there for us. :?
Cheers Joan

 

I spoke to the vet on Monday when the blood results came back and she said it didn't really show anything. So I have booked an Xray at the other clinic (bit further away) on Friday so I will know more then - I hope.


I have been looking for you to post back, glad it is not b/c of bad news.
I think the x ray is a great thing to do next. Did you read Jess' post? She is a tech at a specialty clinic and works w/ a cardiologist -- so she really knows her stuff. Does this same clinic have an echo?
since it is such a drive can you sced to have that test during the visit if needed? It sounds from what Jess wrote that it is very important to have that done.

I never had to have any of my kitties sedated for xray( well, except for the special dental ones and they were out for procedure at same time ;-) )
That said. some cats don't cooperate very well and hold still . So.... some do have to be sedated.

and for an echo. again. no sedation needed for my kitties.

just wondering....... not wanting to be johnny one note --- did they do a thyroid check on the b/w ?
It is sounding less and less like that is the issue. But is always a good thing to rule out. How old is Oscar?


Meanwhile I don't feel Oscar has responded to any of it, he still seems tired and his breathing is more rapid than normal.
:sad:

Not panting which the vet seemed to think would be happening if something was wrong!

good thing you are going for xray an not relying on this vet !


Still he is eating and not in any pain so that's good.

so he is active? still just laying around?
eating is very very good !

I look forward to seeing how his *pictures* turn out. I hope they find out what is wrong and that it is something that can be easily treated.

best wishes for Oscar.

 

HI Cheryl,
1. Does this same clinic have an echo? Not sure but I aim to find out after Jess's message.
2.did they do a thyroid check on the b/w ? NOt sure but a question to ask on Friday!
3. How old is Oscar? 10
4. As for active Oscar jumped out and grabbed me around the ankle at about 4am as I passed by, so still some go in him. He seems to be sleeping mostly during the day - which is pretty normal in summer for him. Just looks a bit tired and active in spurts with a drop after.
Anyway I will ask some of those questions tomorrow.

Talk soon.
Cheers Joan

 

Just a side note, but panting can be a sign of ketones....not that it sounds likely but would be easy to rule out if you have ketostix

Jen

 

Thanks Jen,
Have checked and ketones OK. Good thought though - thanks.
I will come back with more news in 24 hours hopefully.
Cheers Joan

 

I have an asthma kitty, Jack. If that's what you're dealing with, the only way to go is inhaled steroids. You need Flovent (and an aerocat to administer) and no matter what the vet tells you, you should start with the 250 dose twice a day. Jack was originally on two puffs twice a day, but after a few months without any symptoms, I tapered him off to one puff twice a day. Also, I keep Albuterol on hand as an emergency inhaler. Don't use it much, if at all, but when we get wildfires here in Florida, the ash in the air can be problematic for asthmatics of any species. Jack takes his inhaler like a champ, even reminding me sometimes when it's due. It's very easy to administer.

I have great sources for both of these inhalers. If you find out that's what you're dealing with, feel free to pm me for details.

 

Well…. They took xray’s of Oscar yesterday and it seems to me they are not that proficient in reading them. Very Um Ah and we may have to send them to a specialist @$80 to have them read, that was on top of the $300 for the pics. He has come home on prednisolone and we’ll see how we go otherwise a bronchial dilator by tablet will be the next step. She said the inhaler’s are hard to get the dosage right and would require lots of blood test @$120 a go. As you know I don’t begrudge the cost but when I don’t get some reasonable results I start to feel uneasy about it. I think we’ll send the xray’s to the specialist and maybe pay a visit to him/her after the festive season. I did ask lots of questions but with very little results! Oscar seems fine today just a little worn out after the big day cried all the way there and wanted to sit under me feet all the way back (bit hard with the brake, clutch etc, thank God for cruise control).
I asked lots of questions but with very little results - very frustrating. I asked about other meds you girls suggested but to no avail. Better vet is there Monday and wll look at Xrays so I hope she somes back with something. His blood vessels didn't seem right and there is a shadow just along the spine which they don't know about? :?: I don't expect all the answers but some would have been nice :sad: .
Talk soon,
Cheers Joan

 

JOan are the x-rays digital or flat films? If digital you can email me, send me a PM.

It sounds like they are thinking asthma. I think that seems unlikely, given his symptoms, but obviously I'm not there examining the cat or reading the x-rays (and am not a vet anyway ). You should see a significant improvement very soon with the pred, within 24-48 hours so let us know.

 

Joan, you need to join this group: http://pets.groups.yahoo.com/group/felineasthma/ They are as helpful for asthma kitties as this group is for sugarcats.

The inhaler's are not hard to get the dosage right on and you don't need a blood test to determine that. 250 mg of Flovent, 2 puffs 2 x a day and he'd be good to go. After a month or two of being symptom free, you could knock it back to one puff twice a day. Many vets know less about feline asthma than they do diabetes. I've been through this, and after talking to an emergency vet, ended up figuring out Jack needed the flovent through the group listed above. He hasn't had a coughing fit since we started the inhaler - and this was a cat that I had to rush to the emergency clinic after finding him sprawled on my bedroom floor wheezing, his tongue and gums blue from lack of oxygen. It took several days of being in an oxygen chamber to get him right, only to find that the vet's prescription of pills (pred. and theophylline, an asthma medication) weren't really working. It wasn't until we got him on the inhaler at the dose the above group told me about that Jack's quality of life returned. Also, the inhaled steriods are much safer since they go directly to the lungs where they're needed and don't have to be processed by the body like the pills.

This is the flovent (and the best price for those of us in the US anyway): http://www.4cnrs-asthma-allergy.com/flovent.html You want the 1 Flixotide CFC Free 250mcg Inhaler

This is the aerocat inhaler: https://www.vetrxdirect.com/product/vie ... 2godRmWhWA

 

Thanks for the quick response.
The xrays would be digital as they were on the computer screen I will try and get hold of them, but don't think I can until Monday (here) but when/if I can I will send them to you - big thanks.
Meanwhile we will see how prd does and also I will look at the links you have given me
I wonder if I can buy inhaler etc. from the states and get it mailed? Might check that one out.
Cheers Joan

 

sorry to hear that the vets were not very helpful .I think it's good that you are going to send the rads out to the specialist. I don't like mystery shadows. ( or " um ahs" ! ) Will they send them right away? and if you can get them to Jess too that would be fantastic !

I hope the other vet at this practice can can shed more light. It really does seem like they are just guessing.

Please keep us posted as to how Oscar does over the weekend w/ the pred.

 

Oscar not doing so well, pred doesn't seem to make much difference if anything he has been worse perhaps due to so much travelling ( bit stressed Saturday). However he is stll eating and showing interest in things so can't be too bad.
Certainly will be on the phone to vets Monday morning first up.
Cheers Joan

 

Dear Joan, and, of course, you too, precious Oscar,

Sometimes pred can take a day or so to actually kick in... And, a cat who has done so much traveling lately, might be more than a bit stressed...

I'm beyond thrilled he's still eating and interested in cat things! You go, Oscar!!!

We'll be keeping you close in our hearts and thoughts and prayers, okay?

Please consider yourselves loved and hugged,
Deb and Nikki -- and Giz, forever whispering in my heart...

PS: I too am familiar with the whole brake, clutch deal...

 

I just spoke to the vet and her collegue feels it may be Oscar's heart. The only way to know for sure is a trip to Adelaide (capital city), which for lots of reasons I am unable to get away this week to take him all that way. I asked if he might be able to have it between Christmas/ New Year she felt it was unlikely but will come back to me on that. They are discussing putting him on heart meds without the test and/or if he gets worse keep him at Clare clinic 2hours from us. I feel @ the Clinic he would stress more. Not sure what to do? I wish I could get away this week but I am really stuck!
They will send the xrays onto the specialist and send a CD to me to try and email to Jess as soon as I get them, I had hoped they might email to me but not too tech savvy!
Thanks for all ther prayers and hugs.
Cheers Joan

 

just seeing rthis...best of luck, joan!

 

I hope they can get you in next week.

now that they are thinking heart disease, did they take him off the pred?
It is generally contraindicated w/ heart disease.
It alters salt retention and can make things worse. Something to discuss w/ your vet.
( I'm sure Jess can explain it much better )

as far as starting meds w/ o a dx.
this is from jess' post above :
I would ask your vet tomorrow for a prescription for furosemide to keep at home for emergency use. It is a drug used for congestive heart failure. It is not ideal to do it this way, but if the only vet you can see is 3 hours away, starting oral furosemide during a crisis may help him make it to the vet in case of emergency. Your vet can explain the guidelines for its use. This is a human drug that you can get from your local pharmacy.


I hope she stops by soon.

Hang in there (( Oscar )) !!
you too (( Joan ))

 

My worry is stopping Pred immediatley may not be good I thought you needed to reduce dose gradually?

 

Joan the danger in stopping pred is more with animals that have been on it long-term, and at higher doses.

Start furosemide. Don't wait. At worst, he will get dehydrated. At best, it will save his life.

 

Jess,
The vet didn't give me any furosemide - her words were wait and see how the steroid goes, we don't think it's the heart. I have just gone through every pill in the house (and living in the country we have lots of odds and ends) but no Lasix. I will see if I can get some first thing in the morning from someone local, some of the elderly may use them and I might get 5mg to start him off.
With regard to the Pred can I just stop dead with it? He has only been on it since Friday night 2.5mg twice daily - last dose 12 hours ago.
Many thanks,
regards, Joan

 

Just a thought -You don't know that it isn't helping, you just aren't seeing the cat improve. It could be preventing further deterioration.

Usually you taper off pred when it has been given for a while. From last Friday night to Monday isn't long at all, but if you are concerned, cut the dose down a bit at a time. this will also let you observe if doing so makes things worse.

 

He hasn't been on it long enough for it to make a difference if you just stop. No need to taper.


what about the vet that wanted to go ahead and start him on heart med? was that at the other clinic? maybe they can call some lasix/furosemide for you ?

 

Oscar has not had Pred since yesterday morning and appears a lot better today. Still breathing quicker than normal but last night he was battling for every breathe, so I do believe the Pred made it worse. A scary night but he is happier today.
I will start a new entry later in the day as this one is getting so long (with a link) I hope to talk to a vet from Melbourne today, I wish I had the xray to send her but still with the other vets.
Cheryl it is the better vet that has suggested heart meds, but they are all young and I think lacking a bit of experience they work out of 2 clinics and swap around a bit, I think they use it as a stepping stone to city practises. However the alternative is a sheep and cattle vet - not known for success with small animals!
I think I will have to find a vet for Oscar in Adelaide but a 4 hour trip in a crisis may be too long?
Talk later,
Joan

 

Hi Joan

Short-term steroids dont' usually require weaning. Why not hold off on the next dose while you have a call in to your vet to be sure. She can also script out furosemide at this time. If she balks, ask for 5 days worth with the promise that you'll call her for daily updates. You must get food into Oscar if he goes on furosemide however. He will dry out and his electrolytes will get wonky if he doesn't have input for all he's outputting. In many cases, once the cats can breathe their appetite returns (breathing takes precedence for most creatures!).

This is true for many drugs in many different types of disease. In cases of feline asthma, the pred must help or the drug/dosage must change, or the cat doesn't have asthma at all. In drugs meant to restore normal respiration when the cause of the problem is feline asthma, the change should be significant if the drug is working at a normal dosage.

BTW, in terms of furosemide, many vets give wimpy doses and then throw up their hands and say the cat is not responsive to furosemide. Every cat new to furosemide responds to furosemide -- it may not be fast enough, in cats experiencing a critical crisis, or the dose may not be high enough, but every one with even a bit of functional kidney will respond.