Latte Update - choking...anemia...etc.

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carolynandlatte

carolynandlatte

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I took latte in for labwork yesterday. PCV was around 33/34. Low side of normal, but not officially anemic. So we are uncertain about the litter eating. The vet thought it was ironic that I have tried so hard getting her to eat after almost a year of syringe feeding and she goes and eats the worst thing possible for her. *sigh* Eating litter can also be a sign of digestive issues (which she has), play (this only happens in the a.m., so?!?!?!), or deficiency (she has gained almost 2 lbs in the last 2 months and eating well). Its tough to say. Her PCV has almost always been around this range since the kidney failure, sometimes lower. So, I think its a good thing to keep an eye on.

Choking/gagging - I video taped some of her episodes and the vet said she is clearly trying to get something out of her throat. He showed me some video he found as well to see if it was similar. Piecing the two together, he suspects it being some rare disease with a long name (forgot to write it down). Im pretty sure it is what someone alerted me to in the original post about this issue. Im sorry I forgot who it was. But I did look at the information on the disease - basically throat paralysis. It kind of made me a little sick to my stomach, thinking what may come our way in the future. The only treatment is surgery, which is not an option. With that in mind, and considering our finances I will likely have to forgo any future xrays.

I did do a renal panel since we have not had one in about 8 months. Since the anemia is non-existent, I have a good feeling that kidneys will not be too bad, or any worse than they have been. I can post the results when we get them in on Monday.

She is such a sweet girl, overcoming so many obstacles with such grace. If she didnt have such a sparkle in her eye and skip in her step... Considering all her ailments, the vet said she is probably the healthiest looking 17/18yr old cat he has ever seen! :thumbup I would have to agree.
 
Hi Carolyn,

My cat Mini is the one with the rare airway problems. Your thread on the old forum is at http://www.felinediabetes.com/phorum5/r ... ?8,1962850 . The website describing the problem is here.

Can you post the video of Latte choking? That may give us some ideas!

An xray is a good initial step as it can rule out some things, like certain types of foreign objects and it may also show masses (possibly benign). Jess is a vet tech and can no doubt tell you more. If your cat has the larnyx problem like Mini, then from what I was told and have read, an esophageal scoping (endoscopy) is needed to diagnose that condition. The endoscopy didn't indicate anything about the cause though, except in helping to rule out trauma. He had loads of tests for toxins, neuromuscular issues, etc. They never found out why it happened.

I did some more research and there are other possibilities for difficulty in swallowing (dysphagia). Some could be treated by steroids or by antibiotics, some by very minor surgery. Some things to think about: is there any bad odor to the breath? Does she drool a lot? Also, when Latte had bloodwork did she have a T4/free T4? You mentioned she can choke on both food and water - is one more common?

Possibilities include:
  • tumors (as Karen said)
    nasal polyps*
    an object (can be stuck for a long time)
    mouth/dental infections
    swelling of the tongue
    hypothryroid
    laryngitis (can be recurrent! can be caused by meowing/howling, excitement)
    poisoning by some houseplants (such as diffenbachia - is Latte a plant chewer?)
    tonsillitis (I had no idea that cats even had tonsils)
    esophagitis/reflux esophagitis (can be related to frequent vomiting or backflow of gastric juices)
    damage from heat stroke (did Latte ever get really hot?)
    collapsing trachea (treated by rubbing the throat)

* From http://wiki.answers.com/Q/Your_cat_is_h ... g_with_her
"Nasal polyps can be hard to find so it may be necessary for the vet to anesthetize your cat in order to take a close look at this region. A nasal polyp is usually reasonably easy to remove and can provide a lot of comfort or even save a cat's life. Nasal polps in cats cause nasal irritation and difficulty swallowing which may sometimes also result in weight loss and/or coughing or choking sounds. The signs are sometimes intermittent, meaning, they may be hours apart, or even days apart, but not usually weeks apart. Or they may be continuous. Nasal Polyps can usually be seen when a cat is anesthetized and examined but it can take an endoscopic examination to find them. It is sometimes possible to see nasal polyps without the aid of an endoscope but it is advisable to get the cat anesthetized and checked. Removal of nasal polyps is relatively easy and may even save the cat's life."
Click to expand...

So it's possible there is a problem that is treatable at reasonable cost for your elderly cat. Your vet should be able to walk you through his/her thought process as far as what has been ruled out and why. (Bring a pen and paper @-) !)

I'm glad that you have the dishes raised. Have you tried adding a little water to the wet food, so that it is mashed potato consistency? That's what works best for Mini. With only a little added water, Mini doesn't need to drink very often but he doesn't have kidney issues to contend with. Latte may need a lot more water to help her kidneys if they can't concentrate urine well. If I add too much water to Mini's food, then he gets food/saliva discharge from his stoma and is at higher risk for aspiration pneumonia. But remember his dysfunction was so severe as to be fatal without major intervention. You would need to experiment with Latte to find how wet she can take her canned food.

here are some links for you to check out:
http://www.petplace.com/cats/dysphagia- ... page1.aspx
http://wiki.answers.com/Q/Your_cat_is_h ... g_with_her
http://www.familyvet.com/Cats/Resp.html (check laryngitis, collapsing trachea, larynx)
http://www.medicinenet.com/pets/cat-hea ... n_cats.htm
http://vetlearn.com/ME2/Audiences/dirmo ... 261E44355# (video of normal and abnormal trachea function)

FYI Min had several surgeries culminating in a permanent tracheostomy. This actually has worked out pretty well for him because he is able to get air in via his upper passages as well as through the stoma, and he can 'cough' out his stoma. It was real expensive to go through all those surgeries but he was only two and otherwise in terrific health. In case you're curious, you can see some photos. The best photo of his stoma is here.

let us know how Latte's doing,
laur
 
I might be pointing out the obvious or something already discussed previously, but the litter eating is pica (google it) which is caused by anemia. So even though the hematocrit is in the "normal" range, it might be low enough to cause the non-food object eating.

I know a lot about pica because I developed it when I was a vegetarian and became anemic. I probably shouldn't admit this, but I really craved cat litter too!!! The smell was downright appetizing to me (don't worry, I didn't actually eat any). My doctor thought it was humorous. I compromised and ate five pounds of ice a week for several months!

Just a thought.
 
Hi Laur! Glad you found us! :-D
Is there another name for the laryngeal paralysis? A lot of it sounds similar to what he was referring to, but the name of it does not sound like what I vaguely remember him saying. I will speak to him tomorrow and write it down this time. Usually Im much more on top of it. I had just a zillion questions for him and only so much time. The one thing he kept referring to was how purring often triggers these episodes for cats. he wanted me to be very intune to what latte was doing just prior to the episode. I pretty much watch her like a hawk anyway. I still say its after she drink and usually involves lying down after drinking. I have seen it happen a few times when playing. I have not recognized it while purring. Some of his video also included cats who had it so bad they needed to breath with an open mouth.

I tried and think I successfully posted a few videos to photobucket. Only problem is my computer freezes up everytime I go onto the site. I even took 2 bucks out of Latte's 'fund' to register for the site with no adds, thinking that would help. No go. :sad: So I have no way of sending or 'sharing'. I will have to find another site that works better for us. Any suggestions?

I understand an xray is a good initial step, endoscopy, possibly u/s, even surgery. What is important to keep in mind is that Latte is pretty much falling apart. She looks great, but she is showing her age and carrying her fair share of illnesses. Just as I opted against the biopsy to determine if she had ibd or lymphoma, I would do the same for this. What answer would I get that I could actually do something about at this point? I have $250 to spend on Latte right now. I may have bits an pieces coming in here and there, but nothing consistant. If I blew that money on an xray to see if she has something I cant even treat, then what do I do when she develops a uti from high glucose/pred/kidney disease? What do I do if she did get pneumonia and I couldnt afford to have her seen by the vet? What if she developed DKA? These are things, at this point, that I need to consider.

Latte is already on prednisolone. Her vet said that anything involving swelling should be responding to the pred. Unless of course it is not a high enough dose, I suppose. Not sure if I want to increase her pred anymore for something we are not sure it will fix. I already feel like Im playing with fire with the steroid, diabetes, and proneness to UTI's.

We just did a kidney panel this time around. She has had a T4 in the last 8 months and all was normal. No bad breath and she does not drool. She chokes more on water. Only once or twice have I seen it on food...unless of course she drank a lot of water prior to eating.

esophagitis/reflux esophagitis (can be related to frequent vomiting or backflow of gastric juices)
Click to expand...
I think this may be one of the greatest possibilitys. She has spent so much of the last few years vomiting uncontrollably due to first, tummy acid/kidney disease/pancreatitis, then the ibd/lymphoma. I tried everything under the son before we wen to the steroid. And of course, the steroid brought us here. *sigh* I think I would like to look up some more information on this.


* From http://wiki.answers.com/Q/Your_cat_is_h ... g_with_her
"Nasal polyps can be hard to find so it may be necessary for the vet to anesthetize your cat in order to take a close look at this region. A nasal polyp is usually reasonably easy to remove and can provide a lot of comfort or even save a cat's life. Nasal polps in cats cause nasal irritation and difficulty swallowing which may sometimes also result in weight loss and/or coughing or choking sounds. The signs are sometimes intermittent, meaning, they may be hours apart, or even days apart, but not usually weeks apart. Or they may be continuous. Nasal Polyps can usually be seen when a cat is anesthetized and examined but it can take an endoscopic examination to find them. It is sometimes possible to see nasal polyps without the aid of an endoscope but it is advisable to get the cat anesthetized and checked. Removal of nasal polyps is relatively easy and may even save the cat's life.
Click to expand...
Its really too bad this has to be so invasive. I suppose that could also be a possibility.


here are some links for you to check out:
http://www.petplace.com/cats/dysphagia- ... page1.aspx
http://wiki.answers.com/Q/Your_cat_is_h ... g_with_her
http://www.familyvet.com/Cats/Resp.html (check laryngitis, collapsing trachea, larynx)
http://www.medicinenet.com/pets/cat-hea ... n_cats.htm
http://vetlearn.com/ME2/Audiences/dirmo ... 261E44355# (video of normal and abnormal trachea function)
Click to expand...

Thank you for the links! I will check them out!

I really appreciate the time you took to find all the links and get this all out into cyberworld for me to see. I dont by any means want to dismiss your suggestions, or even sound like I am. I just need to be upfront with what I can and am willing to do at this point. There comes a time when there is just no more you can juggle. the question then comes with learning about whatever *might* be wrong and knowing what signs to look for in case we are in a crisis. This way I will know if I need to get her to the ER and/or if I need to make a hard decision before she were to suffer greatly.

Once I figure out a different way to post the video I will. I tried looking for one on google, but have not been successful quite yet. A few were close.

Again, thank you!!!! And I will keep you posted. I hope you dont mind me asking questions as they come up.
 
I dont by any means want to dismiss your suggestions, or even sound like I am. I just need to be upfront with what I can and am willing to do at this point. There comes a time when there is just no more you can juggle. the question then comes with learning about whatever *might* be wrong and knowing what signs to look for in case we are in a crisis. This way I will know if I need to get her to the ER and/or if I need to make a hard decision before she were to suffer greatly.
Click to expand...

I totally understand your position. I think it does often help to know as much as possible about the situations, what treatments are financially feasible, the prognosis if the cat makes it through the current crisis, expected life quality, etc. I was just in that situation with another one of my cats with a rare unexplained condition, plus a serious blood parasite. Answers were few and dollars scarce. For me the most important thing was that he not suffer at all, and I made sure my vet understood that. It looked like he only had days but it seems like we got lucky again. A last ditch try with a risk ymedication seems to have helped him -- but he has a checkup this week.

Also I know firsthand all too well how scary it is when your pet is choking and gasping for air. One thing that has worked for me during Min's sudden severe choking episodes is to handle it like an infant choking. Min knows I am helping him so he doesn't fight; he doesn't have the air to fight anyway. I lay him over my left forearm, head down (face supported by my palm), then I thwack him on the back several times to try to dislodge the blockage. It's worked every time totally except the last, and I called the ER in a panic and they had me stick a q-tip down his stoma to clear it. You can also find the recommended way to handle choking at http://animals.howstuffworks.com/pets/h ... ng-cat.htm but I just don't feel comfortable picking up my cat by his hind legs and swinging him. Though I guess I would do it as a last resort if nothing else worked. Otherwise if he could breathe at all, I'd put him in his oxygen cage and run for the ER.

Anyway, sorry I don't have any ideas on posting the video. Never did it myself but others may be able to help.

Let us know what the doc says tomorrow. I can't think of what he is referring to with the purr-choking.

laur
 
hi laur,
It is laranygeal paralysis that he is speaking of and thinking it could be.

Still need to find some time to figure out where else I can put videos for others to see.
 
Carolyn,

sorry to hear it. Since funds are short, you need high value. I would recommend making it a priority to get the vet to prescribe the rental oxygen tank and make yourself an oxygen cage. The cage cost $12 to make, and took maybe 15 minutes. (Actually you don't really need a cage, you can just put a towel over a carrier and let the hose blow into the carrier. This will use up oxygen quickly though.)

The thing is that as the animal panicks, they try to suck in air and that makes things worse by restricting the airway. Then swelling sets in and worsens things more. By getting the cat right away into oxygen, you can cut short that panicky escalation, and buy time to get to the vet if needed. I trained Mini to the oxygen cage by setting him in it, and giving him treats a number of times, before even shutting the lid. Now he's quite happy to go in there.

Other tips include removal of any collar, keeping the pet in AC away from heat and humidity, as well as avoiding stress including overly excited or strenuous play. For example, Min gets so worked up by catnip, and he salivates so much, that within moments he will start wheezing and having frothy fluid fill up his stoma. A good toy for him is the string-ma-thing because he lays down to play with it, and just moves his arms.

Lastly, I found some excellent diagrams at http://www.michvet.com/library/surgery_ ... alysis.asp .

laur
 
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