Taking Marshmallow to a specialist

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granadilla

granadilla

Member Since 2015
Marshmallow still isn't doing well. She finished 10 days of antibiotics for a UTI on Thursday. Her follow-up blood work looks like the UTI is gone but she's been getting in and out of the litterbox and peeing only tiny amounts. She is still low-energy and not meowing or purring as much as normal. She has also started sneezing a little bit every day. Over the weekend she ate very little. Last night I gave her an appetite stimulant and she ate a few bites but not much. I ended up giving her baby food through a syringe to get more food into her. She is still drinking water though.

My regular vet is stumped so I'm taking her to a specialist this morning. The regular vet is running a urine culture but Larry and Kitties just told me that for a culture to work, she has to have been off antibiotics for 10-14 days. So I think I just threw away money on a useless culture.

I hope it's just a stubborn UTI and maybe a bit of URI because of the sneezing but I'm sure the specialist is going to want to run a million tests. Please send some healing vines. Thanks.

@Shiloh & Rhonda, @Cat Ma, @MrWorfMen's Mom
 
Gosh, I am so sorry to hear this. Please let us know how the specialist visit went. More money spent but a wise move getting her treated more quickly. An URI can certainly make a cat not eat, lethargic and miserable. Keeping paws and fingers crossed and sending you and Marshmallow lots and lots of healing vines.
 
Oh Shane, I am so very sorry to hear Marshmallow is still feeling poorly. I can only imagine how worrying this is for you. :(

While the optimal time to take a urine culture would be to wait 10-14 days after the course of antibiotics, that doesn't mean doing a culture now is a waste of time or money. Given Marshmallow is still having symptoms, it may be that the antibiotic she was given was not the right one to battle back the offending organism. So a culture now will still identify if there is an infectious bacteria still growing.

Unfortunately, when taking antibiotics, there can sometimes be an overgrowth of other bacteria which under normal circumstances don't cause an infection. This might explain the sneezing.
Antibiotics are wonderful drugs but sometimes they actually create more problems than they cure especially when cultures are not done before prescribing them. Now that a culture is being done, I am confident the specialist will be able to come up with a treatment plan to get Marshmallow back to her usually talkative, purring self!

Menace and I are sending big hugs, :bighug::bighug::bighug:prrrrs:cat::cat::cat: and healing vines to both of you. Fingers and paws crossed here too!
 
Thank you all. She's at the internal medicine specialist's office still and he's going to do x-rays and an ultrasound. When he has those results, he'll call me and we'll go from there. I'm hoping it's just a stubborn UTI but since she has been having so many issues over the past few months he wanted to dig a little deeper.

@SpecklesandMe, AJ, my regular vet didn't run a culture before he gave her a course of antibiotics. Now I know to ask for a culture at the beginning of the process. Sending healing vines to you and Speckles too.
 
I just heard back:

— Her left kidney doesn't look good. He can't tell if it's a kidney infection or just deteriorating due to age. He said it could be either.

— Her stomach lining is twice as thick as it should be. It's either gastritis (chronic stomach issue) or lymphoma. Only way to tell is a biopsy.

— Her colon is really full.

— She has bad lungs.

So:

He's doing an enema to empty her colon. That alone might make her feel better. He's giving me some appetite stimulants and is giving her fluids and a shot of vitamins to try perk her up.

He will keep following up with my regular vet about the culture. If any bacteria grows, that should tell us if it's a kidney infection or a stubborn UTI. However, since she already has antibiotics in her system, there might not be enough bacteria to grow a culture.

I said I don't want to do a biopsy. She's 13. So for now I will keep treating her stomach the way I've been treating her IBD.

He sent her lung x-rays to a radiologist. I really don't think her lungs are the problem, unless they've deteriorated to the point of her not wanting to eat. She's always been a bit wheezy.

Hopefully all of the above will be enough to keep her eating and comfortable until we find out about the culture. If bacteria doesn't grow, then he'll want to do a culture himself since more time will have passed and there might be more bacteria in her urine in a few days.

I'm feeling a little overwhelmed right now.
 
Thanks, Rhonda. I'm hoping all the stuff he's giving her today will help even her out until we get more info about the culture.
 
@granadilla I know this is more news than you expected to receive.

Hoping the kidney issue is related to the UTI and will resolve with more treatment.

Sending you lots and lots of healing vines. I know how hard this is. Please take deep breaths and know you did the right thing getting Marshmallow in and checked out thoroughly.
 
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Shane, please take a deep breath and try to not to get too consumed by all of this. Take it one day at a time.

I had an ultrasound done on Menace when we started down this road and they included her kidneys because the vet thought one felt larger than the other and was worried about a tumour. Turned out she likely has a congenitally larger kidney on one side but oh how I worried. My point is that although there can be what appear to be abnormalities on Xrays and ultrasounds sometimes they are minor easily handled problems or just benign differences inherent in each living organism and nothing more.

I'm sure Marshmallow will feel considerably better after the enema as constipation alone can make them (and us) feel pretty miserable! I've had to take my old guy to Emergency a couple of times and it turned out to be constipation. An enema and he was back to his old self.

The vet is certainly right that the culture may not yield any growth but it's equally possible it will, so don't lose hope that it might help sort things out and get Marsh back on the road to health.

Sending you both healing energy. Don't forget to look after yourself too Shane!:bighug::bighug::bighug:
 
Aw, Shane - so sorry to hear Marshmallow's having a rough go of it! Am sending lots of healing vibes your way, & have fingers & toes crossed for improvement in her overall health. And these are for you: :bighug::bighug::bighug::bighug::bighug::bighug: - Robin
 
Oh my, I am sorry to hear Marshmallow is having such troubles. Hope the enema makes her feel much better. My Squallie is 16 and has enlarged kidneys (both of them), enlarged lymph nodes around his heart and aorta, and very wheezy lungs, so I can understand what you're going through, and I know when our babies don't feel well, neither do we. We're sending hugs, healing vibes and strength to you and Marsmallow to help see you through this tough time. Breath deeply, and keep the faith! :bighug::bighug::bighug:
 
Wondering if the lungs could just be due to subclinical asthma. I think this is more common in cats than most vets appreciate.
Anyway, sending lots and lots of positive thoughts and healing vines. Fingers/paws crossed!
 
Thank you all so much for the support. I'm feeling calmer today. :)

Last night I gave Marshmallow an appetite stimulant (Cypro) and she only ate a few bites. I knew she was still hungry because she kept walking up to the bowl and then walking away. I tried 3 different foods and added Fortiflora but she still wouldn't eat. After a couple of hours I pulled out my syringes and fed her some baby food. I know baby food isn't a complete meal but I just wanted to get something soothing into her belly. When I woke up this morning she had eaten about 1/8 cup of kibble so I feel better that she ate on her own. I also raised one of her bowls. Critter Mom had mentioned in a different thread that cats with pancreatitis don't like to hunch over to eat. Marsh's pancreas is okay but I thought it might help if she had some other abdominal discomfort. The bowl she ate from last night was the raised bowl so maybe that helped.

Maybe the enema helped on some level but she's still acting like she doesn't feel well. I agree with you guys that the UTI / kidney infection is bothering her more than the other stuff (lungs, deteriorating kidneys, etc).

If the culture doesn't grow anything by tomorrow, I'm going to ask the vet for his "best guess" antibiotic for the infection until we get a specific answer. He already said he'd do that if the culture doesn't yield anything. I have a long list of questions for him regarding the other stuff. He said we should talk tomorrow because we'll know more from the culture by then. In the meantime I'm writing down all my questions for him.

I really do like this vet. I sent him a panicked email last night when she wasn't eating and he responded within an hour with a very calm, reassuring email.

Thanks again for your support, it really helps a lot. :)
 
Shane, I'm sure that most of our cats, if put under the proverbial "microscope" of ultrasounds, X-rays, blood work etc., would come back showing something not right....especially, at somewhat older ages. Same holds true for us as humans. The more we age, the more they will find wrong with us too. :rolleyes:

I've had a CRF cat who lived MANY years beyond diagnosis with it (he was 18 years when he passed and it was from something else that he passed from) and his kidney's were pretty bad but, kept under control with foods meant for that issue.

I've had 2 cats with cardiomyopathy. One lived to be 17 years old with it and some extra Taurine (those were the days when foods didn't add extra taurine)...I used to break open a capsule and syringe it into her mouth as well as other supplements.

One of my brother's cats was diagnosed with what they believed was a tumour in her intestines and they kept begging my brother to euthanize her at 17 years of age. He didn't. She lived...get this one...until nearly 23 years old!

I had another cat who they said had "mega colon" and would never be able to pass another movement on his own....euthanize him. Guess what? He went on and had BM's on his own. You want to know the trick? It came from a lot of research on MY part...not the vets' (3 of them). Plain old fashioned Zantac (ranitidine) for stomach acid, found over the counter. (You'd just need to get a dosage for Marsh's weight). It helped his stomach acid as well as passing stool on his own. :) They did studies on it in the U.S. and Europe. Worked! And, now...those 3 vets are using it on loads of cats. I taught them! :smuggrin:

So, hang in there as ALL of us are sending good and healing vibes, energies and prayers for both of you! :bighug: :bighug: :bighug: :bighug:
 
Well this sucks Shane but at least you know a lot more. She'll feel yucky for a couple of days from the enema. I have a civie with a small descending colon and poor muscle tone to move things thru correctly. Poop backed up badly for over a year before we finally got a handle on it. He had 3 enemas, none were ever able to clean everything out. When I saw another vet for the third one, he prescribed reglan (in place of cisapride which is very expensive) to help strengthen the muscles and help move everything through. I also gave him Miralax doses twice a day along with 20-30cc's of syringed water daily. After about a week, everything started moving correctly and cleaning out all that stuck poop. He lost 2 pounds, all poop. :) I quit the reglan shortly after that as it works on all muscles, not just the colon. I continued with the Miralax twice daily for another couple of months then was able to drop down to once a day. He's now been moving things by himself for well over a year, I only use Miralax about every 3 days now but continue to make sure he drinks well and syringing water if he doesn't. It made a HUGE difference in how he felt.

Lots of extra big thoughts and prayers for all of you continue!

BIG HUGS Too!
 
Thanks, Lyresa. Just curious, how much Miralax do you give him? I was giving Marshmallow 1/8 tsp daily but the vet said to double it. Thanks. :)
 
Snowshoe is a BIG kitty - a 17lb (without poop) Maine Coon mix. The normal dose is 1/8tsp but he gets a shy 1/4th twice daily if he's having issues, once a day when things are working OK, every 3 days when it's dong good. When we were working to help move things along, 1/4th twice a day consistently. Be sure Marshmallow gets lots of water as Miralax works by drawing water into the colon from elsewhere in the body. I've seen some people say you can't soften what's already there but I was able to do that for him by being sure he got lots of water too. You don't want to end up with really soft stool behind the hard ones - if she were mine, I'd do a heavy 1/8th twice a day for a couple of days and see if things start moving softer. She likely won't have a BM for close to a couple of days after the enema tho' so don't let that really concern you. Watch for signs of straining that may indicate a hard one's nearing the descending colon.
 
Squeaky and KT said:
Well this sucks Shane but at least you know a lot more. She'll feel yucky for a couple of days from the enema. I have a civie with a small descending colon and poor muscle tone to move things thru correctly. Poop backed up badly for over a year before we finally got a handle on it. He had 3 enemas, none were ever able to clean everything out. When I saw another vet for the third one, he prescribed reglan (in place of cisapride which is very expensive) to help strengthen the muscles and help move everything through. I also gave him Miralax doses twice a day along with 20-30cc's of syringed water daily. After about a week, everything started moving correctly and cleaning out all that stuck poop. He lost 2 pounds, all poop. :) I quit the reglan shortly after that as it works on all muscles, not just the colon. I continued with the Miralax twice daily for another couple of months then was able to drop down to once a day. He's now been moving things by himself for well over a year, I only use Miralax about every 3 days now but continue to make sure he drinks well and syringing water if he doesn't. It made a HUGE difference in how he felt.

Lots of extra big thoughts and prayers for all of you continue!

BIG HUGS Too!
Click to expand...

Glad that you found something that worked for you Squeaky and KT! :)

But, *IF* that doesn't work for everyone else...Zantac (ranitidine) works to move the bowels AND calm stomach acid. It replaces the old med Propulsid that was doing a number on cat's hearts. It's a bitter pill (you have to break it into pieces) so, I coated it with a bit of margarine first then, pilled. Finally, I found a compounding pharmacy that would put it into an injectable form and injected it the same way that I did the insulin. Worked miracles. If anyone is in doubt...speak to your vet about it and see what he/she has to say. A lot of vets aren't aware of this off label usage but, U.S. studies showed it worked and it DID...at least for us. :)
 
Here's a piece from an article about constipation and ranitidine...(We also added canned pumpkin...which some cats like :) )


"There are also prescription medicines; lactulose softens the stool, and propulcid speeds up the movement of the bowels. Ranitidine is another medication with a similar effect."

Don't use the propulcid as that can affect the heart as well as give diarehia.

This came from THIS LINK (there ARE other studies but, I'd have to search to find them). Ignore the "scary" parts of this though as they have to cover their rears.

:bighug:
 
I talked to the IM vet this morning. There's nothing conclusive from the urine culture so he's going to give me his best guess antibiotic for the UTI / kidney infection and I'll give that to her for 6 weeks.

The radiologist said that Marshmallow either has fibrosis of the lungs (progressive scarring that will get worse) or lung cancer. The IM vet told me that prednisolone would be good for her stomach (which either has gastritis or lymphoma) BUT it would be the worst thing to give her kidneys because her kidneys are in stage 2 CKD. The compromise is rapid-acting budesonide instead of the slow-release that I have so I just ordered that.

Big picture: I will try to conquer this infection but she has a lot of things going on. He said everything we're doing is treating her symptoms and I need to evaluate her quality of life. Right now she is extremely lethargic and nauseous even though she's on Cerenia. I also gave her Ondansetron last night and I'm going to add Pepcid tonight. I'm giving her appetite stimulants but she's eating only about half the food she needs.

I don't need to make any hard decisions right now but if she doesn't rally then I will need to keep an eye on her and keep evaluating how she is doing. Right now she's still sleeping next to me and she purrs a little bit when I pet her.
 
Oh Shane. I'm so sorry the news was not encouraging. I can only imagine how upsetting this is for you.

Marshmallow's getting the best of care from her vet and more importantly love and care from you, so try to keep positive thoughts that she will rally and get her over this hump.

I'm keeping you and Marshmallow in my prayers. I wish you were closer so I could give you a much needed real hug and Marshmallow some real scritches. :bighug::bighug::bighug::bighug::bighug:
 
Shane, I am so sorry. I wish that computer screens could hug because it would be hugging you for me right now as you're reading this. :bighug::bighug::bighug:

Just know that you're doing all that you CAN do for Marshmallow. We say that to one another and yet, we beat the heck out of ourselves because we think we can do more. The reality is...Nature is doing what it's going to do and you are doing all that you can do. Most people wouldn't have even spent the money/effort on a specialist that you have done...let alone the emotional part of this that goes with it.

Unfortunately, I know, sadly...what this feels like as I've gone through this over and over and over again throughout my life. But, having said that....there ARE sometimes when doctors have handed out some pretty nasty "results" and the pet has gone on once past a hurdle or two. We never know so, we'll hang onto that and send prayers, good energies, healing vibes and everything possibly good. Please keep your mind as open as possible because sometimes...even the impossible...becomes possible. Remember that!

My mother once told me that my heart would tell me what needs to be done and what doesn't. She was right. Your heart will tell you (as will Marshmallow) what needs to be done and what doesn't. There's still hope. Never let go of it. We won't! We're all pulling for Marshmallow to rally back around and....that's POSSIBLE! Our prayers won't stop....for Marsh or you. Promise!

ETA: I have a neighbour whose poodle is deaf and blind (cataracts). He's 15 years old. His kidneys were diagnosed as having disease 3 or 4 years ago now. He went off of food for awhile. He's had Spindle Cell carcinoma and they didn't give a good prognosis (that was 5 years ago now). He's had a tumour removed from his mouth and a few of his teeth to get the tumour out. His lungs are thickened and what the vet said (in laymen's terms) was "old dog lungs". That was also 2 or 3 years ago. His spine has calcified and he has back issues that come and go. His liver was diagnosed as being bad over a year and a half ago now. Long story short...this dog was prancing up the sidewalk with my neighbour yesterday, waiting to get a bit of her ice cream cone. While vets had him "dead and buried" (poor way to put it but, the truth) YEARS ago...he's licking ice cream cones and still going for his walks. :) There's ALWAYS hope!

Just HUGS :bighug::bighug::bighug:
 
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Just remember that docs and vets see what they see on these tests. What they don't see...is the "will to live" in people or pets. So, while they can hand out all kinds of different test results, which can seem pretty "grim", they can't see what love can do. Never underestimate the power of love to perform "miracles". :bighug:
 
I know this is not an easy time for you. I, too, like the others, want to believe Marshmallow will rally through this. Cats do have an amazing ability to defy the odds. That's why they have 9 (or more) lives.

My first thought was if Prednisilone could help with the lungs. I am wondering if any CKD cats here are on Prednisilone. But you have to weigh what works best for Marshmallow given her other issues.

Sending you tons and tons of hugs and healing wishes for Marshmallow. Indeed, cherish and hold dear every precious moment with Marshmallow. Love, as Louellen points out, has an amazing ability to heal.
 
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Oh poop...just Oh poop. I'm sorry she's got so many strikes against her Shane. She'll let you know when she's ready to go - you in tune with her enough to recognize it. Until she tells you, she's still willing to try her best too...

HUGS and hugs and hugs, extra thoughts and prayers too...
 
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