? Need Advice...

Hello all,
Please advise-I don't know what to do about Willee.

July 6- Willee had not gone the bathroom in 3 days going on 4(1st time ever), usually very regular and nice stool. Weighed 10.16 lbs, Vet took Xrays- noticed something sketchy in his lungs, radiologist confirmed it was the early signs of pneumonia/respiratory, gave him an enema & b12 shot & suggested I add Miralax to his food daily. Vet also suggested antibiotics but Willee did not have any symptoms so I held off. Enema did the trick
July 9- Picked up Veraflox antibiotics for Willee from vet because Willee started sneezing and runny nose. Otherwise he was himself, eating well and going the bathroom regularly.
July 19- Finished antibiotics, no problems all is well.
July 29- Willee became ill and did not move for hours and was licking his lips continuously,(he had never exhibited this type of behavior in all the years of being diabetic. Would not eat.
Take him to ER they examine him, weighed 9.69lbs and tell me he's fine(the nausea had subsided), did CBC, looked good(low BUN 12), and 600$ bill & send me home.
July 30- Take him to my vet I tell her he is just not himself and eating very little which is not like him, hiding from me, lethargic, sleeping all day, runny nose. Dr. took Xrays of lungs to see if they cleared of infection, says he looks good.
Aug 6- Take to vet again because he is still not himself since July 29, developed a wheezing type cough, where it's like he coughing up a hairball but doesn't(3 x a day), runny nose, eating well but looking very skinny to me- (I can see & feel his bones up his spine that I never did before), pooping every 3 days. Vet does a CBC, exam, he weighs 9.45 lbs gives him a Cerenia injection & fluids. He perked up when we got home, cough/wheezing thing went away and slept in my bed for the first time since he got ill July 29.
Aug 7- Vet called says Willee's bloodwork came back he's "slightly anemic", but otherwise looks good, tested negative for T4. Told me to continue to give him Cerenia, when needed. Gave him Cerenia 1/2 tablet, he's sleeping all day and night, very lethargic, but eating well. I compared his RBC from the 7/29 to 8/7 and this is what it says;

July 29 Aug 8
RBC 9.81 RBC 5.52
HGB 14.6 HGB 8.3
HCT 44.1 HCT 25.2
BUN 12 BUN 37

Also, RETICULOCYTES are HIGH 77

Aug 8-Willee finally pooped but now he's not talking at all. My otherwise very vocal, chatty boy was quiet?! no meows whatsoever. Out of it totally-slept all day and into the night. I did not continue the Cerenia. His cough/wheezing thing still gone, but still runny nose & lethargic, eating well. Called vet and she suggested I bring him in for Sub Q's, I asked if I could pick the fluid up and give to him at home, which I did, so he would not have to go through the stress again.
Aug-14 Still pooping every 2-3 days, Miralax not working, gave catnip to eat and he goes the bathroom. Still lethargic, still has a runny nose, still not himself, but better because of the fluids I'm giving every other day, meowing more, eating ALOT, crazy hungry. Blood sugar is normal 95 -100 most of the day, was running high 1st 2 weeks of August.
I personally suspect worms of some sort but since they don't show up always on a fecal exam and he's only pooping every 2 days, not sure it's worth it?. Was thinking of getting diatomaceous earth and feeding him that to see maybe if it will help? Would DE be bad because it's dehydrating? Any advice & feedback is greatly appreciated. Thank you.
Michelle

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I'm sorry Williee is having all of these issues. Some of what you said made me think hyperthyroidism, but you said his T4 was checked. When you talked about his coughing, I thought asthma - any signs of that in his chest x-ray? You mentioned that it stopped while he was on Cerenia. Willow has asthma, and her attacks stopped when she was taking Cerenia, and for awhile after we stopped it, but they eventually returned. You mentioned giving 1/2 Cerenia... how many mgs are your tablets? At his weight, I'm pretty sure his dose should be 1/4 of a 16mg tablet (1mg per kg).

I would get a fecal test done to rule out parasites or heartworms.

If they don't see any infection, could the runny nose be an allergy? Willow also has allergies... she gets 'sniffly', and she sneezes. I give her Zyrtec every day to help with her allergies. It does not get rid of the symptoms completely but does help.

Sorry that I cannot really be of any help, this is just a few items that came to mind.

 

The HGB, HCT, RBC appear to be on the lowest end of normal. My concern would be why on earth did the levels drop so fast in about 11 days. That is not normal at all! The first suspicion would be bleeding somewhere. (RBC) Red blood cells carry oxygen through the body. (HCT) Hematocrit is the percentage of circulating RBC's. (HGB) Hemoglobin binds oxygen to the red blood cells. With low numbers you would feel very sluggish, some shortness of breath.

I would strongly suggest pushing your doc on a more definitive diagnosis. The lower his RBC, HCT, and HGB fall the worse he will feel.

I had a dog with severe, rapid onset anemia. She needed a blood transfusion and was better.

https://www.vetinfo.com/cat-anemia-explained.html

https://vcahospitals.com/know-your-pet/anemia-in-cats

http://zimmer-foundation.org/sch/ajf.html

https://www.petplace.com/article/ca...d-work-the-complete-blood-count-cbc-for-cats/

 

Was Willies' poop tested for blood? In a human you just smear a bit on a special card and a lab can see blood in the stool if present. Worms can definitely cause internal bleeding.

 

That is a good sing, It means that the bone marrow is producing more red blood cells in response to the the abnormally low number of them.
The number of RBCs can be low with high reticucytes because:
1. Internal bleeding or other reason that red blood cels are being lost.
2. Some problem is preventing the reticucytes from maturing into RBCs.

 

Regarding Reticulocytes: https://www.2ndchance.info/test.php?page=dxme-ReticCount


IMHO: he is not "slightly anemic". He is Very anemic. Like I said, rapid drop in CBC there is something going on that needs to be corrected zippy quick. As I also mentioned I had a dog with severe anemia.

 

Thank you all so much for your input. After reading all your replies I took him to a different vet earlier to get his complete blood panel workup again and a fecal exam. So hopefully his RBC's haven't gone down any lower.

 

No apologies necessary, I appreciate your input. His cough went away after getting the Cerenia injection at the vet. It returned 5 days later and I gave him 1/2 of the Cerenia tablet(16mg) and took it away. The xrays turned up clear after his pneumonia. Wow, I didn't know you could give Zyrtec to cats I take it myself when I have allergic reactions. What dose do you give Willow?

 

Yes, you can! I found that out when I was researching for something different I could give her. In years past, the vet had suggested Chlor-Trimeton or Benadryl, but those cause drowsiness, and I did not want the poor girl sleeping all the time (cats sleep enough!). It is what they call a second generation antihistamine. It does not cross the blood-brain barrier like the others do so it causes much less sedation. Also, it doesn't affect heart rate or stomach acid secretions. Bottom line, it seems to be safer all the way around. I was initially giving her 1/4 of a 10mg tablet, so 2.5mg. I just went up to 1/2 of a tablet, 5mg, per the vet's recommendation. That is also what I have seen online as the appropriate dose for a cat. Willow is just small (barely 7lbs), so it scared me to give her that much. 10 mg is the daily dose for a person, so it seems crazy to me that a little bitty kitty could take half that. But, apparently, they can! By the way, it seems to boost her appetite a little, too. I have heard that it does that with a lot of cats.

 

I do hope all turns out well for sweet Willee!

 

Aww Willee & I thank youGreat to know about the Zyrtec. I’m glad it makes Willow feel better) I love her name