What happens to Tuni? Update in first comment

Update meeting with the vet 07-02-2023: I talked to the vet and even with all of Tuni's symptoms (drinking a lot of water, urinating many times, licking genital area, constantly licking lips and swallowing, unusual sound with cheeks when smelling), he said it could be “things from the age” and he indicated a gel for the hairballs due to accute vomiting 1 week ago.

A few hours ago I gave her the gel with some fancy feast classic and 1 hour later, she vomited a lot of water and the little food she had ingested, then she sneezed around 20 times and she had a face of fear and pain (although she is not very sociable, looked to me for help) that broke my heart. Minutes later she calmed down but couldn't find a position or place to feel better, she tried to sleep and then I could hear the stomach rumblings that had gone away with last week's vomiting. These are the components of the gel: malt extract, vitamin a and e, thiamine, taurine, oleo del peixe, soy lecithin.

Please I ask for your opinions to know what may be happening. thank you so much.

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Original publication on exam results (February 2, 2023)

Hello, Tuni has new results for T4, biochemistry and fructosamine. It's all very confusing...

T4: The first result was 8.4 ug/dl (december 29), but the second 2 days ago was 3.4 ug/dl.

Fructosamine: The only result (2 days ago) was 397, but the basal glucose of 2 biochemicals were at the limit (they could even be high because Tuni is very, very stressful).

In addition, his urinary density is low (1015), but SDMA and UPC are normal (2 weeks ago). The abdominal ultrasound (1 month ago) showed possible chronic pancreatitis and cholescytitis.

Tuni until december ate cooked chicken, turkey and a little hearts (2 months a year eat dry food orijen or acana). So the vet said to give him senior dry food and I half followed his instructions (the last month give him cooked chicken and dry food plus wet food like fancy feast, royal canin and n&d), but it was not the best idea, Tuni has been having stomach rumblings and vomiting the last days. Last week, although I don't know if it's because of the new diet or because the last week she has eaten giant nocturnal moths....
In addition, his last two stools have been strange (sorry for attaching the unpleasant image). N1 was vertically segmented like a hot dog bun and N2 was 2 thin stools forming a sort of braid. both with a somewhat reddish tone on the outside.

I am really very distressed and still waiting for the vet to call me to see diagnosis and clinical management. I ask you to please tell me about your experiences and if you have any idea what might be happening with my little cat. You can't imagine how much she suffers in silence when going to the vet, for her it's the worst thing in the world.
Thank you.

 

Here is your previous thread for continuity
https://felinediabetes.com/FDMB/thr...ly-able-to-add-the-files.273362/#post-3040128

I'm wondering if you are feeding a balanced diet to Tuna? Are you adding a supplement when you feed cooked chicken, turkey and heart or the chicken and croquettes. They are not a balanced diet. What are senior croquettes?

The fructosamine test is just above normal. When is the vet calling you?. Can you go in and see him?
I'm going to tag @Suzanne & Darcy as she was helping you earlier with some of the test results

 

Now I have corrected it...I say croquettes to dry food...During these years I added omega krill, ground egg shell, a minimum of squash to the diet of cooked chicken or turkey...I think it is possible that there is some kind of nutritional deficit, but stomach and vomiting problems are occurring now with commercial food (dry and wet), until 4 weeks ago the only visible problems were drinking more water, urinating more, licking his area genitals, licking his lips... But the last few days there are new problems with vomiting and feces... Tomorrow I'll try to talk to the vet.
Could fructosamine be increased because the last month has been fatal for Tuni due to trips to the vet?. Thank you.

 

The fructosamine test is not affected by stress.
licking lips is a sign of nausea.

 

How did you introduce the new diet? Did you gradually change the food?

 

I think that all those constant changes in her diet are taking a toll, so I would suggest you select one and try and stick to it ( unless she gets sick , vomiting, diarrhea or something) , I'm not clear about how all the testing was made so I'm not sure if he is diabetic or borderline diabetic but in any case my suggestion would be to give low carb diabetic appropriate food and hopefully that's all he needs to regulate his blood glucose so if it were me I would totally avoid dry food ( "croquetas" as we call them in spanish) in any variety not even senior or any of the prescription ones because they are all high carb and not good for diabetic cats ( actually I think they are not good for any cat) .

If you are going to give a comercial one like fancy feast just make sure is one of the low carb ones, and try to give just one kind or brand so you can actually know if it is not causing any problems to her and if it does you can pinpoint which one is the problem.
You could take a look at the food lists we have here at the forum for guidance and that means no gravy varieties among other things, here are the links to the lists where as long as it is 10% or less carbs it would be ok:

http://catinfo.org/docs/CatFoodProteinFatCarbPhosphorusChart.pdf
http://www.felinediabetes.com/FDMB/threads/food-chart-update.176833/
https://docs.google.com/spreadsheets/d/17hF87V3ER1visK1H1Jg_b2iUsd0YT0NGO1wfib5Go1E/edit?usp=sharing

If you are going to give a home cooked diet I think that's great but you need to make sure it is a well balanced one and has all the nutrients and supplements they need, Taurine being one of the most important ones, I'm not sure if you can get the supplements pre prepared like the have in the US or Canada that you add to the chicken or whatever protein you are using, in Latin america is not easy but maybe you can get some where you live to make sure the food you are giving is balanced .
But if not you may want to take a look at Dr Lisa's recipe and instructions for making cat food from scratch, I think is one the best ways of making home cooked food it literally saved Babu's life, (and she gives a very good explanation on stool appearance and consistency that you may find helpful) here's the link:

https://catinfo.org/making-cat-food/

 

This results doesn't make much sense so I would suggest you wait a few weeks (2 or 3) and do a new complete blood work including T4 as a follow up and depending on the results see if you need to give her thyroid meds or not

 

Hello again, I think the licking of genitals could be from either a urinary tract infections, which I do not believe was found on your urinalysis, or perhaps idiopathic cystitis which can be painful. Tuni must have lost a lot of weight as the creatinine has decreased markedly. What did the vet say about the thyroid? I agree that those two widely different thyroid results don't make sense. I wonder if there was a lab error?

 

One thing that really concerns me is that excess thyroid hormone can "mask" kidney disease, because of the effect of the thyroid hormone on GFR (filtration rate of the kidneys). So this is where it is important to monitor the Urine Specific Gravity although it can be unreliable indicator because of hyperthyroidism. I hope you can get some answers. I feel so sorry for Tuni and for you.

 

His old food was cooked chicken/turkey and I have not removed it completely, I just added royal canin senior food and also those days before the stomach rumblings and vomiting began I had incorporated wet fancy feast and royal canin recovery food (due to low appetite), there were some mixtures of chicken + wet food or of wet food + dry food. He also ate giant moths. These last 3 days the moths have not come and I chosen to give food every 4 hours without mixing anything. Today it took a while to defecate, 40 hours passed after the last time and again it was in the shape of a braid and with one end with a copper tone (but I don't know if it was the initial or final end). The good thing is that he did everything at once. The penultimate 2 times I defecate a little, it went away and then it came back after 5-8 minutes to finish…

 

Hopefully its only because of the mixes or the high carbohydrate content of the dry senior food (40%). In humans, the decrease in the diameter of feces is associated with serious colon problems and although from a distance it seems that the Tuni diameter is normal, when seen in detail they are thin feces united like a braid and today it did again (they go 3 times).
On the tests, T4 was performed in a human laboratory and the differences were that the first had 5 hours of fasting, while the second 2 hours, also in the first the blood was clotted (for this reason there is no complete blood count for that date) and in the regular second. In fructosamineis it possible for the values to increase when there are no long fasts? she only had a 2 hour fast... Thanks for the links, deciding what to eat Tuni is very important... That and discovering if there is any disease that can decrease the values of t4 occupy my time at the moment.

 

Hello, I spoke with a human blood laboratory professional about possible errors and he said that in the case of hormones any error could not change the results so much and that the method used for the test is the best (chemiluminescence). On the urinalysis, it came out negative but it was with a spontaneous urine sample (not with a needle)... The strange thing about this is that he not only licks the anus or vulva, he cleans both and when he does it on the vulva, sometimes, it comes out transparent liquid in the form of a large drop that remains right there (urine?). It is a shame that intestinal symptoms are now added that can mislead the initial problem. On Monday I'll talk to the vet...Today something strange happened again, Tuni was sitting next to me and I pushed her a bit so that she would lie on my leg and she made a sound similar to reflux, but at the same time I think she moved his abdomen, it was very fast but I don't understand how my soft movement caused that...

 

I share the concern about kidney disease, although with the latest results it may be some serious disease that is influencing the decrease in thyroxine results... Until now the only evidence of a kidney problem in tests is the density of the urine (1015) , but as you say I don't know how reliable it would be if she had hyperthyroidism. Urinary density is affected by short lapses of time between one urination and another? Could it decrease by going to urinate more often?. Thanks.

 

I'm not sure you can extrapolate human problems to cats, but what you are describing in several of your posts points more to constipation which can be because of age or a symptom of thyroid problems or other gastrointestinal problems so again I would suggest you try a well balanced diet, that could help in several issues

Is she neutred?

What latest results and to what serious desease?

So far her test results does not indicate a serious problem with her kidneys, even if she had a thyroid problem odds are that her kidneys are not seriously affected probably at early stages of CKD at the most so I think you have to focus right now on getting her gastrointestinal problems sorted out and see if you can get a thyroid test done by a veterinary lab with species appropriate tests.

 

Thanks.

 

Hi @Tuni,

I am not an expert, but one thing I wanted to confirm- did the vomiting just start when you changed her diet?

If this is the case, could you put her back to her old food and work on the diet changes more slowly?

It sounds like Tuni's got some other health issues to deal with, but it seems important to get the vomiting to stop or Tuni will keep feeling worse.

I wonder if the sneezing could be a side effect of the vomit- maybe something entered the nasal passage?

 

How is Tuni?

 

@Suzanne & Darcy

I think @Tuni put their most recent update + question back into their original post (not sure if you saw this already)--

"Update meeting with the vet 07-02-2023: I talked to the vet and even with all of Tuni's symptoms (drinking a lot of water, urinating many times, licking genital area, constantly licking lips and swallowing, unusual sound with cheeks when smelling), he said it could be “things from the age” and he indicated a gel for the hairballs due to accute vomiting 1 week ago.
A few hours ago I gave her the gel with some fancy feast classic and 1 hour later, she vomited a lot of water and the little food she had ingested, then she sneezed around 20 times and she had a face of fear and pain (although she is not very sociable, looked to me for help) that broke my heart. Minutes later she calmed down but couldn't find a position or place to feel better, she tried to sleep and then I could hear the stomach rumblings that had gone away with last week's vomiting. These are the components of the gel: malt extract, vitamin a and e, thiamine, taurine, oleo del peixe, soy lecithin.

Please I ask for your opinions to know what may be happening. thank you so much."

 

Where’s the original post? Thank you!

 

Post #1 in this thread way back at the beginning - I think they edited it to add in this update.

 

Oh my comment did not appear complete...Tuni is castrated as a teenager, she was never a mother. I agree with you, also I think should focus now on the gastrointestinal. Yesterday my little girl suffered a lot. Today I spoke by phone with the vet's assistant to ask him about how to proceed in this situation and he said to continue giving the gel that caused him to vomit yesterday and also to give him cerenia. Of course I will not continue giving him the gel and if there is no vomiting this week, I think will not give him cerenia either. How I would like to give her something to help her with that noise and stomach movement (similar to human reflux or hiccups) that she gets after drinking water, but even if I asked the vet for it, he only focused on the gel

 

Hello it’s just under a line in the first comment, anyway copy and paste here. Thanks.

Hello, Tuni has new results for T4, biochemistry and fructosamine. It's all very confusing...

T4: The first result was 8.4 ug/dl (december 29), but the second 2 days ago was 3.4 ug/dl.

Fructosamine: The only result (2 days ago) was 397, but the basal glucose of 2 biochemicals were at the limit (they could even be high because Tuni is very, very stressful).

In addition, his urinary density is low (1015), but SDMA and UPC are normal (2 weeks ago). The abdominal ultrasound (1 month ago) showed possible chronic pancreatitis and cholescytitis.

Tuni until december ate cooked chicken, turkey and a little hearts (2 months a year eat dry food orijen or acana). So the vet said to give him senior dry food and I half followed his instructions (the last month give him cooked chicken and dry food plus wet food like fancy feast, royal canin and n&d), but it was not the best idea, Tuni has been having stomach rumblings and vomiting the last days. Last week, although I don't know if it's because of the new diet or because the last week she has eaten giant nocturnal moths....
In addition, his last two stools have been strange (sorry for attaching the unpleasant image). N1 was vertically segmented like a hot dog bun and N2 was 2 thin stools forming a sort of braid. both with a somewhat reddish tone on the outside.

I am really very distressed and still waiting for the vet to call me to see diagnosis and clinical management. I ask you to please tell me about your experiences and if you have any idea what might be happening with my little cat. You can't imagine how much she suffers in silence when going to the vet, for her it's the worst thing in the world.
Thank you.

 

drinking a lot of water, licking lips and swallowing all could point to stomach acid, gastritis and for that cernia can really help, I suggest you keep giving it to her

Well actually he could be partially right this kind of things are more common in mature cats, kittens usually don't have this, but that doesn't mean you shouldn't do anything, you should start helping her with all of this, getting her food right giving her a well balanced diet would be a very good start

You could consider some antacids to help with her gastritis (cernia that you are giving is a good option also slippery elm or omeprazole )and something for her constipation you could give her pumking (not the pie filling just puree) or psyllium

Here are some links to Tanya's webpage, it is a CKD page but even though Tuni doesn't have a kidney problem, this suggestions and explanations about stomach acid and constipation could apply and I think they could help
http://www.felinecrf.org/constipation.htm#symptoms
http://www.felinecrf.org/appetite_loss_nausea_vomiting.htm#symptoms

 

@Tuni Have you seen this article about cat hiccups? Cat Hiccups: What You Need to Know | PetMD. There seems to be many potential causes for hiccups.

Hairballs was one of the potential causes listed...if the gel from the vet doesn't agree with Tuni's tummy maybe the vet or some other members could make alternate recommendations. The article suggests Laxatone for hairballs but I have no experience/knowledge of Laxatone.

It sounds like there's been a lot of changes in Tuni's diet too in the last couple months...

 

Hello, something like this…When she started to vomit, 3 weeks had passed since we added royal canin senior dry food to his usual diet (mainly cooked chicken)...also in mid January we gave him wet food (fancy feast and hill's a/d) as a reward for each stressful trip to the vet for ultrasound and draw blood, then there were a few days that he ate 3 types of food: cooked chicken, dry food and wet food...And about 3 days before the vomiting I knew there was a problem because they appeared loud stomach noises that continued on days of vomiting to a greater or lesser degree... About the vomits, the first was a ball of hair with brown liquid, the second only dark pink or brown liquid (this must have been very painful for her because she vomited around 15 times in 5-7 minutes) the third grass, the fourth a giant moth...then we tried to drive away the moths and coincidentally Tuni stopped vomiting for 1 week, but yesterday they came back after giving him the gel... I think it might be a good idea to go back with the chicken and switch to a dry food with less carbohydrates (royal canin senior has 40% and if she has diabetes this hurts her), very gradually...
And it would be It's so good that the sneeze is due to something like what you're pointing out, although it's hard not to imagine the worst scenarios... Today he woke up shaking his nose as if he had something inside but without sneezing and with a slightly hoarse voice. Thanks for your help.

 

I do think I would give the Cerenia, but I would not continue with the gel. It's just a hairball gel, right? They are petroleum jelly based (like Vaseline) type products. This will not settle Tuni's stomach. What type of vomiting is it? The Cerenia should stop the vomiting. It is foamy white vomit? Is it yellow bile vomit? It is vomiting up of all or most food eaten? Or is it regurgitating a small amount of food after eating?

 

Oh, forgot to say that Cerenia is anti-inflammatory in the gastrointestinal tract. It's beneficial for vomiting, and for pancreatitis or other GI inflammatory problems.

Do you have access to Slippery Elm Bark. This is very soothing and can act like a bandage to the whole GI tract. It should probably be given at least an hour after medications like Cerenia or other meds. It can be mixed into food but a lot of cats do not like the taste. I take mine from a capsule that is for humans and I put it into an empty gelatin capsule (size 2, size 3 or 4 may also work ... that is from the largest to the smallest size.) Then I just give it as a pill. If Tuni is too afraid, you may not be able to get pills into her? Is that correct? The Slippery Elm Bark can be mixed into a small amount of food as I said -- but it has to be something really palatable like ham baby food or some food that is really loved by Tuni -- not just the regular food.

 

Is it absolutely necessary that Tuni go outside (with the moths, etc?) Can he stay indoors?

 

Very excellent suggestions!

 

1/4 of a Famotidine 10 mg tablet given in the morning can be very beneficial if there is excess stomach acid with white foamy vomit or if the vomit occurs a lot in the morning on an empty stomach or at other times when Tuni's stomach is empty.

 

With the possible cholescytitis, I would definitely not stop the Cerenia. She may need to be on it indefinitely.
https://www.petmd.com/cat/conditions/digestive/c_ct_cholecystitis_choledochitis