Thoughts on unwell cat

[saltymeow]

I’m a long time lurker, first time posting though. I’m not really sure what I’m looking for other than maybe some comfort in the experience of others.

My 12 year old flame-point Siamese has been through the wringer over the past few years and we can’t seem to figure out what is wrong. He had two urinary blockages last year, second one around this time last year. In advance of that I’d noticed he wasn’t eating quite as well as he had in the past, but blood work was unremarkable. While he was hospitalized for blockage they did an abdominal ultrasound to see if there was any evidence of disease. Again nothing super conclusive, thickening of bowels, maybe some kidney impairment.

He went to internal medicine who honestly didn’t seem all that concerned. They did think he was likely painful somewhere in the abdomen and at that point they decided to keep him on gabapentin long term as it had stimulated his appetite when he had it after urinary issues.

He went back to the vet in August of last year because I thought he just didn’t seem quite right. He was crying in the night and had lost a bit of weight (down from 12.5 lbs to 11.8). At that point his vet referred him to cardiology as he had an abnormal snap blood test and a heart murmur. Cardiologist didn’t find anything wrong on echo and seemed his heart healthy.

Things seemed to be mostly ok after that, he stayed on the gabapentin and was holding his weight. In December I noticed he had a very inflamed premolar so I scheduled him for a dental, which I regret now.

He went in for the dental on Jan 26, had two extractions, but he apparently had a very rough time through the anesthesia. Took 2hrs (and Naloxone) for him to wake up. The vet advised he should not undergo anesthesia again.

He came home in extraordinary pain, the vet said not to give him pain meds for 24 hrs, though eventually after 12 and him crying and pacing/circling I gave him the buprenorphine. He seemed to recover ok once the pain was managed.

But after 2 weeks exhibited signs of urinary distress, vet gave him RX for prazosin but didn’t think he needed to go to hospital as he was still peeing. When all this was happening I thought something was wrong neurologically because he was incessantly circling and his eyes seemed dilated but I convinced myself it was pain.

Fast forward to Sunday (2 weeks later) and things just didn’t seem right. He pooped on the carpet (first time), was pacing and crying. I took him to the vet Monday.

The vet spent 30 minutes with him, going over all my many concerns. Ran blood (elevated blood glucose though vet thinks stress, everything else fine), blood pressure (elevated, 170 but thinks also stress); urine revealed infection and blood - relatively uncommon in male cats. We’ve started antibiotics but I’m really so upset that he’s been suffering with a UTI for 2 weeks and I just assumed it wasn’t possible.

During the exam, the vet raised concerns that he was blind. Now that I have him home I realize he is in fact blind, I can’t be sure but I feel like this is a newer issue (last few days). It’s so hard to watch him wandering around, almost walking into walls. He fell off the bed today. My heart is just shattering. I realize now how many things he used to do that he just isn’t doing. No scratching on his post, no looking out the window. I feel terrible.

He’s scheduled for another ultrasound next Thursday, as we think still potentially something GI (infrequent poops).

But part of me wonders if there is something bigger going on neurologically. He’s pacing/circling always, and while most the neuro tests (aside from vision) were normal, he seems so dull. He also has been holding his tail in a very strange way, it’s like it stays stiff when it should relax, or he doesn’t realize where it is. Picture with tail rigid in the air (held like this, not just caught in a picture).

I feel so guilty to have done the dental, my last cat similarly declined rapidly after a dental but I convinced myself it wouldn’t happen again.

My cat is my guy, he’s been through a lot with me and I just can’t stand not knowing what is wrong with him. I don’t feel like the quality of life is great right now, but he’s still eating and purring, just dull. I’m not sure what I’m looking for in writing this, but I’ve struggled to find support in my personal life around this (bf thinks I’m crazy, friends think he’s just an old cat). Has anyone ever dealt with something similar?

I’ve tried to do everything right for him, but feel like I failed him and I just can’t stand seeing him like this.

[3PonyFarm]

He is a very handsome kitty. So sorry you are going through this. Did your Vet say anything about a possible stroke? Maybe others here will have better answers for you. Best of luck to you and your kitty.

[dressagetraks]

No advice but best wishes for you and him. He’s beautiful.

[Simkie]

High blood pressure can cause retinal detachment, and then blindness, so perhaps that’s how those things fit together?

I’m so very sorry your pretty kitty is struggling in your shoes, I’d likely try to find a vet who’s really interested and curious about cats (or maybe a veterinary behaviorist?) to try to tease apart what’s going on and how he really feels. Cats can live long, happy lives without their sight, but you’ve certainly got more going on.

I find vets often very dismissive of pain (and nausea) in cats and unwilling to dig deeper. They’re such stoic, private little creatures. Keep looking around for a professional who takes your concerns seriously.

Best of luck, I really hope he improves

[OzarksRider]

@saltymeow, your description of symptoms, especially the circling and blindness, makes me think of a brain tumor. Can you take him to a veterinary school or a vet practice with the equipment to do a MRI scan? If it is a brain tumor it may be treatable. If not, at least you would know for sure what you need to do. The urinary symptoms don’t fit with brain tumor, but everything else does. The urinary symptoms could be chronic cystitis and unrelated to the other symptoms.

Here’s a link to an article about meningiomas in cats (the most common type of brain tumor in cats): https://animalmedicalspecialists.com/neurology/ Scroll down the page and click on “Feline Meningioma: Clinical Signs and Treatment Options.” This is directly above video about surgery on a cat’s meningioma.

I’m not saying this is what’s wrong with your cat, but if your cat does have a brain tumor, this is the most likely type. And if it is, it may be curable.

I once had a cat that had symptoms very similar to what you describe. At first she just “wasn’t right,” and when I took her to the vet all her labs were normal. As time went on she became increasingly picky about eating, lost weight, hid all the time, cried out constantly, and finally started circling when she walked. Her eyes were dilated and I wasn’t sure she could still see. The vet was almost certain she had a brain tumor, but the clinic didn’t have the equipment to confirm it with a CT scan. My cat was older than yours and the vet school is a 3 1/2 hour drive from where I live. I was afraid the stress of the trip would kill her, so I just had her euthanized.

I don’t think you’re crazy, and you have not failed your cat. Your cat is not “just old.” Something is wrong; the vet just hasn’t found it yet. I’m sorry you’re going through this, and I hope you’ll keep us posted on what you find out.

[Alex_and_Bodie_s_Mom]

I am so sorry. Hugs and jingles to you and your sweet boy. Please don’t beat yourself up - cats are extremely good at hiding things, and it’s extremely easy for us to believe the vet when they tell us one thing, even if we suspect it’s another.

I would ditto the idea of the brain tumor - and a new vet. Do you have a small animal specialist nearby, or a larger vet practice that might have different ideas on how to diagnose/treat? Or better yet, a university vet clinic where they can do an MRI and possibly a GI scope? It’s also possible he had a stroke under anesthesia. There’s no way you could have known he’d have a reaction, so don’t blame yourself for that - I went through a cat with massive dental issues and I know how truly awful they can be. You have to do what’s best, and hope for the best.

The UTI may have nothing to do with it. I’ve been through two male cats with urinary blockages - one had bladder stones (which I suspect yours might) and took a year or so to clear up totally. The other was a special case we could not resolve and had to euthanize. Either way, the UTI is clearly making him miserable, so definitely treat that as well.

A vet that says 13 is old for a cat doesn’t know cats very well. Listen to your gut. Find a new vet, and give your guy some hugs from us. If you frequent this forum, you’ll know we all go above and beyond for our kitties!

[saltymeow]

Appreciate all the kind thoughts. I will be taking him to recheck BP this afternoon, the vet was concerned it was elevated due to stress so will do this as a stand-alone to see if it is still elevated (if that is source of issues would be easiest to treat).

I’ve booked him in to see a neurologist at the local referral hospital, however the earliest appointment they have is April 13 (with waitlist for sooner). I’m in DC, so I likely have other options potentially nearby, but will wait to pursue until BP results are back.

I tend to agree that his symptoms (aside from urinary/GI) may be consistent with a brain tumor. Unfortunately he’d have to undergo anesthesia for an MRI, and based on challenges with dental that makes me very nervous.

[Simkie]

@saltymeow

Unfortunately he’d have to undergo anesthesia for an MRI, and based on challenges with dental that makes me very nervous.

It’s worth getting the details of what anesthesia was used that he did so poorly with. I’ve had enough critters have a ROUGH time with a ketamine induction that I now work very hard to avoid it for all my animals, and the ones that did poorly have done fine with an alternate induction.

All anesthesia isn’t the same, and there’s a good chance he can still be sedated or anesthetized safely.

[Alex_and_Bodie_s_Mom]

Does he have to undergo the anesthesia, or can he just be sedated heavily? I don’t know how long it takes to do an MRI on a cat, but I would think as long as he’s out for a bit, he’d be okay?

[candyappy]

What a beautiful boy. I am so sorry for what you are going through. Hopefully someone on here will be helpful.

[saltymeow]

As a bit of an update, his second BP read was 170 as well, so he is hypertensive. We will start him on meds for that and recheck Monday, along with another check on his eyes.

His vet isn’t quite satisfied with hypertension as an “answer” because he wasn’t hypertensive 6 months ago at the cardiology consult and it doesn’t necessarily explain everything. Her view is that it likely isn’t high enough to cause blindness.

His UTI seems to be improving at least, he’s not going in and out of the box anymore. He does have a prescription list of a 70 year old man at this point.

Fingers crossed he improves, will keep neurology consult on the calendar and may potentially see if we can get in faster via internal medicine where he’s already a patient.

Really so thankful for the support I’ve received here. Hopefully we can get him feeling better.

[hybriseris]

Wow what a beautiful guy. I’ll have you two in mythoughts, keep us updated! As someone who works in healthcare, don’t be afraid to call the neurologist’s office a few times a week and ask if anything opened up. We do work off call lists, but everyone - especially vets - are swamped and things open up unexpectedly all the time that are filled before they can call you.

[lcw579]

What a beautiful cat. I am so sorry you both are going through this. It is not easy. Our cat Miles had developed a bunch of health issues as he aged. It started with crystals in his urine. He developed diabetes and did experience a few bouts of temporary blindness from that. We were lucky his sight came back. You mentioned that your cat’s glucose numbers had been off - have they been rechecked? Miles had a lot of odd symptoms as we got his numbers under control, including pacing and crying. I would also recommend getting your kitty’s thyroid checked. Miles developed problems there too and that is what led our vet to think he probably had a brain tumor. We kept him stable and happy as long as we could until he ultimately let us know he was ready to go. It’s been over a year and we still miss him. He was stoic and loving through all the needles and trips to the vet. We were lucky to have a vet that was really invested in finding a solution to Miles problems and helping to keep him comfortable and with us as long as possible with a good quality of life. If you don’t feel like you are getting that from your current vet please look elsewhere - you both deserve someone who is looking out for you. I know how hard this is and I’m sending lots of jingles your way.

[shiloh]

Oh, I love him! He is so handsome!

I am sorry you are going thru this. You have done everything possible for him - you have NOT failed him. You have gone above and beyond.

Another thing to think about - maybe the gabapentin is disagreeing with him? Have you had his thyroid checked? Poor kitty - he has a lot going on.

Jingling for you and Mr Kitty.

[saltymeow]

Re: thyroid, that has long been the top suspect for Finn, as it would explain a lot of his issues. We’ve tested multiple times, values have always come back normal (including on Monday).

I will have his blood glucose rechecked on Monday when we recheck BP. He did have elevated numbers on Monday, but vet thought was stress related. He’s not had a big increase in thirst or urine output, so doesn’t seem to fit 100%, though will check again. He’s been getting kitten soup (wet food + water) for the last year+ so I seldom see him drinking from his fountain anymore.

[Angela_Freda]

Is he a big cat?
What were the glucose numbers?

[4horses]

I’m sorry he isn’t doing well. My old cat went blind from high blood pressure. He had kidney disease and hyperthyroidism. Also was developing heart failure towards the end. He was 16.

In hindsight I should have euthanized when he went blind as he just continued to go downhill. He did manage to climb his cat tower so I’m assuming he regained some sight. But he just was not thriving. As his heart failure advanced he became more and more lethargic.

[saltymeow]

Finn’s visit was a bit of a let down. No real improvement since starting hypertension meds, though BP is now normal.

Going to keep him on antibiotics for another week with UTI as he still has persistent pain urinating.

Primary vet suggested trying to get into internal medicine and have neuro do a consultant at the referral hospital. Was able to get appt there for next Monday. They saw him about a year ago for gastrointestinal issues (dx with IBD), but I was not all that impressed. They’re still operating on a curbside only basis which leaves a lot to be desired.

There is another referral hospital with neurologist nearby, they’ve reviewed his file and are trying to get him in ASAP. No availability today, but they’ll call me tomorrow. Other option is to bring him in through ER.

He’s still eating and sleeping, so I hesitate to take him to ER as it would be additional stress with no guarantee that he’d get a neurology consult while there.

[Angela_Freda]

@saltymeow
Look up acromegaly, hypersomatotropism.
The issues with anesthesia, the glucose, the heart/BP, the uti… Made me think of it.

Neurologic disease associated with feline acromegaly is uncommon but can occur with large pituitary adenomas. Neurologic signs that have been observed with acromegaly include dullness, lethargy, abnormal behavior, circling, and blindness. Glomerulopathy and secondary renal failure have also been associated with feline acromegaly. Because of an associated degenerative arthropathy and peripheral (diabetic) neuropathy, lameness has also been noted in cats with acromegaly.

https://www.vin.com/apputil/content/defaultadv1.aspx?id=7259428&pid=14365

[saltymeow]

This is interesting. He does seem to fit a lot of the symptoms. Will ask neurologist about it as a differential.

He has neurology appt for Thursday. He was in a sorry state this afternoon so I took him to the ER. Soonest they can see him is Thursday morning. They spent a good amount of time reassuring me that right now at least he is stable. He is eating and peeing.

Man is it hard to have sick fur babies. Aside from my horse, he’s the one and only.