Case Study – Missy

Case Study “Missy”

By Dale Kantner, Cat Manager

missy.jpgWhen I started working at Pets Alive last June, I must admit to being a bit overwhelmed with the number of cats that lived here. I believe there were about 99, and they were divided into 6 rooms. There was one beautiful 8 year old kitty that lived alone in the kitchen, her name is Missy. I soon found out why Missy lived in the big kitchen all by herself, she HATES all of the other cats!! Or, as I tell her, she is so special that she gets her own room.

Those of you who know Missy, know that she is a staff and volunteer favorite. She definitely has her own personality, part sweetie pie and part MONSTER!

Well, in the last couple of months, my Missy started losing weight and her coat was looking “ratty” (no offense to the rat lovers, I love them too J). She was vomiting almost everyday, and was refusing to eat even the secret special food I would bring in for her. Janet, our vet tech, took her to Dr. Furman for blood tests. Everything came back normal, except for her liver values, they were high. The vet put her on meds and said that we should give her a week and see if she was doing better.

She was not doing any better. Next, Missy got an ultra sound to rule out cancer. Thankfully, it came back negative! Now we were at a loss, Dr. Furmans next move would be exploratory surgery. Before taking that desperate measure, we wanted to seek a second opinion, of course. Janet next took Missy to see a specialist who also thinks it is her liver, as did Dr. Furman.

Missy is presently taking metoclopramide for vomiting, 2.5 mg of prednisolone once a day, and the supplements denosyl and marin. Her appetite seems better most days, and she has not been vomiting as much. She still looks like she is losing weight, and her coat is still not back to normal. She has been taking these meds for a couple of weeks now, and Janet says she probably will be for the rest of her life. We are hoping this will help our Missy get better. It really breaks my heart to see her feeling so poorly all of the time.

We are bringing Missy this week to a third veterinarian to see if there is anything additional that we can try as she continues to do poorly.

Hopefully, soon I will have a good update on my Missy for you. I welcome any suggestions or advice from any of you who has seen this before.

 

UPDATE:

 

Missy’s recent vet visit to specialist (April 2008):

It was very interesting to note that upon meeting Missy and performing a
typical yearly exam, Missy’s specialist noted that based on that info he
would say that Missy was ‘normal’.  But obviously based on prior history,
there is indeed something wrong with her.  He read through all her prior
tests and although he can very easily run additional ultrasounds, he felt
that those would be fruitless.  If we decided to take the path of
additional diagnostics, it indeed would be to surgical remove and send out
biopsies for analysis.  He feels that these biopsies (although they
POSSIBLY could confirm diagnosis), would not change our course of
treatment. If Missy was in grave shape, it should be done, but with Missy
being asymptomatic, he conclusively does not want to open her up.

The drug protocols drawn up originally by Dr. Furman were once again
supported.  This specialist would like Missy to continue on Denamarin (or
Denosyl combined with Marin), Prednisolone, Amoxicillin, and
Metoclopramide (as needed for vomiting episodes).  He stated that some
cats just have chronic liver inflammation (hepatopathy).  Steroids and
liver protectants are the only things that help in those cases.  It’s just
a matter of finding the correct combination of meds to keep her stable.
He did run recheck bloodwork today and the liver values are indeed high.
So we upped the prednisolone to 5mg twice daily.  He would like to recheck
her bloodwork again in one month.

Filed in Case Studies by kerry on Apr 14, 2008.  There are 9 Comments

9 Responses to “Case Study – Missy”

  1. Mark Says:

    My cat was suffering from the same symptoms and she was just diagnosed with a hyperactive thyroid. Your vet probably checked for that, but I wanted to let you know just in case.
    Good luck to Missy.

  2. kerry Says:

    Thanks Mark,
    They did test for that. A few times, and unfortunately that was not the problem. Thank you for the suggestion though. Greatly appreciate the input.

  3. Sera Says:

    Prior to any surgical intervention, ask the vet’s to explore Cholangiohepatitis. This is where the liver functions and bile ducts are affected for various reasons; mainly found in Cat’s which do not get along with their other surrounding pets (stressed) or are aging. This is a DIFFICULT diagnosis, requires a needle biopsy and is significant since it can save their life. It sounds as if you have a differential diagnosis at this time ask for the vet to rule this out for you!

  4. Janet Says:

    Hello Sera! Thanks so much for the info about Cholangiohepatitis. It is actually one of the differential diagnoses our vet has at this point (as you mentioned). Taking the biopsy would be our next step, but the specialist feels that opening her up at this point would not change our course of treatment. Therefore putting her under sedation and biopsying her would just be an additional invasive procedure.

    Thank you so much for posting your comment.

    Janet

  5. Erin Says:

    Poor kitty! I’d adopt her if I could afford the vet or deal with the heartbreak of an older kitty (my cat of 17 years died about a year ago and now I have a younger kitty). Thanks for taking good care of her!

    Oh, and put up more blog entries more often! I check everyday, you guys are my heroin!! Come on I’m getting the shakes here! :)

  6. Sera Says:

    Janet;

    I agree with the vet’s choice. If she is maintaining good health–eating, remaining hydrated, and balancing the medications is key. Another point is due to her personality of not caring much for the other cats; a foster home which can remain permanent with no other animals is a good option for her. If she stops eating or becomes dehydrated; look at the feeding tubes which can be used; they are inserted in the back near the scapula. These are essential if her health declines and at that time she would need to be placed into a household which can manage her health and her needs. Some of our dearest felines develop such conditions & a surgical opening only confirms the diagnosis which will not change the outcome! It causes more difficulty and stress on her and being isolated at the vet during such recovery times becomes a self-defeating, vicious cycle of illness.

    Over time, I have found getting them placed in a household as the sole pet with one who is devoted to her care and her special love need helps reduce the LFT’s and can help decline the illness cycle. People need to understand she has specific needs & an older couple or individual with no real visitors such as small children who frequent the residence are often the best permanent parents–she is their sole focus in a family. She can live a full & happy life for many years to come. The exact cause is somewhat of a mystery and surmising the “cause” of the diagnosis is at best a guess. Surgical intervention for diagnosis suits no real purpose unless she is doing poorly and there MUST be an answer. It sounds as if your vet has pin-pointed the most likely suspect of her condition; does the actual diagnosis matter? No, since you have ruled out the most obvious culprits such as Cancer and your vet is very correct in judgement & using diligence and is cautious such as not jumping into surgical intervention. As you are aware, keeping her in good health and any exhibition of deterioration requires fast interventions!

    Congratulations to all! Hopefully she finds a forever home which has no stress, just much love as a sole feline and the baby for the “empty nester” couples! If I did not have all my animals I would jump at taking her!

  7. Dawn Says:

    Have you tried homeopathy? I have continued success with it -most recently one of my male cats seems cured from ‘inflammatory bladder disease’ (read: western medicine has no clue). Over a year ago my standard vet suggested we keep him on antibiotics constantly (even thought WBC’s were normal) and I said no. I found a homeopath and we tried a couple of different remedies – and all is well. It’s been quite a few months since he was symptomatic.

    Good luck!

  8. carol abramsky Says:

    are you feeding the cat NUTRO as there has been numerous complaints about the food.

    please see http://www.consumeraffairs.com/pets/nutro.html

  9. joan richards Says:

    i know this is past due, by the date, but i have found when a cats liver is high, just give the cat home cooked foods,no salt, and do the natural things, like vitamins. once i had a cat like this and in 2 weeks, the vet called, thinking the cat died, and when heard the cat was doing great, he offered to do blood work for free. this time, the liver was perfect. the solution was:——— get the cat off all cat food. the cat lived another 4 years and it was very old. no dry or wet food was ever given to the cat .only homecooked meats, and veggies.

Leave a Reply