Liver issues, force feeding & teeth grinding

[Moggieslegacy]

Thanks for the kind thoughts and condolences. It means a lot.

As much as I am extremely sad and emotionally exhausted I am really grateful that as far as death goes I think he had a good one.

I had just wrote a message to a friend saying I couldn’t do this much longer. The past month I have spent most of each day trying to help him or comfort him, or trying to figure out what was wrong, and things I need to attend to, like my work are all starting to fall apart. I sent it, went to get him off my bed where he was sleeping and as soon as I picked him up he had a seizure and was gone within a couple hours. It is almost like he waited until I was ready to let him go... I guess long illness is kind in that way. It gives us time to prepare and say good by.

But he was a really special little cat and I was totally in love with him...

 

[Patti]

I am so sorry to hear that Moggie is gone, but like you am relieved for him that he is no longer suffering or languishing. You gave him a wonderful life while he was with you, and he knows he was loved unconditionally.

 

[Ninja-n-Bear]

Deepest condolences for your loss.

I know it's too late now, but in case it helps anyone else: I've heard that jaw grinding noise before: my last cat, a DHS, had lifelong kidney issues and started making that noise when eating about 4 months before he died of lymphoma and kidney failure (11yo). The vet said it was common with kidney issues, but they didn't know for sure why it happened, but thought it had something to do with brittle/loose connective tissues due to low fluid levels. He also did the weird side twist with his head while eating. He started making the noise a couple of months before any other symptoms showed up.

 

[Moggieslegacy]

Thanks Ninja and Patti for your kind words.

I am still waiting for the results of the blood work to both completely arrive and be emailed or mailed to me. Moggie was having a seizure when the vet called and tried to explain what the blood work back so far showed, but there was a lot of unfamiliar words and I was too distressed to follow what he was saying as well as I normally could have. But I think he was saying both Moggie’s liver and kidneys and everything else was failing.

The teeth grinding while eating or whatever it was only started happening in the last week, so for Moggie it was probably just 1 symptom of his whole system collapsing, but from what I read online, it does seem to be often connected with kidney problems.

For closure I really need to know what happened... And I need to have the blood work in front of me so I can look up what all the components mean. I am fairly sure the vet said there was really low albumin, which together with the extremely high globulin, he thought that if the test for the corona virus was positive and had high titres, an autopsy would be not be needed to confirm dry FIP. But from what I read in the last stages of FIP the titres can be very low and possibly not there at all, because the immune system has lost the battle and there is no longer enough unengaged antibodies to even be measured.

I have found the information on this page really helpful.

http://www.vetmed.ucdavis.edu/CCAH/local_resources/pdfs/pedersenfipinterview9-10-08.pdf

“Although a definitive test result would assist decision making, a certain diagnosis can be based on cumulative odds rather than a single, simple, definitive test result. A young cat from a cattery or shelter with chronic uveitis and/or neurologic signs, high serum proteins, hyperglobulinemia and hypoalbuminemia, fluctuating antibiotic unresponsive fever, leukocytosis with a lymphopenia, and an anemia of chronic disease can have no other disease than dry FIP based on odds alone.”

I am not sure if the copper color that appeared at the edges of Moggie’s iris over a couple weeks was uveitis, or would be considered chronic, but it did look really similar to the picture of the cats eye on Dr Addies website that says these changes can be caused by dry FIP http://www.catvirus.com/WhatIsFIP.htm
(Pictures of my cats eye colour change are towards the end of the thread titled Whipworms Juvenile Round Worms,what it this?) But it seems eye color can also just be affected by liver issues.

I have also found information that a high bile resting rate can be caused by the liver problems that can be brought on by a cat not eating enough. Which has been an ongoing issue.

And I have yet to figure out what “leukocytosis with a lymphopenia” or an “anemia of chronic disease” is, or how to see it if it shows in his blood work... when I eventually get this...

I have the kind of brain that has a hard time resting without definitive answers...

 

[Moggieslegacy]

And as I continue reading trying to make sense of what the vet told me, together with the incomplete information I have... I probably was confused about part of what the vet told me. I recalled him saying another possibility was a B cell carcinoma, which doesn't make a lot of sense, as this usually starts in the skin. What he probably told me is it might have been a B cell lymphoma. This often develops as a result of Feline Leukemia. Which fit in with him also mentioning the test that came up negative for Feline Leukemia could have been wrong, and this sometimes happens. As Moggie was immunized twice for this before he had any possible (but unlikely) direct contact with other neighborhood cats, who are also already immunized, I thought this was very very very unlikely. But apparently the virus can be passed from a mother to her kittens, immunizations do not always work, and the virus can hide out for months or years in the bone marrow leading to a false negative result. So I guess this is another possible explanation. But probably less likely than FIP. The more I read the more I realize it is really complicated and I may never know for sure...

I should probably scrap myself up and try to focus on something more productive...

 

[Moggieslegacy]

I just got to have a long talk with the vet about the final bloodwork. Supposedly Moggie had a weak positive for the corona virus with a titre of 1:1600. As I thought a 1:400 is a weak positive I am not sure why they said that about a titre of 1:1600. The albumin globulin ratio was really low, though vet could not tell me exactly what it was. The kidney related stuff in the bloodwork could have just been caused by his anorexia. He didn't think Moggie had uveitis. And the vet seems to think the extremely high globulin level may be more indicative of a b cell lymphoma, which is not that uncommon even in cats that are FLeV negative. When I said I thought FIP was a lot more common than this, he said in this area even though the corona virus is endemic, FIP is extremely rare, and he has only seen maybe 1 case a year in 20 years, only 3 of those dry. Which I find interesting as from what I read, the corona virus seems to be converting to FIP in 1 in 20 to 1 in 10 cases in other areas. The vet said even in catteries here he never sees this problem. And they have a very busy practice.

It looks like I will never know for sure.... They will mail me all the blood work so I can learn about the particulars.

I think I can move on now and let my heart start healing... Thanks to everyone who has shared their knowledge here...

 

[Patti]

I understand how frustrating it can be not to have answers. I have faced this myself more than once so really feel for your desire to find the truth. Here is some additional info that might help you understand a bit more, although without any real answers as to what Moggie finally succombed to:

leukocytosis with a lymphopenia

The means the overall white blood cell count was high but the lymphocyte count was low. There are five different types of white blood counts, the lymphocytes are those WBCs that specifically make antibodies.

anemia of chronic disease

This means that the anemia is chronic, and is caused by another, chronic disease - for instance, one of the most common cause of anemia of chronic disease we see in humans is due to end stage renal failure.

B cell lymphoma... often develops as a result of Feline Leukemia

I have had two cats over the years die from lymphoma that did NOT have feline leukemia.

corona virus with a titre of 1:1600

This is probably an average titer for cats that have been exposed to FeCOV. The problem with corona is that it's quite difficult to eradicate as the cat(s) just continue to reinfect themselves as soon as they use the litterbox again.

he has only seen maybe 1 case a year in 20 years

I am not a vet but have been breeding for 13 years and in that time I have only had one kitten die of FIP. I believe the literature is derived from shelter statistics, so not surprising that their numbers might be higher. On top of this, it seems that vets are very quick to jump to a diagnosis of FIP when they can't find any other answer, which also skews the numbers. BTW, I have also had a cat with an extremely high titer (can't remember exactly what it was but it was >1:10,000) and she never developed FIP.

 

[Moggieslegacy]

Thanks for wanting to help me fill in some of the gaps Patti and I am sorry you lost a couple kitties to lymphoma over the years. But I am glad to hear FIP has only once been problem for you!

I wonder why cats exposed to the corona virus rarely develop FIP in some areas, and in others seem to develop it much more often?

Even though I will never be sure I have been typing the clinical terms I don’t understand into google and have found a lot of good quality detailed information doing this, which leads to other clinical words to look up.

There is some little things that don’t exactly fit with Moggie having lymphoma. His young age, no one noticed any lymph enlargement or palpable mass anywhere, though he did have general inflammation in his colon which could fit with the lymphoma that affects the GI tract. Moggie’s high globulin (even very high) and persistent fever are also more commonly associated with FIP though they can sometimes happen with lymphoma. I think maybe the type of white blood cells that are high and low in lymphomas are different than the ones in FIP, but the vet said the tests that can differentiate between these are not a part of the tests available here.

And I think Moggie had mild uveitis.

I suspect the vet (was seeing 2 in the same clinic) didn’t notice this because it seemed minor in the face of things that were much more obvious, he had to fit me in during his lunch break, and because he probably doesn’t have all the latest details and research on the symptoms of dry FIP stored in his brain if he has only seen 3 cases of dry FIP in 20 years. When I mentioned Moggie’s eyes turning brown he said he didn’t think this was a symptom of uveitis and that uveitis caused a clouding and refraction of light. Like a sunbeam coming in through the trees, not a change in colour of the iris.

But the link below discussing feline uveitis has a picture, in figure 5, of a cats eye with brown tones and says this was caused by FIP

http://veterinarymedicine.dvm360.com/feline-uveitis-review-its-causes-diagnosis-and-treatment

It describes this eye as having Keratic precipitates, also called mutton fat KP and having a condition called Rubeosis iridis which involves the formation of abnormal new blood vessels on the surface of the iris which turn it a copper colour. Using google images and looking up feline rubeosis iridis I see a lot of cats eyes with the odd veins and copper colour I noticed in Moggie’s.

Using google to look up feline Keratic precipitates, in images I see a lot of cats eyes with the peculiar spots I noticed in Moggie’s eyes, and I see something like this is commonly seen in FIP

http://www.vin.com/apputil/content/defaultadv1.aspx?id=3850121&pid=8768&print=1

“Keratic precipitates due to immune complex formation are a characteristic finding in FIP-related uveitis.“

So he probably did have a relatively mild version of uveitis. But maybe this is also caused by lymphomas and things like the herpes virus?

Sorry for the many long posts. So many details in my brain. But I am close to feeling I know as much as I ever will and being able to put it to rest.

 

[admin]

I'm so sorry to hear about Moggie! He is at peace and I hope that brings you comfort

 

[Moggieslegacy]

Thanks Paige...

I don't know if anyone reading is interested, but I got Moggie's blood work in the mail. This was done 2 days before he passed away. There is a really a lot of clinical words and terms I don't understand, and a lot of details I see in other blood work are not included in the tests done, but the Dr doing the tests conclusion if other symptoms were a match, it was suggestive of FIP. For privacy reasons I cropped the photos of the paper work to remove personally identifying information except the name of the Dr who interpreted the tests.