gassy kitten

Re: gassy kitten

Matt Valentine — Tue, 16 Apr 2013 16:41:49 GMT

I think FIP is still a consideration from ones I have seen similar (although not as severely ill.)

Re: gassy kitten

CatherineThomas — Fri, 01 Mar 2013 10:44:57 GMT

I saw the kitten again today.

All of his results were negative - toxoplasma, coronavirus antibodies and faecal pcr. We can't really do any more investigations as the owners can't afford much more.

So he's been on ceporex and panacur for 1 week. he has put on a little weight. His ears and other skin lesions are much less scabby now, just thickened with alopecia. the owner reports that he has good and bad days. The bad days seem to be when he needs to pass faeces and once he has had a good clear out he gets his appetite back. His faeces do tend to look normal though. he was on zantac but it didn't seem to make much difference so I've swapped him onto cisapride today to see if this will help (0.1mg/kg 3 times per day).

Re: gassy kitten

Bob Russell — Sat, 16 Feb 2013 10:45:17 GMT

Poor nutrition, chronic inflammatory gut condition, giardia etc etc leading to compromised immune system then ringworm??

I had a kitten a bit like this to look at (did have severe diarrhoea though) and she ended up coming home and lived until her late teens. Don't write the kitten off too soon!

Re: gassy kitten

CatherineThomas — Sat, 16 Feb 2013 07:31:59 GMT

Well the kitten is doing well at the moment.

X-rays on Wednesday showed that all of the gas was gone from the intestines but the stomach had quite a bit of gas and was in a normal position. I spoke to a dermatologist who said he didn't think there was any point in working up the skin at the moment as it is bound to be secondary to whatever else is going on. So we did a bile acid stim, on which the preprandial result was a little high but the post prandial result was lower. We also did felv/fiv snap test which was negative. We're waiting for corona virus antibodies and pcr and toxoplasma results. We've also started him on clindamycin in case. He's now at home but with strict hygiene/isolation measures. The owners are really pleased to have him home even though they know his prognosis is likely to be poor.

Re: gassy kitten

CatherineThomas — Wed, 13 Feb 2013 09:55:18 GMT

The kitten is doing really well this morning, he's bright and acting like a normal kitten and eating really well.

My gut feeling is telling me that this kitten is not going to do well long term and I've told the owners this.

I had thought about a PSS, but the liver looks large rather than small. Can a shunt cause an enlarged liver? I guess a bile acid stim isn't that expensive so we could do that.

Total protein is low but we didn't assess globulins and albumin so I supose FIP is still possible, there's no abdominal fluid so it would have to be the dry form.

I think the other main differential is pemphigous, has anyone seen a case with systemic symptoms like this as well as the skin lesions? I guess if we can't do anything else we could always try a good course of steroids to either kill or cure.

Re: gassy kitten

Rosie_Skinner — Wed, 13 Feb 2013 09:42:28 GMT

duh! you didn't see any fluid on the scan so ignore that!

Re: gassy kitten

Rosie_Skinner — Wed, 13 Feb 2013 09:35:42 GMT

Oh and I think there may be some free fluid as you can't see the caudal border of the liver, though something is pushing the stomach caudodorsally... I'd be interested to see what you find if you open this poor cat up.

Re: gassy kitten

Rosie_Skinner — Wed, 13 Feb 2013 09:32:26 GMT

I have to say this doesn't look good for this cat, especially in terms of the owners having a small bill! I would be thinking FIP, mesenteric torsion, FeLV, hepatocutaneous syndrome, shunt, lots of things really. Poor little cat.

Re: gassy kitten

Jenny Smith — Wed, 13 Feb 2013 08:08:46 GMT

Could the skin lesions be a hepatocutaneous syndrome type problem? To me the liver looks big on the rads. The axis of the stomach is rotated which could be due to abnormal liver size pushing it that way, or as someone else mentioned an obstruction causing dilation of the gi tract including stomach. We were taught (in cats especially) that a change in stomach axis is always significant. +1 for bloods and if clear/kitten getting worse then exlap Jenny

Re: gassy kitten

Utlendigur — Tue, 12 Feb 2013 23:25:42 GMT

Trying to think of xrays that looked similar I can think of 3 - young cat with chronic intussusception, older GSD with mesenteric torsion, adult spaniel with ileus that didn't seem to have a cause - all died

The stomach axis seems to be rotated dorsally and liver does look big + ? hiatus hernia or just artefact from distended abdomen. There is also another very large gas shadow with ? two parts to it, with either faeces in it or overlying it - not sure if this is large intestine, LI plus stomach or SI dilated with gas up stream of an obstruction. It does look like there is a loss of serosal detail but may just be due to lack of fat. Is there a hint of a pleural effusion round the caudal lung lobes (can't make it out clearly on my monitor)

Raw meat diet - just meat? Just wondering whether bone density is reduced on the xray eg compared to the liver - is it a photo of an xray film?

I know older cats can get strange alopecic lesions on their legs with things like pancreatic neoplasia but not sure if it can occur in younger cats or with abdominal problems generally.

I suspect the cat is looking better because it's not in so much pain - that much gas had to hurt

To be honest I think the owners are being unrealistic about its chances and costs - it's probably going to need more bloods (haematology, bile acids, FeLV, FIV, FeCo), maybe some barium, may ex lap

Re: gassy kitten

Michael Woodhouse — Tue, 12 Feb 2013 23:13:29 GMT

I'd be thinking the same as David. Bloods first. If they find nothing then ex lap.

Re: gassy kitten

David Mills — Tue, 12 Feb 2013 23:10:34 GMT

Shunts can appear strangely like this, with retarded growth and sometimes skin lesions and good response to fluids/supportive tx.

Bile acids would be diagnostic, ideally fasting and post-prandial.

Re: gassy kitten

CatherineThomas — Tue, 12 Feb 2013 22:49:52 GMT

There was no fluid visible on ultrasouns. We didn't get a vd view.

Here are some pictures of the skin lesions:

I'm thinking these lesions look like auto-immune type lesions, maybe pemphigous?

But how is that related to the abdominal symotoms and collapse today?

The kitten is doing much better this evening, he's purring and relatively bright. He's also eaten a reasonable amount this afternoon. we're planning to re x-ray in the morning to see how it has changed. the abdomen definitely feels less bloated now.

Re: gassy kitten

Busybee — Tue, 12 Feb 2013 22:27:49 GMT

Any abdominal fluid seen on the ultrasound cos it looks suspicious for it on that x-ray?

Any VD view to establish what those gas shadow are in the abdomen (?stomach)? All looks a bit odd!