Stunted kitten

Re: Stunted kitten

Emily Nightingale — Tue, 02 Mar 2010 21:38:46 GMT

So sorry to hear you lost your fight for him in the end after such a lot of hard work and research. Just wanted to say dont beat yourself up about it.. you did your very best. Hindsight is a real pain in the backside I find. Interesting case tho.. thanks for posting it!

Re: Stunted kitten

Vikki Moran — Sun, 21 Feb 2010 21:18:51 GMT

i appreciate that he had never been anorectic, but is there any possibility that he may have been mis-fed at some point?

A couple of years ago, as a new graduate (ok so more than a couple!) I saw a small litter of 3 kittens who all had similar symptoms to your guy, but it turned out they had been "rescued" by a kindly person (the presenting owner in fact) and "hand reared" on human baby formula. (sigh) and then weaned onto a combination of adult cat food, soaked in the human baby formula, and egg.

they all failed to thrive by 6 months, and were presented at neutering as small and quiet. I couldn't say they had hepatic lipidosis, as they didn't have any investigative treatment. Based on the history I was able to diagnose a nutritional defeciency, got them onto a lysine supplement, weekly multivit injections (really with the purpose of monitoring) kitten food, cimicat, water to drink and gave the helpful owner a huge lecture on how not to hand rear kittens.

Re: Stunted kitten

Jillian Hall — Tue, 16 Feb 2010 20:26:32 GMT

A final update for anyone who was "following" this thread:

(He got weirder...)

The litter-mate did have very similar changes on bloods but was euthansed a few weeks later as he went down hill very quickly. (Unfortunately no PM)

Went Baloo was 7 mths old (and about 1.5kg) he was castrated and had ex-lap. Liver was a bit big and pale. Everything else looked grossly normal. Liver biopsies were taken and showed only mild hepatic lipidosis. THe comment was that this could be secondary to any cause of anorexia... But Baloo had not at any stage been off his food. On discussion the pathologist suggested things like diabetes and cushings could also cause 2' lipdiosis but highly unlikely as no consistent symptoms and problems evident since few weeks old.

I took bloods for just about every disease I could think of and the only marked abnormality was a very low cobalamin level. I started him on B12 levels but he looked pretty awful at the time of the injection. The owner reported he had been going downhill for 24 hours. A few hours later Baloo represented completely comatose. He was sadly euthanased.

I've since spoken to Penny Watson at cambridge adn her theory was a possible hereditary cobalamin malabsorption problem. This has been reported as a hereditary problem in Border Collies (with not dissimilar symptoms) but there are no reports of primary cobalamin defeciency in cats. It could cause 2' liver problems by interferingwith amino acid synthesis etc.

Sad outcome but the bit I'm really kicking myself over is that if Penny's theory was correct, then B12 injections would have been the answer. The Border Collies responded to regular Vitamin injections. Maybe if the treatment had been started a few weeks earlier the outcome would have been different.

Re: Stunted kitten

Rob Loxley — Sat, 24 Oct 2009 21:47:01 GMT

Lysosomal storage disorder a thought?

Re: Stunted kitten

Emma Jarratt — Thu, 22 Oct 2009 21:20:45 GMT

I saw a similar kitten, healthy in himself, just never grew past 1kg or so, although all bloods were normal. I last saw him at about 7m of age after castrating him and he had still apparently butretained his decidious teeth also. My guess was possibly pituitary dwarfism or congenital hypothyroidism, but as he was well in himself, and also in a rescue situation, we didn't pursue further diagnostics.

Re: Stunted kitten

Jillian Hall — Sat, 17 Oct 2009 14:37:19 GMT

The latest development in this case is that I had a kitten present to me yesterday, which was 5 months old and only 1.1kg. A call to the RSPCA confirmed that this was from the same litter of kittens as the above kitten. Again he is clinically well, just very tiny. I'm waiting for this second kitten's blood results, then I'll have to get my thinking cap on again.

Re: Stunted kitten

Jillian Hall — Fri, 11 Sep 2009 23:07:15 GMT

Thanks for your input. I hadn't considered circulatory problems and Im not sure id pick up a hole in the heart with my echo abilities with him being so tiny. But I'll maybe try this at some point - can't hurt.

Ive basically tried to back off the case a little. Ive told the RSPCA that whether he goes to the new home or not depends on whether the new owner is comfortable with the situation. She would certainly be welcome to take him on in a fostering capacity but she's worried about the children getting attached.

Ive suggested that as he approaches 6 months and he would be due for castration we reassess the situation and decide whether to get a liver bx at the same time. Hopefully he'll keep gaining weight which will make the op a bit less fiddly.

As long as the cattery can be patient Im definately happy to wait and see how he develops. As ever, it would just be lovely to offer them something as simple as a black and white diagnosis. I'm ever hopeful!

I dont think taking him home myself would go down well with either my partner or my dog.

Re: Stunted kitten

Martin Jones — Fri, 11 Sep 2009 22:40:28 GMT

As a ps, in more practical terms you asked what to tell the owner in terms of prognosis. I work for an independent charity, and in cases like this, instead of going through the usual adoption process, we wave the adoption fee and enter into a fostering agreement, where the owner takes on the patient, and looks after it. Any related vet bills are taken care of by the practice, until such time as we know which way the wind's blowing.

It seems to work well, although some careful selection of foster parent is needed. Most prospective owners are proud and pleased as punch to be seen as potential fosterers, and some end up continuing in this fashion. It's the uncertainty, both emotional and financial, of committing to such pets that makes people nervous. Knowing that they won't be such a financial burden, and that it's OK to back out if things get too tough, tends to settle people down.

Hope this helps in some way.

Re: Stunted kitten

Martin Jones — Fri, 11 Sep 2009 22:34:23 GMT

The liver is proof that if a thing can possibly happen, then it will happen. I think we're all a little baffled by how the damn things work, and why they go wrong - and then, why they stop going wrong either because of or in spite of what we're doing.

Basically, this kitten is small, but is growing. That should suggest that whatever's going on with the liver, it's self-limiting. The lack of clinical signs by now doesn't entirely rule out a PSS, but it's getting that way; storage diseases and other weird and wonderful enzyme dysfunctions ought to be out of the picture, simply because it's alive, apparently thriving and not showing overt hepatic dysfunction. I bet any and all liver function tests are within normal limits, or close to.

It's unlikely to be infectious; it's not neoplastic (apart from the incredibly rare [and not properly neoplastic] hamartoma, and I've never heard of one of those in this context). It does have a liver, so isn't any kind of aplasia or dysplasia. It's not PUPD, dysphagic, diarrhoeic or vomiting - so it's unlikely to be secondary or reactive liver disease (apart from the parameters described above). There are no apparent problems with blood supply (have you done an echocardiogram, though? According to some of the diving medicine bods, up to 25% of the human population may have a hole in the heart without any apparent symptoms).

What diet is he on, and are you using any specific hepatic support? An ex-lap, I just bet, wouldn't help a jot - other than to aid a biopsy. Unfortunately, that's probably going to be the best bet for a definitive diagnosis - which is likely to be without specific treatment recommendations, so in real terms you'll be back where you started.

One question: if this kitten were off the homing programme, would you still be pushing for a diagnosis, or would you be more content to let the situation play out a little? It sounds like one of those cases where you're destined to add to your own household, 'just for the time being', until you find out he's actually fairly normal and keep him.

We used to see a lot of lambs like this. With the vagaries of farm practice, some made it and some didn't, but a good many never really did develop any overt symptoms. The word 'runt' is a four letter one in our practice, but it's amazing how many of these patients just come through in their own time.

Let us know how the bile acid stim tests go

Martin