What's Bugging Annie and How it Can Help Your Cat.

Over the past few years I’ve come to understand that it isn’t always possible to get a firm diagnosis of what's ailing a cat. It’s extremely frustrating and often ends up being very expensive, as well as potentially stressful on both the cat and the cat-mama/dad. The goal is to find balance between what could be garnered by such a test, the cost, and the stress. Personally, I want to go to the ends of the Earth for every cat, until it’s clear that the value of a test result does not change treatment. In my cat Gracie’s situation, we were told she either had cysts or cancer in her liver. The treatment would be the same, but sadly her time with us would be much shorter if it was cancer (which is was). She was too frail to risk a biopsy so we began palliative care, monitored by our vet, until she passed away.

©2016 Robin AF Olson. Annie and Mr. Peabody take a lap break on yours truly.

What it means for Annie, is that right now we don’t know for certain what is causing her to be “unthrifty” (she’s thin, bony-thin even though she eats well and is hungry) and have non-regenerative anemia (she’s making new red blood cells but the tax on her from whatever is infecting her is so high that she can’t make enough red blood cells fast enough). Her white blood cell count is high (which means infection) and she has other wildly high or low values on her blood work, but the anemia and white cells are the most concerning.

The ultrasound has been done, but we don’t have enough funds to keep going with tests and Annie is nowhere near getting a diagnosis. Treatments have been started but they're only an educated guess on whether or not they’re what she ultimately needs.

©2016 Robin AF Olson. Annie waiting for her ultrasound.

This is the assessment from the Ultrasound:

“Renal asymmetry with left kidney smaller with abnormal architecture compared to right- r/o congenital dysplasia vs other- both kidneys appear to be growing steadily with her increasing age, which is appropriate. Messenteric lymphadenopathy –r/o reactive (infectious, inflammatory) vs age-related vs less likely FIP, neoplasia, other.”

We knew Annie’s kidneys were wonky but so far they’re working all right. The scary part of the assessment is some of the things that might be making Annie sick. Neoplasia is cancer. FIP is something no one ever wants to hear or read. It’s a fatal disease and in Annie’s case it would be the dry form, which we lost our dear Fred to four years ago. The disease that is so horrible I swore I would stop doing rescue if I ever had to face it again.

But what is more likely and treatable is if Annie has Bartonella (the bane of my rescue-existence because I see this all the time but it manifested very differently in the cases we’ve had before) or another infection.

©2016 Robin AF Olson. You're going to shave my belly...AGAIN?

This is what our Board Certified Internist wrote on Annie’s discharge papers.

“Suspect infectious disease-Bartonella, Toxoplasma, tick-bourne illness, other… I suspect that Annie has an underlying infectious disease and that likely given her flea history and outdoor exposure that it is Bartonella, but toxoplasma and tick-bourne illness are possible as well. As we discussed, Bartonella testing is frustrating (note from Robin: Annie WAS tested in Sept and was +1, meaning no need for treatment at that time) and can be quite expensive. Therefore, we are going to empirically treat her for it. We are going to test her for toxo and tick-bourne (Robin note: later she was negative for tick-bourne illness like Anaplasma and Erhlichia).”

Here’s where things get dicey.

Normally we treat Bartonella for 4 weeks with Azithromax. It usually clears the infection, but our Internist said to put Annie on Zeniquin (Marbofloxacin) in addition to the Clavamox Annie is already getting. That’s two very strong antibiotics and in the case of Zeniquin it could be bad news.

Every time I have to treat a cat with a medication I'm not familiar with, I look it up on the internet. I read the manufacturer’s information sheet about the medication, noting the side effects so I’m prepared should I see the cat exhibit any odd symptoms.

I was sitting in bed, barely awake, when I realized I hadn’t looked up Zeniquin even though I’d already given Annie her first dose. I first read the sheet on my phone screen. What I read made my blood run cold.

Clearly this is not something you give a cat unless you really have to AND clearly you are not supposed to give this to a KITTEN. Annie is 8 ½ months old.

I called the Internist and told her my concerns. I realize that with any medication there is a risk of side effects and if you need to kill a bacteria explosion you need to do something. I remember years ago I had to take antibiotics and one of the side effects was a black furry coating on the tongue! Thankfully I only got an upset stomach, but what could happen to Annie?

We had a good conversation and it was very respectful. She assured me that this is a more effective way to treat Bartonella, but that if I wanted to go to what we’ve used in the past that was OK, too. I should discuss with Dr. Larry as he was already up to speed on Annie’s case and I agreed.

Last night I spoke with Dr. Larry and this is why I love him as my vet-he told me he’d never used Zeniquin on cats, period. Not that it was bad, I’m not saying that and neither is he, but he was not aware of that as a treatment for Bartonella. We talked further about the risks and he asked me to keep Annie on it until Monday, when he would call Zoetis and get information from them. If this WAS a better treatment we needed to know about it, but if it could put Annie in danger, we needed to know that, too. I am gathering facts before I flip out.

So I gave Annie a second dose, but with a heavy heart. I sat with the foster kittens for a few hours after the dosing. Annie seemed to be a bit perkier earlier in the day already. I’d given her an injection of Vitamin B12 and some iron-rich raw chicken liver.

I didn’t know if the medication or the iron boosters were helping her, but then she jumped off my lap and laid down on the floor. She chose a strange spot to sit, not really hiding, but not in her regular hang-out place. She cried a tiny cry, then got up and used the litter pan, peeing quickly then jumped out of the pan, laying down in another odd place. She seemed flat again and in pain.

I decided to give her another meal and she and the others ate every bite. She seemed a bit better after that, but I'm definitely not feeling very comfortable about all these medications. Tonight, when her next pill is due, I’m not sure I’m going to give it to her.

©2016 Robin AF Olson. A moment of levity in an otherwise troubling day.

We don’t even know what it is wrong with Annie for certain, which makes this choice even harder. Maybe she doesn’t even need these antibiotics or maybe she really does and not giving it to her will make her get even more anemic..and that could be VERY VERY BAD.

Annie doesn’t need a transfusion, yet, but if she continues to go downhill she will.

All that remains is our sad little fundraiser. We didn’t make our goal and our accounts are in the dust. I’m praying for a holiday miracle that we can pull in another $500-$1000 (ideal) so that we can get Annie’s blood work updated and cover the costs of changing her medications if needed.

If Annie has a bad reaction to the current medications, we won’t be able to afford to take her to the Vet for care. That’s how bad off we are right now and it’s not a place I want to be in.

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Your gift is tax deductible. Kitten Associates is a 501c3 non-profit. Our EIN Tax ID is 27-3597692. Thank you for helping Annie!

©2016 Robin AF Olson. Annie hasn't sat up and looked comfortable for a long time. When she did, I couldn't believe what I saw. She's got a heart-shape on her chest!