Cat not doing well.

Hi Dr. Marie,
First I want to say I love your page on Facebook and I am a big Fan of yours – so I'm hoping you can give me some advice/and perhaps a different perspective / viewpoint to see if there is perhaps something that I may have overlooked or missed that could help my little boy Stanley – he is a 1-1/2 yr old neutered Oriental Shorthair, who has had some very tough obstacles to overcome right from day-1 – Just to give you some background –According to Stanley's breeder, his Mom had an emergency C-Section and he was the only one of littler who survived, they thing cause he was so tiny, the smallest one - and it was touch & go for him and he almost did not live. By @ 8 wks still so very tiny and not eating enough and had to supplement his diet w/formula. I finally got him July 2010 @ 4-1/2 mths old weighing only 3-1/2 lbs. After having him just a few days he ended up having diarrhea – I started to think he may have caught something from one of my other cats (I have an older 13-yr old girl, Chinagirl– and 2 other kittens (Madeline & Oliver) that we got 2-mths prior to getting Stanley– unfortunately unbeknownst to us Oliver came to us having Tritrichomonas foetus which was first misdiagnosed as being Giardia, & later we found out he had herpes & calicivirus, and corona virus, plus at the age of 6-7 mths Oliver had Juvenile Periodontits Disease (the advanced 3-4 stage) along with Stomatitis –diagnosed by a Board Certified Vet Dentist – who was already treating Chinagirl for advanced Stomatitis requiring all her teeth to be extracted – and when the Vet Dentist cleaned Oliver's teeth she had to extract 1/2 his new Perm Teeth. Back to Stanley, we did not know Oliver had Tritrich until months after getting Stanley - so unfortunately all my cats got it w/the diarrhea– it took a lot of work & research to finally get the Tritrich under control – and under our Vet's care back in Nov 2010 we treated them all with Ronidazole (extremely toxic) (also according to Dr. Jody Gookin's research and recommendations) –at first seemed like they were finally cured, but then a couple weeks later Oliver & Madeline had diarrhea again! Ugh!! And seemed they were all taking turns vomiting just like they did before the Ronidazole- so their digestion is still an issue - Although Stanley & Chinagirl stools are solid (almost too hard). But just because China & Stanley did not have diarrhea doesn't mean they don't have Tritrich - we're assuming if one still has it, they all do? But rather than retreating them all again with Ronidazole we opted to find alternative remedies/solutions to ease digestive & diarrhea & vomiting symptoms – One way to help them is to find high quality easy digestible single protein food. Ironically though, by trying different foods in hopes of finding the best one I was inadvertently kept the tritrich symptoms going – so in effect by constantly trying & switching foods I was exacerbating Tritrich – so we now feed Evangers & Weruva can food and Evangers dry along w/giving them Purina Forti-Flora and L-Lysine –maintaining this diet w/ no deviating has made them all better except for Stanley. Stanley still has digestion problems w/ vomiting and has been battling Tonsillitis since Mar 2011 – He’s been on so many different antibiotics to no avail – his tonsillitis keeps coming back which causes him to cough and gag. He still vomits frequently almost daily sometimes – and we found when he starts gagging/coughing and trouble swallowing it seems we immediately feed him Baby Food Turkey Beech Nut which make him feel better immediately – quiets his cough and soothes his throat. But so our Vet told us since we tried so many different antibiotics that should have cured tonsillitis but instead all failed that we should consider surgery – but there has been no real discussion as to WHY is he's having Tonsillitis? But so before we opted for Surgery we gave it one last non-surgical try and gave him a Steroid Shot this past August 2011– but a couple days after being at the Vet and getting the shot Stanley ended up getting really really sick with bad URI –took him back to Vet and gave him Clavamox which he never had before. He started to improve but then all my other cats started getting realy sick –and Oliver got it the worst super high fever and couldn’t breathe thru his nose & struggled for each breath - We rushed him to the Vet – we did a swab and ran a PCR test for all possible URD –it came back Positive for Herpes, Calcivirus and Mycoplasma Felis - so starting Sept 9 we started all my cats on a 21-28 day treatment of Doxycycline– but Stanley seemed to vomit much more almost once or twice a day immediately after eating a big meal – so we lowered his dose of Doxy and started giving him frequent small meals which seemed to help and he'd go 2-3 days before vomiting – usually because I possibly let him eat too much –
So this gives you a pretty good background on Stanley – and here’s the problem – he vomits frequently and cries when he goes to use the litter box – and I really haven't seen him have a bowel movement but I keep seeing these very small very hard stools in the litter and since I see the other young cats stools are large and more normal I'm thinking he's having a problem with having hard stools – and his tonisillitis is back again with vengeance – so my question is could this be a form of stomatitis? Could he have gotten this from the other cats with stomatitis? And we know they all were infected with Calicivirus which I believe is somehow connected with Stomatitis? And why does he cry when using the littler? He doesn't moan, he just meows like announcing or could be crying, not sure? But still haven't seen him have a bowel movement so not sure but pretty sure his are hard little stools. Could this be causing the frequent vomiting? And he doesn't eat much dry so why would he have small hard stools? What would cause this?

I appreciate any insight or suggestions you can offer or offer a different approach I can maybe take with Stanley –like what tests should we should ask for? Thanks so much, and sorry for being so long winded.

Dr. Marie,
Thanks so much for your information - To answer your question, 'no' he has not had complete blood chemistry profile done - I will definitely ask my Vet to do this. As I'm sure this will be the best starting point. I was just kind of hoping you might suggest a Thyroid problem - because that would be treatable - but deep down I was so afraid you may say FIP - OMG that is an awful disease and causes such suffering from what I've heard - I'm guessing you suggest FIP because we know Stanley has Coronavirus? The liver problem doesn't sound much better either- I'll have to research Liver Shunt because I have never heard of this. I pray he doesn't have either -And just really afraid if turns out to be FIP at what point do we know for certain - what are the tell-tale signs before the disease really progresses so we can maybe catch it before he suffers? Thank you again so much, I greatly appreciate your insights and sharing your thoughts for my little Stanley. I'll keep you posted. Best, Ellen

Hi Dr. Marie,
I just wanted to give you an update on Stanley. I took him to the Vet last Friday afternoon for a complete check and to also draw blood to get a complete panel on him. I ended up seeing the newest Vet of the practice that I go to (the Vet I usually see was not available)-But in a way I'm glad - it was good having a fresh pair of eyes reviewing his case. He was able to review his case history/ file, and we talked and he really listened to me too which I appreciated (of course I asked him about Liver Shunt and FIP) - Here's what saw and what he thinks - in reviewing his file/history and giving him a thorough exam:
1) definitely swollen tonsils – his Tonsillitis is back! (not sure why)
2) gums / teeth look fantastic – nice pink – no redness at all! Great gums!
3) everything else looks great in his physical exam – even his stools are soft - whereas I thought he could be very constipated – but not the case from what he feels.
OK – Here's his evaluation.
A.) He doesn't feel it can be Liver Shunt because his growth would have been very stunted (not by weight but rather by skeletal size)-& even though he's very skinny/ boney - he pointed out his skeleton is fully developed and lanky of normal size, plus he pointed out yellowing is usually seen which he doesn't have. So I was happy to hear this as I’m you are too – as I know it’s hard for you because you can’t see him in person to assess his size.
B.) Regarding FIP, even though he has coronavirus he just doesn't think the signs are really pointing him in this direction. He wasn’t really very specific on this point.
C.) Regarding Crying at the little box – He said perhaps he was a little constipated at one point to cause him discomfort and pain enough to cry at the box – but can’t really explain it because his stools feel fine – And regarding Vomiting, it does not appear to be caused by constipation since he is not right now. But suggested I add a little metamucil to his food (& explained how to & that it could help his digestion) –
But for right now he’s asking me to not leave food down for my cats so Stanley can’t keep eating- and only feed Stanley very tiny portions at a time several times a day, and we'll see if this helps.
RE: Treatment: for his Tonsillitis he gave him a 2-week acting Steroid shot to counter the inflammation and pain, and start him back on Clavamox again for two weeks (antibiotic he said is given as a precaution because the steroid lowers his immune system which puts him at risk since he has an infection with the tonsillitis and we don't want him to get sick or should I say sicker).
Results: His blood work the next day came back Perfect!! everything well within the normal ranges –
And with feeding him tiny meals this past week he hasn't vomited - only once when I forgot to pickup dry food and he definitely ate too much! and his bowels do seem normal - and a week later we can tell his throat is definitely feeling better! (I'm thinking his sore throat contributes to his vomiting! but that's just my opinion) This little boy definitely his high energy and loves playing and obviously eating is not an issue - I truly think he'd eat himself to death!! Yet he's so skinny! weird - I'm thinking part of the problem is he truly cannot sense when he's full or had enough food! He still announces when he goes to the bathroom - and that still has me puzzled - but he doesn't really seem to be in pain.
Summation: My only fear at this point is after the steroid wears off and has finished his antibiotic that his tonsillitis will still be there! I just wish I knew what is causing his tonsillitis? and do you think if it’s still swollen and keeps coming back that this could this be the beginning of Stomatitis? and taking him to a Vet Dentist? or should we think about having his tonsils removed? Would love your thoughts on that. I found this great website about FIP and Stomatitis by Dr. Addy (http://www.dr-addie.com/stomatitis.html) and I definitely learned a lot from this site and their ebooks and was wondering if you had heard about this site and what you thought. Thanks again so much. Best, Ellen

THANK YOU!