"Tiny' Kitten who is failing to gain weight and thrive

by Suzanne
(Middleburg, VA)

We rescued a ferrel kitten in Aug 2013 who was 1/3 the size of her other 2 siblings. She weighed 2 lbs but was about 6 months old. Since then, she has yet to gain an ounce and been to several Vets and Internal specialists. She had very elevated ALT enzymes in August (624) which subsequently came down to the 200 range, and then went back up about 1 week ago. She's had an ultrasound which only showed an enlarged spleen, but normal sixe liver. She also had an EPI test (negative) and a bile test (which was inconclusive for a shunt).
She was on metronidazole (8 mg/every 12 hours) since August. In early Dec, I think she showed signs of toxicity to this medication because she was staggering and unable to keep herself balanced. Now she's ONLY on Clavanox. Unfortunately, she is NO BETTER, still unstable, pale gums and has not gained ANY weight.

I am at a lost with what to do next? Do we visit another Specialist?

Our Vet believes it's a liver infection that she'll eventually kick. This little kitten has been struggling to thrive since mid August!

Is their a liver Specialist anywhere in the Maryland/Virginia/DC area that you could suggest we visit?

Thanks.
Suzanne

RESPONSE:

Suzanne,

I’m sorry to hear your problems with the kitty. We also took in a feral kitten that was 2½ pounds when she was 6 months old but we were fortunate that all she needed was lots of groceries. She ate anything put in front of her and gained weight nicely. By the time she was a year old she was over 5 pounds. Chanel is now 5 years old and a healthy 9 pounds.

Metronidazole is an antibiotic that is able to gain access to central nervous system infections and that makes it effective enough that it regulates the immune system and helps relieve inflammatory disease of the bowels as well as being useful in protozoal infections. For all its welcome uses, it does have some side effects and prolonged use can impair the functioning of the brain which accounts for the difficulty in maintaining balance your kitty is displaying so it’s good news that she is off of it. Clavamox contains both Amoxicillin and Clavulanic acid…the Amoxicillin is similar to penicillin and it’s effective killing bacteria etc. Unfortunately, both of these drug your kitty has taken also have a side effect of killing appetite which is not what you want.

The elevated ALT levels are justifiably a cause for concern. This test is used to detect not only toxicity from drugs but also liver damage in cats, especially when a cat is anorexic and hepatic lipidosis could be the culprit. Typically fat reserves are used to supply necessary nutrients to an anorexic cat but the liver becomes overworked and excess fat builds up in the liver. Typically the liver enlarges in later stages but could be missed in earlier stages.

In severe cases your cat may need to be hospitalized for intensive care and treatment where fluid therapy will help to overcome fluid and electrolyte imbalances and perhaps vitamins such as cobalamin and thiamine are given. Once stabilized and the cat returns home, the over-riding treatment is dietary. The cat’s protein needs have to be immediately gotten under control even if you have to force feed with a syringe etc. and taurine, vitamin E and L-carnitine will need to be added to the diet. Hopefully this is not your case.

I am not a vet but when you’ve gone this long without any improvement, it’s correct to consider another Specialist. I googled “feline liver specialist in Virginia” and the top listing was VCA Southpaws Veterinary Specialist & Emergency Center. This really caught my attention because recently when I had an episode with one of my cats that concerned me deeply and it was a weekend…I went to the Emergency Clinic listed on my vet’s webpage for after-hour care. Perhaps it’s because they deal with emergencies and get a lot of experience with a variety of dire “need help fast” situations, but I was impressed with VCA Emergency & Critical Care. They have branches all over the USA and they are open 24/7. A little more expensive, but my cat Max, has been on medication for the past 3 months and is back to normal. Sure was worth it to me.

If you go to www.vcahospitals.com you can see if there is one closer to you. Or, if you prefer, see if there is a Veterinary University in your area. They are usually up to date and have sophisticated equipment not always available in a regular vet’s office.

This health problem with your kitty has gone on too long and something has to be done quickly before she succumbs and wastes away. I empathize and send my best wishes for a happy outcome and a healthy kitty.