I would carry on with the Zithromycin and see where you are at after she finishes. I am not 100% convinced it is FIP, but in my experience (I had taken in a kitten that turned out to have FIP), it is a possibility. I do not like that the abdominal fluid was yellow, plus the amount that was drained.
There is some blood test that is supposedly for HCM...again, in my experience, we haven't used it because it is not reliable. I would schedule an echocardiogram with a cardiologist...that is the most definitive way to rule in/rule out HCM. Although I am a relatively new graduate, I haven't seen a case of HCM with abdominal ascites...usually it's pulmonary effusion.
I know you want definitive answers...I did, too, when I went through this. I really think the best course is to keep on the antibiotics, and try to schedule the echo. Please keep us updated!
Karen Plasket, DVM
From: wintersdadoo <parrystrain@...
To: feline-heart <firstname.lastname@example.org
Sent: Thu, Nov 8, 2012 4:53 pm
Subject: [FH] New to forum-Winter, 4 month old kitten HCM?FIP? Bloodwork included
Then on Sunday we noticed something was very wrong. She was lethargic all the
time, didnt want to play, slept all the time and her coat did not look properly
groomed. If we tried to play with her she would perk up, be alert but not have
the energy to chase. Wanted to play but couldnt.
We took her to the vet and the vet immediately suspected wet FIP. She had a
temp of 104...They tapped her stomach and drained (I think 150cc, I could be
wrong) the fluid and
ran blood work. She brought us the vial of fluid which is kind of a bright
yellow and said she really thinks it is FIP. The blood was sent out as was the
vial of fluid.
We were given clavamox for the fever and have been giving WInter multivitamin
with her food. She still eats a ton, drinks a ton, uses the bathroom regularly.
She still lacks the energy a 4 month old kitten should have and would rather sit
on our lap and purr and be loved. We have only had her for a month of her life
but she has become a member of our little family
Day 2 We received the blood test results, below
eference is after the / mark
Total Protein : 6.7 / 5.2-8.8
Albumin; 2.2 (LOW) / 2.5-3.9
Globulin: 4.5 / 2.3-5.3
A/G Ratio 0.5 / .35-1.5
AST (SGOT) 39 / 10-100
ALT (SGPT) 13 / 10-100
ALK Phosphatase 10 / 6-102
Total Bilirubin 0.6 (HIGH) / 0.4-0.6
BUN 26 / 14-36
Creatinine 1.1 / 0.6-2.4
BUN/Creatinine ratio 24 / 4-33
Phosphorus 7.7 / 2.4-8.2
Glucose 122 / 64-170
Magnesium 1.8 /1.5-2.5
Sodium 147 / 145-158
Potassium 5.4 / 3.4-5.6
Na/K Ratio 27 (LOW) / 32-41
Chloride 114 / 104-128
Cholesterol 192 / 75-220
Triglyceride 81 / 25-160
Amylase 1267 (HIGH) / 100-1200
Lipase 71 / 0-205
CPK 97 / 56-529
WBC 12.3 / 3.5-16
RBC 6.1 / 5.92-9.93
HGB 8.7 (LOW) / 9.3-15.9
HCT 28 (LOW) / 29-48
MCV 46 / 37-61
MCH 14.3 / 11-21
MCHC 31 / 30-38
Platelet Count 132 (LOW) / 200-500
Neutrophilis (HIGH) 10209 / 2500-8500
Lymphocytes 1722 / 1200-8000
Monocytes 123 / 0-600
Esoinophils 246 / 0-1000
Basophils 0 / 0 -150
Total T4 1.1 / 0.8-4.0
Elisa FELV Negative
FIV Antibody Negative
FCV IFA at 1:400
Toxoplasma Antibody Titer IgG and IgM Negative
Reticulocyte Total 0.2 / 0-1
Absolute Reticulocytes 12200 / <45,0000
Doctor called regarding the blood work and says everything seems normal (organ
function, blood, etc) but at the same time FIP cannot be ruled out due to low ab
and moderate a/g ratio. He does think it is odd that the protein levels are
not high so FIP cannot be confirmed.
The vet does not think this is a case of bacterial infection because if it was
he feels that some kind of irregularity would show up in the blood work. The
breeder (who is also a doctor) on the other hand, says that due to the low
protein levels we may have taken Winter in right when the infection started.
She asked us to switch out for a stronger antibiotic (Zithromycin) in the event that this is a bacterial infection, as she feels bacterial infection cannot be ruled out. SHe is now on day 2 of Zithromycin
Apologies for the length of this post but if anyone has any insight into what we
should do we would greatly appreciate it.
Our effusion PCR test results will not be ready until friday or monday.....
She seemed in better spirits this morning, much more awake and alert, the fluid, however is returning to her midsection. She is very alert and awake in the morning and then her energy nose dives after we give her the Zithromycin and she wants to sleep. She still perks up when food is around and eats and drinks like a horse (which is not typical of FIP)
A member on another FIP support group indicated that cholangitis is a possible
different diagnosis. Another possibility is HCM which I have read can cause abdominal effusions. The doctor did say that she could hear a heart murmur. Unfortunately I am unable to find any info regarding diagnosing HCM through a blood test. If any one has any experience, please let us know if any value/levels look suspicious as we are desperate!
Thank you for your help everyone.
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