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Ask Dr. Michael Salkin Your Own Question

Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Cat
Satisfied Customers: 26185
Experience:  University of California at Davis graduate veterinarian with 44 years of experience.
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Our 14 year old cat has started drinking a lot more water than

Customer Question

Our 14 year old cat has started drinking a lot more water than usual. She went to our vet last week and was given antibiotic injection for a sore mouth and carried out a blood test. Results were all clear to blood test. Still a little brown discharge from her mouth and she doesn't stop licking her paws now? Please help.
Submitted: 1 year ago.
Category: Cat
Expert:  Dr. Michael Salkin replied 1 year ago.
I'm sorry to hear of this with your 14 year old. I have a couple of concerns that I'd like to discuss with you.I need clarification for "sore mouth". Were you given a cause for her sore mouth? Is her oral cavity diffusely inflamed (stomatitis) or is there a discrete ulcer(s) or growth(s) which might indicate neoplasia (cancer) at her age? Is her sore mouth associated with dental disease - gingivitis, periodontitis, endoclastic disease, or dental root abscessation, e.g? Primary bacterial infection in the mouth is rare. It arises secondary to another disorder in the great majority of cases.There has to be a reason for a 14 year old now polydipsic (increased thirst). The most common reason is chronic renal insufficiency (and if toxins accumulate in the bloodstream instead of being excreted by the kidneys, oral ulceration can arise), and we also consider hepatic insufficiency, urinary tract infection involving the kidneys, diabetes mellitus (she would also be polyphagic/increased hunger), and less commonly, electrolyte (sodium, potassium, chloride) imbalances as well as hypercalcemia (increased serum calcium level). Something has been missed. Can you upload a copy of her test results to our conversation? I understand that you might not have a copy at home but her vet can give you one which you can scan into your computer and then give me file link or you can photograph the pages and upload them by using the paperclip icon above your message box (if you can see the icon) or by using an external app such as dropbox.com/ I not only review the test results but also note which tests should have been performed but weren't. Her oral discharge tells me that the inflammation is still active and her licking her paws reflects her cleaning them after cleaning away the discharge with them.
Customer: replied 1 year ago.
Many thanks for your quick response. The vet gave her a full check and stated that her mouth was fine and the inflammation was slight, but could be a small ulcer. He gave her an injection convenia and another dexadreson. The blood test was a general health profile including electrolytes and telephoned to confirm that she was all clear, but did show border line kidney issues. He stated she was in good shape for her age. She eats normal, albeit she has never been a big eater. There is no smell to any slight discharge. Her fur is a little dried gel like feel below her chin etc. There is no other physical changes to her routine, although she has not been to the toilet for a couple of days.
Thanks.
Expert:  Dr. Michael Salkin replied 1 year ago.
Thank you for the additional information. I want to know what that "small ulcer" represents but it sounds as if the vet wasn't sure. The use of dexamethasone should be circumspect if renal insufficiency exists - and it does at her age. Please note that kidney values (BUN, creatinine) may stay in the normal range until 75% of normal kidney tissue is gone. Her continuing to eat normally and keeping to her normal routine are positive prognostic indicators. She'll eliminate shortly. What goes in must come out. Geriatric constipation is relatively common, however, and so if she didn't have a bowel movement in 72 hours, please alert her vet. I still would like to review her test results for you. Please continue our conversation if you wish.
Dr. Michael Salkin, Veterinarian
Category: Cat
Satisfied Customers: 26185
Experience: University of California at Davis graduate veterinarian with 44 years of experience.
Dr. Michael Salkin and 2 other Cat Specialists are ready to help you
Customer: replied 1 year ago.
Many thanks, ***** ***** not get anything from the vets until Monday now as they are closed for the weekend. Can I send them to you on Mon/Tues of next week?
David
Expert:  Dr. Michael Salkin replied 1 year ago.
Yes, please do. You can return to our conversation even after rating at your convenience. Please don't open up a new question.Thank you for your kind accept. I appreciate it.
Customer: replied 1 year ago.
Hi, we had no choice but to take our cat to the vet yesterday as she will not eat at all now (we have offered her everything that is her favourites) she is hungry as she tries to eat and drinks lots of water and cat milk. We noticed that her right eye had dialated to a round pupil but her left eye was as normal (almost day and night sight in each eye). He gave her another full check up and stated that there was no ulcer or tooth or any other mouth problems. Her lungs were OK as was her heart. He checked her glands and they were normal. He injected her with Metacam and gave us some liquid to give daily (for pain and swelling) I think that he feels deep down that there is a serious problem which can only be proved via a scan. He seemed to suggest that maybe her time had come unless we spent a lot of money with no guarantees and which we can not afford, he just did'nt know or was sparing our feelings. She seems a little more active than usual which is strange? However, she is still dribbling excessively and licking her paws/legs to the point now that her fur is coming out and now smells (like a wet dog). Sorry but I did'nt get the blood test results. It is very frustrating as our cat seems normal otherwise. Many thanks, David
Expert:  Dr. Michael Salkin replied 1 year ago.
I understand, David. Her anisocoria (unequal pupil size) can be a clue for quite a few disorders.The two most common causes are the leukemia (FeLV) virus and the spastic pupil syndrome - a condition unique to cats in which owners report anisocoria, which may sometimes be transient and independent of ambient light levels. Clinically, cats with this syndrome appear to be healthy, are visual, and have no ocular abnormalities beside unusual behavior of the pupils. Unfortunately, most affected cats test positive for FeLV at the initial presentation but not all which confounds the diagnosis. I can't imagine your 14 year old suffering from FeLV. Anisocoria also results from primary iridal (iris) disease - any inflammatory process causing miosis (an abnormally small pupil); and primary neurologic disorders involving cranial nerve III and Horner's syndrome. Mydriasis (abnormally large pupil) can result from glaucoma and retinal hemorrhage/detachment - often secondary to hypertension - as well as central nervous system disorders such as brain tumor. The initial database should involve testing for FeLV and a complete ophthalmic examination including menace response, dazzle, palpebral, pupillary light, and vestibulo-ocular reflexes. Fluoroscein staining of the cornea should be performed looking for corneal trauma and intraocular pressure should be measured (the elevated pressure of glaucoma will enlarge the pupil (mydriasis) and the lowered pressures of uveitis will make the pupil miotic). I understand the pragmatic approach at this time, however. We're not looking for curable disorders at this point. Much of the above is beyond the capability of many generalist vets so Benjamin's vet may recommend referral to a board certified veterinary ophthalmologist. Please see here: www.acvo.org Please respond with further questions or concerns if you wish.
Customer: replied 1 year ago.
Many thanks Dr. Michael, I fear that our vet feels that it is a tumor. But I do not understand why the dribbling would occur and the loss of the ability to eat/swallow solids (but can take liquids) and is it short term or fatal? if you would be kind enough to answer these final questions I would be extremely grateful. We will then be in a position to accept the way forward.
Kindest regards, David
Expert:  Dr. Michael Salkin replied 1 year ago.
Encephalopathies (brain disorders) such as tumors and strokes can cause most every symptom imaginable and disorders in the cranial nerves governing how the tongue and eating/swallowing work aren't uncommon in people or pets. Strokes aren't necessarily progressive but tumors most common are.
Customer: replied 1 year ago.
Thank you. David
Expert:  Dr. Michael Salkin replied 1 year ago.
You're welcome. Keep me posted, please. No need to reply at this time.

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