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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Cat
Satisfied Customers: 34836
Experience:  University of California at Davis graduate veterinarian with 45 years of experience.
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My 1 year old Russian Blue Kitten had diarrhoea/soft stools

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My 1 year old Russian Blue Kitten had diarrhoea/soft stools since we got her with 12 weeks old. In January this year she started losing weight so we visited a vet who first put her on a special diet. It did not get better and in April an ultrasound was done. From the ultrasound the vet suspected amass in the abdomen, probably Lymphoma, and put her on Prednisone 1 mg a day (cat weight was 2 kg). On the prednisone she improved rapidly, gaining weight and having normal poo. When we did another ultrasound in May the vet could no longer see a mass, so was unsure if the cat has actually lymphoma or IBD. Beginning of June we weaned her off the prednisone because the vet wanted her off to neuter her. First we switched to 0.5 mg a day and she was fine, then we switched to 0.5 mg every other day and she got worse again, losing weight and soft stools. The vet then recommended to start prednisone again on 1.5 mg which we did 2 weeks ago. Appetite and weight normalised initially but after two days on 1.5 mg her rear legs became wobbly. That got worse day after day, first the rear legs became wobbly, then the front legs, then she fell over to the side more and more often, and since 3 days she cannot move at all. She is still eating when we feed her, but cannot move and is lying around. Poo is normal. Temperature is low (35.7 C). We measured blood glucose and that is normal. Any ideas what is wrong with her? Can it be anything related to either IBD, or lymphoma, or prednisone use? (Had to issue this question again as customer team inadvertently closed original question)

You're speaking with Dr. Michael Salkin. Welcome to JustAnswer. I'm currently typing up my reply. Please be patient. This may take a few minutes.

I'm sorry to hear of this with Gigi. Lymphoma is certainly an important consideration as it's the most common tumor affecting the spine of cats and is typically seen in a young subset of patients (median age 24 months). I see no reason to consider IBD or prednisone therapy. Diagnosis of spinal lymphoma requires a high index of suspicion and careful attention to involvement of other body systems. Hematologic abnormalities are frequently found and include anemia, leukopenia (decreased white blood cells), thrombocytopenia (decreased blood platelets), and circulating lymphoblasts (immature lymphocytes). A careful fundic (back of the eye) examination, three-view thoracic (chest) X-rays, lymph node aspirates if lymphadenopathy (swollen lymph nodes) is evident, and recheck abdominal ultrasonography are all warranted.

Inflammatory and infectious myelopathies (spinal cord disorders) need to be considered as well as they represented 32% of cases of spinal cord disease in 208 specimens submitted for histopathologic evaluation in one study. The majority of cases will occur in cats younger than 2 years of age with clinical signs present for less than 30 days. These myelopathies most often affect the cervical (neck) spinal cord which would explain her losing function in her front legs as well as hind legs. The FIP (feline infectious peritonitis) virus is the most important of the infectious agents and we sporadically see Crytococcus, Toxoplasma, bacterial meningomyelitis, Coccidioides, Histoplasma, FIV (feline immunodeficiency virus), FeLV (feline leukemia virus), rabies and others.

Advanced imaging such as CT or MRI should be considered when attempting to distinguish inflammatory myelopathies from other spinal disorders. Treatment is aimed at the underlying cause and may include antibiotics, antifungal agents, bladder management, pain control, and corticosteroids such the prednisone. Please respond with further questions or concerns if you wish.

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