Help! Poorly cat advice needed

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catlover1983
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Help! Poorly cat advice needed

Post by catlover1983 »

Hi, my 10 year old cat had cat flu when he was a rescue kitten. He’s an indoor cat as he once had an allergic reaction to his immunisations.

—Two weeks ago he had brown discharge from his eye. Vet diagnosed cat flu flare up and gave antibiotic ointment for his eye which worked. Said he also had a nasty ulcer on one side of his tongue which was causing drooling and she thought caused by biting himself.

-A few days later (1 week ago) we noticed a swelling on his right foreleg, different vet had a look and said it was a cyst that would resolve on its own which it has.

-Over the course of the last week he’s started biting at the inside of all four legs, mainly around his armpits, to the point they are stained with saliva, matted and bald in places (he’s left his tummy alone). Vet doesn’t think stress (I don’t think so either), thinks possible allergy and has given steroid injection. Vet is concerned about the ulcer in his mouth and thinks possible tumour, so due to go back in 3 weeks to check if it’s grown/responded to steroids/do biopsy.

- Vet thinks mouth problems/eye/cyst and biting himself are unrelated, but I think this is a big coincidence.

Has anyone ever had a cat who has manifested with the self biting/hair pulling/eye infection and mouth ulcer? Was it a cat flu flare up or something different? Is there anything you could recommend to help him?

My suspicion is he’s biting at his joints as he’s in pain with some sort of flare up, but the vet thinks not?!
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susand
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Re: Help! Poorly cat advice needed

Post by susand »

My cat has cat flu and gets eye swelling related to this. He also has itchy skin which the vet thinks is down to allergies but we don’t know what he is allergic to. So, two unrelated conditions in Harvey’s case and I agree with my vet on that because he has a typical ‘atopy type’ presentation with his skin so the likelihood of it being anything else is negligible.

However, certainly humans can get a ‘reactive arthritis’ causing joint pain secondary to a viral infection but I don’t know about cats. It’s an autoimmune disease caused by antibodies to a virus cross-reacting with proteins in the joints. Also, inflammation of the eye can also be caused by an autoimmune disease, as can mouth ulceration so certainly in a human a combination of arthritis, mouth ulcers and eye inflammation could all be caused by the same (autoimmune) disease process but as I say, I don’t know about cats and obviously I don’t know why your vet favours skin allergy, cat flu and mouth tumour in your case, other than that “common things are common” and the alternative diagnosis is rare if it occurs at all in cats. She/he may have good reason for making the diagnosis he/she has but if you are worried get your vet to explain the reasoning behind the diagnosis they have made and you could suggest a referral to a specialist veterinary rheumatologist if you are still worried.
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susand
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Re: Help! Poorly cat advice needed

Post by susand »

PS I just looked on Google and yes, autoimmune related joint disease, eye disease and mouth ulceration does occur in cats. Not common though.
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Re: Help! Poorly cat advice needed

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Hi,

Thank you so much for your reply. I totally hear what you are saying about common conditions don’t necessarily need to be linked.

He seems to only be biting around his joints (tummy, back, rest of legs etc have been left alone?), which I thought seemed odd for an allergy, plus he’s an indoor cat.

The eye/mouth/biting himself all seemed to start at the same time and the biting/mouth seem to have got worse, whereas the eye was treated and has been resolved.

We’ve seen a few different vets through the same practice, some who seemed better than others, hence I’m partially not confident with the diagnosis, but don’t want to keep dragging him back to the vets and stressing him out until I’ve given the steroid injection a chance to work.

Is there anything I can do that would help a mouth ulcer apart from a steroid injection? I’m giving him mousse to eat and going to ask them today about painkillers again. Has anyone had a cat with mouth ulcers in the past and used anything with success? I asked if he need antibiotics as it had got worse, but they said not?
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Re: Help! Poorly cat advice needed

Post by Mollycat »

True allergies in cats are not common, though reaction to irritants can be, but I think some vets use the word as a substitute for idiopathic, and personally I think both are overused.

Do you have any more news or investigations due on the mouth ulcer / possible tumour? If it was a tumour it could be partly responsible for sending his immune system into overdrive - I've seen it with humans, when a naughty lump has been found just after they have suddenly become allergic to a load of things they were never allergic to before. It may well be unrelated, but it might not be.
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Re: Help! Poorly cat advice needed

Post by susand »

Just to add, reactive arthritis can also occur secondary to a tumour so if he does have a mouth tumour he could have either a dermatitis or an arthritis related to it (it’s called paraneoplastic syndrome).
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Re: Help! Poorly cat advice needed

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Thank you so much for your replies.

I spoke to the vet yesterday and she said we could add in a youmove tablet to help his joints which I’ve started him on today.

He’s definitely only biting around his bum at present and it’s much reduced. His bum is a bit dirty from the anal gland clear the vet did (apparently they got the same amount out that they would usually get from a dog!), so she suggested giving him a clean up with some mild shampoo to see if the dirty fur is what bothering him.

I’m pretty sure he’s at least got some cat flu symptoms as he’s been occasionally sneezing/sounds like he’s trying to clear something from his upper airways. I’m just not sure if this flare up of whatever it is is as a result of cancer or if the ulcer is the result of whatever it is that’s making him ill in other ways.

I’m booked in to see the vet again in a couple of weeks to see if the ulcer has improved with the steroids. The vet said I could then choose whether or not to do a biopsy.

Hoping so much that it improves, as he’s the loveliest boy and just wants cuddles all the time.
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Re: Help! Poorly cat advice needed

Post by susand »

Ok. Good luck and let us know how you get on.
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Re: Help! Poorly cat advice needed

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Hi, just an update as I really appreciated the replies before!

We took him back to the vet last Tuesday as over the weekend his sneezing had got worse, had developed runny eyes/nose and was shaking out his legs which google told me was a sign he was in pain.

I saw a different vet who said it was all cat flu and that his ulcer had already decreased in inflammation and although it could still be nasty, she was hopeful as all the symptoms had started together.

He’s still got another 2 1/2 weeks left of his steroid injection, he’s on antibiotics as his temp was a bit raised, antibiotic eye drops and joint supplements. He’s eating and drinking well and pestering me to be fed!

He’s definitely perked up in the last few days although still not himself.

My question is, he’s still biting himself and pulling out fur around his crotch and onto the inside of his legs. The vet thinks he’s stressed so we’ve got a feliway plug in, do you think it could also be pain? The vet thinks he has arthritis and he wasn’t happy when I just tried to have a look at the bits he’s pulled out which is not like him at all?

Any tips for anything else I can try to help him? I’ve considered a cone/babygro but he’s obviously doing it for a reason?

Thank you!
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Re: Help! Poorly cat advice needed

Post by Mollycat »

catlover1983 wrote: Sat Jun 18, 2022 9:16 am but he’s obviously doing it for a reason?
I love you for this. Yes he is, in some situations we need to do what we can to ease discomfort, but I so agree with you that stopping a behaviour should be about getting to the root cause and helping to sort it out properly.

Glad to hear there is some progress though. Is the biting better or about the same? Perhaps it's taking time, and behaviours like that can become habit too.
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Re: Help! Poorly cat advice needed

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Thank you for your reply! I would say it changes day to day, we’ve had a few days where it seemed greatly reduced and others where it’s seemed just as bad.

On the days I’ve taken the children out he’s seemed happier when we’ve got home, although he’s normally pretty good with children, especially the eldest (6 yrs) and sleeps on his bed, comes down and socialises when we have other children around to play etc.

I’ve wondered if this whole thing has been triggered by us being away from home for a few weekends quite close together, then not long after he was first ill we were away over half term and him and his sister had a week staying at my mums. This has all been interspersed with multiple vet trips and I wonder if these have just added to his stress. I could be wrong with all this though.

Is there anything I can try other than feliway, treats and cuddles to reduce stress?

Could it be possible that the biting is down to pain in his back legs?
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Re: Help! Poorly cat advice needed

Post by susand »

Hi, yes - the biting could mean pain. It’s difficult to be sure though. You could ask the vet about prescribing metacam, which is a type of drug similar to nurofen, to see if it helps. If he has runny eyes he probably has conjunctivitis related to his cat flu and the metacam might help with pain and inflammation from that as well.

Yes, if his routine was upset with all the going away and staying at your mums, that may have caused him stress and triggered a cat flu recurrence. My cat Harvey has recurrences when his routine is disturbed. I don’t go away very often but when I do, I find cats generally are happier staying in their own home rather than being moved. I ask a neighbour to come in to feed him rather than taking him to a friend or Cattery. I’ve got several neighbours in reserve in case the one I usually use isn’t available and for times I can’t really ask neighbours, such as Christmas, I pay a professional cat sitter. That is expensive at £12 per visit but the costs pale into insignificance compared to the vet and medication costs if he gets an attack.
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Re: Help! Poorly cat advice needed

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Thank you for the suggestion of the metacam, the last vet told me that he couldn’t have any pain meds due to the steroid injection, apart from this new £80 injection which she advised using as a last resort.

Annoyingly, we usually use a cat sitter, but because he was already under the weather, my mum had them and he seemed to get worse whilst there, which I wonder if the problem was he was already having a flare up and then us going away/him having to stay elsewhere caused the flare up to get worse? It’s hard to tell.

He was really happy this morning playing in boxes whilst the children were building model robots and hadn’t over groomed all day until this evening when he’s been back to pulling out fur.
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Re: Help! Poorly cat advice needed

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I’m not a vet but I’m a bit confused. I can see the logic to avoiding using steroids and metacam together because both can cause stomach ulcers so used together they increase the risk of that but if the vet is worrying about the use of a drug because of adverse effects, why isn’t he/she worrying about compromising your cat’s immune system by using steroids, which won’t be helping his cat flu flare up any? And if your cat is in pain it is wrong not to address that and also pain causes stress, which will aggravate both the joint pain and the cat flu so I would have thought pain relief should be the number one priority.

Metacam can be given as an injection, so may be that was the injection the vet was talking about but it is cheaper to give it orally and as cats like the taste, not difficult either. Steroids given orally are very cheap too and better than an injection tong term as you get a more constant dose in the blood stream, rather than it tailing off over the course of a couple of weeks.

As I say, I’m not a vet and I haven’t seen your cat so I may be missing something here but the treatment rationale seems a bit odd to me as pain relief should definitely be in there if your cat is in pain and metacam is also an anti-inflammatory so would help with his cat flu as well as his arthritis.

If the vet is concerned about steroids and metacam being given together, has he/she considered stopping the steroids and giving metacam instead? From what I understand from your posts, the steroids were given for biting and licking due to ‘dermatitis’ but the vet now thinks that’s probably all down to arthritis, so if that is the case, why does he need steroids anyway?
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Re: Help! Poorly cat advice needed

Post by fjm »

If the steroid was given as a long acting injection then metacam is an absolute no-no until it has completely worn off, so that is probably why the vet has ruled it out for the time being. Definitely worth considering if he is still uncomfortable when the steroid has cleared his system, though.
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Re: Help! Poorly cat advice needed

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Hi, thank you for the replies. If I’m honest I think the problem has stemmed from seeing 4 different vets (at the same practice) within the last month. I’ve not been happy with this (and there were other issues too), so I did try and get him into a different practice who have a good reputation with cats but they have a waiting list.

The first and last vets I’ve seen I think have been very thorough, I think the issue has arisen with one of the vets who I saw in the middle who disagreed that it was cat flu and gave him the steroid injection as she said it would help his immune system and that the issues were caused by dermatitis/allergies.

In summary:
First vet - diagnosed cat flu flare and gave antibiotics for eye. Spotted ulcer and said to leave to see if it healed on its own and to intervene if it didn’t.
Second vet- diagnosed cat flu and arthritis, could t find the mouth ulcer that was clearly there.
Third vet - thought allergies not cat flu and gave steroid injection. Found the mouth ulcer on second inspection of his mouth (couldn’t find it first time) and said it was possibly cancer, chance it was granuloma.
Fourth vet - diagnosed cat flu (as symptoms had got worse), thought mouth ulcer improved and hopefully linked to cat flu and that fur pulling was down to stress. Gave antibiotics as he had a temp, antibiotic eye drops, youmove joint supplements and feliway.

He seemed to perk up within 3 days of antibiotics and now seems largely himself apart from fur pulling (which has reduced but continues) and still can’t groom himself properly/eat totally normally (which I suspect is down to a sore tongue but still better than it was, he puts his head on the side to chew but does chew on both sides). His eyes are still runny but the sneezing has stopped and he’s had a really good appetite throughout all of it.

I’ve refused to see the second and third vet again as there were other issues as I wasn’t particularly confident in them, but I’m booked in for a follow up with the fourth vet next Tuesday to see how he’s getting on.

He just looks really scruffy due to the fur pulling/not being able to thoroughly groom, when he’s usually pristine. Had a good chase of a fly earlier and has been jumping up on things trying to eat/do what he shouldn’t and coming for some big cuddles!
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Re: Help! Poorly cat advice needed

Post by susand »

Aww poor boy. Is he Ok with being brushed? That might help him with his coat until his tongue is better. Loose fur, dirt and oil will be building up while he’s unable to wash properly and that might make him a bit itchy and uncomfortable. He might enjoy a grooming session with a nice brush instead.
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Re: Help! Poorly cat advice needed

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Good idea, I might give that a try. He has zero tolerance for a flea comb, but might have a look at different brushes and see if he’ll put up with a different type.
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Re: Help! Poorly cat advice needed

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My girl is very difficult and I have managed to get her used to a medium toothbrush for her fur, by starting with the face and under the chin where she loves to rub, and then sneaking one stroke further down her back every now and then. It's hard to keep disciplined enough not to try and rush but I can do so much more with her than I ever thought possible. Small brush, big patience.
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Re: Help! Poorly cat advice needed

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It’s so hard. Choosing the right brush for his coat is a must. I used to recommend the ‘zoom groom’ for every cat which is a rubber brush and gives the cat a nice massage, as well as clearing lots of fur. Most cats I have known come to love it. However, my last cat had a really, really dense coat and needed one of those spikey wire brushes to get to the undercoat and he would purr like crazy when I used it so obviously liked it. I couldn’t possibly use that on Harvey though because although he is semi-longhaired, his coat is actually very thin, with no undercoat and if I used a wire brush on him, I’d tear his skin to pieces. For him, a fine toothed comb is best because it gets rid of any tangles in the longer hair. He’s not overjoyed by it and used to bat my hand away but I’ve found “little and often” is the way forward. Try and end the grooming session before your cat loses patience, so he remembers next time that it was ok and doesn’t associate the brush with getting cross and all upset.
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Re: Help! Poorly cat advice needed

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Thank you so much again for the replies. We’ve bought him a double sided brush which he seems to like on his back and chest and has had a bit of a purr when using it!

We’ve noticed though that he finished his tablet antibiotics at the start of the week and within a few days he’s become picky with his food (although still eating), the fur pulling has got worse, eyes are still runny (sneezing has stopped) and he’s still doing the paw shaking thing from time to time which apparently can be a sign of arthritis.

He’s had a real good go at his fur and stripped it all across his bum and inside of his hind legs/top of his tail. He’s back to having an occasional nibble at his armpits on his front legs as well. He looks a bit of a stained mess on his underside.

He’s back at the vets on Tuesday, has anyone got any thoughts on what I should be asking for in terms of treatment/investigations?

- are there any standard treatment plans for treating mouth ulcers?
- are there any reasons why his flare up would last this long? He’s had all of these symptoms for around 5 weeks now and they seemed to start together not long after we’d been away quite a bit
- any ideas why if cat flu is viral the antibiotics seem to have helped?

Thank you!
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Re: Help! Poorly cat advice needed

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catlover1983 wrote: Fri Jun 24, 2022 8:46 pm
- any ideas why if cat flu is viral the antibiotics seem to have helped?
My retired stud boy had a bit of a cough, was a bit sneezy in phases, had runny eyes, and sometimes blew snot bubbles. He also snored, and although he was a bit short nosed he was a Traditional Ragdoll so not exactly flat faced. I had vets listen to his breathing and every one said his upper and lower respiratory tract were clear and would we like x-rays, no thank you.

It wasn't until he was 14 we got an answer. Probably a latent herpes infection - viral - with an occasional bacterial infection on top, which explains why the two times he had antibiotics for something else it would clear up. Why was the herpes never picked up in his regular stud checks? Because it had to be in a flare to show up. Perhaps it works the same with flu?
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Re: Help! Poorly cat advice needed

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That’s interesting, thank you.

I’ve had another google and apparently chlamydophila felis (bacterial infection) is a type of cat flu caused by bacteria, or maybe it’s just a cat flu flare with a bacterial infection mixed in like you say?

He’d been on the steroids over a week and I hadn’t seen much change at all (apparently from mouth ulcer was less inflamed). Within a few days of steroids his appetite was amazing, sneezing stopped and much brighter in himself. Now the course finished (5 day course), within a day or two pickier with food, definite increase of fur pulling, eyes seem to have started running again etc.

Would he always need a temperature to require antibiotics? He had a low grade fever at his last appointment.
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Re: Help! Poorly cat advice needed

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Sorry, realised that should have read we noticed not much change with steroids, but with antibiotics he really picked up (although was still biting fur).

Within a few days of finishing the course, struggling to eat, biting all over himself, generally looks a mess 😢.
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Re: Help! Poorly cat advice needed

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Well it sounds like it’s probably too complex an issue to be solved by non-veterinarian’s on a forum I’m afraid but the distribution of the fur loss, inside legs, belly etc that you describe in your most recent post does sound more like stress than arthritis, although of course he could have both and to add to the complexity there is nothing to say that if a cat has arthritis and stress related issues he can’t have allergy as well!

A few thoughts:-

May be the steroids didn’t work because he doesn’t have atopy/allergy or maybe because the dose wasn’t high enough?

May be he still has an ongoing bacterial infection - which antibiotics would help - or maybe he’s developed a secondary fungal infection, which will need a different treatment.

If the mouth ulcer isn’t getting better and the vet has any doubts about whether it could be a cancer, a biopsy would be helpful.

If things don’t improve and your vet is running out of ideas, a referral to a veterinary dermatologist might be an idea. There is now an online service as well that you don’t need to go via a vet to access. Just Google it. You send photos of your animal and the dermatologist sends you a report for a fixed fee. I’ve never used it so I can’t personally recommend it but my vet speaks highly of the dermatologist who set it up. I think it was started during lockdown, to avoid face to face, and has just carried on.

I’m very glad he likes his brush :D
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Re: Help! Poorly cat advice needed

Post by susand »

PS:- Regarding what I said about the steroids in my last post, in case it causes confusion - I’m not suggesting the vet gives a higher dose of steroids as this would aggravate his cat flu and he shouldn’t really be on steroids at all during a cat flu flare up but if he was only given a very low dose it might explain why they didn’t appear to work for his skin issues.
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Re: Help! Poorly cat advice needed

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Hi, thank you for the replies as always!

I took him to the vet again tonight as he was due another check up and his eyes had got worse again since yesterday. Saw the original vet who’s first spotted the mouth ulcer.

The conclusion is the vet isn’t sure what’s going on.
- could be a tumour in his mouth, but then all the cat flu symptoms would be unrelated

- could be all cat flu/immune related

Vet says she’s 50/50 at the moment which one it is.

He’s been given a two week prescription of antibiotics (tablet and eye drops) and a prescription for pain killers which I can pick up in a week when the steroid jab should have worn off. (Vet said the steroid injection shouldn’t be a problem if it’s is cat flu, but I didn’t know if that was maybe not wanting to cause a issue with the vet who’d given it to him.)

If he’s no better in two weeks then he’s going to have a biopsy. She said all the symptoms together were quite unusual, as was the state of his fur. (We’ve given him a bit of a clean and brush tonight as he’s had a real go at it again).

He’s definitely in pain with his back legs as complaining and didn’t want us to touch when cleaning him up, so I’m hoping that the painkillers he can start on next week along with he antibiotics will really help him there.

All quite stressful and hate to see him poorly as he’s usually such a proud man. He’s the gentlest soul and hate to see him looking ill.
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Re: Help! Poorly cat advice needed

Post by susand »

I’m really sorry he is so unwell. I hope the vet gets to the bottom of it soon xx
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Re: Help! Poorly cat advice needed

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Thank you. I appreciate it’s got to the point now that if the vet is struggling I’m probably not going to find the answer on an online forum, but just being able to talk through the problems he’s had have been helpful, so I really appreciate that. xxx
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Re: Help! Poorly cat advice needed

Post by susand »

You’re very welcome. If there are further developments do let us know, especially if a firm diagnosis is finally made as it is useful learning for all of us and may be helpful for other forum users with similar issues. Good luck with everything x
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