Expert: Ali - 8/9/2009

Question
I have a female approx. 4 years old. This will make day 3 that she is very lethargic and feels warmer than what I would consider normal for her. She has been sleeping a lot and not wanting to play. She eats and drinks when the other cat in the house does. They do not go outside. We had vaccinations done last December, so I don't think she is missing anything there. I don't remember seeing her use the litter box for a bowel movement the last day or two. I did give her some hair ball medicine yesterday because I know she gets those and they can cause constipation. I can't really afford to take her to the vet, especially if there is something we can do for her at home.

Answer
Jennifer,

I have to be completely honest with you, I'm not a veterinarian - I can't diagnose your cat, recommend treatment or provide you with a prognosis. Ideally this cat should be seen by a vet to make sure that she's not seriously ill. I understand how difficult economic times are, I know so many people who are out of work and unable to find another job - it's nobody's fault, it's just a fact of life. Veterinary care can be quite expensive, my husband and I have recently dealt with my middle cat's medical bills, he got quite sick for several weeks early in July which cost us in excess of $1000 that we didn't have when all was said and done. Since I don't feel that judging a person's love and ability to care for their pets based on their financial ability to pay for unexpected veterinary expenses is appropriate or helpful I've done my best to provide pet parents with home remedies when it's appropriate and work towards finding them alternatives when I don't have any simple remedies to fix the situation. I've made a practice of keeping an ever growing list of organizations and charities that may be of help to cover some or all veterinary costs if you apply for assistance from them. You could try speaking with your veterinarian and asking if it would be possible to make arrangements to pay the bill in installments that you can afford, some vets are okay with that while others will refer you to a financing company. If you live in the US you could try contacting Care Credit and explaining your situation, these folks would allow you to borrow what you needed and make low monthly payments until the debt is gone, if you're in a situation where you've tried talking to the vet and/or other organizations that might be willing to help then it's another option available to you. There may even be some not for profit veterinary clinics in your immediate area or nearby, these clinics often subsidize veterinary care and/or run through the generosity of donations and if financial repayment isn't something you're able to do they may accept payment in the form of volunteer hours completed in your spare time. In order to save you time by not providing you with tons of resources that you can't use because they're not in your area and save me time so that I don't waste time sending out long lists of resources that cover much of North America I'd appreciate it if you could contact me again and provide me with the general area you're writing from so that I can send you a list of organizations that will be most likely to offer assistance. Saving this time allows me to help other pet parents with their kitty related concerns so everyone wins in the end.

In my experience vague symptoms like lethargy and fever don't really provide much information that will lead to a diagnosis. This cat could potentially be sick with a minor viral or bacterial infection that her body is capable of fighting on its own or your little girl might be seriously ill. Since your cat is a relatively young cat I'm assuming that she's quite healthy for the most part, some of the conditions below are more likely to affect older cats than others. While doing some research on your cat's symptoms I've compiled a list of some medical conditions that repeatedly came up based on the symptoms you've sent my way(this list is by no means 100% complete). Some of these conditions are quite serious, this is just a list of possibilities, it's not intended to diagnose your cat's condition, that's a job for a veterinarian. The list of potential  health problems that came up during the course of my research is as follows:

- Anemia or other blood disorders: Anemia refers to an abnormally low red blood cell count, this can cause the cat to become very lethargic and have pale gums. You can easily check your little girl's gums at home, all you have to do is gently lift the cat's upper lip and have a look at the color of her gums. If your little one's gums are white she's most likely got anemia and should be seen ASAP to determine what's causing her to have fewer red blood cells than she normally would. Once the vet knows what's causing the low red blood cell count s/he can provide you with treatment options and a prognosis.

- Chronic inflammation: This can be the result of arthritis and other medical conditions that cause swelling anywhere in the cat's body.

- Infections: If your cat has an infection anywhere in her body that could explain her fever and lethargy

- Electrolyte abnormalities: If your cat is dehydrated then her electrolytes may be out of balance. If this is the case your kitty may need to be hospitalized and treated with IV fluids until her electrolyte levels have been stabilized.

- Gastrointestinal diseases: If your cat has a problem within her digestive tract her symptoms could be associated with that. The fact that you haven't seen her defecate in a couple of days could mean that your little girl's got an issue within her digestive tract that's making her feel pretty rotten. If you have children and your cat has a thing for eating objects other than her food it's possible that she's swallowed a foreign object that's stopping her from pooping and making her feel pretty rotten.

- Urinary tract disorders: If your cat has an infection in her urinary tract that could explain her fever and she'd be feeling pretty rotten. In a multiple cat household it can be difficult to know for sure if each cat is urinating/defecating and whether the number of times in a day they're going to the washroom has changed. It's quite possible that a urinary tract infection would go undetected because your cat would still be going to the litter box, you could expect to see an increase in the frequency and urgency of litter box trips, fever, blood in the urine, pain when the cat urinates and she may also strain and produce less urine than she normally would. Sometimes cats with UTI will seek out an alternate place to urinate because they begin associating their litter box with pain, in my experience most cats will choose a porcelain sink, bathtub or tile floor as their first option because these surfaces feel cool which would help decrease their pain when they urinate. Left untreated a UTI can result in a kidney infection which could potentially cause permanent kidney damage if not diagnosed and treated in time

- Immune diseases: New research is suggesting that our pets receive too many vaccines and they're getting them too frequently. Researchers believe that annual vaccines are beginning to cause significant negative effects. Veterinarians know that each time a vaccine is administered the cat's immune system kicks into high gear, the new research is showing that by vaccinating our pets each year their immune systems are forced to stay more active than normal. Holistic veterinarians have long believed that vaccines administered annually may be playing a major part in the increased numbers of cats developing  allergies or serious autoimmune conditions. Today more veterinarians practicing conventional medicine are in agreement with this conclusion, in fact annual vaccines aren't being recommended anymore by many veterinarians whether their practice uses a holistic or conventional treatment approach. If you want more information on potentially serious side effects associated with our pets receiving vaccines too frequently then you may want to check out the following websites:

- http://www.holisticat.com/vaccinations.html
- http://www.pet-informed-veterinary-advice-online/vaccine-side-effects.html
- http://www.shirleys-wellness-cafe.com/petvacc.htm

Your veterinarian can perform a blood test on each of your cats to determine their level of immunity to illnesses our cats are commonly vaccinated against, this is referred to as testing blood titers. If your cats were vaccinated properly as kittens and they're indoor cats you may not have to administer any further vaccines aside from those required by law in your area. If you do decide to vaccinate your cat against rabies it's best to use the 3 year vaccine because it's given less frequently and therefore minimizes the cat's exposure to vaccines. You may also want to consider cycling vaccines if you decide to continue vaccinating your cats against all of the conditions normally prevented by using vaccines. Cycling vaccines simply means that you don't administer every vaccine each year, in fact there may be years when none of your cats get vaccinated at all when they go for their annual health check.

- Nutritional disorders: If cats are fed a poor quality diet or food that's not species appropriate this can result in serious nutritional deficiencies. Sometimes these deficiencies can prove fatal. Many commercially produced cat foods today aren't formulated with a cat's unique nutritional needs in mind, all too often in order to cut costs and maximize profits pet food manufacturers will use vegetable or grain proteins as a way to increase the amount of protein in their product, unfortunately what they don't consider is that cats are obligate carnivores, this means that they must eat a meat based diet. Feline obesity is on the rise, sometimes this is related to overfeeding, I suspect that another serious culprit is the fact that many cat foods are seriously lacking in species appropriate ingredients which prompts some cats to gorge on food in an attempt to feed their body the nutrients lacking in their diet. If you'd like more information about nutrition I'd encourage you to check out these two websites, the first one was created by a veterinarian to help educate pet parents about the best ways to meet the nutritional needs of their feline companions, there is a link to the second website on Dr. Pierson's web page: catinfo.org and catnutrition.org. If you're interested in checking out a commercially prepared diet similar to the one Dr. Pierson recommends on her website I'd recommend checking out http://www.felinespride.com this company ships their frozen food within the US and Canada and they sound like they're fairly good about shipping promptly and getting their product to your doorstep by courier while it's still frozen.

- Acute or chronic kidney failure: Renal failure can happen for a variety of reasons. Your vet can diagnose this condition by doing blood work, the results are usually available quite quickly. Depending on the severity of your kitty's condition conventional management would mean that she would be stabilized in hospital then you'd have to provide her with a prescription diet and supplementary fluids as prescribed by your veterinarian. My experience with kidney failure is somewhat different than the currently accepted conventional treatments and management. If your kitty is diagnosed with kidney disease I'd strongly recommend that you seek out the advice of a holistic veterinarian who uses homeopathy in addition to conventional treatments. My eldest cat's kidneys failed during the Menu Food recalls in 2007, her condition was so serious that the emergency vet recommended euthanasia and her condition deteriorated while she was hospitalized and treated by our family vet to such an extent that my vet's business partner recommended that I start seriously considering euthanasia. My vet provided conventional treatment in the form of IV fluids and a prescription diet in addition to the regular conventional treatment the good doctor also administered homeopathic remedies that I believe are responsible for my baby girl's survival. Any research I've done about feline renal failure has proven that my little one's condition was grave enough that she would have died on her own or I would have had to relieve her suffering by having her humanely euthanized - no veterinarian that I've talked to has an explanation for my little miracle's survival since she was so seriously ill and had lost the majority of her kidney function. My kitty refused to eat her prescription food when she came home so she was given the food I was feeding my other two resident cats at the time and I did have to provide supplementary fluids at home for a year or so, however this little girl hasn't had any extra fluids since the second week of May 2009, her kidney values have been 100% within the normal range and she is completely healthy which defies conventional wisdom.

- Constipation: Can sometimes cause a low grade fever and substantial discomfort. The only way to treat constipation is to get this kitty to evacuate her bowels through the use of laxatives, suppositories or enemas prescribed by your veterinarian.

- Feline herpesvirus

- Feline Infectious Peritonitis (FIP)

- Feline Immunodeficiency Virus: Similar to HIV/AIDS in people, can not be passed from cats to people

- Feline Leukemia Virus: Somewhat similar to HIV/AIDS in people, can not be passed from cats to people

- Nephritis: Kidney infection, would cause fever, lethargy and possibly kidney damage if not diagnosed and treated promptly.

- Liver disease: You may see jaundice if your kitty's got something happening with her liver, her gums and tongue may be yellowish in color, the whites of her eyes  and her skin may also be yellowish. If these symptoms are present your kitty needs to see a vet on an urgent basis.

- Pyometra: If your cat isn't spayed there are some other potential issues that could be causing her to have a fever and be lethargic. Your queen may have developed a potentially life threatening infection in her womb called pyometra, this happens as a result of hormonal imbalances related to the cat's estrus (heat) cycles. Pyometra is usually seen in older queens, but it's occasionally seen in cats as young as 4-5 years old. Some time after the cat's last estrus cycle cysts (pus filled pockets) will begin to form within her uterus, these little pockets of infection stimulate the cat's immune system to produce more white blood cells (white blood cells are the immune system's tool to fight infection) and send them to the uterus, the increased amount of fluid in the cat's womb makes the situation worse. A cat's uterus is normally Y shaped with two distinct uterine horns that are roughly the size of small ribbons, when a queen has pyometra the uterine horns fill with pus and other fluid. The symptoms associated with pyometra are: fever, increased water consumption, vaginal discharge which may be white, yellow or red in color, foul smell, lethargy, reduced appetite, increased water consumption, increased urination, distended abdomen and a kitty that avoids being touched. Sometimes a queen's cervix swells significantly in response to the uterine infection, in this case you wouldn't see vaginal discharge. If the pus, blood and fluid aren't able to leave the cat's body through her vagina her uterus is more likely to rupture and spread infected material throughout her abdomen. If the queen's womb ruptures and pus spreads throughout her abdomen her chances of survival aren't good and she's likely to die within a few days. In some the queen's kidneys will start trying to filter the infection out of the body, if the cat doesn't receive immediate treatment her kidneys will eventually start to fail. Once the cat has been diagnosed with pyometra the veterinarian must remove the cat's reproductive organs including the pus filled uterus, if there is any infection in the surrounding area then the queen may require IV antibiotics and a short hospital stay. The best way to prevent pyometra is to spay your cat, this serious infection is often fatal without prompt treatment.

- Cancer

- Feline Chlamydia: More common in young kittens. Antibiotics and antibiotic eye ointment are the treatments for this infection.

- Idiopathic: A term used to describe a condition of unknown origin

The following is a list of symptoms that could potentially mean your kitty is much sicker than she appears. Since cats have evolved over thousands of years to be very good at hiding signs of illness it's quite concerning when they seem to be sick or hurt because illness or injury in the animal world means you're weaker and you can become prey for a stronger, healthier animal. Here's a few symptoms to watch out for in addition to what you're already seeing (lethargy and fever): changes in behavior (for example, a cheerful kitty is suddenly a cranky, difficult kitty), hiding (avoiding contact with human or animal family members), swellings or lumps (may be abscesses or tumors), draining wounds, diarrhea, increased thirst/urination, vomiting, weight loss/gain, general change in demeanor, listlessness, reluctance to play/exercise or perform normal behaviors, decrease in appetite or thirst, difficulty breathing, tremors, weakness, changes in the level of consciousness, decreased grooming, poor hair coat.

Here is a list of tests your vet may recommend in order to diagnose what's going on with your kitty: CBC – complete blood count, (this will determine white blood cell count, red blood cell count and platelets), blood chemistry profile (helps determine the overall health of the animal and detect any changes in organ function), blood smear (detect blood parasites), blood tests (for immune system diseases), feline leukemia and feline immunodeficiency virus testing, urinalysis (detect a urinary tract infection), x-rays (to find internal masses, pneumonia or other abnormalities), abdominal/cardiac ultrasound (detect a source of infection such as liver, kidney, heart valves), ACTH stimulation test,
Fecal examination, tests for pancreatitis and/or heartworm tests (I doubt that heartworms are causing the symptoms your kitty is having since she's an indoor baby, but if the vet can explain the need for this test to your satisfaction then go ahead with it), bacterial culture of urine, feces/blood, hormone tests (to make sure everything's balanced), eye exam (some eye conditions point to specific diagnoses), neurological exam (deficits could indicate that something involving this kitty's brain is happening), immune system tests (detects autoimmune conditions), CT scan/MRI (could indicate that the vet suspects a physical abnormality). If blood and urine tests are inconclusive or they show abnormal results then your vet may need to do other tests to diagnose this kitty's problem.

Unfortunately when the vet doesn't know what the underlying problem is s/he may not be able to treat her symptoms successfully which is why a diagnosis is so important when the kitty isn't showing specific symptoms that point to a specific diagnosis. Once the vet knows what's wrong with this kitty then s/he can make recommendations and develop the best possible treatment plan for your cat. Since this kitty has a fever and she's lethargic it's quite possible that the vet will prescribe a course of antibiotics to see if that makes her feel any better. In the event that your kitty has a fever above 103 F then she may need medication to lower her fever because such a high body temperature can cause other problems to develop. If your vet prescribes an antibiotic and your kitty's temperature is still elevated after she's finished them then your vet will most likely need to perform additional tests.

It's not a bad idea to purchase a digital thermometer that reads oral/rectal temperature for the cats' use only. If you haven't taken a cat's temperature before you'll probably want to have a second person help you since some cats can be a bit squirmy - nobody likes to have their temperature taken rectally! Normal body temperature for a cat is between 100.5 - 102.5 degrees Farenheit. When taking a cat's temperature it's important to make sure that she's properly restrained for two main reasons: 1) you want to avoid causing accidental injury to the cat's rectum or intestinal tract, 2) you want to avoid putting you or anyone else in a situation where the cat may become anxious and scratch or bite you or another person. Before going ahead to take your cat's temperature I'd recommend taking a few minutes to tell your baby girl what you are going to do and why you need to do it - I've found that providing the cat with an explanation seems to help minimize the negative reactions for the most part (I don't guarantee that she'll be thrilled, but you may be able to avoid a rodeo reaction that could end up causing serious injury to the cat or the humans involved in restraining her and taking her temperature. Safely restraining a cat to take her temperature can be done in one of two ways: 1) you can tightly swaddle the cat in a towel and wrap her so that only her anus is free from the towel or 2) you can have someone gently restrain your little girl. Being prepared is the first major rule of thumb when it comes to administering medication, taking her temperature or doing something else she's not likely to enjoy. If you restrain the cat it's very important to have everything ready before your help brings her over to the table so she can have her temperature taken. The way that I typically restrain a cat if they're having their temperature taken is to gently pick the cat up properly and place her onto a table or countertop so that her left side is against your helper's belly. Your helper then needs to place his/her right forearm against the cat's right side and make sure s/he's got a firm, but gentle grip on your kitty. If at all possible I recommend having the helper use his/her right hand to prevent the kitty from going forward and the right elbow to prevent the kitty from backing out of the situation. The helper can use his/her left arm/hand can be used to maintain control of the cat so that she isn't able to escape or move in such a way that she ends up causing damage to her intestinal tract. Before taking the cat's temperature clean the thermometer with a cotton ball soaked in rubbing alcohol or use an alcohol swab, allow the thermometer to dry completely. Use vaseline or KY jelly to lubricate the tip of the thermometer, our kitty first aid kit includes a small squeeze tube of vaseline specifically for lubricating thermometers when it's necessary to take anyone's temperature so we simply insert the tip of the thermometer into the tube of vaseline as far as it will go and remove it. You'll need to be patient, your kitty needs to be as still as possible and your helper should have good control over her movement to prevent any accidental injury. You'll want to turn the thermometer on just before you insert it into your kitty's rectum. When you're ready you can go ahead and insert the thermometer 1/2 - 3/4 of an inch into your cat's rectum and wait for it to read her temperature. While you wait for the thermometer to beep signalling that it's got a temperature reading for you feel free to praise your kitty and tell her how wonderful she is. The cat's overall personality and level of socialization really has an impact on what's going to work for her, if you have a cat that's not willing to be held or restrained in any way then you'll want to keep things as gentle and brief as possible to minimize the amount of stress she has to deal with.

Based on my experience any number of different things could be causing this kitty's fever and lethargy. To be completely honest these symptoms could be the result of a minor illness, they may also indicate the possibility of a life threatening illness or infection - without a veterinarian to perform tests and make a diagnosis there's no way to know for sure what's going on. Your kitty may have swallowed a foreign body such as string, ribbon or other similarly shaped objects, if you have children foreign objects may include small toys that are too large to travel safely through the cat's digestive tract and if this little girl's intestinal tract has a blockage for any reason she could be in very real danger. Some cats develop a low grade fever when they're constipated. A decent home remedy for kitty constipation is a tbsp or so of pure canned pumpkin (not pumpkin pie filling) or strained baby food veggies like squash, carrots or sweet potatoes mixed with 2-3 tbsp of plain, unsweetened yogurt given divided up and given in small amounts throughout the day could help if your girl will eat it voluntarily. You may have to syringe feed this mixture to your kitty, if so you can go ahead and give it to her daily when it's most convenient for you. The plain yogurt will help increase the amount of beneficial bacteria in your cat's digestive system and the strained veggies add a touch of fibre that may be lacking. You can also try giving your cat a small saucer of milk to drink if she likes it, although milk isn't normally suggested because it can cause diarrea that works in your favor when the cat's constipated because it will help to soften her stool. Another option is for you to consider feeding your cats a commercially produced or homemade raw food which has nutrients that the majority of cat foods available on the market don't have because these foods cater to what cats have evolved over thousands of years to eat - raw meat. The websites I've recommended for nutritional information have plenty of accurate information. If you aren't prepared to make your cat's food at home or feed a raw diet then you may want to think about giving your kitty a high quality canned cat food like Spot's Stew by Halo or Wellness (these are two excellent high quality cat foods made from human grade ingredients, the food actually smells like what it says it is on the label unlike some of the rude smelling low quality canned foods) if she normally eats kibble. A cat's natural diet contains significantly more water than dry cat food so cats eating a diet made up exclusively of kibble can become chronically dehydrated over time which could cause serious health issues later in life. If you do offer canned or raw cat food then I'd recommend adding a bit of extra water to increase the amount of fluid this little girl is taking in because a fever can cause dehydration since fluids are used more rapidly when a cat's got an elevated body temperature.

I really do wish that I could offer an inexpensive home remedy that would get your kitty back on track, but I'd be lying to you if I said I had one. There are so many issues happening here that I really think your kitty should see a vet. I'm absolutely willing to do what it takes to find some resources in your area that might be willing to offer help with the financial costs of diagnostic tests and treatment. I've actually spent hours on the computer trying to find organizations that would help pet parents with medical expenses when finances made veterinary care impossible for many loving caregivers who simply wanted to do what was best for their cat.