Expert: Jessica - 10/3/2010

Question
I have a full-grown male Persian. I have had him about 2 and a half years now. He was full-grown and neutered when I got him, but I'm not sure how old he is. He doesn't seem to be old though. He is both inside and outside. He sleeps and eats inside, but he loves being out too. He has always been healthy, energetic, and happy until the past year. He has not been as playful over the past year, but I moved to a new home and was busy in graduate school, so that may have a lot to do with it.

Anyway, in January, he had an incident where he stayed alone and quiet all day, and then that afternoon I noticed he didn't feel well. He eventually started moaning loudly and didn't want to be touched. The vet couldn't find anything wrong. They gave him a shot for inflammation and pain, and he felt fine the next day. There were a few days out of the following few months that he didn't feel well, and he was sluggish, but he always seemed fine the next day, and he wasn't moaning like before.

One day in June he woke up not wanting to eat. He wouldn't jump up on furniture like normal, and he hardly wanted to move. He moaned and moaned, and he didn't want to be touched or held. He face also kept twitching, and he kept smacking a little and swallowing. He wasn't convulsing though. This time he was also sneezing and had a little bit of a runny nose. I took him to the vet again, and he had a fever, but they couldn't find anything wrong. He was given another shot and antibiotics to take for a week. He sneezed for about 2 weeks, but he only felt bad and had the twitching that one day.

A little less than a month later, he had all of the same symptoms again, except for the sneezing or runny nose. He was moaning, sluggish, twitching, and smacking. It's mainly his whiskers that were twitching, and his mouth would take on a strange shape. His smacking was as if he was tasting something, but he kept doing it a lot. He also took his time when he laid down, as if it hurt. He had been tested for the Feline Leukemia Virus months before, and he doesn't have it. This time the vet did an x-ray, ran blood tests, and some other test I can't remember. They said he appeared totally healthy and to just monitor him and keep up with any changes.

I always have fresh water for him. I keep dry Iams food out all the time, and every morning he gets different varieties of Fancy Feast canned food. I never change anything except that I switch out the flavors of the Fancy Feast. About a month and a half after the last mentioned incident, he seemed to feel pretty bad again. This was on September 17th. He ate that morning, but he was very sluggish, his whole face looked tired, he wouldn't get on furniture, and was careful and slow about lying down on his front legs. His whiskers were twitching again, his mouth would make a funny shape while twitching, and his head twitched when I petted it. His head seemed to jump every now and again when he was lying down. He was also smacking frequently again. He kept pacing beside me and wanting to be around me, but he didn't moan this time. Since the vet never can find anything wrong, I didn't rush him to the vet that time. The only change I can think of was that he slept outside on the porch the night before. That's not uncommon for him to do, but he hadn't done it for a while before that. I don't know if he may have gotten hot, thirsty, or stressed out there, triggering whatever this is or what.

On September 27th, he felt fine in the morning, but around midday he started feeling bad again. He hadn't stayed outside or anything that time. He was sluggish, his face and eyes looked tired, and his whiskers were twitching again. I didn't notice any smacking, but he may have been. He wasn't moaning, and this incident didn't last all day like usual. After a long nap he seemed to feel better.

And the most recent and severe incident was October 2. It's 1:00am on October 3 for me, and he has felt bad all day and night so far. His twitching is much worse and more constant. His whiskers twitch anytime he moves. When he falls asleep, it seems to stop. When he's lying down his head and upper body tend to jump just a little every now and then. I rubbed on his cheeks and noticed that all the muscles of his upper body were trembling. His arm twitched then also. He started moaning this afternoon, and he kept walking a few steps and then trying to lay down, but he couldn't seem to get comfortable for a long while. He's not getting on furniture, and he's not wanting to be held. He is extremely sluggish. He keep crouching and not lying down all the way too. He eventually relaxes his legs and lies down like normal, but it takes him a while every time. He ate a little this morning, and he licked on some canned food this afternoon, but he hasn't drank or eaten anything since this morning. If I come around him, he moans. His face looks so tired and awful. I can tell he feels terrible. His eyes also looked dilated earlier. I just don't know what's wrong with him, and I'm scared. I hate seeing him feel so bad. My vet is closed over the weekend. I plan on bringing him in first thing Monday. Do you know what could be wrong? Should I try to find an emergency clinic that is open on Sundays? I have never seen him feel this bad, and it's never lasted this long. Thank you so much for your help!

Answer
Hi Lydia,

I'm sorry to hear he's doing so poorly.  I don't know what's wrong with your kitty.  I would be a bit concerned about nausea, as this can cause lip smacking, and the way that he's reluctant to settle down on his belly would also seem to indicate that his abdomen might be involved.  However, dehydration can also cause lip smacking and muscle tremors, and this can be a real emergency.  In otherwise healthy cats, it can be brought on by not drinking enough or by a fever.

I think you should strongly consider having an abdominal ultrasound done on him unless the vet finds clear neurological signs on his exam, which would suggest you should proceed in another direction.  An ultrasound will give you answers that blood tests will miss.  It can pick up subtle changes in texture, density, size and even the color of his tissues to determine whether he may have cancer, inflammation, polyps/cysts or an infection of any of his internal organs. It can also help determine if there is an accumulation of gas or fluid where there shouldn't be.

If the vet finds neurological symptoms such as an abnormal response of the pupils to light, delayed reflexes, or he notes the tremors and feels they are neurological in nature, then you will probably need to be referred to a neurologist.  There are some diseases that can cause neurological problems, including Feline Infectious Peritonitis (this is uncommon in healthy adult cats), toxoplasmosis and cancer.

Just in case your kitty is dehydrated, it would probably be safest to get him to a vet today.  Most often, the emergency centers have more diagnostic tools available to them than everyday vets do, so they may be able to help diagnose him, as well.  Emergency centers do tend to cost a bit more than you'd usually pay, although depending on where you go, this is not always true, and the one that I use actually is less than my regular vet in many instances.

Best of luck!

Jessica