Expert: Jessica - 8/19/2010

Question
Hi Jessica,
My cat Mindy is 8 years old and has been a natural cat her entire life (when she was a kitten was the only time she has been vaccinated). She has been a totally indoor cat since 6 weeks of age. I took her to a vet in the beginning of June just to get her nails trimmed because I can not do it myself without a lot of resistance from her. The vet told me I needed to give her a rabies shot, which I knew, was the law. She also said Mindy needed a distemper booster, a feline leukemia, and a feline AIDs vaccine. I protested on the grounds of her being an indoor cat, but the vet would not let up and was very pushy. I caved in and Mindy wound up receiving a rabies shot, an FeLV shot and a FeloVax IV shot, PLUS 2 dewormers and heartguard. This was all in one sitting and I was instructed to give the heartguard the next day. I did not initally notice a change in appetite because I have another cat and they eat from the same bowls. Two weeks later I realized she was not eating OR drinking much of anything at all. I took her back to the same vet (yes, I am very trusting) and turned out she had a severe hairball impacting her colon that was removed with the help if an enema. She was dehydrated at the time and her ALT liver values were double than normal. She was given fluids and hand-fed for 2 weeks at the vet. The vet also gave her a series of antibiotics (although she did not show any white blood cell signs of infection). Aside from costing me a fortune, this did not help Mindy at all who was still not eating on her own and her ALT liver values doubled again (4 times more than normal) upon rechecking at discharge from the vet. She went from 14 lbs to 11 lbs in a few weeks time. I brought her home and have been hand feeding her ever since. It is hard to believe this is going on 2 months now. The only thing that has greatly improved is her water intake. I have not had much issue with this, but could be because I am diluting her wet food with a lot of water to uptake into the syringe. She has been acting like a new kitten with a ton of energy which I attribute to the drastic weight loss (I now see what that extra weight was doing to her). I brought her to a different vet for a second opinion and her blood test from August 6 said her ALT values are back to normal, but her other liver value (don't remember what they are called, but it's the one associated with hepatic lipidosis# were slightly elevated. The vet said this is because I had not been feeding her enough food because she weighed 10.6 lbs at the time. I was instructed to feed her around the clock and was given an appetite stimulant that works well. I backed off from this, hoping she would start to eat on her own, but she showed no signs of eating more than the usual 1/8 cup of dry food.  Because I backed off on the hand-feeding since last Saturday, her weight has gone down to 10.2 lbs. I haven't gotten results of her follow up bloodwork yet from yesterday. FINALLY...my question to you is: could the series of vaccinations, dewormers, etc. have overwhelmed her body/liver to point where it made her completely lose her appetite and desire for water? In turn, she developed this terrible hairball because she was so dehydrated and could not pass it? I feel so guilty about letting her get all those vaccinations and going against my gut instincts that she did not need them at all. Could this have caused some sort of permanent problem?? She is not throwing up nor vomiting #although her stools are pretty dark), but I have read that this occurs in only 50% of cases of GI lymphoma or inflammatory bowel. I am also very scared that the vaccinations could have caused one of the illnesses it was trying to prevent. My instincts tell me no because she is acting so spunky, but I have read cats are great at hiding things. I am not sure if I should get a biopsy? Ultrasound? Another leukemia/AIDS test to make sure she didn't get it from the vaccine. I'm sorry for the tons of questions, but I am really stumped and so is the vet. She said ultrasound might be the next step. Any advice you can give will be greatly appreciated. Thank you for caring enough to offer this service. - Lisa

Answer
Hi Lisa,

If I could get my hands on that vet!!!  Don’t beat yourself up – my vets have pulled things over on me, too.  The good news is, it doesn’t look like she got an AIDS vaccine, after all!  The other good news is that the rabies, the Fel-O-Vax IV, and most of the FeLV vaccines are all killed vaccines and can’t cause clinical disease.  

The bad news is that the rabies and leukemia vaccines can, unfortunately, cause injection-site sarcomas.  So keep an eye out for lumps, and get her right to the vet if any bumps develop.  

If your cat DID receive an AIDS vaccine, there is a bit more information you should know.  She will test positive for AIDS.  This is because the usual test, called an ELISA, relies on antibodies to determine whether or not the cat is infected.  When your cat was vaccinated, the vaccine forced her to produce the antibodies that will cause tests to come back as positive.  The test can’t distinguish between a cat who is naturally infected, or just vaccinated.  A vaccinated cat may have these antibodies for years.  There is a more specific test that you could send blood off for, called a Western Blot, that can tell the difference.

Dewormers are pretty benign, although I’m a little leery of Heartguard, myself, and I would never recommend giving a cat all those vaccinations at once.  I would never recommend giving an indoor cat most of those vaccines at all!  Truthfully, there are many cats who come through these things just fine, but I will tell you with the utmost confidence, the rabies vaccine has been the end of many of my hospice patients.  If Mindy had the slightest thing brewing, I certainly believe all of these things may have put her over the edge.  

Mindy should have recovered from any acute side effects of the vaccines, such as fever, body aches and anorexia after just a couple of days. It’s a possibility that after a couple days of not drinking, the dehydration itself is what kept her so down, and this just spiraled out of control.  Dehydration can certainly lead to an obstruction (my cat had one earlier this year for the very same reason, after a stomach virus).  It’s also possible the two incidents are just coincidences.  Normally, you would expect to see the cat get sick a lot sooner, but maybe Mindy is just a fighter!

I’m guessing you’re waiting for another SAP reading, right?  If her levels are coming down, then maybe all you’re dealing with is hepatic lipidosis because she wouldn’t eat because she had a bowel obstruction.  I’d be inclined to keep up with the feedings and see if she’ll start eating on her own.  However, an ultrasound is not a bad idea.  They give you a lot of answers for the money.  An experienced ultrasonographer can tell you in great detail what they have found, and how they know whether it’s cancer, an infection, a polyp, etc.

If you’re thinking about doing a biopsy, make the decision before having the ultrasound done.  In some cases, they can do an ultrasound-guided needle biopsy in case they find anything abnormal while they’re performing the ultrasound.  This avoids the need to perform an invasive procedure to collect a tissue sample in many cases.  Let your vet know you’d be interested in this.

I think it looks good that Mindy’s activity level is picking up, so keep your fingers crossed.  If you want my opinion, go back to not vaccinating Mindy anymore!  You DO have to vaccinate her against rabies by law.  But she certainly doesn’t need the Chlamydia vaccine, please not the leukemia or AIDS vaccines.  Mindy should be immune to distemper for life now, and there is actually evidence that all of the kidney failure we’re seeing in our cats is because of an ingredient in the distemper vaccine.  If her risk levels change, you may need to reconsider, but since she’s an indoor only cat, there’s no need to put her body under the stress of useless vaccinations.

Best wishes!

Jessica