1/31 Sunday

Drogo exhibited some interest in going outside in the backyard in AM, but was still lethargic and walked with effort. Took a swat at the scratching post early AM but mostly crouched under cat tree or on dog bed.

He favored the Hills Prescription Diet Urgent Care a/d canned food so we have proceeded to feed him all day with it. The thick pate texture is also a plus since there's little risk of aspirating. To get it into the syringe, we add a few drops of water. With the exception of the corn flour and guar gum, I am pleased with the ingredients of this canned food. It seems that Drogo also has no problems with it as he is receptive to being fed. On one occasion he nibbled it out of the dish, but we still have to syringe feed him since he is not eating enough.

Had a concern that for the afternoon feeding he wet the bed.

2a 10mL formula #2
9:30a 10mL Hills with prednisolone
3p 10mL Hills with orbax
6:30p 10mL Hills
9:30p 10mL Hills with mirtazapine

Observed another incontinence incident on bed. Must call vet ASAP.

Energy: low energy AM/PM, slept most of the day, very low energy PM
Movement: Mobile, requires effort, will move toward bed or cat tree
Tracking: Slow tracking, did not engage in play. Tracked cat teaser wand.
Appetite: Hills a/d diet, formula #2
Attitude: Passive, will lay down next to dogs, tail swishing when petted
Hygiene: Has exhibited some self-grooming, fur matted around ruff, urinary incontinence
Hydration: Derived from syringe feeding

While appetite and nasal problems improved, overall he seems to have deteriorated; his energy seems to have crashed, and his loss of bowel control is disheartening.

I fear he is near the end.

1/30 Saturday - Vet visit

AM feeding #1 10mL with prednisolone dosage.

Took Drogo for fluid drain ~70mL
Prescribed broad spectrum antibiotics Orbax, appetite stimulant Mirtazapine, and Hills Prescription Urgent Care a/d diet canned food. Dr indicated jaundice had progressed.

Drogo was vocal during car rides.

Came home, showed no interest in backyard, sat on chair to sun bathe, drank from big dog bowl.

2nd feeding #2 10 mL @ 3pm, administered with 1ml antibiotic.

Slept on dog bed till 8:30pm feeding 10mL #2, added appetite stimulant .5mL.

10:30p feeding 10mL #2, followed by 1mL prednisolone.

Slow, unsteady at times, hesitated when jumping down. Very tired, lethargic, let him sleep for most of day.

1/29 Friday

Very lethargic and sluggish AM, showed some weakness standing.
Tracked cat teaser, alert to bell sounds.
No appetite for solid foods either dry kibble or Applaws canned.
Sipped at big dog bowl.
Did not seem very strong or alert during first AM feeding.

Came home mid-afternoon to let the crew out. Drogo jumped out of his cage and immediately went outside to explore. Was alert, but had to rest every few minutes. Was vocalizing excitedly, came back to me every once in awhile for reassurance but continued to sniff and explorer. He ventured out as far as the middle of the backyard, then went back inside to have a long drink. Still a little unsteady.

Gave formula #1 10 mL for 3:30p feeding. Rested on bed.
Formula #2 ~8mL @ 5:30p feeding. Kneaded cuddler before settling down.

#1 @ 8pm.

#2 @ midnight. 

Received both dosages of pred am/pm

Energy: Alert for new objects, but low energy AM/PM
Movement: Mobile, requires effort, made passes at scratching post, wandered the kitchen for water
Tracking: Slow tracking, did not engage in play. Tracked cat teaser wand. Almond eyes, pupil dilation/contraction sluggish.
Appetite: Ate some lifesource bits from dry dog kibble, force fed liquid formula #2
Attitude: Passive, lethargic in AM.
Hygiene: Spent 2-3 minutes in the AM grooming himself.
Hydration: Sipped from big bowl, force fed liquid formula #1 & #2.

Man discussed additional treatment options with Dr Cowser, after which we decided to schedule an appointment Saturday AM.

1/28 Thursday

Found more hopeful reading here:
http://www.askthecatdoctor.com/feline-fip.html

Energy: Alert for new objects, but low energy AM/PM
Movement: Mobile, requires effort, made passes at scratching post, slipped out the back door for some backyard grazing, jumped out of cage, wandered the kitchen and living area until settling on bed both AM/PM
Tracking: Slow tracking, did not engage in play. Tracked cat teaser wand. Almond eyes, pupil dilation/contraction, slow response AM/PM.
Appetite: Ate some lifesource bits from dry dog kibble, force fed liquid formula #2
Attitude: Passive, some lethargy.
Hygiene: Fur very unkempt, dry, matted around neck/head area. Observed super-brief self-grooming. Crusty butt*, did #1
Hydration: Sipped from big bowl, took liquid formula

Administered 5mL x2 AM feeding, 8mL x2 PM feeding with formula #2.
Received AM 1mL prednisolone dosage.
AM: jumped out of his cage to hit the dog bed, he was observed to be on top shelf for the majority of the time.
*Exhibited crusty butt (failed cleaning/hygiene, possible diarrhea), but vocally protested baby wipe application, man took care of this.
Directly afterward he then used big litterbox.
Attempted to rinse ruff with water to clean off food spills, fur still matted.
Noticed licking himself around neck afterwards.
Very little vocalization AM/PM.
Continues to exhibit nasal discharge and sounds congested.

Drogo was not disturbed by Hodor coming over to plop down next to him (it's his bed after all!). Personality seems to indicate he is not stressed or perhaps just oblivious to everything around him.

Formula #1 is quite potent methinks (and very fishy), not to mention that I disliked the vegetable content in the chicken broth. I decided to whip up a new batch of liquid formula (#2) that has more vitamin C to boost Drogo's viral defense.
3oz raw Pilgrims Pride chicken liver
1 extra large egg yolk
.5oz Simple Truth Organic tomato paste
1 500mg Natures Bounty Vitamin C tablet, crushed to powder (contains vegetable cellulose)
2oz warm water

Blend until liquified.

The question of how much to feed a cat on a liquid diet answered in this article:
https://virtuavet.wordpress.com/2010/03/15/how-to-syringe-feed-a-cat/

The volume a cat can take is 3-6 cc at a time, every 1-2 hours maximum, for a total of about 40-60 cc to fill the stomach at any one sitting.  In a sick cat, it may take 3-6 hours for the food to leave the stomach enough to get a new batch in there!  Good luck!

What a difference zygomatic arch control does for syringe feeding!

Also, based on several reads, warmed food via steam basket and hot water bath, this coupled with the technique in the article led for a successful and quick evening feeding.

I also found a 4-ingredient canned food which looked promising (Applaws Chicken with Pumpkin) but Drogo did not eat.

1/27 Wednesday

Did plenty of research on supplementation for sick and FIP-afflicted cats. The general recommendations are (see references):

Vitamin A (liver, kidney, tuna, fish oil, eggs, butter, milk, NOT beta carotene in veggies)
Vitamin C (sodium ascorbate, ascorbic acid, tomato sauce/juice)
Vitamin E (egg yolks, butter are phytate-free sources, avoid greens and seed/nut oils)
Taurine (organ meat, trace amounts in Blue Wilderness large breed adult dry dog food)
Arginine (present in liver and muscle meat, preferably from free range/pasture raised animals)
Omega Fatty Acids: Omega-3 EPA/DHA/GLA (wild caught fish sources)

http://www.angelfire.com/fl/furryboots/fip.html
http://www.dr-addie.com/treatment.htm
http://www.peteducation.com/article.cfm?c=1+1400&aid=665
http://hpathy.com/veterinary-homeopathy/feline-infectious-peritonitis-fip-case-management-and-suggested-new-rubrics-developed-from-500-cases/
http://www.neighborhoodcats.org/how_to_nutrition
http://www.marksdailyapple.com/natural-cat-diet/

Drogo received 5mL liquid formula AM, 10mL total in PM.
Drank water from large bowl due to contaminated dish.
Within 1 hour, used 2 litterboxes.
1mL prednisolone in AM/PM.

CONCERN: New symptom of nasal discharge, wet breathing discovered in PM. At first I was alarmed that he might be displaying labored breathing due to chest effusion, but nose bubbles confirmed that he might have contracted a cold or respiratory infection.

Energy: Alert for new activity, but low energy both AM and PM
Movement: Mobile, requires effort, but will jump down from cage, walk over to bed or cat tree. Made a pass at scratching post.
Tracking: Slow tracking, not really interested. Have not introduced play.
Appetite: Did not observe him eating any hard food, force fed liquid formula
Attitude: Lethargic, appeared tired or subdued
Hygiene:Fur appears unkempt, he did groom himself in an attempt to clean matted hair on his throat, did #1 and #2
Hydration: Sipped from big bowl, took liquid formula

Internet literature suggests that cats prefer warm food to cold, so have to determine a better storage method.

Also feeding too much of the liquid formula induced vomiting in Conan, may have to rethink this formula to include extra Vitamin c.

This was a disheartening day overall as I am not very optimistic with Drogo's lack of energy and progress.

1/26 Tuesday

Found some interesting (hopeful) reading regarding a homeopathic approach to treating FIP.

http://www.angelfire.com/fl/furryboots/fip.html

This homeopathic vet posted a science paper on FIP supportive care:

http://hpathy.com/veterinary-homeopathy/feline-infectious-peritonitis-fip-case-management-and-suggested-new-rubrics-developed-from-500-cases/

A very good summary of FIP as of 2014:

http://www.cliniciansbrief.com/sites/default/files/attachments/Feline%20Infectious%20Peritonitis.pdf

I crated Drogo last night, but did not observe him eat this morning. He has navigated up and down the crate throughout the night. When I left him out this morning, he was in no mood to engage in play with Conan, who harassed him frequently. But when presented with isolation in the cage, Drogo preferred to huddle at the base of the cat tree and would rather tolerate Conan.

Seems wobbly this morning, but not disoriented.

Upon arrival in evening, Drogo was more alert and vocalizing for attention. He wanted petting and calmed down once he got his 3 minutes of love. He also showed extreme interest in a new cuddle bed placed in the crate, which he kneaded for 5 minutes or more before he settled down to curl up in it. He was quiet and hunched the rest of the evening.

Energy: Alert for new activity, but low energy both AM and PM
Movement: Mobile, requires effort
Tracking: Slow tracking, lost focus
Appetite: Nibbled on dog food in AM/PM, nibbled on salmon PM
Attitude: Lethargic, appeared tired or subdued
Hygiene:Fur appears unkempt, he did groom himself in an attempt to clean matted hair on his throat, did #1 and #2
Hydration: Sipped from big bowl due to contaminated dish, took liquid formula

When offered some canned red salmon, he nibbled.
Added fish oil to dog food which he nibbled.

Found dry hard stool on top level ledge.

Administered 7mL of liquid formula (Conan loved this enough to suck from syringe).
Showed little interest in new toys.
Not interested in playing with others (Conan keeps harassing him to play).

He received both dosages of 1.5mL Prednisolone today. Switching to 1mL starting Wednesday.

Found this recipe online which I adapted for this current batch of liquid formula:

3oz raw chicken livers (Pilgrims Pride)
2oz Swanson chicken broth
1oz Honey Boy canned red salmon
1oz Simple Truth Organic tomato paste

Blend until liquified. Administered via oral syringe. Refrigerate leftover in air-tight non-porous container.

1/25 Monday

Went to work today so didn't have much interaction with kitty. Drogo showed more energy in the morning, even ate twice and used litter box. He showed some interest in ball/string but did not give chase. He has been able to navigate up and down the cage with some effort.

As usual, showed considerable lethargy during evening. Was able to receive full morning and evening 1.5mL dosages of prednisolone. Watched ball/string but did not engage.

Energy: Alert in AM, low in PM
Movement: Mobile, but still has foot drag, requires effort
Tracking: Showed some interest in play, was slow to track string
Appetite: Dog food in AM/PM
Attitude: Lethargic, appeared tired or subdued
Hygiene:Fur appears unkempt, gave him a brushing but seemed a little sensitive, did #1 and #2
Hydration: Sipped a few times today

Drooled a lot when receiving dosages.

1/24 Sunday

Morning IM:
he is back in the game room. he was messing with the ball/string for a minute and now he is kneading the bed
well he brought be the ball/string while i was playing
now he is batting at the string, i have it hanging on your chair
he is vocalizing for attention
he is definitely sharper, he is biting at it and swatting

Energy: Alert in AM, low in PM
Movement: Mobile
Tracking: Showed some interest in play, was slow to track string but was batting at it
Appetite: Dog food in AM/PM
Attitude: Lethargic, appeared tired or feverish?
Hygiene:Fur appears unkempt, gave him a brushing but seemed a little sensitive, did #1 and #2
Hydration: Sipped a few times today

He approached litter boxes in kitchen, but contemplated how to enter
He was more brisk with covering litter this evening
He did go to food bowl in cage around feeding time
He is more vocal today
He is watching ball/string today though didn't seem to have energy to fetch

1/23 Saturday

Stronger this morning, received full 1.5mL dosage. Indicators of #1 and #2 in litter, will investigate in evening. LS says he appears more bloated but eyes seem more focused

Energy: Low in AM, very low in PM
Movement: Plopped to floor in AM, very little activity in PM
Tracking: No interest in play, wasnt focused on play
Appetite: Dog food in AM, no food in evening
Attitude: Lethargic, appeared tired or feverish?
Hygiene:Fur appears unkempt, no bathroom visits observed
Hydration: Water bowl was 3/4 empty

Bad evening for Drogo, hardly any activity or appetite. Did not want to engage in play, was hunched most of the time.

1/22 Friday

Energy: Low, shows interest in playing but won't give chase. More energy in the evening.
Movement: Still dragging paws against floor. Will jump to ledge, dining and arm chair and ottoman. Tracking: A little better. Vision shows some improvement, pupils are slightly more reactive
Appetite: Ate evening meal dog food, has been trying to bury food. Wasn't really in the mood for tuna this morning. Nibbled on cat food.
Attitude: Wants attention during the late afternoon/twilight hours, typical vocalization during petting.
Hygiene: No interest in litterbox yet. Fur appears dry and little self-grooming.
Hydration: Drank more water this morning.

Administered extra 1/2mL morning.
Excessive drooling when trying to give prednisolone.
Will jump in lap for petting. Will vocalize and come looking for attention.
Quiver in lower jaw when vocalizing.
Showed interest in new activity: entered cat cage during assembly.
Discharge from eyes.
Stronger struggling during prednisolone administration.
Has been at scratching post.
#1 in litter

Spent night in cat cage, was able to navigate to top ledge. Monitored for any signs of stress. Ate dog/cat food mix and drank some water. Received full dose of prednisolone.

1/21 Thursday

Energy: Low, did fetch ball/string 3x in evening
Tracking: Slow, unable to stay focused.
Attitude: Some interest in playing during evening hours. Subdued during most of the day. Will vocalize and seek attention.
Appetite: Enjoyed some wet tuna, drank more tuna juice. Tried to bury leftover tuna. Nibbled on cat food.
Movement: Seems to generate effort while fetching. Walking labored and sluggish. Will jump deliberately on food ledge, chair, ottoman.
Hydration: Spent 1 minute at waterbowl. Fur is dry.
Hygiene: Has shown little self-grooming. No litterbox interest.

Has gotten upset with Conan 2-3x in the evening (doesn't want to wrestle)
Glazed/cloudy eyes, discharge.
Stronger struggling during prednisolone administration.
Has been at scratching post.

Vet called in morning to confirm that CBC indicated high proteins in blood. He concluded that Drogo has FIP.

1/20 Wednesday - Vet visit

Drogo showed no interest in morning meal and displayed lethargy. His energy picked up when presented with a new environment: car trip to the vet. He remained insistently vocal in his cat carrier while riding to vet.

Advised vet, Dr Cowser @ Sandy Lake VCA Animal Hospital that Drogo had not eaten, drank, played for nearly 48 hours. No litter box visits observed during the same timeframe.

Dr Cowser observed:
Cloudiness in the ocular region
Pupils were not contracting to bright light
Bloat and tenderness in abdominal region
Discharge in eyes
Surmised some muscle loss due to slight weight loss since last visit
Blood serum presented as yellow/amber color
Temperature taken 2x, first time was normal, second time @ 102F indicating fever

Indication of inflammation. Differential diagnosis of FIP, wanted to conduct a full blood panel Chem (8) CBC to get more information. Prescribed Prednisolone 3mg 1.5mL 2x daily for first 7 days, then once daily afterwards.

Asked about where we got Drogo -> Irving Animal Shelter
Seemed interested that we had his brother -> littermate Conan
Indicated that Drogo most likely was already infected with virus since kittenhood, may have been exposed to it at shelter.

Uncertain about the transmission to other household cats, advised isolating Drogo.

Drogo was actively exploring in cab of truck, moving from one area to the next, while continuing to vocalize. Upon arrival at home actively sought a comfortable place while man and I took the rest of the day off to ponder the future.