In November of 2005, Arlo wasn't feeling himself.  When I saw him visiting the litterbox frequently but not producing anything, I immediately suspected that he had a urinary blockage.  This is a fairly common condition in cats and is usually caused by crystals in the urine.  It can be fatal in male cats in a short period of time, since toxins quickly build up if they're unable to urinate.  Arlo went to see the emergency vet right away.

He did indeed have a blockage and had to stay in the hospital overnight.  In addition, he was constipated - probably because he'd become somewhat dehydrated.  The blockage was not caused by crystals, however:  it was a mucus plug (which sounds really disgusting).  His regular vet explained that this type of plug is a random occurrence and, unlike the crystal plugs, is unlikely to happen again.  Fortunately he was correct: it was a one-time problem.

"SKIN CANCER" - OR NOT

Early in 2006, Arlo developed an odd, discolored spot on the bottom of his nose.  We figured he'd rubbed it raw or something and waited for it to clear up, but after several weeks, it was still there, unchanged.  Since he's a light-colored cat, we started to worry about the possibility of skin cancer and made an appointment with his vet.

His vet did the usual exam and looked at his nose a bit, then decided to wet down the fur over the discolored spot so she could see the skin better.  She gave his nose a few good swipes with a wet piece of gauze and voila:  no more "skin cancer."  The discolored spot had been dirt.  Evidently, Arlo wasn't much into washing his face!

This was probably the silliest visit I've ever made to the vet.

RENAL INSUFFICIENCY / HYPERTENSION

In the fall of 2008, we noticed that Arlo kept having episodes in which he became constipated, then got nauseated and threw up. He didn't have any other symptoms and at seven, he wasn't all that old, but we decided to take him to the vet and have bloodwork and an exam done anyway, just to be on the safe side.

Unfortunately, the tests revealed that he had renal insufficiency, which means he was in the early stages of kidney failure at an unusually young age. This was horrid news, of course, and at that point, we just hoped that it would be a long time before things got worse.

We started giving him a potassium supplement and treating the constipation by adding Benefiber to his food twice a day. The latter helped immensely. We'll repeat the bloodwork on a regular basis, watch for any new symptoms, and keep our fingers crossed.

June 2009 Update

A recheck of his bloodwork showed that his kidney values had not changed in six months, which is great. We're continuing with the Benefiber and the potassium supplement and will check his blood every six months unless new symptoms crop up.

December 2009 Update

In September, Goo started having increased problems with constipation, so we gave up the Benefiber and started him on Lactulose. That helped significantly for a while, but by mid-December, the problem cropped up again in spite of the medication and in addition, he seemed to be feeling off. We decided it was time to start him on subcutaneous fluids even though the bloodwork we did in late September showed that his kidney values had not changed.

The physical exam also revealed that his blood pressure was through the roof - something that is fairly common in cats with kidney problems. The vet suggested treating the hypertension with a supplement called Epakitin. Its primary function is as a phosphorous-binding agent, so I'm not really sure how it helps with high blood pressure. We'll give it a shot, though.

I had doubts about the Epakitin helping his blood pressure, but a recheck on January 8 showed that his blood pressure had dropped from 240 to 175, which is a bit high, but still in the normal range. We'll continue to monitor him. It would be great if the Epakitin continues to work and we can avoid putting him on a prescription blood pressure medication.

At this point he seems fairly stable, but we'll have to watch him closely.

March 2010 Update

Ultimately, we had to start giving him blood pressure medication, as the Epakitin alone wasn't controlling his hypertension. For a while there, he was still acting like he didn't feel very well even though his kidney values hadn't gotten any worse. In February, however, he perked up quite a bit and has been acting very normal ever since. We aren't sure what caused this change, but are keeping our fingers crossed that it will last. At his last checkup, his blood pressure was normal and he'd gained almost half a pound.

We attempted to give him fluids every other day instead of every day but his kidney values started creeping up, so...back to every day. That's not a problem, since he actually seems to enjoy getting fluids.

April 2010 Update

He's continuing to do very well and act quite normal, so we're weaning him off of the Epakitin, Forti-Flora, and Prednisolone. If that works out, it will be very nice to have him on fewer medications.

Multiple Myeloma (Probable)

In early May 2010, Arlo started losing a bit of weight. At first this didn't alarm us, as he always loses weight in the late spring/early summer. After a couple of weeks however, he began to eat less and less and acted like he didn't feel good overall. 

We assumed this was a repeat of whatever had plagued him in the fall, but when we ran bloodwork, there were some odd findings. His calcium levels were through the roof (over 16, when the upper end of normal is 12) and his total protein and globulins were also high. Later testing showed that he'd become anemic. More rounds of testing followed to rule out various maladies such as primary hyperparathyroidism that can cause high calcium levels. We also put him back on prednisolone.

Sadly, his test results and x-rays pointed to a diagnosis of multiple myeloma, which is a fairly rare type of cancer in cats. A bone marrow biopsy is required for a definitive diagnosis, but he was not in good enough shape to go through that. 

We started him on Alkeran (Melphalan), which the the preferred chemotherapy drug for this type of cancer, with the hope of buying him some time. (Curing the cancer was not a possibility.) The one low dose he had improved his lab values; however, it also made him extremely ill for the better part of a week. We feared that giving it to him again would kill him, so we abandoned that idea.

We kept him on prednisolone, which made him feel better and brought his calcium levels back into the normal range. His appetite improved and he started to regain some of the weight he'd lost. 

On June 23, his appetite was a bit off, which concerned us. When we cooked him some fish, however, he ate a fair amount of it and he pursued his normal activities that day, including going out for Supervised Outdoor Playtime. In the evening, he looked relaxed and happy, much to our relief.

Early the next morning though, he began having grand mal seizures. It was obvious at that point that the cancer had taken over and we could no longer maintain a decent quality of life for him, so we had to say goodbye. We knew he was terminally ill, but had no idea he would go that quickly. It was very distressing, particularly coming just one month after Andromeda's death.

Looking back, I suspect that the tough time he went through in the fall and winter of 2009 was actually the start of the multiple myeloma. As for the seizures, my understanding is that they were likely caused by one of two problems: very high calcium levels ( perhaps the prednisolone was no longer keeping them in normal range), or an increase in the viscosity of the blood, which sometimes occurs with this illness.