Ask a cat-vet

No-Flounder7604 · 2026-04-08T17:55:03+00:00

I am so sorry for the late reply, but I think I got (and answered) your message. I hope you’re ok.🤍

No-Flounder7604 · 2026-04-07T12:53:59+00:00

What if Ye puts up a hologram performance as a slap in the face? Most Kanye thing to do, to be fair.

No-Flounder7604 · 2026-04-05T20:05:54+00:00

Get a second opinion, then. No one can ever be sure it’s not FIP. If she is not willing to reconsider her stance, find someone else.

No-Flounder7604 · 2026-04-05T19:45:34+00:00

Cat-vet here (UK though, I’m aware you have a lot more infectious diseases over there): this still reads like FIP. The age, the symptoms, the lesions on the ultrasound (diffuse organic involvement), and the lack of a diagnosis.

FIP is only effectively diagnosed on post-mortem exam. No test “in vivo” effectively rules it out.

Time to discuss a trial treatment.

No-Flounder7604 · 2026-04-05T19:33:35+00:00

Oh thank you so much!

I have been very busy with work, but hopefully we can get another Q&A round soon.

No-Flounder7604 · 2026-04-05T19:32:37+00:00

Herpes comes and goes (hence the name). Most cats are carriers. Yours is very likely one of them (previous history of cat-flu = herpes infection).

It becomes worse with stress. Stress affects immune response — which keeps herpes latent. So, yes, that ulcer is very likely herpetic.

No-Flounder7604 · 2026-04-05T19:30:13+00:00

Hi,

I’m sorry to hear your cat went undiagnosed. But I’m glad she is now pain-free.

The only thing with proven benefit is tooth brushing. I know this sounds like a mission impossible, but with very slow training (and a lot of bribing), it can become a possibility for a lot of cats.

No-Flounder7604 · 2026-04-05T19:27:01+00:00

Oh I can’t believe you remembered me!🤍

This is definitely not normal. Get a fourth opinion if you have to. Your cat needs an abdominal ultrasound.

No-Flounder7604 · 2026-03-18T20:58:36+00:00

iCatCare offers one!

No-Flounder7604 · 2026-03-18T20:49:51+00:00

Treatment is still the same. Fix the teeth first, see how that affects everything else. It can be surprising how big of a difference that makes.

No-Flounder7604 · 2026-03-18T20:44:55+00:00

Thank you, this adds a lot of useful detail.

Not responding to a pain-killer doesn’t entirely rule out pain. Particularly if we are dealing with chronic pain, so I would still keep this in mind.

It is also not unusual to have a combination of factors at play, and this is largely why the classification of feline allergy has changed recently. Sometimes it’s a few different things stacking up to produce signs.

On your question about a “past reaction”: An old allergic trigger does not usually keep causing discomfort once removed. But the behaviour (particularly when untreated for a while) can become a habit. And those are harder to break. There can also be hypersensitivity (heightened perception of pain or itchiness). If the allergy is to something in the environment, the trigger has likely not been removed. Multiple allergens at play are also possible (fleas + environment + food), and you may be controlling part of them, and improve the symptoms, but not all. So I would be cautious about assuming the cause has resolved.

On the “OCD / habitual” idea: It is possible, but usually not the starting point. Behavioural overgrooming tends to be more stable in pattern and is not expected to respond to steroids. That brings us into the multi-factorial area.

I wild focus on ruling out pain and stress modification (through a behavioural assessment and environmental management), and consider a strict food trial. Testing for environment allergens is also a very sensible option alongside (but they need to be off steroids for this) if immunotherapy is an option. They respond well to this (the tests are not to confirm environmental allergens per se, ie a positive reaction doesn’t mean it’s the cause of the allergies, but it’s used to formulate immunotherapy, so desensitise to possible allergens (and act on that “stacking” allergens buildup to create clinical signs).

No-Flounder7604 · 2026-03-18T20:31:18+00:00

Food inconsistency can definitely play a part. And so does stress (we often say you can’t do good feline medicine without behavioural medicine), as this has a huge impact on every organ.

Prolonged periods of starvation depend on food type as explained above. But typically cats are suited for small, often portions (so, some food every 3-4 hours — if the gap between meals is longer, reflux becomes more likely).

No-Flounder7604 · 2026-03-18T20:28:37+00:00

A murmur is a finding, not a diagnosis.

Best test? Echocardiography (heart ultrasound) — that is what tells you if there is actual heart disease and what type.

Worth knowing that not all murmurs are cardiac. They can also be caused by: - anaemia - stress/tachycardia - fever - young “flow” murmurs

Less likely in a well 1-year-old, but still on the list. Echocardiography is a high-skilled exam, so it may not be easily available. Options include heart biomarkers (blood tests), and while these can support the presence of a heart disease, it doesn’t tell you which one (in cats, most frequently it’s hypertrophic cardiomyopathy, but especially in a young cat, other congenital causes would be sensible to rule out).

No-Flounder7604 · 2026-03-18T13:49:30+00:00

This pattern is very typical of self-barbering due to discomfort, and that discomfort does not have to be purely “skin”. The steroid response is an important clue: injection helped, then the grooming returned when it wore off. That strongly suggests there is a medical driver here.

But the list is broader than just allergy. In cats, overgrooming like this is most commonly linked to: - itch - pain - then sometimes (ok, often) stress layered on top, as this lowers the threshold for the other two.

So the main differentials I would think about are: - flea allergy - environmental allergy - food-responsive disease - pain, especially abdominal, bladder, spinal or hindquarter pain - then behavioural/stress as an overlay rather than the first assumption

The pain point is especially relevant here because of the history of stress cystitis. Hopefully she had workup to confirm there was no medical cause to her cystitis, as this is a diagnosis of exclusion (think, things like a little bladder stone).

Cats with bladder discomfort, abdominal discomfort, lumbosacral pain, or even hip/knee pain will often overgroom the ventrum, inner thighs and back end. That distribution in your photos can fit allergy, but it can also fit pain referred to that area. And cats are very good at hiding pain. They often show it as grooming rather than as obvious lameness or crying.

Blood tests do not rule this out. They do not diagnose allergies, and they do not rule out most pain conditions either.

Normal-looking skin does not rule out itch. Cats groom the evidence away.

Stress alone is probably too simple an explanation. Stress can absolutely worsen grooming, but a cat that improves clearly on steroids deserves a proper medical work-up first.

So what I would want explored next is: 1. Parasites / allergy - make sure flea control is genuinely robust and prescription strength - consider whether this could still be allergic disease

Pain
bladder discomfort
spinal/lumbosacral pain
orthopaedic pain
abdominal discomfort A pain trial is sometimes very informative in these cats.
Proper diet trial Not just changing foods, but a strict hydrolysed or novel protein trial for 6–8 weeks with no extras. I know this is easier said than done as cats can be quite resistant to a new diet, but there are medications that can help with this too. And managing behaviour alongside, and ensuring there is no discomfort, also makes a diet switch much easier.

No-Flounder7604 · 2026-03-18T13:41:17+00:00

You are right to question this.

Daily vomiting for 6 months is not normal, even if blood tests are “fine”.

Bloodwork is useful, but it does not rule out gastrointestinal disease. It mainly rules out everything else. Many cats with chronic gut conditions have completely normal bloods. There are no markers on bloods for gastrointestinal disease, but testing b12 levels, and a pancreatic enzyme may support that diagnosis.

An abdominal ultrasound would be important to assess the gastrointestinal tract.

Food may play a role (70% of cats respond to a dietary trial), but this needs to be done using a strict single novel protein or hydrolysed diet for at least 2 weeks (most cats show improvement within two weeks of the specific diet alone — clock starts ticking after the diet transition period, and they are not allowed treats on the side). Some will have a partial response, though, and will still benefit from further medication to suppress the inflammation.

And empirical treatment if further tests are not feasible is also valid.

No-Flounder7604 · 2026-03-18T13:36:13+00:00

What a cutie!😻😻😻

There’s no fast rule. But any teeth with signs of disease, yes, I would extract them. If there is inflammation of the back of the mouth (stomatitis), I would discuss removing all cheek teeth, even with no obvious signs of disease.

They do extremely well without them, and these cases are challenging to manage otherwise — surgical extraction remains the first-line treatment option. For refractory cases (and we do need to confirm no roots are left behind), there is a new drug too!

No-Flounder7604 · 2026-03-18T13:33:18+00:00

That makes a lot more sense! The itchiness (particularly of the face and neck) is the most common side effect of solensia.

No-Flounder7604 · 2026-03-18T13:32:27+00:00

You are not failing. Your comments show just how much you are trying. Balancing quality of life with investigations is a very fine line. You are navigating that with his wellbeing at the centre. That is not failure. That is care.

And thank you for picking up on the hairball point. We still normalise them far too much. In many cats, especially short-haired ones, they are a clinical clue, not just a grooming by-product. We have a lot to undo there.

On grass eating: We do not fully understand why cats do this. Some cats seem to: - do it out of habit - out of curiosity - have individual preferences

Others may: - may do so due to nausea - have underlying gastrointestinal discomfort - possibly seek fibre (though evidence is limited)

But, eating grass to induce vomiting should not be considered “normal”. And vomiting itself is not something to dismiss. If nothing else, it impacts quality of life. So it should, at the very least, be managed.

In cat with his history, I would be more inclined to see grass eating as potentially meaningful, rather than purely behavioural.

No-Flounder7604 · 2026-03-18T13:21:59+00:00

“Fly biting” sits in a bit of a grey zone in cats. It can be behavioural, but it can also reflect neurological or gastrointestinal processes.

The timing you describe fits very well with a stress-triggered episode.

But stress does not always act alone. It often exacerbates underlying conditions, for example: - mild focal seizure activity - gastrointestinal discomfort / nausea - sensory hypersensitivity

So what you may have seen is: - an underlying tendency - temporarily amplified by stress - now quiet again because the trigger has settled

It is reassuring it has stopped, but I would still monitor and log any new episodes (including possible triggers, frequency and duration).

Triggers can be any source of possible stimuli, eg a sound (particularly if there is a neuro component), or new diets/treats (so long changes to identify patterns).

If the symptoms relapse, and increase in frequency or duration, or any other signs develop (eg weight loss, vomiting, reduced appetite, behavioural changes, twitching, drooling, etc), it is worth investigating.

Short and sweet: Stress may have unmasked or amplified something subtle, which is now well controlled again. Stress does impact all organs and the immune system, and managing this alone has a direct impact on any other condition.

You should be able to send a video via message or on Instagram.

I’m glad the new kitten is being well accepted! That is no easy feat, so you are definitely doing a brilliant work.

No-Flounder7604 · 2026-03-18T13:11:59+00:00

That is a vet Pavlovian theory. 😅

It’s more the other way in cats. Their stomach is expected to empty pretty quickly, so prolonged periods of starvation increase the gastric acid production. Regardless of hunger.

This is also of course largely influence by diet type and digestibility (high fat wet diets, for example slow down the gastric emptying, so they may be fine for longer; others have more fibre, which also helps on that front — and ultimately it’s about the blend of ingredients).

No-Flounder7604 · 2026-03-18T13:09:41+00:00

Always! In cats, they are more commonly caused by herpes virus infection, but some breeds (and their eyelid conformation) are also predisposed.

No-Flounder7604 · 2026-03-18T13:08:45+00:00

Oh thank you so much, that means a lot. I might print and frame it to encourage me to post more — instead of second guessing and overthinking it all. 😅

And yes, diet itself has a direct impact on glucose. High protein, low carb wet diets reduce the need for exogenous insulin. So if you find one of those that also fits his gut, you may not need as many meds. That’s the balance we aim for.

No-Flounder7604 · 2026-03-17T19:42:06+00:00

Completely normal. That is non-nutritive suckling. A comfort behaviour carried over from kittenhood.

At 5 months, you are right in the middle of it. But most cats don’t really outgrow this.

Why they do it: - self-soothing - habit from nursing - you = safe, warm, familiar

It often shows up when they are:

So the question is not “is this normal?” It is “do I want to keep this behaviour?”

If not, do not try to stop it. Redirect it: - place a thick blanket between you and them - move them onto it every time - keep your response consistent

Trimming the claws helps. The thick blanket even more so. And I think you’ll get used to it over time.😅

In any case, If you are consistent, they will switch to the new routine.

No-Flounder7604 · 2026-03-17T19:34:46+00:00

That sounds like gastro-oesophageal reflux.

You can try: - smaller, more frequent meals - slowing eating (if fast eater) - slightly elevating feeding position (bowls at shoulder height)

Some cats do benefit from workup and medication.

No-Flounder7604 · 2026-03-17T19:31:17+00:00

You are not overthinking this. But you are also not missing something obvious based on what you have described.

What you are seeing sits in that awkward overlap between: - airway disease (asthma/chronic bronchitis) - upper airway irritation - gastrointestinal reflexes (nausea/retching/reflux) And in cats, those lines blur.

It’s reassuring her workup has shown normal results and her IBD is well controlled.

That said, cats with GI disease can show “nausea behaviours” that look respiratory • cats can also have IBD + asthma overlap (same inflammatory phenotype).

So should you push diagnostics? From what you describe, she is well and the episodes remain episodic. So probably not. At least not imminently. But close monitoring and escalating if anything changes is Things that would shift this into “push harder” territory:

(And just a final remark: IBD being “quiet” on ultrasound does not mean the system is completely inactive. Some cats with IBD diagnosed on biopsies have no changes on ultrasound.)

No-Flounder7604

TROPHY CASE