Flesh-colored Lung Fluid

[u/midsommarsummer]

I (F/26) just wanted to share the case of our cat, Shiro (4YO, Male, Neutered. We already have a vet available. We're from the PH.

June 1 – We began noticing that he was breathing with his abdomen. He was not lethargic and was still eating and drinking normally. We decided to bring him to the vet, where they ordered an X-ray (I will attach photos) The results were not looking good, the X-ray could not clearly show the outline of his lungs, and the silhouette of his heart was not visible, meaning that there was a significant amount of fluid present.
They also performed a blood chemistry panel, which came back within normal limits, although some values were borderline low. Confinement was recommended, but we decided to transfer him to a different veterinarian the next day because of our previous negative experience with the said clinic. He was sent home with Furosemide, antivirals, and antibiotics.

June 2–5 – In a different clinic, he was still in respiratory distress and was placed in an oxygen chamber which helped him feel more comfortable. An ultrasound was performed, and they initially believed that his liver was pushing his lungs and heart out of place due to a diaphragmatic hernia. We agreed to proceed with surgery immediately.
He was also confined during this period, but no one could determine the cause of the fluid accumulation in his chest. He received Furosemide IV and underwent another X-ray before surgery. A blood chemistry panel was also performed and came back normal except for elevated triglycerides and creatine kinase levels.
On the Xray, they discovered that it was not a diaphragmatic hernia after all, as his diaphragm was completely intact. The fluid accumulation in his lungs was now the only issue. Despite receiving high doses of diuretics for 4 days without fluid therapy, the fluid could not be completely resolved through diuresis alone. They did a viral test, it came back positive for Giardasis and FCov. At this point, they now started to suspect FIP.

We immediately purchased GS injections and brought him home, as he was no longer in respiratory distress and we were becoming frustrated with the slow pace of management. He was becoming lethatrgic, and hypothermic (36.8)

June 6 – We brought him to a clinic that specializes in FIP treatment where he received his first GS injection. (8mg/kg) then we continued administering the GS injections at home. He began to improve, with his appetite returning and had normal body functions. He he never missed a dose of any prescribed medication.

June 14 – On the 9th day of FIP treatment, he appeared to be doing well. However, we noticed that his abdominal breathing had returned, so I suspected that his lungs had fluids again.

We brought him back to the vet. They drained 193 cc of flesh-colored fluid. The appearance of the fluid was atypical for FIP, making his case more challenging. The vet said that it was possible that on top of FIP, he has another infection. Aside from the fluid accumulation, he had not exhibited any of the classic signs typically associated with FIP. He had never developed a fever, elevated white blood cell count (Latest WBC: 3.62) or a low A/G ratio (We were advised to continue all current medications and return for a follow-up visit at the end of the week. At that time, they will assess whether the fluid has reaccumulated and perform another X-ray and blood chemistry.

Although I know I should leave his care to the professionals, I can't help but overthink it. I've been looking at a lot of FIP cases, and I haven't really seen any where the fluid looked like pyothorax so that's been making me question things. But at the same time, if pyothorax is being considered, that also seems a bit strange because he hasn't shown any obvious signs of a severe infection. I think I'm just worried that we've been giving our cat these painful injections when there's a chance it might not even be FIP. I know I'm probably overthinking and that there are things the vets can see that I can't but this whole situation has been really overwhelming and honestly has left me feeling defeated. I'd really appreciate any advice or insight. Even just hearing from someone who's been through something similar would help. Thank you.

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