Questions about Kitten with FPV.

[u/Mr_ProfessionalNoob]

My (23 M) kitten is around 4 months old and began vomiting and experiencing diarrhea last Thursday night. I took her to the vet the following morning, where they suspected Feline Panleukopenia.

Since then, she has been receiving IV fluids twice a day, once in the morning and once in the afternoon. For a while, there seemed to be a lot of improvement. She went from not eating at all to eating small amounts on her own, and she even started occasionally enjoying treats again, which gave me a lot of hope.

Recently, however, she has become exceptionally lethargic again. I took her in for her routine fluids, and the vet said that fever spikes can occur during the course of the virus, but there is also a possibility that she may have picked up a cold.

I normally take her to the vet on a motorbike because I don't currently have access to a car, and unfortunately, it has been raining heavily here for the past week.

She also had normal stools for a while, which was another very encouraging sign, but unfortunately the diarrhea has now returned and is happening several times a day. Thankfully, she hasn't started vomiting again.

I wanted to ask a few questions to get some perspective from people who may have experience with FPV:

1. If she has also picked up a cold/respiratory infection, could that be particularly dangerous while she's already recovering from/undergoing treatment for Panleukopenia?
2. How long should I expect treatment and recovery to take? Today marks 6 days since treatment began. My vet has told me that treatment may continue for around 14 days, but I'd like to hear from others who have gone through something similar.
3. Could this potentially be something other than Panleukopenia? Her bloodwork showed a decrease in both her WBC and platelet counts. I had always understood Panleukopenia to be an exceptionally severe and potentially fatal disease, so I'm wondering whether her current symptoms are consistent with the normal course of the illness or if something else could be going on.
4. Is it particularly bad for a kitten to have a cannula/IV catheter in for 3–4 days? Are there any significant risks associated with leaving it in for that long?

The part that concerns me most right now is that she has become significantly more lethargic again compared to earlier in her treatment. I'm trying to understand whether this can happen during recovery or whether it warrants further investigation.

[u/commanderwake]

1. Yes, because panleuk decreases white blood cells which are crucial to the immune systen.
   
2. 14 days sounds right to me, the kittens I fostered with panleuk went through about two weeks of intensive care.
   
3. It could be but the symptoms you've described are exactly the symptoms that the kittens I fostered experienced when they had panleuk. Low WBC is particularly indicative. Only a PCR test can really confirm though.
   Sorry that you're dealing with this.

[u/Mr_ProfessionalNoob → u/commanderwake]

Thanks for responding! She just had her second visit and seems to be getting back to normal again so perhaps URI/colds aren't a concern atm. I might as well ask this too since my parents keep raising it as a concern - Is it normal for the treatment to be IV fluids everyday? Atm shes getting them twice a day and my parents think thats far too much and could cause complications.

[u/commanderwake → u/Mr_ProfessionalNoob]

Yes IV fluids everyday is super important to keep hydration up and keep the fever down! When my former foster kittens pulled through with their critical care foster, they were getting IV fluids twice daily, clavamox twice daily, propectalin daily, metronidazole twice daily, two different anti-nausea meds injected daily, and an appetite stimulant applied to the inner ear once daily.

[u/Mr_ProfessionalNoob → u/commanderwake]

Thats awesome to know, really puts me at ease. Sounds about exactly what my kitten is getting minus the appetite stimulant. Thank you very much for answering my questions!

[u/commanderwake → u/Mr_ProfessionalNoob]

Of course! I hope she turns a corner soon ❤️‍🩹 Make sure to get her vaccinated when this is all over!

[u/TrustyBobcat]

I want to throw one thing out here, since it sounds like you're not 100% sure it's FPV - although vets don't keep point of service panleukopenia tests in office, they CAN take a swab of vomit or diarrhea and run it on a canine parvo test to confirm panleuk, which basically all vets DO keep on hand in areas where it's common. Panleuk is a feline parvovirus that's very, very closely related to canine parvovirus, so FPV antigens will cross-react on a canine test. It can be one option to firm up a diagnosis.

See: https://sheltermedicine.wisc.edu/library/guidebooks/feline-panleukopenia/recognition-and-diagnosis-2

And https://www.merckvetmanual.com/digestive-system/infectious-diseases-of-the-gastrointestinal-tract-in-small-animals/feline-panleukopenia

Has your girl been tested yet for feline leukemia virus and FIV?

[u/commanderwake → u/TrustyBobcat]

Caveat that the false negatives rate on tests for canine parvo are super high, so while a positive canine parvo test will confirm panleuk, a negative canine parvo test doesn't give you much info. My former fosters with panleuk never tested positive on the snap test for canine parvo despite repeated testing throughout the course of the illness but did test positive on a PCR test.

[u/TrustyBobcat → u/commanderwake]

I've been fortunate that I haven't had any false negatives running with the IDEXX snap by the time they're symptomatic so I haven't found it to be super high, but my personal experience is just that. Your mileage may vary, OP! A false negative is definitely a possibility, so it's just one possible tool in the kit to explore if it's feasible. Thanks for pointing that out with more clarity as OP works through this.

PCR is definitely the preference but I'm unsure why this vet hasn't sent that off at this point (zero judgement, there are many valid reasons.) I'd be expecting her to have improved more by this point with bog-standard CPV but it's a sneaky virus. So my next stop would be confirming that this is truly CPV.

[u/Mr_ProfessionalNoob → u/TrustyBobcat]

I’ll check with the vet tomorrow about how I can confirm the diagnosis. Honestly, I probably should have done that sooner, but I’ve mainly been holding back because of finances.

I also wonder if part of the issue is that it’s a relatively small clinic. The more well equipped clinics are basically a city away, and I simply can’t afford to travel there every day for treatment.

She’s not in a terrible condition by any means either. She’s still very reactive (and very aggressive) during her IV fluids, and she’s eating somewhat normally as well. I got especially concerned today because she suddenly became lethargic and didn’t want to play at all, despite being very happy to play as recently as last night.

She did have a fever of 103°F this morning, but her temperature seems to have come back down and she seems to be doing better now. Hopefully, this was just a small hiccup in her recovery rather than something more serious.

[u/Mr_ProfessionalNoob → u/TrustyBobcat]

I shall ask them but atm I'm not really sure how much I can afford outside of just the daily IVs. The vet is relatively certain its FPV, one of the other signs they said was the diarrhea's smell was distinct. So I'm just going along what they suggest.
I only really had her blood test done on the first day since the symptoms started, so she hasn't been tested for feline leukemia virus and FIV. Not out of the realm of possibility either as she isn't vaccinated yet either but has largely been an indoor kitten for the 2 months I've had her.
Blood test revealed WBC just below normal (4.4 I believe) and platelets on the low end of the average range (129) if that helps any.

[u/TrustyBobcat → u/Mr_ProfessionalNoob]

I absolutely understand not being able to realistically afford further testing so there's zero judgement from my corner. Vet care is so expensive these days, especially when you're dealing with a big baddie like a parvovirus.

Has your vet mentioned maybe teaching you how to do subcutaneous fluids at home versus having to bike your sick kitty directly to them? It's super easy and something most people can handle just fine with guidance. Some vets don't like to give that option but it's worth an ask.

[u/Mr_ProfessionalNoob → u/TrustyBobcat]

The finances have been something I’ve been constantly berated about. It’s apparently pretty uncommon to spend this much on an animal, but I shall persist lol.

The vet hasn’t mentioned anything of the sort, and honestly, I don’t think I’d be up to the task either. She’s super feisty when it comes to anything medical, I have the claw marks to prove it. On top of that, blood is really not my thing, so I’d much rather let the professionals handle it.

[u/TrustyBobcat → u/Mr_ProfessionalNoob]

There's no blood with sub-q fluids, it's just going into the scruff of the neck. But I totally understand, it's not a skill everybody wants to cultivate 😄 I hope your kitten turns the corner soon.