Chin Acne Returns to Jimmy and Also to Katharine-Laser Treatments Next!

So, we have an ongoing curious case of chin acne among the cats. Katharine's face is swollen and black against her usually pristine white chin. She saw Compassionate Care vet Dr. Forbes for laser treatment last night. She also received a shot of Convenia, the antibiotic. She and Jimmy will return on Sunday (yes, a place with Sunday hours!) because Jimmy's has returned a bit. Elizabeth and Bette also have it but not as bad so I will hold off taking them in. But Baby and Myrna have no acne.

Two possible reasons since they all get different goops, somewhat different foods, all get the same clean glass dishes for each meal, use the same litter boxes, etc.: either it's the toothpaste or the exposure to the herpes virus. Toothpaste-same tube and brand we always use by CET but this is a tube we've had for a month when-voila!-chin acne appeared. Four siblings get their teeth brushed daily while Baby-being the difficult, angry cuss she can be (but very loving and sweet most of the time) gets her teeth brushed a couple times a week. She doesn't always get her meds first thing and gets them later when my husband comes home (when she's decided to hang out in the basement on the top shelf all day where I can't get her but I can reach up and feed her.) She doesn't need her meds first thing so far so she's fine. But by the time he comes home, the toothbrush has been put away and we don't think about it since we are busy with other things at that point. And Myrna hasn't had her teeth brushed a lot recently because of her CHF and meds and vitamin goops and it's just one thing I've let go of but she gets brushed at least once a week.

The other thing is the herpes virus: siblings were exposed as kittens when spayed/neutered. They initially got sick as kittens in the order of when they were spayed/neutered and a week apart just as they were spayed/neutered. The only two to have recurring bouts of herpes related illness over the last six years are Jimmy and Katharine. Baby being the oldest is considered immune and Myrna was never as sick as the others initially and was the last to be spayed. Bette and Elizabeth were sick initially but not as sick as Jimmy and have never been as bothered by a virus-such as the one last summer-as were Jimmy and Katharine.

According to photos from this site, they only have acne-black granules on the chin-and not herpes sores. They do get lysine daily to fight off the herpes virus and I can easily increase their daily dose to see if it helps. We will change the type of toothpaste or even stop using it-the dentist from MSU said we don't need to use toothpaste as it's the scrubbing of the gums with the brush that does the trick (but wet the brush as a dry brush can irritate the gums, hurt the cat.) If we stop using toothpaste at all and the acne clears up and doesn't return and then comes back if we use it again, we'll know. And process of elimination is the only way to know for sure. But then again, who wants it to return?

So, more lysine, no toothpaste for the next week or two and we'll see how it goes.

Difference between Acne and Herpes sores?

I was wondering what the difference was (as in the look) of acne vs herpes sores? I noticed a...

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Jimmy Stewart Visits New Vet for Laser Treatments for Chin Acne

There's a new vet in town and she's on Myrna's Cats Living with HCM Facebook page.  She read about Jimmy's chin acne and her new practice has a new laser treatment machine. She invited us to come have a free laser treatment and visit the practice. Jimmy was really well behaved and wore his glasses. The laser wand is small, warm-not hot, and the skin doesn't peel as it would with humans.  While the Convenia shot curbed the redness and swelling, the laser treatments have healed his chin acne, almost after the first treatment.  He's had two so far and will have one this week. But each subsequent day after treatment, when I clean his chin with chlorhexadine pads, there is less and less debris coming off.  I highly recommend laser treatments for stubborn, infected chin acne. There are also other reasons for laser treatments. Call around and find a vet who does such treatments if you need anything.  

Jimmy Stewart getting new glasses! He wore these goggles today during his first laser treatment for his chin acne. He was a trouper!

Myrna Has Her Two Week Cardio Visit to Remove Fluid Build-up-and Jimmy Stewart Tags Along for the Visit to the ER

Jimmy Stewart saw the vet on Friday for swollen chin acne.  We spent the weekend cleaning his sores.  He seemed otherwise fine until Sunday when he wasn't urinating the volume that he would usually.  And then late in the day he began to sit in the box.  We took him out and then he went back in.  He wasn't cleaning his genitals; he wasn't going frequently; he wasn't going tiny amounts.  So, I didn't think he had a UTI. But that didn't mean he couldn't suddenly have a blockage.  The antibiotic shot wasn't suppose to make him sick and he hadn't had any gastro upsets or diarrhea.  Since I was taking Myrna to see the cardiologist Monday and the regular vet can never see last minute patients on Mondays, I decided to take him to the ER in Novi that is in the same building as Myrna Loy's cardio.

Jimmy Stewart at ER

Xrays didn't show stones, most of which would show up on an xray. Urinalysis didn't reveal crystals-another cause of blockages-nor any bacteria.  Xrays did reveal that his colon system was full of bile that hadn't been expelled yet.  Exam didn't reveal that it was impacted but his anal glands were impacted.  The vet expressed them.  She hypothesized that packed glands may have made him feel unable to pass fecal matter and being uncomfortable made him lay in the litter box-which cats are known to do when trying to go and are unable to or when upset enough that the box is a safe place.  Blood work didn't reveal anything other than slight dehydration which would also lead to less water in the colon, lead to constipation.  His urine pH was 8.5.  With a lack of water and a high pH, he is susceptible to forming stones and getting a blockage.  I am to give him daily doses of Methigel-DL methionine, an acidifier-which should lower his pH.  They gave him sub-q fluids to rehydrate.   So, we are to give water by mouth, add fiber to his food, give Methigel, clean his chin acne, and continue to monitor.  

He came home smelling of vanilla which must be from the shampoo they used to clean him after expressing his glands.  His siblings didn't care for it.  "You stink!" they seemed to hiss.  He has been content to spend last night and all today upstairs in bed.  He could have come downstairs but never did until this evening. He has used the litter box twice during the day, going large amounts. He continues to eat very well.  

Myrna Loy

Myrna Loy is now seeing the cardio every two weeks since Christmas to have fluid withdrawn. We have regular two week appointments set up through April for now.  And we will go in sooner if needed.  Myrna had more fluid withdrawn from her pleural effusion.  She had 7 oz. last time and 8 oz. this time, despite high levels of torsemide and despite me giving her extra torsemide this past week as needed to lower her breathing rate.  The ONE good news: her afib-atrial fibrillation, has disappeared.  The cardio has never seen that before.  But that's how it goes with Myrna-she's always presenting with something other cats don't present with to the cardio. 

Her heart rate is steady at 160. 

Her weight is down now to 9.4 lbs, down from 9.8 just a few months ago and around 10 lbs a year ago.  While we wanted her weight to come down for her heart, she's now at the place where we want her to be.  To help her kidneys and her body function, she actually can't get below 9 lbs.  It's a bad sign when cats lose weight which they do because they don't feel like eating which can have many causes. But the result is a lack of water which leads to dehydration, which itself leads to a myriad of issues because of a lack of electrolytes.  And a lack of eating means a lack of protein which causes the body to waste away, and a lack of vitamins and minerals to supply the body with what it needs for energy which would allow the body to function from brain to heart to kidneys, etc.  We have had to give mirtazapine, an appetite stimulant, about once a week which helps her eat enough.  We will have to make sure she eats well every day and give more mirtazapine if needed. 

Her potassium is down to 3.2 from two weeks ago at 3.5.  Potassium is needed for kidney function and a decline in potassium means a decline in kidney function. So, we must increase her potassium levels by increasing the amount of supplements and sweet potato baby food we give her.  The BUN is 37 the same as two weeks ago; creatinine is 2.9, up from 2.7 two weeks ago.  Those are the kidney values that are analyzed the most for kidney function. An increase in values means a decrease in function which is crucial when you are asking the kidneys to process the diuretic medication for the diuresis process of removing extra fluid from the body.  

So, she's ok, stable enough, eating well enough, and for about three days a week still plays with toys and runs around before she runs out of energy.

Here are the vet's notes: "We removed 130ml of chylous effusion from the right side of Myrna's chest today.  Only a small pocket of fluid remained after the procedure was performed. Myrna's kidney values are stable compared to her last visit earlier this month. However, her potassium level is on the decline again. Myrna's is developing pleural effusion at a more rapid rate despite our incredibly aggressive medical efforts.  I see no benefit to increasing her torsemide dose further. Rather, it is very likely that this will be a detriment to her health.  Sadly, we have maxed out on all of her cardiac medications.  We are left with no other great options other than to periodically drain her pleural effusion as her symptoms dictate." 

Jimmy Develops Horrible Case of Chin Acne

Two weeks ago, Jimmy developed chin acne.  I cleaned it with chlorhexidine pads and the next day it seemed to clear up.  But last Thursday, I noticed his face was misshapened but couldn't figure out why.  He just seemed to have taken on a new longer, pointer shape. Then I realized that his chin and bottom lip were swollen. Upon closer examination, the entire area of his bottom lip, chin, and underneath were horribly red and swollen.  Friday, he saw the vet who gave him an antibiotic shot of Convenia so that we didn't have to pill him each day.  The shot also helps avoid gastro upset such as vomiting and diarrhea.  I have to clean his chin each day with the chlorhexidine.  The area is a mess of dirt and blackheads.

I thought they were bugs but thankfully, just horrible blackheads covering the area that unfortunately are infected.