Varia

24.06.2025IDEXX: routine check-up + allergy screening (lab no. LZ405526)#

The earliest of all documents received — a month before the tumour was found. At that time no signs of cancer were recorded.

• Biochemistry: creatinine 159.12 µmol/l [79.56–203.32] — normal; urea 12.14 [5.71–13.57] — upper limit of normal; Na 154, K 4.9, total protein 77, albumin 36, globulin 41, A/G 0.88, ALT 42, AST 35, ALP 26, total bilirubin 3.42, cholesterol 4.76 — all within the reference range.
• CBC: RBC 9.46, haematocrit 0.415, haemoglobin 128, MCV 43.9 (for comparison — normal; microcytosis developed later), MCH 13.5, MCHC 308, WBC 7.05, platelets 427 — all normal.
• Allergy screening (GREER, IgE, CCD inhibitor): grasses, trees, mites/moulds, fleas — all negative.
• Nutridexx food panel: IgE antibodies — R0 (negative) for all items. IgG antibodies — positive to varying degrees (R2–R4) to almost all foods tested (milk, various fish, poultry, beef/lamb/pork, cereals, potato, soy, etc.). The document gives no clinical interpretation of raised food IgG in cats, and it is generally debated in veterinary medicine — listed as an objective finding without interpretation.

25.07.2025tumour found at the right 2nd teat#

Chest radiograph — unremarkable.

ALAB cytology (order no. 293/25-07-2025 of 25/28.07.2025, material received 28.07.2025, examined and reported on 01.08.2025 12:44; requesting vet lek. wet. Olga Jaworska, pathologist prof. dr hab. Rafał Sapierzyński): “Guz sutka kota. 5 rozmazów”. Conclusion: “nowotwór nabłonkowy gruczołu sutkowego, z minimalnie wyrażoną złośliwością cytologiczną” — epithelial mammary tumour with minimal cytological malignancy. The pathologist notes the moderate correlation between cytology and histology in cats and recommends surgical removal with histology.

06–07.08.2025IDEXX: pre-operative check-up (lab no. LZ029307)#

• Biochemistry: creatinine 150.28 µmol/l [79.56–203.32] — normal (an important point: the last normal creatinine immediately before surgical treatment); T4 and SDMA — normal.
• CBC: haemoglobin 138, haematocrit 0.386, RBC 10.81, platelets 325. MCV 35.7↓ [39.0–56.0] — mild microcytosis appears here for the first time and persists throughout the rest of the history. Reticulocyte haemoglobin 13.4↓ [15.3–22.9] — the laboratory itself flagged the result: “Result implausibly low. We recommend retesting from new material” — no retest can be traced in the documents.

08.08.2025, 18:22ALVET, dr Olga Jaworska: surgery no. 1 — total right-sided mastectomy#

Total right-sided mastectomy with removal of the inguinal lymph node. Sedatex appears among the visit’s drugs for the first time (probably sedation for premedication/anaesthesia; composition and regimen not established from the documents).

ALAB histology: “rak prosty lity o złośliwości III stopnia z wąskim marginesem” — simple solid carcinoma, Mills grade III, narrow resection margin, with foci of necrosis; the margin is about 0.2 mm. (The exact Polish wording from the photo of the document needs a final check against the original — part of the text is small.)

29.10.2025nodule found near the surgical scar in the lower abdomen#

Radiograph — clear.

31.10.2025IDEXX: blood count and biochemistry#

Creatinine 185.64 [79.56–203.32] — normal, but higher than on 06.08 (150.28); urea 8.57; glucose 7.22; MCV 37.6↓, MCH 12.0↓ — the same pattern of mild microcytosis. Everything else normal.

04.11.2025, 09:49ALVET, dr Olga Jaworska: surgery no. 2 — removal of the nodule near the scar#

Per the owner: softer stools for 3–4 days, improved after the probiotic Sustain, softened again the day before the visit.

Surgery: mastectomy of the right chain in the region of the 3rd and 4th teat pairs; “guz hyperagresywny wrastający od strony uda licznymi naczyniami z ciemną cieczą” — an aggressively growing tumour from the thigh side with many vessels and dark fluid inside; partial removal of the abdominal muscles; layered closure. Prescribed: Biotrakson (ceftriaxone), NaCl, Tolfedine; collar for 10 days.

ALAB histology (13.11.2025): “Tkanka tłuszczowa podskórna objęta wieloogniskowym zlewającym się jałowym zapaleniem mieszanym... W badanym materiale brak cech procesu nowotworowego gruczołu sutkowego” — no neoplastic process found, the changes proved benign (sterile multifocal inflammation of fat tissue, fibrosis).

19.12.2025~1.5–2 cm lymph node found on the right#

20.12.2025IDEXX: full blood work (lab no. 1000226201, report created 20.12.2025 03:16 UTC)#

Creatinine 221 µmol/l [79.56–203.32] — above the reference range. This is the earliest documented episode of raised creatinine in the whole history. Also glucose 8.33 [3.5–7.77] — above normal (possibly stress hyperglycaemia).

• Other biochemistry: urea 9.28, Na 153, K 5.0, total protein 76, albumin 31, globulin 45, A/G 0.69, ALT 32, AST 24, ALP 25, bilirubin 3.42, cholesterol 2.61 — normal.
• CBC: RBC 10.62, haematocrit 0.38, haemoglobin 120, MCV 35.6↓, MCH 11.3↓ (the same microcytosis pattern), MCHC 317, WBC 11.28, platelets 279.

29.12.2025, 17:27ALVET, dr Olga Jaworska: surgery no. 3 — tumour on the side of the body, behind the right scapula#

Chest radiographs, 2 views — no visible changes in the lungs. Anaesthesia: dexmedetomidine, methadone, propofol, isoflurane.

Surgery: removal of the tumour “on the side of the body, behind the right scapula” (“guz z boku ciała, za łopatką prawą”) — the tumour grew right between the muscles and invaded them, the affected muscles were removed; the tumour was multilobed, black-green, furrowed. After surgery: Biotrakson, Tolfedine, Ringer’s at the clinic; at home — Bunondol; collar for 10 days.

Note on anatomy: the histology sample is labelled “tkanki miękkie z pachy kota” (soft tissue from the axilla), “probably an altered lymph node” — so the location broadly matches the previously known “~1.5–2 cm lymph node on the right”, but the document describes the tumour/affected tissue itself, not an isolated lymph node.

ALAB histology (order no. 211/05-01-2026, material registered 07.01.2026, examined 12.01.2026, reported 12.01.2026 19:52): specimen — “Tkanki miękkie z pachy kota”. Conclusion: “Rak prosty lity o wysokiej złośliwości histologicznej, prawdopodobnie zmieniony węzeł chłonny, w okolicznych naczyniach limfatycznych skupiska komórek raka” — high-grade simple solid carcinoma, probably an altered lymph node, clusters of carcinoma cells in the surrounding lymphatic vessels (lymphovascular invasion confirmed verbatim).

The pathologist’s comment (prof. dr hab. Rafał Sapierzyński) gives a general reference list of unfavourable prognostic factors in feline mammary tumours (age, breed, stage, tumour diameter, Mills grade, vascular invasion, lack of oestrogen receptors, expression of Ki67/COX-2/TP53/TIMP, etc.) — this is the laboratory’s general reference information, not an indication that these markers were measured in Varia.

09.02.2026follow-up examination (primary document not uploaded)#

Radiograph clear; ultrasound of all organs (documentation unavailable, known from the surgeon: everything looked clear on a screening scan). A possible small kidney stone and one kidney slightly larger than the other — possibly an individual normal variant. This is the earliest mention of renal findings on ultrasound specifically (on blood tests, as is now known, azotaemia had already been recorded on 20.12.2025).

~02.02.2026Neoplazmaxan started (per the summary of 13.04.2026)#

The cat was also receiving Apoquel (oclacitinib — a Janus kinase (JAK) inhibitor with antipruritic and anti-allergic action; its European authorisation is for dogs) and was switched to a renal diet because of raised creatinine on the latest test at the time.

02.03.2026fine-needle aspiration#

Result per the summary of 13.04.2026: suspicion of a neoplastic process. Clarified from the primary document — ALAB cytology, examination of 09.03.2026: conclusion — “carcinoma of low/moderate cytological malignancy” (the more precise wording).

02–04.03.2026radiograph of the nodule (~2 cm); dark fluid during surgery#

⚠️ The radiographs themselves were received (2 files, lateral and ventrodorsal views) labelled by the owner “02/03/2026”, whereas the original records gave the date “04.03.2026” — it is unclear whether this is one study with a typo in the date or two different studies; needs clarification with the clinic/owner.

On the lateral view, in the abdominal/inguinal region caudal to the ribs, a large structure of heterogeneous (mottled/speckled) density is visible; on the ventrodorsal view a similar structure is seen beside the spine in the lumbar/pelvic region. This is a lay description of the image — the exact anatomical location and clinical significance of the finding must be confirmed by the treating vet/radiologist; no vet’s report is attached to the images.

17.03.2026IDEXX: blood test#

Creatinine 212.16 µmol/l — above the reference range (79.56–203.32). Urea 13.21 (upper limit of normal). Haemoglobin 103.0 (lower limit of normal 103.0–162.0).

19.03.2026ALAB: urinalysis#

Protein detected in urine (+), haemoglobin strongly positive (++), fresh red cells 20–25 per field (normal — occasional) — marked haematuria and proteinuria. Quantitative protein 27.38 mg/dl.

20.03.2026, 12:00ALVET, dr Olga Jaworska: surgery no. 4 — tumours from under the right axilla and from the abdomen#

Inhalation anaesthesia with isoflurane. Both tumours lay under the muscles; part of the abdominal and thoracic muscular wall had to be removed; the axillary tumour lay against the large vessels and nerves of the axilla, was highly vascular, with haemorrhages. The vet noted that the surgery was highly traumatic, with a risk of oedema/paresis of the right forelimb.

Post-operative treatment: Marbocyl (marbofloxacin), Tolfedine, Ceporex (cefalexin), lactated Ringer’s IV, buprenorphine, Bunalgin at home 0.5 tablet every 8 h, collar for 10 days.

The ALVET vet explicitly recorded: “Ogólny wygląd guzów, rozpoznanie HP, liczne już wznowy są spójne w rozpoznanie raka gr mlekowego o wysokiej złośliwości, rokowanie ogólne nie jest pomyślne” — the general appearance of the tumours, the histopathological diagnosis and the already numerous recurrences are consistent with a diagnosis of high-grade mammary carcinoma; the overall prognosis is unfavourable.

ALAB histology (27.03.2026): “W obu badanych wycinkach nisko zróżnicowany nowotwór o wysokiej złośliwości histologicznej, prawdopodobnie rak lity, wieloogniskowo komórki nowotworowe stykają się z marginesami histologicznymi, w badanym materiale nie stwierdzono naciekania naczyń” — in both samples a poorly differentiated high-grade tumour, probably solid carcinoma; tumour cells multifocally reach the resection margins (margin not clean/questionable); no vascular invasion found. The pathologist notes separately that distinguishing carcinoma/sarcoma/carcinosarcoma requires immunohistochemical staining (pancytokeratin, vimentin) — the exact histological type of the tumour is not fully established even by the ALAB documents.

~01.04.2026#

As of this date, per the summary of 13.04.2026: “stable, eating and using the litter box”.

13.04.2026, 16:00LoVet, dr Agata Drewniak: first oncology consultation at LoVet#

At this visit an English-language summary of the full history since 07.2025 was produced (it formed the basis of section 4 of this report). Examination: BCS 4/9, abdominal wall soft, non-painful, lymph nodes not enlarged, scar clean.

TFAST: right — single subpleural consolidations, up to 1.4 mm; left — a small amount of free fluid near the heart, a 1.4 mm change (possibly a fibrosed lung lobe), also subpleural consolidations.

Vet’s conclusion: disseminated cancer with lung metastases — i.e. on 13.04.2026 the oncologist clinically considered the disease metastatic with lung involvement based on TFAST and the overall oncological picture; there is no morphological verification of the lung lesion in the documents. The decision was made to start toceranib (Palladia) 10 mg, 1 tablet Mon/Wed/Fri, with gloves, not to be crushed/split, given the metastatic disease. Recheck in 2 weeks.

• Haematology (16:31, sample no. 5885): WBC 7.33, Neu# 4.18, Lym# 2.73, Mon# 0.05, Eos# 0.37, Bas# 0.00, RBC 8.03↓, HGB 10.0↓, HCT 28.7↓, MCV 35.8↓, MCH 12.5, MCHC 35.0, PLT 266.
• Biochemistry (23:52): TP 71.0, ALB 32.0, GLO 39.0, TBIL 2.79, AST 21, ALT 43, ALP 40, BUN 9.50, CRE 202↑ [1–168], CK 88, AMY 1328, GLU 7.87↑ [3.05–6.1], CHOL 5.12, Ca 2.85, P 1.19.

27.04.2026laboratory forms (visit document not uploaded)#

• Biochemistry: creatinine 161 µmol/l (decreased, within the 1–168 range); K+ 5.23↑; Ca 3.01↑ (upper limit); glucose 6.73↑.

• Haematology (sample no. 6002): WBC 9.94, HGB 11.0, HCT 31.9, MCV 34.9↓, MPV 8.6↓.

Around this date (reconstructed from the Retina record of 18.08.2026) prednisolone 5 mg/day was started — the dose did not change until 15.06.2026.

29.04.2026, 15:00LoVet, dr Agata Drewniak: follow-up ultrasound#

Per the owner: breathing asleep 30/min, feeling well, eating, no vomiting/diarrhoea.

Ultrasound: left — marked improvement, less free fluid; right — free fluid present but less than on Monday; mild pulmonary oedema in the accessory lobes; subpleural consolidations visible.

Prescribed: continue Palladia 10 mg Mon/Wed/Fri; keep the steroid at 5 mg once daily in the evening; Libeo 10 mg (furosemide) added — 1/2 tablet in the morning (= 5 mg furosemide); recheck in 2 weeks. Weight 4.80 kg.

By 11.05.2026mention of an abdominal ultrasound “in February 2026”#

Per the owner, recorded in the LoVet note of 13.06.2026 (“USG jamy brzusznej w lutym, ok”). Result — normal. The document of this ultrasound itself was not uploaded.

11.05.2026, 18:15LoVet, dr Agata Drewniak#

Chest tap (160 ml), progression on ultrasound; Palladia 15 mg Mon/Wed/Fri introduced; Furosoral 1/4 tablet; Cyklonamina 1/4 tablet twice daily. Weight 4.80 kg.

18.05.2026, 19:45LoVet, dr Agata Drewniak: first documented chemotherapy#

Per the owner: has recovered, more active, appetite fine, no vomiting or diarrhoea. Itching — the owners changed the food. Breathing at the visit 26–30/min. Ultrasound: the amount of fluid is comparable to that after the tap.

Decision to give carboplatin (Carboplatin Ebewe) 200 mg/m² in glucose + Cerenia 0.5 ml IV — the first clearly documented chemotherapy in the history.

Prescribed: Cyklonamina 250 mg 1/4 tablet twice daily; prednisolone — 5 mg 1 tablet once daily; Palladia — dose reduced to 10 mg Mon/Wed/Fri from 25.05.2026; furosemide reduced to 1/4 tablet once daily; for diarrhoea — Carobin Pet Forte; next chemotherapy in 3 weeks (expected ~08.06.2026). Weight 4.80 kg.

08.06.2026, 19:30LoVet, dr Agata Drewniak: chemotherapy postponed because of neutropenia#

Per the owner: 2 weeks after chemotherapy — the first week poor appetite, no vomiting; the second week — better. Blood test — severe neutropenia (WBC 2.56, Neu# 0.45): chemotherapy cannot be given today. Ultrasound: left — less free fluid; right — unchanged.

Decision: chemotherapy postponed by a week (actually given on 15.06.2026 — but as doxorubicin, not carboplatin, see section 6). Antibiotic Veraflox started. Among other things, Palladia 10 mg 20 tablets (3 packs) were bought. ⚠️ This confirms the purchase of the drug on 08.06.2026 but does not prove continued use after the neutropenia was found: per the owner, both carboplatin and Palladia were stopped at that time. Weight 4.80 kg.

Haematology (19:58, sample no. 6306): WBC 2.56↓ [5.50–19.50], Neu# 0.45↓ — severe neutropenia, Lym# 1.71, Mon# 0.02↓, Eos# 0.38, RBC 7.85.

13.06.2026 (Saturday), 16:30LoVet, dr Oliwia Szaflik#

Per the owner: in the morning rapid breathing ~57/min at rest (but not asleep); 1/2 tablet of furosemide given — slightly better; after a phone consultation with dr Drewniak another tablet was given (1.5 tablets in total that day) — better, breathing ~30/min. Drinking, urinating. Weight per the owner — 5.3 kg (⚠️ the official weight in the same document — 4.80 kg). Abdominal ultrasound in February was normal. Receiving prednisolone, Veraflox, furosemide. “Latest results good except for the neutropenia.”

Examination: mucous membranes pink, moist, CRT < 2 s. Peripheral lymph nodes not enlarged. Heart sounds normal, lung sounds reduced.

Ultrasound: fluid in the chest on both sides, more on the left; enlarged lymph nodes (⚠️ different from the examination just above — possibly different node groups). An attempt to place an IV cannula — the patient pulled away, catheter not placed.

Prescribed: furosemide 1/2 tablet once daily, if breathing speeds up — another 1/2 or a whole tablet; 2 hours before a visit — 1 capsule of gabapentin 100 mg (the purpose — sedation before stressful visits — formalised for the first time). Official weight: 4.80 kg.

Haematology (16:57, sample no. 6359): WBC 3.53↓, Neu# 1.42↓ (neutropenia), Lym# 1.98, RBC 7.23, HGB 9.9, HCT 26.7, MCV 36.9↓, MCHC 37.2 (H flag — inconsistent with the reference range, but the quality of the thermal printout makes some values hard to read), RDW-CV 24.2↑, PLT 699↑.

~14.06.2026 (Sunday)probable visit to an emergency clinic#

Reconstructed from the note of 15.06.2026: “W ndz pogorszenie — 3×1,5 Tbl furosoralu — at night 23 — słychać było oddech głośny. Wizyta na dyżurze — 28 ml płynu wolnego”. Apparently — deterioration on Sunday, noisy breathing at night, a visit to an emergency clinic, 28 ml of fluid drained. The visit document itself was not uploaded.

15.06.2026, 20:30LoVet, dr Agata Drewniak: doxorubicin I (after the change of drug)#

Doxorubicin 1 mg/kg = 2.5 ml + maropitant; prednisolone increased to 1.5 tablets/day (7.5 mg); weight 5.30 kg. ⚠️ The document bears a handwritten date “18/05” that does not match the visit date (this note relates to the separate visit of 18.05.2026, see above).

23.06.2026, 11:15LoVet, dr Agata Drewniak: oncology recheck#

TFAST: new lesions 0.65×0.83, 0.45×0.55, 0.82×0.93 cm on the right; on the left 0.22–0.25 cm; deeper — 1.40×1.24 cm. Conclusion: “stable disease”. Temperature 38.30 °C, weight 5.00 kg.

24.06.2026, 17:30LoVet, dr Oliwia Szaflik#

Per the owner: weak since yesterday, livelier after eating. Breathing ~30/min, stable.

Examination: mucous membranes pink, moist. Peripheral lymph nodes not enlarged (⚠️ unlike the note of 13.06.2026). Heart sounds normal.

Ultrasound: fluid in the chest on both sides — similar to yesterday. Abdomen: a single focal change in the liver parenchyma (new finding); the left kidney has an irregular, “furrowed” capsule (new finding). No free fluid in the abdomen. CBC normal, slight decrease in haematocrit. Marked lipaemia — biochemistry not run.

Vet’s recommendations: if worse — run biochemistry to assess renal function; it was noted that in the event of kidney disease the therapeutic options are limited, as Varia may not tolerate intravenous fluid therapy. Weight 5.00 kg.

06.07.2026, 21:00LoVet, dr Agata Drewniak: doxorubicin II#

Per the owner: felt well in the morning, small amount of stool. Has felt well for the last 2 weeks, eaten well, gained weight.

Examination: mucous membranes pale pink. Breathing worse — tap performed — 60 ml of haemorrhagic fluid drained from the chest (the fluid had not previously been described as haemorrhagic). Ultrasound — subcutaneous oedema on the right (new finding).

Given: doxorubicin 1 mg/kg via the cannula + maropitant 1 mg/kg.

⚠️ The document is internally inconsistent about the steroid dose: the “Zalecenia” section says “steryd bez zmian tj 1,5 Tbl”, but just below — “Prednizolon 5 mg 1 Tbl 1 x dziennie”.

Temperature 38.50 °C, weight 5.20 kg.

Laboratory data (21:30–21:36): haematology — WBC 9.74 (normal, neutropenia resolved), MCV 37.3↓; biochemistry — BUN 11.5↑, K+ 5.19↑, GLU 6.85↑.

10.07.2026, 13:15LoVet, dr Joanna Żak: severe constipation#

Per the owner: chemotherapy was on Monday (06.07.2026). Before chemo — small “pellets” of stool. Since Monday the cat has passed almost no stool. Received wet food RC Intestinal, Purina Sterilised, lactulose. Since yesterday many unsuccessful attempts to defecate; vomited twice while straining.

Examination: mandibular lymph nodes slightly enlarged, temperature 39.5 °C (raised). Rectally — no faeces within reach of the finger.

Lateral radiograph: large accumulations of faeces in the colon before the pelvic inlet; the colon is dilated — constipation potentially leading to megacolon. In addition, more radiopaque structures are visible in the kidney region and in the bladder (possible calculi/mineralisation — not investigated or confirmed further).

Laboratory — a “stress leukogram” (neutrophils 94.3% with marked lymphopenia 3.8%); glucose 16.47 mmol/l — much higher than other measurements (probably stress hyperglycaemia); phosphorus low (0.62, unusual with a suspected renal problem); K+ 5.04↑ (raised again, as on 06.07.2026).

Prescribed: continue lactulose twice daily; Fiberactiv (fibre); Dicopeg (macrogol, laxative); recheck on Monday 18:30 (= 13.07.2026, document not uploaded). Weight 5.20 kg.

27.07.2026, 16:45LoVet, dr Agata Drewniak: doxorubicin III#

Doxorubicin 1 mg/kg, 2.5 ml + maropitant. ⚠️ The document contains an unclear phrase: “właścicielka włączyła steryd: 3 razy” — could not be interpreted unambiguously.

Per the owner: furosemide was stopped completely from 27.07.2026 and was not given to Varia after that date, including at the visits on 02.09 and 07.09.2026.

03.08.2026, 16:00LoVet, dr Joanna Żak#

Examination: worse coat condition — areas of thinning/translucent coat where the undercoat shows through. Anal sacs expressed — the left one markedly enlarged, impacted. Iron (Suiferrin) 0.3 ml IM given. “CBC stable” in the vet’s opinion (the laboratory results, however, show signs of mild anaemia and neutropenia — see below). Sucralfate dispensed — 7 doses of 1 ml. Weight 5.10 kg.

Haematology (16:14, sample no. 6733): WBC 6.06, Neu# 1.41↓ (neutropenia), RBC 6.74, HGB 8.3↓, HCT 23.5↓, MCV 34.9↓ — mild microcytic anaemia added to the neutropenia.

17.08.2026, 16:45LoVet, dr Agata Drewniak: doxorubicin IV, corneal ulcers found for the first time#

Doxorubicin 1 mg/kg, 2.4 ml + maropitant. Prednisolone reduced to 5 mg/day (1 tablet) — from 27.04 to 15.06.2026 the dose was 5 mg/day, from 15.06 it was raised to 7.5 mg/day (1.5 tablets), now reduced to 5 mg again.

Extensive corneal ulcers/erosions of both eyes found for the first time (fluorescein test +++). Started Tobrex 6× daily, Yellox twice daily, Corneregel 3× daily. Ophthalmology consultation recommended.

18.08.2026, 14:45Retina, dr Paweł Stefanowicz: 1st ophthalmology visit#

History: the cat is under oncological treatment, receiving doxorubicin. Eye problems for about a week — tearing (per the owner — onset ~09.08.2026), Veraflox was given.

Examination: IOP OD 18.3, OS 20 mmHg. Scant mucoid discharge at the canthus on both sides. Conjunctival and corneal hydration impaired (low tear meniscus, short NIBUT). Cornea: extensive endothelial changes (maceration, “wrinkling”), corneal epithelial abrasion visible on both sides. Lens — age-related changes (nuclear sclerosis). Fundus unremarkable.

Diagnosis: superficial corneal injury (epithelial abrasion). Dry eye syndrome (ZSO). Possible causes: general condition, age, medications (including corticosteroids, chemotherapy), possible carriage of feline herpesvirus FHV1 (typical for the breed) with reduced immunity.

Recommendations (verbatim — “for the treating vet to consider”): reduce the corticosteroid dose, “of course, if the general condition allows”; introduce an immunomodulator, e.g. beta-glucan. Prescribed: Tobrex 4× daily, Corneregel 2–4× daily, Optixcare at least 4× daily — “the drugs in this order and at least 2 minutes apart”. Optixcare Eye Lube Plus 20 g dispensed. Recheck within 14 days or immediately if there are worrying signs. Age given: 12 years 7 months.

⚠️ The requirement to keep intervals between drops is thus already in the first ophthalmology record and is repeated at every subsequent visit (25.08 — 2, 5–10 and 15 minutes; 03.09 — 2, 5–10 and 10 minutes). The earlier wording of this report, that intervals were first prescribed on 10.09.2026, was wrong and was corrected on 24.09.2026 from the full text of the documents.

19.08.2026, 17:00LoVet, dr Agata Drewniak#

Bought: Famogast/Ranigast (famotidine) 20 mg; Varenzin 23.3 mg/ml, 27 ml — 1 ml once daily by mouth. Varenzin (active substance — molidustat) is an anti-anaemic drug that increases endogenous erythropoietin production; it is authorised for the treatment of non-regenerative anaemia associated with chronic kidney disease in cats. The vet’s note does not state a specific reason for prescribing it to Varia. Weight 4.94 kg.

25.08.2026, 11:42Retina, lek. wet. Veronika Chybowska: 2nd ophthalmology visit#

History: the eye discharge has stopped, but the cat squints very strongly and looks very painful. Eating, drinking, normal urination and defecation. Prednisolone reduced to 5 mg since 17.08. Beta-glucan introduced. The cat tries to rub off Optixcare and Dexoftyal gel.

Examination (both eyes described the same): squinting. IOP OD 19, OS 19 mmHg. Scant mucoid discharge at the canthus — improved at this recheck. Eyelids normal. Conjunctival and corneal hydration impaired (low meniscus, short NIBUT) — improved compared with the first examination. Conjunctiva normal. Cornea: extensive endothelial changes (maceration, “wrinkling”); corneal epithelial abrasion visible — horizontal, with irregular edges. Lens — age-related nuclear sclerosis, fundus normal; neuro-ophthalmic responses preserved.

Conclusion: superficial corneal injuries (epithelial abrasion). The signs indicate impaired corneal hydration — ZSO. “We are intensifying treatment.” Possible causes — the same as on 18.08.

Prescribed — in the stated order: Optixcare EMS 1 drop once daily (store in the fridge, 10 minutes’ break before the next drugs) → 2 min → Tobrex 4× daily → 2 min → Corneregel twice daily → 5–10 min → Optixcare at least 4× daily → 15 minutes’ break before the serum → allogeneic serum/plasma with EDTA 4× daily (store in the fridge, warm in the hand before instilling). EMS (Eye Support), a serum bottle and Tobrex dispensed. Recheck within 10 days. Age given: 12 years 8 months.

⚠️ Correction of 24.09.2026. Earlier, this report attributed to this visit an epithelial defect of OD ~70% / OS ~80%, the conclusion “worse despite intensive treatment” and a request to replace the steroid. According to the full text of the document this is wrong: on 25.08 there are no percentages and no conclusion of deterioration; on the contrary, improvement in discharge and hydration is noted. All three points belong to the visit of 03.09.2026 (see below).

26.08.2026, 18:36ALPHAVET, Dr Paweł Łyp: cardiology consultation#

Echocardiography without signs of HCM; an incidental ~0.9×0.7 cm mass at the heart apex/in the mediastinum with a cyst inside. Blood pressure 155 mmHg. No contraindication to continuing chemotherapy found.

02.09.2026, 13:15–13:20LoVet, dr Małgorzata Malec#

New sign: pain on palpation of the thoracic spine. Ultrasound: 0.8 cm of free fluid on the left, 0.53 cm on the right. Weight 4.81 kg.

Biochemistry: all renal and hepatic values (urea, creatinine 120, AST, ALT, ALP, bilirubin) — within range, despite the abnormal left kidney capsule on the ultrasound of 24.06.2026. Glucose 6.93↑ (possibly stress-related). ⚠️ The form wrongly gives the age as “9 Lat”.

IDEXX Haematology — only page 1 of 2 received; page 2 (with graphs and laboratory comments) for this date was never received.

03.09.2026, 13:58Retina, lek. wet. Veronika Chybowska: 3rd ophthalmology visit#

History: slightly better, but still squinting and painful. Optixcare every 2 hours brings relief. The cat eats and drinks but is inactive. ⚠️ Per the owner — “yesterday blood tests were done (normal), an oncology-therapy visit, and a visit to the cardiologist — no abnormalities”; there is no separate document of a cardiology visit on 02.09.2026 itself (the nearest documented one is 26.08.2026).

Examination: squinting. IOP OD 19, OS 19 mmHg. Scant mucoid discharge — improved at this recheck. Hydration impaired (low meniscus, short NIBUT). Conjunctiva normal. Cornea: extensive endothelial changes; epithelial defect OD ~70%, OS ~80% of the surface — the previously separate defects have merged into one extensive defect. Neuro-ophthalmic responses preserved.

Conclusion: extensive superficial corneal injuries — epithelial defects. Worse despite intensive treatment — larger areas of epithelial defect. Cause — ZSO; possible causes the same. The owners report that the treating oncologist could replace the oral steroid with another drug; “if the replacement is safe for the cat’s general condition, please replace the drug”.

Prescribed — in the stated order: Tobrex 4× daily → 2 min → Vital Drop 3× daily (note: may sting — try on one eye; if uncomfortable, stop and use Optixcare EMS once daily first in line) → 5–10 min → Corneregel twice daily → 5–10 min → Optixcare at least 5–6× daily → 10 min break → serum 4× daily (in the fridge). Vital Drop, Tobrex, Optixcare Eye Lube Plus and a serum bottle dispensed. Recheck within 7 days. Age given: 12 years 8 months.

This is the first record with a numerical estimate of the defect area.

07.09.2026, 18:00LoVet, dr Agata Drewniak: doxorubicin V (last dose)#

Per the owner — “were at Retina 3 times” (confirmed by the three visits on 18.08, 25.08, 03.09.2026). Varenzin stopped; steroid reduced to 3/4 tablet/day.

Ultrasound per the written note: 2.0 cm of free fluid on the left, 1.5 cm on the right. ⚠️ The change in the pleural effusion between 02.09 and 07.09.2026 is ambiguous. The written note of 02.09 gives 0.8 cm on the left and 0.53 cm on the right, and that of 07.09 — 2.0 cm on the left and 1.5 cm on the right. However, during the examination on 07.09 dr Agata Drewniak told the owners verbally that the amount of fluid was at about the same level as before. Therefore the available data do not allow a confident statement that a clinically significant increase in the total volume of pleural effusion occurred over these 5 days. It needs to be clarified with the treating vet whether the differing centimetre values reflect a real change or a different site/technique of ultrasound measurement. Weight 4.77 kg.

IDEXX Haematology of this date (full) — see the laboratory tables, section 8; compared with 02.09.2026 it shows a decrease in RBC/HCT/HGB, a decrease in MCH, an increase in RDW and reticulocytosis, and an increase in WBC/neutrophils/monocytes.

10.09.2026, 15:14Retina, dr n. wet. Paweł Stefanowicz: 4th ophthalmology visit#

History: Prednicortone dose reduced to 3/4 tablet/day. In the owner’s assessment — slight improvement, discomfort less noticeable. Pregabalin is being given. ⚠️ All previous documents mention gabapentin, and the LoVet note of 11.09.2026 again mentions gabapentin — which of the two drugs is actually used cannot be resolved from the documents.

Examination (the right and left eye are described identically in the document): scant mucoid discharge at the canthus, along the lid margins and on the corneal surface. Conjunctival and corneal hydration impaired (low tear meniscus, short NIBUT). Conjunctiva normal. Corneal epithelial defect over ~70% of the surface, geographic in shape — on both sides. Lens — age-related changes (nuclear sclerosis). Fundus normal (examined without mydriasis). Neuro-ophthalmic responses preserved on both sides: at rest the pupil constricted appropriately for the light, menace — present, dazzle — present, PLR — present (direct and consensual).

Conclusion: extensive superficial corneal injuries — epithelial defects. Worse despite intensive treatment — larger areas of epithelial defect. The signs point to impaired corneal hydration — ZSO — as the cause. Possible causes of the impaired hydration: the cat’s general condition, age, medications (including corticosteroids, chemotherapy), and potential FHV1 carriage (typical for the breed) in the context of reduced immunity.

Bandage (therapeutic) contact lenses fitted today — the list of procedures includes “SZKŁO KONTAKTOWE 2” (i.e. both eyes), ophthalmology visit, disposables, Acatavir.

Prescribed — strictly in the stated order and keeping the intervals (as at all previous visits since 18.08): Acatavir 4× daily → 2 min break → Tobrex 4× daily → 2 min → Vital Drop 3× daily → 5 min → Corneregel twice daily → 2 min → Optixcare at least 4–6× daily → 10 min break before the serum → allogeneic serum 4× daily (store in the fridge). Recheck within 14 days or immediately if there are worrying signs. Age in the document: 12 years 8 months.

⚠️ Numerical discrepancy: on 03.09.2026 the defect was estimated as OD ~70% / OS ~80%, and on 10.09.2026 — ~70% on both sides, although the same document concludes there was deterioration. These estimates cannot be compared as exact measurements of area.

Acatavir is a topical ophthalmic antiviral; prescribed for the first time and consistent with the earlier suggestion of a possible role of FHV1. ⚠️ Its composition should be checked on the package — it is not stated in the medical record itself.

11.09.2026, 12:30LoVet, lek. wet. Oliwia Szaflik: unscheduled visit, day 5 after doxorubicin V#

Services: USG FAST, visit. Dispensed/bought: Bupredine Multidose 0.3 mg/ml 10 ml (0.3 pack), Cerenia 10 mg/ml 20 ml, Gastrovom cane e gatto 30 sachets (5 packs).

History (per the owner): the cat is not fasted. Respiratory rate 27–38/min. Doxorubicin was on Monday, fluid “as usual”. About the pleural effusion it is written: “first 1 cm, then 0.8 cm, now 2 cm, but information from dr Drewniak that unchanged” — ⚠️ a written record of the same discrepancy described for 02.09/07.09.2026. Usually gabapentin half a capsule once daily is given, but not today. Zofran (ondansetron) given today because the cat was licking her lips (a sign of nausea). Eye discomfort — receiving drops and the lens. Eating, but less: 5 small portions (e.g. 10 kibbles), low activity. Urination and defecation normal. 5 days after doxorubicin. Weight today 4.86 kg. Breathed faster on Varenzin.

Examination: mucous membranes pink, moist. Moderate dental calculus. Heart sounds regular, lung sounds audible. Temperature 38.8 °C.

Ultrasound: the amount of fluid on both sides of the chest is the same as at the last examination. Suspected malaise after doxorubicin.

Recommendations: return prednisolone to 1 whole tablet; buprenorphine (Bupredine, opioid analgesic) — 1 syringe on the gum or cheek mucosa twice daily; Gastrovom 1 sachet a day. If there is no improvement — a fasted visit for abdominal ultrasound and blood tests +/- drainage of fluid from the chest.

⚠️ The “Waga” field of the document gives 4.77 kg, whereas the history in the same document gives 4.86 kg “today” per the owner.

14.09.2026, 15:30LoVet, lek. wet. Aldona Gromny: oncology recheck#

Services: fructosamine (Vetlab), LoVet pre-anaesthetic blood profile, blood sampling, oxygen therapy, USG FAST, oncology recheck. Dispensed/bought: Peritol 4 mg (10 packs of 20 tablets), Gastrovom (20 packs), Cerenia 60 mg tablets, Cerenia 10 mg/ml, Bunondol 0.3 mg/1 ml 5 ampoules, Prednicortone 5 mg (10 packs of 30 tablets).

History (per the owner): better on Friday, worse on Saturday — inactive. On Sunday, after Yellox — better. No opioids were given. Respiratory rate: at night 28–29, maximum 34–35/min on Sunday; similar values on Saturday and Friday. Furosemide 10 mg, 1/4 tablet given — furosemide as needed, prednisolone at night. “The cardiology examination was fine.” Appetite low. Nausea and discomfort. Stools regular; mirtazapine was used in the past to stimulate appetite — there was a problem with constipation. Last stool yesterday during the day. Last chest tap — in July.

Examination: temperature 38.5 °C, weight 4.78 kg. On auscultation heart sounds regular, breathing rapid, no dyspnoea, the patient is stable.

TFAST: moderate amount of free fluid on both sides; proliferative changes within the thoracic wall visible.

AFAST: both kidneys abnormal — irregular outline. Pancreas hypoechoic, mild signs of gastritis. No free fluid in the abdomen.

Blood tests: CBC without significant abnormalities, biochemistry without significant abnormalities (full numbers — section 8).

A chest tap was not done because the patient was stable.

Further plan: Gastrovom and Prednicortone — unchanged; Bunondol — analgesia every 12 hours (“for the eyes!”); Peritol 1/4 tablet twice daily — appetite stimulant; antiemetic — Cerenia 60 mg, 1/8 tablet/day. If stable — recheck in a week. If worse — contact the clinic.

⚠️ The examination notes give the weight as 4.78 kg, the “Waga” field of the same document — 4.87 kg.

Fructosamine (Vetlab, Katowice; form CBD8215): 277.0 µmol/l with a reference range of 160.0–335.0 — within normal limits. Sample taken 14.09.2026, test performed 15.09.2026, referring vet — lek. wet. Aldona Gromny, result approved by mgr Paweł Jaromin.

This is a clinically significant negative result. Fructosamine reflects the average glucose level over the preceding 1–3 weeks and does not depend on stress at the time of sampling. A normal value against four consecutive raised spot glucose measurements (6.85 → 16.47 → 6.93 → 8.55 mmol/l) means that Varia has no persistent hyperglycaemia, and the glucose rises are stress-related. Diabetes mellitus as an explanation of these findings is excluded.

⚠️ “The cardiology examination was fine” — per the owner; there is no separate document of a cardiology consultation after 26.08.2026. This repeats the same discrepancy as in the ophthalmologist’s note of 03.09.2026.

21.09.2026, 14:32Retina, lek. wet. Veronika Chybowska: 5th ophthalmology visit#

History: the owners noticed the eyes got worse after a new batch of serum. In the first week after the lenses were fitted — improvement. Bunondol and No-spa injections are being given. Age in the document — 12 years 9 months.

Examination: the lens in the right eye in place, the left one has fallen out. Both eyes: scant mucoid discharge at the canthus, along the lid margins and on the corneal surface; hydration impaired (low meniscus, short NIBUT); on the right, in addition, thick, greenish discharge — sampled for testing. Conjunctiva hyperaemic (10.09 — normal). Cornea: epithelial defect ~70% of the surface, geographic; deep perilimbal vascularisation of 2–3 mm; an arc-shaped leucocyte infiltrate visible temporally, directly at the vascularised zone. Lens — age-related nuclear sclerosis, fundus normal; neuro-ophthalmic responses preserved.

Conclusion: extensive superficial corneal injuries — epithelial defects. Worse despite intensive treatment — larger areas of epithelial defect, leucocyte infiltrate, precipitates on the corneal endothelium on both sides. Cause — ZSO; possible causes the same. A new bandage contact lens was fitted in the left eye today.

Procedures: bacterial culture (aerobic), Vet Lab; contact lens; disposables. Vigamox 0.5% (5 mg/ml) dispensed — moxifloxacin eye drops (a fluoroquinolone antibiotic).

Prescribed — in the stated order: Acatavir 4× daily → 2 min → Tobrex 4× daily → 2 min → Vigamox 4× daily (new) → 2 min → Vital Drop 3× daily → 5 min → Corneregel twice daily → 2 min → Optixcare at least 4–6× daily → 10 min → serum 4× daily. Recheck on Thursday (24.09.2026) or earlier if there are worrying signs.

⚠️ The serum is kept in the regimen 4× daily, although the history in the same document records deterioration after a new batch of serum; there is no separate comment from the vet. The culture result had not been received at the time of this update.

⚠️ The owner’s observation “improvement in the first week after the lenses” (i.e. about 10–17.09) matches the home note of 16.09.2026. There was no examination that week, so it cannot be objectively confirmed or refuted; by 21.09 the objective picture is deterioration.

21.09.2026, 16:00LoVet, lek. wet. Aldona Gromny: oncology recheck#

Services: USG FAST, oncology recheck, injection. Dispensed/bought: Famogast/Ranigast 20 mg (3 packs of 20 tablets), No-spa inj. 0.04 g/2 ml (1 pack of 5 ampoules), Cerenia 10 mg/ml (2.5 units).

History (per the owner, a mixed Polish-English note): still suffering with the eye. Breathing — unchanged. Serum is given in the eyes; the owners noticed that after the serum is instilled the eyes get worse and the pain increases. Bunondol works for about 1 hour. There was nausea; on Sunday (20.09) she received maropitant; stomach problems, poor appetite. A No-spa injection was given today at 10:00. Sleeping poorly.

Examination: weight 4.75 kg, temperature 38.5 °C. fPL — planned for the next visit (a pancreatitis test not previously performed).

TFAST: fluid 1.15 cm on the left, 0.89 cm on the right — measured at heart level. This is the first record that states the measurement site.

AFAST: pancreas — left lobe homogeneous, not enlarged, no focal changes; right lobe slightly hypoechoic. Signs of gastritis (“cechy zapalenia żołądka”): a distinct muscular layer of the stomach wall, gas, hyperechoic surrounding fat. New finding: a 0.46 cm subcutaneous mass in the abdominal region — recurrence should be considered in the differential diagnosis (“w diagnostyce różnicowej do uwzględnienia wznowa”).

Treatment of gastritis (“leczenie zapalenia żołądka”): No-spa (drotaverine) 1–2× daily SC; Cerenia once daily SC; Ranigast (famotidine) 20 mg 1/4 tablet twice daily. Chemotherapy in a week (i.e. ~28.09.2026); contact the clinic if there are worrying signs. Prednisolone reduced again to 3/4 tablet/day (“REDUCTION OF PREDNICORTONE: 3/4 PILL PER DAY”).

⚠️ The “Waga” field of the document — 4.87 kg, versus 4.75 kg in the examination notes (see sect. 2, weight over time).

23.09.2026, 18:07Retina, lek. wet. Veronika Chybowska: 6th ophthalmology visit#

History: “Deterioration”. Age in the document — 12 years 9 months; name written as “Waria”.

Examination: the contact lens in the right eye in place, the left one has fallen out. ⚠️ Exactly the same phrase appears in the note of 21.09.2026, after which a new lens was fitted in the left eye; so either the new lens fell out again within two days, or the phrase was carried over from the previous note. Both eyes are described identically:

• conjunctival and corneal hydration impaired (low meniscus, short NIBUT); thick, greenish discharge;
• conjunctiva hyperaemic (as on 21.09; on 10.09.2026 — “normal”);
• cornea: epithelial defect ~70% of the surface, geographic; deep perilimbal vascularisation of 4 mm (21.09 — 2–3 mm); keratomalacia;
• lens — age-related nuclear sclerosis; fundus normal (without mydriasis);
• neuro-ophthalmic responses preserved: pupil appropriate to the light, menace, dazzle and PLR (direct and consensual) — present.

Conclusion: extensive superficial corneal injuries — epithelial defects. Worse despite intensive treatment: larger areas of epithelial defect, precipitates on the corneal endothelium on both sides, keratomalacia on both sides. The signs indicate impaired corneal hydration (ZSO); possible causes — general condition, age, drugs (including corticosteroids, chemotherapy), potential FHV1 carriage with reduced immunity.

Proposed approach:

• Urgent surgery recommended: corneal cross-linking + ACell Vet + tarsorrhaphy (temporary suturing of the eyelids), possible the same or the next day. Per the owner (LoVet note of the same evening) — the eyelids are sutured for 14 days.
• Chance of success — about 60%, limited by the steroid therapy and impaired hydration.
• Verbally, per the owner: the surgery can help and does help in most cases; if not for the chemotherapy, the confidence would be about 95%. ⚠️ The written conclusion attributes the reduced chance to the steroid therapy and impaired hydration, not to chemotherapy; the verbal account — to chemotherapy. Which factor the vet considers the main one is worth clarifying: it determines whether anything can be changed before surgery.
• Without surgery the prognosis for the eyes is from very guarded to poor; enucleation may become necessary (which would require a longer anaesthetic).
• If no decision on surgery is made that day — UV-C therapy is offered.
• That evening the owner has an appointment with the primary vet (in the document — at 20:00); the decision on surgery is to be sent to diagnostyka.retina@gmail.com.

Prescribed — in the stated order, unchanged from 21.09: Acatavir 4× daily → 2 min → Tobrex 4× daily → 2 min → Vigamox 4× daily → 2 min → Vital Drop 3× daily → 5 min → Corneregel twice daily → 2 min → Optixcare at least 4–6× daily → 10 min → serum 4× daily (store in the fridge). Procedures: ophthalmology follow-up visit.

⚠️ The defect area is again recorded as ~70% on both sides — the same figure as on 10.09.2026, with the verbal conclusion “larger areas”. The progression is seen in other findings. Conjunctival hyperaemia, purulent-looking discharge, endothelial precipitates and deep vascularisation had already appeared on 21.09; within two days the vascularisation advanced from 2–3 to 4 mm, and on 23.09 keratomalacia was described for the first time (softening, “melting” of the corneal stroma — the lesion is no longer confined to the epithelium). It is these findings, not the percentages, that change the prognosis.

⚠️ The “deterioration” history and the objective picture on 23.09 were obtained after ten days of using the drops with the intervals kept (from 13.09.2026) and nine days of continuous buprenorphine (from 14.09.2026). The improvement the owner noted in the first week after the lenses were fitted was not confirmed by examination: the next examination (21.09) already records deterioration.

23.09.2026, 21:15LoVet, lek. wet. Oliwia Szaflik: urgent visit after the ophthalmologist#

Services: follow-up visit. Two printouts of the same visit were received, with the same text but different product lists: one — Bunondol 0.3 mg/ml (0.4 pack), Mirataz 20 mg/g, 3 g (1 pack), Cerenia 10 mg/ml (0.4 pack); the other — Cerenia 10 mg/ml 20 ml (1 pack). Probably the drugs given at the clinic and a separately dispensed vial.

History (per the owner): an urgent 15-minute visit. For a week she has been eating about 1 teaspoon of food a day, does not want to eat, does not want to drink. ⚠️ Later the owner clarified that the cat does not drink on her own because water is given to her by syringe; and that the “1 teaspoon” figure was deliberately exaggerated because, in his view, the clinics were not reacting to the deterioration; at the same time, in his observation, the cat is genuinely unwell (see the owner’s observation of 23.09 below). The eyes are very painful; today there was a visit to Retina, “the only chance is surgery with the eyelids sutured for 14 days”. Nausea, retching; Zofran given today — not working; Cerenia did not work either, nor did No-spa.

Examination: enormous discomfort visible. Mucous membranes pink, moist. Breathing rapid; on ultrasound from the heart side fluid ~2.6 cm on the right, 1.6 cm on the left. Temperature 38.5 °C. Weight 4.6 kg.

Abdominal ultrasound: reactive lymph nodes; stomach empty; increased echogenicity of the fat around the stomach; pancreatic region normal; no free fluid in the abdomen. “Latest blood tests without abnormalities.” Cerenia, Bunondol transmucosally and Mirataz given.

The vet’s conclusion (in English in the document):

Varia’s condition is not good. She is not responding to the treatment of gastritis. Higher doses of opioids may worsen her breathing. Reducing the steroid may have led to more fluid accumulating in the chest, but the steroid is also bad for the stomach. If the owners want the eye surgery, the only way is to try increasing the opioid doses and place Varia in a 24-hour veterinary hospital, where she can receive analgesia and antiemetics intravenously, where excess fluid will be removed from her chest [in the original — “from her lungs”] and where she will probably be fed through a nasal tube. The risk of the eye surgery is high, and her general condition may remain poor afterwards. […]

Home treatment: sucralfate 1 ml twice daily 30 minutes before food; Helicid (omeprazole) 20 mg — 1/4 capsule twice daily with food; Bunondol 0.05 ml transmucosally, to effect (maximum 0.15 ml) every 8 hours.

⚠️ Ranigast (famotidine), prescribed on 21.09.2026, is not mentioned in the prescriptions of 23.09, and Helicid (omeprazole) appears for the first time. Whether omeprazole replaces famotidine or is added to it is not stated in the document.

⚠️ Mirataz is a transdermal mirtazapine ointment (an appetite stimulant applied to the skin of the ear). Per the history of 14.09.2026, mirtazapine had already been used to stimulate appetite and caused constipation, which is why Peritol was chosen at the time. This is not discussed in the document of 23.09; what happened to Peritol is not stated.

⚠️ Pleural effusion: 21.09 — 1.15 cm left / 0.89 cm right “at heart level”, 23.09 — 1.6 cm left / ~2.6 cm right “from the heart side”, breathing rapid. The measurements were taken by different vets. ⚠️ Per the owner, the vets measure differently, hence the spread of figures, and verbally they say the fluid level stays at about the same level. Therefore the difference 21.09 → 23.09 cannot be read as an increase. The vet links possible fluid accumulation with the reduction of the steroid (on 21.09 the dose was reduced to 3/4 tablet).

⚠️ The “Waga” field of the document — 4.87 kg, versus 4.6 kg in the examination notes (see sect. 2).

23.09.2026, eveningowner’s observation (no medical document)#

• Clarification of the LoVet history: the phrase “eats one teaspoon a day” was deliberately exaggerated — the owner said it because, in his view, the clinics were not reacting to the deterioration. The actual amount eaten over the week was not measured. At the same time the owner sees that the cat is genuinely unwell; this is objectively confirmed by the weight loss 4.78 → 4.6 kg in 9 days.
• Water: the cat does not drink on her own — water is given by syringe. The owner suspects that the refusal to drink on her own is related to the eye pain. The volume drunk from the syringe was not recorded. ⚠️ Other possible causes that cannot be separated by home observation: nausea and gastritis (nauseous cats often refuse water too), general weakness, and that with syringe watering thirst may simply not arise. To assess hydration, the vet most needs to know how many millilitres a day the cat receives.
• After Mirataz was applied to the ear (at the LoVet clinic at 21:15) the cat ate and urinated, then lay down.
• Respiratory rate — 35–36/min (state — asleep or awake — not specified). Per the owner, all week (about 17–24.09) breathing has stayed at 34–40/min. There are no separate timed records marked “asleep” for this period.
• Per the ophthalmologist at the 23.09 visit: the surgery can help, “mostly helps everyone”; ~60% in writing, verbally — that without chemotherapy the confidence would be ~95%.

These are not objective clinical data. The first response to Mirataz is a valuable guide: whether the appetite persists over the next day is worth recording (what and how much she ate, and when).

24.09.2026owner’s observation (no medical document)#

• Respiratory rate 32/min — at rest, the cat is falling asleep (not deep sleep). This is the lowest value the owner gave for the week (34–40). No measurement was taken in deep sleep.
• Sucralfate given — as prescribed by LoVet on 23.09.2026 (1 ml twice daily 30 minutes before food). The exact time was not recorded.

⚠️ Sucralfate coats the gastric mucosa and may reduce absorption of other oral drugs; they are usually spaced about 2 hours apart. Per the 23.09 prescriptions Helicid (omeprazole) is given with food, i.e. ~30 minutes after sucralfate, and prednisolone is also given orally. The order and intervals between them are not specified in the documents — see sect. 15.

25.09.2026 (Friday)Retina, dr n. wet. Paweł Stefanowicz: surgery on the corneas of both eyes#

Visit record, 2 pages, time 13:53; handwritten in the margin — weight 4.55 kg. Age in the document — 12 years 9 months; name — “Waria”. The description and recommendations are in Polish and duplicated in English.

Description: chronic inflammation and ulceration of the corneas of both eyes; early signs of malacia (keratomalacia); leucocyte infiltration of the stroma. The cat is receiving oncological treatment (chemotherapy, steroids), is being assist-fed; chest taps are done periodically because of accumulating fluid.

Performed:

• corneal cross-linking (CXL) — both eyes (in the list of procedures: CXL ×2, riboflavin Ricrolin, ophthalmic sutures 9-0–5-0 ×2, surgical assistance, medical oxygen);
• the corneas were covered with the prosthetic material VetFTShield72 (Soft Shield / Vet Shield Collagen 72), impregnated with an antibiotic;
• both eyes temporarily closed with third eyelid flaps.

⚠️ The plan proposed on 23.09 (cross-linking + ACell Vet + tarsorrhaphy) was carried out in a modified form: instead of ACell Vet — a VetShield collagen shield, instead of suturing the eyelids — third eyelid flaps. The reason for the change is not stated in the document.

Comment / prognosis: the risk of systemic complications of general anaesthesia and the prognosis for the eyes were discussed; because of concurrent diseases, general condition and current medications the prognosis is guarded. The surgery does not guarantee a cure but gives a chance to stop the destruction of the corneal stroma and improves the conditions for healing. Despite the surgery, complications are possible because of the usually severe course of keratomalacia (an immunological process destroying corneal tissue).

Recommendations:

• protective collar; protect the eyes from rubbing and injury;
• clean away discharge gently with a damp cotton bud;
• if there are worrying signs (dyspnoea, worsening general condition, refusal of food) — consult the primary vet; with severe dyspnoea — straight to a 24-hour clinic with hospitalisation available;
• recheck with the primary vet as planned, continue general treatment; at the primary vet’s recheck — gently palpate the eyes through the closed lids (shape, size) and check that the sutures are intact; if the sutures loosen or break — to the ophthalmologist without delay;
• scheduled ophthalmology recheck and suture removal — in 14–21 days (≈ 09.10–16.10.2026).

Prescriptions — both eyes, in this order, at least 2 minutes apart: EMS (Eye Support) — 1 drop every 2 days; Acatavir 4× daily; Tobrex 4× daily; Vigamox 4× daily; Vital Drop 4× daily; Dexoftyal (“dexoftal”) 4× daily. Last, no sooner than 15 minutes later: serum with Optixcare 4× daily (store in the fridge).

Drugs recorded on the visit record (used/dispensed): EMS (Eye Support) 2 pcs, Linco-Spectin 1 ml (lincomycin + spectinomycin, injectable antibiotic), Rheumocam 1 mg chewable tablets — 11 pcs (meloxicam), Soft Shield/VetShield Collagen 72 shield — 2 pcs, Dexoftyal 1 pack, serum with Optixcare 1 pc.

⚠️ Compared with the 23.09 regimen, Corneregel and Optixcare as a separate drug have disappeared from the prescriptions, Vital Drop is 4× daily instead of 3×, EMS and Dexoftyal have been added, and the serum is now mixed with Optixcare.

Rheumocam is on the record’s drug list but, per the owners, is not being given.

25.09.2026, 15:40Retina, lek. wet. Maciej Rudnicki: anaesthesia record#

Anaesthetist’s record, 2 pages (the list of procedures includes “anaesthetist out of hours”), plus the monitor printout.

History: anaesthesia for emergency surgery. A cat with advanced cancer (lung involvement), with fluid accumulating in the pleural cavities and requiring taps (“wczoraj również” — “yesterday as well”), with gastritis / pancreatitis. On admission — noticeably deepened breathing.

⚠️ The words “yesterday as well” point to a chest tap on 24.09.2026. There is no document for it, and it is not mentioned in the owner’s observation for 24.09 — it needs to be clarified with the owners whether there was a tap on 24.09 and where (sect. 15).

Protocol: premedication Comfortan (methadone) / dexmedetomidine IM, good sedation after about 10 minutes; pre-oxygenation 15 minutes; induction with propofol IV; intubation with a size 3.0 tube; maintenance — isoflurane by inhalation; Ringer’s infusion 3 ml/kg/h.

Values during surgery (every 10 minutes): temperature 38.5–37.9 °C; HR 120–130/min; RR 20–28/min; SpO₂ 96–98%; EtCO₂ 30–29 mmHg; BP 120/90–120/80 mmHg. Monitor printout (13:29): HR 124, SpO₂ 98%, NIBP 120/88 (mean 100), RR 27, CO₂ 32, isoflurane 0.5/0.8%.

Anaesthesia went without complications. After surgery — Cerenia.

Given: Ringer’s 1 pack; Cerenia 0.45 ml; Insistor (methadone) 10 mg/ml 0.1 ml; Dexdomitor 0.5 mg/ml 0.1 ml; Plofed 1% (propofol) 0.5 ml; lidocaine 2% 1 ampoule.

The protocol matches the undated handwritten note (sect. 4, “probably 23.09.2026”): dexmedetomidine, methadone, propofol, isoflurane. Ketamine, listed in the note as possible, was not used.

26.09.2026 (Saturday), 14:26university veterinary clinic, lek. wet. Katarzyna Czuba: urgent visit, bilateral thoracocentesis#

Visit record, pages 1–3 of 4 received. The letterhead is cut off in the photo; the form shows tel. 12 662 49 73, e-mail kontakt.upw@urk.edu.pl (by the domain — the university clinic of Uniwersytet Rolniczy w Krakowie; ⚠️ the exact name cannot be read from the photo). The text is duplicated in English. Age in the document — 12 years 1 month (consistent with the date of birth 25.08.2014). Weight 4.5 kg.

History (per the owners): yesterday — corneal cross-linking; after surgery everything was fine, she felt normal; today she started breathing worse. Today she does not want to eat, received Cerenia, urinated, moved little. An oncology patient receiving doxorubicin; chronic corneal ulceration, possibly secondary to chemotherapy. Advanced cancer with lung involvement, because of which fluid accumulates in the pleural cavities. […] Cardiology 26.08 — a “non-cardiac” patient; [fluid] in the lungs — secondary to the cancer. Today she received eye drops as prescribed by Retina.

Examination:

• mucous membranes pale-cyanotic, dry; capillary refill time prolonged;
• palpable lymph nodes not enlarged;
• tachypnoea, rapid breathing with abdominal effort; RR 43/min;
• trachea without palpable changes, reactive;
• pulse normal, of good quality, matching the heartbeat; HR 142/min; heart sounds clearly audible on both sides;
• crackles over all lung fields;
• abdomen — no worrying changes on palpation; abdomen slightly painful on palpation.

TFAST: anechoic fluid around the heart on both sides — 2.2 cm on the left and 2 cm on the right in depth; no fluid in the pericardium, chamber proportions preserved. A ~1 × 1.5 cm mass in the thorax is visible.

AFAST: no free fluid in the abdomen.

Treatment:

• IV catheter placed; butorphanol 0.1 mg/kg IV;
• bilateral therapeutic thoracocentesis — about 128 ml of dark haemorrhagic, non-clotting, thin fluid removed;
• after drainage breathing improved — became deeper and slower;
• oxygen therapy after drainage;
• Cerenia SC; subcutaneous fluids (multi-electrolyte solution Optilyte) at the owners’ request; Mirataz on the ear; Ventolin (salbutamol) — 2 puffs.

The list of procedures includes “Torakocenteza 0.5” twice, a basic visit, Mirataz 0.4 mg, fluids; drugs — Bupaq Multidose 10 ml (0.3 ml), Optilyte 250 ml (1 pack).

Recommendations:

• Bupaq (buprenorphine), diluted, at a low analgesic dose — tomorrow (27.09) twice daily on the oral mucosa and on Monday morning (28.09);
• a spare dose of Mirataz — tomorrow at about 16:00 on the inner surface of the ear (with gloves), if there is no appetite;
• count breaths at home: if the rate rises to 40/min or more — urgently to a 24-hour clinic;
• collar — protect the operated eyes from scratching;
• eye drugs — per the Retina regimen;
• on Monday (28.09) — a visit to the primary clinic; all the owners’ proposals and doubts about further chemotherapy and treatment are to be agreed with the lead oncologist, lek. wet. Aldona Gromny; until then — monitoring of the general condition and assessment of quality of life.

⚠️ This is the first documented chest tap since 06.07.2026 (not counting the tap “yesterday”, 24.09, for which there is no document). 128 ml is the largest known volume (06.07 — 60 ml, ~14.06 — 28 ml).

⚠️ “~1 × 1.5 cm mass in the thorax” — the document does not make clear whether this is the same mass found by the cardiologist on 26.08.2026 (~0.9 × 0.7 cm at the heart apex / in the mediastinum) or a different one. If it is the same — it has grown; this can only be compared using the images.

⚠️ Page 4 of 4 not received.

27.09.2026 (Sunday)per the owners, from the LoVet note of 28.09#

After Saturday’s tap she was better. Breathing worsened overnight; on the morning of 28.09 — no appetite. Furosemide given on 27.09.

28.09.2026 (Monday), 10:15LoVet, lek. wet. Aldona Gromny: urgent visit, decision to switch to Palladia#

Visit summary (“Podsumowanie wizyty”), 2 pages, description in English. Services: urgent visit, oxygen therapy, catheter placement, blood sampling, LoVet pre-anaesthetic blood profile, chest tap, subcutaneous fluids. Products: Torphadine (butorphanol) 10 mg/ml — 0.05 pack; Sucralfat Genericon 1 g/5 ml, 250 ml — 20 units; Clamoxyl L.A. (long-acting amoxicillin) — 0.5 unit; Optilyte 250 ml — 1; furosemide injection 10 mg/2 ml — 1 ampoule; Prednicortone 5 mg — 10 tablets; Palladia 15 mg — 2 tablets.

History: urgent; on Saturday a visit with thoracocentesis, 128 ml of fluid removed; better after that. Breathing worse overnight, no appetite in the morning. Furosemide given yesterday.

Examination and treatment:

• oxygen; IV catheter, butorphanol IV;
• thoracocentesis — 50 ml of fluid on the right; the left side was not tapped because the patient was restless;
• the owners were told of a poor prognosis and a high risk of disease progression on doxorubicin. The owner wants to try Palladia;
• blood tests: leucocytosis with neutrophilia, slightly raised urea (BUN); no contraindication to Palladia;
• Palladia regimen: 10 mg on Monday and Wednesday; if there are no side effects — 15 mg on Friday and Monday. Recheck visit next week;
• today SC: multi-electrolyte solution 100 ml + Clamoxyl (antibiotic) + furosemide 1 mg/kg; in the evening — furosemide as a tablet, as recommended by dr Drewniak.

Other treatment: analgesia — as recommended; stomach — unchanged; eyes — as recommended; Prednicortone 5 mg — 3/4 tablet alternating with 1 tablet, once daily; antibiotic — repeat at the clinic on Wednesday (30.09). Keep counting breaths at rest.

⚠️ The “Waga” field — again 4.87 kg (Retina 25.09 — 4.55 kg, clinic 26.09 — 4.5 kg; see sect. 2).

⚠️ The haematology form (“leucocytosis with neutrophilia”) was not received — no numbers. Only Palladia 15 mg tablets were bought; where the 10 mg dose for Mon/Wed comes from is not stated in the document.

⚠️ The sixth doxorubicin dose, planned on 21.09 for ~28.09, was not given; according to the vet’s note the doxorubicin course was in effect replaced with Palladia at the owner’s request after the conversation about prognosis. Palladia had earlier been stopped after the severe neutropenia of 08.06.2026, when it was given together with carboplatin (sect. 7).

LoVet biochemistry, 28.09.2026, 11:23 (serum, in-house lab):

Compared with 14.09.2026: creatinine 126 → 152 µmol/l and urea 6.85 → 12.0 mmol/l — both rose; urea is above the reference range, creatinine within it (1–168). Against almost a week of poor drinking, furosemide and two taps, this is consistent with dehydration, but the cause cannot be established from a single test; repeat after rehydration. Potassium is not above the reference range for the first time since July. Glucose 8.79 — as before, stress-related (fructosamine on 14.09 normal).

05.10.2026 (Monday), 19:00LoVet, dr Agata Drewniak: oncology recheck — ultrasound worse, liver lesion#

Visit summary (“Podsumowanie wizyty”), 2 pages. Handwritten at the top: “wizyta 12/10 20:30 dr Drewniak” — next visit on 12.10.2026 at 20:30. Weight 4.19 kg, temperature 39.0 °C (form fields).

Services: follow-up ultrasound, oncology recheck, consumables. Products: Furosoral 10 mg — 10 tablets; Convenia (cefovecin, a long-acting antibiotic) injection — 0.45 ml, listed twice; Cerenia 10 mg/ml — 3.2 ml; Zofran 4 mg — 1 tablet; Palladia 10 mg — 4 tablets; sucralfate — 15 ml.

History (in addition to the entry above): today (05.10) furosemide in the morning (10:00–10:30) — “again didn’t work”; at 17:00 — once more; has not urinated. Eating — a little, but interested in food. Nausea — Cerenia (injection daily) and Zofran twice daily; sucralfate at night. “Furosemide helps; now two doses help.” Receiving Purina Hydra Care. Drugs: Cerenia, Zofran, Helicid, sucralfate, furosemide, Mirataz. The owners saw improvement after Palladia.

Examination: temperature 39.0 °C; lymph nodes not enlarged; mucous membranes pale pink; abdomen non-painful; breathing rapid, diaphragmatic.

Ultrasound: “worse picture” — fluid 1.9 cm on the left, 1 cm on the right. Oedematous changes on both sides, collapse of the right lung, changes in the thoracic wall. In the midline — a round hypoechoic mass “up to 0.5 mm” (⚠️ probably a typo — 0.5 cm). Stomach empty, muscular layer of the wall slightly thickened, total wall thickness 2 mm. In the liver — a 0.78 × 0.65 cm heterogeneous lesion — possible metastasis.

Recommendations:

• Palladia 10 mg — every other day (instead of Mon/Wed/Fri);
• steroid — unchanged;
• gastric protection: sucralfate — try 2–3× daily; if that fails — Gastrovom once daily in the morning and sucralfate at night;
• furosemide 3/4 tablet three times daily (Furosoral 10 mg — i.e. about 7.5 mg three times daily, ~22.5 mg/day);
• blood recheck with potassium and fructosamine — on Monday in a week (12.10);
• Elura (capromorelin) — to be ordered to improve appetite;
• Convenia SC — for 2 weeks;
• Zofran 1/2 tablet three times daily; if no improvement — add metoclopramide (MCP).

⚠️ For 04–05.10 the owners describe little urine despite furosemide and plenty of drinking. On 05.10 the furosemide dose was increased to 3/4 tablet three times daily; two days later, on 07.10, — creatinine 250 µmol/l and urea 16.5 mmol/l, after which furosemide was stopped for a day and reduced to 3/4 tablet twice daily.

⚠️ The 0.78 × 0.65 cm liver lesion — measured for the first time. A single focal liver change was described on 24.06.2026 and not followed up since; whether it is the same lesion cannot be established from the documents.

⚠️ The effusion centimetres of 05.10 (1.9 / 1 cm) were measured by a different vet from other visits; they should not be compared as a trend. The vet’s conclusion — “worse picture”.

⚠️ Convenia is listed twice at 0.45 ml — whether one injection or two is unclear from the document; the recommendation is “Convenia SC for 2 weeks”. The repeat Clamoxyl L.A. on 30.09 is not documented.

The purchase of Palladia 10 mg answers the question of where the 10 mg doses came from (on 28.09 only 15 mg tablets were bought). There was no switch to 15 mg; from 05.10 the frequency was reduced to every other day.

06.10.2026no documents#

07.10.2026 (Wednesday), 20:00LoVet, dr Agata Drewniak: urgent visit — breathing worse, jump in renal values, 100 ml tap#

Visit summary (“Podsumowanie wizyty”), 2 pages. Weight 4.19 kg (the “Waga” field — same value as on 05.10; whether she was reweighed on 07.10 is unclear, see sect. 2).

History: breathing worse — urgent visit.

Description:

• biochemistry — jump in renal values;
• 100 ml of haemorrhagic fluid removed from the right side of the chest;
• 100 ml of Optilyte given subcutaneously;
• home — Nefrokrill Gatto (a feed supplement for renal support).

Recommendations:

• tomorrow (08.10) no furosemide; from Friday (09.10) — 3/4 tablet of furosemide twice daily;
• renal recheck on Saturday (10.10); if worse — on Friday;
• Palladia 10 mg — a break today, give from tomorrow (prescribed every other day since 05.10);
• the owners were told of the cat’s poor condition and poor prognosis.

⚠️ The phrase “Kontrola parametrów nerkowych w sb. Przy pogorszeniu w pt” also allows another reading: if worse — change something on Friday. The reading taken here is “if worse — recheck already on Friday”. The strength of the furosemide tablet is not stated in the document.

Services: urgent oncology recheck, chest tap, blood sampling, LoVet pre-anaesthetic blood profile (biochemistry + haematology), subcutaneous fluids 0.5. Products: Moonlight Creme 15 g (treat paste) — 2 pcs; Mirataz 20 mg/g — 0.4; Zofran (ondansetron) 4 mg — 5 tablets; Nefrokrill 60 capsules — 10 pcs; Bonqat (pregabalin) 50 mg/ml — 0.4; Comfortan (methadone) 10 mg/ml — 0.1.

⚠️ Bonqat is veterinary pregabalin for cats (usually given before stressful visits). This is the first direct documentary confirmation of pregabalin; earlier, the Retina note of 10.09 mentioned pregabalin, while LoVet mentioned gabapentin (sect. 9, 15).

LoVet biochemistry, 07.10.2026, 19:52 (serum, in-house lab):

IDEXX ProCyte Dx, 07.10.2026, 19:54 (2 pages; page 2 — RBC and WBC scattergrams and the laboratory comment):

IDEXX laboratory comment: “Zwiększone RDW – obecna anizocytoza – zweryfikować w rozmazie krwi” — raised RDW, anisocytosis; confirmation by blood smear recommended. ⚠️ According to the documents, no smear was done.

⚠️ The IDEXX header says “British Shorthair”, “Female Entire” (technical errors; the cat is longhaired and spayed).

What the tests of 07.10.2026 show:

• Creatinine 152 → 250 µmol/l and urea 12.0 → 16.5 mmol/l in nine days (28.09 → 07.10, the same LoVet laboratory) — creatinine above the LoVet reference range for the first time since April; the highest value in the whole history (the previous maximum — 221 µmol/l by IDEXX on 20.12.2025). On 05.10 the furosemide dose had been increased to 3/4 tablet three times daily. In response the vet paused furosemide for a day, then reduced it to 3/4 tablet twice daily, gave SC fluids and paused Palladia for one day. Three days later at TENVET (10.10, different analyser) — about 159 µmol/l and 11.4 mmol/l (sect. 4, entry of 10.10).
• Neutrophilia 15.08 ×10⁹/l (WBC 17.38) — the leucocytosis with neutrophilia noted verbally on 28.09 persists. Three days later (TENVET) neutrophils 10.43 — within the reference range.
• No neutropenia on Palladia.
• Red-cell values — normal, as on 14.09; low MCH and high RDW persist. Platelets 550 — the thrombocytosis of 14.09 (700) did not recur.
• Amylase 2158 U/l ↑ — above the reference range for the first time (14.09 — 1503, 28.09 — 1509). In cats amylase is of little diagnostic value for pancreatitis; it can also rise when glomerular filtration falls. fPL has still not been done.
• Globulins 39.2 → 47.6 g/l, total protein 69.6 → 81.7 g/l — within range, rising. Glucose 10.33 — as before, apparently stress-related.

10.10.2026 (Saturday), 02:53TENVET 24h, lek. wet. Joanna Serowy: urgent night visit, admission to an oxygen cage#

Klinika Weterynaryjna TENVET (24-hour), ul. Galicyjska 4, 31-586 Kraków. “Karta informacyjna wizyty”, 2 pages. Age in the document — 12 years 4 months (⚠️ with a date of birth of 25.08.2014 it would be 12 years 1 month, see sect. 2). Weight not stated.

History: two weeks on Palladia 10 mg per cat, before that — 5 doses of doxorubicin. Dyspnoea during the day, especially after activity. Fluid in the chest confirmed, last tap — on Wednesday. Furosemide given today at a low dose as prescribed by the primary vet (last time — at 01:00). Creatinine raised on the latest blood tests — to be rechecked in the morning. After the eye surgery — third eyelid flaps on both sides, Tobrex.

Examination:

• conscious, allows examination; normal posture, lying sternally; normal muscle tone; BCS 4/9;
• mucous membranes pink, moist, glossy; CRT < 2 s; external jugular veins not distended;
• HR 150/min; RR 33/min, breathing at times slightly shallow, mouth closed;
• femoral pulses symmetrical, matching the heart sounds;
• on auscultation — muffled breath sounds, suspected fluid in the chest;
• abdomen non-painful on palpation; temperature 38.2 °C; no clinical signs of dehydration.

T-FAST ultrasound: free fluid in the chest — about 1.5 cm on the right, about 1.8 cm on the left. Ventral lung regions — compression atelectasis. Pleura fragmented, irregular.

Discussion with the owners: admission to an oxygen cage, butorphanol and monitoring are indicated — an attempt to stabilise before further procedures (tap, blood tests); stress may worsen her condition. A tap may be needed if RR clearly exceeds 40/min; the owners ask to be contacted before a tap — at this point consent only to conservative treatment. The owners were told that the prognosis is guarded: dyspnoea may worsen despite treatment, and pulmonary thromboembolism, which may cause death, is possible. With the owners’ consent — admission.

Treatment: oxygen cage; butorphanol (Butomidor 10 mg/ml) at a low dose IM — 0.1 ml; Cyclonamine (etamsylate) 12.5% injectable — 1 ampoule, because the tablet could not be given at home.

Recommendations: in the morning — contact the owners; fasted — blood tests (creatinine to compare with the last result) and a follow-up ultrasound to assess the amount of fluid.

10.10.2026 (Saturday), 09:40TENVET 24h, dr n. wet. Diana Stopka: morning examination, tests, 120 ml thoracocentesis, discharge#

“Karta informacyjna wizyty”, 4 pages; description in Polish, duplicated in English.

Morning examination: conscious, responsive; mucous membranes pink, moist, CRT < 2 s; temperature 37.7 °C; heart rhythm regular; HR 160/min; RR 40/min; abdomen soft, non-painful. Appetite — only licked the sauce; no thirst; urinating; no stool.

T-FAST: free fluid on both sides, amount — as at the night examination.

In the vet’s conclusion, renal values are normal, there are signs of dehydration. The infusion was continued at a very low rate — 1 ml/h — because of dehydration in the presence of pleural effusion. Furosemide given at a maintenance dose as prescribed by the primary vet.

Discussion with the owners (by phone): three options were discussed — (1) thoracocentesis at TENVET, discharge and a recheck tomorrow; (2) discharge and an urgent visit to the primary vet today — who will decide whether a tap is needed; (3) discharge without thoracocentesis or further work-up, against medical advice, at the owners’ responsibility. At first the owners decided to take the cat and go to the primary vet; it was explained to them that fluid remains in the pleural cavity and breathing may suddenly worsen despite the currently stable condition. After a second call the owners agreed to thoracocentesis: 120 ml of haemorrhagic pleural fluid removed. After the procedure — clinically stable, no signs of respiratory failure.

Discharged home in stable condition. Recommendations: recheck with the primary vet tomorrow (11.10); monitor breathing and general condition closely; with rapid or laboured breathing, open-mouth breathing, marked weakness, collapse or any deterioration — immediately to an emergency clinic. The owners were told that fluid may reaccumulate.

Services: day hospitalisation 0.5, catheter placement, CBC, blood gases and electrolytes, basic biochemistry panel (10 parameters), thoracocentesis. Drugs: Butomidor (butorphanol) 10 mg/ml — 0.1 ml (dose 0.05).

Biochemistry (Seamaty Lab 3Dx), 10.10.2026:

Blood gases and electrolytes (Seamaty Lab 3Dx):

⚠️ The sample type (arterial or venous) is not stated on the form. pO₂ of 17 mmHg and a saturation of 23.8% are more consistent with venous blood; oxygenation is not assessed from such values.

Haematology (BC-60R):

The analyser flagged lymphopenia. In the photo of the form the values are shifted by one row relative to the row names; the correspondence was restored using the units and reference ranges.

What the tests of 10.10.2026 show:

• Creatinine ≈ 159 µmol/l and urea ≈ 11.4 mmol/l — within the TENVET reference range; on 07.10 at LoVet they were 250 µmol/l and 16.5 mmol/l, on 28.09 — 152 and 12.0. After 07.10 — SC fluids, a day without furosemide, a one-day pause in Palladia. ⚠️ The analysers and reference ranges differ, so the fall 250 → ≈ 159 in three days is a guide, not an exact value; a recheck on the LoVet analyser will show whether the improvement holds.
• Signs of haemoconcentration: RBC and haemoglobin above the reference range, haematocrit near the upper limit — the vet interpreted this as dehydration. On 14.09 the IDEXX haematocrit was 38%; ⚠️ different analysers.
• No neutropenia after about two weeks of Palladia: neutrophils 10.43 ×10⁹/l. The neutrophilia of 07.10 (15.08 ×10⁹/l, IDEXX) had not persisted by 10.10 (WBC 11.77 within range). A high neutrophil proportion and lymphopenia — as on 14.09; expected with the steroid and stress.
• Chloride low, bicarbonate slightly above the reference range — this combination can occur with furosemide; not commented on by the vet.
• Lactate 2.47 mmol/l — slightly above the reference range; not commented on.
• Glucose 11.3 mmol/l (biochemistry) and 9.6 mmol/l (blood gas) — as before, apparently stress-related (fructosamine on 14.09 normal).
• Platelets 372 ×10⁹/l — no thrombocytosis as on 14.09 (700).

⚠️ 120 ml three days after the 07.10 tap (100 ml on the right) — comparable to 128 ml on 26.09. The T-FAST centimetres of 10.10 (1.5 / 1.8 cm) were obtained by a different vet and machine from those of 26.09 (2 / 2.2 cm) — they cannot be compared as a trend.

⚠️ At night the owners agreed only to conservative treatment; the tap was done in the morning after two phone calls — about 7 hours after admission, at RR 40/min.

11.10.2026no documents#

The recheck with the primary vet recommended by TENVET for 11.10 took place, according to the documents, on 12.10.

12.10.2026 (Monday), 20:30LoVet, dr Agata Drewniak: recheck after TENVET, ultrasound, weight 3.90 kg#

Visit summary (“Podsumowanie wizyty”), 2 pages. Weight 3.90 kg (“Waga” field); the examination notes say “has lost weight”.

Services: ultrasound (USG FAST). Products: Mirataz 20 mg/g — 0.5; Cyclonamina 12.5% injectable (25 mg/2 ml) — 2 ampoules; Prednicortone 5 mg — 10 tablets; Furosoral 10 mg — 40 tablets; Palladia 10 mg — 4 tablets; Zofran 4 mg — 10 tablets.

History (per the owners, about the days before and after TENVET):

• on Thursday (08.10) no furosemide was given — breathing normal; on Friday (09.10) everything was also fine, but she urinated little. The owner tried a smaller dose — 1/4 tablet (3/4 tablet twice daily had been prescribed) — she urinated;
• at about 19:00 she started jumping around, breathing sped up; 1/4 tablet was given — breathing did not settle; she felt well, abdominal breathing;
• the steroid, 3/4 tablet, was given — breathing improved;
• at about 01:00 — deterioration, a visit to the emergency clinic (TENVET, 10.10); before leaving she was given 3/4 tablet of furosemide. At the clinic — oxygen, blood tests (“creatinine normal”), 120 ml of fluid removed;
• now — furosemide 3/4 tablet twice daily; up to 30 breaths per minute; feels a little better — looks for the scratching post, jumps;
• drinks twice a day — morning and evening;
• received Palladia today (12.10);
• eats a little — the owner cooks: tuna, liver, chicken;
• Zofran twice daily — better.

Examination: has lost weight; more interested in her surroundings; breathing better.

Follow-up ultrasound: “fluid level 1.6–2” — centimetres (confirmed by the owners). ⚠️ The side is not stated; a different vet and machine from TENVET on 10.10 (1.5 / 1.8 cm) — not to be compared as a trend.

Recommendations: recheck next week; a decision on repeating Convenia at the same time.

⚠️ On 05.10 a blood recheck with potassium and fructosamine was ordered for 12.10; there is no blood test among the 12.10 services. Blood was taken on 16.10, and fructosamine is not mentioned in the 16.10 documents.

⚠️ Cyclonamina was dispensed in injectable form (on 10.10 at TENVET the tablet could not be given); how and by whom it is given at home is not stated in the document. Prednicortone was bought; the steroid regimen did not change in the document.

15.10.2026 (Thursday), 12:07Retina, lek. wet. Veronika Chybowska: recheck and suture removal#

“Karta informacyjna wizyty”; page 1 of 2 received. Age in the document — “12 years 9 months” — ⚠️ an error by Retina, as confirmed by the owners (with a date of birth of 25.08.2014 — 12 years 1 month, see sect. 2).

Reason for the visit: recheck and suture removal.

Examination: no purulent discharge; the sutures are holding well, not covered with exudate. IOP: right eye 13 mmHg, left 14 mmHg. Corneal clarity improved. No squinting, no signs of discomfort. Menace and dazzle responses preserved on both sides.

Recommendations, both eyes:

• Vigamox 4× daily — until the recheck; 3 minutes’ break;
• Vital Drop 3× daily — until the bottle is finished; 15 minutes’ break;
• serum with Optixcare 4× daily (store in the fridge) — until the vial is finished; 3 minutes’ break;
• Optixcare 4× daily — long-term.

Target treatment if the good condition holds: Dexoftyal drops 3× daily; after 3–5 minutes — Optixcare gel 4× daily.

Recheck within 14 days or earlier if there are worrying signs. Procedure — ophthalmology visit, follow-up. Used: Vigamox 0.5% — 1 pack.

Compared with the post-operative regimen (25.09), Acatavir, Tobrex and EMS have been dropped; Dexoftyal is postponed to the “target treatment”.

⚠️ That the sutures were removed follows from the reason for the visit and from the LoVet history of 16.10 (“eye sutures removed yesterday”); the examination notes say “the sutures are holding well” — apparently an assessment before removal. Page 2 not received. Before the visit the cat was given Bonqat at a reduced dose (per the LoVet history of 16.10).

16.10.2026 (Friday), 12:00LoVet, lek. wet. Joanna Żak: weakness, nausea, constipation; blood tests#

Visit summary (“Podsumowanie wizyty”), 2 pages; description in Polish, duplicated in English. Weight 3.90 kg (“Waga” field — same value as 12.10).

Services: follow-up visit, blood sampling, LoVet pre-anaesthetic blood profile (biochemistry + IDEXX haematology). Products: Furosoral 10 mg — 4 tablets; metoclopramide 5 mg/ml — 1 ampoule.

History:

• yesterday (15.10) the eye sutures were removed, she felt well; before the ophthalmology visit she received Bonqat at a reduced dose;
• furosemide twice daily;
• the owner woke before dawn: the cat was not sleeping, swallowing with difficulty, licking her lips, nauseous — Zofran 2 mg given;
• at 8:00 still lying on the carpet; food was offered — she ate and drank, but looked weaker;
• urinated a lot overnight, did not urinate in the litter box in the morning;
• 32–34 breaths per minute, thoracic not abdominal breathing;
• last stool — on Wednesday (14.10); Dicopeg from Monday to Wednesday; stool normal, small, fairly soft and moist.

Examination: temperature 38.2 °C; mucous membranes pink, moist, oral cavity heavily pigmented; lymph nodes not enlarged; on auscultation — no significant changes compared with previous examinations; abdomen soft, a large amount of faeces palpable in the rectum; rectally — hard faeces; a small dry lesion in the middle of the nose, possibly an injury.

The vet’s conclusion on the blood: CBC stable, white cells and neutrophils decreased, platelets about 800, the rest as last time; biochemistry — urea increased, creatinine back to normal, glucose and amylase raised but less than last time, slight rise in cholesterol; proteins and electrolytes unchanged; liver values normal.

Recommendations:

• reduce furosemide to 1/2 tablet twice daily — breathing must be monitored; if it speeds up worryingly — return to the previous dose (3/4 tablet twice daily) and do a follow-up ultrasound;
• skip the Palladia dose because of weakness and nausea: the dose was due today (16.10), the next — on Sunday (18.10); do not give today, give Sunday’s as planned;
• metoclopramide SC 0.25 mg/kg given; Dicopeg and Dulcobis (bisacodyl) recommended.

LoVet biochemistry, 16.10.2026, 12:41 (serum, in-house lab):

IDEXX ProCyte Dx, 16.10.2026, 12:33 (2 pages; page 2 — RBC and WBC scattergrams and the laboratory comment):

IDEXX laboratory comment — the same as on 07.10: “Zwiększone RDW – obecna anizocytoza – zweryfikować w rozmazie krwi” (raised RDW, anisocytosis; confirm with a blood smear). ⚠️ According to the documents, no smear was done. The IDEXX header again says “British Shorthair”, “Female Entire”.

What the tests of 16.10.2026 show:

• Creatinine 250 → 156 µmol/l — within the LoVet reference range, as the vet said; comparable to 152 on 28.09.
• Urea 16.5 → 23.7 mmol/l — the highest on record (reference 5–11.3); the BUN/CRE ratio rose from 16 to 38. Urea rising while creatinine falls can occur with dehydration, a high-protein diet (currently tuna, liver, chicken), steroids and gastrointestinal bleeding; the cause cannot be established from the documents, and the vet does not discuss it.
• Haemoglobin 121 → 98 g/l (lower limit of the reference range), haematocrit 0.394 → 0.331, RBC 10.99 → 9.00 in nine days; reticulocytes rose from 15.4 to 38.7 K/µl. Between the tests — two taps of haemorrhagic fluid (07.10 — 100 ml, 10.10 — 120 ml); on 10.10 at TENVET there were signs of haemoconcentration (different analyser). The vet described the CBC as “stable”.
• Platelets 840 ×10⁹/l ↑ — the highest on record (14.09 — 700, 07.10 — 550), plateletcrit 1.39 ↑.
• Neutrophils 15.08 → 11.86 ×10⁹/l — decreased but still slightly above the reference range; WBC 13.95 — normal. No neutropenia on Palladia.
• Glucose 8.90 ↑ and amylase 2145 ↑ — as before; cholesterol 6.73 — slightly above the reference range for the first time. MCH 10.9 ↓ and RDW 28.9 ↑ — as before.
• Potassium 4.71 and sodium 148 — normal.

16.10.2026 (Friday), 20:23TENVET 24h, lek. wet. Aleksandra Skawińska: oxygen cage and thoracocentesis ~140 ml#

Klinika Weterynaryjna TENVET (24-hour). “Karta informacyjna wizyty”, 1 page; description in Polish, duplicated in English. The owner on the record — Huliaiev Dmytro. Age — “12 years 4 months” (as on 10.10).

History: weak in the morning, ate and drank, lay down; furosemide given; breathing fast — up to 40 per minute. They had been to a clinic where constipation was found and a suppository was given, after which she passed stool. Today at “their own” clinic — drugs for constipation, she passed stool; after that she got worse, breathing sped up. Still weak now; at 18:40 the owner gave Prednicortone, RR 44–46/min, furosemide given. The owners doubt whether the furosemide worked — it was given late. The owner suspects the constipation persists; breathing rapid, thoracic, not abdominal. Yesterday she received Bonqat before the eye sutures were removed, and felt better.

Treatment: about 1 hour in an oxygen cage, then thoracocentesis: about 60 ml of haemorrhagic fluid from the right pleural cavity and about 80 ml from the left. Butomidor (butorphanol) 10 mg/ml — 0.2 ml.

After the procedure discharged home. Recommendations: further work-up and treatment under the oncologist’s supervision. The owners were told that fluid may reaccumulate and dyspnoea may return. Monitor the rate and effort of breathing and the general condition closely; with dyspnoea, rapid or laboured breathing, open-mouth breathing, marked lethargy or sudden deterioration — immediately to a clinic, transporting with minimal stress and exertion.

⚠️ The examination at the clinic (HR, RR, temperature), ultrasound and tests are not recorded.

⚠️ The TENVET history says “they had been to a clinic where constipation was found and a suppository was given” and separately “today at their own clinic — drugs for constipation”. Per the LoVet record of 16.10, metoclopramide was given and Dicopeg and Dulcobis were recommended; no suppository is recorded there. Whether this was one visit or two is unclear from the documents.

⚠️ On the morning of the same day LoVet reduced furosemide to 1/2 tablet twice daily, with the instruction to go back to 3/4 tablet if breathing sped up; in the evening — 44–46/min and a 140 ml tap. Which dose was given in the evening is not stated in the documents.

⚠️ ~140 ml six days after 120 ml (10.10) — the largest volume of all taps. Since 26.09 — five taps in three weeks: 128, 50, 100, 120 and 140 ml.

17–18.10.2026per the owners (no medical document)#

• 17.10 — Palladia given (per the LoVet recommendation of 16.10 the next dose was due on Sunday 18.10). In the owners’ observation, Palladia is the only part of the treatment that works.
• 16.10, after the tap at TENVET — RR 34/min.
• 17.10 — after furosemide and Palladia breathing improved: RR 26 and 28/min, even while the cat was awake. In the owners’ observation, breathing improves only after these two drugs.
• 18.10 — eating, drinking, urinating and defecating (constipation on 16.10).
• Furosemide — back to 3/4 tablet (as of 18.10). This is the previous dose to which LoVet said on 16.10 to return if breathing sped up; on the evening of 16.10 there was a ~140 ml tap.

This is the latest date documented in the uploaded materials at the time of this update (18.10.2026).