Kitten drinking a lot, peeing a lot but dehydrated

Hi! I've talked with 4 vets and I'm mostly looking for ideas on what to look for next. I have this kitten who's almost 4 months now but he's max 1 lbs. He drinks a stupid amount of water and he pees a lot but his skin still shows that he's slighlty dehydrated. His urea levels were at 26 when I tested it. He seems to have neurological signs, like losing balance when scratching his ears. He had episodes of seizures 3 weeks ago before I got him where he would fall to the side, get tense, throw his head backward and scream. They would last a few minutes but a cluser of them for hours. I've done two full blood tests, and after discussing it with two of the vet we checked for a liver shunt. The test was negative. Now some vets told me to just wait and see. But honestly that worries me. I'd like to keep testing because I'm affraid he will get issues if I don't. But I don't know what to look for. I was told his kidneys looked fine from the blood tests. His thyroid was okay, his glycemia and electrolyte too. Other than that he is a spunky little kitten. Always playing and purring.

Hello - and what a puzzle.  The signs are drinking a lot and a positive skin tent (sometimes suggesting dehydration) despite blood glucose, kidneys, liver etc looking normal on the bloods.  There have been neurological signs which can be associated with salt imbalance, present or possibly historical, although from what you sat the salt balance is currently under control.  My first step in such cases is usually to test whether the pet can concentrate their urine or not, but this is basic;  it sounds as though your vet feels as though they've done everything they can regarding diagnosis and you and they have resorted to monitor and see how things progress.  You ask what else you can do. Obviously, I am not your vet and not qualified to give you (or you vet) clinical advice but I can explain some general considerations.  In general, cats that are dehydrated have a high red blood cell count (less fluid in the blood, the %age of red blood cells : fluid around them would go up) - however, this particularly value is only credible when measured by hand using a haematocrit tube, rather than by blood machine. There is a disease called 'psycogenic polydipsia' which involves drinking for the sake of it due to possible brain pathology;  however I have never seen a case and think that this label may sometimes be overused when the cause is difficult to identify.  Causes of PUPD that need to be ruled out may include cancer (as far as possible - no-one can stand in front of an animal and tell you that it definitely doesn't have cancer), Addisons Disease and Cushings disease (rare in cats, but I have seen it). Generally, if a vet cannot figure out the next step, it pays to refer upwards to a specialist in the field (in the UK we might say a 'medical specialist'), who can give them more guidance.  There are kidney imalances, for instance, that don't present with the normal pattern.  I wouldn't expect a cat to drink a lot when they are normal , so while yours appears to be healthy on the outside, it may be a good window for specialists to search more thoroughly for underlying disease.

I should have mentioned hyperparathyroidism in my list of general differentials; however again, your vet may well have looked into this.

About speaking to 4 vets, you don't mention whether these four vets were in sequence or working together;  it is a common frustration amongst vets trying to work up a case, that clients get fed up of jsut another test' and go to a different vet, who starts again at the beginning.  if this is happening to you, it may be best to print off all the histories so far (in the UK at least, vets are obliged to provide them) and take them all to your chosen vet for a case review.  They may then suggest the next, most logical test, or refer you to a specialist in the field.

Either way, we look forward to hearing how you get on.

Thank you for the replies. There seems to be a million potential issues with him it's so stressful. He's a tiny runt on top of it so it's from birth.   I ended up with 4 vets opinions because my vet works with another one so they work the case together.   The kitten fell in the toilet one day and stayed there for who knows how long and I went to another emergency hospital because mine was closed. That's where the other two vets' opinions come from .   I was told to test his urine for kidneys issues maybe and an ultrasound of his organs. I suppose kidneys and heart. I don't know why my vets think it's something that might get better on its own  

Thank you for the replies. There seems to be a million potential issues with him... I ended up with 4 vets opinions because my vet works with another one so they work the case together.   The kitten fell in the toilet one day and stayed there for who knows how long and I went to another emergency hospital because mine was closed. That's where the other two vets' opinions come from .   I was told to test his urine for kidneys issues maybe and an ultrasound of his organs. I suppose kidneys and heart  

Oh, good.  I am pleased that the vets are collaborating on this;  it's much the preferable situation to serial opinions.  I wonder if it's still the vets' opinion that it ill get better on its own?  Sometimes asking the person you can talk to the best, questions like:  what possibilities are you concerned about at the moment, given the information available?  (perhaps you could write them as a list) and How can you narrow this down to find the answer? would be a good place to start building a picture of what is going on.   Best of luck and please do keep me updated;  I hope that they find that they can help.