Acute Symptoms When Purring - gurgling, distress

Hello there. My cat, Kizzy, is 18 years old, 7 lbs, with a healthy history and active lifestyle (indoor/outdoor). I took her for a routine annual exam in November 2022 and to get her nails trimmed (for the first time ever - they grew long). The annual exam noted increased kidney disease (she had been diagnosed in 2020/2021) and subcutaneous fluids were given at the vet plus a urine sample taken. Two days later after that vet visit, Kizzy began to make a strange sound only when purring; sounded like gurgling/fluid. She would have this gurgling sound,  stick her neck out, lick her mouth, and walk away whenever she purred. Clearly distressed when purring. Also her voice has changed. Then additional symptoms have started: gurgling in her stomach, wheezing sounds in her nose occasionally, belching after eating, vomiting clear fluid. I have been to 3 vets and one internal medicine vet for a consult. An xray of her lungs, sonogram of her stomach, and throat scope have been performed. It is now 4 months later and she has no clear diagnosis outside of kidney disease and possible thyroid issue based on recent blood test. Her bloodwork for kidney function I am told is not healthy enough for her to try steroids which the internal med vet thought to try nor can she be sedated to have a CT scan or endoscopy. The internal med vet thinks there may be something going on with her larynx that is causing her symptoms however that is not clear at this time. From all these tests and $2500 spent over 4 months, her only diagnosis is kidney disease. When I brought her to the vet for the annual exam and resulting appt for subcutaneous fluids and urine sample, she did not have any of the symptoms she now has. The vets are not clear on what is happening and without the ability to do CT or endoscopy, they can't tell if her larynx is the issue. Meanwhile, I can't pet my cat because when she purrs, she goes into distress and walks away. She sleeps alone and avoids as much contact as is normal for her. She is eating well and is not losing weight and she drinks a lot of water. Now they want me to do an additional thyroid panel in her blood work to see if she needs thyroid medication. I am feeling sad and confused about how to help my cat and feeling disappointed there is no clear diagnosis or treatment. I appreciate your thoughts and feedback. Th.ank you

Hello!  It sounds as though your cat has physical symptoms affecting the throat, and your vet is trying hard to fathom the cause.  They have done quite a lot of tests and ruled out various possibilities.  There is already a known kidney condition.   What are your options?  I agree that it may make sense to test the thyroid, as low weight and a fast heart rate are typical signs of thyroid disease and there sounds to be a high suspicion of something not being quite right in the neck, where the thyroid gland sits. Can they feel the thyroid gland?  Another posibility may be of a neurological abnormality to the throat - if your vet thinks so, they might have tested / be testing the cranial nerves.  One possibility in that area may be cancer.   It does sound as though tsting the thyroid might be helpful in order to rule in or out an overactive thyroid.

Here are some questions to ask your vet:  what might this still be? Is there anything that you might find that you feel could be treated at this point?  Would this make a difference to the throat sigms?   What are these possibilities and how would they be diagnosed?   What do you think the long term prognosis is likely to look like?  What would you do if this was your cat?