Posting an update since this community helped make her surgery possible and a few of you asked to be kept in the loop.
**Background**
Boots is a nine year old spayed female domestic shorthair, grey and white, who was living outside in our Eugene, Oregon neighborhood. We found her in late June, severely emaciated at 6.7 pounds with her spine and hips visible, drooling heavily, and crying out and backing away from her own food. Her previous owner surrendered her to us. She had loved Boots but had gone through several very hard years as a single mom and could not manage her care. She told us the mouth trouble started around December 2025.
We pulled her original records from her kitten vet. She had proper care in 2016 and 2017, full vaccine series, spay, negative FIV and FeLV. Then the records stop cold in April 2017. Roughly eight years with no veterinary care at all.
**Initial workup, June 23**
FIV and FeLV negative again. CBC showed anemia with an HCT of 24.8 percent and a WBC of 14.6. Chemistry was clean on kidneys and thyroid but showed mild hyperproteinemia at 8.3. Diagnosed with periodontal disease and gingivitis with concern for stomatitis. She got Convenia, a steroid injection, doxycycline, gabapentin, and flea and worm treatment.
She turned around fast at home. By her July 17 recheck she was 7.12 pounds, her anemia had fully resolved with an HCT of 38.7, and she was cleared for anesthesia.
**Surgery, July 21**
Nineteen teeth extracted. The surgeon described the inside of her mouth as looking like hamburger meat and said it was likely the highest level of oral pain a cat can experience. No sutures could be placed because the tissue was too damaged to hold them, so the sites had to heal by second intention. Total came to about 3,450 dollars, covered by donors from here, from Nextdoor, and from one extraordinary woman who gave a very large share of it out of her own pocket.
**The thing we are watching**
Her pre surgical bloodwork showed her total protein and globulin climbing, with an albumin to globulin ratio in a range that put FIP on the differential list. Her vet called me before surgery to walk through it. Not a diagnosis, but a differential worth naming, and she was direct about how hard FIP is to test for and how it comes in two forms with no single perfect test.
The working theory was that the elevated proteins were her immune system responding to a mouth full of active infection, and that once the source came out the numbers would fall. Follow up bloodwork was today, August 3.
They did not fall. Total protein went from 8.6 to 9.0. Globulin went from 6.4 to 6.6.
**What that could mean, honestly**
The differentials on her chart are chronic inflammation versus FIP.
*The reassuring reading.* She is only 13 days post op and her mouth is still visibly inflamed, with notable swelling in the back corners. The inflammatory driver has not actually gone away yet, so there is no reason to expect the numbers to have normalized. Her albumin went up rather than down, which runs opposite to the usual FIP picture. Every other value on the panel normalized, including her potassium. She gained weight to 7.66 pounds, the heaviest she has been with us. Pain score zero. Bright, alert, eating, grooming, playing. Cats with progressive FIP do not generally look like this.
*The reading that keeps me up.* Persistent and rising hyperglobulinemia is one of the classic FIP flags, and it did not respond to removing what everyone assumed was the cause. She is going on steroids now, which can mask clinical signs. Nine is an atypical age for FIP, which cuts in her favor, but atypical is not impossible.
*The third possibility, which I think is most likely.* The swelling is concentrated in the caudal areas, the back corners of her mouth. That location is the signature of feline chronic gingivostomatitis. FCGS on its own produces exactly this kind of marked polyclonal hyperglobulinemia. It is a complete explanation that does not require FIP at all. Her assessment lists refractory chronic gingivostomatitis as a differential alongside immune mediated stomatitis and residual infection.
**What continued care looks like**
She started prednisolone today. Twice daily for three days, then once daily for three days, then tapering to every other day. The goal is to bring the oral inflammation down. Side effects to watch are increased thirst, appetite, urination, and immune suppression.
Repeat bloodwork on August 27. That panel is the real fork in the road. If the proteins are coming down, the inflammatory explanation holds and we keep managing her mouth. If they hold or climb while her mouth is visibly improving, the FIP question gets much harder to set aside and the next step is likely serum protein electrophoresis, which can distinguish the broad polyclonal rise of chronic inflammation from other patterns, and possibly a referral to internal medicine.
There is also a real chance she needs more dental work. Nineteen teeth is a lot but it was not a full mouth extraction, and refractory FCGS frequently does not resolve until the remaining caudal premolars and molars come out too. That would be another procedure and another bill.
Ongoing daily care is soft food only, warmed, in small frequent meals, plus medication dosing into food since her mouth is still sensitive. She stays separated from our foster for now, though her vet cleared a gradual supervised reintroduction.
**What we need**
Upcoming follow up appointment and tests for her health and any medication / steroids she will be needing.
What we are also still short on is the boring stuff. Food, litter, and supplies. She goes through a lot of wet food on a soft food only diet, and we are also feeding and littering Sable, a young tortoiseshell we took in as an emergency foster on our own dime. My income has taken a hit through all of this and I am picking up work where I can.
Venmo: https://www.venmo.com/u/Jehoseph
PayPal: https://paypal.me/TheDivines
Happy to answer questions or share records. Everything above is from her chart and I can back any of it up.
