Mobility issues on 16yr old cat

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Hi All,I have a few questions re: a mobility consult that we did on a 16 yr old Himalayan MN. The primary reason for the referral was due to lameness and weakness in the hind end, especially the L hind per O. The refDVM also informed us that the cat has a history of UTI's, renal disease (stage 2) chronic and that the cat also has lymphocytic lymphoma (intestinal) which has been treated (on and off) with Chlorambucil and Prednisolone since 2007. In addition, he also has severe bouts of SIBO and is often inappetant and was diagnosed with Spondylosis (thoracic through to sacral per O). Currently, he is off of the Chlorambucil (for about 1 month) and current medications include: Prednisolone 10mg SID, Metronidazole 1/4 tab SID, Lactulose 1.25ml twice/wk, recently started Eprex

due to anemia, is receiving Cartrophen injections and Supplements are: Omega-3s (salmon oil), Recovery (started 1 mo ago), Renal Advanced and Potassium supplement. O's concerns are weight loss in the past couple of months (does feed Hill's a/d and is often syringe fed), he has had a recent UTI that was treated with antibiotics and is clearing up. Will be resuming Chloambucil once he is stronger. But O's main concern is the mobility issues with the hind end, especially the L hind. O reports that it is worse when he first gets up, walk crooked. Also struggles when getting into the litter box and his L hind will slide out when he is on hardwood floors. He is an indoor cat, but O does take him outside on a harness to allow him some fresh air. He walks "crouched" and tends to hold the L hind a little more abducted. Our assessment found that he is resents extension of the L shoulder,

has excellent PROM in both hind legs and there is mild discomfort on palpation of the T-L spine caudally. There is a CP delay on the L hind, but feel that it is more due to muscle weakness as all nerve reflexes were normal. He is thin, current weight is 2.5kg, but felt that there is slightly more muscle atrophy in L hind, Gulick measurements found a difference of 0.3cm. Following out assessment, it was determined that there is osteoarthritis, spondylosis and generalized muscle wasting resulting in weakness.We have currently sent the O home with the following txex: PROM of forelimbs, 3-legged stands, walking up stairs, use of laser pointer ~1' up the wall, obstacle course and encourage a stand whenever the cat is sitting. Are there any other txex that we should be doing, the cat is very compliant and the O is very dedicated. The

other question that I have is re: supplementation, the O is quite happy to add additional supplements as he is quite tolerant to pilling. I remember some information from awhile back on the use of Coenzyme Q10 and L-Carnitine in dogs... I was wondering if there is any information out there for dosing in cats, has anyone tried it. Due to the circumstances with this cat I am thinking that it may be of benefit. If anyone has any other ideas that would be greatly appreciative.Thanks in advance, Brickett AHT, MSc, CCRA, CMT