Ascites.

[Ellisonia]

Two year history of well-managed pancreatitis (fPLI >50) with very few ( very short-lived) periods of inappetence. In fact, very atypical since appetite excellent most of the time despite weight loss while on normal wet food ( refused to eat the Hills) in last few months. Hyperthyroidism ruled out. Owner noticed lethargy and bloodtests revealed falling HCT 18% and moderately low Albumin. Anaemia though not as low previosly had resolved when pancreatitis treated-likewise albumin. Elevated GGT also noted in bloodtest the same week. Renal levels, though still within range also elevated since last tests. Some protein loss in urine though contained blood so difficult to say how accurate. Cat also blind due to retinal detachment.

Cat presented with ( moderate)  ascites later that week - serous exudate-high protein and cell count. What are your thoughts please? Acute pancreatis?  Vet wondering about FIP in view of sight problems

Many thanks.

[Ellisonia]

Forgot to mention the albumin on the day of presentation ( ascites) was 2.1 g/dL and the fluid was also straw coloured. Also renal levels were mildly (2.5 ) increased from last results.

What is the best treatment plan for him?

[Ellisonia]

Thank you very much for your response.

Are you considering nephrotic syndrome then given the sudden onset blindness as well? If so would that be consistent with the ascites - serosanguinous exudate-apologies it had a LOW cell count, not a high one as previously stated? Have read about the connection with glomerular disease and inflammatory condtions like pancreatitis. Now I just heard the cat has tested postitive for it with an fPLI of 15. Have read low albumin was common with pancreatitis but not heard about the connnection with EPI though understandable with lack of enzymes. Do you think this is a possiblity given the increased appetite? Stools were traditionally larger and more tan coloured than other cats, though no diarrhea, ever.

Like the anaemia above, the albumin levels in the past did rise and fall-again with what appeared to be pancreatic flare-ups. Protein did feature in recent urine sample with a UPC of 1.6 though again with the blood difficult to know how accurate this was. However, a strong immunosuppressive of steroid was administered the same week and I've read this can increase urine protein loss. Albumin levels, though below normal weren't alarmingly low ( they were once before with no adverse effects or resultant ascites ) in the same week before this, before the steroid, that is! I will try and find out what the last reading was on presentation though I'd imagine with dehydration it would be higher!

Once again, many thanks for your helpful response!

Ellie

[Cliff Redford, DVM]

An acute pancreatitis in my experience does not normally cause ascites. FIP is a possibility but I would be more interested in looking at causes of a low serum protein. Low protein causes a buildup of fluid in the abdomen and is often associated with a condition called exocrine pancreatic insufficiency. Protein could be lost via the intestine (protein losing enteropathy) or in the urine (protein losing nephropathy).