Undiagnosed Medical Issue

[emerald42]

I am concerned not only because my cat is ill, but more so because despite 4 vet visits in the past 6 months no diagnosis has been made. My cat eats only dry food and has suffered with constipation since she was around 10 years old. In the past putting benefiber in her water worked decent, but in the past year the constipation has increased. She now takes cispirade and benefiber on a daily basis. However, in the past 4 months she has rapidly lost weight (8 lbs to now weighing 4.5 lbs), had periods of time where she would not drink, and during the visits was consistently dehryrated. I am now giving her SubQ fluid 100 ml every other day and my cat was given 2 steriod shots in the past month, which help a lot also.

The vet I go to has many young associates and despite all this I have never been given any "formal" diagnosis. I have asked if she has CRF which most of the signs point to. The only suggestion was that she may have cancer at a "cellular level". For all the time and money I have spent at this Vet I can not understand how no diagnosis has been made. At this point I just want to make sure my cat is comftorable.

I am curious if there are vets the "specialize" in just cats as I have not really been able to find this.

[Jennifer Mathis, D.V.M.]

I hope to help you more with a more complete answer, but can you tell me what tests have been run?  Was a CBC, Chemistry including a thyroid (aka t4) run?  If so, when?  My own cat at a elderly age lost weight and the blood tests didn't change for 6 months and I tested her three times before the changes (kidney in her case) showed up.  It does take a 70% change to all kidney function - ie both kidneys, to show up on std bloodwork.  Has an ERD test been run on urine? Has urine been analyzed?  Thyroid changes can have similar kidney symptoms and cause dehydration which is the major culprit with constipation.  ie She may be predisposed to constipation, but something else is making it flare up.

Yes there are feline specialists and they can be found at: http://www.catvets.com/

There are many excellent veterinarians for cats as well that are not listed at catvets.com, so your veterinary office may still be appropriate.

What was the white blood cell count?  If you don't have this information, it's alright, as it alone cannot provide a complete picture.

ie it is not standard to check thyroid with all blood tests, so I would assume by your notes that CBC, Chemistry and xrays have been done, but I don't know thyroid nor FeLV/FIV bloodwork status.  Having been to the veterinarian 4 times, it is likely those have been evaluated, but we should start there - to know what has been done and when was it done.

Looking forward to your reply,
Dr. Jen

[emerald42]

Edits: she now takes cispirade and LACTULOSE and there have been period of time where she would not EAT she never had any trouble drinking.

[emerald42]

I have obtained a copy of all the medical records. She did have a t4 test in July. The results were 1.0 which is whichin the normal range.

I can not decipher all the test results but these were the only results which were higher or lower than normal

CA(calcium?) 11.7 (11.5 on 05/21)
Glucose 177 mg/dl (168 in may) I think they said this may be due to stress
NEU was high 14.45 which was normal in may
BASO was 0.14 K which was .05 in May

On the Vetstat her HCO3 and PCO2 were low (17.1 and 33.0 respectivley)
and her tCO2 was low at 18.1, while Na was high at 170, other than tCO2 this was all normal in May.

[Jennifer Mathis, D.V.M.]

With the information I have, I would say your veterinarian is likely on the right track.  It may take time for changes to actually appear in the lab work.

It seems that your main goal is to get a diagnosis to treat your cat with better targeted therapy.  Without seeing the patient and records myself, I cannot say what is best for your cat at this time.

I would ask your veterinarian for a FeLV/FIV test and an abdominal ultrasound (by a qualified veterinarian).  Surely one or both of those test will be able to give you more information that may lead to a diagnosis/improved treatment that you are seeking.

In the meantime, the fluid therapy and all that you have mentioned are appropriate.  Fluids are economical and extremely beneficial - keep it up!

Thank you for checking on lab tests so you can have some better direction.  As mentioned before - even my own cat didn't show up with a diagnosis for quite sometime.  You're doing right by your cat.