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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Cat
Satisfied Customers: 30794
Experience:  University of California at Davis graduate veterinarian with 45 years of experience.
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I am worried about my 10yo british blue female cat named

Customer Question

Hello, I am worried about my 10yo british blue female cat named dolly. She had blood tests at my request about 6 weeks ago. She was a little unwell at the time and was vomiting just clear liquid had a couple of watery stools and wasnt eating for a couple of days. I had been worried about her kidneys since last year because i felt her bun and creatinine although normal were a little high. Her repeat bloods came back normal last year including sdma of 11. This year however there was a rise in crea and sdma. sdma was 17 and crea 2.1 (converted from UK). The vomiting cleared up quickly with a course of antibiotics and she has been fine since then until 2 weeks ago when she started having loose stool. No vomiting this time, still eating well and fine in herself but every day loose stool 2 or 3 times. I treated with prokolin and peridale to little effect and my vet saw her on thursday and administered an antiinflammatory injection. Nothing to find on examination and said to repeat bloods when she is better with urineanalysis also. Dolly is an extremely nervous cat so vet visits terrify and stress her. Her stool is still loose, partly formed but thin and soft with some less formed matter also. I want to get her thoroughly checked to see what is going on and I am very fearful she may have intestinal lymphoma causing the diarrheoa. I understand CKD cats usually have constipation, so this doesnt sound right for the kidney problem. I had also asked for a pancreatitis test to be done but I dont think it was so this is something else I would like checked out. My vet didnt want to do bloods until the stools were back to normal, but that doesnt seem to be happening. Can you help advise re anything that could help her stools or the best way to proceed re tests. I understand we need an ultrasound but this will need to be done at a specialist centre I think. Would lymphoma show on blood tests at all? I was hoping she may have a couple of years with me yet because the kidney disease has been picked up early, but now I am feeling she might be deteriorating or have other things going on too. She hasnt lost any weight, well hadnt as of 6 weeks ago, in fact she had gained.25gk from her previous weight check. She seems a similar weight to me. Thanks you. I am in UK if that helps.
Submitted: 1 month ago.
Category: Cat
Expert:  Dr. Michael Salkin replied 1 month ago.

You're speaking with Dr. Michael Salkin. Welcome to JustAnswer. I'm currently typing up my reply. Please be patient. This may take a few minutes.

Expert:  Dr. Michael Salkin replied 1 month ago.

I'm sorry that your question wasn't answered in a timely manner. I'll address your concerns as you presented them...

1) I don't understand your vet's reticence in repeating testing which is more likely to be informative when Dolly's stools are abnormal rather than normal.

2) A gastrointestinal diagnostic panel of blood, urine, and fecal tests is the most complete and cost-effective manner of testing Dolly. It should contain a PSL which is most sensitive for detecting the presence of pancreatitis, TLI for detecting exocrine pancreatic insufficiency (EPI/a deficiency in digestive enzymes produced by the pancreas), and serum folate and vitamin B12 assays looking for malabsorption syndromes.

3) If nothing untoward is seen in such testing, an abdominal ultrasound is the next diagnostic of choice. This imaging is the most sensitive and readily available imaging modality for the abdomen and can "see" inflammatory bowel disease (IBD) and its sequela small call lymphoma. Small cell lymphoma rarely will be seen in the peripheral blood as part of a complete blood count (CBC).

4) Her maintaining her weight is a very positive prognostic sign. It's not consistent with lymphoma, EPI, or malasorptive disorders.

5) Thank you for posting her last diagnostics. Chronic renal insufficiency is likely but the very important complete urinalysis is missing to better understand Dolly's kidney health.

Customer: replied 1 month ago.
Thank you so much for your answer. I will look into getting the tests you mention and many thanks for your reassuring comments. Jessica x
Expert:  Dr. Michael Salkin replied 1 month ago.

You're quite welcome, Jessica. I can't set a follow-up in this venue so please return to our conversation - even after rating - with an update at your convenience. You can bookmark this page for ease of return.

Dr. Michael Salkin and other Cat Specialists are ready to help you
Expert:  Dr. Michael Salkin replied 1 month ago.

Thank you for your kind accept. I appreciate it.

Customer: replied 1 month ago.
Hi Dr salkin. Just to update you.....Dolky had ultrasound and bloods with full GI panel on Friday and urineanalysis. I am awaiting the bad results but her scan was done by an ontology specialist and was completely normal at this stage. No ibd or masses seen. No enlarged lymph nodes. Normal looking kidneys so far. Bp normal and weight good....slight gain from last time there a year ago.She still has the loose stools so we are none the wiser. The vet thinks possibly stress related or food sensitivity maybe. Maybe bloods will tell us more. Can I request you for another consult when I get all the labs back just for your opinion. I know in the US the vets are a little more proactive about things like CRF than we are over here. I would appreciate your thoughts. She is a fussy eater so changing food will not be easy but I will have to do my best.Thanks Jess x
Expert:  Dr. Michael Salkin replied 1 month ago.

Thank you for the update. Can you upload a copy of Dolly's test results to this conversation? Molly's vet can give you one which you can scan into your computer and then give me the file link or you can photograph the pages and upload them by using the paperclip icon (if you can see that icon) or by using an external app such as dropbox.com/

.

Customer: replied 1 month ago.
Hi Dr Salkin. I'm sorry I haven't been able to attach dolly s lab results yet. I haven't had the results reported back to me yet! I chased them yesterday but the vet in question isn't in until tomorrow so I will hopefully hear then. The trouble is dolly has stopped eating last 2 days. I'm really worrying about her as I think she feels nauseous. She keeps licking her lips and walking away from food. I really need to see what the bloods show us. I will be in touch once I hear if that's ok. I am very happy to open a new question. I always appreciate your opinion and guidance.Many thanks Jess x
Expert:  Dr. Michael Salkin replied 1 month ago.

I understand. We both need to be patient because those bloods are important. Meanwhile, she needs both fluid and caloric support and so I recommend that her vet give her subcutaneous fluids as an outpatient and send home a syringeable and palatable convalescent food such as Hill's a/d. I'll watch for your next post.

Customer: replied 1 month ago.
Thank you. She has some hills ad and she ate a little on her own. So far her bloods are all normal! Haematology and chemistry....all normal. Sdma back at 11. We still await pancreas and go result and urineanalysis. We are both thinking the pancreas hold the answer. I will send labs as soon as I receive the completed results. She's not giving us many clues.....bless her. I have a horse just like her too!Jess xx
Expert:  Dr. Michael Salkin replied 1 month ago.

You're welcome, Jess. So far so good. Please keep me posted.

Customer: replied 1 month ago.
AAArgh!! Im so sorry, I really wanted to get Dollys labs to you before the weekend! I missed amessage from the vet this morning with the remainder of her results. We have all but the proteinuria test back. No idea why urine culture and casts etc is back but not the proteinuria, but thats the last one. Urine all normal, stool all normal. Bloods all normal no pancreatic issue showing. The only abnormality is a "slightly low folate" Colbalamin is normal. This is frustrating because lovely as my specialist vet is he is quite elusive, so I had missed him when I called back and he is on holiday now. So I cannot discuss these finding with him until middle of next week. So, I asked the staff to email me all the labs so I could look through and of course, forward on to you in the meantime just for some idea of what we may need to consider. No treatment recommended as yet and Im not sure of the implications. Its been a stressful week here! I havent received the labs yet, having requested 3 times.....grrrr and business is now closed so I suspect I will not see them until next week. I really want to know how low the folate is. Plus would quite like to cast my eyes over the kidney values.Again, once I have the full report I will forward to you i a new question. Dolly seems ok in herself for now and soft poos seem to have improved. Im hoping my girls has one more lfe left.Have a great weekend Dr Salkin. Jess xx
Expert:  Dr. Michael Salkin replied 1 month ago.

No worries, Jess. I'll watch for your next post.