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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Cat
Satisfied Customers: 37500
Experience:  University of California at Davis graduate veterinarian with 45 years of experience.
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I am very worried about my cat. I have just found cat poo on

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Hi thereI am very worried about my cat.I have just found cat poo on my bed (very unusual) and there seems to be blood in the centre of it (see photo).The slight complication is that I have two cats. One who tends to stay upstairs because she is scared of the dog so can’t go out till he has gone to bed (so it could have been her if she suddenly needed to go) and another cat who comes and goes as he pleases (and is not at all scared of the dog) but in recent times lost a lot of weight - down from 4kg to 3.5 over a period of 6-12 months with a lot of vomiting.He underwent tests at the vet which showed there is no kidney disease, thyroid ok and sugar ok too. There were some abnormalities however: albumen and low potassium and slightly elevated cholesterol. He had an ultrasound which did not show any abnormalities. He had some medication for two weeks and I changed to a prescription diet (hills z/d food sensitivities) and the vomiting has stopped. However his weight is 3.4kg (down from 3.5 in February) but neither our nor the vet’s scales are that accurate. He seems well in himself, and happy, but I am worried that - if this was him - this could be a concerning development.The photo is badly lit but there was some blood (red colour) in the middle of the stool.The other cat is of good weight, has vomited a few fur balls recently but is otherwise very well.Thanks for any advice!
Customer: replied 6 months ago.
I forgot to attach the photo so here it is! Also, I don’t know how to change the category for my question to veterinary...

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.

I'm sorry that your question wasn't answered in a timely manner. How old is the cat who lost weight? Can you upload a copy of all of his test results to our conversation? I understand that you might not have a copy at home but his 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/

I not only review the test results but also note which tests should have been performed but weren't. Cats vomiting as he had been doing are most often diagnosed with inflammatory bowel disease (IBD) - an idiopathic (unknown cause) inflammation of the gastrointestinal tract which usually responds to a glucocorticoid (steroid) such as prednisolone, the antiinflammatory antibiotic metronidazole, or both. We also need to consider a particularly nasty type of hairball called a trichobezoar, chronic pancreatitis (a PSL blood test is most specific for identifying the presence of pancreatitis and may not have been included in his testing) or hepatitis, as well as a food intolerance. If nothing untoward is found, an abdominal ultrasound is indicated because that imaging modality is particularly sensitive for evaluating the gastrointestinal tract itself. We're mainly interested in seeing if the inflammation associated with IBD or its sequela small cell lymphoma (older cats, usually) is present.
Food intolerance/allergy is addressed with prescription hypoallergenic diets as you've done. It's also seen concurrently in many cats suffering from IBD.

Customer: replied 6 months ago.
Thanks very much! I will see if I can get the test results from or vet. He is 11 years old and his u/s was normal I believe. I will be back with more as soon as I can....

I appreciate it!

Customer: replied 6 months ago.
Hi again. Just wanted to update you that I took my cat to the vet today because he had lost yet more weight. He vet took a urine sample which he said was not concentrated at all (far too light) and has taken a blood test. I will be back in touch when I have the results. I am really concerned that it is renal failure...

I'll watch for your next post. Yes, dilute urine is a marker for renal insufficiency

Customer: replied 6 months ago.
Can this be caused by a gut issue (eg IBD)? So, can it be treated?

Any disorder that increases thirst (polydipsia) can then produce a larger than normal amount of dilute urine. This isn't expected with IBD, however. I'll review his test results for you.

Customer: replied 6 months ago.
Thank you so much!

It's my pleasure.

Customer: replied 6 months ago.
Hi again. Hope you’re having a nice weekend.I now have Louis’ blood and urine test results (see attached). He is now 3.4kg down from 4.5kg around 16 months ago.Many thanks for your help
Customer: replied 6 months ago.
Photo 1/3

Thank you. Give me a moment to take a look, please...

Customer: replied 6 months ago.
Photo 2/3
Customer: replied 6 months ago.
Photo 3/3

Contrary to what you were told, Louis's serum albumin and potassium are normal. The elevated cholesterol isn't a significant finding. His mildly increased urea concurrent with a normal creatinine can suggest early renal insufficiency which is supported by his quite dilute urine of specific gravity of 1.018. His urinalysis reveals a bacterial urinary tract infection (the presence of bacteria, increased red and white blood cells). I don't see a T4 (total thyroid) and so I can't assess if he's hyperthyroid or not. How old is Louis, please?

Customer: replied 6 months ago.
He is 11 years 2 months
Customer: replied 6 months ago.
I’m not sure if hey did thyroid test this time (this was all they gave me) but last time it was ok

Thank you. Early chronic renal insufficiency is most likely and would account for polyuria (increased volume of urine) and compensatory polydipsia if seen. A prescription diet designed for early renal insufficiency might be considered but isn't essential at this time. His UTI needs to be treated with a broad spectrum antibiotic for 7-10 days and his urine rechecked 2 days after the course of antibiotic had been completed. Is vomiting (and/or diarrhea) well-controlled at this time?

Customer: replied 6 months ago.
the vomiting pretty much stopped when we put him on a food sensitivities diet (z/d)
Customer: replied 6 months ago.
What is the prognosis with renal insufficiency?
Customer: replied 6 months ago.
I only spoke to the vet on the phone (and not the one who has seen Louis) and they didn’t mention the urine infection (which is terrible!!!!) but they did suggest a kidney diet (Hills k/d) which we have started this afternoon but not sure how Louis will cope as all food except z/d were making him vomit

That's good to hear. That diagnoses food intolerance which may accompany IBD or be a sole entity. You're correct to be concerned about the k/d possibly not being hypoallergenic for Louis.

The prognosis is predicated upon how quickly the kidneys deteriorate and that's determined by performing serial measurements of the BUN and creatinine...perhaps every few months.

Customer: replied 6 months ago.
Thank you so much!!! Shall we continue trying the k/d and see?
Customer: replied 6 months ago.
Oh, and could the IBD cause the kidney findings or is it certainly onset of renal insufficiency

Yes, let's see how the k/d affects both the urea and his GI tract. No, IBD isn't related to his kidneys. Nothing is "certain" in medicine but early chronic renal insuffiency is quite likely. 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 2 other Cat Specialists are ready to help you
Customer: replied 6 months ago.
Thank you so much! I am really grateful for your time and thorough review

You're quite welcome. Thank you for your kind accept. I appreciate it.