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Linda Simon
Linda Simon, Veterinarian
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My cat started to get sick a month ago. First time I took

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Hi. My cat started to get sick a month ago. First time I took him to the vet they said change his diet, second time they ran blood work said every was fine and said possible stomach virus, third time they said gums looks infected more antibiotics. Third time around I asked for X-ray, the spleen looked abnormal so we did an ultrasound and it confirm spleen is in large. My doctor said that a tumor can be causing his lack of appetite but said if I’m going to do the biopsy not to give my cat steroids. He also said they should do biopsy of the small intestine bc the ultrasound also indicated possible IBS.
Assistant: I'll do all I can to help. There are all sorts of infections your cat can pick up. I'll have you talk to the Veterinarian who'll sort out what is wrong and help you decide what to do about it. What is your cat's name and age?
Customer: My my cat as of today isn’t eating I am so worried
Assistant: Is there anything else important you think the Veterinarian should know about your cat?
Customer: I have him anti-nausea and medicine to increase appetite and not eating he’s sleeping a lot
Customer: replied 7 months ago.
Gizmo 11 months

Hi there, you are through to Dr Linda. I'm sorry to hear Gizmo has been unwell but it sounds as if he is being very well looked after.

At 11 months of age a cancer would be unlikely, though not impossible. Certainly, something like an IBS or food allergy would be a lot more likely.

Unfortunately, vomiting in a cat is a very non-specific symptoms, meaning it can be triggered by all sorts of things. Because of this, we often have to run several tests before being able to determine the issue.

In a young cat, I would always do several things as a primary course of action:

1) Ensure they are up to date with a good quality wormer e.g. panacur or drontal

2) Trial them on a strictly hypoallergenic diet e.g. Hill's Z/D or Royal Canin Anallergenic for 8 weeks with nothing else. Many supermarket foods will claim to be hypoallergenic but are actually not and there are only a handful of diets available that can be used in diet trials. During a trial, the cat cannot have access to anything else at all e.g. treats, chews, human foods. If they go outside, get a collar that says DO NOT FEED ME. If they manage to eat something on say the fourth week, you then have to start the trial again from day 1 for 8 weeks. The theory is that if they do have a food sensitivity or allergy, this trial will ensure they are not exposed to whatever it is that is causing the reaction and they should then have no symptoms. If it works, many will continue this diet for life.

3) A course of ant-acids and anti-nausea medicine can help to manage symptoms in the short term and make a cat more comfortable

4) Ensure there is no exposure to anything irritant or toxic in the home or wherever the cat goes e.g. house plants, chemical cleaners, detergents etc.

With regards ***** ***** work, it may be worth ordering some more specific tests (if not already done) such as FIV/FELV viral tests and B12/cobalamin/tli gut absorption tests. If not already done, I would also request a urinalysis, to rule out e.g. a grumbling urinary infection.

With regards ***** ***** it is important to know who did this. A G.P vet can typically do a basic ultrasound, but a specialist would be able to do a more specific scan that may pick up more subtle lesions and be more helpful. If not already done by a specialist, I would request this.

In some case, an endoscope (small camera) of the stomach and gut can help to diagnose issues such as ulcers and can be useful. Similarly, this endoscope can be used to take biopsies in a minimally invasive way. Not every clinic will have access to an endoscope, so consider asking being referred to a clinic that does.

We definitely need to get to the bottom of this as it is not normal for a cat to have chronic vomiting, so until we have our diagnosis, more tests will need to be run. In the mean time, tempting him with highly digestible foods and supporting him with medicine is essential.

It has been a pleasure helping you out today, and I hope that you feel I have earned a five-star rating. Please remember to rate the service by selecting the stars at the top of the screen, otherwise the website will not compensate me for my time. There is no extra charge for this (it’s included in your question fee). Even after rating, you are more than welcome to continue asking questions. Thank you, ***** *****

Customer: replied 7 months ago.
Thank you for your respond. Gizmo did have the blood work you recommend but not the second one. He did have the ultrasound at a specialists that where they picked up the enlarge spleen.My vet did recommend the scope and also a biopsy of the spleen.But unfortunately after I wrote this he got worst. He is now at the ER in an oxygen tank. The vet here did more X-ray and found what might be fluid in the lungs. Waiting on radiology to confirm and then we go from there. Main concern now is getting his oxygen levels normal. Any suggestions what cause the respiratory distressed. And since he’s a baby do you think the breeder willing sold me a bad cat. I’m sure it’s genetic? Please advise
I'm very sorry to hear this update. He's in the best place now and I'm sure they are taking very good care of him.
Fluid on the lungs can have a number of causes. It would be important to know if it is a pleural effusion (fluid in the space between the lungs and their lining) or pulmonary oedema (fluid within the lungs themselves). The radiologist report short be able to tell you this. These each have different causes, with potential causes including heart disease, anaemia, low blood protein, pneumonia etc. It will be important to determine if this is secondary to the chronic issue (for example, the immune system is weakened so an infection has taken hold or the cat has not been eating well so the protein is low), or part of the primary process (whatever caused the vomiting is now causing fluid in the chest).
The lung fluid may be sampled, letting us know if it is e.g. pus, chyle or something else.
When there is fluid in the chest, an animal needs to be supported on oxygen and may need medicine or a procedure to drain the fluid.
Whether or not the breeder knows of any issues in the line or knew that this cat was unwell , I cannot comment. Was the cat seemingly well when you first got it? If so, it is unlikely the breeder was aware of an issue. It would be worth discussing what is happening with them. I find most breeders to be very upfront and they should want to know about any potential health issues in their lines. They should be able to tell you if any other cats are affected.
At this stage, it is impossible to know if the issue is genetic (inherited in the gene) and/or congenital (present from birth) or not. Even young cats can become ill when they are genetically sound, for example, from a virus. Further testing will help us to determine the answer to this.
Another diagnosis to consider at this stage would be FIP. Young cats can be affected. If the vet is considering this, they will analyse the chest fluid.
I'm sorry your cat is so unwell at the moment and you are still waiting on a diagnosis, whose can be incredibly frustrating. I would welcome any updates and further questions. Dr Linda
Customer: replied 7 months ago.
The chest x Ray confirmed no fluid or mass. The vet is unsure why this is happening. When I took him in his respiratory was 160 three hours later 60 now it’s at 45. He is staying over night and still in the oxygen tank. She said he should see and internal medicine doctor. Once his respiratory rate is stable I’m going to take him in. I will def contact the breeder. And clues what is causing this? The vet said it could be the stress from being sick and taking him from vet to vet but unsure. Please asvise
Customer: replied 7 months ago.
Or maybe I should bring him home and let him rest for a day or two before I take him to a specialist. Please advise
Oh that's good to hear. As to what is causing this, a high breathing rate can be caused by a number of things including stress, anxiety, fever or a disease process. Initially, the vet suspected that there was fluid on the x-ray, so I would be keen to ask what it actually turned out to be. Reading the radiologist report would be useful as this would tell us what exactly is going on with the chest.
Given the fact that his breathing rate got so high and we are currently so uncertain of his diagnosis, I would not delay the specialist referral and I would have him seen ASAP.
Customer: replied 7 months ago.
I will take him to a specialist once he is stable. I’m just afraid it will cause him anxiety and again his breathing goes up.
Customer: replied 7 months ago.
Can an enlarge spleen cause this. All labs are normal except the spleen
I completely understand your concern, though would suggest the sooner he is seen the better. I feel it is unlikely that stress alone is the reason for his breathing issues and, if he were mine, would want a specialist to assess him urgently. The worry is that he could deteriorate before he is seen.
The enlarged spleen may well be a clue as to what is going on as it can occur with an infection, inflammatory bowel disease, in some types of cancer. Typically, the issue is not related to the spleen itself and the spleen is just letting us know something is wrong. Taking a sample (FNA) of the spleen may well provide some answers.
As we can see an enlarged spleen in both heart disease and FIP, and these are two conditions that are on the table, we do need to rule both of these conditions in or out. A heart scan may be useful at this stage.
Customer: replied 7 months ago.
On the preliminary report FIP has been ruled out. The vet where he is now did suggest heart scan. I just hope I can afford all these exams. Is it too late to get health insurance?It’s obvious I can’t take him from the vet to rush him to a specialist. Once he’s release from the ER don’t bring him home but rush him to a specialist? Can you recommend one in Pasadena california? The closes one I know is in Ontario which is 45 miles from Pasadena. Is there any medication they can give him now to stabilized his condition. Make him breath better? Without needing the oxygen tank. I don’t want him to Soficate while I drive him to the specialist
Its reassuring to know that FIP has been ruled out for now but it can be hard to diagnose in some cases so I wouldn't exclude it completely at this stage.
Whatever is going on with him now will be classed as a 'pre-existing condition' by health insurance and will not be covered I'm afraid. If you did try to purchase health insurance now it could potentially cover any new and unrelated issues that may develop in the future. You may find as he is unwell at the moment, it would be difficult to insure him.
With regards ***** ***** to the specialist, typically the ER vet will know the usual procedure and would be best able to recommend if he should be brought straight there or not. This will depend on how the specialist works. Sometimes, there will be no appointments available for a day or two.
I'm afraid I am practising in the UK so would not be able to recommend any clinics local to you but your vets will certainly know the best local places to go and should have working relationships with several specialists.Any medicine they would give him would have to directly treat what was wrong. For example, if there was fluid on the lungs (which we now know there is not), we would give a medicine to drain this. As we do not know why he is having breathing issues, it is unlikely any medicine would be prescribed for now.
He would not be discharged if the ER vet thought that he was so unwell he would pass away on the journey. If they thought that were a possibility, they would not discharge him.
Customer: replied 7 months ago.
I’m a registered nurse work in the cardiology department. I know when heart failure is involve I know the signs and symptoms are obvious, fluid in the lungs, BLE edema and shortness of breath. He doesn’t have any of that. I am so confused why his respiratory was unstable bc X-ray also ruled out PNA. ARDS is uncommon unless he drowned or if he had severe inflammatory in the lungs ugh don’t know which specialist I should take him to once his discharge. I made an apt with cardiologist this coming Monday and determine to leave him in the ER till Monday even if the vet says he’s okay to be discharge before. Idk please help me figure out what exam is the next step. Here in the US vetenarians are all about the money and do t care about the furbabies well most. I don’t want to be given the round around. I’m using my nursing skills and trying To make an effective diagnosis as to what step is best for gizmo before he gets any worst. Any suggestions

Are you a human nurse or veterinary nurse? It is important to know that cats will show signs of illness very differently to people and typically cats affected with heart disease will not show any symptoms until they are quite severely affected. They are masters at masking their condition in the early stages so a cat that has quite significant heart disease may not be showing any signs at all. This is why a heart scan can be so useful in any case of respiratory distress.

I agree that leaving him in the ER for now is a sensible option, especially if we are concerned about a decompensation once removed from the oxygen chamber.

In his case, we need to determine why the spleen is enlarged and what is causing the chronic vomiting and lack of appetite. Hence, referring to internal medicine is advisable.

Having said this, we do want to rule in or out primary cardiac disease as well and if the respiratory episode cannot be explained after looking into this, we would want to explore it further.

It may be possible to refer him to a centre that has both a cardiologist and an internal medicine specialist, hence, if the internal medicine doctor feels the primary issue is the heart, they can have him change departments quickly and efficiently. As mentioned, I am not familiar with your area, but typically complicated cases would be referred to teaching hospitals, so perhaps UC Davis would be a viable option?

Ah, I have just seen that UC Davis is very far from where you are, so the Ontario option (or another advised by your local vet) may well make more sense for you.

Customer: replied 7 months ago.
Human nurse. Heart scan ? You mean echo gram? Sorry I know it’s totally different

Not at all, it's a huge bonus that you work in that field and will be able to have a much better understanding of what is going on than the average person. This can make communication a whole lot easier!

By heart scan I do mean an Echocardiogram, yes.

Customer: replied 7 months ago.
the facility I am taking my him to has both internal medicine and cardiology. I did my research and made sure they have them two onsite. Thank you so much for replying. I really love gizmo and willing to fight for his health. Have a great weekend. If I have any further questions regarding his apt I will contact you

Oh that's fantastic. They should certainly be able to get a diagnosis and start him on whatever therapy is needed.

It's evident how much Gizmo means to you and he is incredibly lucky to have an owner as dedicated as you!

Please do keep me updated, wishing all the best to Gizmo for a full and speedy recovery. Dr Linda

Customer: replied 7 months ago.
Good morning
How long can my kitty go without food. He hasn’t ate in the last 24 hours. Thursday he ate but very little. I’m asking bc he has an apt with cardiology this Monday for the echo follow by internal medicine for the possible IBS and enlarge spleen. The vet will discharge gizmo home with vitamins. I am debating if u should start him on steroids to help with the possible IBS and spleen. But I know if I do this and once spleen is remove biopsy the test will come back negative.But I fear if u doesn’t eat soon he will die. PleSe advise best option.
Than you
Hi there. How long a cat can go without food is dependent on the individual, their fat reserves, muscle mass, hydration status etc. An obese cat who suddenly stops eating can develop a condition called 'fatty liver' in a short amount of time. An average sized cat can typically go a few days without eating before any adverse effects are noticed although they will feel weak and lethargic. Normally, if a vet is concerned that food intake is not sufficient they will start the cat on tube or syringe feeding. Similarly, if they are worried about their hydration they will start them on a drip. As your cat is currently in the clinic, the vet will be constantly monitoring them and considering these things.
As his diagnosis is so up in the air at the moment, I would not be considering steroids. Are you considering them because they may increase appetite? If so, an appetite stimulant such as mirtazapine would be more appropriate.
Linda Simon and other Vet Specialists are ready to help you
Customer: replied 7 months ago.
After I gave him the mirtazapone he started to breath fast so to play it safe even though highly unlikely I’m not giving him that.I was considering the steroids to help with the IBS thus help with the appetite. I will ask about syringe feeding. Thank you