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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Cat Veterinary
Satisfied Customers: 26903
Experience:  University of California at Davis graduate veterinarian with 44 years of experience.
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And thank you in advance time and your knowledge.

Customer Question

Hello and thank you in advance for you time and your knowledge. I am inquiring about my male cat who is five years old. He has been fully vaccinated and in general good health until recently. For 5 days he has had diarrhea and has been vomiting all food intake. He was seen by a vet and kept in the animal hospital for three days where he received infusions but all food was withheld. His blood tests were normal except for an elevated AST at 124, a low ALT at 120, an ALP of 15 and a normal bilirubin. He was also given x-rays and an ultrasound which were normal as well. The vet pronounced him well and not vomiting with a small intake of food and allowed me to take him home and said feed him normally. He had his normal meal of high quality, fresh beef cut in very small pieces. he immediately vomited all he had eaten. I have several other cats in my home who also have diarrhea but are not vomiting and are eating normally. Their activities are normal and they show no signs of debilitation. All cats are indoor and completely vaccinated. Thank you and I look forward to your prompt reply. What should I do?
Submitted: 1 year ago.
Category: Cat Veterinary
Customer: replied 1 year ago.
I am concerned I have not received an answer.
Customer: replied 1 year ago.
Perhaps someone else is more available.
Expert:  Dr. Michael Salkin replied 1 year ago.
I'm sorry that your question wasn't answered in a timely manner. The AST isn't useful in small animals. The ALT is slightly elevated at 120 but this isn't considered a significant elevation. i become alarmed when the ALT elevates 2-3X. An ALP of 15 has no significance in cats because the ALP is readily excreted in the urine, Thus, any increase in ALP is a significant finding. In summary, it appears that blood work and imaging have revealed nothing abnormal. These cats need to have their GI tracts scoped and biopsied if symptoms persist. We're looking for infiltrative disorders such as inflammatory bowel disease (IBD) and small cell lymphoma (both of which should have been apparent in the ultrasound if inflammation were advanced enough to visualize) or a food intolerance that has emerged. Food intolerance/allergy is addressed with prescription hypoallergenic diets. These special foods contain just one novel (rabbit, duck, e.g.) animal protein or proteins that have been chemically altered (hydrolyzed) to the point that Marko's immune system doesn't "see" anything to be allergic to. The over the counter hypoallergenic foods too often contain proteins not listed on the label - soy is a common one - and these proteins would confound our evaluation of the efficacy of the hypoallergenic diet. The prescription foods are available from his vet. There are many novel protein foods and a prototypical hydrolyzed protein food is Hill’s Prescription Diet z/d ultra (my preference). A positive response is usually seen within a few weeks if we’ve eliminated the offending food allergen. Food intolerance can arise at any age and even after our patient has been eating the same food for quite some time. The most common offending food allergens are beef, chicken, corn, wheat, eggs, rice, and soy. Please respond with further questions or concerns if you wish.