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Dr. Elizabeth Ann
Dr. Elizabeth Ann, Veterinarian
Category: Cat Veterinary
Satisfied Customers: 117
Experience:  More than 18 years in small animal medicine/surgery and more than 8 years in ER and critial care.
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My 15 year old cat was just diagnosed with a perforated

Customer Question

My 15 year old cat was just diagnosed with a perforated bowel. Vet says cat most likely wouldn't survive a surgey. He gave her an antibiotic shot and also a shot to rehydrate her. This was 3 days ago. Cat is very lethargic, has some appetite but still is getting around. What do you suggest?
Submitted: 1 year ago.
Category: Cat Veterinary
Expert:  Dr. Elizabeth Ann replied 1 year ago.
  • I am so sorry to hear about what is going on with Zena. How did the veterinarian diagnose a perforated bowel? Is there fluid in the abdomen? Did barium leak out? Did the vet say it was a perforated colon or a perforated small intestine? Have they done blood work? Do they know why the bowel is perforated (ie due to medications or a foreign object)? If you can help me answer some of these questions, it will help me to give you a better and more complete answer.
Expert:  Dr. Elizabeth Ann replied 1 year ago.

Some general info without the answers to the questions I asked:

If there is a perforation of the bowel, I generally recommend surgery to close the perforation and flush the abdomen extensively. Surgery would also help us to identify why there is a perforation (cancer, foreign object etc) and potentially correct the cause. Also, when bacteria are free within the abdomen and infection sets up, it is generally very painful. Generally, this is not a condition that will resolve on its own without surgical intervention. Sometimes, a surgeon will even leave the abdomen open for a period of time after surgery in order to flush out the infection over a few days (done under anesthesia, bandage placed to hold abdomen closed) while other times drains may be placed in order to facilitate flushing for a period of time. It is all dependent on how severe the infection is. Cats can be amazing healers, and sometimes, the body can wall off an area of infection and with the help of antibiotics, get rid of the infection. Sometimes the omentum (a leaf like structure in the abdomen) will fold over a perforation and seal the area, and then the body has to rid itself of the infection if it can. Then there is the question of whether to do surgery on a 15 year old cat. Some cats can live into their 20's, so in an otherwise healthy cat, maybe we have a lot longer time with them. In other cases, 15 is close to the end of the life span. So, that makes it a tough question. If the cat has been healthy up to this point, surgery is an option. If finances allow, it is an option. Then we get into the current condition of the cat. If Zena has serious other secondary problems (such as kidney failure), surgery might not be a good option. I am in favor of surgery in many cases, but there are a lot of details that ride on that decision - and her post operative recovery may be difficult and long. I will be on and offline through the day today and will try to watch for your response to the questions I asked. If you do proceed with surgery, getting Zena hydrated prior to surgery will be important. I will wait to hear from you and then I can probably be more helpful.

Customer: replied 1 year ago.
The vet found a mass (2-3 CM) on her lower intestinal area on an X-ray. Her blood test show MCHC 36.5 g/dL
WBC 54.88 K/uL
NEU 51.51 K/uL
Mono .74 K/uLEverything else in blood is in normal ranges.She has lost almost 3 pounds since last vet visit 6 months ago. She is doing well. We are considering an exploratory surgery but our vet finds paratonitis we will have to take Zena 60 miles to Dallas for the abdominal flushing and drainage.It’s been over days now she has been home. Did seem to be doing better but then last night and this morning shows her to be failing. Much difficultly walking, moving, drinking and eating.Vet gives her maybe a 10% chance of surviving surgery post care. I am beginning to agree. Please tell me what your thoughts are asap.Thank you,
Michael
Customer: replied 1 year ago.
The vet found a mass (2-3 CM) on her lower intestinal area on an X-ray. Her blood test show MCHC 36.5 g/dL
WBC 54.88 K/uL
NEU 51.51 K/uL
Mono .74 K/uLEverything else in blood is in normal ranges.She has lost almost 3 pounds since last vet visit 6 months ago. We are considering exploratory surgery but if our vet finds paratonitis we will have to take Zena 60 miles to Dallas for the abdominal flushing and drainage.It’s been over 4 days now she has been home. Did seem to be doing better but then last night and this morning shows her to be failing. Much difficultly walking, moving, drinking and eating and very shallow breathing.Vet gives her less than 10% chance of surviving surgery and post care. I am beginning to agree. Please tell me what your thoughts are asap.Thank you,
Michael
Expert:  Dr. Elizabeth Ann replied 1 year ago.

Sorry, I have not been online today. It sounds like surgery will be a difficult proposition at best. It is likely the mass is a tumor (at her age), but it is possible it is an object. If it is cancer, that area of the intestine would need to be removed and then there may have already been spread of the cancer. I am wondering if it might be lymphoma Of course, there are many possibilities. With the high WBC, she is certainly fighting infection and she is dehydrated as well. Have you evaluated kidney and liver function? It sounds like Zena is getting worse each day. I think there is no shame in humane euthanasia if you think that is the right thing to do. She is obviously very weak and prognosis is poor - fair at best I would think. If you wanted to go forward with surgery and get that small chance of survival, as long as finances allow, you get your opportunity and a definitive diagnosis and course of action. I always tell owners to be ready to make a decision during surgery - if we go in and find a tumor we can't repair or spread of cancer throughout the body, I often suggest we euthanize the patient at surgery and not recover from surgery (so there is no further suffering). It sounds like your vet has a good handle on the situation and it sounds like Zena is failing quickly, so a decision likely needs to be made soon. Difficult decisions for you! I am sorry.

Expert:  Dr. Elizabeth Ann replied 1 year ago.

How is Zena doing?