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Doc Sara
Doc Sara, Veterinarian
Category: Cat Veterinary
Satisfied Customers: 952
Experience:  I am a dog and cat veterinarian with a lifetime of experience in our family veterinary hospital.
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My 19-year-old female cat is behaving very strangely. She

Customer Question

My 19-year-old female cat is behaving very strangely. She pees over the side of the litter boxes ( I have 3 cats and 2 litter boxes). She has chronic diarrhea and vomits frequently. She also cries a lot more than usual... she was always a "talky" cat, but she does this in the middle of the night to get us up to feed her. I have changed her dry food brand to one that I thought would be more more digestible and give her wet food (1/3 of a can of Friskies) plus some dry just before we go to bed ( around 11 PM). She drinks a lot of water and urinates frequently. The ultrasound was inconclusive. The vet says she has a thickened bowel and prescribed Pancraved which I put on her food. This has not changed her diarrhea nor her vomiting. She doesn't like it, eats the other two cats' food but still has lost a great deal of weight.
Submitted: 6 months ago.
Category: Cat Veterinary
Expert:  Doc Sara replied 6 months ago.
Hi there, I'm Dr. Sara. I'm a licensed veterinarian who works exclusively with cats and dogs. I'm so sorry to hear that you are having this rough patch with your elderly kitty. What is her name?There are multiple parts to your question that will take me a few moments (10-15 minutes) to type out responses for. In the mean time, I wonder if you could provide me with a little more info so that I can get the best idea of what's happening:Has she had any blood work performed? If so, what were the results?What treatments have been tried so far? What were the results?Thanks and I will get to typing while I'm awaiting your response.~Dr. Sara
Expert:  Doc Sara replied 6 months ago.
Vomiting and diarrhea can be a sign of "whole body" diseases like diabetes, hyperthyroidism, kidney disease, or cancer, so it's important to get her checked out. Chronic (long standing) vomiting and/or diarrhea in kitties is a very common complaint. If bloodwork and physical exam findings are all normal, the very first thing that I consider with chronic vomiting kitties is dietary sensitivity. I suggest that vomiting kitties avoid all things fish and seafood - these are common food allergy triggers. Some cats also do better on canned than dry food, as dry foods have been shown in research to contribute to inflammation in the gut and vomiting. My favorite over the counter foods for vomiting kitties are Natural Balance's Limited Ingredient Diets (they have multiple flavors) or Nature's Variety's Instinct diets. In severe cases I will suggest a prescription hydrolyzed diet or one formulated to be easily digestible like Purina EN.I usually perform both blood work and a broad spectrum deworming (like Profender or a course of fenbendazole) at the first visit with my vomiting kitties and recommend a diet change, followed by a recheck exam in about a month as long as they stay stable. If they aren't doing better at that point, I may recommend a prescription cat food like Royal Canin's Hypoallergenic Select Protein diets or a prescription hydrolyzed diet to further investigate for dietary sensitivity or suggest an X-ray and/or abdominal ultrasound. If the blood work was all normal, then I'm suspicious that we may have inflammatory bowel disease, which can be tricky to diagnose without biopsies. In a young cat or a cat with severe signs, I do recommend getting intestinal and/or stomach biopsies, and possibly run some tests to check pancreatic function. In an older cat I might discuss a trial of prednisone with the owner. Prednisone treats for IBD and it's usually quite effective, but it is usually a long term maintenance medication and can have some undesirable side effects such as predisposing the kitty to becoming diabetic. The choice on whether or not to begin prednisone is one that is individual to each cat, client, and situation. If they respond well to prednisone but relapse and start vomiting after we wean off the pred, I'll sometimes also consider trying a drug called budesonide. Budesonide is a steroid that is not absorbed as much through the intestinal tract into the blood stream but can have local anti-inflammatory effects and help keep the vomiting under control. Unfortunately, in older kitties with vomiting and diarrhea that don't respond to symptomatic treatment, cancer becomes a much higher likelihood. Intestinal lymphoma is a very common cancer in kitties and the signs can initially look exactly like IBD. They even tend to respond well to prednisone treatment, but the difference is that the treatment only helps for a few weeks or a couple of months before the signs return as the cancer progresses. Sometimes we can diagnose cancer with an ultrasound, but sometimes it does require biopsies obtained either by endoscope or an abdominal exploratory surgery - which is a lot to put her through at her advanced age. As for her litter box issues, it's really common for cats to stand on the edge of the box with their bottoms pointed outward. I suspect that it's usually the kitty's way of saying that they don't like the feel of the litter on their feet. All you can really do here is either make it easier to clean up the outside of the box or try to minimize her ability to "perch" on the outside of the box by placing the box up close against something taller like a wall or furniture. Yowling in the middle of the night and general night time restlessness is not uncommon also for cats of her age. If she has had blood work including a thyroid level run that all came back normal, then this is likely a sign of brain aging and senility. We have limited ways to control this, but your vet may be willing to discuss medicinal options like anti-anxiety medications, sedatives, or herbal calming products. Given all of her other health problems right now, I don't feel that it's appropriate for me to recommend anything specific since I'm not her veterinarian. I haven't received a reply yet regarding the questions that I asked earlier but I will be online for another hour or so and I'll continue to wait. Please let me know what questions I can handle for you.~Dr. Sara ----------------------------------------------------------------------------------------------------------------------------My goal is to provide you with the most complete and accurate “five star” answer. If my answer isn’t what you were expecting, it’s incomplete, or you have more questions PLEASE REPLY to let me know what information you are looking for BEFORE giving me a negative rating! If my answer has been helpful to you, please show me by giving me a favorable rating. Thank you so much :)