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Dr. B.
Dr. B., Cat Veterinarian
Category: Cat Veterinary
Satisfied Customers: 19026
Experience:  Small animal veterinarian with a special interest in cats, happy to discuss any questions you have.
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My cat is 7yrs old, had a history of red blood in his

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My cat is 7yrs old, had a history of red blood in his stools, has had a lot of vomiting over the years too. Every time he's taken to the Vet to find it what's wrong they have no answer. He recently stopped eating and drinking. He stayed overnight at the vet on a drip and being force fed. He still refuses to eat and will spit out whatever he can. I've tried to entice him with fav foods. It's a battle and a food fight every time I try to feed him. He growls and howls everyone I pick him up. He is a cat that normally has separation anxiety and I'm wondering if it could be stress related and if it was possible that he could have ulcers? I don't know what to do, I hate fighting him to eat
JA: I'm sorry to hear that. Hopefully it didn't make a mess. Did your cat eat anything unusual?
Customer: Not that I know of. He is not a hunter either
JA: OK. The Veterinarian will know what to do. What is the cat's name?
Customer: Prince
JA: Is there anything else the Veterinarian should be aware of about Prince?
Customer: The Vet that saw him said that his blood test checked out. Nothing serious to put it down to so generally nothing wrong.

Hello & welcome, I am Dr. B, a licensed veterinarian and I would like to help you today. I do apologize that your question was not answered before. Different experts come online at various times; I just came online, read about your situation, and wanted to help.

Again I do apologize that my colleagues could not aid you sooner. If you would still like assistance, can you tell me:

How old is Prince?

What tests besides bloods have his vet done?

What treatments besides fluids have been tried?

Have his stools ever been black?

Are his gums pink or pale/white?

Is it when you press on his belly he seems sore?

Customer: replied 6 months ago.
Hi Dr BSorry for the delay, was at work.
In answer to your questions
1. Prince is 7yrs old
2. Tests were Spec Fpl Snap, P C V/T P, Biochem Panel Full.
3. Force feeding with Hills A/D dog/cat
4. Stools have been very hard and small amounts usually accompanied with blood and sometimes mucous. Stools don't usually appear black. However at this stage I have not seen him do one since Wed afternoon before he spent the night at Vets on Thurs.
5. Gums are yellow as he has been dehydrated as well.
6. He hates being held, always growls when picking him up but noticed he complained when I tried paying him along his sides.I'm thinking if he could be severely constipated? Vet seemed to think he was generally otherwise a healthy cat and this complaint has been undiagnosed for several years on and off. He has had vomiting for no apparent reason too.I hope this helps
Linda

No worries Linda,

Now I have to say that if Prince gums are yellow, I am quite worried. Yellow gums is a sign of liver issues or possible immune mediated haemolytic anemia (less likely if the PCV which is a check of red blood cell levels is normal). So, that would be a major concern here and if he has a swollen liver (from inflammation, infection, bile duct obstructions, or a mass), then he could certainly be sore when lifted and pressure is put on this. And while constipation could also cause discomfort, it’s a bit less likely if he isn’t eating well and only having easily digestible food like A/D.

As well, I would just note that since the liver is responsible for some clotting factors and if those are low then we could see blood in the stools. Though mucus/blood can also be a sign of colitis (inflammation in the lower bowel) and that is associated with nausea leading to vomiting or appetite loss in the cat. So, that too is a concern but if he truly has yellow gums then I am worried about his liver.

Therefore, if that is a new finding, we’d want to make his vet aware of this. Liver values should have been tested with the biochemistry but they may need to think about a bile acid stimulation test +/- ultrasound to see what is going on with that liver. Depending on their findings, he may need anti-nausea medication (ie Zofran, Metoclopramide, Cerenia), appetite stimulants, and liver supportive treatments (ie Sam-E, milk thistle, etc). And we’d hope that if we can tackle those angles the vomiting will reduce and he will eat for us as well.

Overall, there are many reasons to see the signs you reported in a kitty and colitis (bacterial, inflammatory, protozoal) would be a concern for his general signs but if he does have yellow gums then I am concerned that his liver is the source of his major signs and something we need his vet to focus on with Prince.

Kind regards,

Dr. B.

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Customer: replied 6 months ago.
The Vet suggested that v it could be the bile causing the yellow color as they could not feel any lumps when examined him. They also suggested an ultrasound to be sure. Still force feeding him today and no poop in his tray yet. I have added a small amount of olive oil to his A/D in the hope that it may help elimination. I need to call the Vet again to let them know how he went over the weekend. Should I pursue the ultrasound?

Hi again,

Now bile can discolour the vomit but wouldn't really stain the gums. If there is any doubt, liver issues can also cause yellowing in the whites of the eye or on the skin where the fur is thin (or where he may have been shaved for bloods). Or you are welcome to send me a picture of his gums (using the paperclip icon above your text box or posting it on any site and sending me the link). Otherwise, I do think that it is worth ringing them about what his liver enzymes were at on the bloods and then thinking about an ultrasound. As well, since olive oil is a bit too digestible, if you don't find that gets things moving in the gut then try cat hairball treatment, Miralax or have his vet dispense Lactulose to help with that.

Best wishes,

Dr. B.

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If you have any other questions, please ask me – I’ll be happy to respond. **Please rate me afterwards by clicking on the "Rate my Expert' button at the top of the page as this is the only way I am credited for helping you. Thank you for your feedback!: )

Customer: replied 6 months ago.
Thank you so much for your assistance. So far the Vet is organising an ultrasound today.
The yellowing of his gums is the same in his eyes and skin. Vet is concerned about liver and gall bladder even though blood testing for liver was normal. Suggested more information would be gained through U/s.
Prince did cough up a very large hairball yesterday about 1:30 and had bowl movement... stool looked like started with dark dry bit but changed to same color and softer consistency of A/D that he's bbeing force fed. At 2pm visited Vet for checkup after weekend and he was given fluids and half a tab of appetite encourager.
Bought roast chicken and he was very interested in having some. Eventually he managed to consume approx a 1/4 of the chicken (drumstick & wings inc some small bones). He's started cleaning himself and wandering through the house.
Can't wait to see what the results will be from U/s today.

You are very welcome and thank you for the update.

I am glad to hear that the gum situation has been confirmed and that the ultrasound is being organised so we can get to the root of this for Prince. I agree that this tends to be our best tool for checking the liver (of inflammation, abscesses, masses, scarring, etc) and the bile ducts (for inflammation, blockages, etc). And it can really shed light when the bloods aren’t giving us clue. So, it was a good catch on your part of have seen their being yellow along with those other tissues and letting them know.

As well, its positive that he did eat quite a bit of the chicken (though do take care with the bones since we don’t’ want any gut damage or irritation) and is showing signs of being in better spirits.

So fingers crossed for his ultrasound giving us a definitive answer here and keep up the good work,

Dr. B.

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If you have any other questions, please ask me – I’ll be happy to respond. **Please rate me afterwards by clicking on the "Rate my Expert' button at the top of the page as this is the only way I am credited for helping you. Thank you for your feedback!: )

Customer: replied 6 months ago.
Hi again Dr BI am so glad that I am able to discuss these concerns with you and I really appreciate your advice. So here is another update on Prince since the Ultrasound.The result of the U/s was a lot of inflammation around the RHS of his pancreas and lots of extra fluid outside in surrounding tissues. The Vet gave him a Cortisone injection and sent him home with more cortisone tablets (20x Microlone) to give him one per day and also some appetite enhancer tablets to help him to keep eating. We are looking at pancreatitis now. Is this something that he should recover from? What signs do I look for if this goes bad? How long should this process go to know if it is working the way it should for him to get better? Long term prognosis... is it likely that he will suffer from now on with this and we will always need to be careful and watchful of relapse or is it something that he should get over and be ok?He has been slowly increasing in strength so giving him any food by syringe or tablets are now getting more difficult, which in a way is a good sign. We did buy him another roast chicken and are giving him the meat in small doses but often so that he won't gorge but will keep it down and keep eating it fresh when it is put out.He wants to go outside but I am worried that he will end up fighting with the cat over the back fence while he is still in this weak state so I am letting him wander the house during the day and when he needs the litter tray I put him in the pen until he uses it then let him out again after he's done.He is still not drinking fluids so I am biding my time before attempting to syringe water for him, not sure how long I should wait. The last time he was given fluid subcutaneously was on Monday, what do you suggest I do?The Vet said that they would call us again on Friday to see how he is but if we had concerns then we should contact them. We have a Public Holiday on Thursday so they will not be available then.Thank you so much for your help.
Linda

Good morning Linda,

What a wee little mystery Prince likes to be. I am glad to hear that this pancreatitis (which sounds quite severe) has been found despite his PLi being normal and his having been jaundiced. In any case, its good that we have had the scan and have some answers to focus our treatment with. So, his vet’s course of action sounds good so far and hopefully we can get that inflammation down and get him back to normal. Though I would just note that when you can, speak to them about pain relief (ie Buprenorphine) for him since pancreatitis is know to be quite painful in people (and we assume it is in cats as well). And I’d suspect that if we could counter that for him as well, we’d continue to see him feel better.

Now while he is keen to go out, we cannot let him do so at this stage. If you have a kitty harness/lead, he could go out supervised but we’d not want to risk him popping away and thus missing treatment. And in regards ***** ***** and your question of prognosis, provided there is no abscess or tumor on the pancreas, then he has a good prognosis. Some cats can be tricky to settle with this condition but most do respond and the inflammation does go down. That said, some will have chronic or recurrent flare-ups . So, often we need to keep them on low fat food to prevent that but again its more treatable then if we had found a mass or an abscess on the pancreas.

In regards ***** ***** to look for with deterioration, we’d just have an eye out for belly pain, vomiting, anorexia, weakness, and him withdrawing. But from what you have said his being more naughty about his medications and being more interactive all supports positive progress and a move in the right direction for Prince.

Keep up the good work,

Dr. B.

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Customer: replied 6 months ago.
Thank you so much, it had been great getting your advice and reassurance.So far Prince had been feeding himself, not just chicken but also some wet food and drinking water with a small amount of dry food.I haven't needed to give him the appetite enhancer yet so I am very happy with his progress. I will keep an eye out for any changes like you mentioned and on Friday when the Vet calls back I'll ask them about pain relief.Thanks again for all your help
Linda