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catzanddogz
catzanddogz, Veterinarian
Category: Cat
Satisfied Customers: 221
Experience:  I am a Veterinarian and a pet owner. I have practiced cat and dog clinical medicine for over 25 years.
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My 18 1/2 year old cat used to be 9 pounds years ago and is

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My 18 1/2 year old cat used to be 9 pounds years ago and is now 4 lb 7 oz. She has orange colored diarrhea every time she eats. My vet has looked at her liver, pancreatic and kidney enzymes. All are pretty normal. An internal medicine vet did an ultrasound on her and said her bile duct looked twisted, otherwise everything looks very good!  She is just a skeleton with fur, I am beside myself at her state. Please can you tell me what is wrong with her? Could it be gallbladder disease? Please for goodness sake help us.


catzanddogz :

Hello, I am Dr. Andrea Russo and I will be happy to try to answer your questions about Puffin. I am so sorry to hear about her condition. I have a few questions: I am wondering if any of the medication helped at all? especially the steroids? How long ago was bloodwork and the ultrasound done? Do you have a copy of the ultrasound report (if you get that you might post the results here). It sounds like Puffin isn't able to digest or metabolize food well anymore. How is her appetite? what are you feeding her? Have to tried different types of diets? Does her skin or the whites of her eyes look yellowish or orange in color? From your description of her history, the orange colored stool and "twisted" bile duct could indicate that she has disease related to her gall bladder. However, at her age, with chronic weight loss, I would also be concerned about lymphoma, or some other type of intestinal cancer.

Customer:

All the tests are recent as in less than 2 months old. It's very hard to say if she has jaundice because of her eye and fur coloring.... Her appetite is VERY poor, hence the 4.7 lb (now maybe less than that:() weight The best she felt was about 3 weeks ago, right after she'd gotten a long acting antibiotic injection. She was eating and acting like herself, grooming, etc. Then last week the vet gave her antibiotic injection and a steroid injection together and this did not perk her up at all. That's why I'm thinking it could be bacterial cholicystitis. There is such a thing, correct? What antibiotic would work best for this?

catzanddogz and other Cat Specialists are ready to help you
Cats can get cholangitis. Sometimes it is acute disease and other times chronic, it can be bacterial to begin with then sometimes advances to a chronic immune-mediated condition. Therefore we usually use antibiotics and steroids. I am guessing that the long acting antibiotic she was given was Convenia, which is one of the antibiotics we use. I have also used Clavamox or Amoxicillin. Sometimes we also use Metronidazole although it is harder to give cats because even the flavored liquid form is somewhat bitter. Depending on the condition of the liver and the bile duct, we will also give them Urosodiol to help bile flow. This condition can involve the liver and pancreas as well. These cats sometimes need fluids and Vitamin B12. The vet who did the ultrasound can do a needle aspirate of her gall bladder or liver to get a more definitive diagnosis but this sometimes requires sedation and can have risks associated with it. Sometimes we will repeat bloodwork for comparison to see if values looks better or worse but despite any diagnostic tests - the prognosis is guarded at her age and cancer is the hardest thing to rule out. I would also ask for probiotics from your vet - that might help with the diarrhea.
Customer: replied 3 years ago.

My vet thinks it's lymphoma... he tried to give her half a Zeniquin pill but she threw it up as her stomach was empty. He also injected her with Cerenia and Buprenex and also gave her a fluid pac with B vitamins and has given me a prescription for Leukeron to start tomorrow... what do you think?

I think his plan makes sense. You can do endless diagnostic tests (needle aspirated, surgical explorations, biopsies) and in the end you still have a sick cat with multiple symptoms. Perhaps the ultrasound showed thickened intestines as well as a twisted bile duct. The majority of cats this age with chronic weight loss have lymphoma, and it commonly affects the intestinal tract. I am comfortable with the Cerenia, Buprenex and Fluids and B- Vitamins - these medications treat possible infectious gall bladder disease and treat for pain and dehydration. You can ask him about Mirtazepine - a medication that helps stimulate appetite, and probiotics if the stools stay loose. I hope some of this makes her feel better. It's so hard to see them get old and sickly. Feel free to keep me updated - I'd like to know how things go.
Customer: replied 3 years ago.

She weighs 4 lbs now :(((((( And she still isn't eating anything, I don't know how she is going to keep any pills down on an empty stomach...


:(((((( I am so sick about what's happening to my Puffin, i don't know what to do... seems like there isn't anything I can do :(((((((


She seems a little high, probably from the Buprenex... I just hope she will eat something soon because she is evaporating right before my eyes :((((((((

Some medications can be "compounded" into liquid form - some vets have something called Flavor-X which gives recipes to take pills and mix them with flavored liquids or there are online pharmacies, such as Wedgewood, that can supply certain medications as liquids. There are even some people pharmacies (not the big standard ones but the smaller independent ones usually) that can make pills into liquids. I hate to have you struggle to get pills into her. The Leukeran is pretty small if I remember. You should be careful to wash your hands after handling the pills so you don't absorb the medication yourself. I'm so sorry that she is so ill. I know it won't make you feel any better to say that she has lived a long life, 18 1/2 years, thanks to your care and love. The most important thing now is her comfort.
Customer: replied 3 years ago.

She just won't eat and I don't think she will survive very long if she doesn't eat... I nursed her back from FIP but this seems pretty hopeless.


We just tried to give her some Catsure with a syringe and she just wouldn't take it and now is hiding from us...


Maybe this is the end after all...

I am so sorry. I can tell that you love her very much. You may have to let her be for the night and let nature take its course. Hopefully she will come out from hiding after a little while. You have certainly tried to everything you can.