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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Cat
Satisfied Customers: 24471
Experience:  University of California at Davis graduate veterinarian with 44 years of experience
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I´m sitting here being in a lot of doubt about what to do. I

Customer Question

Customer: Hi ***** *****. I´m sitting here being in a lot of doubt about what to do. I have a 16 year old cat who I see is in pain (sitting in typical "pain positions") after eating and also after being to the toilet (urinating). He gets 5 mg of felimazole daily (I just increased the dosage from 2,5 mg forhyperthyroidism) and also Onsior (pain medication) every day. He has a calcification in his back and he therefore walks a little funny. He has had a lot of bladder infections (blood in bladder) and gets antibiotic for this 3-4 times a year. His fur is a little scruffy-looking and he has lost quite a lot of weight the last months. His blood samples are all right, both organ profile and hematology. I now give him wet food that´s easily digestible (Hill´s i/d), because everything else makes him very bloated, bulging especially on one side. He does not produce a lot of faeces, but urinates quite a lot. The vet´s done an ultrasound on his belly, but couldn´t find anything.
JA: Thanks. Can you give me any more details about your issue?
Customer: My name is ***** ***** I am uncertain if I should proceed with treatments or euthanize him.
JA: OK got it. Last thing — JustAnswer charges a fee (generally around $19) to post your type of question to Cat Experts (you only pay if satisfied). There are a couple customers ahead of you. Are you willing to wait a bit?
Customer: yes, but I don´t know why you call me ***** ***** ;)
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Submitted: 1 year ago.
Category: Cat
Expert:  Dr. Michael Salkin replied 1 year ago.

I'm sorry that your question wasn't answered in a timely manner, Linn, and I understand your concern at this time. My primary concern is whether or not I can maintain a good quality of life for my patient. I understand that he's being treated for hyperthyroidism (2.5 mg of felimazole twice daily will be more effective than 5 mg once daily) and with robenacoxib (Onsior) for his discomfort (please note that the maximum duration of administration of this nonsteroidal antiinflammatory drug is 6 days in cats according to the label). His weight loss in spite of being dosed with felimazole suggests that he's being underdosed and/or a concomitant disorder exists. You mentioned that his "blood samples are all right". Can you upload a copy of his test results to our conversation? I understand that you might not have a copy of the results at home but his vet should be able to give you one which you could scan into your computer and give me the link or you can photograph the page(s) and upload the images by using the paperclip icon in the toolbar above your message box (if you can see such an icon) or by using an external app such as dropbox.com. I not only review the test results but also note which tests should have been performed but weren't.

His appearing painful in spite of the Onsior indicates that this type of drug isn't appropriate for his type of pain; in particular, visceral pain is better addressed with a narcotic analgesic such as buprenoprhine. Please discuss this drug with his vet. Pragmatically speaking, if buprenorphine weren't helpful you'll have a difficult decision to make. It frustrates me that I can't be more specific for you at this time. A cat of his age will suffer from multiple disorders in the great majority of the time. I'm less interested in advance testing than I am in keeping him comfortable. I'm hopeful that the narcotic, stopping Onsior administration, adjusting the frequency of his felimazole, and spoiling him with the Hill's i/d warmed in your microwave will provide him comfort in his old age. Every day is a gift at this time.

Please respond with further questions or concerns if you wish.

Expert:  Dr. Michael Salkin replied 1 year ago.
Hi,
I'm just following up on our conversation about your pet. How is everything going?
Dr. Michael Salkin

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