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Dr. Drew
Dr. Drew, Veterinarian
Category: Pet
Satisfied Customers: 16429
Experience:  Small Animal Medicine and Surgery
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Hi Dr. Andrew, have a cat that is about 17 years old with a

Customer Question

Hi Dr. Andrew, have a cat that is about 17 years old with a few problems. The main one is that she has a tumor next to the liver -- although, not clear if it is malignant or benign. The kidney issue is not urgent and appears to be manageable. Need to understand if surgery is an option for us for Smokey? She is still fully functioning, but is very lethargic and we are giving her pain medication. She still eats, but not as much. A lot of information to cover, so let me just give you the blood work that was done recently:Yes, blood work was recently done, and it is not good. These are abnormalities:

Bun: 67
Creatine: 3.2
Amylase: 2802
WBC: 25.7
HGB: 8.9
HCT: 28
MCV: 35
Platelet: 524
Neutrophiles: 23644
Lymphocytes: 771
Eosinophils: 1028

Smokey weights 5.1lb (her normal weight was between 6.4 and 7.5 lb)

She has no nausea, but eat very-very little food.
She was prescribed Mirtazapine and we started it today.

Gave her Buprenorphine and it appears to be coming her down.
Submitted: 11 months ago.
Category: Pet
Expert:  Dr. Drew replied 11 months ago.

Dr. Drew :

Hello, thanks for your question today! I am Dr. Drew, and I am a licensed veterinarian. I'll be happy to help you in any way I can.

Dr. Drew :

Surgery is rarely going to be a means to a cure, in a very elderly cat, unfortunately.

Dr. Drew :

additionally, the risk of anesthesia in elderly cats is quite high.

Dr. Drew :

When one of my patients is in a situation like this, it is very very rare for me to recommend surgery.

Dr. Drew :

I tend to want to make my patients' quality of life, the main priority --

Dr. Drew :

and I have a hard time convincing myself that a 17 year old cat is going to have a better quality of life after a significant abdominal surgical procedure, in most cases.

Customer:

Thank you for the quick response -- Understood! Is there any medication that we should be giving her such as Prednisone or anything else that could help? Anything at all?

Dr. Drew :

Prednisone is certainly something to try, as some cancers might improve slightly, for a period of time,

Dr. Drew :

and it can enhance appetite as well.

Dr. Drew :

also, your vet can show you how to perform sub-cutaneous fluids at home, to help maintain Smokey's hydration.

Customer:

Understood. Based on the blood test provided, does it look really bad or is there more time for smokey?

Dr. Drew, Veterinarian
Category: Pet
Satisfied Customers: 16429
Experience: Small Animal Medicine and Surgery
Dr. Drew and 5 other Pet Specialists are ready to help you
Expert:  Dr. Drew replied 11 months ago.
Our chat has ended, but you can still continue to ask me questions here until you are satisfied with your answer. Come back to this page to view our conversation and any other new information.

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If you haven’t already done so, please rate your answer above. Or, you can reply to me using the box below.
Customer: replied 11 months ago.

It looks like the chat system went haywire for a while... just to follow up on the last question regarding smokey trouble eating -- shaking head after taking a few bites. It seems that she has pain, but no inflammation in mouth and nothing that is obstructing her throat. Initially, a few months back she was doing the same thing after eating, but doc found an inflammation and after some antibiotics, it went away, and now it has returned with a vengence, but no sign of any inflammation and our doc is perplexed. Thought you might have seen it before and have some suggestions for treatment?

Expert:  Dr. Drew replied 11 months ago.
Yes, the chat system seemed to not be cooperating!

Anyhow, the shaking of the head when trying to eat, might point to an abscess of a tooth root, or a problem in the TMJ (the joint of the jaw), or the inner ear, which lies immediately next to the joint.

These sorts of issues can be tough to identify on examination alone, more advanced imaging such as intra-oral x-rays, and/or MRI or CT scan might be necessary to identify the cause.

The prednisone we discussed earlier, might help reduce such symptoms, so it's probably my best suggestion at this point.
Expert:  Dr. Drew replied 10 months ago.
Hi Danny,

I'm just following up on our conversation about Smokey. How is everything going?

Dr. Drew
Customer: replied 10 months ago.

Thank for following up. We took her to the doc yesterday and he gave her a Vitamin B12 injection. Also, we gave her earlier today a subcutaneous fluid inejction.


 


She was better in the morning, and walked and drank some milk. But she hasn't eaten anything since. And we've tried everything, including Stella & Cheweys raw food, which she has eaten before and generally works. Any suggestions?


 


Thanks,


 


--Danny

Expert:  Dr. Drew replied 10 months ago.
Elderly cats who refuse to eat, are difficult to manage without more aggressive measures such as a feeding tube placed in the esophagus. Unfortunately, many elderly cats with illnesses of varying types, will eventually decline significantly due to an inability or loss of interest in eating. Many owners elect euthanasia when nothing seems to be helping in this situation. You're already giving Mirtazipine, so there's not much else to try in terms of non-invasive approaches.

Customer: replied 10 months ago.

Understood. Hi, besides the vitamin B-12 injection, also gave her MPA steroid injection. And administring subcutaneous fluids. She appears to have a bad rejection to the steroid injection and currently not eating -- is that possible?


 


Any suggestions?


 


Thanks,


 


--Danny

Expert:  Dr. Drew replied 10 months ago.
Steroids can sometimes cause cats with underlying heart disease (whether recognized or not), to suddenly worsen... that's about the only situation I have encountered where a steroid would cause a loss of appetite.

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