Increased thirst and weight loss

My 14-year-old male cat has been exhibiting increased thirst and has been losing weight over the past few months, despite eating just fine. We've done two different sets of bloodwork and urine tests over that time, and they both came up perfectly fine. The vet is now suggesting an X-ray and ultrasound, and is muttering about intestinal cancer.

So, a few questions:

- do the symptoms sound like something that would show up on an X-ray and ultrasound? I'll be frank, I don't have a ton of money to spend on tests, and I really only want to spend that kind of money if there's a chance that we'll find something that will be of use.

- so say it is some form of cancer. Is there really any chance of treating it? That sounds awful, but doing the tests just to know that he's got something that can't be cured seems kind of pointless.

- on the other hand if there's a chance that he's got something curable, then I'm more willing to do the tests. Is there much likelihood of that, based on the symptoms I've mentioned?

- is there something else that the vet should be looking for that maybe they've missed?

Hello and welcome to TCS. I'm sorry to hear of your sick kitty.

This is how I see your situation. Either you pay for the necessary diagnostic tests and find out what's going on, or you leave him be and let him go when his quality of life deteriorates.

You do of course also have the option of getting a second opinion from another vet, or a veterinary internal medicine specialist.

No one can make this decision but you. Some cancers are treatable, there are surgeries, and chemo therapy. Some are not.

14 is not too terribly old, and I would have the diagnostic tests done, in your situation (and have done so). Even if the results show something untreatable, or even a treatment that I would not agree to anyway, I prefer to know what is going on.

However not everyone sees things the same way. If you decide against the diagnostics, be sure to ask your vet for ways to make him as comfortable as possible until his quality of life is gone.

Did the blood work include a thyroid test? If so, what was the T4 result? It would be very important to take a look at that number.
Also, what about the blood glucose level in the chemistry profile? Elevated blood glucose would go with weight loss, increased thirst and normal appetite.

In addition, increased thirst can be a sign of CRF, infection, liver disease or liver cancer, intestinal inflammation, or intestinal lymphoma. But you don't see good appetite with any of these conditions. You see a troubling loss of appetite and weight loss.

Intestinal cancer may or may not show up on X-rays, or even if you do an ultrasound. Some cancers can only be found with exploratory surgery.
Liver cancer (a tumor) may show up on an X-ray, but some liver tumors remain hidden and can be seen only if you do an ultrasound. However, such tumors cause an elevated ALT, so you know what you're looking for when you decide to do X-rays and an ultrasound.

In this situation, if I were you, I would start by getting copies of all the blood work that was done and go over all the results myself most carefully. Very important to look at some of the values in the CBC, and several values in the complete chemistry profile.
(Sometimes out of range values get overlooked, the owner doesn't find out about them, so you'll want to make sure this didn't happen.)

Also consider going to another vet and have all the blood work redone. (In addition to a very thorough physical.) Make sure the sample is sent out for testing (not done in-house) and that the other vet uses a different lab than your regular vet.

My feeling is, there are (and will be) some clues in the blood work results, so you should really start there. X-rays and ultrasound can wait a little, a few days won't make a tremendous difference.

I had them fax me the bloodwork results today (going back a couple of years). His T4 levels are in the normal range (1.6), and haven't really changed much over the past couple of years. His glucose levels have risen and fallen in the tests, but were all within normal (106 - 120). The only things that are abnormal in the tests (both from a few months ago and from last week) are some urinalysis results:

Protein: 1+ (HIGH)
Occult Blood: 2+ (HIGH)
RBC/HPF: 4-10 (HIGH)

Think it means anything?

What do you have for most recent BUN, creatinine, albumin, and WBC?

Did your vet say anything, anything at all, about the urine test results?

I'm thinking that doing a simple X-ray to look at the kidneys might not be a bad idea at this point. Your vet might even have suggested that.

Here are a few articles with some very basic information

http://www.vin.com/proceedings/Proce...nt=1&O=Generic

http://www.peteducation.com/article....+1473&aid=3136

http://www.cat-world.com.au/urinalysis

http://www.winnfelinehealth.org/Heal..._Tests_Web.pdf

http://local.petmd.com/Excess_Protei...nction_AZ.html

BUN: 34
creatinine: 1.9
albumin: 3.6
WBC: 6.2

Does that tell you anything?

Sounds like our best bet is to start with an X-ray, and then go from there...

Since 15-34 is the normal range for BUN, 34 is still within normal range, but on the high end. Coupled with normal creatinine (1.9 is well within normal range - 2.3 would be high normal), this might indicate the beginning of a kidney problem. Not necessarily though, things can still be all right with the kidneys unless urine test results show some definite problem. I believe you need to talk to your vet, ask some questions about the urine test results you posted earlier.
There is nothing alarming in the blood values you have just shared, all four values are normal. So no answers there.

From what I've noticed with my own cats, they start drinking more when they reach a certain age, but their kidney values (based on blood and urine tests) remain normal for several more years.

According to information, weight loss can be a normal part of the aging process, but it can also be a sign of illness. Going by my own experience again, finding the underlying cause can be difficult sometimes.

This article talks about age related weight loss and other problems.
http://www.vet.cornell.edu/fhc/brochures/seniorcat.html

Under Proper Nutrition you'll find this:

Other cats actually become too thin as they get older, apparently as part of the normal aging process. But progressive weight loss can also be caused by serious medical problems such as kidney failure, cancer, diabetes mellitus, inflammatory bowel disease, liver disease, hyperthyroidism, or some other condition. Subtle changes in weight are often the first sign of disease;

Click to expand...

I keep thinking about your situation, wondering what would be the best thing to do. If you trust your vet, you might want to have a long talk, do the X-ray we talked about, and repeat the blood work. If you have doubts, do seek advice from another vet (perhaps someone friends or relatives have found trustworthy) and have blood work and other diagnostic work done there.