Help!!!!!! Help me decide whether this is an emergency :(

After his urinary blockage in December, Spencer got a clean bill of health at his follow up appointment on Jan. 30. Perfect pee PH, no crystals, no UTI, kidneys perfect.
Fast forward 2 weeks, and last Sunday Spencer started acting weird: sleeping a lot more, not playing (like running after the laser pointer) anymore, and a decrease in appetite.
On Tuesday night I took him to the vet. Of course at the vet Spencer acted totally normal, like he knew he had to put on a show for the vet: eating the treats the vet gave him, playful etc. so basically the vet checked him out and found nothing. His bladder was small (and anyway I saw him pee), no fever at all, and because he has not vomited or had diarrhea the vet told me it was probably just a mild "cat cold". He gave me some cerenia.

Well, it's now Saturday and I'm franking out. It's like Spencer is not improving at all, he's still the same, sleeps most of the day and eats very little. I don't know what to do. His regular vet is closed tomorrow. I'm sure they can fit him in on Monday. I'm trying to avoid the emergency vet hospital, because basically after his blockage which cost me $3200 plus the follow up visits, I am now broke. If I do have to take him there tonight I will, but if it could wait for Monday, or maybe I could find another another vet open tomorrow I'd take him there, if this can wait tomorrow.

Basically his symptoms are:
Looks grumpy, like he's in pain or something. But he doesn't yowl or anything when I touch him
Lack of appetite
He's alert but somewhat lethargic, not as playful

He DOES pee fine (I've been following him to the litter box) but I haven't seen him poop since last Tuesday and he does have the look of someone who's constipated. His behaviour is different from when he had the blockage.
He shows interest in food but mostly just licks it, the kibbles too he lick them and walks away.
He has not vomited nor had diarrhea.

Does anyone have any idea/previous experiences about a situation like this. I don't understand what's wrong with him, should I take him to the emergency? Or can I wait tomorrow. I'm sorry I have so many question and I'm rambling so much, but I'm at the end of my rope. I can't take seeing him like this anymore.
Why was he doing so great for a whole month after his blockage incident, when he came home he was like a kitten again and then Jan. 30 he passed all the tests fine and on Tuesday the vet can't find anything wrong but now he looks like this?

*Well, it's now Saturday and I'm franking out*
I meant "freaking out" !
That is such a weird typo because my fiancé's name is Frank! First smile of of the day

I'm sorry you're going through this. I would definately call the vet right now and tell them he hasn't pooped since Tuesday and see what they say about that.

I hope all is well soon.

The vet is closed... It's 8 pm here. I'm not a 100% sure he hasn't pooped since Tuesday. I saw him do it Tuesday, haven't seen him since. There was poop in the litter box everyday but I do have 2 other cats. He definitely hasn't pooped today cause I'm at home and I've been watching him.

It sounds like he is constipated.  Five days is one day longer thank good.  You can give him canned pumpkin with a syringe and you mix it with a little molasses and that will help.  We've done this several times and it has worked.  I would see a vet asap if that doesn't work by Sunday and get him in after it does work for an evaluation.  He might be dehydrated as well. I hear the worry and have been there many times myself.  He may need a little help. Sometimes this just happens without reason. He's lucky you know him so well to see this before it's a bad deal.  Laura
 

I meant you could call the 24 hour vet and see if they think he needs to be seen before Monday.

Oh I see. Nope the 24 hour vet won't tell me anything, only "you have to bring him in, etc..."

Why do they always get sick in the evenings and on weekends and holidays???!!

Make sure he eats. Syringe feed if necessary. Sounds like constipation (if bowels fill up, then he feels full), so go for the pumpkin.

Do you know anyone who can feel the colon and tell if it's full of stool?

Not really I've been force feeding him but he HATES it. It's morning now here - 8:15 am - and has peed this morning, twice - phewww - but still looks pissed off, won't play, won't eaton his own... I'm trying to find a vet that open on Sundays. If I can't, it's going to be the emergency...

If-you-suspect,a-kitty-has-pee/poopie-issues,in-a-multi-cat-household,what-you-do-is-put-that-kitty-in-a-room-by-him/her-self,with-a-cat-box-and-food-and-water.That-way-you-can-tell-for-sure,if-the-kitty-is-peeing/pooping-normal,and-how-much-food-they-eat-or-don't-eat.No,they-aren't-going-to-like-it,but-even-a-vet-will-tell-you-to-do-this,and-who-is-the-parent-here,lol.

You-could-try-giving-him-Petromalt,but-I-wouldn't-know-how-much-to-tell-you-to-give,mine-get-a-dose-once-a-week,for-hairballs,but-you-can-also-give-this-if-you-catch-constipation-very-early,or-poopies-are-harder-than-they-should-be.

If-he-has-not-pooped-since-Tuesday,he-may-need-help,as-in-an-enema,from-the-vet,and-he-will-have-to-stay-for-the-day.

If-he-is-not-eating,then-he-is-not-drinking,and-you-need-to-be-concerned-about-dehydration,which-would-also-make-him-act-like-that,not-feeling-good.

In-any-case,he-needs-to-go-in-first-thing-Monday-morning,and-ask-for-an-x-ray.That-will-show-if-he-is-constipated.Been-that-route-once,you-can-see-the-poop-in-his-intestines,on-the-x-ray.If-that-is-what-shows-up,he-will-be-given-an-enema,and-stay-for-the-day,or-until-he-poops.

If-he-is-not-constipated,the-x-ray-will-show-if-anything-else-is-going-on-in-there.

If-the-x-ray-shows-nothing,then-they-need-to-do-a-CBC-and-Wellness-blood-panel.That-will-show-if-any-values-are-not-normal,and-he-may-have-other-issues,it-gives-the-vet-a-place-to-start.

The-vet-should-have-done-this-when-you-went-in-the-first-time,with-a-kitty-that-does-not-feel-well,and-an-visual-exam-shows-nothing.

If-you-don't-have-the-money-to-take-him-to-the-ER,then-call-your-vet,first-thing-Monday-morning.Best-of-luck.

Thanks a lot I am shy and wanted to ask for more tests last Tuesday but did not, it's my fault, I should have been more assertive.
I can take him to the emergency, it's just that I would have rather avoided it.
I am also very suspicious that it is constipation, because when I took him to the vet last Tuesday they took his rectal temperature, of course, and then when we came home Spencer ran to the litter box right away and I remember thinking, oh that's gonna be a big one, because he was pushing like crazy; but then only 2 thin, little poops came out. So I think maybe having the thermometer up there stirred things up a little and helped, but not enough.
I will most probably take him to the emergency today, hopefully they can proceed by elimination, like do the x ray first, then if nothing the blood test, etc., so that they don't do all the tests at once and I would have to pay for an urine analysis and a blood test for nothing.
I'm just praying its not cancer

It-was-the-vet's-job-and-responsibility,to-do-the-tests,when-presented-with-a-kitty-that-was-not-eating/didn't-feel-good,when-a-visual-exam,shows-nothing.

Some-medical-issues,when-presented,a-visual-exam,will-pinpoint-the-prob,case-closed.

If-they-can't-see/determine-the-cause,then-its-their-job,and-their-responsibility,to-do-an-x-ray,thats-usually-the-first-thing-done.It-shows-if-something-else-may-be-going-on-in-there-that-may-be-causing-the-issue.The-normal-is-done-on-their-side,that-either-shows-something,or,it-doesn't.OK,now-we-gotta-look-further,so-they-do-the-blood-panel.In-most-cases,the-values-that-are-not-normal,give-the-vet-a-place-to-start,tells-them-what-the-issue-might-be-and-they-know-what-other-tests-to-run,or-what-areas-to-pursue.

When-my-female-didn't-eat-her-breakfast,she-went-right-in,eating-is-her-mission-in-life,she-has-a-masters-degree-in-it,lol,so-I-knew-something-was-wrong.

Visual-exam,nothing,did-an-x-ray,nothing,did-the-blood-panel,ahhhh-now-we-are-getting-somewhere,showed-her-ALT-value-was-917.Normal-is-10-100.

My-vet-got-right-on-the-phone-with-an-internal-medicine-specialist.He-said,run-it-again,they-did,3-times-they-pulled-blood-from-her,and-retested-that.Still-read-917.

Specialist-said,now-do-the-x-ray-from-the-top.Binnnn-goooooo,that-showed-"something".Vet-said-it-showed-something,but-she-could-not-determine,what-it-was,but-something-that-was-not-right.Specialst-said,send-her-for-an-ultra-sound,like,on-a-ER-basis.

THAT,showed-what-the-issue-was,and-now-she-was-put-on-the-right-meds,and-now,they-knew-what-they-were-dealing-with.

Like-you,I-sat-in-the-waiting-room,for-a-very-long-time,while-all-this-was-going-down,and,like-you,scared,thinking,what-the-heck-is-wrong-with-her.

I-have-an-awesome-vet.She-pursues,until-she-finds-the-issue,even-getting-on-the-phone-to-the-specialists.I-cannot-even-imagine,being-told-that-day,she-prob-has-a-cold,and-sending-her-home,she-would-have-died.

Like-you,I-imagined-the-worst.

Insist,on-the-tests,insist-on-him/her-calling-a-internal-medicine-specialst.Stand-and-fight.Spencer-can't-do-it,ya-gotta-do-it-for-him.

Let-us-know,what-the-tests-show,be-very-glad-to-help-you,if-your-hitting-a-brick-wall.

It pretty much sounds like constipation. Let us know how he's doing after the vet. Good luck.

Spencer-update (a Spupdate??)

I took Spencer to the emergency vet yesterday morning.

The vet there did a radiographic of his abdomen.

They found nothing, all normal. No constipation, actually he pooped later after I took him home.

She did a complete, thorough blood test.

They found nothing.

No temperature, normal heart rate, etc.

They prescribed an appetite enhancer and I took him home.

The appetite enhancer did nothing, this morning Spencer still hadn't eaten, so I took him to his normal vet as soon as it opened, 8am.

They tested him for FIV and leucemia, as well as pancreatitis.

All tests came back negative.

The vet called me at work. She mentioned the name of what Spencer has been diagnosed with, but I forget what it was... a french word anyway (I'm from Montreal).

Basically, he's got HL - and thank god it's still the early stages. He hasn't started getting yellow yet.

They are keeping him at the vet today, overnight and tomorrow all day, and force feeding him with a syringe, which I'll have to continue at home afterwards. I'm really nervous and scared about that But the vet says Spencer is taking really well to the syringe, he hasn't vomited or regurgitated.

So that's it, I hope all goes well. I'm really scared and questioning myself why this is happening to him... the blockage in December and now this. I wonder if the HL is due to the 6 lbs he lost following his blockage, anybody has any thoughts??? 

The HL is from not eating, but it's not obvious WHY he's not eating since all the tests came back negative. I would call the vet back and find out what the diagnosis is that you forgot.

Basically it was something to do with his liver... I'll check.

The HL is a liver condition, which is the result of his not eating. Maybe the diagnosis was simply the French for HL, but let us know.

Get a syringe and stock up on foods that he likes to eat. Make sure he eats everyday when he comes back. And don't give up hope! The liver is one of the more resilient organs.

Spencers Mom said:

Basically it was something to do with his liver... I'll check.

Click to expand...

Yes - HL is hepatic lipidosis (see description from wikipedia below). The part that is puzzling is the loss the appetite. The HL is most likely a consequence of the loss of appetite, but from the test results it's not clear what caused his loss of appetite in the first place.

Feline hepatic lipidosis, also known as feline fatty liver syndrome, is one of the most common forms of liver disease of cats.^[1] The disease officially has no known cause, though obesity is known to increase the risk.^[2] The disease begins when the cat stops eating from a loss of appetite, forcing the liver to convert body fat into usable energy. If this process continues for too long, fat builds up in the cells of the liver, and the disease has officially onset.^[1] Prognosis varies depending on the stage of the disease, with both a high recovery and mortality rate at different stages. The disease is reversible through intense feeding.^[3]

Fortunately, you said it was early stage. Wikipedia also says this, note second sentence (bold added):

Untreated, the disease has a mortality rate upwards of 90%. Cats treated in the early stages can have a recovery rate of 80-90%.^[4] Left untreated, the cats usually die from severe malnutrition or complications from liver failure. Treatment usually involves aggressive feeding through one of several methods.