Take kitty to another vet after visiting bad one?

My kitty had a low appetite, so I tried to schedule an appointment with my regular vet. They did not have appointments, so I wound up at another vet. I was very excited very this one advertised alternative therapies.

The appointment was horrible. My kitty has had problems with constipation, and low appetite was one of the signals. This time she was pooping, but had low appetite. The vet kept insisting that constipation would be the total lack of bowel movements at all. He obviously doesn't know constipation vs. obstipation.

He also kept pushing me towards obtaining a fructosamine test because some of her previous records showed high blood glucose. All my previous vets said that it was probably stress induced because she showed no clinical signs. We did get the test, but I've later learned that the other vets were probably correct because diabetes needs to be confirmed through fasting blood tests, urine tests, and clinical signs.

We also got a fecal test for parasites and an appetite stimulant (mitrazapine), which can cause constipation. She's eating now, and very vocal and friendly.

He did not take x-rays or do a complete blood test or urine testing.

So I'm wondering now if I should go another vet to get the initial question of whether she's backed up resolved. He did feel the colon and said there was nothing unusual.

If I go to another vet, should I do so before or after I get the test results back? If after, I'd have to wait until at least Fri.

I'm so sorry you had such a bad experience. So annoying when that happens - both for you and kitty.

Is her stool volume normal? Frequency normal? Is she trying to go frequently? Or is that part of the concern? I must admit, I'm a little confused. Is the only current symptom the low appetite? Because an off appetite can be caused by about a million things. But if she didn't have a fever, it is hairball season. Has she ever had an issue with hairballs? That's a pretty common reason for an off appetite.

Does she eat wet food, dry food or a combo? If she eats scheduled meals, have you tried offering her smaller amounts of food more frequently?

Hi Laurie,

Low appetite before has meant backed up. She has been going regular, with decent volume, it's just that there haven't been other symptoms besides low appetite, so it doesn't seem logical for there to be diabetes, as I would think the appetite problem would surface more slowly. Parasites, well, I suppose maybe, but she's indoor.
 

So I guess I just wanted to get behind the low appetite, but his refusal to consider constipation backup made me really uncomfortable, I would've felt better with an x-ray denying it. I don't have enough experience with backups yet to know if she can be having what seems like regular movements but still be backed up. He also was making illogical theories such as not wanting to eat the food because it was associated with an antibiotic dose--when the last time she had antibiotics was 2 months ago, and she has been eating the same food without problem before and after, up until last Thurs.

She is long hair, and has had hairballs before, so that is quite possibly the culprit. 100% wet food, 2 tsp. water added to each meal. After switching to 100% wet, she no longer spits out hairballs, but they have to make the trip out the colon, which could be causing problems.

Normally she wolfs down her food within 15 minutes, but does walk away for a little rest. Unfortunately we both work, so I can't offer smaller meals in the morning.

Yeah, he sounds like a nut. I'm sorry he wouldn't give the x-ray just to see.

So what tests did he do besides the fecal? Which sounds crazy, quite honestly. None of his theories sounds like anything to pay attention to though, as you say.

And you gave her the mirtazipine?

At this point, I'd just wait to see what happens when it wears off in 2-3 days.

But if you're worried about the constipation, how do you normally treat it? Because I'd go ahead and use miralax or pumpkin or something, just to see if it helps. When you have a history of loss of appetite from getting backed up, makes sense to me to try whatever it is you normally do to see if it helps. If it doesn't, then see the (regular!) vet. :nod: If you schedule an appointment for some time next week, you can always cancel it if the problem goes away.

What is weird is that with my regular vet I'd trust his judgment if he just felt the colon and said, "Nope, it feels norma. We have to look at other causes..." He felt her once and based on that and her change in pooping pattern as reported by me (went down to every 2 days from every day), he said we needed an enema. Didn't bother me then, I just figured we didn't have to pay for an x-ray.

He kept on pursuing diabetes, so we got a snap blood sugar and a fructosamine. I figure numbers from an independent lab will be the same anywhere, and Poppy's always tested high in blood sugar (but is a very nervous, homebody cat), so might as well put that question to rest.

He gave her the mirtazipine. So far it's worked as far as appetite. She's also friendlier now, and less scaredy cat (not too bad before). I have to admit I like that part. 2012/2013 have not been good years for her medically. Last year was a struvite stone, this year chronic constipation, and she's had to go to the vet a lot - probably about 8 or 9 times last year and almost once a month this year. Last night I saw a few happy, confident behaviors return. I've read mirtazipine can be used as an anti-depressant, so I'm wondering if Poppy is too nervous and could use some stress relief?

I have to admit that everytime there's something wrong with her, I freak out. My friend came last month for a vacation with me. Poppy started having trouble then and I almost had to take her to the vet, so my friend saw me and the tenseness. Part of the vacation involved me taking my friend on a car trip while my husband watched over Poppy. During this time period Poppy improved as far as constipation. She went once a day, even twice once. Afterwards my friend put forth a theory (unsolicited) that perhaps Poppy sees my tenseness and it's a vicious circle.
 

Constipation--I normally just give Miralax on an ongoing basis. What do I normally do for appetite loss? The two times it's happened I go to the vet and have wound up with an enema.

:nod: Mirtazipine is a human antidepressant, actually. I'm glad it's working - and with added benefits!

Given her (and your) stress issues (which definitely feed off of each other!), have you every tried the Feliway plug-ins, and/or Bach's Rescue Remedy? It might be worth trying both, if you haven't tried either one before.

Do you give her miralax on a regular basis, or only when you suspect constipation? Because it's probably best used intermittently.

And if part of the problem may be hair ingested, have you tried feeding her egg yolks? Those may not only help with the hair passing through her better, but they may help keep her more regular. :nod: If she likes them and they help, you can feed them 2 or even 3 times a week, as a treat.

I've been considering the Feliway. The (bad) vet said that I shouldn't do it unless I need something to change, as right now Poppy seemed to be having fairly regular bowel movements (almost everyday, skips once a week). I don't hold his advice in high regard, but that part did make some sense.

Miralax is on a regular basis. It takes 2-3 days for results to show up, and it only works on the new stool being formed. So with chronic constipation it's usually given on a daily basis like lactulose. You can't give it when problems show up since it's too late by then.

I've tried egg yolk lecithin. When I had her on egg yolk lecithin, she'd still have hairballs that were pooped out, only there were more of them, but smaller. When she was on egg yolk lecithin she was also on pumpkin, and that was when she backed up for the second time. I theorized that maybe the pumpkin had too much insoluble fiber and that since the egg yolk lecithin was making the hairballs pass through the bowel instead of going out orally, maybe the two in combination were causing blockage. Since then I've started adding digestive enzymes instead because the digestive enzymes are supposed to help reduce stool volume. Do you know if the egg yolk lecithin is superior to the digestive enzymes as far as hairballs?

Thanks for your help, Laurie. I always find your suggestions helpful.
 

I try.

Yeah, I don't now about combining pumpkin and egg yolk lecithin in a kitty with constipation. :dk: I'm wondering how egg yolks, not the lecithin, would work. Here's the discussion: http://www.ferretharmony.net/2013/04/27/hairballs-eat-an-egg/ It's the choline in the egg yolks. There is a small amount in lecithin - but the egg yolk lecithin is primarily for emulsifying the fat. The egg yolks should result in improved motility because of the acetylcholine. So the lecithin is more for when there is a hairball, and the egg yolk more for helping to prevent them in the first place. Plus with the high level of phosphorus (due to the protein in the yolks) and little calcium in yolks, it should help with stool consistency, making them easier to pass.

Just thinking out loud.

And you HAVE to see this! It's a very interesting idea, one I think I'm going to try. :nod: Have to FIND the (food grade) DE I've got around here somewhere... http://www.thecatsite.com/t/227971/vomiting-hairball-butter-or-vaseline#post_3371743 Seems to me this might be superior to the digestive enzymes when it comes to passing the hair.

As to the Feliway, I was thinking of it for her stress/confidence, nothing to do with the constipation. (Same with the Bach's Rescue Remedy).