Cat with sudden onset vomitting & pain. Vets unsure of cause.Not eating or drinking.Sick for 4 days

Hi

I have a 4 yr old male Maine Coon (house cat) with no previous health issues. Had vaccincation last Saturday and was treated with Frontline flea treatment. Health was fine. Vet felt a slightly solid poo but advised not an issue but may be a little hard when it came out. All fine for next 3 days then started vomitting clear liquid early hours Wednesday morning. This settled. Wednesday evening he was in pain, behaviour changed, he was growling and hiding under bed. Signs of more clear vomit. No sign of any food eaten and no sign of litter tray being used. Took to after hours vet. Xrays done- no issues. Bloods done. No evidence of any issue other than slight evidence of stress (raised glucose) and low potassium. Given pain relief. Given fluids by IV with potassium. Treatment for vomitting & over night monitoring. No problem with urination. Early morning he vomitted more clear liquid (vile smelling) and was given treatment to stop vomitting. Transferred to another vet who monitored for the day and continued IV & potassium. Gave anti-inflammatory. Improved during day and was sent home with no medication on Thursday evening. Seemed fine that night but following evening seemed to be going down hill again. By Saturday was lethargic and hiding away. Not urinating and no bowel movement. Took to our local vet who checked fully and found some muscle tremor in right hind leg during movement. Gave anti-inflammatory, steroid, parrafin oil, small dose valium to induce appetite (which didn't work as hoped). As he hadn't eaten for days he was fed liquidised wet food by syringe.  Took him home with various medications and treatment plan and advice on food/ fluids and request to keep in contact with any change. Used bowel within the hour- all okay. That night he went down hill again with drooling and making grunting sounds (scared the life out of me as I thought I was going to lose him). Settled overnight and today seems better and has been at a constant state all day. However, he has not used the litter tray and he will not eat or drink himself. He is being fed  2-3 hourly with a  very watered down mix of his favourite cat food, natural yoghurt  & plenty of water. No signs of pain or discomfort but just lying behind lounge.  Does anyone have experience of a similar range of symptoms? At this point all the vets are unsure of the cause of the problem and the most we can do is treat the symptoms. Vets were thinking a bowel obstruction or pancreatitis but tests don't support this. Any suggestions of similar case/causes would be appreciated so we might be able to narrow things down to the cause and possibly nore specific treatment.

Thanks

I assume when you say he isn't using the litter box you mean a bowel movement rather than urination.  It sounds like the way my kitty would be when he was having an IBD flare, IBD will produce perfectly normal lab findings.  The fact that he improves with a one time dose of anti-inflammatory and then goes downhill again supports that it is at least some kind of inflammation.  My kitty is on a maintenance dose of steroid, some kitties IBD can be controlled through more natural means.

http://ibdkitties.net/   is a good source of info about IBD.  If you go down to post 97 in this thread there is a good outline of the more natural ways to control IBD  http://www.thecatsite.com/t/278273/the-well-known-problem-of-ibd-or-lymphoma/90

While a kitty is in a flare which your kitty may be, a course of steroids rather than a one time dose may be needed to get things under control.  You could then, with vet supervision, taper off the steroid and try the more natural means to keep things controlled.

I would ask your vet about the possibility of IBD.  I think a lot of vets don't think of IBD as a possibility when there is no diarrhea.  I know that happened to my IBD kitty that is prone to constipation, he is 11 now and actually has never had diarrhea.

I was thinking obstruction and pancreatitis as well, but that's a no go. No fever I presume so infection unlikely.  Abdomen palpates normally?  Have you done xrays and echo's? As @Denice says, IBD should be considered, but it does feel like an unusual presentation if that's what it is.

Here's a thought:  could it have been a transient idiopathic (cause unknown) illness that has changed into hepatic lipidosis from lack of nutrients?  Have they tested the liver for this?

StephenQ said:

 
I was thinking obstruction and pancreatitis as well, but that's a no go. No fever I presume so infection unlikely.  Abdomen palpates normally?  Have you done xrays and echo's? As @Denice says, IBD should be considered, but it does feel like an unusual presentation if that's what it is.

Here's a thought:  could it have been a transient idiopathic (cause unknown) illness that has changed into hepatic lipidosis from lack of nutrients?  Have they tested the liver for this?

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I know it's unusual that's why I did 6 years of vet hopping to get a diagnoses.  His first flare was when he was only 18 months old and obstruction was the assumption.  No surgery just hospitalization on an IV with a lot of x-rays.  One vet, a cats only vet not certified but cats only, said it was pancreatitis.  4 vets, 2 ER visits, two hospitalizations  and six years later vet number 5 diagnosed IBD.  At that point I had waited too long to try another vet because the cats only vet had told me fatty liver wasn't a concern because he was underweight, he had fatty liver.

My experience is why I tend to have a jaded view of many vets.

phoenix1308 said:

Vets were thinking a bowel obstruction or pancreatitis but tests don't support this.

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When you say tests don't support pancreatitis, are you referring to the CBC blood test done at the vet? There is a specific blood test for pancreatitis. Was this done? The two most widely use are the SNAP fPL (done in-house with results in minutes) and the SPEC fPL (sent out to TAMU and is more reliable), both provided by Idexx Labs.

Hi

Thanks for your information.

Vet did raise the possibility of IBD and suggested that the addition of natural yoghurt to his slurry mix food would help balance out any imbalance. He is also having natural benefibre in this mix. She also suggested that he may require long term treatment with an anti inflammatory if it was identifed as IBD.

 He was not urinating or using his bowel last night at the time I posted here. Just before I posted I gave him his Metacam injection. Within the hour he drank water on his own and urinated in the litter tray. He was also more mobile and curious. Strong enough to jump on to a meter high cabinet and drink from a vase (a usual past time). Went to bed a little after midnight thinking we were on the upside of the hill  This morning he was also drinking. This evening he has tucked himself away in the walkin robe. I got him out to sit for a quiet cuddle. Wasn't interested. Just wanted to head back and be alone. Offered water and he walked away. He is not staggery when walking but is slow and careful. I am concerned that, although he was drinking this morning and last night, he is heading for dehydration. He has clearly lost weight.

Given his condition tonight we will need to start the food and fluid force feeding again

You can't repeat metacam but it does sound like pain relief is what made the difference.  You might ask your vet for some pain medication to take home (NOT metacam.)

Red Top Rescue said:

 
You can't repeat metacam but it does sound like pain relief is what made the difference.  You might ask your vet for some pain medication to take home (NOT metacam.)

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Hi All

Thanks for you advice. After further episodes of improvement and decline over weekend I took him back to vet this morning. After no urine (but heaps of fluid orally by syringe over night) and onset of pain again I was starting to think we had some type of bladder blockage happening. An ultrasound later we had a diagnosis of intussusception. Emergency surgery complete and 20cm of bowel removed later he is hopefully now going to feel a whole lot better. Vet beleives intussusception is very recent and not the initial cause of the problem as did not show on xray on Wednesday night. Thinks that there was some other cause (probably swallowed foreign object as he has a tendency to eat thigs he shouldn't) and the intussusception is end result of this. Either way, he has pulled through the surgery well and will hopefully be on the mend and feeling a lot happier really soon.

Thanks again for the advice.

Wow, it's great they were able to react so quickly and he did well through surgery! Hope he has a swift recovery!

intussusception is when one part of the intestine slides into another! Great diagnosis and great catch by your vet in the nick of time! Congrats and let us know of the progress!

It's a good thing you have a great vet who figured this out!  It's more common in horses than in cats, I think.