Abdominal Ultrasound Results Inconclusive

Monsieur is an 11 year old indoor male cat. I noticed he had become very thin the very end of July.I'm not sure how long he wasn't been eating well because I had a family member move in that kept his bowl full. When we went to the vet his weight was down 2 lbs. He's always been a small cat maxing out at 8.5 lbs.
Monsieur had no other symptoms that I could see beyond inappetence. That day we did a blood draw, urinalysis, and I brought in a fecal sample from his litter. The tests all came back normal- only a small amount of crystals in his urine. We switched from royal canin to Hills Science Diet mature dry and A/D &I/D wet food. Several weeks pass going back and forth and up and down with food. Mirtazipine helped a little at first, but then it wasn't worth the side effects. We've had some vomiting but it seemed coincide with the trials of wet food changes.
This weekend,I took him in for the abdominal ultrasound after being told this would give me the most bang for my buck. The specialist couldn't tell me much- he had several abnormalities but nothing definitive.
His pancreas had large dark area on the end of one lobe. It couldn't be aspirated because his colon was gassy and in the way. She said it could be an infarction or cancer. It didn't look typical of cancer.There was also a potentially inflamed lymph node there as well. He had a bilobed gallbladder that might have had stones but it's hard to tell with it having 2 lobes- but no blockage. His right kidney is small, but I've known that for a few years. There was no visible evidence of thickening of his intestinal walls.
So that's where I am now. I'm waiting to hear back from my vet upon receipt of the ultrasound report. He has been doing well since the ultrasound and I wonder if it has anything to do with his comfort level. He was given a very large dose of gabapentin to calm him for the ultrasound. He ate more in the 24 hours following the fasting and ultrasound than he had in 3 days combined. And the past two days he wants to sleep on my lap and hasn't been vocal.
Any insight would be appreciated!

Since Gabapentin is a pain pill, I'm surprised they gave it to him to calm him down.  At least I was given it as a pain pill when I had shingles.  And my mom takes it for neuropathy pain.  So...if he was in pain and he got a pain pill, I can see how he'd feel better. 

Anyway, that doesn't help you with how to interpret the ultrasound, which I really think is better left to your Vet.  Best not to speculate, which can lead to all kinds of worrying, possibly unwarranted.   That being said, you said the "specialist" couldn't tell you anything about the ultra sound.  What specialist?  I can't quite tell from your post. 

Hoping your Vet will be able to tell what's wrong, or at least narrow it down and get your little guy started on a "fix".  Keep us posted.

Gabapentin is also used to help calm animals. I gave him 100mg vs the typical 25-50 mg for pain. It works really well. It's predictable and fairly long lasting. I called my doc yesterday and explained to the front desk about seeing the change while on the medication. They called back and said to try 50mg and monitor his behavior and appetite.

He was pretty amped up after an hour and a half. I think he was uncomfortable with the way he felt and was battling the feeling and drowsiness. He lept from the litter pan and made a triumphant lap around the house after he went poop! That doesn't happen often! When he finally chilled out and stopped trying to attack my ankles, he ate a fair amount of food with excitement. He's been licking gravy off of wet food while I add warm water with a monoject syringe to trick him into thinking he's getting endless gravy. He actually ate some of the meat.

To answer your question about the ultrasound-I took him to a large multi disciplinary animal hospital in my area. He saw a vet that specializes in radiology & diagnostics.I'm feeling pretty discouraged she couldn't give me a clear answer (she wanted to!)

We have an appointment tomorrow to follow up with my regular vet at my request. I'm going to request a light pain medication- I don't think gabapentin is whats RX'd for abdominal pain, get advice for antacids, maybe ask to have his blood, urine and feces tested again?
Ive been paranoid about his posture now. I've been seeing this position- he could be in pain or he gets annoyed when I take pictures.
He'll swat at me when I have my phone in his personal space.

I am a human doctor, not a vet but, in humans, Gabapentin was originally a medication for epilepsy.  However it was found that it had a side effect of drowsiness and that is why it is used to sedate cats, but  sedation is only a side effect in humans and it  is not used for that purpose.  It was found that it was an effective treatment for pain from irritation of nerves (neuropathic pain) and this is now its main use in humans.  The diseases that cause neuropathic pain are nerve root irritation from any cause and this includes pressure on the nerve from cancer, osteo-arthritis, and slipped disks.   It is also a treatment for shingles which is viral inflammation of the nerve root. 

Incidentally Gabapentin is useless for pain other than neuropathic pain

With kind regards,

Geoffrey

I'm getting the full picture now, and am disappointed too that the specialist wasn't able to give you a better picture of what might be wrong.  It does sound like she knows what she's doing.

Keep us posted as to what your regular Vet says.  It's always worrisome when you know something is wrong, yet it can't be diagnosed .   It happens all too often, in humans too.  I guess that's just the way it is sometimes .

Thanks for the concern!
We had a follow up with our regular vet last night. Somehow, Monsieur put on almost 1 pound in two weeks! He was weighed three times to make sure it was true!! [emoji]128079[/emoji][emoji]128079[/emoji]
I showed our vet photos from the past two years and she agreed with me the subtle changes that occurred in his eyes, posture and the way his fur latex. She recommended we start treating him for pancreatitis for now. Even if I wanted to do the "biopsy buffet", she really doesn't think he's strong enough for that yet. They administered 80mg of cefovecin and B12. I'll be giving him the b12 injections at home weekly. We also left with denamarin, cerenia, and more gabapentin. We're holding off on steroids for now. I'd like to stay away from those as long as we can.
I was able to squeeze the Pepcid, cerenia and gabapentin into one gelcap- which made dosing him super easy. I woke up an hour earlier to give him the denamarin on an empty stomach. That's going to be the real challenge in managing his medication. The denamarin is recommended on an empty stomach.
For now I'm feeling more optimistic. Monsieur's eyes looked more attentive last night and he seemed less agitated. He was affectionate and a little more vocal like he used to be. This is Monsieur after getting weighed. Doesn't look like he gained a pound but I was a proud mama!

Hopefully this regimen will make him feel better and he will gain back that other pound he lost and just feel better in general.  Glad he's easy to pill That makes it so much easier.

He's such a handsome boy