Looking for experiences with sedation for abdominal ultrasounds in older cats

baztien

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Hi all!

My cat, who's about 11 years old, has had diarrhea for about a month, has an abdominal ultrasound scheduled for tomorrow morning. I'll give some context but feel free to skip to the bottom for the general question!

She was having diarrhea every night since around June 5th and I took her to the vet the next day. They ran a fecal test, bloodwork, did a senior profile, and prescribed some Metronidazole. She hated the medicine but I gave it to her for about 2 days and stopped because her stool started to look normal. Fecal test came back and the only thing she had was tapeworm eggs, so they also gave me some Profender and I applied that on June 12th, a few days after her dose of Revolution. That week also had normal stools.

We had a trip scheduled for that weekend so we dropped her off at a really great cat hotel that she's been to before and she ended up having diarrhea and vomiting one night while she was there. Her stool was a little normal once we picked her up but the diarrhea came back so we took her to the vet again. They ran x-rays and didn't find anything too concerning, aside from a lot of gas and maybe a larger colon. I started giving her the Metronidazole again for a week and that seemed to help. Solid stools but maybe a little hard from constipation (my guess) from pretty much June 25th-July 2nd.

Unfortunately the diarrhea came back a few days after we finished the Metronidazole so we did another vet visit and the doctor said an ultrasound might help. At this point I agreed and scheduled it. He also suggested a hydrolyzed diet so I picked that up some Hill's z/d and have been transitioning her to it with mixtures of her old food. I've also been adding pure pumpkin here and there and she's been having FortiFlora in every wet meal.

This morning she had a small amount of stool but also threw up some clear foam, maybe about 2 quarter sized puddles. Then around 1pm had very normal stool, in both color, look, and smell (the diarrhea smell was quite something). Throughout all of this, her behavior has been normal, she's active, maybe sleeps a little more than usual post diarrhea, eats and drinks everything just fine. She did vomit a bit here and there throughout the month but that's semi normal for her throughout the years we've had her. There's a small theory in the back of my mind that it's stress related. This is my parents cat that I do all of the health related matters for and I don't live with them but she's honestly the light of my life. They had some guests at the end of May, then I arrived at a similar time, then we had our weekend trip where she was boarded, and then my parents left for a long weekend for a wedding so she was just with me for that time. Since she's been having diarrhea I've decided to stick around at my parents since I'm the only one that can wrangle and medicate her if necessary. I know switching up schedules and timings can stress cats out.

Now this all leads to my concern. She's only been sedated once while I've had her, in February 2022. She did fine then. I'm a little worried because she's older and she does have some signs of a URI (seems congested at times, sneezes occasionally, a little clear eye discharge) that the vets know about but haven't diagnosed and don't seem concerned with. She's never had a diagnosed heart murmur but I know they can pop up and that's obviously not a good thing for sedation. She's also kinda fiesty - she's gotten bloodwork and xrays done there before without sedation, but for this, they'll have to shave her and I know that sound will scare her. And having that ultrasound gel on her plus the device will not sit well with her, I'm guessing. She also will pant here and there at the vet so I know her little body gets really stressed when she's there.

I've already talked to one of her vets and the vet tech who was working today and asked a hurricane of questions. They said they start light and do more if necessary but can't guarantee which meds will be used, as they choose on a case by case basis. I also asked the tech about complications and she said she's been doing these for 20 years so of course she's seen complications but overall things usually go well. I didn't ask specifically about deaths. Obviously I appreciate her honesty but it does scare me more. I know sedation cannot be 100% safe so I'm wondering whether this is a bad idea given that her behavior is totally normal. If something were to happen to her when it was really just a temporary thing that she could get through herself, or the hill's diet and probiotics were helping, I really don't know what I'd do. And I know she's so tired of these visits and I'm not sure if this one will just add to any stress she's having or had.

Okay, finally the questions! Have your cats been sedated? How did it go? What was the process like for you and for your cat? Any advice for a really worried cat mom? Anything I can ask tomorrow morning when I drop her off? I appreciate anyone even skimming this and passing along a thought!
 

FeebysOwner

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Hi. Not sure what she is going through warrants an ultrasound, but that is not your question. Many cats do not need sedation for an ultrasound, so ask about what they will do to determine that she does - not to be given automatically, which it sounds like that might be their plan. My 18+yo cat has had 3 ultrasounds in the last 2 years, and only the first one required a calming agent so they could shave her belly. The other two, no sedation or calming agent was needed. They gave her a small dose of butorphanol, and it did not knock her out. It is fast acting, short lived, and if she had any grogginess from it afterward, I couldn't tell at all. Find out what they think they might have to give her, and ask if it will anesthetize or simply calm her down.
 
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baztien

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Thanks for your reply! I forgot to mention she did have some weird moments where she'd sit in her litter box or once she even laid in it, so I was a little worried there may be a blockage. I also agreed to the ultrasound in the midst of a diarrhea week so I was a bit desperate for any answers. But today's stool has me second guessing - I watched her go and there was zero discomfort or struggle, just a normal stool passing like you'd expect from a healthy cat.

Is your cat good with vets? Mine doesn't get aggressive from what I've seen (not sure what she's like when they take her back for bloodwork and all that) but she does get very anxious, scared, will growl and make generally unhappy noises.
 
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baztien

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Oh and they did mention they'd decide about sedation when they shave her, to see how she reacts. If she's chill then no sedation. But being near loud noises scares her so with that and having a shaver near her belly, I'd assume she'll show some not so chill behavior.
 

silent meowlook

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Hi. This is tough, because while you want to do what’s best for the cat, this will stress her and there is always risk. No anesthesia or sedation is without risk.

What concerns me is that if she gets so stressed with vet visits, have they ever sent home medication to help with the anxiety of the visit? The current guidelines with a stressed out cat is if the problem isn’t life threatening then send home with an Rx of Gabapentin and start over the next day. Once a cat is stressed they don’t un-stress, they just wind up more stressed.

There is a big movement for vets to provide better care for cats ( think instead of Me 2, Meow 2). Cats have long been having to deal with treatments and human behaviors veered for dogs. About 10-15 years ago the feline friendly handling guidelines came out and some vets follow them, some don’t.

Is the vet doing the ultrasound experienced in ultrasound or just a regular vet with no special training. If the latter it could be a waste of money, time and stress on your cat. Ultrasounds give very useful information but the person doing them must know what they’re doing and looking for.

They have done a full blood panel that came back normal? Do you know if they checked for pancreatitis? It would be a separate test.
Do you know if they did a GI panel?

How long have you given the food to work? Did they explain that once on this diet there can be no treats or any other food. Is it the canned variety or the dry? Have they tried any medication other than the metronidazole?

Sorry this isn’t the answer to what you were asking. I am just trying to understand what’s going on with your cat and help offer the best veterinary direction to go in. Of course, listen to your vet if you trust they are helping. I am not a vet and have never seen your cat, so I am just speculating and offering some input for you to make your own decisions with.


With sedation, I have seen it be fine and I have seen it not be. I am surprised they couldn’t tell you what they planned on using.
 
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baztien

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All good questions and things to consider. She was only prescribed Gabapentin a little over a year ago for a different health thing, I think it was a urinary issue. And another mobile vet that we like but has lesser availability prescribed it for future in clinic vet visits around the same time but it's never been brought up at this clinic.

It's an ultrasound specialist coming in with their assistant. I think the clinic contacts them when there's a need and schedules time for them to come in with their equipment and all that.

She had a senior profile on 5/10 which I believe included bloodwork, and a renal profile on 6/6 (we thought she might've been exposed to lilies), and that also includes blood I think? Either way, a few days ago I called and asked if the vet would recommend new or extra bloodwork for this and he said no. I don't know if they checked for pancreatitis but I don't see anything listed for that on my invoices, same for a GI panel. Just something called "IDEXX Fecal & Parasites w/ Giardia."

We have both the wet and dry Hill's z/d because she usually eats both wet and dry. We only started it July 5th and haven't 100% transitioned to it because she's still a little iffy about it, so we're at the point of doing 50/50. They also did prescribe Tylosin on July 5th but didn't carry it in the office so I had to order it on Chewy and it won't be here til tomorrow.

We've been to this vet a few times since they're close but I can't say I love them. They do listen to all of my concerns and don't rush me which I appreciate, but I do hope the ultrasound is a genuine recommendation rather than a rushed one.

What kinds of things have you seen happen with sedation?
 

FeebysOwner

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My cat is pretty chill at the vet's but can get a bit antsy. Giving a cat something to help them relax is not, to me, the same as sedating them. So, I guess that is what I would be asking them - what do they mean by sedation exactly. Then, they should also explain what the typical effects are with whatever it is that they give her and what you might expect to experience with her thereafter.
 

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Can’t offer much advice but I can tell you it was more me that needed the sedation than the cat when I dropped off Zorro for a biopsy. He was 17 at the time and I’m sure they put him under for that. He came through with flying colors. All of the above advice sounds good -asking questions never hurts- but for me it was more in the end that I A. Trusted my vet and B. Wanted answers (which I received). I know it’s hard but if you can find ways of staying calm during the wait it helps both you and your cat. Deep breaths. Go for a walk. 20 years sounds like a lot of experience. ❤
 
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baztien

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That's great for Zorro! We definitely sound similar - I'm a ball of nerves and don't know how I'll sleep tonight. 20 years is a lot for sure but it'll be a different vet tech tomorrow morning 🙃 She's just the one I happened to catch on the phone today.
 

silent meowlook

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Hi. I think they are probably looking for signs of IBD with the ultrasound. It is good that they have a specialist come in to do it. Make sure they know to let you pick her up right away when she is done. Sedation is probably better than her stressing the entire time while she is getting the ultrasound. Is she long hair or short hair. The clipping shouldn't be to bad provided they don't think they can turn an awake cat upside down and shave them.

I am not sure what the tylosan is for. The thing that has me a little concerned is I don't understand why your vet is throwing antibiotics at your cat when it is not confirmed that she has something that needs them.

If it was me, I would look for a feline only vet hospital if not happy with the current vet.

My cat is so terrified at the vet that when I had her ultrasound done the first time, I thought I would not sedate at all and just hold her. She did okay as in not moving, but after a while she got very stressed and started wiggling. In her defense, she was upside down for so long because the vet kept getting sidetracked and leaving us waiting.

The next time I did her ultrasound, of course I held her but I thought that maybe some sedation would make her feel better about it, She was pretty much wiped out for three days.

Before approving any diagnostics always ask yourself and the vet: What information will this provide? What is the benefit of having this information? How will this information change the treatment plan?
 
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baztien

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She's short-medium length but has a very fluffy belly. She's a Lynx Point Siamese for reference (or at least that's what she looks like!) I think they prescribed the Tylosin because the diarrhea was still going on and she had responded well to the Metronidazole. The vet said Metro has not so great side effects long term so he wouldn't want to put her back on that, and apparently Tylosin is better tolerated for longer periods.

Interesting that you're allowed to hold her and be in the room! I definitely don't have that option. I know she'd be more comfortable if I was the one holding her. However she's so, so sensitive about her lower legs and lower abdomen. Just as a test now I kind of laid her on her back and pet those areas - no dice! She gets very swat-y about those spots so I think they'll opt for a sedative.

I do think there are things to gain from the ultrasound, this diarrhea issue really came out of nowhere as she's never had stool issues in the past 11 years. So it'd be helpful, I guess, to know if there's anything internal that's out of the ordinary or if maybe this was just a random flare up. Just odd because everything else with her is normal so I don't know what to make of this whole situation.

When they sedated your cat, I'm guessing you didn't fast her before? I have to fast this time but I know they sedated her back in Feb 2022 for bloodwork and other stuff but I definitely didn't fast her back then. No idea what they used that time but maybe another question for when I drop her off tomorrow morning.
 

silent meowlook

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I fasted her for the ultrasound so she was already fasted. It was a feline only hospital with AHHA rated and feline friendly gold certification. I worked there at the time. Although we would let clients hold their cats for everything. We never took the cat to the back unless hospitalized and even then, owners could come back and hang out with their cat.
 

FeebysOwner

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Fasting for an ultrasound is usually required first and foremost to reduce peristaltic movements and the amount of intraluminal air in the intestines. Secondly, it is done in the case that sedation is needed. Again, the degree or kind of sedation plays a role, along with the procedure, in determining when/if fasting is necessary.

I know that in my area, cat owners are not permitted to be in the area with the cat where the ultrasound is done, and in most cases not even for simple bloodwork or cystocentesis. It can be distracting to the examiner and can sometimes negatively affect a cat's behavior.
 
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baztien

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Hi everyone! So shockingly she didn't end up needing sedation. I've heard that cats can pick up on their parents feelings and so maybe she's always been anxious in vet visits when I'm there, but is a bit calmer around the actual vet staff when I'm not around! She apparently growled and hissed but didn't do anything that the staff was worried about. No info back on what the ultrasound specialist found but I'm just happy to be home - just going to watch any litter box activity and make sure she's eating and drinking alright.

Really do appreciate the thoughtful replies here. I'd been lurking for a bit reading through threads for the past few weeks and it's cool seeing so many strangers helping each other out. I hope the results come back with good news and I may update here or on another post if I have more questions.
 
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