Vet wants more tests and I'm confused??

[Cat_Parent]

I'll try to keep this brief. My 13-year-old cat got unwell at the start of Nov, not eating, lethargic, not moving around much, weight loss, and she puked a couple times. We took her to the vet (a new vet to us since we moved house) and I was told there was an 80% chance she had lymphoma (she had yellowness and something the vet could feel in the intestine), or alternatively inflammation. I spent ages upset and panicking as the vet was VERY serious about the likelihood of cancer and I was preparing myself to lose her, she'd visibly lost so much weight. We did blood tests (showed some liver elevation), meds (steroids and antibiotics), new food, meds for upset tummy, flea treatment, and when she was no better, they encouraged an ultrasound and a specialist, who basically found nothing of note, and said it's not cancer and more likely inflammation.

We did another round of meds and she is SO much better, basically back to her normal self – moving around, energetic, purring, cuddly again, eating, etc, which made me incredibly happy. I was told she is "no longer yellow" and "massively improved". At this point she's had 2x rounds of meds, a blood test, and an ultrasound, plus some special food and flea treatment. Vet said he wanted another blood test with her off the meds, to see what it's like without the steroids, and the specialist agreed, so we did that. Took her in for that today, and he made no comment about her appearance in terms of yellowness when he looked at her. Her weight is still good. Cue waiting for result.

Now, I've spent around £1500 at this stage. I get a call about the most recent blood test just about an hour ago, and the receptionist says we need to do a bile acid stim test to see what's going on due to liver levels being elevated, and possibly a biopsy after that if *that* is inconclusive. I'm told she's "still fairly yellow". Which totally contradicts her not being yellow and "massively improved" before. Her ears/mouth look fine to me and she's back to normal behaviourlly and she's eating again.

I've spent a lot of money, and obviously I did all this because if there was any chance I could treat her if it wasn't cancer, then I was going to do it! But the quote for this next test is another £224 and Christmas is just around the corner. I just don't know what to think at this point, she's so much better and I don't have unlimited cash. I don't have insurance, she's a senior cat and it's now classed as a preexisting condition. She has always been a "pukey" cat and I assumed after all this testing that it was something like IBD.

Does anyone have any advice?

Do I just see how she is over the month of December?

Do I spend more money and get a second opinion? Spend more money on testing and prodding my cat (who is already a very anxious little lady) yet again? At a loss here.

 

[Kieka]

It sounds like your vet is worried about something in the realm of liver failure, kidney failure, fatty liver, etc where off the meds she isn't doing well but on them she is much improved. Thing with those is that sometimes there are things to treat the unlaying cause and medication just masks. Which means she could have a scenario where the issue causing the problems isn't being treated, just the symptoms. It might be one of those where the medication needs to be lifelong or it might be one where a treatment options allows her to get off the medications. That she responded how she has allows the vet to narrow in on the cause.

I would call your vet and have a talk with them. Find out if the further testing can wait until after the holidays and what they are looking for. Find out what options are depending on what further testing reveals. Because it may be that the test now will get her off meds sooner, which would save you money in the long run. Or it could be that the test now is needed because the treatment could cause damage if it is for the improper condition.

 

[FeebysOwner]

Additionally, make sure the steroid your cat is getting is/was not prednisone as that can impact a cat's liver. Most vets give prednisolone because it does not have the same impact on the liver in most cases. (I don't know how many vets use the former anymore, but it can't hurt to verify which ones she is/was taking.) The other thing to consider is asking if budesonide would be a good alternative to either of the pred's. It is more focused on the intestinal tract as opposed to having as much effect on other parts of the body.

 

[mrsgreenjeens]

I totally agree that a thorough discussion with your Vet is needed here to get more information, especially since you don't see any jaundice in her AND since she doesn't appear to feel bad anymore. Ask what good this test will do, what happens if they find something, what if they don't, etc.

Our 16 year old with kidney disease also had liver issues, but she would get antibiotics everytime her values went up and then be fine for several months and then we would do that again because our Vet said IF they found anything it might require surgery, and there was no way we were going to put a 16 year old kidney cat through that. Of course, each case is different,

 

[Cat_Parent]

Thank you everyone for the advice. I'll be discussing properly with the vet on Monday when they reopen. She's been off meds since then (that was the last day of tapering) and she's not eating much again (but is licking her food like she wants to eat it!). She's otherwise pretty perky. She was previously on anti-nausea meds as well for the upset tummy. No more puking but I wonder if she's nauseous!

I feel the same way about wanting to avoid surgery on an older cat. I was told if the bile acid stim test was inconclusive, the next stage would be biopsy, and I'm very reluctant to do that given her age and how anxious she gets about the vets already.