Advice On Possible Ibs And Ultrasound

[wafflesnomnom]

Hi there, I want to thank everyone in advance for reading through my wall of text because Waffles has a medical history that I thought would be relevant to my current situation.
Cat: Waffles, make, 2 years old, ragdoll

History of: UTI, urinary crystals, inflamed bladder

Ultrasound images: Waffles’ vet did a set of abdominal ultrasounds a year ago when he had a urianry crystals and he found two things:
1) waffles had intestinal wall thickening and inflammation of the mucosa
2) his kidneys had a thick dark outline

The vet concluded that waffles had lymphoma from these signs and showed us relevant images from other cats and the PowerPoint he uses to teach other students on this issue and thoroughly convinced us. I have a background in anatomy and life sciences so the images made sense to me and I could tell the vet wasn’t lying or trying to scam us. However the tests and biopsy cost is a lot of money and miraculously it came back negative. To this day the vet calls Waffles his mystery cat because he should have had cancer.

Current issue:
Waffles had a seizure this past weekend and he’s had two more previously, all more than 6 months apart but we just realized they were seizures because the other two happened at night when we asleep. I take him to the vet and his heart is fine and he had his annual check up a few months ago and was healthy, he also had a dental cleaning a couple of months ago and that was fine too.

So the vet suspects IBD and that he’s missing some electrolytes or nutrients causing the seizure, and the other possibility is he had a brain tumour but a scan is over $1k so that wasn’t in our budget at this time. I would revisit it if he was having more frequent seizures with other symptoms.

Waffles eats normally, no vomiting or diarrhea or weight loss, no other symptoms besides his seizure.

The blood test came back with 3x the normal amount of triglycerides, high magnesium, and low sodium and chloride.

The vet is suggesting another abdominal ultrasound which is expensive and we are way more wary and cautious of doing more tests because of our false cancer experience last time. Plus his ultrasounds from that incident shows that Waffles has thickened intestinal walls and inflamed mucosa, the signs of IBD.

My question is do we fork over another $500 to do another set of scans or do we just assume he has IBD from the information so far and put him on a special diet and treat it without the scan?

I know having the images would help us know where he is currently and gives us a comparison point if we decide to do another set of scans in the future, but if it’s just going to confirm that yep his bowels are irritated then we already know that and we’d be out $500 that could have gone to getting him premium food or something. I wish I was made of money but I’m not

All his other blood work came back normal so I’m assuming we ca rule out diabetes and liver and kidney issues cuz his enzymes and proteins were fine.

I have a consult with the vet next week to discuss options but I’m scared I’ll get convinced into getting another set of scans. The other thing I’m worried about is if something bad comes on the scans and then we do more tests and we go down that rabbit hole again and we did last time and he was perfectly fine.

My vet has amazing reviews and experience and is highly rated l, I did my research before picking this clinic, so it’s hard to know what to think.

Also if anyone else has experienced with IBS/IBD or inflames bowels can you let me know what worked best for your kitty? Waffles doesn’t vomit or have diarrhea or any of the classic IBD symptoms so it’s really frustrating trying to figure out what’s wrong.

Thanks!

 

[duckpond]

I don't have any advice, maybe someone else who has experience with these problems will chime in. I personally have never known a cat with IBD to have seizures, but no throwing up, or diarrhea? Im sure your vet knows more than me, but just like with our human Dr.'s sometimes a second opinion, from a different vet might make you feel better on the direction to take? Just wanted to offer support, and well wishes!

 

[artiemom]

I am so sorry you are going through all of this..((hugs))
IBD is hard enough to handle, never mind having a seizure issue. I cannot imagine.
My guy has IBD and Megacolon.

I will apologize in advance if I say anything to upset you.

While your vet is very well respected it just seemed he was a bit too fast to mention cancer, based on just an ultrasound scan, without evidence of enlarged lymph nodes or masses... IBD and SCL can look the same as far as thickened mucosa. Most IBD cats, when treatment fails, usually begin chemo treatment, to help with symptoms-- Because of this, many people feel that the biopsy is not needed.

However, SCL and IBD are treated pretty much the same way. I am not certain how the mix would be if your baby has a seizure disorder. Yes, depletion of electrolytes can induce a seizure. I would hope your baby was hydrated with an IV Solution, to resolve this.

What symptoms of IBD does you kitty have? Nausea, Vomiting, weight loss, diarrhea are all indicative of IBD and SCL..

From my understanding there are a ton of meds for IBD: daily pepcid AC, prednisolone, Cerenia, even Zofran, Reglan, Flagyl... It all depends on symptoms.. and a novel diet is usually suggested.

The theory is that IBD is usually from an allergy to something in the food; although there is a genetic predisposition to it. You need to calm the allergic reaction.

The questions I am thinking are: What are the symptoms? and Are you scheduled to see an Internal Medicine Vet? What meds, if any, is your cat currently taking?

The IMVet can give you so much more information. Also one more thing for you to think about: If you are deciding on a biopsy, then all steroids will have to be discontinued for a while prior to the biopsy due to a false negative biopsy. You would have to make your baby sick again, in order to get a true biopsy..

Also, not all endoscopic biopsies are conclusive. The most conclusive biopsy is a real surgical, cut down, biopsy. I decided against that; having the endoscipic-biopsy instead.

I think you need to decide on where to scan next; as to what needs to be prioritized.
An Internal Medicine Vet can be so helpful in deciding this.

My internal Vet is really good at palpating abdomens. He can tell so much from just an external exam.

Personally, I would begin medical treatment for IBD and see what happens.. You can always have an ultrasound, if needed.

The seizure issue bothers me.. Blood tests and watching will probably be the way to go....but what do I know? I am not a Vet, I am just going by my own experiences..

Sorry, but I seem to have written a book, and have not really answered your questions.
I know you have tons are in shock right now-- your head is spinning.

I hope I have not confused you even more.. IBD is a horrible, frustrating disease.. Just when you feel it is under control, it returns with a vengeance...

Also, there is a great website, explaining it all; IBDKitties.com I suggest anyone who has an IBD kitty read it. I helped me so much...

((hugs))

 

[Timmer]

Yes. My cat Timmer just passed away on Friday. He was diagnosed right after the first of the year with IBD. I did pay close to $4,000 to have him diagnosed. This included all kinds of blood work, he had to be sedated and the stool manually removed, scans, drugs, stays at the hospital (over night), colonoscopy, biopsies, ultrasound, chest x-rays... you name it. He saw one of the best GI specialists in my area.

If your kitty had thickened walls of the intestines at the last scan, unless he or she was put on prednisone to reduce the inflammation, Waffles probably has it still. To my knowledge, IBD doesn't go away on its own. IBD encompasses many diseases, such as Crohn's and colitis.

Having said that, my cat's symptoms were bloody stool, loose stool, very smelly and then eventually in his last few days, his large bowel and colon swelled so bad he couldn't pass stool on his own. He never threw up, nothing out of the ordinary. I didn't catch it until it was probably too late. He was on a full dose of prednisone for close to two months and two weeks of chemotherapy. Nothing was working. Our regular vet suspected he also had GI lymphoma which is a very progressive disease.
But he never had a seizure. I think something else is going on with your kitty. I'm no vet, so don't take my word for it.
I prefer getting information off the Cornell University veterinarian website. That seemed to be spot on with my situation.
No one can tell you what to do regarding spending more money. The question is maybe if you have the knowledge of the test results, what will you do with that knowledge? If your kitty has a brain tumor, then what? Will you keep Waffles comfortable for the rest of his/her life or see if they can operate? I have no answers, I'm just telling you what I went through. I always swore I wouldn't have any operations done on my cats because they never seem to bounce back when operated on. But for me, the decision was that I owed it to Timmer to find out! Because what if it was something simple that could be treated??? I could never live with myself knowing that. So...what I did was got another credit card and put his medical bills on that. That's me.
I wish you the very best. I feel for you. My heart goes out to you. I hope it works out for the best and you and Waffles have more wonderful years together!

 

[artiemom]

Timmer (((Hugs)) to you.. so sorry.

Yes, Cornell has a great website for info on any medical diseases.

 

[Margret]

I've never dealt with IBD myself; most of what I know about it has come from this site, and specifically from Artie's thread, so keep that in mind when evaluating the credibility of anything I say.

The ultrasound results sound like IBD to me, but none of the rest of it does. He's eating okay. He's pooping okay. But his blood work is off.

I think that, if it were me, I would be concentrating on that last detail. A definitive diagnosis is always a good thing to have, but I don't think any of the suggested tests are going to give you that. Another belly scan? He's already had one of those, which gave a "definitive" diagnosis of lymphoma, which was totally inaccurate! A brain scan? If it shows a tumor, that gives you a definitive diagnosis for the seizures, but still doesn't tell you why the blood work is off. But if the brain scan doesn't show a tumor you still don't have a diagnosis; all you've done is ruled out one possibility. I think perhaps you need to be looking for a food that addresses those specific issues.

According to Understanding Blood Work: The Biochemical Profile for Cats - PetPlace:

Triglyceride is important in storing fat and releasing fatty acids. High levels are not considered relevant in cats. Low levels indicate starvation or malnutrition.

Chloride is important in maintaining the acid balance in the blood as well as combining with hydrogen to form hydrochloric acid for stomach digestion. High levels indicate dehydration, metabolic acidosis and kidney disease. Low levels indicate vomiting and metabolic alkalosis.

Sodium works in combination with potassium and is very important in maintaining normal function of muscle and nerves. It is also an important electrolyte in every part of the body. High levels indicate dehydration, lack of water, diabetes insipidus, Cushing’s and excess salt intake. Low levels indicate starvation, severe diarrhea, vomiting and metabolic acidosis.

And according to Potassium or Magnesium Problems in Cats:

Hypermagnesemia: Too Much Magnesium
Too much magnesium is uncommon in cats; it's seen typically in cats with kidney disease. Proper magnesium levels are essential for Kitty's heart, respiratory and nervous system function. Kidney failure, constipation, endocrine disorders such as hypothyroidism, and too much magnesium in her diet can lead to hypermagnesemia. Common symptoms of having too much magnesium include vomiting, lower heart rate, poor reflexes, weakness, paralysis and mental depression. In severe cases, cardiac arrest and coma can occur. Your vet will perform many of the same tests as for hyper- and hypokalemia: a biochemistry profile, urinalysis, a complete blood count and an electrocardiogram. Usually the vet will start fluid therapy to eliminate excess magnesium, and will add calcium to the diet to promote magnesium excretion. When the cause of the condition is determined, your vet will be able to develop a more comprehensive treatment plan.

I think I'd be asking about kidney disease; the combination of high magnesium levels, thickening of the kidney walls in the previous scan, and history of problems with urinary crystals all point that way.

It sounds like your baby should be on a diet that's easy to digest, contains extra salt and extra calcium, is low in magnesium, and may need subcutaneous IVs, which you can do at home with a little training. And if it is kidney disease your pet's seizures may result in you catching it early, which is a huge plus.

I hope this helps. Remember, nothing we say on TCS is a substitute for veterinary care; all we can do is give you the benefit of our intelligence and experience.

Margret

 

[Timmer]

Artiemom, I reread your post and I don't understand how your vet concludes that your cat has lymphoma but then doesn't suggest you do anything about it. I'm confused.
Anyway, what others have said reminded me of what I went through -- that your cat cannot be properly diagnosed if it is on prednisone, but it sounds like it is not.
Your kitty is eating normally and no weight loss, no vomitting. That's good. My cat did not vomit but in hindsight, with his IBD, I do remember before it was diagnosed, like last summer, he would sometimes not finish his meal, his bowel movements smelled terrible but looked OK. He was normal in other ways but when I took Timmer in for his check up in October, he had lost some weight. About a pound and a half. We didn't do anything about that but just made note of it. By November when he got sick, he had lost even more weight. His stool was loose and at the end of his bowel movement, blood would come out. The blood wasn't in the stool, it was let out later. Colitis. But you don't have that either.
From what I read, yes, those IBD issues are from food allergies. Unfortunately those take awhile to figure out because you have to spend time finding out exactly what food ingredient caused it. He refused to eat rabbit or duck -- which people usually tell you to try if you suspect food allergies to the usual, fish, chicken, etc. I did put him on grain free, but that caused him to be constipated! My poor Timmer.

If your kitty has thickened walls in the large bowel then Waffles probably does have some kind of IBD. The seizure is puzzling. Can't they do more blood work?
Would you consider a second opinion?

 

[artiemom]

Timmer my cat does not have lymphoma. I never said he did.

My cat has IBD & Megacolon. Began with IBD. My vet is a specialist.

The original thread starter, wafflesnomnom is the one whose vet said lymphoma.

She was asking about IBD. I was explaining.

I think you got a bit confused.

 

[wafflesnomnom]

I don't have any advice, maybe someone else who has experience with these problems will chime in. I personally have never known a cat with IBD to have seizures, but no throwing up, or diarrhea? Im sure your vet knows more than me, but just like with our human Dr.'s sometimes a second opinion, from a different vet might make you feel better on the direction to take? Just wanted to offer support, and well wishes!

That is an option depending on what the vet says next monday, someone suggested in this thread to see a internal specialist which sounds like a good idea.

 

[wafflesnomnom]

I am so sorry you are going through all of this..((hugs))
IBD is hard enough to handle, never mind having a seizure issue. I cannot imagine.
My guy has IBD and Megacolon.

I will apologize in advance if I say anything to upset you.

While your vet is very well respected it just seemed he was a bit too fast to mention cancer, based on just an ultrasound scan, without evidence of enlarged lymph nodes or masses... IBD and SCL can look the same as far as thickened mucosa. Most IBD cats, when treatment fails, usually begin chemo treatment, to help with symptoms-- Because of this, many people feel that the biopsy is not needed.

However, SCL and IBD are treated pretty much the same way. I am not certain how the mix would be if your baby has a seizure disorder. Yes, depletion of electrolytes can induce a seizure. I would hope your baby was hydrated with an IV Solution, to resolve this.

What symptoms of IBD does you kitty have? Nausea, Vomiting, weight loss, diarrhea are all indicative of IBD and SCL..

From my understanding there are a ton of meds for IBD: daily pepcid AC, prednisolone, Cerenia, even Zofran, Reglan, Flagyl... It all depends on symptoms.. and a novel diet is usually suggested.

The theory is that IBD is usually from an allergy to something in the food; although there is a genetic predisposition to it. You need to calm the allergic reaction.

The questions I am thinking are: What are the symptoms? and Are you scheduled to see an Internal Medicine Vet? What meds, if any, is your cat currently taking?

The IMVet can give you so much more information. Also one more thing for you to think about: If you are deciding on a biopsy, then all steroids will have to be discontinued for a while prior to the biopsy due to a false negative biopsy. You would have to make your baby sick again, in order to get a true biopsy..

Also, not all endoscopic biopsies are conclusive. The most conclusive biopsy is a real surgical, cut down, biopsy. I decided against that; having the endoscipic-biopsy instead.

I think you need to decide on where to scan next; as to what needs to be prioritized.
An Internal Medicine Vet can be so helpful in deciding this.

My internal Vet is really good at palpating abdomens. He can tell so much from just an external exam.

Personally, I would begin medical treatment for IBD and see what happens.. You can always have an ultrasound, if needed.

The seizure issue bothers me.. Blood tests and watching will probably be the way to go....but what do I know? I am not a Vet, I am just going by my own experiences..

Sorry, but I seem to have written a book, and have not really answered your questions.
I know you have tons are in shock right now-- your head is spinning.

I hope I have not confused you even more.. IBD is a horrible, frustrating disease.. Just when you feel it is under control, it returns with a vengeance...

Also, there is a great website, explaining it all; IBDKitties.com I suggest anyone who has an IBD kitty read it. I helped me so much...

((hugs))

Thanks for this, I am definitely going to consider seeing an internal medicine vet. The vet thought waffles had cancer due to the increased kidney thickeness and inflamed colon. I agree the vet jumped the gun on that one, but he also thoroughly explained the ultrasound images to us with comparisons and stuff, so I believe he thought it was lymphoma and wanted to catch it early.

Yes. My cat Timmer just passed away on Friday. He was diagnosed right after the first of the year with IBD. I did pay close to $4,000 to have him diagnosed. This included all kinds of blood work, he had to be sedated and the stool manually removed, scans, drugs, stays at the hospital (over night), colonoscopy, biopsies, ultrasound, chest x-rays... you name it. He saw one of the best GI specialists in my area.

If your kitty had thickened walls of the intestines at the last scan, unless he or she was put on prednisone to reduce the inflammation, Waffles probably has it still. To my knowledge, IBD doesn't go away on its own. IBD encompasses many diseases, such as Crohn's and colitis.

Having said that, my cat's symptoms were bloody stool, loose stool, very smelly and then eventually in his last few days, his large bowel and colon swelled so bad he couldn't pass stool on his own. He never threw up, nothing out of the ordinary. I didn't catch it until it was probably too late. He was on a full dose of prednisone for close to two months and two weeks of chemotherapy. Nothing was working. Our regular vet suspected he also had GI lymphoma which is a very progressive disease.
But he never had a seizure. I think something else is going on with your kitty. I'm no vet, so don't take my word for it.
I prefer getting information off the Cornell University veterinarian website. That seemed to be spot on with my situation.
No one can tell you what to do regarding spending more money. The question is maybe if you have the knowledge of the test results, what will you do with that knowledge? If your kitty has a brain tumor, then what? Will you keep Waffles comfortable for the rest of his/her life or see if they can operate? I have no answers, I'm just telling you what I went through. I always swore I wouldn't have any operations done on my cats because they never seem to bounce back when operated on. But for me, the decision was that I owed it to Timmer to find out! Because what if it was something simple that could be treated??? I could never live with myself knowing that. So...what I did was got another credit card and put his medical bills on that. That's me.
I wish you the very best. I feel for you. My heart goes out to you. I hope it works out for the best and you and Waffles have more wonderful years together!

I'm so sorry about your kitty. Waffles doesn't have any digestive symptoms at all, no smelly stool, diarrhea, constipation, vomiting, etc, which is why it makes it harder to figure out what it is.

I've never dealt with IBD myself; most of what I know about it has come from this site, and specifically from Artie's thread, so keep that in mind when evaluating the credibility of anything I say.

The ultrasound results sound like IBD to me, but none of the rest of it does. He's eating okay. He's pooping okay. But his blood work is off.

I think that, if it were me, I would be concentrating on that last detail. A definitive diagnosis is always a good thing to have, but I don't think any of the suggested tests are going to give you that. Another belly scan? He's already had one of those, which gave a "definitive" diagnosis of lymphoma, which was totally inaccurate! A brain scan? If it shows a tumor, that gives you a definitive diagnosis for the seizures, but still doesn't tell you why the blood work is off. But if the brain scan doesn't show a tumor you still don't have a diagnosis; all you've done is ruled out one possibility. I think perhaps you need to be looking for a food that addresses those specific issues.

According to Understanding Blood Work: The Biochemical Profile for Cats - PetPlace:




And according to Potassium or Magnesium Problems in Cats:


I think I'd be asking about kidney disease; the combination of high magnesium levels, thickening of the kidney walls in the previous scan, and history of problems with urinary crystals all point that way.

It sounds like your baby should be on a diet that's easy to digest, contains extra salt and extra calcium, is low in magnesium, and may need subcutaneous IVs, which you can do at home with a little training. And if it is kidney disease your pet's seizures may result in you catching it early, which is a huge plus.

I hope this helps. Remember, nothing we say on TCS is a substitute for veterinary care; all we can do is give you the benefit of our intelligence and experience.

Margret

Thank you for all the information you got! I definitely have kidney disease on the list of questions to ask. If all of his enzymes came back normal could it still be kidney related?

Artiemom, I reread your post and I don't understand how your vet concludes that your cat has lymphoma but then doesn't suggest you do anything about it. I'm confused.
Anyway, what others have said reminded me of what I went through -- that your cat cannot be properly diagnosed if it is on prednisone, but it sounds like it is not.
Your kitty is eating normally and no weight loss, no vomitting. That's good. My cat did not vomit but in hindsight, with his IBD, I do remember before it was diagnosed, like last summer, he would sometimes not finish his meal, his bowel movements smelled terrible but looked OK. He was normal in other ways but when I took Timmer in for his check up in October, he had lost some weight. About a pound and a half. We didn't do anything about that but just made note of it. By November when he got sick, he had lost even more weight. His stool was loose and at the end of his bowel movement, blood would come out. The blood wasn't in the stool, it was let out later. Colitis. But you don't have that either.
From what I read, yes, those IBD issues are from food allergies. Unfortunately those take awhile to figure out because you have to spend time finding out exactly what food ingredient caused it. He refused to eat rabbit or duck -- which people usually tell you to try if you suspect food allergies to the usual, fish, chicken, etc. I did put him on grain free, but that caused him to be constipated! My poor Timmer.

If your kitty has thickened walls in the large bowel then Waffles probably does have some kind of IBD. The seizure is puzzling. Can't they do more blood work?
Would you consider a second opinion?

I will definitely ask about more blood work.

Thank you all for the responses. I made a list of questions to ask. My thinking is if the US is to just confirm he has IBD, then I'm not interested b/c it's pretty much a given, but if the vet thinks there's diagnostic information for kidney/gall bladder/pancreas issues, I might consider it but I will also give the referral to an internal medicine vet a serious thought too as well as see if there are more blood tests that can be done before we go to the US route b/c I know it's not that invasive, it still involves sedating him and shaving off his fur and having him stay at the vet for half a day which he hates.

If you have any other suggestions let me know! I really appreciate it!

 

[Timmer]

Timmer my cat does not have lymphoma. I never said he did.

My cat has IBD & Megacolon. Began with IBD. My vet is a specialist.

The original thread starter, wafflesnomnom is the one whose vet said lymphoma.

She was asking about IBD. I was explaining.

I think you got a bit confused.

I'm sorry. Please forgive me. It's been a long stressful day. Sorry.

 

[Margret]

Thank you for all the information you got! I definitely have kidney disease on the list of questions to ask. If all of his enzymes came back normal could it still be kidney related?

I don't know; it's been too long since I dealt with a cat who had kidney failure (thank goodness it's only happened to me once), and the vet I had then was a lot less forthcoming about lab results and how to interpret them than I would insist on now. Here are some other resources from TCS that you may want to investigate:

• Seizures In Cats
  
• Your Cat’s Kidneys Called
  
• And this one is the now closed (you can no longer ask questions there) Expert forum on kidney issues which is mentioned in the previous article: One more: 2%?

One of the things I noticed in the information I posted previously is that low chloride levels indicate metabolic alkalosis while low sodium levels indicate metabolic acidosis, which, if I understand properly, are opposites. How to interpret this? Totally baffled here.

Margret

 

[Margret]

Regarding IBD, you may want to read this article: Inflammatory Bowel Disease In Cats
and you may be interested in this rather long thread: Artie and his Issues (I should mention that the reason this thread is so long is that Artie has survived more that a year longer than anyone expected.)

Margret

 

[artiemom]

I'm sorry. Please forgive me. It's been a long stressful day. Sorry.

It's ok.. I know you have been through a lot... it is seriously, ok.. ((hugs))

 

[artiemom]

I am thinking that your regular vet will state that the ultrasound is too visualize the other organs also. Then the decision is up to you.

If it were me, I would wait on the ultrasound, until you see the Internal Medicine Vet. They will probably suggest it, but it will be done with the Internal Medicine Vet and not your regular vet, who misinterpreted your baby's prior ultrasound.

This way, you would not be wasting money on an ultrasound, with the regular vet. There are Radiologists who do read the ultrasound exam. It is not up to your regular vet to interpret them. Why he decided on cancer, I will never know.. but we are moving forward from that horrible time.

In my experience, attitude means a lot with doctors. I would not allow your regular vet to bully you into staying with him, avoiding an Internal Medicine Consult, and bullying you into an ultrasound. I would try to stay strong and wait until you see the IM vet.

Just say it is for your own piece of mind, you have so many questions, you need an expert to help you sort them out. If your regular vet is human, he will understand your reasonings.. if not, then I would definitely change him... He seems too arrogant for me.
Also, if he thought Waffles had cancer, and did not treat him for it, then I have questions about him. Sorry for being so blunt, but.....

Blood tests are really a 'given'; interpreting them is very complicated. Some things I understand, others I do not.

The seizures do worry me. These are not to be pooh-poohed.

Please let us know how you are doing.. keep us updated..
((hugs)) to you and Waffles

 

[Timmer]

Thanks. I did have a cat with IBD so at least I got to share our experience with you.
I truly hope this all turns out for the best for you and your kitty. It is a very stressful and emotional time.

 

[wafflesnomnom]

I am thinking that your regular vet will state that the ultrasound is too visualize the other organs also. Then the decision is up to you.

If it were me, I would wait on the ultrasound, until you see the Internal Medicine Vet. They will probably suggest it, but it will be done with the Internal Medicine Vet and not your regular vet, who misinterpreted your baby's prior ultrasound.

This way, you would not be wasting money on an ultrasound, with the regular vet. There are Radiologists who do read the ultrasound exam. It is not up to your regular vet to interpret them. Why he decided on cancer, I will never know.. but we are moving forward from that horrible time.

In my experience, attitude means a lot with doctors. I would not allow your regular vet to bully you into staying with him, avoiding an Internal Medicine Consult, and bullying you into an ultrasound. I would try to stay strong and wait until you see the IM vet.

Just say it is for your own piece of mind, you have so many questions, you need an expert to help you sort them out. If your regular vet is human, he will understand your reasonings.. if not, then I would definitely change him... He seems too arrogant for me.
Also, if he thought Waffles had cancer, and did not treat him for it, then I have questions about him. Sorry for being so blunt, but.....

Blood tests are really a 'given'; interpreting them is very complicated. Some things I understand, others I do not.

The seizures do worry me. These are not to be pooh-poohed.

Please let us know how you are doing.. keep us updated..
((hugs)) to you and Waffles

Our regular vet is trained in ultrasound and he specializes in cardiac ultrasounds, which is why he was interpreting them. He also teaches a course on ultrasound, but I do you're right that if I do do an ultrasound, I will want a second opinion or someone more specialized.