Anyone want to help with this mystery? (mild pancreatitis??)

[Time 2 Recognize]

Ok. So here's a weird one I'm trying to figure out with my girl Echo.

It starts like this:
Earlier in April there was a week she was most constipated, her energy/playfulness was less which I attributed to the constipation. She was also more picky with food...Again, can happen with constipation. Vet visit brought us home with psyllium (pumpkin wasn't doing it). Once the psyllium was working, her poops are definitely better. I would not say ideal, because I'm still figuring the amount of psyllium that isn't too much (bulky stinky or even too wet) or too little (hard). Anyway, she's been pretty regular for about a week. Her appetite is generally good, some foods she was simply over.

However, between the 26th and yesterday morning (29th) she had this weird down shift in energy. Not all that interested in playing. Would sorta try for a minute before walking away or looking just "meh". I pulled out old toys, I created some new ones, no luck getting her super into playing. She is only 2 years old just as of last week and usually has regular zooms around the place. Once a day normally, I would say, though some days are full wacko and some are just general zoomies. But those 3-4 days, she was really off. She acted older.

Other things I noticed:
-Less vocal with (or demanding of) me
-Sometimes slept in a way that made me question if she felt ok? Like loaf, but not happy loaf for, example (I have pic)
-Sleeping through whole night with me and getting up after me (she usually wakes up first, goes beneath the bed, and grumps and grunts until I get up. lol)
-Occasionally leaving bit of food in bowl overnight
-Had a runny eye one day, slightly runny nose the other -could be seasonal from having doors open more

So we went to the vet. In NY, that means dropping them off and waiting outside to talk on the phone with them. She saw a vet I haven't met before (this was high anxiety trip for both her and I). Physical exam was perfectly fine, abdomen was fine/nothing stood out, and they were somehow able to get blood (both regular panel + Pro BNP because she pants when freaked at vets, she's had one before elsewhere and results were fine -I was told). She also had a slight fever of 103, vet said could be stress.

After appointment she was ok, more normal than prior day but still eh. No rambunctious run arounds. Just...a little disengaged? After looking up slight fevers/what they could be I was worried that combined with her other oddities from prior days, maybe something viral or something like mild pancreatitis was going on. The loafing on occasion really has me wondering this. Then I realize the brands she's been eating most of lately are higher fat like Rawz turkey, which is 66% calories from fat, Holistic Select Lamb which is 60% fat. I was previously giving Hound and Gatos, all of which seem to be high fat as well (60% and up)

So last night for dinner I gave her Tiki succulent chicken (28% fat) with added water (also salmon oil and some probiotics). Not her favorite but I got her to eat most and she finished off by morning and then for 10:30am breakfast did 1/3 can Rawz. Her energy dipped and she was napping a lot in carrier. Then hours later at 5pm, gave her Purina One pate I picked up because it seems to be lower fat (28% for chicken pate) and ingredients not that bad honestly. Her energy was pretty good after lunch and she had zoomies/rambunctious energy first time in a number of days! Then dinner I gave her other 1/3 can Rawz and now she is curled up in her carrier and to me, seems uncomfortable again. So 2 meals of Rawz/high fat maybe too much?

Could this be mild pancreatitis? Possible slight fever, sleeping like she might not feel well, less willing to play, less vocal/engaged.... I'm going to call vets office tomorrow and ask they do that more specific pancreas test if they can. When the vet called about blood panel earlier -which apparently all looked fine-, she did say it was possible to run more specific pancreas test but, she did not think the test was necessary since Echo doesn't have other or more dramatic symptoms. But I'd rather figure this out before its a bigger issue if this test will help indicate one way or another what is or isn't going on with her. . . I'm a proactive type person (and very thankfully got kitty insurance when I adopted her) so why not run the test right? Would love to hear what more experiences cat owners think or have experienced? I feel guilty for giving her fatty dinner now Is there anything I can do?

 

[Elphaba09]

It might be. But it could be other things, too.

Our Tara has chronic pancreatitis. When it starts acting up, she becomes lethargic and cranky. She gets runny stools and vomits, despite not eating. When it gets to that stage, she has to have IV fluids to "rest" her pancreas. Afterward, she still does not want to eat, so I syringe feed her after giving her ondansetron.

 

[Time 2 Recognize]

It might be. But it could be other things, too.

Our Tara has chronic pancreatitis. When it starts acting up, she becomes lethargic and cranky. She gets runny stools and vomits, despite not eating. When it gets to that stage, she has to have IV fluids to "rest" her pancreas. Afterward, she still does not want to eat, so I syringe feed her after giving her ondansetron.

So sorry your girl deals with it. I don't know what else it could be, but the vets office hasn't sent me her blood work yet to see the numbers myself. Just said it "looked good". Echo has had some looser stools, but it's hard to know what exactly is going on there because I've been adding psyllium and she eats different brands.

The sad loaf position and her demeanor makes me thing it's got to be something digestion related and while I have to double check the past weeks foods/fats, I'm pretty sure as I've switched some meals to be lower fat cans, her energy has improved a lot. I guess we'll see if they can do the pancreas specific test what it says and go from there...It will drive me nuts trying to figure out what the weird bout of malaise was...seeing her so dull is scary

 

[solomonar]

Difficult to assume a certain condition.

An echography? Second opinion of a feline-specialized vet?

Make sure you follow the recommended diet.

 

[Time 2 Recognize]

So I did ask they go ahead with the pancreas test and they sent me her standard blood work this morning.
She has been acting pretty much herself last 48 hours. Had a proper full on case of the zoomies yesterday, has been vocal, waking up before me and being more engaged overall. The blood work is where I get concerned though, because her bloodwork has some raised levels...I Did speak with the vet briefly about it and she told me urinalysis could be next step, but since the values are “within range” she isn’t too concerned about it, but wondering what anyone else thinks? I plan on getting vials to collect home urine to see specific gravity (was 1.036 in early March).

first pic is January’s panel, second is this past weeks. Her SDMA rose from 7 to 12 and her creatinine went from 1.5 to 1.9. She had eaten (wet food added water) the day of the January test as it was afternoon appointment, but did not the morning of the recent test since it was earlier in day and when I asked if I should feed her was told not to. She also had the random malaise going on, so that could factor in perhaps...some kind of temporary inflammation maybe...

I don’t have any first hand experience with kidney issues and cats...but our dog died last year from sepsis and her kidneys shutting down. It’s days from the one year anniversary of her passing. So this is scary to me to see the numbers up this much. I don’t know what is normal fluctuation but the SDMA going from 7 to 12 seems like quite a jump in a few months time...and I’m reading that some Vets disagree with the typical lab ranges for creatinine and consider 1.6 to be cause for concern. she’s only 2 years old...

 

[Time 2 Recognize]

solomonar About A feline specialized vet, there’s one in my area, but we had bad experience with him back in December (and honestly, since then it’s been back to back issue. UTI, then sprained leg, then constipation, then this). He incorrectly answered a question about a shot and lied about what he gave my cat when she had reaction to a steroid. So he’s out.

There is vet at this practice that is specifically trained in feline care, so I will see if maybe she could look at the blood work too, but I disagree with her about feeding schedule (she says two meals, everything else I find online says smaller more frequent is better). I’ve been told by a cat rescuer who used Dr C (other one I’m currently working with -same practice) and found her to be great. So far I do like her, maybe I’m just more prone to concern over these increased numbers. At the end of the day I have lots of trust issues with vets so I’m double checking whatever I can.

 

[solomonar]

I won't go with blood tests alone. The values vary anyway with lots of factors.
I know that on myself.

A consultation is needed, and that means examination+behavior. Blood tests should be considered in relation to clinical facts and perhaps with echo in this case.

When the vet becomes familiar with the cat she/he can better spot the problems.

 

[Time 2 Recognize]

I won't go with blood tests alone. The values vary anyway with lots of factors.
I know that on myself.

A consultation is needed, and that means examination+behavior. Blood tests should be considered in relation to clinical facts and perhaps with echo in this case.

When the vet becomes familiar with the cat she/he can better spot the problems.

The SDMA can vary up/down as well? She was fasted for 13 hours (vet apointment was right around breakfast so we skipped that morning). I'm getting conflicting answers on that and if dehydration can raise that number. Or if 13 hours counts as dehydration even. The vet initially told me the test was normal, all fine. I asked to be sent results and thats when I noticed. Technically yes, SDMA, Crea and BUN aren't in the red, but considering her SDMA was 7 few months ago...I would think that's concerning especially because she is only just 2 years old.

She had a full physical exam and was palpated before blood draw, nothing was tangibly enlarged and was told she seemed good, but I will discuss with them tomorrow when I drop off a urine sample to get a new reading on specific gravity and protein etc....I'm trying not to think the worst but am scared. She gets wet food and I add water as well, so I never see her drink. She tends to pee 4-5 times a day and that's been the case since I've been tracking that (since back in January).

 

[Time 2 Recognize]

She seems to not feel 100% again. Just a bit dull and less playful. Was possibly in uncomfortable loaf position earlier... I don't understand or know what else I should or can do. I will try and collect some questions to ask vet tomorrow. I'm really concerned about her kidney levels rising the degree that they did, especially SDMA. Please hope with me that her urinalysis is good and healthy.

I'm worried that maybe some supplements I used, or how I used them may have done her harm. D mannose -I gave this possibly too long, 1/8 tsp for 2 weeks, morning and night meal. Or perhaps L-lysine, which I was also giving at one point..Or the ingredients in her probiotic from Mercola maybe not great (has microcrystalline cellulose and silicon dioxide as filler, looking to change to better one). All things I plan to ask my vet. Going to send an email because even written down its hard over the phone to get to everything.

She was also sedated by a different vet for x-rays back in Feb when she sprained her leg. Thats when I gave d mannose because I was concerned she would get UTI, she got one week or two after bad reaction to steroids. About 8 days after being sedated, she had a 3 day period of noticeable increased urine output, I stopped d mannose, but then the increase going stopped and she resumed normal.

 

[solomonar]

Echography can detect bladder inflammation.

Not drinking is worrying.

 

[Time 2 Recognize]

Not drinking is worrying.

She's always eaten wet food and I've pretty much always put water added in too, so she gets hydration. I've asked the vet before and she's told me that if I'm also adding water to her meals she might not drink water. She's pretty much always been like that...did drink after coming home from vet when she had to be sedated for x-rays though.

I'm waiting for her to use vet litter to collect urine sample to bring to then today.

 

[Time 2 Recognize]

Pancreas test came back normal -so that was not issue or cause of random malaise.

Brought in her sample of urine and my own observation was that it was a little bit cloudy, which is concerning. Home pH test read 7, so maybe crystals or infection...but I haven't noticed odd behavior in the box or increased amount or small clumps...only thing is she sometimes sounds dribble while peeing and I've asked vet about this but they didn't think much of it. I think it will take them a day to get results, which means might not know more until Monday or Tuesday
Her last urinalysis was a little over a month ago and was all clear, though I can't seem to get her pH below 6.5.

 

[solomonar]

Some say minimal crystaluria is natural.
It is easy to spot crystals at microscope exam, I doubt they can go unnoticed.
Bladder inflammation is oculte- echo can spot it.

===

SDMA - well, it is in the normal range (laboratory or sampling errors, variation in diet etc may cause ups and downs, but I cant say for sure). Repeating in 2 months may be conclusive.

High albumin may have a lot of triggers: inflammation, liver disease or just stress.

It is really impossible to judge from blood tests alone.

- Daily diet changes?
- Stress? (Changes in daily routine)

 

[Time 2 Recognize]

So spoke to one of the vets at this clinic about the urinalysis. It was good, she did have some crystals, but the sample was also refrigerated before processing so that is a factor. I do believe she did have some crystals coming out just because the urine was a touch cloudy. They did note epithelial cells, which have not been seen really on her past urinalysis, and her pH was a touch high at 7 (I measured that at home with a strip right after collection so I believe the lab results to be accurate there).

I still feel funny about whether or not she is ok. Yesterday and day before her energy was great. Today she's a bit less active. Still eating and doing all the things and doesn't seem to not feel well...I don't know. I asked this other vet about her kidney values and he said "they're still in range". I was just dazing in to a nap when he called, so I didnt really get to ask "yes, but given her prior test results in January and her age, should there be any concern with the numbers increasing such as they did?". I will email about this. I'm just not sure I 100% trust this clinic. The blood test also showed low Neutrophils (2.24 when low is marked anything below 2.62) so I don't know what that could be about either.

Do you guys think I should have a follow up blood test in a couple weeks time? The vets there aren't at all concerned. But last year this time none of the vets we saw about our dog were concerned and she died of sepsis because no one thought it was necessary to change her bandage (no one taught us how and she had a feeding tube)....so I'm distrusting.

 

[Pine]

Hello, I am new to this community and have been looking for posts to understand what is wrong with my 2 year old boy.

He has a lot of the same symptoms as your cat. It's been weeks now that he's been off, not talking when he's usually very chatty, not wanting to play when he's usually a spaz, sleeping all night and waking up after me, and the LOAF POSE oh my gosh it's exactly like that, which I've also seen referred to as the hunch I believe. He usually lays all sprawled out and its been very concerning to me. He's barely been eating the past few weeks and food is usually his favorite thing. He also has been congested but not sure if it's unrelated.

His basic blood work was normal but he had ultrasound for concern for a blockage and was diagnosed with possible pancreatitis from the scan (a few hypoechoic areas on the pancreas). He has not had the pancreatic blood tests yet, but I was told by two vets (hospital and our regular vet) that the test could be negative and he could still have pancreatitis. I don't think the diagnosis can be definitive without a biopsy which seems unneccesary at the moment. Like your baby, he's had a bunch of ups and downs this whole time but has not been fully back to normal for any of it.

You mentioed the cat's only vet was out and that you might not trust this clinic, which is understandable given your experiences. Do you have any specialty internal medicine vets or university hospitals where you are?

Have they found any more info on what exactly is wrong?

 

[Time 2 Recognize]

Hello, I am new to this community and have been looking for posts to understand what is wrong with my 2 year old boy.

He has a lot of the same symptoms as your cat. It's been weeks now that he's been off, not talking when he's usually very chatty, not wanting to play when he's usually a spaz, sleeping all night and waking up after me, and the LOAF POSE oh my gosh it's exactly like that, which I've also seen referred to as the hunch I believe. He usually lays all sprawled out and its been very concerning to me. He's barely been eating the past few weeks and food is usually his favorite thing. He also has been congested but not sure if it's unrelated.

His basic blood work was normal but he had ultrasound for concern for a blockage and was diagnosed with possible pancreatitis from the scan (a few hypoechoic areas on the pancreas). He has not had the pancreatic blood tests yet, but I was told by two vets (hospital and our regular vet) that the test could be negative and he could still have pancreatitis. I don't think the diagnosis can be definitive without a biopsy which seems unneccesary at the moment. Like your baby, he's had a bunch of ups and downs this whole time but has not been fully back to normal for any of it.

You mentioed the cat's only vet was out and that you might not trust this clinic, which is understandable given your experiences. Do you have any specialty internal medicine vets or university hospitals where you are?

Have they found any more info on what exactly is wrong?

I'm so sorry about your boy. Do you know what pancreatic test they would run? I think there is one that is meant to be fairly sensitive. Spec fPL is the test they ran for Echo and it came back .9 on a scale of 0.0-3.5 ...I don't know how good or bad of a result that is, but was told it was fine and thus not pancreatitis. I'm curious how long his ups and downs last? Is is good week, not so good week type thing? Do you have his blood work? Echo had low neutrophils on hers (I linked them somewhere above) and the other thing of concern to me was increased kidney values. They're within range, but higher than her last test in Jan. The clinic just told me things looked good -no explanation really.

Our other vet is sometimes hard to work with honestly. Not very receptive to questions, isn't usually the one to call about blood or test results, but I in general do think she's a good vet. I may ask her to look at the blood work I did at this other clinic and inquire about getting a follow up with her instead of them to run things again. I worry she will get annoyed I went elsewhere. My issue was that last time I had called about something, front desk suggested she would want to sedate my cat for exam. I do not want to do that to my cat and the other clinic was able to exam and draw blood without doing that. So if that's how they would want to do things I will stay with this clinic we went to. Then we have a local feline only vet that many locals love, but I and Echo had a bad experience there. So I feel so stuck. I hate the idea of bringing her somewhere new and not being able to go in with her at all because I've had too many bad experiences with other pets as well, even in places that are supposedly very high end or state of the art.

Echo went back to her normal self for the week following the vet visit. The vet felt everything was normal and I'm guessing felt I was a bit of a panic mom. I am, but then the past couple days, I've noticed decreased energy again. I increased her meal times to 4x a day, one can of a less-often-fed low fat Weruva flavor gave her a bit of diarrhea and thought maybe those things combined is what precipitated that but I just don't know. Today she was her normal vibrant self, had some zoomie spunk, chatty and eager to explore but I gave her afternoon meal and since then (about 4:30pm, now 8:30pm) she's been tuckered out on the bed. No loaf position though. So I'm just trying to re-grasp what is normal for her/her age and what is "off" because it CAN be so subtle! Her appetite has consistently been good though. But I'm constantly questioning if what I'm feeding her is the cause So I really don't know. What does your boy eat? How have his stools been?

I wish I had answers and I wish for you to get answers too! I'm sorry you too are having an unexplained situation. One thing I do that I recommend is keep a daily journal. I put down when/how many times she's gone to bathroom, when/what she was fed and anything notable about her energy on a scale of 1-5. It can potentially be helpful

 

[Time 2 Recognize]

P Pine -something else I want to mention, in terms of getting your boy more interested to eat food (I'm assuming wet food?) is to warm it up slightly. Just warm to the touch kind of thing. I avoid microwave, but use a double boiler situation. Shallow kitty food bowl goes in larger container, hot water is poured just to midway up the side of the food bowl and I stir gently till warm to the touch. My kitty is noticeably less interested in food that isn't warmed up a little. Makes the smell stronger and is a more instinctual experience for them.

Other thoughts: Echo's malaise, I feel after keeping tight notes about meals and timing of her slumps, is most connected to her meals than anything else...I think... I tend to add water to her wet meals since she doesn't drink out of bowls (ordering cat fountain soon to try that out), but this can make a moderate size meal "larger" and I notice her wet burping or at times looking more uncomfortable after a meal (like hunched or sitting upright but with her legs awkwardly chest tight?). So in her case, I also question if the way I have been feeding her, adding too much water on occasion, perhaps leads to some digestive upset or imbalance of stomach acids (and perhaps pancreatic enzymes -don't know). Don't know if that is helpful to you, but thought I'd mention it!

 

[Pine]

I'm so sorry about your boy. Do you know what pancreatic test they would run? I think there is one that is meant to be fairly sensitive. Spec fPL is the test they ran for Echo and it came back .9 on a scale of 0.0-3.5 ...I don't know how good or bad of a result that is, but was told it was fine and thus not pancreatitis. I'm curious how long his ups and downs last? Is is good week, not so good week type thing? Do you have his blood work? Echo had low neutrophils on hers (I linked them somewhere above) and the other thing of concern to me was increased kidney values. They're within range, but higher than her last test in Jan. The clinic just told me things looked good -no explanation really.

Our other vet is sometimes hard to work with honestly. Not very receptive to questions, isn't usually the one to call about blood or test results, but I in general do think she's a good vet. I may ask her to look at the blood work I did at this other clinic and inquire about getting a follow up with her instead of them to run things again. I worry she will get annoyed I went elsewhere. My issue was that last time I had called about something, front desk suggested she would want to sedate my cat for exam. I do not want to do that to my cat and the other clinic was able to exam and draw blood without doing that. So if that's how they would want to do things I will stay with this clinic we went to. Then we have a local feline only vet that many locals love, but I and Echo had a bad experience there. So I feel so stuck. I hate the idea of bringing her somewhere new and not being able to go in with her at all because I've had too many bad experiences with other pets as well, even in places that are supposedly very high end or state of the art.

Echo went back to her normal self for the week following the vet visit. The vet felt everything was normal and I'm guessing felt I was a bit of a panic mom. I am, but then the past couple days, I've noticed decreased energy again. I increased her meal times to 4x a day, one can of a less-often-fed low fat Weruva flavor gave her a bit of diarrhea and thought maybe those things combined is what precipitated that but I just don't know. Today she was her normal vibrant self, had some zoomie spunk, chatty and eager to explore but I gave her afternoon meal and since then (about 4:30pm, now 8:30pm) she's been tuckered out on the bed. No loaf position though. So I'm just trying to re-grasp what is normal for her/her age and what is "off" because it CAN be so subtle! Her appetite has consistently been good though. But I'm constantly questioning if what I'm feeding her is the cause So I really don't know. What does your boy eat? How have his stools been?

I wish I had answers and I wish for you to get answers too! I'm sorry you too are having an unexplained situation. One thing I do that I recommend is keep a daily journal. I put down when/how many times she's gone to bathroom, when/what she was fed and anything notable about her energy on a scale of 1-5. It can potentially be helpful

I'm assuming the test is the feline specific lipase but they are doing a full "GI panel" on Monday. My understanding regarding the test is that sentivity is low, around 54%, but specificity is high, around 80-90%. A highly sensitive test (value appoaching 100%) is useful for ruling out disease if the test is positive, and highly specific test (value approaching 100%) is useful for ruling in disease with a positive test. So if the test is negative, I was told it could still be pancreatitis, but if the test is positive, the pancreas is certainly involved. Beyong that, I don't know anything about interpreting the results.

I would say his ups and downs seem to last a few days each, with the significant lows ending us up back at the vet or the ER if it's a weekend, after which an upswing starts again. He will have a very low few days, and then seem to be getting better and I get optimistic again, and then after several days, sometimes a week he goes back down. On the "ups" he never fully gets close to his normal energy levels and apetite. I have blood work from a month ago and it was all normal, but he didn't have his first serious bout of legarthy/inappetance until just over 2 weeks ago. He was hospitalized with a urinary blockage a month ago and his apetite never fully came back since then, though it has been having the ups and downs. My cat also had low neutrophils but the vet did not comment on it so I assumed it was not far enough from the reference range for concern, similar to your experience.

Due to covid circumstances I also had to go to another vet to have his blood drawn before all this because he's quite "fractious" at the vet and it is much worse when I'm not there, so I had to go to a different place that would allow me to occompany him, even though I think his regular vet is great and the most knowledgable I've ever worked with, and would have rather gone there. I send them the labs because I wanted them to have all the info, but I do think they may have been a tad annoyed I went somewhere else. Not being able to go in with them is agonizing so I understand how you feel. Did they say whey they want to sedate her for an exam? It should not be necessary for an exam and bloodwork. Does Echo get really worked up at the vet? Do you feel like any of the offices have an understanding of what is going on with her and are willing to find a diagnostic and treatment plan to get her better? I have also found that repuation and popularity of an office aren't neccessarily markers of the best quality of care or fit for your pet and your needs.

I've also been feeling like a panic mom, even wondering if I'm way overreacting at times. It's very scary when they aren't themselves and aren't consistently getting better! I'm happy to hear she at least had a burst of her old self and even some zoomies! And no loafing is also a good sign. It could be that she's starting to feel better and just isn't fully there yet. Has what you've been feeding her lately been different from what she normally eats? My boy before all this ate grain free wet and dry, but then once I realized he was having some FLUTD symptoms I switched to a urinary formulation wet and dry. After the blockage he now gets all wetfood, but his apetite has been so poor that I have been trying cans of everything I can find that I think he may eat. A month ago he had a couple weeks of constipation, which has now become a couple weeks of sporadic diarrea and two instances of vomiting.

I hope we will get our answers soon! It's so hard when you don't know what's going on. Since his blockage I've been keeping a daily log of his litterbox use, but I didn't think to start tracking his feeding and energy. That's a great idea, thank you!

I'll see if I can rig up a double boiler system. He's eating spoonfulls here and there but turning his nose up at quite a bit, and he's usually a food vaccuum. I've been adding water to his food too to increase hydration. I havent seen him drink water at all in a month and he's been ignoring his fountain too. I hope you have better luck! That is interesting you've found a correlation with her meals, I've have to pay more attention to that. Maybe I've also been adding too much water!

 

[Time 2 Recognize]

My understanding regarding the test is that sentivity is low, around 54%, but specificity is high, around 80-90%. A highly sensitive test (value appoaching 100%) is useful for ruling out disease if the test is positive, and highly specific test (value approaching 100%) is useful for ruling in disease with a positive test. So if the test is negative, I was told it could still be pancreatitis, but if the test is positive, the pancreas is certainly involved. Beyong that, I don't know anything about interpreting the results.

Ah, ok. I was not informed of this at all. See, would like a vet that discloses these things. I did some searching and reading on veterinary websites and it seems the Spec fPL is regarded as the most accurate, but in mild cases it is less reliable of an indicator like you said in terms of sensitivity.

I would say his ups and downs seem to last a few days each, with the significant lows ending us up back at the vet or the ER if it's a weekend, after which an upswing starts again. He will have a very low few days, and then seem to be getting better and I get optimistic again, and then after several days, sometimes a week he goes back down. On the "ups" he never fully gets close to his normal energy levels and apetite.

My cat also had low neutrophils but the vet did not comment on it so I assumed it was not far enough from the reference range for concern, similar to your experience.

Ugh I'm so sorry you and he are going through this and I hope answers come soon for you guys. I'm very grateful that Echo's appetite has been good, when it dipped, I think it might have been more related to her disliking the food because switching did help. I bought two cases of Hound and Gatos in chicken/turkey to solve potential food sourcing issues in quarantine, which I swear I've tried with her before, and she decided to shun in 1/4-1/3 into each case. Maybe it wasn't making her feel good though. I did ask a vet online (royal canine has a 24/7 vet chat that is free -though you're getting a random vet so who knows how correct or insigtful they can be from afar) about the low neutrophils. Some values are regarded as more significant if low than others and she said often times there is some value "out of range" in tests and it depends on the patient and the whole picture of the blood panel overall.

Knock on wood, today has been good day so far, but after her early evening meal, she slept in her carrier. So going on 5 or so hours of being sleepy and not in the same room as me. Like I opened door to balcony (has a screen), even took out my snake (which usually excites her at least upright and out of a nook) and she picked her head up but did not come out. It's just weird for her, but she's not loafing...It is hot though, 77 since the AC apparently is not working correctly. Is it just because it's hot now? If so, carrier isn't coolest place to sleep so I don't get it. Does she not feel well? I don't know. Am I crazy? I don't know She doesn't react with pain when I massage her tummy at all. Since cats are so secretive about their discomfort, it's really hard. I've never raised a cat before, so I also don't know what normal is as they adult-ify. I am used to wacky kitten hood with regular zoomies.

Has what you've been feeding her lately been different from what she normally eats? My boy before all this ate grain free wet and dry, but then once I realized he was having some FLUTD symptoms I switched to a urinary formulation wet and dry. After the blockage he now gets all wetfood, but his apetite has been so poor that I have been trying cans of everything I can find that I think he may eat. A month ago he had a couple weeks of constipation, which has now become a couple weeks of sporadic diarrea and two instances of vomiting.

Since Feb, she was getting either Rawz Turkey or Holistic Select Chicken, I attempted to add the Hound and Gatos Chicken, then turkey as Holistic ran out...and she started shunning HG without toppers, also had manageable bouts of constipation that I attributed to increased shedding/hair ingestion since whenever things did pass, hair wads every time. In April she was thoroughly displeased with HG, I like you, I started trying other foods. She's never before had issues changing foods, but I did used to use Mercola probiotics then stopped after this first bout of "whats going on??". Tiki after dark is liked. It's high moisture, low carb low fat. Downside is it lacks caloric density and is $$$. Their regular succulent chicken was "meh", but she likes both After Dark flavors tried so far. I even tried Purina (gasp) which she liked and hey, eating is eating. I hear friskies pate is highly palatable and some are decent ingredients for the price point. I don't know if her inappetence was pickiness or truly inappetence. With your boy, it sounds more definitively inappetence. But warming her meals made a difference with Echo and she got more gusto for meal time again. Worth trying. Aside from Tiki, the others mentioned are higher fat foods. I've read in other threads that lowering fat has helped some others with pancreatitis. So Tiki and Weruva are good ones for lower fat, high moisture, low carb (some Weruva are higher carb). But if their appetite is really decreased, whatever you can get into them is worthwhile.

Is he eating close to his daily amount? Have you asked vet about probiotic? Fortiflora is a really basic-bi*** probiotic as it is single strain, but, it also has animal digest which is apparently a very affective appetite stimulant. It might help both diarrhea and getting him to eat if your vet thinks its worth a try.

Did they say whey they want to sedate her for an exam? It should not be necessary for an exam and bloodwork. Does Echo get really worked up at the vet? Do you feel like any of the offices have an understanding of what is going on with her and are willing to find a diagnostic and treatment plan to get her better? I have also found that repuation and popularity of an office aren't neccessarily markers of the best quality of care or fit for your pet and your needs.

In February, I brought her to the regular vet we used for x-ray when she hurt her leg one morning. She was in pain and isn't fond of vet visits, so they had to sedate her then. I guess since then, the vet decided she needs sedation. But in my mind, she had sprained leg and was in certain pain, so yes, she was "fractious" being lame and scared.

Yeah, the biggest, fanciest most up-talked hospital in my state killed our dog last year. Their reviews had warnings though, saw them too late. But, it looked like such a high scale, state of the art place. Looks and reviews can be decieving. And it really sucks to indefinitely not be able to get face time with vets now to both see what they are doing in exam room and "meet" them if new. I hope clinics consider video chatting as part of exams and will be offering that feedback to the clinic we went to recently.

I've been adding water to his food too to increase hydration. I havent seen him drink water at all in a month and he's been ignoring his fountain too. I hope you have better luck! That is interesting you've found a correlation with her meals, I've have to pay more attention to that. Maybe I've also been adding too much water!

Hydration is super important, so worth adding if they don't drink, but also worth mentioning to your trusted vet and asking if too liquid of a meal can pose any issue?

 

[Pine]

Ugh I'm so sorry you and he are going through this and I hope answers come soon for you guys. I'm very grateful that Echo's appetite has been good, when it dipped, I think it might have been more related to her disliking the food because switching did help. I bought two cases of Hound and Gatos in chicken/turkey to solve potential food sourcing issues in quarantine, which I swear I've tried with her before, and she decided to shun in 1/4-1/3 into each case. Maybe it wasn't making her feel good though. I did ask a vet online (royal canine has a 24/7 vet chat that is free -though you're getting a random vet so who knows how correct or insigtful they can be from afar) about the low neutrophils. Some values are regarded as more significant if low than others and she said often times there is some value "out of range" in tests and it depends on the patient and the whole picture of the blood panel overall.

Knock on wood, today has been good day so far, but after her early evening meal, she slept in her carrier. So going on 5 or so hours of being sleepy and not in the same room as me. Like I opened door to balcony (has a screen), even took out my snake (which usually excites her at least upright and out of a nook) and she picked her head up but did not come out. It's just weird for her, but she's not loafing...It is hot though, 77 since the AC apparently is not working correctly. Is it just because it's hot now? If so, carrier isn't coolest place to sleep so I don't get it. Does she not feel well? I don't know. Am I crazy? I don't know She doesn't react with pain when I massage her tummy at all. Since cats are so secretive about their discomfort, it's really hard. I've never raised a cat before, so I also don't know what normal is as they adult-ify. I am used to wacky kitten hood with regular zoomies.

I have heard it can be a challenge switching cats' food, so that may indeed be a factor! That is interesting feedback from the Royal Canin vet, and it definitely makes sense to correlate the findings with the whole clinical picture and other laboratory findings.

It's so hard to tell whether a behavior is different or concerningly different, and I have questioned my sanity several times throughout this process! I think it's worth mentioning any behavior changes to your vet, even if its a new sleeping place. I've always been told any behavioral changes in cats can potentially be a warning sign since like you said they don't often overtly show pain, and I figure it's good for the vet to have as much information as possible so they can sort out what they think is important.