Diarrhea, Constipation, Refusing food and water

[kg84]

16yo female cat, spayed, otherwise healthy until two weeks ago.

Two weeks ago I noticed her straining when pooping and some hard poop found outside the litterbox. I assumed constipation and made an appt with her vet, but first available appt wasnt for two weeks out. She was eating/drinking and behaving normally otherwise so I thought it was fine to wait.

Two days ago she suddenly started having diarrhea multiple times, refusing food or water, acting lethargic. I was able to get a same day emergency appt with our vet and rushed her in. I assumed constipation was still the root issue and maybe she had a blockage.

Vet examined her, felt no stool or abnormalities in her colon on exam. Did not feel constipation was the root issue and said she could be having general motility issues because of her age, but that she felt "clear". On exam she had a slightly elevated temperature, a noticable heart murmur, and obviously lethargic. Vet gave injection of a nausea med, an anti-inflammatory med, and took blood work. We will not have blood work results until Monday (tomorrow). Vet sent us home with the nausea and anti-inflammatory med in pill form to continue to give to her for a couple more days... I have enough to last until Monday then I am out.

After the vet she seemed to be 75% back to normal and was eating and drinking again, looking alert and acting relatively normal. I've been continuing her meds as prescribed and it seems that she's slowly getting worse again. Diarrhea and lethargy is creeping back in despite the meds.

I'm expecting to get a call from the vet with blood work results tomorrow. One thing I'm not clear on is, at what point should I seek emergency care for her rather than wait for my regular vet to give me results? She is my baby so this feels like an emergency to me, but I don't want to rush her in for more poking and prodding if I should just be patient for the blood test results.

Any ideas of what might be the culprit would also help. I know this is kinda vague but it's all I've got to go on right now. It feels very sudden and that she suddenly got very sick about 48 hours ago and I'm so worried about her.

 

[Anne Valentine]

My super senior recently had similar symptoms. In her case it was constipation and she needed a stool softener to sort it out. Talk to the same vet or a different one. Also if she hasn't improved the emergency vet may not be a bad idea.

 

[stephanietx]

Is she eating anything? Have you changed food recently? Opened a new bag or fresh batch of cans?

 

[kg84]

Is she eating anything? Have you changed food recently? Opened a new bag or fresh batch of cans?

Shes eating tiny bits here and there for around the first 6hrs after she gets her nausea and pain meds. Not a lot but she will eat a few bites then back off like it bothers her. The meds are supposed to be 24hrs so I can only dose her 24hrs apart, but it doesnt seem like the meds last that long. After the first 6hrs it seems like she's just moping around and in pain, no interest in food/water or moving much really.

She used to be very food motivated and would love to eat so this is new for her.

No changes at all in the house... same food, same everything.

 

[kg84]

Blood work results are back and we are more stumped than before. Everything came back completely normal except for extremely low sodium and extremely high potassium.

We are having her admitted for the day tomorrow so they can run tests to determine whether she has addison's disease. My vet has been in practice for 30 years and said she's only seen one other cat in that time period that had addison's disease. I'm hopeful she will "fail" her test tomorrow which will prove that she has it, because according to the vet she will only need steroids for the rest of her life to treat it.

If she doesn't fail the test tomorrow, she will go for xray to look for anything else they can find.

I've been mentally and emotionally a mess. I'm not mentally ready to potentially lose her (are we ever?).

She's the sweetest kitty ever. She has always wanted affection but now that she is sick she just wants me to hold her 24/7. I've had her attached to me nonstop for the last 3 days and passing her off to my husband for a few moments to shower and use the bathroom. It's like having a newborn again, I just want her to feel better!

 

[fionasmom]

It is the variations in the potassium and sodium levels that is making your vet suspicious of Addisons. Her other general symptoms of lethargy, lack of appetite, and constipation also generally fit this condition, but they are vague enough to fit others as well. I have had dogs with Cushings, which is the opposite of Addisons, and in the old days before better meds, Cushings was treated by sending the dog into an Addisonian crisis and then reversing the treatment, so I am familiar with this condition. So tomorrow is probably an ACTH stim or dexamethasone suppression test and possibly other diagnostics. Cats with Addisons are treatable; there is a period of adjustment to the meds during which time you might be seeing the vet on a regular basis for monitoring, but this will taper off as the cat continues to be stable. Yes, if she "fails" the test you do have an answer.

As for your question yesterday, animals with either condition can require emergency treatment if they start to crash, but at this point I think that your vet is on top of it and the test is tomorrow.

Please let us know what happens.

 

[kg84]

It is the variations in the potassium and sodium levels that is making your vet suspicious of Addisons. Her other general symptoms of lethargy, lack of appetite, and constipation also generally fit this condition, but they are vague enough to fit others as well. I have had dogs with Cushings, which is the opposite of Addisons, and in the old days before better meds, Cushings was treated by sending the dog into an Addisonian crisis and then reversing the treatment, so I am familiar with this condition. So tomorrow is probably an ACTH stim or dexamethasone suppression test and possibly other diagnostics. Cats with Addisons are treatable; there is a period of adjustment to the meds during which time you might be seeing the vet on a regular basis for monitoring, but this will taper off as the cat continues to be stable. Yes, if she "fails" the test you do have an answer.

As for your question yesterday, animals with either condition can require emergency treatment if they start to crash, but at this point I think that your vet is on top of it and the test is tomorrow.

Please let us know what happens.

Thank you, this reply gave me some hope.

I went to work for a few hours today and came home to her. She is having muscle spasms/twitching now... a new symptom from when I left her this morning. It isn't impacting her ability to get around right now but still concerning.

I'm hopeful we will get our answers tomorrow.

 

[kg84]

Results are in, she "failed" her ACTH stimulation test by a long shot so it is confirmed she has Addison's disease. We are starting two meds today and will check in with vet in a couple of days if no improvement.

For now I am very relieved that we have answers.

 

[fionasmom]

Thank you for posting an update. Your vet did the right thing to test for Addison's; other might not have as it is so rare in cats. My current dog has been treated for Cushings for 7 years, also with an excellent vet, so this can be managed. Definitely stay in touch with the vet. Ask if there are any warning signs that the meds need to be adjusted or that the cat needs to be reevaluated. This will hopefully be very manageable and your cat will return to good health.