Enlarged Spleen?

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Jabzilla

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Hey folks,
One of my cats, Rocket, has been unwell for a week now. She is normally not picky and eats all her food, but now she only eats 20-30g instead of the full 50-60g per meal. She was at the vet on Sunday and had an X-ray on Monday. They sent blood and urine to the lab and the results for both came back normal. Her abdominal X-ray was also normal, except for a slightly enlarged spleen. The vet said that’s a normal response to having been sedated.

Is that correct? I’d never heard of such a thing. My cat continues to eat small amounts of food, and that’s when she eats anything at all. I’ve noticed Rocket going to the litter box and sitting in there, sometimes laying in there, and sometimes squatting without producing anything. That’s a new behaviour that started on Sunday after her vet visit. Yet there are also times where she goes and pees or produces soft poop. The soft poop also started a week ago and is very unusual for her.

I’ve been adding S Boulardii and Fera probiotics to her food for the past few days, but it’s hard to know how much of it she’s gotten since she’s eating so little food. On Sunday, Rocket weighed 4.61kg, down from 4.89kg. I feel like something is clearly wrong here. She’s been given Cerenia and Mirataz, but still only eats small amounts of food, as if she physically can’t eat more than a few pieces at a time. Without the Cerenia, she won’t eat anything at all. I’ve tried different foods and treats, all have been refused.

I have a few days worth of Cerenia left and figure I’ll take her to a different vet if this is still going on by then. I wanted to check here to see if anyone has ever heard of sedation causing an enlarged spleen, as that sounds pretty suspicious. Especially when everything else came back normal, yet the not wanting to eat continues.
 

silent meowlook

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Hi. I am sorry your cat, Rocket is unwell.

Do you know what she was sedated with? If I remember correctly, ace promazine can cause a pooling of the blood in the spleen or something like that. But I’ve never had a veterinarian look at an x-ray and say the spleen was enlarged to the sedation. I believe it is usually something that is seen with an ultrasound. But here’s An article regarding splenomegaly in cats that receive different sedation protocols.


It sounds like your cat is sick. It sounds like your cat does not feel well. When cats lay in the litter box, it’s a pretty classic sign of a cat that is not feeling good at all. So obviously something is very wrong.

If she was my cat, I would ask for a referral to an internal medicine specialist. I think that will get you the most answer. Hopefully get her on her road to feeling better.

X-rays are useful for some things. Unfortunately, they don’t show everything. Abdominal ultrasound as much needed diagnostic when dealing with the internal abdominal regions. But, you don’t want just a regular vet to do an ultrasound. It’s kind of a waste of money. It’s much better to have a specialist do it since they’ve had a lot more training And ultrasound are very subjective to the person reading them.

Is there anyway you can post her bloodwork? They should give you a copy of it.

I still would try to get her into a specialist as soon as possible.
 

fionasmom

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Referring to the article, my cats have been sedated with the other two agents, but never acepromazine. No one has ever had a problem with their spleen after sedation or, frankly, any problem with the sedation itself.

I agree that this is not the end of the story and that seeing an internist would be a good next move. As for the ultrasound, it has to be read by someone who is competent in understanding what they see and that is usually not the ultrasonographer and regular vet.
 
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Jabzilla

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Thank you Silent Meowlook and Fiona'sMom. Rocket's brother, Cosmos, has been sedated many times for x rays, ultrasounds, and to have his prolapse put back in when it was bad. None of those times resulted in an enlarged spleen. I've called the vet and asked for a copy of the lab work, the name of the drugs used to sedate Rocket, and a referral to the local internal med specialist. I gave Rocket her Cerenia this morning and she still won't eat. Hopefully she will do so in an hour or two, since the vet said that's how long Cerenia takes to kick in,
 
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Jabzilla

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Alrighty, here's the lab work. Rocket's been given Mirtazapine as well, but still wont eat. I'm going to take her to the ER this morning. I haven't heard back about the referral, but the specialists work at the same place as the ER, so at least her info will be there.
 

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Jabzilla

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The vet is surprised that Rocket is refusing to eat when her labs look so good. They’re going to have the internal med specialist do an ultrasound and based on what they find, they might also take a sample from Rocket’s spleen. I’ll report back here when I have more info.
 
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Ok, I'm back with some results. Rocket is going to be staying at the hospital for 24 hours. The ultrasound showed her spleen is abnormally shaped and has a bunch of small nodules on the inside. They said that could be from an infection, an inflammatory issue, or cancer. Rocket's colon and the section where the small intestine and colon connect are also inflamed. A sample from her spleen was sent out to rule out cancer, and if she poops while she's there they'll send that out for a PCR test. The vet said based on the ultrasound, they're leaning towards an infection of some kind, since that would cause inflammation in the intestines and affect the spleen. Rocket will be given Cerenia and more Mirtazapine while she's in the hospital to see if they can get her to eat. If she still wont eat, they'll give her a feeding tube.

I'm really glad I brought her in, rather than going with what the previous vet said about an enlarged spleen being normal after sedation. Fingers crossed it isn't cancer!!!
 
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Jabzilla

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Thanks Silent Meowlook. After multiple doses of Cerenia, Mirtazapine, and now Gabapentin (as she's an anxious kitty by nature), the ER team has finally gotten Rocket to eat some food. <3 Hopefully this means the in hospital feeding tube wont be needed. As for the spleen results, we should get those sometime tomorrow afternoon or so. The poop results will take longer though, they said it usually takes about a week.
 

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If they do a feeding tube, you might want to discuss an esophageal feeding tube. It is a tube that can stay in long term.

I hope it is good news tomorrow.
 
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Jabzilla

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Morning folks,
I also hope there will be good news! I got a text this morning and am waiting on a call back from the vet so I can ask them some questions. The team was able to get Rocket to eat late last night, so they didn't need to put in the feeding tube. It sounded like giving her some Gabapentin along with more Mirtazapine and Cerenia made her comfortable enough to eat. In the text message it says Rocket has developed B lines in her lungs on ultrasound and has scant amounts of free fluid in her abdomen. They're monitoring her breathing and noticed she started breathing slightly faster than normal overnight.

I wanted to ask for more information about that, how that could have happened, could it be connected to what's going on with her spleen, whether the faster breathing could be due to fear since Rocket is already an anxious cat and this is her first time staying in a hospital, etc. So hopefully the ER vet will call me back soon.
 

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I would be concerned that she got to much fluids if she was on them overnight. A few b lines can be normal, but more than that can be a sign of pulmonary adema.
 
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Jabzilla

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Is Rocket on IV fluids?
I'm not sure, since she's still in the hospital. Isn't it standard procedure to put a pet on an IV when they're hospitalized? I still haven't heard from them either. Hopefully that means these b lines aren't an emergency.
 
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Ok, I called them back and got to speak with a vet. She said Rocket is in IV fluids and she's reduced how much she's getting now. The ultrasound they did this morning shows the b lines and scant fluid in the abdomen in the same state as what was found last night. I asked if Rocket had more b lines than what's considered okay and the vet said they were mildly elevated. Since we're still waiting on the spleen results, I opted to continue to monitor and see how she does with the reduced IV fluids. If there hasn't been an improvement or they've gotten worse by the evening, then we'd do the x ray. It's frustrating since the vet said the x ray wont 100% give conclusive results, but it's all we have now to try to determine if the b lines are from IV fluid, heart failure, infection, or some kind of aspirational pneumonia from when Rocket threw up a hairball on Saturday. It's frustrating that these things cost so many hundreds of dollars while still potentially giving inconclusive results. I'm not blaming the vets for that, just the fact that this is the state of things.
 

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It's frustrating that these things cost so many hundreds of dollars while still potentially giving inconclusive results. I'm not blaming the vets for that, just the fact that this is the state of things.
So true. Sending good thoughts that this will resolve and Rocket will be back to better health.
 
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Jabzilla

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I'm back with some fantastic news! The spleen test results came back as normal, no cancer to be found! So that just leaves an infection or IBD as the cause of Rocket's illness. Her b lines and breathing haven't changed (her respiratory rate is 40), but they want to monitor her overnight to be sure. If those dont get worse, then she can come home in the morning. <3 Rocket still hasn't pooped, so they dont have anything to send off to do a PCR test. The vet wrote a referral for her to see the same internal med specialist as her brother, Cosmos, which is excellent. Said specialist wants Rocket to be on the same regiment as her brother, daily S Boulardii, Gut Soothe, fish oil, and a low fat diet. The vet said if she doesn't poop while she's there, then I can collect her poop at home and have the Animal Biome test done instead since either option will show if she has a bacterial infection of some kind. If it is a bacterial infection and the probiotics and S Boulardii don't clear it up, then they'll put her on antibiotics. I really appreciate the fact that this clinic doesn't throw antibiotics around like candy.

I'm so glad that the spleen results were unremarkable! <3 I guess she'll just need a daily combination of Cerenia, Mirtazapine, and Gabapentin for a little while to ensure she continues eating when she gets home. I'll find all of that out tomorrow though when its time for her to be discharged from the hospital.
 
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