Spooky could use a few vibes....

ldg

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OK, I'll *try* to be short. Most of you know, I'm not very good at that. ;)

This has been a tough hairball season for my four oldest (siblings). They all turned 12 this year. Lazlo is 2.5 years into remission from large cell lymphoma that presented as a "massive" cancerous mass in this stomach, so no surprise his GI system is a bit messed up. So I break out my full arsenal of treatments, and we STILL have some hairballs. BUT... my kitties don't have IBD. Hairballs are an inconvenience for them - but doesn't normally make them act ill. Maybe nauseous here and there, but otherwise, they act normally. So Spooky starts acting "off" a few days ago. She's sleeping all the time, not coming at meal times, and is having trouble keeping food down.

I've been having to syringe feed her on a somewhat frequent basis as I'll only let my cats go 24 hours without the full requirement of calories. I chalked it up to hairballs at first. But then I realized - there were other subtle signs that she just wasn't OK, and they became more pronounced the past few days. We headed to the vet on Friday morning for an exam, blood work, and x-rays.

She's just ... a lump there (not normal!). The vet palpates her abdomen, and feels several small lumps: either poop, or swollen lymph nodes. I'd been thinking she hadn't been able to keep food down that morning due to a hairball. The x-rays indicate her system is empty, top-to-bottom. Her stomach is normally shaped - no hairball. Intestines, colon, empty. No poop in there. The x-ray also shows her intestines are thicker than they should be (and we have images to compare from 7 months ago). Weight? She's lost a pound in those 7 months - despite me syringe feeding her to ensure she gets her daily caloric requirement.

The vet called today. Her blood work values are all exactly the same as 7 months ago - except her T4. It is LOW. As cats do not get hypothyroid (there are some, but it is VERY rare), this is an indication there is something else going on. She is scheduled for the ultrasound on Thursday. Of course... she has other symptoms that seem to indicate there may be an underlying issue.

The most likely culprits given the symptoms (loss of weight despite being getting the same calories; likely swollen lymph nodes in intestinal area; thickened intestines on x-ray; inappetence; vomiting) are IBD, intestinal lymphoma, chronic pancreatitis, or triaditis (being a liver infection, not fatty liver).

I've never heard of this, but.... :dk: The vet says it is possible her intestines are thickened from fluid - as in water in her intestines, or moisture from food that did stay down being absorbed. The x-ray just "melds" everything together. Thus the ultrasound is the next diagnostic step, to get a better look.

We did not run spec fPLI at the time, nor the folate cobalamin test. We may do those Thursday, depending on what is found via ultrasound.

But your good thoughts, vibes, and/or prayers would be very appreciated. :heart2:


 

pinkdagger

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Poor Spooky - fingers crossed they'll be able to narrow down the cause and she can get on the mend! Sending lots of vibes!
 

cocheezie

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The low T4 does not make sense. Good that you are on top of it and having further testing.  Sending vibes galore.
 

quiet

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I am very sorry Spooky is so ill.
 

betsygee

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Oh, poor Spooky.  Hoping you get some answers and can get your little girl back on track soon!  
 

oneandahalfcats

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Very pretty girl .. Max had been acting like a blob for a bit as well in the last month or so, sleeping an extraordinary amount, but regular appetite. The thought of hypo was starting to cross my mind. But there have been the hairball issues and we have had some pretty warm weather. With the change to cooler temps in the last week coupled with the supplements, he seems to have perked up quite a bit. 

I hope that you can get to the bottom of this and it turns out to be nothing too serious.
 
 
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juniorthecat07

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Sending some good vibes for your kitty.  I know what it's like to have a sick cat!  
 
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mrsgreenjeens

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Man oh man....Thursday is so far away to have to sit and worry
.   Here's hoping it's just some goofy anomaly and she'll be just fine


Sending some of this famous TCS vibes your way


HANG IN THERE
 
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ldg

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Thank you, all. VERY appreciated. :hugs: . :heart2:



The low T4 does not make sense. Good that you are on top of it and having further testing.  Sending vibes galore.
A friend sent this: http://www.ncbi.nlm.nih.gov/pubmed/2254153

The abstract:

"We reviewed the medical records of 494 cats with a variety of nonthyroidal diseases in which serum thyroxine (T4) concentration was determined as part of diagnostic evaluation. The cats were grouped by category of disease (ie, renal disease, congestive heart failure, diabetes mellitus, focal neoplasia, systemic neoplasia, hepatopathy, inflammatory bowel disease, inflammatory pulmonary disease, miscellaneous diseases, or undiagnosed disease), degree of illness (ie, mild, moderate, or severe), survival (ie, lived, died, or euthanatized), and presence or absence of a palpable thyroid gland. The mean (+/- SD) serum T4 concentrations in all 10 groups of cats, which ranged from 10.5 +/- 11.1 nmol/L in cats with diabetes mellitus to 18.7 +/- 7.8 nmol/L in cats with focal neoplasia, were significantly (P less than 0.001) lower than those of normal cats (27.0 +/- 10.4 nmol/L). The number of ill cats with low serum T4 concentrations (less than 10 nmol/L) was highest in the cats with diabetes mellitus (59%), hepatopathy (54%), renal failure (48%), and systemic neoplasia (41%). When the serum T4 concentrations in cats with mild, moderate, and severe illness were compared, mean concentrations were progressively lower (21.3 +/- 6.8, 14.8 +/- 8.1, and 6.5 +/- 5.8 nmol/L, respectively) as degree of illness increased. Severity of illness had a more significant (P less than 0.001) effect in lowering serum T4 concentrations than did disease category. Mean serum T4 concentrations in the cats that died (7.8 +/- 9.8 nmol/L) or were euthanatized (10.0 +/- 7.0 nmol/L) were also significantly (P less than 0.001) lower than those of cats that survived (15.2 +/- 8.8 nmol/L).(ABSTRACT TRUNCATED AT 250 WORDS)"

Basically.... low T4 can be an indicator of some other underlying disease: diabetes, liver disease, kidney disease, and systemic neoplasia (cancer) were most common: the worse the illness, the lower the T4.


We know from the y/d diet that a low iodine diet can cause a cat to be hypothyroid (too low). But I supplement it. And if it were deficient in the diet, you'd think it'd be more than just Spooky affected. Though expensive, iodine levels can be tested. If an underlying problem isn't found, I guess that'd be one of the diagnostics. Univ of MI runs the test.
 

stewball

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I hope your very pretty spooky will not have anything seriously wrong with her.
I'm sending vibes for her and you. :vibes: :vibes: :vibes:
 
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ldg

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Thank you all for the good thoughts and vibes!

The ultrasound indicates no organ inflammation, but a generalized thickening of her intestines, and yes, the swollen lymph nodes. The Doc did send the images to a Board Cert Radiologist, and we'll have his insights tomorrow. Doc just wanted to make sure he didn't miss anything.

As there was no localized inflammation, no biopsy was taken via needle aspirate.

So Spooky most likely has either IBD or early stage intestinal lymphoma. The only way to know would be via exploratory surgery, taking a number of samples to be biopsied along her GI tract.

As I don't want to treat her for IBD if it's lymphoma, but I don't want to give her chemo if it's IBD, we'll probably do this. But we'll see what the radiologist has to say.... we should have word back tomorrow.
 

quiet

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Hi,

I am sure you already know this but they can get those samples through endoscopy. Still an anesthetic procedure and takes about 40 minutes, but not as invasive as surgery. They usually keep them the entire day and do give an enema before the procedure is done. But you don't have all the risks that you would with surgery. I think it is probably not as expensive but I don't know. Just a thought, but like I said I am sure you are already aware of that option.

Sure hope everything goes well with whatever you chose to do.
 
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ldg

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:) :hugs: That was on the list of questions to ask the vet this morning when she calls. I assumed this is what she meant when we chatted. In this day and age I can't imagine them cutting her open for something like this. But it's best I find out for sure!
 
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ldg

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Ah. No, when she said exploratory surgery, she meant not an endoscopy:

1) The main area of thickening is beyond endoscopic reach
2) Endoscopic biopsies only biopsy the middle layer of the intestines. It often does not provide a definitive diagnosis.
3) With the surgery, they can remove small wedges, getting all of the layers. A definitive diagnosis is likely.

As she's otherwise healthy, no reason not to pursue it. She's scheduled for Wednesday, Aug 6.
 

feralvr

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Hi sweetie. Still sending MEGA MEGA MEGA vibes each and every day for dear Spooky. :rub: :cross: :vibes: I have to agree that I would want to find out one way or another whether Spooky is dealing with IBD or Lymphoma. Would want to treat the right thing. :nod: I am hoping for the IBD, of course rather than the latter. But, no matter what the outcome, Spooky could not be in better hands or more loved. She is such a sweet kitty and I will keep her close in prayer this coming Wednesday for her exploratory surgery, biopsies AND that you get a definitive diagnosis. Then, we go from there. :hugs: :hugs: :hugs: :hugs: :hugs: :hugs: :heart2: :rub: :vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes::vibes: SPOOKY :heart3:
 
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