Urgent: Ideas Needed

JMJimmy

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Mama has been sick for some time and losing weight.

He's showing pain signs, vomiting a LOT (5-7 times a day) despite not eating much of anything. His blood tests (wellness profile + pancreas) are normal except for elevated SDMA (21) and low ALP. X-rays showed nothing other than minor constipation from being dehydrated (we're now forcing water after each vomit)

We've tried a dozen different types of foods (wet and dry), we've been to multiple vets. No one has any clue what might be wrong with him.
 

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zygote

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The high SDMA could indicate early kidney disease...have you had his phosphorus level checked? I don't see it on the bloodwork you posted. It can often be elevated in kidney disease, and that would make him lose his appetite. If kidney disease is indeed the cause, cerenia and an antacid could help settle his stomach and make him stop vomiting/eat again. Even if it's not kidney disease, maybe it could help him feel better and regain some strength while you keep trying to figure out what's wrong. Something to discuss with your vet, anyway.
 

artiemom

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It looks like his bladder is huge on the last x-ray... but I am not expert...and yes, he has a good amount of stool in his bowels.

Did the vet give him any sub-q fluids? those are through the skin with an IV line. This hydrates cats very quickly and can sometimes help with constipation.

Did you happen to change food? and is he eating wet or dry. If it is dry, I would try adding some extra water to his food.

Wonder if he is just constipated and vomiting from feeling so full....

Hopefully, someone more experienced can come on and help you better than I am...

You can also try getting him to eat some baby food.. make sure it is the first stage food with just meat--no onions or garlic.. Beech-nut or Gerber...This food usually entices cats to eat. You can thin it out a bit with water also....

And did your vet give you anything for the nausea?

I think just hydrating your baby with sub-q fluids could help her out a lot.


sorry if these are a lot of questions, but we really do need to know.. and how old is your baby?

Good luck and please keep us updated...
 

babiesmom5

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Most cats with possible early kidney disease have a SDMA between 15-19 ug/dl. Since SDMA increases as kidney function decreases, SDMA >/= 20 ug/dl are typically seen in more advanced disease along with an increased creatinine. SDMA is a more sensitive indicator of kidney function in poorly muscled cats as yours is having lost weight.

I would recommend you see a specialist. I would request a complete urinalysis to evaluate for inappropriate specific gravity, proteinuria and other evidence of kidney disease.

I would not wait on this.
 
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JMJimmy

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The SDMA results are somewhat suspect at the moment, however, we are treating him as if he's in stage 2 kidney failure. I say they're suspect because he was dehydrated & starving when the blood was taken - both of which can affect the results. His previous test showed 14ug/dl which is the top end of normal and creatinine is relatively unchanged so we're treating it as if it's early rather than late kidney failure.

He's received sub-q iv fluids and we tried treating him with anti-vomiting meds without success. The only anti-vomit med that worked was a direct shot but that only lasts 48 hours at most. He'll eat new types of food until he throws up then refuses to eat it again. The last things we've successfully fed him is canned salmon and tuna as any cat food he refuses to eat.

As I type this he woke up from a dead sleep to vomit. Sigh.

The vets said that the early kidney failure should not be causing this much vomiting.
 

babiesmom5

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I agree early kidney failure should not be causing him this much vomiting.

Another possibility: Pancreatitis.

I had a male cat who showed a SDMA of 15 ug/dl with similar symptoms. It was acute pancreatitis. He DID NOT have kidney failure.

Perhaps a blood test to "rule out" pancreatitis should be done.

Vets can do one in their office, the SNAP fPL which only takes a few minutes. It is however often unreliable unless the pancreatitis is really really bad.

The "gold standard" test is the Spec fPLI which is very reliable. It must be sent off to Texas A&M Univ. labs for analysis and takes a few days to get back, but worth it.

I would ask your vet about this as soon as possible. Acute Pancreatitis can be fatal.
 
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JMJimmy

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We did that (mentioned in first post, shown under "Special Chemistry" at the bottom of the blood test report) Spec fPL was normal. Thanks for the suggestion though!

Edit: We've all but ruled out the "common" reasons for it. Laxatives cleared up any chance of it being constipation, kidney failure is on the table but not to the severity we're seeing, pancreas has been ruled out. No signs of cancer (blood or xray), there appears to be some calcification of the urinary tract but he's a sprayer and we know he's still peeing by the daily cleanup. Manual hydration is helping.

The newest symptom is that the vomit he had earlier was fecal (not a hairball or stomach - two small pieces of very normal fecal matter)
 
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artiemom

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I wonder if your baby has IBD? an allergy to a certain protein or an additive.

Was it Cerenia that you tried for vomiting? Sometimes you need to have cerenia and zofran and pepcid AC...

I am thinking it is a bad case of IBD or Pancreatitis. The best test, most definitive test, for Pancreatitis has to be sent to Texas A&M University. This is the most accurate one...

In the mean time, I would hope your vet is treating him for pancreatitis/IBD...pretty much the same treatment..
Pepcid AC, daily Cerenia, novel protein food, Prednisolone (steroid) and pancreatic drugs... along with daily sub-q's because of the excessive vomiting. Sometimes Zofran is also added to this mix....and an antibiotic...
If you can get the vomiting under control, then you can work on finding the cause...

I would think that the SDMA would be elevated because of the severe vomiting and constipation.. Are you certain he is not constipated anymore?

If he is this bad, then I think he would need to be hospitalized.. Daily sub-q's can do wonders.

An an appointment with an Internal Medicine Vet should be very strongly considered, if not, at least a consult...

I am just going by my own experience.. sorry if I sound too harsh...wising you the best...

If it were me, I would even consider going to an ER Vet....
((hugs))
 

babiesmom5

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Vomiting fecal matter sounds like there may be an intestinal blockage of some sort. Why else would he vomit fecal matter other than he cannot pass it the normal way?

If this was my cat, I would head straight to the closest Vet emergency hospital ASAP!
 

artiemom

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Are you sure it was fecal material or a dried up old fur ball...if you are certain it is fecal material, the you definitely need to go to the ER VEt...

I would go anyway.. You cat needs intensive treatment..

She could have eaten something.. please take her...and worry about the expense later....

((hugs))
 

PushPurrCatPaws

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...

He's received sub-q iv fluids and we tried treating him with anti-vomiting meds without success. The only anti-vomit med that worked was a direct shot but that only lasts 48 hours at most. He'll eat new types of food until he throws up then refuses to eat it again. The last things we've successfully fed him is canned salmon and tuna as any cat food he refuses to eat.

As I type this he woke up from a dead sleep to vomit. Sigh.

The vets said that the early kidney failure should not be causing this much vomiting.
He needs sub-q or IV fluids a lot right now, with this much vomiting and etc. I'm hoping you just didn't give him these electrolyte fluids just once? Simply trying to provide water won't do the trick if an animal is already severely dehydrated. Plain water does not have the electrolyte makeup that he needs.
:crossfingers:

I agree with babiesmom5, a hospital stay, immediate vet and supportive care, would be what I'd want for my cat.
:grouphug2:
 

mewcatmew

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If this is IBD/Intestinal lymphoma, blood work and xrays would be normal. An abdominal ultrasound could give you a better idea to see if the intestinal walls are thickened, as well as looking at the kidneys to see if they are shrunken.
 
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JMJimmy

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I wonder if your baby has IBD?
Possible but unlikely. Vomiting occurs on an empty stomach simply drinking water.

Was it Cerenia that you tried for vomiting?
He was given a course of omeprazole. I'm not sure what the shot was but I suspect it was Cerenia (I'll verify)

I am thinking it is a bad case of IBD or Pancreatitis. The best test, most definitive test, for Pancreatitis has to be sent to Texas A&M University. This is the most accurate one...
As I said, we already got that test done and it was normal (1.2) - pancreatitis has been definitively ruled out.

I would think that the SDMA would be elevated because of the severe vomiting and constipation.. Are you certain he is not constipated anymore?
That was my thought as well with the SDMA test. Our hope is to correct whatever is causing the vomiting, get him healthy and re-test to confirm. 100% sure there's no constipation. While I didn't see him poop, he's a private kitty when it comes to bathroom habits. I've monitored his bum and there was new fecal mater leftovers and no herniation so he did poop at some point.

Vomiting fecal matter sounds like there may be an intestinal blockage of some sort. Why else would he vomit fecal matter other than he cannot pass it the normal way?

If this was my cat, I would head straight to the closest Vet emergency hospital ASAP!
He's been to 2 vets 4 times in recent weeks - he's not in critical condition but if we can't figure out what's causing it very soon he's going to crash. As to the fecal mater - there's no blockage (xrays confirm that), I'm hoping it's intestinal sensitivity from being empty, the consistency seemed to be mostly bile (very firm but not dry).

Have you specifically tried to test his ionized calcium level?

Just throwing this out there....
Feeding the Cat with Hypercalcemia | petMD
This is genius and a serious possibility! Not a standard test, not something normally considered in cats, especially in the absence of any urinary issues, almost all of the symptoms fit.

You've given me hope! Thank you!

If it turns out to be this I have a sinking feeling I know exactly what caused it... for now it's time to confirm/rule out this excellent idea ASAP.
 

babiesmom5

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I am so very sorry and can truly relate to the "gutted' feeling after receiving this diagnosis.

Do you know at this point if the Lymphoma is Small Cell or Large Cell?
Treatment protocols and prognosis are different for each.

I do hope your cat is, or soon will be, under the expert care of a good Oncologist.
 
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JMJimmy

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Do you know at this point if the Lymphoma is Small Cell or Large Cell?
The Idexx report was incredibly vague so we've had to go back to them to get proper details. Regardless, with the condition/age & kidney failure on top of it all the prognosis is not good.
 

babiesmom5

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It is good you are trying to get as much information as possible so that you and your vet, in consult, can make informed decisions.

Again, I am so sorry.
 
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