What is wrong with my cat? We've been to both the regular and emergency vets in the last 24 hours, and we still don't know what's wrong or why she isn't improving. (Details within.)
Our geriatric female cat (about 14 years old) is extremely listless, almost to the point of unresponsiveness. In the past six months, she has been drinking a lot more than usual (polydipsia), as well as urinating more than usual (polyuria), but our efforts to determine what was wrong through blood tests had not been successful (elevated BUN but normal creatinine and phosphorus; tyhroid panel normal). Behaviorally, otherwise, she seemed perfectly normal and active, perhaps even more hungry than in previous months (she's fed a tin of wet food a day, and always has dry food available).
On Thursday evening, she managed to trick my girlfriend and I into feeding her two tins of wet food, and seemed happy to eat both. On Friday, my girlfriend discovered that she had vomited all over the kitchen (food with chunks of solid kibble, some hairball) as well as left stool on the kitchen floor (highly unusual for her!). Friday night, there was more vomiting, of thin brown foul-smelling liquid. By Saturday, the cat was listless and showed no interest in eating or drinking. We took her to the vet, who ran a blood workup (elevated BUN, normal creatinine and phosphate, no elevated white blood cell count, still awaiting thyroid results) and provided sub-Q fluids and suggested a bland diet of baby food. The cat was down from ~ 8 lbs (six months ago) to ~ 6.5 lbs, which was very worrying. Feeding her baby food via syringe seemed fine at first -- she held it down for a few hours -- but it all came up eventually, as this thin brown foul-smelling liquid. Some urine was produced after the vet visit, but no stool.
Late Saturday night, as she became increasingly unresponsive (she normally would put up a bit of a fight if you picked her up) and she continued to sit in a hunched-over posture, we took her to the emergency vet. An examination suggested nodules on the thyroid, and the vet could feel stool in her abdomen. They provided her with more sub-Q fluilds, an antiemetic to help relieve the nausea and vomiting, and 1/4 of a 15 mg mirtazapine to stimulate her appetite. After the mirtazapine, she looks somewhat stoned, and her heartrate is very rapid. Her discomfort hasn't improved since we brought her home several hours ago, and in fact, the mirtazapine may have made her more uncomfortable. In principle, it was *supposed* to perk her up and get her interested in eating again, but it doesn't seem to be having this effect.
Longer-term, I'm hoping that the thyroid retest will give us some clue as to her excessive thirst/urination problem, and then we'll probably need to address any renal issues that show up as well as the possibility of irritable bowel disease or feline leukemia, but I'm honestly at a complete loss as to how to pull her through the current acute issue. The best I can do right now is to try to make it comfortable, it seems, and make sure she stays hydrated with sub-Q fluids and see if she will keep some force-fed bland food down.
But I wonder if we might be missing something obvious. She's an indoor cat, so parasites would seem unlikely. She's had similar vomiting/hairball issues in the past, but has always pulled through them in quick order. We've been in a number of times for urinal tract infections, but urination seems fine and there's no elevated white blood cell count.
Does anybody have any other ideas? Should we pursue other types of screening (X-ray, ultrasound) that are expensive and likely won't actually tell us anything definitive?
posted by enoent to pets & animals (37 comments total)
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