Intestinal Obstruction in Cats

Intestinal Obstruction in Cats

Suspected intestinal obstruction

Question: we have a dear 18 year old mixed tabby Siamese small 7 lbs on good day - now down to 61/4 lbs lives indoors only has had Feline leukemia tests always negative and has had regular multiple vaccinations for just about everything over the years we give her 250 cc's sub cutaneous fluid every 3 days due to decreased kidney function as we have done over the past three years she has 1/2 of her thyroid gland left due to previous nodule removal (corrected excess hormone output 3 years ago -that's when fluids were stared to help her kidneys) 7 days ago she started acting ill reduced eating then stooped eating - LOTS of gas rumblings in abdomen - loud all night then a bout of explosive diarrhea - no blood or other unusual stuff except maybe some whitish lumps which vets said might be intestinal lining??? temperature 100.9 at vets - kept over weekend with IV fluid - tests for thyroid, diabetes, urine density, fecal parasites / infection metrodizole antibiotic (not sure spelling) vet reports ------------- tyroid normal no parasites or infection found - normal white count slightly anemic but may be due to extra fluid input no diabetes vet urine test, dilute but same as previous (my observation same size clumps as usual in litter pan) kidney BUN above normal but in line with past readings - not spiking - not super high creatine high normal - again same as past readings abdomen feels normal - kidneys smaller than normal and deformed again about as in past one vet said she maybe could feel a slightly enlarged may lymph node in abdomen NO ANSWER says maybe cancer - get x-ray / get ultrasound don't know if either one will show anything, won't say which is better Cat back home yesterday- acts achy doesn't want to jump up to her basket - doesn't' want to eat - drinks a little vomit big time in car on way home No fecal output - urinates same amount but not as often LOTS of gas rumblings temperature 100.9 gave subC fluids last night sick kitty - no improvement same antibiotic once a day - we to repeat for ten days my wife takes cat in today for x-ray intestinal blockage? gas gangrene? does cancer come on this quickly with no other previous symptoms? hairballs? UFO's? Have we missed anything? your quickest advice appreciated Thanks Turq

Answer: Turq- I am hoping that your cat is already feeling better. If not, these are my thoughts on what you report. Your vet has provided a good list of possible differential diagnoses for the history and lab work reported and appears to be working through them in an appropriate manner. This always makes situations like this much more frustrating because it doesn't leave a lot of room for alternative advice. I think that ultrasound is a better screening test for abdominal problems if the person taking and reading the ultrasound exam is good at it. However, the best approach is to take X-rays and do an ultrasound exam, as they each have some strong points and having the information from both is useful. Despite thinking this way, most of the time when I see X-rays with excessive gas accumulation I want to do exploratory surgery, even in older sick cats. My reasoning is that most intestinal obstruction problems get worse rapidly and delaying an attempt at treatment just makes it more likely that removal of a portion of the intestine will be necessary. If there is not an obstruction most cats recover from surgery very well, even if they are older kitties. I would not be put off by mild rises in BUN or creatinine, nor would minor anemia bother me in this decision making. Cancers can and often do show a very rapid onset of clinical signs. I don't think that the cancer has suddenly appeared in these cases, I think it has suddenly managed to do something the body can't tolerate, like block a bile duct or block an intestine. In a cat in your cat's age range cancer has to be among the list of possible problems and usually makes the top of the differential list. Some cancers are removable and surgical biopsy can give information on the type of tumor that allows for making an accurate prognosis and better treatment plan. I kind of wonder about the "feeling achy" part of your message. Do you know if potassium levels were checked? This is not always a part of routine blood screens. If it wasn't checked it would be a good idea to ask about doing so. Low potassium levels make cats look like they have muscular cramps or muscular weakness if they are low enough. I know that it is an aggressive approach to advise surgery right off the bat. I really do think that it is a reasonable approach to suspected intestinal obstructions, though. Good luck with this. Please feel free to write for clarification or additional information if you need to. Mike Richards, DVM 3/31/2000

Suspected intestinal obstruction - outcome cancer

Reply: Thanks for your advice We did go directly to surgery with the idea of fixing if we could and finding out for sure if not Sorry to report that it turned out to be the hard choice - we did have to make the decision to let Caitlin go on - my wife and I waited outside for the word - as per our agreement with our vet she sent her college out to tell us - the small intestine was almost completely closed with a growth about 2 inches long all around it just below the stomach - and spots of growth were all around the lining of the intestinal cavity, on the other surfaces of the intestine and with lymph node involvement Apparently cats have a good capacity to tolerate cancer with few external symptoms - up until it become really major We had discussed the possibility beforehand with the idea that an encapsulated mass would be removed and based on cancer type or mechanical obstruction we might have from 2 months to 2 years depending - but if it was cancer and had significant spread the recovery would likely lead right back into another crisis with significant discomfort in between We had decided not to subject our friend to multiple procedures if the cancer was widespread Our vet draped Caitlin and we went in to touch her as she went directly with the euthanasia - not having to come out from anesthesia - we had spent a fair time with her before surgery after the iv was placed but before anesthesia to tell her goodbye My wife Deborah and I had always agreed that our animals deserved our best care and had talked about that far far future day when the hard choice might come - I just never realized how that day could be this day I won't say it was easy but it was the right thing for my wife and I and we believe for Caitlin - we got to say our good-byes hoping that they would not be needed and we were there when her spirit left It did help some little bit to have spoken of the worst, and to have made the decision before the actual word came out - one always hopes for the best - having the choice nailed down as much as possible before getting the shock of the result let us not have to jump back and forth (and run away) at the critical time - and we explained to Caitlin what we were going to do and how the decision would be made Our vet was kind and understanding throughout and in having us be part of the actual euthanasia, we feel very fortunate to have had her helping us - talking before of the best and the worst, of what specifically we would do in each case, and making firm decisions is in my opinion the only way to get through this kind of thing We have a duty to our pets to not let them linger in pain or distress for our own selfish reasons - we will always miss the best cat in the world who was kind enough to adopt us And hopefully, after the animals get to heaven (as they surly will), they will speak a good word for us and we'll be allowed in I'm writing this maybe to help others who may face similar choices thanks Turq

Answer: Turq- I am sorry to hear about Caitlin. Your thoughts on this are valuable and were expressed very well. I'm certain that Caitlin must have had a very good life with you and that she must have known that, as well. Mike Richards, DVM 4/1/2000

Last edited 09/17/02