Diagnosing cats is no easy task
None of the patients actually tell us what is going on, but it seems that dogs are better about letting us know than cats.
There is a Farside cartoon where it has vet students studying and the book says Equine Medicine at the top, various conditions are down the left side and for every disease on the right it says “shoot.”
My version would have cats with vomiting and/or not eating listed as a symptom for every cat disease there is and it is my job to sort them out and treat appropriately.
Anyway it all started last week. I think Sara started it all. She had vomited 6-7 times last night and several more today. She had not been eating since Tuesday night and wasn’t very active.
A CBC (complete blood count: red blood cells, white blood cells and platelets) is relatively boring. Sub cutaneous fluids and medicine for vomiting and Sara seems to be doing well.
No vomiting in the hospital until right before she is going home. We tell the owners and they decide to take her home. We are OK with that, Sara is looking good.
Monday morning Sara is back. She is not eating and vomiting. She is dehydrated so we do fluids. More blood work and radiographs and everything seems OK. We will see if Sara does okay at home this time. She is eating some and being force fed.
Just after Sara is hospitalized the first time, Sookie comes in. She is supposed to be for routine vaccinations, but she is lethargic and probably is the one that is having the diarrhea.
Wait, well, uh, there is blood free floating in the anterior chamber of the eye. We don’t see that very often. No history of trauma. We check for clotting factors and do a CBC and Chem.
The chemistry shows a very high CK which is produced in the muscle and filtered out the kidneys.
Trauma is looking more likely. We do chest rads to look for damage. That is okay. She gets fluids and goes home in two days, only to be returned in a few hours because she is vomiting.
A weekend and more fluids and she goes home and does fine. Her eye is doing well also.
Then the next room is ready, yet another cat, Puss is coughing, gagging, raspy and, you guessed it, vomiting. Puss is also 11 years old. More blood work, more fluids and Puss is better. Puss is still not meowing right, but is still feeling better.
Meanwhile, Midnight was at the ER a week ago on Monday. He had been in for vomiting and seizuring, but now is urinating in unusual places.
He is lethargic, but still eating. At 11 years old, Midnight could have any of the old cat diseases, plus the things that happen to all of us.
A urinalysis is our first step, but Midnight does NOT cooperate. Again the CBC is relatively boring. A blood chemistry is drawn and run in house.
His blood glucose is significantly high. Cats can spike a increased blood glucose level just because you look at them wrong. (They are cats, it is always your fault, just accept that.)
But Midnight’s urine is also positive for a lot of glucose. The fasting sample is normal. Certainly no insulin for this cat. Turns out the ER has given a long acting corticosteroid which may be interfering with glucose metabolism.
By now, Midnight is feeling better and will go home on a special food. We will check his blood sugar again later.
Wednesday, Abby’s mom calls. Abby is not eating, lethargic and is too friendly. She comes in. Her mom is right. It only takes two people to get a CBC.
Her white blood cell count is low and she gets some fluids and special food. Two days later, she goes home doing well. We think this was viral or stress related.
Cats, cats, cats! Vomiting cats, not eating cats and diarrhea cats! Morning rounds is starting to sound like a Dr Seuss book.
And then Saturday all cats are home and seem to be doing well.
Oh, wait, Lucky just came in, not feeling well and not eating. White blood cell count is 35 thousand. (Way high!) I think this is going to be a little more than subcutaneous fluids.
MJ Wixsom practices veterinarian medicine at Guardian Animal Medical Center in Flatwoods, Ky. For questions, call 606-928-6566.