Cat is not eating.

Dr. Marie replied:

Oh, I am sorry to hear that Mikey is not feeling well. Cases like this can be really frustrating because it is often hard to know what is going on.

Do you know if your vet ran a test called a PLI level? This test is fairly accurate at telling us if there is pancreatitis. Cats with pancreatitis can show all of the symptoms that Mikey has. When the pancreas is inflamed it can put pressure on the bile duct which can cause the bilirubin to increase. Cats with pancreatitis will be off of their food and can have a fever as well.

The way to treat pancreatitis is to keep Mikey hydrated and to give medications to help the pancreas to recover. Often cats with pancreatitis will need IV fluids given over several days at the hospital.

Another possibility is a vague condition called "fever of unknown origin". Sometimes I will get cats who have a fever off and on and a lack of appetite and we basically treat them with antibiotics and fluids as necessary.

A liver problem is a possibility but usually we do see other things that are increased such as ALT or ALP.

An infection in the bile duct or liver could cause this as well. While we would usually see an increase in white blood cells not all cats read the textbook - i.e. they don't always have blood results that we would expect to see.

I think your doctor's plan is a good one though. We can try the antibiotics and see how he does.

If he doesn't start to eat then my plan would probably include keeping him in the hospital on IV fluids for a few days and also doing an ultrasound. The ultrasound is to look for things like an abscess in the liver, a tumor in the liver or bile duct area, and more things. I sometimes will prescribe a medication called remeron (mirtazapine) to help as an appetite stimulant as well.

Again, these cases can be frustrating. It sounds like your vet is doing the same things I would though.

I hope he is feeling better soon!

Dr. Marie.



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Dr. Marie replied:

It sounds like your vets are doing a very thorough job! Now you can understand why the job of a veterinarian is so frustrating at times! Cases like this are difficult.

I'd love to hear how Mickie does in the next few days.

Dr. Marie.