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Cat is not eating.

Species: Cat
Breed: domestic short hair
Age: 5-8 years
Our 6 year old male cat has not been eating or Drinking. He has not been using the litter box that we know and was / lethargic.
We took him to our Vet yesterday and blood tests showed everything was normal except his Bilirubin was on the high end. His Red blood cells looked good after he got therapy for all day hydration and his white blood cell cound was good or ok. (not abnormal or high).
the vet said his temp was 105 (in the mornging when we took him in) and then in the afternoon after hydration and broad spectrum antibiotic his temp went back down to 101.9 . We took him home to bring him back to the Vet this morning and his Temp was back up to 104. the Doctor checked his Urine this morngin and it showed elevated Bilirubin and a slightly elevated glucose today. The Doctor wants to put him on antibiotic (Amoxicillin and Metronidazole?) for a week or two and see if this will stop the "liver" issue. He took X-Rays and he said that everything looked good but that his Liver was inflamed. His suggestion is to try the Anti-biotics and if this does not work then try and ULTRA sound and Biopsy.

Do you concur, have any input suggestions? we trust and like our Doctor but I am just worried and looking for 2nd opinion confirmation.

Online vet, Dr. Marie

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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Disclaimer: Although Dr. Marie is a qualified veterinarian, the information found on this site is not meant to replace the advice of your own veterinarian. and Dr. Marie do not accept any responsibility for any loss, damage, injury, death, or disease which may arise from reliance on information contained on this site. Do not use information found on this site for diagnosing or treating your pet. Anything you read here is for information only.

Customer reply:

Thank you Doctor! I will ask if ALT and ALP test have been done and if PLI level has been checked.
We are on the 3rd day of different Anti-Biotics(broad spectrum anti-biotic and I think two other he gave by shot and we are giving by pill).
One anti-biotic shot is supposed to last for a week or two. Our Cat Mikey is not Jaundice, he is not vomiting, the Doctor does not feel any masses or abnormal issues in palpatating. his eyes are clear and his mouth and gums look good and the x-rays appear normal except for Liver is inflamed on x-rays.
Between GREAT Vets like you and our VETS and the Washington State University Vet school resource I use -- this feels frustrating that we have the "BEST MINDS" on this but cannot find a definitive answer. I may be asking you again in future for input but of coarse with paypal. thank you. Wayne and Mickie.

Online vet, Dr. Marie

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.

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Dr. MarieDr. Marie is a veterinarian who practices in a busy animal hospital in Ottawa, Ontario. She created Ask A Vet Question as a resource for good, accurate veterinary advice online. Dr. Marie treats dogs, cats, hamsters, guinea pigs, and rats. She has been a vet since 1999.

Is an online vet visit just as good as a trip to your veterinarian? No! But, many times, asking an online veterinarian a question can help save you money. While Dr. Marie can't officially diagnose your pet or prescribe medications, she can often advise you on whether a vet visit is necessary. You can also ask Dr. Marie for a second opinion on your pet's condition.