Older cat losing weight.
Breed: Domestic Shorthair
Age: 8-11 years
My eleven year old cat has congenital hipdisplasia however she has been happy basically healthy until recently. A A bit of background (I worked for a holistic vet in California and she received adequan and acupunture when she seemed painful) She also has an apparent allergy to grains although she often refused wet food or homemade food. This would cause vomiting but she was still basically healthy.
In the past month she has lost a great deal of weight. The vet said she weighed eleven pounds in the carrier. Her hips seem stiff and the vet confirmed this. She had a detailed blood and urine panel and although I suspected hyperthyroid it turned up nothing. Liver numbers were fine. I requested metacam for her hips but the vet said not until more tests were done. Is it true that thyroid numbers may appear normal but actually the cat is hyperthyroid? My finances are stretched and I'm trying to help Bonnie within what I can do. What would you suggest? PLEASE ask any questions you need. Thank you.
Dr. Marie replied:
Aw, poor Bonnie. It sounds like she has been through a lot.
Any time I see significant weight loss in a cat there is some type of medical issue.
, my experience is that the vast majority of the time if there is a thyroid issue then there will be some type of elevation of the cat's T4 level. I have had one case that I can recall (in 13 years of practice) where I suspected hyperthyroidism
, the test was normal, but when we repeated the test a few months later it actually had a high level.
Unfortunately, when I have a cat with significant weight loss and normal blood tests I get really worried about cancer. There are some types of cancers in cats that are difficult to diagnose.
I find it a little bit strange that your vet was reluctant to prescribe Metacam. I think it would be reasonable to do a 1-2 week trial to see if some pain relief medicine will make a difference. I usually want to do blood and urine tests first and if there are obvious kidney issues I will proceed with great caution. But if Bonnie's tests were normal then there really shouldn't be any harm. Now, granted, I may not have 100% of the diagnostic information so it really is a good idea to trust your vet.
It's really hard to know where to proceed from here. When I have a case like this I usually give my clients a few options:
1. Have a specialist do an ultrasound to see if we can detect cancer of any type.
2. If the cat is currently eating ok, then another option is to wait for a month and repeat blood tests (i.e. to see if the thyroid level has started to come up or if there are other issues.)
3. Do a trial of pain meds such as Metacam.
4. Do a trial of steroids. This is not usually my first choice...but steroids help to reduce inflammation. They may work if there was possibly inflammatory bowel disease. IBD can be a cause for weight loss, even if there is no obvious diarrhea.
I wish I had more answers for you. Cats are really hard to figure out some times.
Please let me know if you have more questions.
QUIZ: Is your cat secretly planning to murder you?
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Thank you. Just to let you know the vet she saw was at a Banfield Hospital. She doesn't have a regular vet here yet. We are in New York now. I totally understand that vets need to do the right thing for their patients by being accurate and that they are people too and need to make many but I really had the feeling after 300 dollars worth of blood tests and urine tests that she was trying to get more money before she would give her a prescription. I too thought not giving the metacam was odd and cruel. Bonnie is in pain. I will take her to another vet but don't know how to choose, I cant afford to "start over" to get her a prescription. I would be happy to pay you for another "question" if you think that my sending you her numbers from antech would be helpful.
Thank you again. Ann
Dr. Marie replied:
I'm happy to look at her numbers but really, if they are in the normal ranges then there is nothing that I will be able to determine.
I do find that it is rare that a vet will push to do tests just to make money...perhaps I live in a sheltered world, but I do believe that most vets are above board.
With that being said, if you want to find another vet, here is a good way to find one. I usually recommend that people go to the park and find people who are walking with their dogs. Ask them who their vet is and what they think. Now, most people may say that their vet is a little expensive, but you'll soon get the idea as to which vets are most respected in the area.
I've had a number of cases like Bonnie's that are frustrating where I just can't find a medical reason for the weight loss. Unfortunately in some cases we end up doing a lot of tests and sometimes it takes a long time to get the answer. :(
I agree that most vets are above board. I loved the vets I worked for, they always gave alternatives and tried to work with patients and their people the best they could. This being said, I think we just got a bad one this time. The refusual to prescribe any pain meds really upset me. I won't take up your time with all of her numbers. Her total T4 reads: Results 0.0 Reberence Range 0.8-4.0.
Her Creatinine was: Lab Result 1.1 Lab unit mg/dL Normal Lab Range 0.8-2.4
BUN 19.0 mg/dL Normal 16.0-36.0
Below Normal were Glucose at 50.0 Lab range 71.0-159.0
Total Protein4.7 Lab Range 5.7-8.9
Potassium 6.0 Above Normal 3.5-5.8
Platlet Count Below Normal70.0 200.0-500.0
I am not expecting a diagnosis from you this way but would just like your opinion or ideas and also if you could tell me if you would prescribe a pain med with these numbers to one of your patients. I would like to know what direction to go in with the next vet. Thank you again.
Dr. Marie replied:
The only thing that's a little bit unusual to me in those blood results is the low platelet count. However, it's really uncommon for a cat to have low platelets. Usually when we see a low level it's because there was some difficulty in getting the blood sample (and that's really common with a cat.)
Plus, a low platelet level really should have nothing to do with the symptoms that you are describing.
The rest of the bloodwork looks totally normal to me.
It never hurts to get a second opinion though!
Ok, thank you. I didn't know that about platelets. You have been so helpful! I feel armed with some knowledge to take to a new appointment which I will be making soon.
Can you suggest anything I can give her for pain until then? I know only what I can't give. She is eating pretty normally, only wet food now and has stopped vomiting.
Dr. Marie replied:
There really is no over the counter medication that is safe and effective to give cats for pain.
If she's eating normally then this is a good sign. Actually, cats that are in significant pain usually have a greatly decreased appetite. I would hold off on any meds until you have your second opinion appointment.
All right. Thank you again, so much!!