Cat not eating, dilute urine, help!
Cat not eating, dilute urine, help!
Squeaky cat is is 10 years old now, has not been eating much since Sunday. Today he drank the liquid off some wet food and I gave him some nutro. He had a slight fever, a little over 102 on Monday when I took him to the vet. She prescribled clavamox, assuming he had an infection. He was producing very dilute urine but recent lab work on 6-30 was okay except for high amylase and one of the liver enzymes, snt results to Traci. I am going to take him back to the vet. Do you have any ideas or questions that I could ask the vet to check on or consider? He will get fluids on Friday if not sooner. Thanks, everyone.
Helen
Re: Cat not eating, dilute urine, help!
Hi Helen, I did email you, but in case you haven't checked email:
If Squeaky isn't vomiting, lethargic or depressed, and if the kidneys on palpation (or xray) weren't abnormally small, I doubt there is any renal disease. What you need to rule out is pancreatitis or GI tract inflammation or infection somewhere. There might be a liver infection going on, but I strongly advise repeating the bloodwork again, since one would see significant changes in liver values and the pancreatitic enzymes (lipase and amylase). Lipase usually is more predictable for pancreatitis than amylase, but neither of these two tests should be used soley to diagnose pancreatitis. If the vet suspects pancreatitis, she should use a Pancreatic TLI test, it has to be sent to an outside lab. Also, she should take an xray to see if there is any inflammation (or effusion) involving the kidneys, liver, pancreas or inflammation in the intestines. An ultrasound can also be helpful to detect size/shape/inflammation on certain organs above. A complete urinalysis to check urine glucose and other urine markers should also be done ASAP, and to rule out infection.
Did Squeaky ever recieve corticosteroids for anything in the last year or so? Is he on them now? If so, for whatever reason, they should probably be lowered to lowest dose possible or ceased altogether, with bloodwork subsequent.
What were you feeding him? Is it high in protein and fat? If so, the vet needs to instruct you on a suitable diet so that it is not high in protein or fat. Pancreatic patients need a low-fat, low-protein diet temporarily, fed in small amounts, and lots of fluid support! She may want to rule out liver infection and liver involvement, and again, lots of fluids (sub-q might be ideal for you at home). Remember, the ALT liver enzyme can rise significantly due to stress and at time of blood draw, so this is another important reason the bloodwork should be repeated and so the vet can detect any changes in both the liver enzymes and the pancreatitic enzymes.
So, assuming you have an appointment tomorrow, ask about retesting bloodwork to detect changes in kidney/liver/pancreatic activity, get urinalysis, get xray if possible, or ask about ultrasound. Need to rule out pancreatitis, liver infection, gastrointestinal infection/blockage/inflammation/mass, detect size and shape of liver and kidneys. Discuss diet and see if vet feels low-protein/low-fat diet applicable, lots of fluids support if heart and lungs ok. (do not want to overload with fluid support with any sort of heart or lung disease)
Go through your home and ensure no plants were nibbled on, no chemicals or human medications, no toxic anything.
Edit to ad: I see you're feeding Nutro, ask vet about more appropriate diet until she accurately diagnoses, ask about sub-q fluids at home, but I'd recommend repeating bloodwork/urinalysis first.
If Squeaky isn't vomiting, lethargic or depressed, and if the kidneys on palpation (or xray) weren't abnormally small, I doubt there is any renal disease. What you need to rule out is pancreatitis or GI tract inflammation or infection somewhere. There might be a liver infection going on, but I strongly advise repeating the bloodwork again, since one would see significant changes in liver values and the pancreatitic enzymes (lipase and amylase). Lipase usually is more predictable for pancreatitis than amylase, but neither of these two tests should be used soley to diagnose pancreatitis. If the vet suspects pancreatitis, she should use a Pancreatic TLI test, it has to be sent to an outside lab. Also, she should take an xray to see if there is any inflammation (or effusion) involving the kidneys, liver, pancreas or inflammation in the intestines. An ultrasound can also be helpful to detect size/shape/inflammation on certain organs above. A complete urinalysis to check urine glucose and other urine markers should also be done ASAP, and to rule out infection.
Did Squeaky ever recieve corticosteroids for anything in the last year or so? Is he on them now? If so, for whatever reason, they should probably be lowered to lowest dose possible or ceased altogether, with bloodwork subsequent.
What were you feeding him? Is it high in protein and fat? If so, the vet needs to instruct you on a suitable diet so that it is not high in protein or fat. Pancreatic patients need a low-fat, low-protein diet temporarily, fed in small amounts, and lots of fluid support! She may want to rule out liver infection and liver involvement, and again, lots of fluids (sub-q might be ideal for you at home). Remember, the ALT liver enzyme can rise significantly due to stress and at time of blood draw, so this is another important reason the bloodwork should be repeated and so the vet can detect any changes in both the liver enzymes and the pancreatitic enzymes.
So, assuming you have an appointment tomorrow, ask about retesting bloodwork to detect changes in kidney/liver/pancreatic activity, get urinalysis, get xray if possible, or ask about ultrasound. Need to rule out pancreatitis, liver infection, gastrointestinal infection/blockage/inflammation/mass, detect size and shape of liver and kidneys. Discuss diet and see if vet feels low-protein/low-fat diet applicable, lots of fluids support if heart and lungs ok. (do not want to overload with fluid support with any sort of heart or lung disease)
Go through your home and ensure no plants were nibbled on, no chemicals or human medications, no toxic anything.
Edit to ad: I see you're feeding Nutro, ask vet about more appropriate diet until she accurately diagnoses, ask about sub-q fluids at home, but I'd recommend repeating bloodwork/urinalysis first.
..........Traci
Re: Cat not eating, dilute urine, help!
Thanks much, Traci. I will check on all that. I appreciate your ideas and knowing which questions to ask. Bloodwork is definitely going to be repeated tomorrow. Squeaky has NOT ever been on corticosteroids.He has been, to this point, very healthy except for one bout with a bladder problem which was not too bad.
I will check fat and protein content of his food. Petey is on Modified and K/D and vet had recommended that Squeaky go to that also. I see that it would not be advisable, since it is high fat, if he has pancreatitis and I will ask the vet about it. He has eaten almost nothing except for the nutro I forced. I offerd him several types of food, wet and dry; bacon, sardines; sliced turkey; baby food and salmon without avail.
I just gave him some fluids and I hope they help and he will eat voluntarily tonight. Hope the fluids do not affect the blood work tomorrow but I was afraid to wait and vet advised that I give him fluids today.
I will check fat and protein content of his food. Petey is on Modified and K/D and vet had recommended that Squeaky go to that also. I see that it would not be advisable, since it is high fat, if he has pancreatitis and I will ask the vet about it. He has eaten almost nothing except for the nutro I forced. I offerd him several types of food, wet and dry; bacon, sardines; sliced turkey; baby food and salmon without avail.
I just gave him some fluids and I hope they help and he will eat voluntarily tonight. Hope the fluids do not affect the blood work tomorrow but I was afraid to wait and vet advised that I give him fluids today.
Helen
The fluids won't affect the bloodwork, unless of course, the antibiotics have kicked in and bloodwork seems to be normaling off by tomorrow.
I think your vet might have meant, that if Squeaky were otherwise healthy, it wouldn't hurt to feed him K/D for maintenance, due to his age and because Petey is already on it; we also use it as preventative (renal) in older patients -- while it doesn't truly prevent renal disease, it does help to keep kidney levels at a safe level.
However if she did in fact, recommend the K/D on Monday during the exam/testing, I'm not sure it's a good idea or not. K/D isn't too high in fat, the protein content is lower, but ideally, in pancreatitis, you want a mild, gastrointestinal diet, easy to digest, easily metabolized (like a temp dietary course of I/D, depending on other blood parameters like kidney and liver function), and fed in small amounts, more often, to see if kitty can keep it down without vomiting, nausea, etc. Most pancreatitis patients show signs of acute pancreatitis and the signs are obvious (typically vomiting, dehydration, lethargic, feverish, liver values may be significantly high, painful abdomen, icterus, etc and bloodwork is sometimes remarkable).
See what repeat bloodwork/urinalysis shows tomorrow and go from there. It would be nice to think this might only be some infection somewhere, but when pancreatitis is suspected, bloodwork more frequently is imperative to monitor pancreatic and liver function. If it normallizes, it may have been an early indication of acute pancreatitis, but it could also be liver infection, etc. If bloodwork is not normal tomorrow, your vet will proceed further, but I would definately ask about xray and maybe ultrasound if indicated.
In the immediate sense, anything is better than nothing at this point, to get him to eat, but perhaps start with fluids, maybe some cooked white chicken in small amounts, or sprinkled over some dry food or canned that is not too smelly or offensive if he is nauseous, also call vet and ask if a senior canned formula might be ok for now, in small amounts only. Many an ill, nauseated cat will take to a senior formula, so it's worth a try, just try to keep protein and fat percentage down when you're looking at labels. Please confirm food choices with vet first, since you're waiting for new bloodwork results and if pancreatitis, one must be very very careful with type of food.
Hang in there, Helen, I'm keeping Squeaky in my thoughts.....
I think your vet might have meant, that if Squeaky were otherwise healthy, it wouldn't hurt to feed him K/D for maintenance, due to his age and because Petey is already on it; we also use it as preventative (renal) in older patients -- while it doesn't truly prevent renal disease, it does help to keep kidney levels at a safe level.
However if she did in fact, recommend the K/D on Monday during the exam/testing, I'm not sure it's a good idea or not. K/D isn't too high in fat, the protein content is lower, but ideally, in pancreatitis, you want a mild, gastrointestinal diet, easy to digest, easily metabolized (like a temp dietary course of I/D, depending on other blood parameters like kidney and liver function), and fed in small amounts, more often, to see if kitty can keep it down without vomiting, nausea, etc. Most pancreatitis patients show signs of acute pancreatitis and the signs are obvious (typically vomiting, dehydration, lethargic, feverish, liver values may be significantly high, painful abdomen, icterus, etc and bloodwork is sometimes remarkable).
See what repeat bloodwork/urinalysis shows tomorrow and go from there. It would be nice to think this might only be some infection somewhere, but when pancreatitis is suspected, bloodwork more frequently is imperative to monitor pancreatic and liver function. If it normallizes, it may have been an early indication of acute pancreatitis, but it could also be liver infection, etc. If bloodwork is not normal tomorrow, your vet will proceed further, but I would definately ask about xray and maybe ultrasound if indicated.
In the immediate sense, anything is better than nothing at this point, to get him to eat, but perhaps start with fluids, maybe some cooked white chicken in small amounts, or sprinkled over some dry food or canned that is not too smelly or offensive if he is nauseous, also call vet and ask if a senior canned formula might be ok for now, in small amounts only. Many an ill, nauseated cat will take to a senior formula, so it's worth a try, just try to keep protein and fat percentage down when you're looking at labels. Please confirm food choices with vet first, since you're waiting for new bloodwork results and if pancreatitis, one must be very very careful with type of food.
Hang in there, Helen, I'm keeping Squeaky in my thoughts.....
..........Traci
Re: Cat not eating, dilute urine, help!
Traci, the vet probably meant for me to feed Squeaky k/d as maintenance if he is otherwise healthy. I think she expected this episode to be minor and be over soon. So far as his symptons go, he is feverish
(low grade) and lethargic, has not vomited. He has not eaten this afternoon but has been moving around a bit more since I gave him fluids and he also cleaned himself where I spilled something on him yesterday--he had not bothered before. DOes pancreatitis need antibiotics or does that depend upon the cause of the inflamnation?
(low grade) and lethargic, has not vomited. He has not eaten this afternoon but has been moving around a bit more since I gave him fluids and he also cleaned himself where I spilled something on him yesterday--he had not bothered before. DOes pancreatitis need antibiotics or does that depend upon the cause of the inflamnation?
Helen
Re: Cat not eating, dilute urine, help!
Generally yes, because it can also affect the liver, and sometimes, the stomach. And it is also a prophylactic measure, in the event it is a bacterial infection somewhere.
Fluids also help to combat dehydration and fever activity, common with infections, ideally intravenous fluids are better for this purpose, but as you know, sub-q fluids can help perk kitty up considerably. Tomorrow, if he still hasn't eaten much and if bloodwork shows improvement, ask the vet about a GI anti-ulcer med, or an appetite stimulant, but this would most likely be contraindicated with pancreatitis (poor absorption and harsh on stomach and pancreas, antiemetics are also not always a good idea with pancreatitis, but he isn't vomiting, so antiemetics not indicated). Do ask about food ASAP, maybe try dry instead of numerous canned types. Something bland if possible. Also ask about Squeaky's oral health, there may be an overload of bacteria in the mouth that could be exacerbating periodontal disease, making chewing/eating difficult for him.
Fluids also help to combat dehydration and fever activity, common with infections, ideally intravenous fluids are better for this purpose, but as you know, sub-q fluids can help perk kitty up considerably. Tomorrow, if he still hasn't eaten much and if bloodwork shows improvement, ask the vet about a GI anti-ulcer med, or an appetite stimulant, but this would most likely be contraindicated with pancreatitis (poor absorption and harsh on stomach and pancreas, antiemetics are also not always a good idea with pancreatitis, but he isn't vomiting, so antiemetics not indicated). Do ask about food ASAP, maybe try dry instead of numerous canned types. Something bland if possible. Also ask about Squeaky's oral health, there may be an overload of bacteria in the mouth that could be exacerbating periodontal disease, making chewing/eating difficult for him.
..........Traci
Re: Cat not eating, dilute urine, help!
will follow your suggestions with vet. He will not eat dry food either, have tried several kinds.
Helen
Re: Cat not eating, dilute urine, help!
Can you try mixing one of the canned foods with water, maybe his mouth is painful, and he might prefer lapping as opposed to chewing (mash the food with a fork and add water, to make pudding-like consistency). Try also canned white chicken, mix it with a small amount of cooked white rice (nothing added), again, mash with fork to make it soft. He isn't constipated, is he?
..........Traci
Re: Cat not eating, dilute urine, help!
Yesterday I gave fluids which I think helped. Today he has eaten some dry food, not a lot but a big improvement over yesterday, will not eat wet food or "soup" made with wet food. Vet repeated blood tests, also ordered a urinalysis. She is thinking that maybe something happened that the kidneys took a nose divesince the June 30 test . I also thought this was possibly the case but cannot find anything that he may have gotten in or eaten that caused it. However, I was not at home when he started decling. I guess we shall see how the BUN and creatine are now and also see how the amylase values go. Vet also had said that kidneys cleared amylase from the blood and that the high value probably meant a beginning kidney problem. We will also see how dilute the urine is today.
I think her next step would be to check for pancreatitis, test for which she said took 2 weeks to get results. Hopefully this will not be necessary. Will let you know tomorrow of tests results if she emails them to me.
I think her next step would be to check for pancreatitis, test for which she said took 2 weeks to get results. Hopefully this will not be necessary. Will let you know tomorrow of tests results if she emails them to me.
Helen
Re: Cat not eating, dilute urine, help!
Wish the results could have been done today. The first tests didn't really note any high kidney values.
I think you should call vet back first thing in morning and ask about the I/D food (get a sample of both canned and dry) or ask about Eukanuba prescription Low-Residue (again, sample of both canned and dry). Did she say to give fluids again? Did she take Squeaky's temp again today and weigh him?
Do you know if he's constipated? When was his last stool? Is he urinating normally? Is he drinking at all?
I think you should call vet back first thing in morning and ask about the I/D food (get a sample of both canned and dry) or ask about Eukanuba prescription Low-Residue (again, sample of both canned and dry). Did she say to give fluids again? Did she take Squeaky's temp again today and weigh him?
Do you know if he's constipated? When was his last stool? Is he urinating normally? Is he drinking at all?
..........Traci