Intestinal Obstruction in cats

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Intestinal Obstruction in Cats

Suspected intestinal obstruction
Intestinal obstruction - cancer

also see megacolon and constipation
also see cancer

Suspected intestinal obstruction
Question: we have a dear 18 year old mixed tabby Siamese
small 7 lbs on good day - now down to 61/4 lbs
lives indoors only
has had Feline leukemia tests always negative and has had regular multiple
vaccinations for just about everything over the years
we give her 250 cc's sub cutaneous fluid every 3 days due to decreased
kidney function as we have done over the past three years
she has 1/2 of her thyroid gland left due to previous nodule removal
(corrected excess hormone output 3 years ago -that's when fluids were stared
to help her kidneys)
7 days ago she started acting ill
reduced eating then stooped eating - LOTS of gas rumblings in abdomen - loud
all night
then a bout of explosive diarrhea - no blood or other unusual stuff except
maybe some whitish lumps which vets said might be intestinal lining???
temperature 100.9
at vets - kept over weekend with IV fluid - tests for thyroid, diabetes,
urine density, fecal parasites / infection
metrodizole antibiotic (not sure spelling)
vet reports
-------------
tyroid normal
no parasites or infection found - normal white count
slightly anemic but may be due to extra fluid input
no diabetes
vet urine test, dilute but same as previous (my observation same size clumps
as usual in litter pan)
kidney BUN above normal but in line with past readings - not spiking - not
super high
creatine high normal - again same as past readings
abdomen feels normal - kidneys smaller than normal and deformed again about
as in past
one vet said she maybe could feel a slightly enlarged may lymph node in
abdomen
NO ANSWER
says maybe cancer - get x-ray / get ultrasound don't know if either one will
show anything, won't say which is better
Cat back home yesterday- acts achy doesn't want to jump up to her basket -
doesn't' want to eat - drinks a little
vomit big time in car on way home
No fecal output - urinates same amount but not as often
LOTS of gas rumblings
temperature 100.9
gave subC fluids last night
sick kitty - no improvement
same antibiotic once a day - we to repeat for ten days
my wife takes cat in today for x-ray
intestinal blockage?
gas gangrene?
does cancer come on this quickly with no other previous symptoms?
hairballs?
UFO's?
Have we missed anything?
your quickest advice appreciated
Thanks
Turq
Answer: Turq-
I am hoping that your cat is already feeling better. If not, these are my
thoughts on what you report.
Your vet has provided a good list of possible differential diagnoses for
the history and lab work reported and appears to be working through them in
an appropriate manner. This always makes situations like this much more
frustrating because it doesn't leave a lot of room for alternative advice.
I think that ultrasound is a better screening test for abdominal problems
if the person taking and reading the ultrasound exam is good at it.
However, the best approach is to take X-rays and do an ultrasound exam, as
they each have some strong points and having the information from both is
useful.
Despite thinking this way, most of the time when I see X-rays with
excessive gas accumulation I want to do exploratory surgery, even in older
sick cats. My reasoning is that most intestinal obstruction problems get
worse rapidly and delaying an attempt at treatment just makes it more
likely that removal of a portion of the intestine will be necessary. If
there is not an obstruction most cats recover from surgery very well, even
if they are older kitties. I would not be put off by mild rises in BUN or
creatinine, nor would minor anemia bother me in this decision making.
Cancers can and often do show a very rapid onset of clinical signs. I don't
think that the cancer has suddenly appeared in these cases, I think it has
suddenly managed to do something the body can't tolerate, like block a bile
duct or block an intestine. In a cat in your cat's age range cancer has to
be among the list of possible problems and usually makes the top of the
differential list. Some cancers are removable and surgical biopsy can give
information on the type of tumor that allows for making an accurate
prognosis and better treatment plan.
I kind of wonder about the "feeling achy" part of your message. Do you know
if potassium levels were checked? This is not always a part of routine
blood screens. If it wasn't checked it would be a good idea to ask about
doing so. Low potassium levels make cats look like they have muscular
cramps or muscular weakness if they are low enough.
I know that it is an aggressive approach to advise surgery right off the
bat. I really do think that it is a reasonable approach to suspected
intestinal obstructions, though.
Good luck with this. Please feel free to write for clarification or
additional information if you need to.
Mike Richards, DVM
3/31/2000

Suspected intestinal obstruction - outcome cancer
Reply: Thanks for your advice
We did go directly to surgery with the idea of fixing if we could and
finding out for sure if not
Sorry to report that it turned out to be the hard choice - we did have to
make the decision to let Caitlin go on - my wife and I waited outside for
the word - as per our agreement with our vet she sent her college out to
tell us - the small intestine was almost completely closed with a growth
about 2 inches long all around it just below the stomach - and spots of
growth were all around the lining of the intestinal cavity, on the other
surfaces of the intestine and with lymph node involvement
Apparently cats have a good capacity to tolerate cancer with few external
symptoms - up until it become really major
We had discussed the possibility beforehand with the idea that an
encapsulated mass would be removed and based on cancer type or mechanical
obstruction we might have from 2 months to 2 years depending - but if it was
cancer and had significant spread the recovery would likely lead right back
into another crisis with significant discomfort in between
We had decided not to subject our friend to multiple procedures if the
cancer was widespread
Our vet draped Caitlin and we went in to touch her as she went directly with
the euthanasia - not having to come out from anesthesia - we had spent a
fair time with her before surgery after the iv was placed but before
anesthesia to tell her goodbye
My wife Deborah and I had always agreed that our animals deserved our best
care and had talked about that far far future day when the hard choice might
come - I just never realized how that day could be this day
I won't say it was easy but it was the right thing for my wife and I and we
believe for Caitlin - we got to say our good-byes hoping that they would not
be needed and we were there when her spirit left
It did help some little bit to have spoken of the worst, and to have made
the decision before the actual word came out - one always hopes for the
best - having the choice nailed down as much as possible before getting the
shock of the result let us not have to jump back and forth (and run away) at
the critical time - and we explained to Caitlin what we were going to do and
how the decision would be made
Our vet was kind and understanding throughout and in having us be part of
the actual euthanasia, we feel very fortunate to have had her helping us -
talking before of the best and the worst, of what specifically we would do
in each case, and making firm decisions is in my opinion the only way to get
through this kind of thing
We have a duty to our pets to not let them linger in pain or distress for
our own selfish reasons - we will always miss the best cat in the world who
was kind enough to adopt us
And hopefully, after the animals get to heaven (as they surly will), they
will speak a good word for us and we'll be allowed in
I'm writing this maybe to help others who may face similar choices
thanks
Turq
Answer: Turq-
I am sorry to hear about Caitlin. Your thoughts on this are valuable and
were expressed very well. I'm certain that Caitlin must have had a very
good life with you and that she must have known that, as well.
Mike Richards, DVM
4/1/2000

Last edited 09/17/02

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