Old cat...

Re: Old cat...

Stephen Courtney — Fri, 26 Aug 2011 23:26:36 GMT

I'd be surprised if this cat was hyperthyroid. i think you have a chronic disease process going on - slightly anemic, not much else to shake a stick at. Certainly no evidence of liver disease, usually hyperT4s have raised ALT and ALP, also often a leukocytosis.

the cat is 17.....it's probably neoplastic/ age related/ untreatable..... Options involve scans, radiograph, more in depth bloods, wait and see for a while...everything becomes clear with time. How active you get at this point should be dependent on the owner's appetite for further investigations. in a cat of that age I'd be more inclined to wait and see, but you need to communicate well, and give options and let the owner decide.

Re: Old cat...

Martin Atkinson — Thu, 25 Aug 2011 09:39:27 GMT

[quote user="Gillian Mostyn"]

I've always thought that up to 25ish can be 'normal' in a stressed cat, and would request a fructosamine to confirm a persistent hyperglycaemia if I got 22 ....???

[/quote]

IME over 20 would almost certainly be DM. I would get a fructosamine on anything over mid teens, lower if DM was among my primary differentials.

Re: Old cat...

Gillian Mostyn — Wed, 24 Aug 2011 22:40:47 GMT

[quote user="Utlendigur"]Could also be borderline diabetic. Just had one of our nurses cats which had similar presentation and bloods last month - including a blood gluc which was at the high end of "stress" level - this month the blood gluc is 22[/quote]

I've always thought that up to 25ish can be 'normal' in a stressed cat, and would request a fructosamine to confirm a persistent hyperglycaemia if I got 22 ....???

Re: Old cat...

Rob Loxley — Tue, 23 Aug 2011 12:33:42 GMT

[quote user="missmo"]I advised the owners have a full profile run as I suspected there may be more than just hyperthyroid disease going on[/quote]

Would always do a profile, as missing the renal failure and treating the thyroid could make things worse for the cat!

If t4 & freeT4 (or the vetT4) are normal I'd be looking at primary GI disease and in an old cat imaging would probably be my the next stage.

Re: Old cat...

Martin Atkinson — Mon, 22 Aug 2011 17:38:22 GMT

If the T4 comes back normal request a vet specific T4 from Idexx. I had one cat with classical symptoms of hyperthyroidism but bloods were all normal including ALP and T4 which was even towards the lower end of normal. VST4 is cheaper than free T4 by equilibrium analysis and came up high and the cat is showing a clinical response to Felimazole.

Re: Old cat...

Martin Atkinson — Mon, 22 Aug 2011 17:38:22 GMT

Re: Old cat...

CatherineThomas — Mon, 22 Aug 2011 16:16:10 GMT

My next step would be to check blood pressure and urinalysis. Even if the T4 is high I would still check the blood pressure aswell.

Re: Old cat...

Utlendigur — Mon, 22 Aug 2011 14:58:38 GMT

Could be guts - malabsorption or maldigestion of some sort if polyphagic, thin and diarrhoea. Do the guts feel normal? (Could add folate/cobal +/- TLI +/- pancreatic lipase) May also be worth checking BP if some visual problems. Could also be borderline diabetic. Just had one of our nurses cats which had similar presentation and bloods last month - including a blood gluc which was at the high end of "stress" level - this month the blood gluc is 22

Re: Old cat...

Robin Grimmer — Mon, 22 Aug 2011 14:55:36 GMT

If you have ruled out hyperthryoidism as a cause of pp and weight loss, then the main differentials are malabsorption -

inflammatory bowel disease, alimentary neoplasia, chronic pancreatitis which could lead to exocrine pancreatic insufficiency.

Re: Old cat...

Claire Edgington — Mon, 22 Aug 2011 13:58:11 GMT

I would put money on the t4coming back high. what was the value of the tt4 in house? what makes you think liver? are there any abdo masses?