Lucy going downhill quickly for no apparent reason, at a loss

[hellolucy]

My older Lucy girl does not feel good and I am in full emotional panic mode trying to figure out what is going on.

About a week ago, Lucy woke us up 2x vomiting in the middle of the night. It happened again the next night as well and she clearly wasn't feeling great the next morning. Not eating nearly as much as she normally does (she is well known for her 'ample' appetite), lethargic, and we also noticed her back legs sliding just a bit and she almost seemed to be drooping or sitting lower on her haunches is how the vet described it. She does have pretty severe arthritis in both her front and back legs but normally does not slip around as much as she was. We took her glucose numbers all times/do so regularly and there were no extremes and Ketostix came back normal.

We took her to the vet that day and they ran a blood panel, comprehensive metabolic panel, tested for UTIs, thyroid panel, tested for DKA. Everything came back normal. She was in 2 months prior for her biannual checkup and everything was normal then as well. They gave her fluids and a Cerenia shot that day for the nausea. We brought her in the next 2 days after for more fluids and Cerenia shots. They sent us home with an appetite stimulant and more Cerenia.

She has been eating which is good but not nearly as much as she normally does. She is eating some of her usual food but will mostly only eat different foods she doesn't normally get (vet said to just feed her whatever she will eat at this point). She is using the litter box regularly with no diarrhea. However, she is still moving slowly and is still slipping around, still seems to be 'sitting lower', and just in general does not look like she feels good. The vet said the next step since all the results came back normal would be an intestinal ultrasound so will be calling first thing Monday to get that going.

I am at a total loss as to what could be going on and it breaks my heart to think something could be seriously wrong and I hate not knowing what it is. She was an older diabetic arthritic cat before this all started, but was doing great and seemed to be in good spirits. She was getting Solensia shots for the arthritis which seemed to be helping. All of this just came out of nowhere and it's like she aged years overnight.

I am beyond grateful for any ideas of what could be going on that I could look in to this weekend or ask the vet to look in to.

 

[Sienne and Gabby (GA)]

Did the vet happen to test for pancreatitis? It's not usually part of a general blood panel. You want to ask for either a Snap or Spec fPLI. The Snap test can be done in the office if the vet has the test kit. Otherwise, the labs need to be sent out.

 

[hellolucy]

Did the vet happen to test for pancreatitis? It's not usually part of a general blood panel. You want to ask for either a Snap or Spec fPLI. The Snap test can be done in the office if the vet has the test kit. Otherwise, the labs need to be sent out.

Yes, they did say they tested for pancreatitis and that it came back negative. I'm not sure how they tested for it though. Looking at her bill, it says there was an in house CBC blood panel and then a 'FE Cobalamin Folate TLI & P' that was sent out. They called me the next day saying it wasn't pancreatitis. I'm wondering if there is any way the test could have been wrong and/or if it needs to be redone? She's had pancreatitis several times before and that's honestly what I thought it was initially.

Edit to add: each time she's had pancreatitis, they've diagnosed it at the ER and believe it was done via ultrasound in addition to the blood tests. An ultrasound was not done this time at the vet, just the blood test.

 

[Sienne and Gabby (GA)]

Even with an fPLI, if the timing is off you can get a false negative.

I don't think that the 'FE Cobalamin Folate TLI & P' is a test for pancreatitis. If you Google the test, it looks like it's for small intestinal bacterial overgrowth. TLI (trypsin-like immunoreactivity) on its own is used to assess whether there is exocrine pancreatic insufficiency. It would explain weight loss but it's not a test for pancreatitis.

If your cat has a history of pancreatitis, I would suggest that the strategy with the vet is, "Humor me." and get her treated with whatever has been effective in the past. Pain meds may do a lot to ease the symptoms if it is, in fact, pancreatitis.

 

[hellolucy]

Even with an fPLI, if the timing is off you can get a false negative.

Ah, this was my fear. I am really struggling with whether I should bring her in to the ER or wait until the vet opens back up on Monday to ask for another test and even ask if they can refer her out to get an ultrasound as well just to be sure. She is eating (small amounts) and still drinking water which are good signs. Seems moderately alert, just that she doesn't feel good. I am a hovering emotional wreck worrying about her

 

[Sienne and Gabby (GA)]

I think we can all relate to how you're feeling. I'm a wreck whenever there's something going on with one of my cats. The best I can say is to trust your gut. You're there with your cat and you know her best.