Upon physical examination, she had a moderate elevation in heart rate, normal temperature, but a moderately distended abdomen with pain on palpitation of the anterior quadrant.  Blood work showed an elevated white cell count and elevated liver enzymes.

Radiographs demonstrated matter in her stomach that appeared to be food, but her owner had withheld food overnight because of planned anesthesia.  After repeating the radiographs several hours later and noting no change in gastrointestinal contents, an exploratory was elected and performed.

Upon entering her abdomen, severe hemorrhage was noticed in the wall of the bladder and in the retroperitoneal space around her kidneys and ureter.  A urine sample was obtained which was near normal.  Due to the risk of bleeding a biopsy of the area was ruled out.  Her liver was noted to be small and firm with a pebbled texture and yellowish pink in color.  A wedge biopsy of a liver lobe was taken.  Kwindi’s stomach was then opened and eight pieces of cloth were removed.

In discussing the findings with Kwindi’s owner post-operatively, she related that 2 weeks prior Kwindi had fallen hard against her restraining seat in the car when having to make an abrupt stop to avoid an accident. That explained the kidney trauma.

The liver biopsy and a subsequent liver function test confirmed an early stage of liver cirrhosis which by itself carried a very guarded prognosis and needed to be addressed rapidly if we were to have a chance at saving her life.  She was placed on Lecithin, Denosyl, and Vitamin E…..all liver sparing, somewhat holistic medications.  Also perhaps more importantly, with Urosodial for biliary stasis and Cholchicine, an antifibrotic, antibiotics, pain medications, and intravenous fluids.

Further complicating the therapeutics was her historical problems of arthritis and allergies that also needed to be addressed with a balanced medical approach.

Twenty months later, Kwindi’s problems are still responding well to medical and dietary management.  While the eating of clothing is a life threatening vice, in this situation, because her exploratory alerted us to her liver disease before its terminal stages, her dietary discretion saved her life.  As Paul Harvey would say, “and now you know the rest of the story.”

Blood work revealed mildly elevated liver enzymes and a slight decrease in protein levels.  She was also noted to be passing orange colored stool.  Radiographs (X-rays) demonstrated normal liver and spleen silhouettes and no sign of obstruction.

A tentative diagnosis of pancreatitis was made and she was placed on intravenous fluids and antibiotics for 72 hours.

Further testing demonstrated a significant increase in bile acids (poor liver function or inflammation).

Because of her lack of a satisfactory response and her bile acids test results, an exploratory abdominal surgery was elected to establish a definitive diagnosis.

Exploratory revealed a liver that was pale in color with a very mottled appearance as well as a 10 x 7 centimeter mass in the area of the pancreas.  Both sites were biopsied and submitted for histopathology.  The mass was a non-cancerous inflammatory response due to chronic pancreatitis.  The pancreatic enzymes had also caused the injury to the liver.

Ellie was continued on intravenous fluids for two more days along with a more intensive antibiotic regime.  A relatively new liver sparing neutroceutical, Denosyl SD4, was also given daily for 60 days.  She was to be maintained on a restricted bland diet for the rest of her life.

She had one additional episode of nausea that quickly responded to medication. But because of this she was maintained on Denosyl an additional 60 days until her laboratory values returned to normal.

Ellie has now returned to her normal weight and happy lifestyle although she may complain her diet is rather BLAND!!!

When Scooby’s owners brought him in to see us, he was more quiet than he would normally be.  The only abnormality upon physical examination was a wheezing sound when his lungs were auscultated.  After discussing the findings with the owner, radiographs of his chest and two different blood tests, the first a CBC and the second a heartworm test, were recommended.  The bloodwork was all considered normal.  The chest radiographs showed a consolidated lung lobe and thickenings of the airway.  The possibilities for the changes included feline asthma, pneumonia, which could be caused by parasites, bacteria, or fungal infections, or heart disease.  The most likely cause, given his age and the fact that he is an indoor only cat, was feline asthma.

Feline asthma is a disease that usually affects young to middle aged cats (2-8 years), with females being affected about twice as commonly as males.  The disease is characterized by inflammation in the airway, which causes narrowing of the airway.  The narrowing results in difficulty breathing and the irritation produces a cough.  Owners will commonly notice coughing episodes followed by gagging or retching as if the cat was trying to vomit.  In severe cases, owners will find their cat breathing with it’s mouth open.  The clinical signs can be seasonal, but are more commonly a year round problem, due to airway hypersensitivity.

There are different treatment options depending on the severity of the clinical signs and the individual response to the treatment.  The mainstay of treatment is corticosteroids, which are designed to decrease the amount of inflammation in the airway.  The steroids can be given by several routes, including orally, injection, or through the use of inhalers.  In addition to steroids, the use of bronchodilators is commonly used to relax the airway and allow the cat to breathe easier.  Bronchodilators can be given orally or through inhalers.  The majority of cats will respond well to medical therapy and can be managed long term on a combination of medications.

Scooby has returned to his normal active and happy personality and is doing quite well at home.  With medication Scooby should be able to live a long and happy life.