Meet Simba, a domestic long-haired cat, who wandered into our client’s home in December 2024 and we estimated his age at 1. He was intact and fully grown at that time. They graciously opened their home to him and after testing him for Feline Leukemia and Feline Immunodeficiency Virus, had him neutered, dewormed, and vaccinated. He has lived a comfortable indoor-outdoor life for the last 2 years with our client and their other cats.
On September 24th I got a call that his breathing had changed. She had just noticed this and was willing to observe him for a longer time to see if this breathing was temporary or constant. The following week she set an appointment to have us do lab work and radiographs to determine cause of breathing changes since they were consistent at home. He also was less interested in eating. Spent more time sleeping. It was difficult for her to assess any changes in thirst or urination since they have more than one pet drinking from the water source and peeing in the litter box.
We started with a physical examination to see what observations we could detect. The first observation was he had lost 5 lbs in 9 months. He needed to lose some weight but since she indicated nothing had changed at home with the feeding schedules it was assumed this was related to his clinical condition. The next observation was the pigment of his ears and skin were bright yellow. Icteric yellow skin is not a good sign. I asked if there was any reason he had stopped eating completely in the last month since a condition called hepatic lipidosis can create icterus in cats. There was no history of that happening. We discussed the options of referral verses us doing the work up at WVC. We do not have ultrasound which can be a non-invasive way of seeing the internal organs easier. She declined the referral at this time and requested we do lab work and radiographs.
The lateral radiograph showed concerns for enlarged mass pushing the abdominal organs upward. The thought was an enlarged spleen but without ultrasound it would be difficult to know for certain. The kidneys were both normal shape and size and easily seen on the ventral – dorsal radiograph. We still had a mass noted along side the abdominal wall that was a space occupying structure.
Abnormal results of the lab work are listed here. SDMA 33.4 which is well above the normal range of 0-16. This test can elevate when there is as little as 25- 40% of kidney function lost. We had an expected elevation in Total Bilirubin in the blood at 10.6 with the normal value of up to 0.6. This is the cause of the yellow skin often called jaundice in humans. In the urine we saw orange – brown discoloration and large amounts of bilirubin present. The urine had normal specific gravity at a concentration of 1.040. There was no blood in the urine. The Thyroid was normal. The cat was anemic and was not showing regeneration at this time. This can be a concern with a cat in kidney failure. We can see anemia associated with auto-immune conditions. We can see anemia with blood parasites present. If his body is destroying his red blood cells that can cause a yellow color to the skin also. We shared the results of the diagnostic tests, and they elected to have abdominal exploratory surgery over taking him somewhere for an ultrasound. It was scheduled for the following day.
Simba was prepped for abdominal surgery, and a midline incision was made. Early observations were the yellow fat tissue related to the jaundice. The liver had spots all through the parenchyma with nodules present in some locations of the lobe. There was an enlarged spleen that also had abnormal spots and nodules. It was determined the mass we were seeing was the enlarged spleen pushing other abdominal organs upward. The owner had requested no major procedures if this was cancer and had appeared to be in multiple organs which it was. Simba was sutured closed and recovered uneventfully later that day.
Our clients were interested in trying to make Simba more comfortable for as long as possible so we dispensed Prednisolone 5 mg give 1 every 12 hours for 5 days and then 1 daily. After 2 weeks he seemed to be his more normal self. He was eating for them and becoming more active. The wonderful thing is that his bilirubin dropped from 10.6 to 2.8. The yellow was disappearing from his skin when we saw him. His red cell numbers have not dropped any more but have not returned to normal yet. Simba did not gain weight or drop weight. Discussing this with the client we decided to continue at the current level of medication and recheck again in 2 weeks. We are just going to enjoy every day that he is with us for as long as he is feeling good and eating and drinking for them. I explained that his eating and drinking can be a direct result of the prednisolone that he is receiving.
I cannot explain why he is feeling better. Why is the color returning to normal in his skin. Sometimes all the client wants is for their pet to feel better and have more time with them. We do not know how long he will be here with us, but they are just going to love him for as long as possible. They are happy and love the fact he is eating and even played the other day. I am happy he is still with us. Little reasons to be grateful.
