Vet please help: difficult case

Hi to all,
the message is quite long so I'll try to be as schematic as possible, I
just say here that I got 3 different diagnosis from 3 veterinaries: I
would like to have your opinion/suggestion.

=General Info
Male cat fixed, 13 years old.
Found in street when was 1 month old and lived in my flat, no contact
with other cats.
During all the things which follow my cat always drunk and urinates
regularly; his urine and feces have a normal color.

=Begin of 2006 October
My cat stopped eating (4 days) after having vomit for 2 days (used
Plasil).
First visit to the vet and simple blood analisys showed high
transaminases and we proceeded giving him an alimentary integrator to
help his liver.
For 6 days my cat ate something ... in the meanwhile he lost a lot of
his weight.
At 6th day again vomit and stopped again eating.
Again to the vet and then to a vet clinic to have ecography and a
complete blood analysis.
My cat is icteric and he had a phleboclysis; the vet thinks to
bartonella.
The eco showed anything strange.
We went home and started using antibiotics ... my cats started eating a
bit again.
Here are the results of the blood analysis:

Out of range values:
Type Measured_value max_value_allowed
CPK 505 235
GOT 316 42
GPT 618 53
ALP 682 70
GGT 12.2 4.6
Bilirubina Tot 6.7 0.3
Cholesterol 401 150
Azotemia 68 50
Creatinine 1.69 1.65
Glicemia 142 130
Phosphorus 6.15 5.6
Ratio Na K 39 reference value=29

In range values:
Type Measured_value min_value_allowed max_value_allowed
Proteins totals 6,1 5,8 8
Albumin 2,9 2,5 4
Globuline 3,2 2,8 5.5
Ratio A/G 0,9 0,4 1.3
triglyceride 86 40 100
Amylase 846 200 1790
Lipase 20 0 50
Calcium 9,4 8 11
Sodio 145 141 155
Potassio 3,7 3 5.5
Chlorine 112 102 130
Iron 134 110 170
Calculated osmolarity 330 219 371

Emocromo
Type Measured_value min_value_allowed max_value_allowed
Red globule 7,21 5,3 10
Emoglobina 10,6 8 15
Ematocrito 32,6 32 48
MCV 45,2 39 55
MCH 14,7 13 18
MCHC 32,5 30 36
erythrocyte nucleated 0 0 1
Reticolocitario index 0
white globule 8,4 5,5 19.5

leucocytotic formula
Metamielociti 0%
Neutrophil banded 0%
Neutrophil segmentated 80%
lymphocytic 16%
monocyte 2%
eosinophils 2%
Basophils 0%
Metamielociti 0 0 0
Neutrophils banded 0 0 0.3
Neutrophils segmented 6,72 2 12,5
Lynfocytes 1,34 1 7
monocytes 0,17 0 0.35
Eosinofili 0,17 0 1.5
Basophils 0 0 0.5
Unripe cells absent
platelet 146 200 500
platelet esteem Adequate-Aggregate

serum proteins
% proteins reference_value
Albumin 48.41 02.95 39.50 51.50
Alfa1 05.84 00.36 02.16 09.00
Alfa2 17.19 01.05 08.36 17.90
Beta 16.39 01.00 18.90 31.80
Gamma 12.17 00.74 06.50 18.40
Total 100.00 06.10 g/dl

Ratio A/G = 00.94

We excluded an autoimmune disease and bartonella.
We made one new flebo and for therapy: flebo, Ursacol, vitamin B, oral
antibiotic for 15 days from today.

= October 23
My cat didn't have vomit anymore but he continues to become thin and it
eats very little. I consult therefore others 2 veterinaries ... I
reassume the 3 diagnoses I got:
1-My vet has said clearly to me that he does not know what to do and it
has prescribed flebo+ursacol+vitaminaB +antibiotic and he excluded the
hypothesis bartonella; I am following this therapy;
2-this vet said to me that it is bartonella indeed and prescribed
flebo+Vibravet+rossovet;
3-third veterinary said to me that it is necessary to make one biopsy
to liver and a thoracic x-ray and thinks to one hepatic lipidosis,
prescribes rossovet.

= November 15
Thoracic Rx and analysis of feces are negative.

= December 13
The cat eats more or less regularly asking also the food with
insistence, in general eats very little but often ... it remains the
fact that even if he is eating is ulteriorly become thin. The icterus
persists. Currently the cure in agreement with my vet is Ursacol,
vitamin B and flebo (not every day) and suspends the antibiotic.
We made also new analyses:

Type Measured_value min_value_allowed max_value_allowed
ALT 303 130
CREATINine 1.9 2.4
glycemia 104 159

= January 10
The cat eats but still becomes thin.
I analyze some other symptoms:
- Lethargy = now is much lethargic (he has been always a cat very
active on the contrary)
- Loss of appetite with consequent loss of weight = yes
- Gingivitis and stomatitis = perhaps ... often, but not always, he
tries to eat because he is hungry but then does not succeed to chew
and/or to swallow the pieces of food that takes from my hands

I reassume diagnosis, therapies and my question that is simply: a
cue/suggestion that I could submit, with the due discretion, to the
judgment of my veterinary:
1° vet: no diagnosis (a not visible tumor to the liver), prescribes:
flebo, ursacol, vitamin B (rossovet), antibiotic (suspended hour);
2° vet: bartonella, it prescribes: flebo, vitamin B (rossovet),
antibiotic specific; I have not followed this way;
3° vet: no diagnosis, prescribes: new echography and x-ray but in
order to only discover not curable things.

Ace

try posting this to alt.med.veterinary also.
Gail
wrote in message
ups.com...
Hi to all,
the message is quite long so I'll try to be as schematic as possible, I
just say here that I got 3 different diagnosis from 3 veterinaries: I
would like to have your opinion/suggestion.

=General Info
Male cat fixed, 13 years old.
Found in street when was 1 month old and lived in my flat, no contact
with other cats.
During all the things which follow my cat always drunk and urinates
regularly; his urine and feces have a normal color.

=Begin of 2006 October
My cat stopped eating (4 days) after having vomit for 2 days (used
Plasil).
First visit to the vet and simple blood analisys showed high
transaminases and we proceeded giving him an alimentary integrator to
help his liver.
For 6 days my cat ate something ... in the meanwhile he lost a lot of
his weight.
At 6th day again vomit and stopped again eating.
Again to the vet and then to a vet clinic to have ecography and a
complete blood analysis.
My cat is icteric and he had a phleboclysis; the vet thinks to
bartonella.
The eco showed anything strange.
We went home and started using antibiotics ... my cats started eating a
bit again.
Here are the results of the blood analysis:

Out of range values:
Type Measured_value max_value_allowed
CPK 505 235
GOT 316 42
GPT 618 53
ALP 682 70
GGT 12.2 4.6
Bilirubina Tot 6.7 0.3
Cholesterol 401 150
Azotemia 68 50
Creatinine 1.69 1.65
Glicemia 142 130
Phosphorus 6.15 5.6
Ratio Na K 39 reference value=29

In range values:
Type Measured_value min_value_allowed max_value_allowed
Proteins totals 6,1 5,8 8
Albumin 2,9 2,5 4
Globuline 3,2 2,8 5.5
Ratio A/G 0,9 0,4 1.3
triglyceride 86 40 100
Amylase 846 200 1790
Lipase 20 0 50
Calcium 9,4 8 11
Sodio 145 141 155
Potassio 3,7 3 5.5
Chlorine 112 102 130
Iron 134 110 170
Calculated osmolarity 330 219 371

Emocromo
Type Measured_value min_value_allowed max_value_allowed
Red globule 7,21 5,3 10
Emoglobina 10,6 8 15
Ematocrito 32,6 32 48
MCV 45,2 39 55
MCH 14,7 13 18
MCHC 32,5 30 36
erythrocyte nucleated 0 0 1
Reticolocitario index 0
white globule 8,4 5,5 19.5

leucocytotic formula
Metamielociti 0%
Neutrophil banded 0%
Neutrophil segmentated 80%
lymphocytic 16%
monocyte 2%
eosinophils 2%
Basophils 0%
Metamielociti 0 0 0
Neutrophils banded 0 0 0.3
Neutrophils segmented 6,72 2 12,5
Lynfocytes 1,34 1 7
monocytes 0,17 0 0.35
Eosinofili 0,17 0 1.5
Basophils 0 0 0.5
Unripe cells absent
platelet 146 200 500
platelet esteem Adequate-Aggregate

serum proteins
% proteins reference_value
Albumin 48.41 02.95 39.50 51.50
Alfa1 05.84 00.36 02.16 09.00
Alfa2 17.19 01.05 08.36 17.90
Beta 16.39 01.00 18.90 31.80
Gamma 12.17 00.74 06.50 18.40
Total 100.00 06.10 g/dl

Ratio A/G = 00.94

We excluded an autoimmune disease and bartonella.
We made one new flebo and for therapy: flebo, Ursacol, vitamin B, oral
antibiotic for 15 days from today.

= October 23
My cat didn't have vomit anymore but he continues to become thin and it
eats very little. I consult therefore others 2 veterinaries ... I
reassume the 3 diagnoses I got:
1-My vet has said clearly to me that he does not know what to do and it
has prescribed flebo+ursacol+vitaminaB +antibiotic and he excluded the
hypothesis bartonella; I am following this therapy;
2-this vet said to me that it is bartonella indeed and prescribed
flebo+Vibravet+rossovet;
3-third veterinary said to me that it is necessary to make one biopsy
to liver and a thoracic x-ray and thinks to one hepatic lipidosis,
prescribes rossovet.

= November 15
Thoracic Rx and analysis of feces are negative.

= December 13
The cat eats more or less regularly asking also the food with
insistence, in general eats very little but often ... it remains the
fact that even if he is eating is ulteriorly become thin. The icterus
persists. Currently the cure in agreement with my vet is Ursacol,
vitamin B and flebo (not every day) and suspends the antibiotic.
We made also new analyses:

Type Measured_value min_value_allowed max_value_allowed
ALT 303 130
CREATINine 1.9 2.4
glycemia 104 159

= January 10
The cat eats but still becomes thin.
I analyze some other symptoms:
- Lethargy = now is much lethargic (he has been always a cat very
active on the contrary)
- Loss of appetite with consequent loss of weight = yes
- Gingivitis and stomatitis = perhaps ... often, but not always, he
tries to eat because he is hungry but then does not succeed to chew
and/or to swallow the pieces of food that takes from my hands

I reassume diagnosis, therapies and my question that is simply: a
cue/suggestion that I could submit, with the due discretion, to the
judgment of my veterinary:
1° vet: no diagnosis (a not visible tumor to the liver), prescribes:
flebo, ursacol, vitamin B (rossovet), antibiotic (suspended hour);
2° vet: bartonella, it prescribes: flebo, vitamin B (rossovet),
antibiotic specific; I have not followed this way;
3° vet: no diagnosis, prescribes: new echography and x-ray but in
order to only discover not curable things.

Ace

wrote in message
ups.com...
Hi to all,
the message is quite long so I'll try to be as schematic as possible, I
just say here that I got 3 different diagnosis from 3 veterinaries: I
would like to have your opinion/suggestion.

=General Info
Male cat fixed, 13 years old.
Found in street when was 1 month old and lived in my flat, no contact
with other cats.
During all the things which follow my cat always drunk and urinates
regularly; his urine and feces have a normal color.

=Begin of 2006 October
My cat stopped eating (4 days) after having vomit for 2 days (used
Plasil).
First visit to the vet and simple blood analisys showed high
transaminases and we proceeded giving him an alimentary integrator to
help his liver.
For 6 days my cat ate something ... in the meanwhile he lost a lot of
his weight.
At 6th day again vomit and stopped again eating.
Again to the vet and then to a vet clinic to have ecography and a
complete blood analysis.
My cat is icteric and he had a phleboclysis; the vet thinks to
bartonella.
The eco showed anything strange.
We went home and started using antibiotics ... my cats started eating a
bit again.
Here are the results of the blood analysis:

Out of range values:
Type Measured_value max_value_allowed
CPK 505 235
GOT 316 42
GPT 618 53
ALP 682 70
GGT 12.2 4.6
Bilirubina Tot 6.7 0.3
Cholesterol 401 150
Azotemia 68 50
Creatinine 1.69 1.65
Glicemia 142 130
Phosphorus 6.15 5.6
Ratio Na K 39 reference value=29

In range values:
Type Measured_value min_value_allowed max_value_allowed
Proteins totals 6,1 5,8 8
Albumin 2,9 2,5 4
Globuline 3,2 2,8 5.5
Ratio A/G 0,9 0,4 1.3
triglyceride 86 40 100
Amylase 846 200 1790
Lipase 20 0 50
Calcium 9,4 8 11
Sodio 145 141 155
Potassio 3,7 3 5.5
Chlorine 112 102 130
Iron 134 110 170
Calculated osmolarity 330 219 371

Emocromo
Type Measured_value min_value_allowed max_value_allowed
Red globule 7,21 5,3 10
Emoglobina 10,6 8 15
Ematocrito 32,6 32 48
MCV 45,2 39 55
MCH 14,7 13 18
MCHC 32,5 30 36
erythrocyte nucleated 0 0 1
Reticolocitario index 0
white globule 8,4 5,5 19.5

leucocytotic formula
Metamielociti 0%
Neutrophil banded 0%
Neutrophil segmentated 80%
lymphocytic 16%
monocyte 2%
eosinophils 2%
Basophils 0%
Metamielociti 0 0 0
Neutrophils banded 0 0 0.3
Neutrophils segmented 6,72 2 12,5
Lynfocytes 1,34 1 7
monocytes 0,17 0 0.35
Eosinofili 0,17 0 1.5
Basophils 0 0 0.5
Unripe cells absent
platelet 146 200 500
platelet esteem Adequate-Aggregate

serum proteins
% proteins reference_value
Albumin 48.41 02.95 39.50 51.50
Alfa1 05.84 00.36 02.16 09.00
Alfa2 17.19 01.05 08.36 17.90
Beta 16.39 01.00 18.90 31.80
Gamma 12.17 00.74 06.50 18.40
Total 100.00 06.10 g/dl

Ratio A/G = 00.94

We excluded an autoimmune disease and bartonella.
We made one new flebo and for therapy: flebo, Ursacol, vitamin B, oral
antibiotic for 15 days from today.

= October 23
My cat didn't have vomit anymore but he continues to become thin and it
eats very little. I consult therefore others 2 veterinaries ... I
reassume the 3 diagnoses I got:
1-My vet has said clearly to me that he does not know what to do and it
has prescribed flebo+ursacol+vitaminaB +antibiotic and he excluded the
hypothesis bartonella; I am following this therapy;
2-this vet said to me that it is bartonella indeed and prescribed
flebo+Vibravet+rossovet;
3-third veterinary said to me that it is necessary to make one biopsy
to liver and a thoracic x-ray and thinks to one hepatic lipidosis,
prescribes rossovet.

= November 15
Thoracic Rx and analysis of feces are negative.

= December 13
The cat eats more or less regularly asking also the food with
insistence, in general eats very little but often ... it remains the
fact that even if he is eating is ulteriorly become thin. The icterus
persists. Currently the cure in agreement with my vet is Ursacol,
vitamin B and flebo (not every day) and suspends the antibiotic.
We made also new analyses:

Type Measured_value min_value_allowed max_value_allowed
ALT 303 130
CREATINine 1.9 2.4
glycemia 104 159

= January 10
The cat eats but still becomes thin.
I analyze some other symptoms:
- Lethargy = now is much lethargic (he has been always a cat very
active on the contrary)
- Loss of appetite with consequent loss of weight = yes
- Gingivitis and stomatitis = perhaps ... often, but not always, he
tries to eat because he is hungry but then does not succeed to chew
and/or to swallow the pieces of food that takes from my hands

I reassume diagnosis, therapies and my question that is simply: a
cue/suggestion that I could submit, with the due discretion, to the
judgment of my veterinary:
1° vet: no diagnosis (a not visible tumor to the liver), prescribes:
flebo, ursacol, vitamin B (rossovet), antibiotic (suspended hour);
2° vet: bartonella, it prescribes: flebo, vitamin B (rossovet),
antibiotic specific; I have not followed this way;
3° vet: no diagnosis, prescribes: new echography and x-ray but in
order to only discover not curable things.

Ace

wrote in message
ups.com...
Hi to all,
the message is quite long so I'll try to be as schematic as possible, I
just say here that I got 3 different diagnosis from 3 veterinaries: I
would like to have your opinion/suggestion.

=General Info
Male cat fixed, 13 years old.
Found in street when was 1 month old and lived in my flat, no contact
with other cats.
During all the things which follow my cat always drunk and urinates
regularly; his urine and feces have a normal color.

=Begin of 2006 October
My cat stopped eating (4 days) after having vomit for 2 days (used
Plasil).
First visit to the vet and simple blood analisys showed high
transaminases and we proceeded giving him an alimentary integrator to
help his liver.
For 6 days my cat ate something ... in the meanwhile he lost a lot of
his weight.
At 6th day again vomit and stopped again eating.
Again to the vet and then to a vet clinic to have ecography and a
complete blood analysis.
My cat is icteric and he had a phleboclysis; the vet thinks to
bartonella.
The eco showed anything strange.
We went home and started using antibiotics ... my cats started eating a
bit again.
Here are the results of the blood analysis:

Out of range values:
Type Measured_value max_value_allowed
CPK 505 235
GOT 316 42
GPT 618 53
ALP 682 70
GGT 12.2 4.6
Bilirubina Tot 6.7 0.3
Cholesterol 401 150
Azotemia 68 50
Creatinine 1.69 1.65
Glicemia 142 130
Phosphorus 6.15 5.6
Ratio Na K 39 reference value=29

In range values:
Type Measured_value min_value_allowed max_value_allowed
Proteins totals 6,1 5,8 8
Albumin 2,9 2,5 4
Globuline 3,2 2,8 5.5
Ratio A/G 0,9 0,4 1.3
triglyceride 86 40 100
Amylase 846 200 1790
Lipase 20 0 50
Calcium 9,4 8 11
Sodio 145 141 155
Potassio 3,7 3 5.5
Chlorine 112 102 130
Iron 134 110 170
Calculated osmolarity 330 219 371

Emocromo
Type Measured_value min_value_allowed max_value_allowed
Red globule 7,21 5,3 10
Emoglobina 10,6 8 15
Ematocrito 32,6 32 48
MCV 45,2 39 55
MCH 14,7 13 18
MCHC 32,5 30 36
erythrocyte nucleated 0 0 1
Reticolocitario index 0
white globule 8,4 5,5 19.5

leucocytotic formula
Metamielociti 0%
Neutrophil banded 0%
Neutrophil segmentated 80%
lymphocytic 16%
monocyte 2%
eosinophils 2%
Basophils 0%
Metamielociti 0 0 0
Neutrophils banded 0 0 0.3
Neutrophils segmented 6,72 2 12,5
Lynfocytes 1,34 1 7
monocytes 0,17 0 0.35
Eosinofili 0,17 0 1.5
Basophils 0 0 0.5
Unripe cells absent
platelet 146 200 500
platelet esteem Adequate-Aggregate

serum proteins
% proteins reference_value
Albumin 48.41 02.95 39.50 51.50
Alfa1 05.84 00.36 02.16 09.00
Alfa2 17.19 01.05 08.36 17.90
Beta 16.39 01.00 18.90 31.80
Gamma 12.17 00.74 06.50 18.40
Total 100.00 06.10 g/dl

Ratio A/G = 00.94

We excluded an autoimmune disease and bartonella.
We made one new flebo and for therapy: flebo, Ursacol, vitamin B, oral
antibiotic for 15 days from today.

= October 23
My cat didn't have vomit anymore but he continues to become thin and it
eats very little. I consult therefore others 2 veterinaries ... I
reassume the 3 diagnoses I got:
1-My vet has said clearly to me that he does not know what to do and it
has prescribed flebo+ursacol+vitaminaB +antibiotic and he excluded the
hypothesis bartonella; I am following this therapy;
2-this vet said to me that it is bartonella indeed and prescribed
flebo+Vibravet+rossovet;
3-third veterinary said to me that it is necessary to make one biopsy
to liver and a thoracic x-ray and thinks to one hepatic lipidosis,
prescribes rossovet.

= November 15
Thoracic Rx and analysis of feces are negative.

= December 13
The cat eats more or less regularly asking also the food with
insistence, in general eats very little but often ... it remains the
fact that even if he is eating is ulteriorly become thin. The icterus
persists. Currently the cure in agreement with my vet is Ursacol,
vitamin B and flebo (not every day) and suspends the antibiotic.
We made also new analyses:

Type Measured_value min_value_allowed max_value_allowed
ALT 303 130
CREATINine 1.9 2.4
glycemia 104 159

= January 10
The cat eats but still becomes thin.
I analyze some other symptoms:
- Lethargy = now is much lethargic (he has been always a cat very
active on the contrary)
- Loss of appetite with consequent loss of weight = yes
- Gingivitis and stomatitis = perhaps ... often, but not always, he
tries to eat because he is hungry but then does not succeed to chew
and/or to swallow the pieces of food that takes from my hands

I reassume diagnosis, therapies and my question that is simply: a
cue/suggestion that I could submit, with the due discretion, to the
judgment of my veterinary:
1° vet: no diagnosis (a not visible tumor to the liver), prescribes:
flebo, ursacol, vitamin B (rossovet), antibiotic (suspended hour);
2° vet: bartonella, it prescribes: flebo, vitamin B (rossovet),
antibiotic specific; I have not followed this way;
3° vet: no diagnosis, prescribes: new echography and x-ray but in
order to only discover not curable things.

Ace

---------------Response Separator---------------

Could be a possible bile duct obstruction. Speak to your vet about an SBA-
(serum bile acids test). Don't allow a FNA (fine needle aspirate) unless
BDO has been ruled out. FNA could cause peritonitis if the bile duct is
obstructed.

Thanks a lot for your answers ... I'll follow also the tip to post to
alt.med.veterinary.
Regards,
Ace