10 year old kitty with hard small clay colored, crumbly stool

[MariaL]

Hi, my special mellow soulmate kitty, Bede (ten years already, as a baby would not let go of my shirt from the LA pound, when I tried to put her back), now has had hard small clay colored stool, it turns to powder when pressed (through a bag), or crumbles like a dry crumbly cookie. I am frustrated, the Dr has not suggested an ultrasound and I have zero direction going forward. This whiteish stool showed up overnight about twelve weeks ago, and I am frustrated with the lack of direction. There is no homeopathic or holistic dr. within driving distance. The local vet directed me to give her Metamucil (i believe) or Psyllium husk and mentioned a few more fiber things to help with digestion. I was afraid to .. eventually (about a month later) I did, and it stopped her up, which was my initial concern. I was holding my breath and worried about blockage, until Bede finally went on day three. The quantity is very little (for all twelve weeks). I have no idea why the vet has not done an ultrasound, or why the liver, pancreas and bile ducts have not been suspect, or the ducts inspected for partial blockage. I will post her senior screen bloodwork, the vet referred to her bloodwork, as to why she did not suspect it was bile duct blockage, she spoke about pancreas and liver - but I still don't understand why she does not think it may be any of these. The stool last evening, is by far the largest stool she has had in three months, but it appears as cracked clay - that has been in the sun too long. I also wonder if it could be that the stool stays in her intestine too long, taking out all the water, but Dr. states during the physical exam, she showed no hard lumps, and appeared to be in no pain when pressed. All three cats have the same diet. Bede's turned like this overnight. I am so concerned, my vet is entirely open to your suggestions as for testing (I think an ultrasound... but besides bile duct blockage, exactly looking for what else?) I love my Bede with all my heart and I am scared for her. Please help direct me. Bile duct blockage (if this is it) should not go on and on like this! I am frustrated that I feel left to try to diagnose what is happening alone. My mom is the one who thought it may be a bile block.
Here is Bede's senior screen bloodwork:
L RBC 5.9
L Hematocrit 26.9
L Hemoglobin 9.5
MVC 49
H MCH 17.3
MCHC 35.3
% Reticulocytes 0.1
Reticulocytes 5
Reticulocyte 18.1
Hemoglobin
WBC 6.7
% Neutrophils 52.6
% Lymphocytes 37.5
% Monocytes 2.7
% Eosinophils 6.8
% Basophils 0.4
Neutrophils 3524
Lymphocytes 2513
Monocytes 181
Eosinophils 456
Basophils 27
L Platelets 60
Remarks Slide reviews microscopically. Fibrin strands noted Platelets appear moderately decreased on the blood film (50,000-1000,000 per microliter)
Chemistry
Glucose 90
IDEXX SDMA 10
Creatin 1.6
BUN 30
BUN: Creatinine 18.8
Ratio
Phosphorus 4.5
Calcium 9.8Sodium 151
Potassium 4.5
Na: K Ratio 34
L Chloride 113
TC02 21
(Bicarbonate)
Anion Gap 22
Total Protein 7.9
Albumin 3.7
Globulin 4.2
Albumin: Globulin 0.9
Ratio
ALT 95
AST 35
GGT 1
Bilrubin - Total < 0.1
Bilrubin - 0.0
Unconjugated
Bilirubin 0.1
Conjugated
H Cholesterol 306
Creatine Kinase 88
Hemolysis Index 2+
Lipemia Index 1+
URINALYSIS
Collection CYSTOCENTESIS
Color Yello
Clarity Clear
Specific Gravity 1.02
pH 6.5
Urine Protein Trace
Glucose Negative
Ketones Negative
Blood / Hemoglobin 3+
Bilirubin Negative
Urobilinogen Normal
White Blood Cells 0-2
RBC 75-100
Bacteria None Seen
Epithelial Cells Rare (0-1)
Mucus none seen
Cysts non seen
Crystals None Seen
ENDOCRINOLOGY
Total T4 2.1
notes:
Hematology a. see platelet comment
Chemistry b. SDMA and creatinine are within the reference interval: impairment of GFR is unlikely. Recommended next step: evaluate complete urinalysis
c. Index of N, 1_, 2_ exhibits no significant effect on chemistry values.
Endocrinology d. Cats with no clinical signs of hyperthyroidism and a T4 within the reference interval are likely euthyroid. Cats with concurrent illnesses may need further assessment. For cats being treated for hyperthyroidism with controlled clinical signs, this result suggests adequate therapeutic response.

I apologize for the photo, but I am very concerned! This is Bede's (left) - obviously constipated, and PJ's (right).

 

[Dr. Christina]

Before we can be more specific about your questions it would be good to know a few things about Bede.

In the 12 weeks that she has had the dry stool, has her behavior changed at all? Does she strain to pass these stools? Has her energy level, playfulness, enjoyment of life decreased?

How is her appetite and thirst? What is she, and the others, fed?

We call these overall criteria BEAM (behavior, energy, appetite, mood) and they help us understand the context of any one symptom.

What about her hair coat, gums, teeth, etc? Weight loss?

Are there now, or in the past, any other problems?

Dr. Christina

 

[MariaL]

Thank you Dr. Christina,

In the 12 weeks that she has had the dry stool, has her behavior changed at all? No, Bede is my quiet corner kitty, she always has been (her sister has bullied her a lot)
Does she strain to pass these stools? She does not appear to... However, because one little tiny lump in one box, and two tiny little lumps in the 2nd box - even though she does not appear to strain as she goes, she is only able to get a tiny little piece out at a time.. about 99% the last 12 weeks, (she has had only 1-4" poo, the rest are like 1/2 inch to 3/4". poor Bede!

Has her energy level, playfulness, enjoyment of life decreased? Same (Bede has been lethargic and shy her entire life.. I am trying to get her to be more active, but she is not an active kitty by any means). I think she has had much depression (because she feels replaced when i foster or help other cats). I currently have my last foster living with us, PJ. It is too hard on my two kitties, when i try to help. It will be extremely hard for me to not help another cat. Not sure if I can say no, but it is affecting my kitties physical health.

How is her appetite and thirst? What is she, and the others, fed? Appetite - same. Thirst - stopped drinking water 1 1/2 years ago, when my neighbor's home burned down (PJ's home). 99% of her water comes from canned food and the water I mix with it, surprisingly, Dr. Flores says she her hydration is fine (relief). We have the saline bag close by if need be, but she has stabilized. She tries to drink water, at rare times, but it appears difficult for her to do so, sometimes she will swallow, then swallow again real hard.. and do this several times. I tell her she needs to drink water... she tries, but it appears to be difficult. Before the fire, she drank a LOT.

We call these overall criteria BEAM (behavior, energy, appetite, mood) and they help us understand the context of any one symptom.

What about her hair coat, gums, teeth, etc? Weight loss? Weight loss - no. Hair - glossy and shiny. Gums - I will have to get back to you on this. Teeth - I wish I could afford a cleaning, tartar. The vet does not seem to be concerned, but I am, I know this is not right.

Are there now, or in the past, any other problems? chronic lifetime vomiting which finally improved with probiotics. Extremely finicky eater (lifetime), and I have to be careful changing or adding anything due to her choosing not to eat at all. Very sensitive tummy. A terrible spay as a kitten (she cannot be held without crying, so i never get to hold her, unless it has to be done). In past - eosinophil granuloma (about six years), my fiancé fixed her after his research (she went on limited ingredient duck kibble), while five vets only offered lifelong steroids. Since the fire, Bede would only eat her baby food- fancy feast (now fancy feast naturals), I feel fortunate with the diet change, the eosinophil granuloma did not come back (at least not on her nose and into her nostrils).

 

[aruna]

Latest update about Bede:

Do you think my Bede should have a esophagal tube inserted? I absolutely cannot force feed her. She growls and fights and i am so sick. and even if i was well, i dont know. i just cant fight with her like that.

Satureday 25 calories
Sunday 70 calrories
Monday 25 calories
Tuesday 70 Calories
Today 150 calories

the dr said she needs 250, i had no idea she needed THIS many.. i always thought it was 160 to keep from hepatic lipidosis. this has now turned into crisis mode.. and i would GREATLY appreciate your weigh in. Although.. looking at the above.. wow.. it seems like the answer is a yes.

 

[Dr. Jeff]

Hi Maria. Sorry I didn't see you post until just now.

Since her weight and coat are OK, you may not want to worry too much about the exact number of calories she gets every day. They will even out.

~200 calories/day may be *average* but there are no average kitties IMHO .

 

[EdwinA]

Hi Maria.

I think bile duct blockage usually causes bilirubin to back up and leak into the blood, at least over time. I think lots of digestive upsets can cause pale and dry stools.

Have you tried her with white fish or salmon? Or a scrambled egg? In case she doesn't touch food for about a day, I found a good way of force-feeding a cat who objects very strongly:

Get some squidgy but not sloppy food and make it into little balls (some squeezed-together fish is good); put your cat on your lap facing away from you, and firmly hold her whole body in your left arm (if right-handed), with just her head above your arm; make sure you're holding both of her front legs firmly with your left hand; with your right hand, take a food ball and very calmly ease open her mouth and slowly push the food to the very back of her mouth, even push it down her throat a little bit; when she tries to pull her head away just go with her - don't be afraid to get your fingers right in there and just be very calm and zen, even if she writhes a lot. The calmer you are, the less of a big deal it will seem to her. You might get a tiny bite, but it won't really hurt - just make sure you give it a wash.

I'd avoid the feeding tube if possible.

Do you generally feed fresh food? I think it makes a huge difference. Processed food messes up the digestion, and constitution generally. We give our cats boiled chicken thighs or boiled salmon - always with a tonne of the juice from cooking.

Also, why don't you try some dandelion extract and milk thistle extract while you figure out the right homeopathic remedy? They're general digestive tonics and detoxifiers, as well as having a whole range of beneficial effects on liver/pancreas/kidneys. Vitamin C and curcumin can have a big impact. I'd go for highish cat doses (check the web). Some B complex (especially methylated) also often help these things, I think.

Let me know how it goes! She'll be fine!

Edwin x

 

[Dr. Jeff]

Thanks Edwin!