I have a 2 week old orphan that has upper respiratory infection and low weight. It is suffering with anorexia as well. The kitten is also tube feeding. Today is day 5 and the kitten has started showing lathargic behaviors again and has not had a bowel movment in 24 hours.

I am wondering if this is normal or if I should take it to the er.?

Question for Dr. Krista; sorry, complicated question(?)

First, to review for benefit of others reading this question:

Patient: Cookie
Rottweiler, spayed female, 2 years old

Presented with lethargy, anorexia, vomiting and diarrhea (threw up only twice and one time diarrhea, then taken to vet, given antiemetics and antibiotics; diagnosed with pancreatitis; getting better since – this was Monday)

During exam foreign material found in stool (grain and corn; we think she got into the horse feed) painful cranial abdomen, low and large bowel diarrhea, enlarged submandibular nodes – this part worries me because these were temporarily enlarged not long ago; resolved quickly, though)

As I’m reviewing the blood results, there are things I could understand as being consistent with digestive distress/pancreatitis but some which are concerning me, namely the globulin and lymphocyte levels, even though they are not extremely low but low nonetheless.

Beside the cPL which is clear in its meaning, the free T4 is low – I assume this is what is meant by not testing for hypothyroidism in ill animals, because the thyroid hormones would be low with any disease process? Is that correct?

I would figure that the ALT/unhappy liver enzymes would also be consistent with such insult to the body, is that correct? And I imagine same would apply to bilirubin in a situation of digestive upset?

The values that concern me are the globulin and the lymphocytes, particularly together with the "easily aggravated" sub mandibular lymph nodes in the mix, particularly as it seems that lymphopenia would be present with both CPV and lymphoma … ? I’d assume that a) Cookie was recently vaccinated for CPV and is improving too rapidly to think CPV? Lymphoma has been on my afraid mind since the first time they were found enlarged.

It also says, though, that lymphopenia could be a result of underactive glands (the source doesn’t say which ones) so would that perhaps have to do with the lowered thyroid function during the digestive distress?

Didn’t find much on low globulins, other than immunodeficiency types of situations, which doesn’t seem to apply. What is the "life-span" of a globulin, and if short, would the low globulins have to do with the unhappy liver?

Can you, please confirm about the free T4 and talk to me about the globulin and more importantly the lymphocytes?

Blood results attached.