A question for Krista Magnifico:

Hello! Hoping to get some advice on recommended next steps for my cat, Sammie, who is being evaluated for IBD vs. small cell lymphoma.

Sammie is 17 years old and is overall quite healthy! Throughout the time I’ve had her, she’s had a history of vomiting a ~once per week or two (sometimes more frequently). Vomit is usually clear, foamy. No other GI issues or health issues otherwise. She is active and energetic, and has not had any health issues until ~1 month ago when I noticed she stopped eating as much as she previously did. She stopped eating her dry food altogether, and seemed to become quite picky with her wet food. I initially thought her teeth may be bothering her because of the avoidance of dry food, so I brought her to the vet.

Vet found that she had lost a couple of pounds, unintentionally. Based on presenting symptoms, vet thought she might have a GI pathology so ordered an abdominal U/S:

Ultrasound, Abdominal Study Outcome:
Kidneys: overall normal size but mild reduction in detail and small mineral foci. Trace pylectasia noted w/out ureteral disension.
GI: Avg SI thickness normal. Mild corrugation is noted in some regions and some ileus (luminal fluid distension up to 4 mm w/ reduced
peristalsis) noted w/out obstruction. No discrete abnormalities appreciated throughout the small intestines.
Caudal abdominal nodes are prominent to mildly enlarged and rounded w/ smooth texture. One irregular cystic structure noted near right
kidney. The mesentery around the ileus segments is mildly hyperechoic.
A:
Intestines most consistent w/ enteritis
Nodes: r/o reactive vs other
Cystic strucure: r/o benign mesenteric vs inflamed node
Kidneys have evidence of chronic disease.

Here are her prior labs:
PRIOR LABS:

7/15/24: Wt loss 0.28 lb; PCV: 40/7.6; Chem18: BUN 41, creat 1.7, K+ 4.3, phos 4.2
U/A: USG 1.019, pH 6.0, rare wbc/rbc; no bact/cryst; cobalamin: 437; folate: 11.2

2/13/24: Wt loss 0.8 lb; CBCcomp: hct 44, diff wnl (clots in sample; rec. resubmit)
Chem25: BUN 40, creat 1.3; T4: 2.8; SDMA <10
U/A: USG 1.025, pH 6.0, rare wbc, no rbc/bact/cryst, rare fine gran casts.

1/19/23: Wt loss 0.4 lb; CBC: (hct 40, diff wnl); Chem25: (BUN 32, creat 1.3)
T4: 1.8; U/A: USG 1.051, pH 6.5, 1+ prot, rare wbc, no rbc/bact/cryst

11/19/21: CBC: (hct 46, diff wnl); Chem: (BUN 34, creat 1.5); T4. 1.9; DGGR lipase 9
U/A: USG 1.053, pH 7.5, rare amorph. crystals, no wbc, no rbc

6/17/22 Wt loss 0.16 (as desired); USG 1.040; SDMA: 11

Most recent A&P:
A:
1) Intestines most consistent w/ enteritis (IBD vs SCLSA); ileus likely cause of decreased appetite.
2) Nodes: r/o reactive vs other
3) Cystic strucure: r/o benign mesenteric vs inflamed node
4) Kidneys have evidence of chronic disease ; in keeping w/ previous lab findings.
P:
1) Rx: metoclopramide 5 mg: 1/4 tab po every 8-12 hrs.
2) Continue vit B12 as Rxed.
3) picked up Mirataz but hasn't started it yet. Rec. give. metoclopramide for 2-3 days and then if not improved appt, start Mirataz.
4) to consider presumptive pred tx vs ex-lap for biopsies.

Sammie is seeming to eat better with the metoclopramide.

My question:
Is pusuing an ex-lap for biopsy recommended vs. empiric tx for IBD with steroids vs. empiric tx for SCL with steroids + chlorambucil.

Thank you!!!

My 10 year old cat has a giant nasal polyp. I took him to a specialist and they said he needs a bulla osteotomy, and possibly a double as he may have it growing on both sides. My question is if you are able to do that surgery, along with a CT scan, and if so what is the earliest appointment I can get in. (“You” meaning Dr. Magnifico at the Jarretsville Vet Center). Bc he now can not eat due to the obstruction of everything, he still wants to eat and tries to everyday but it is too difficult to swallow and it kills me that this superficial thing may actually kill my otherwise healthy cat. My other option is to get the CT scan here, along with a feeding tube, to help bridge the gap for me to get an appointment with you. Any help or suggestions I would appreciate. If you need any other info just ask. I could ramble endlessly telling you everything but I’m trying to be as concise as possible. Thank you for your help.

My 3 year old male cat had emergency urinary tract obstruction. Luckily we very able to get him to teh hospital on time. He stayed 2 nights in hospital (super expensive). All went well and he was back home on Friday. Eating well, purring, playing, sleeping. He also goes and pee in litter box, but also is peeing small amounts around house. Like he cannot hold it. I just hope that is because of sensitive urethra and relaxation medication that they gave him. I stopped that relaxation medication immediatelly.

Another worry is he also has not been able to poop. He ppooped in hospital last time on Friday and today is Monday morning. I am thinking because of brand new urinary food that he started eating and his stomach needs to adjust. Or maybe antibiotics.
I hope he is OK and that this is just healing process. Ut has been only 2 days since catheter was pulled out. I am worried so much here.

Gastropexy with splenectomy yay or nay?

11 years old female Rottweiler, spayed, on smaller side of the breed. Splenectomy going to be done due to incidental splenic mass finding while diagnosis non-resolving diarrhea and inappetence. I wanted to look for obstruction but instead, this was found. Larger mass, >6cm. Surgery Tuesday.

I have a cat that I suspect likely has a soft palate or nasal polyp. So far we have seen my usual vet twice. The 1st visit they just looked at the cat and told us it was probably a respiratory infection and sent us home w/ a course of antibiotics (Orbax). That was a $150 visit. The cat completed the antibiotics and showed no improvement in it’s respiratory status, plus it seems like the meds made the car loose his appetite to the point of hardly eating. We just went back for another f/u visit, this time insisting on at least some diagnostic tests and they drew blood for labs, and did a chest x-ray (which the said appeared clear). This time they sent us home with azithromycin and prednisolone (more antibiotics and a steroid). That was a $500 visit. I expressed concern about an obstruction or polyp to the vet, and was told that if this course of meds didn’t work, we might need to see a specialist. I would be very grateful if anyone could put me in touch with a vet like Dr. Krista Maginfico that could help us address the medical issue at a reasonable price in the Austin, Tx area. Please, help if you know of anyone…..thank you in advance.

Good afternoon, I have a 3 years old cat, neutered male. Last Monday he had an obstruction, I went to ER, could not afford to hospitalize him, therefore, they just unblocked him and we went home with meds. 6 days later my cat became more alive, however, he is using litter box frequently and producing small amounts of urine. My question is- is this because of the medications that he cannot hold it and empties it little by little or is this because he is getting blocked again? Current medications are Buprenorphine, prazosin, gabapentin. Also, because he has not been hospitalized for 2 days, does that mean I have to try to find someone who will keep him on fluids for 2 days or there is a chance he can recover?

Hi my cat was neutered on July 21st. He has eaten normally & pooped normally but for a couple days now I haven’t noticed any urine in his box. I wish I had paid closer attention to it in the beginning to see if this has been a problem since the surgery or only the last couple days. I’m worried he might have some sort of obstruction but reading about the vet procedures we can’t afford thousands to have him unblocked. I hate I got him neutered now because apparently they did something to cause this & now my cat will likely die if I don’t find low cost help in my area. I’m around Pensacola, FL. If you know of any places that can help please let me know! Also if it was something they did to cause this shouldn’t they fix it? Curious how neutering could cause obstruction. Thanks!

My daughter’s beautiful 5 year old pitbull died suddenly last night. He was current with shots and vet visits, bloodwork, etc. and had no known health issues. My son in law had played frisbee with him. He did not exhibit any signs of heat exhaustion. Drank a lot of water when he came inside and was fine while my son in law took a shower. He fed him after his shower and he cried out while eating, seized a bit, collapsed and died. Son in law checked for airway obstruction and did several compressions on his chest, but he did not recover. They are heartbroken. How does this happen?

My cat got a FLUTD diagnosis yesterday morning after spending the night in the animal hospital because they were checking for an obstruction. He hadn’t obstructed, but they couldn’t get enough urine for a urinalysis, so when we picked him up yesterday morning they gave us a container. I got a hair under 3ml, dropped it off and was told they’d run it and let me know if it was enough but I have yet to hear if anything has come from it. He’s on an anti-inflammatory and a muscle relaxant. He’s a very vocal and clingy cat, but he’s been very quiet since we brought him home. He produced a decent amount of urine yesterday, but he hasn’t done more than a little dribble for about 4 hours now. I was told, if there were no additional or worsening symptoms, to bring him in immediately if this reaches 12 hours with no output. He doesn’t yell or talk or grunt when he’s in the litter, just stays there for a while and scrunches his back up as he tries to go but can’t, and will turn around frequently. He’s walking normally and isn’t having trouble getting to sleep, he’s eating normally and drinking frequently.
I was advised to start a vet prescription diet made up of 90% Hills Science Metabolic Urinary Care + CD dry food and 10% wet food, but the vets didn’t have any and after making a few calls around, was told my best option was to order it online and wait. Waiting is very stressful, and I’d really like to know if there is anything else I can do in the meantime to prevent any further discomfort or an obstruction. I would also like to know if there is a safe way to get him to the animal hospital the fastest. I’m worried if he’s obstructed, picking him up and carrying him or putting him in his cage might cause even more pain or make his urethra rupture.
Any additional tips or advice is very much appreciated. Thank you for your time.

I have a two year old male yellow lab that has already had two obstruction surgeries. Both of these, Scout stopped eating and drinking and was vomiting. Last week we believe he ate a sock in which he has been eating on and off, he is drinking, peeing and is pooping. He wakes up every morning wagging his tail and is in good spirits, just lacking some energy on the days he doesn’t eat. He weighed 80 pounds on his previous checkup, yesterday we took him to our local vet, he weighed 70 lbs. The performed an x ray on him and said they believe it was a soft material that he swallowed and couldn’t determine if it was in his intestine or in his colon. While at the vet Scout was wagging his tail, holding the leash in his mouth as he usually does and ate about 20 treats. My vet charged me $360 and told me they recommend me to go to the animal hospital for an ultrasound to get a better idea of where this sock is located. I waited for 4 hours for them to tell me that they performed the ultrasound, it was somewhat inconclusive, his colon was enlarged and recommended exploratory surgery. I requested we wait to see if he will pass this. They kept him overnight, asked for an $800 deposit and called this morning saying that he was the same, and took x-rays to say it hasn’t moved. Your thoughts, suggestions or advice?