Uncle's reply
He hasn't seen the blood work yet but this was his reply from the other day...
" I'll try to help if I can. Generally, cats w/ jaundice (icterus) are pretty sick cats. Unfortunately, its hard at this point to know the cause as there are several possibilities (more on that later). A comprehensive profile is a good place to start; also, a urinalysis (need partially full urinary bladder--not likely if dehydrated), and a fecal if he spends much time outside. At this stage of the investigation, Denamarin, a combination of SAMe and Silybin to protect the liver, is a reasonable start. However, it's very non-specific. Ideally you want to get a definitive diagnosis to identify the underlying cause.
The signs (low grade fever, jaundice, decrease appetite, weight loss, etc) you describe could be due to any of the following:
Immune mediated disease (eg immune mediated hemolytic anemia), infection (bacterial, viral [good to screen for FELV, FIV, (FIP less likely at his age)], neoplastic disease (ie cancer), pancreatitis, endocrine (glandular) diseases (eg diabetes, hyperthyroidism), primary GI disease (parasitism, inflammatory bowel disease). As you can see, jaundiced cats can be a challenge to sort out. To add to the confusion, some of our over-weight cats who stop eating can be subject to a secondary problem peculiar to cats called hepatic lipidosis (or fatty liver disease). This latter category of cats may, in some cases require a feeding tube surgically implanted to support these guys (sometimes for several weeks). [BTW: tapes are the least of my concerns on these cats; fleas, however, can carry a variety of diseases]
Unfortunately, diagnostics can get pretty expensive and so can the supportive care. Sometimes abdominal radiographs, an abdominal ultrasound are necessary. Occasionally, a biopsy of the liver, intestines, lymph nodes are helpful (should do a clotting test beforehand to make sure no bleeding tendencies). I won't try to second guess your veterinarian; he/she will need to look at the initial profile and make decisions on what is most appropriate diagnostically and therapeutically.
But don't give up hope. Sometimes we get pleasantly surprised, and some of these guys will come around w/ generic supportive care (Denamarin, low stress environment, fluid therapy as necessary (some clients learn how to do this at home), encouraged feeding if not vomiting, and possibly other meds as indicated.
Hope this helps. Keep me posted. See you Christmas eve.
Pat"
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