Fred's Story: The Importance of Team Medicine
November 3, 2011
We would like for you all to meet Fred. Fred is a 9-year-old, Siamese whose body decided to throw us a medical curveball earlier this year. In April, his owners reported a sudden onset of vomiting one afternoon. The material they found in his vomitus was rather odd…it looked, well, like something the cat drug in! They called immediately and we admitted Fred to the hospital within hours.
Supportive care was instituted while we were waiting for a plethora of diagnostic tests, including blood work to check for proper clotting, infection, and liver disease. We also took abdominal x-rays and noted things looked off, but were unable to determine exactly what was “off” about them. Despite no more vomiting, Fred clearly did not feel well. His blood work did not point us in any one direction, so we decided to call in the radiologist for an ultrasound of his abdomen. While the radiologist was here, he examined Fred’s x-rays and explained our “off” areas. We had a diagnosis…pneumatosis intestinalis.
The first question from all of us was, “What on earth is pneumatosis intestinalis?” It is apparently a rare condition found in dogs and humans, where gas is found between the intestinal wall muscular layers. To our knowledge, it has never been reported in cats. The most common causes in other animals are post-intestinal surgery or severe gastrointestinal inflammation, such as that found in cancerous processes. Fred had no history of these things or the less commonly reported causes found in the literature.
Needless to say, we consulted a large number of veterinarians regarding treatment, possible outcome, etc. Despite having at least 5 different specialists’ input, it came down to continued supportive care versus surgery to rule out cancer, the latter of which was not safe for Fred. The owners elected supportive care and Fred became a well-loved fixture in our hospital’s ICU for nearly 2 weeks. He received a blood transfusion, antibiotics, pain control, antacids, and a lot of TLC. Eventually, he recovered to the point that he could go home.
Since we were still unsure of the underlying cause of Fred’s condition, he had several follow-up visits with us, all indicating continued improvement. At this point, Fred remains on intestinal supportive supplements and comes in every 6 months for regular examinations. Thanks to a team approach between his many doctors, his owners, and Fred himself, we are pleased to report that he has returned to his normal playful and loud, Siamese self. Fred loves playing and cuddling with his 2 housemates and visits us as a healthy cat for boarding when his owners are out of town.
Fred, you will always remain a beloved member of the Cats Exclusive family and we are so happy that you continue to do well at home.