We have two Egyptian Maus, Farah and Sais. They are both about 4 years old, and we love both of them. The smaller of the two, Sais, has developed a syndrome where she eats very little and does not drink much water. Our veterinarian first thought and hoped that she had a bacterial infection that affected her gall bladder, liver and pancreas as her blood work showed she had inflammation in these areas. We were treating her with antibiotics. She was hospitalized twice in 20 days for treatment and observation. This treatment seemed to have little effect, so we stopped. We then did an ultrasound to look at the gall bladder, pancreas and liver. They all appeared normal from this test. Sais still will not drink much water so we are providing lactated ringers subcutaneously to provide her with hydration. The dehydration has is improved, and she is eating small amounts. She loves shrimp, so we have been cutting up one cooked shrimp and making a "soup" in a bowl. This she eats. She is still refusing plain water, however, so we are making other varieties of "soups" from canned Iams food, tuna, etc. Our veterinarian really does not seem to know what's wrong with her. After a week of lethargic behavior, she has relatively good energy. Our primary concern is her water intake, and the possibility that she has a chronic pancreatic condition. Have you ever heard of this syndrome and can you recommend a course of treatment or a veterinary specialist that we should take her to? We live in Tempe, AZ, near Phoenix. Your advice and recommendations would be greatly appreciated. We love this cat and don't want to lose her. Thanks, Dennis and Eve Millett Dear Dennis and Eve: I have not heard of or come across any references to a syndrome of this nature particular to Egyptian Mau's. Any cat runs the risk of debilitation to the digestive organs due to anorexia as well as other etiologies involving specific systems. One thing to discuss with your veterinarian or an internal medicine specialist would include a behavioral disorder. Cats are exquisitely sensitive to changes in their environment. These changes may not appear significant to us, but they may greatly disturb your cat. It might be helpful to search your collective memories for anything out of the norm that might have preceded this ailment. Changes in diet, the introduction of new food or treats; environment, any changes made to the cat's personal space (litter box). Have there been any changes in the house in general, furnishings, renovations, etc.? Have you changed your schedules, working or traveling, more or less? Anything that might disrupt the cat's routine. Are there any new household members, a new baby, and the loss of a family member or the moving out of a housemate? These are just some examples of potential problems for you cat to sort out psychologically. Some behavioral problems manifest in destructive tendencies, inappropriate eliminations, aggression or psychogenic repetitive behaviors. Other times, behavioral disorders may trigger pica (the ingestion of inappropriate foods and materials) or anorexia (the lack of ingestion in general). Both of these disorders that share a psychological root, may ultimately lead to physical and metabolic degeneration. Typically, once the causative agent has been identified and expelled (when within reason), the cat may return to her normal vigor. Sometimes (especially if the causative agent and the cat must find a common ground) medications are employed to facilitate tolerance. Medications such as tricyclics and antidepressants as well as appetite stimulants and antihistamines have found on and off label uses for these conditions. Other medications or specialty diets might be necessary to combat any secondary organic dyscrasias. Other areas to focus on with your cat's caregiver include general gastrointestinal disorders. It sounds as though a bacterial etiology was suspected, but subsequently ruled out, as antibiotic therapy was unrewarding. Were different antibiotics tried? Some antibiotics may be more appropriate than others, especially if the liver is compromised. It is essential to understand that cats, unlike people and dogs, may have only mildly elevated enzymes and negligible ultrasound studies and still suffer from cholangitis, cholangiohepatitis (disorders of the liver gall bladder and bile duct) or pancreatitis. Pancreatitis in cats is often insidious and low grade. It might be characterized by nonspecific signs such as anorexia and weight loss, diarrhea and or vomiting. Many times the liver, gall bladder and bile duct are affected due to the anatomical proximity in which they live. So if the pancreas is diseased it may affect its neighboring organs or vice versa. Treatment of feline pancreatits /cholangiohepatitis is tedious and usually invasive. Treatment hinges upon resting pancreas and digestive enzymes, especially from foods high in fat and protein, which greatly tax the organ. It is usually necessary to restrict oral consumption for 3-4 days or in extreme cases 1-2 weeks. During this break for the pancreas, nutrition must be given exogenously. Sometimes even IV fluids may stimulate the pancreas-alternative methods such as a jejunostomy tube (which feeds the gut by bypassing the pancreas) or TPN (total parenteral nutrition, usually administered at ICU facilities) are employed to maintain sustenance. You might want to ask your practitioner about alternative methods as described above. It may also be prudent to seek the advice of a feline internal medicine specialist. Your local veterinarian should have a list for referral at his disposal. This is certainly a challenging case with no easy answer. Just remember you are your cat's advocate. It is your right and some might argue, obligation, to request another opinion if current therapies are not successful. Sincerely wishing Sias full recovery, Dr. M. C. Lane |