I have an almost 10-year-old cat. I took him to the vet after noticing that he had a painful swollen belly and had difficulty walking. (He had been like that for about 10 days.) The vet gave him a urine test, which came back okay. We ran a full blood count, which also showed fairly normal results.
The vet then thought it could be a furball and decided to give him laxatives and an X-ray, which showed a fairly large mass pushing against his stomach and kidney. She suggested it could be a tumor or perhaps some internal bleeding and recommended an ultrasound. He is still urinating, but that’s it. He is also eating small amounts of BBQ chicken, as recommended by the vet. Any thoughts? I have spent a fair bit of money so far trying to figure this out, and really can’t spare another $500 for an ultrasound.
I have quite a few thoughts on this matter. First, from your description it sounds like your cat is not bleeding internally. You have described a discrete or focal lesion, located between the stomach and one kidney. Internal bleeding does not usually cause discrete lesions and has a completely different appearance on X-rays. The lesion in question sounds like a mass.
Unfortunately, in a 9- or 10-year-old cat, such a mass will likely be an enlarged lymph node caused by lymphoma, a blood and immune system cancer that is the most common cancer I see in cats. Sadly, it is usually aggressive and dangerous. The most common symptoms are loss of appetite, weight loss, and an abdominal mass. Other symptoms might include vomiting, jaundice, unkempt hair, breathing irregularities, and neurological irregularities.
There is no question that an abdominal ultrasound would be the best step to take next. That would likely determine whether your cat has lymphoma or a less common issue such as a benign tumor, a focal infection (granuloma), or a different type of cancer.
The ultrasound will probably diagnose the problem, but it alone won’t do anything to make your cat well. If the mass is a benign tumor (which is not likely since your cat is clinically sick) or a granuloma, then he may need surgery to remove it. If the ultrasound confirms lymphoma, chemotherapy is recommended — possibly after further tests such as DNA analysis of tumor cells. If the ultrasound uncovers a different type of cancer, then your vet may suggest surgery or hospice.
In other words, you could be looking at very significant testing, treatments, and expenses after you have paid for the ultrasound.
The best choice is to perform the ultrasound and any other tests and treatments a specialist may recommend. However, if you don’t have the resources, you may want to consider a different option. There is a high probability that your cat has lymphoma. Cats with lymphoma sometimes enjoy a period of clinical improvement if they take prenisolone or similar medications. Prednisolone affects the immune system, and it can cause the symptoms of lymphoma to improve temporarily in some cases. It also stimulates appetite.
It is highly unlikely that prednisolone will cure your cat, but it does have the potential to help him. You may want to talk to your vet about this option.