Dear Cheryl,

It is exhausting to hear the same answer three times and still feel like something is being missed, so I understand why you’re looking for another opinion. Cats carry their weight very differently from one another, and a rounder middle at fifteen is often just the way muscle tone and fat settle with age, rather than a red flag on its own. That said, an ultrasound would give a much clearer picture of what’s happening inside than an exam alone can, since the liver, spleen, and any fluid buildup all hide easily behind a soft, round belly.

Being classified as a geriatric cat, having some blood tests would be a great idea too. These can help rule out metabolic disorders, as well as assess his liver and kidney function.

The breathing episodes concern me more than the shape of his abdomen. What you’re describing, a heave that looks like a hairball attempt but produces nothing, along with what sounds like real effort to breathe, is a pattern seen often in cats with asthma or other inflammation of the airways. It tends to get mistaken for hairballs for years because the posture looks so similar, even though what’s actually happening is a squeeze in the airway rather than something stuck in the throat or stomach.

A full year of these episodes is long enough to ask for a chest x-ray, not just another hands-on exam, and sharing the gasping detail specifically will help guide what the vet looks for on the film. If you can, try to take a video of the heaving, as this can be very helpful for the vet to see.

If your current vets aren’t willing to pursue that, a referral to an internal medicine specialist would be a fair next step for a cat his age with signs that have gone on this long. Once there are actual images to look at, you and your vet will have something solid to work from instead of another guess based on how he looks on the exam table.

I hope this helps!

– Dr Paola