Baldur is a cranky patient, so when he spent yesterday at the vet's for an ultrasound and chest X-ray (looking for cause of weight loss) it came as no surprise that they reported a lot of growling and hissing. The folks doing the ultrasound suggested a blood test that requires taking blood before and after eating, so they called to see if I'd authorize that. We also had roughly the following conversation:
Them: Do you think he would eat if --
Them: He seems awfully upset.
Me: Don't put any body parts you care about between him and the food.
Them: Does he have any food preferences?
Me: Already dead is best; he's not a mighty hunter.
When I picked him up they confirmed that they had slid a bowl of canned food into his kennel, covered the kennel (to try to calm him down; didn't know that wasn't just a bird thing), and immediately heard much slurping and chomping. That's my little vacuum cleaner!
Baldur has been losing roughly 2 ounces per week since early November despite starting then to treat him for hyperthyroidism (and despite the fact that he has all the food he wants), so my vet and I are concerned. We did assorted blood tests that were mostly normal -- T4 still good, WBC fine, PTH low, calcium tending high over the last year or so, ionized calcium high, ALT a little high). She recommended a tumor hunt and also, because he has a heart murmur, a look at the heart.
We've spoken briefly but she didn't yet have the report, so we'll talk more on Monday. The X-ray was fine, she said, and the ultrasound mostly fine (no tumors). She reported that his liver is bigger than it should be and "speckled", whatever that means. Also his bile ducts are a little dilated -- nothing like what Erik had, but not completely normal. I asked what this means and she said she's not sure but her working hypothesis is cholangiohepatitis -- what his brother has. (What's wrong; wasn't catching the hyperthyroidism wave enough? :-) )
When I picked him up they gave me a copy of the report, which says: "Assessment: Chronic hepatic disease (cholangitis/cholangiohepatitis, other) is suspected based upon the sonographic appearance of the liver, long term chronic low grade ALT elevation and chronicity of weight loss. Other causes of liver disease (lymphoma, mast cell tumor, hepatic lipidosis) have not been excluded but the degree of chronicity would be unusual. A cause for the hypercalcemia was not identified. Differential diagnoses include idiopathic hypercalcemia (likely) and occult neoplasia."
I am glad I live in the Google age, because otherwise I wouldn't have known what some of that meant. "Occult neoplasia" is med-speak for "hidden tumor", just to save you the search.
So there isn't a big obvious cause yet, which is both good and bad (depending entirely on whether big obvious causes would have been fixable). But it's very weird for the "big" cat to be under 11 pounds, so if it is cholangiohepatitis I hope treating it fixes that.