Just not feeling well is a common complaint in cats and naturally the problem might be minor or catastrophic, but here's what to expect if you bring in a feline patient for just not feeling well.

History and Exam:

The first step is narrowing the problem down and a good vet can often get a pretty good idea with just a pertinent history and a hands on exam.  What's important in the history is age, sex, recent heat or pregnant?, duration of the problem, and obvious observations such as diarrhea, no stool, gagging, vomiting, not eating, straining to urinate, not using the litter box, limping, energy level and so on.

During the exam, we will be listening to heart and lungs, looking closely at the mouth, eye, gums and ears, and feeling the lower abdomen, bladder, and lymph nodes.  We will get a temperature, palpate the spine,  go over the joints ,and ask a lot of questions.  Usually this will allow us to get a good idea whether the problem is respiratory, abdominal, urinary, neural, a bite wound abscess, a suspected hair ball, parasites, a tooth or ear infection, a suspected poisoning, or any number of other things that can go wrong.

If the problem is pretty obvious on exam...say a bite wound abscess with high fever or a hair ball clogging up the lower bowel  (both these problems are very common without the owner realizing it)...then we usually just go ahead and treat the obvious problem.  At the bottom of this page there is a complete directory to see how we treat wounds, constipation, diarrhea, and a many, many other problems

If the problem is not obvious or we suspect there's more going on than meets the eye; then we're left with two basic choices which each vet deals with differently based on  the situation and their experience.  This is where the "art" of veterinary practice comes into play.  Anyhow, the two basic choices are to either treat by trail and error based on the veterinarian's instincts for a day or two or spend a little more effort and money in an attempt to get a real diagnosis.  This usually means using our lab to check urine, stool, and blood to get as many clues as we can.  It may also mean taking radiographs or ultrasound images.  Such diagnostic tools are wonderfully helpful.

We vets are frequently surprised that people who look like they might not be able to make the rent on a mobile home are more than willing to pay a couple of hundred dollars on radiographs and laboratory work if it will help their pet.... while people that spend that much on a night out bulk at spending much money on their sick pet at all.  People are funny this way.

At any rate, most vets will recommend what is reasonably ideal for the case and then give you some less than ideal options and let you decide how aggressive to get with the case.

At our clinic, if you opt to skip recommended lab work, radiographs, hospitalization, I.V. fluids and so forth, we will gladly try symptomatic treatment... often with great success... but encourage you to return for more aggressive diagnostics and therapy if your pet isn't much better soon ... or if the problem is temporarily relieved but then returns.  Medical therapy is not a "one shot" affair.  Monitoring and follow up are important... as is the willingness to change tack if initial treatment is not working.

So here we go.

Plan A: is to treat the problem IF your experienced vet can make a fairly certain diagnosis in the exam room.  It still gives me a little thrill when the whole family doesn't have a clue why their cat is sick and I can come up with a solid diagnosis within a few moments of hearing the history and doing a quick exam.
It comes from lots of basic study, continuing education, and seeing case after case.  And every vet with a few years of experience is good at this.  But it's still a thrill to feel like Sherlock Holmes.

However.  Some things are obvious to everyone concerned.  Take diarrhea for example.  The big question then becomes Why... what's the underlying cause?
And is this particular case going to respond to simple home treatment or is this a case where the patient might die if we don't determine and fix the underlying cause?

Plan B:  If the problem or seriousness of the case is NOT obvious, the next step is to start ruling things out without breaking the bank... and that's what an experienced vet is very good at.  This means taking radiographs if appropriate and/or doing lab work on urine, stool, and/or blood.

I tell my clients that being a vet evaluating a sick cat is like a pretty woman evaluating a man on a first date.  The initial history and exam is like the first dinner date... you can get a good "feel" for the guy by what he says, how he listens, how he behaves, how he tips, how much he brags, and how he drives ... all this is helpful, but as you know... it's easy to be fooled.  If you really want to know what's real, you need a police report, a credit report, and a reference letter from the ex-girl friend.  That's what getting information from x-rays and lab reports is like.  It's usually worth it to know sooner than later.

Plan C:  sometimes it takes a little time and observation to figure what's going on.  So your vet may recommend keeping your cat in the hospital for supportive care and observation.  I don't want to be over dramatic, but we often have "eureka" moments of insight just by observing your cat and performing our vital sign checks several times during their stay.  Often the problem, in hindsight, is something I might have detected day 1 if only all my little gray cells were working at 100% capcity.

Plan D:  often this is concurrent with plans A-C but involves simply blasting away with treatment that is LIKELY to help even though we don't have a solid diagnosis yet.  Typical treatments include bowel evacuation with laxatives or enemas if the abdomen is a little gassy or tight,  I.V. fluids, antibiotics, a little hit of steroids, atropine, and/or B12.  It's often the case that the patient will be all better before we truely figure out what the problem was.  It's important as a vet not to get lazy and rely too much on Plan D, but life in the medical world is not all perfectly categorized... sometimes we have to "wing it"... and that's where experience is golden and where the "art" of medical practice comes in.

Plan E:  When initial lab tests, radiographs, and symptomatic treatment fail to get a diagnosis or a positive treatment result ... or if there is a good tentative diagnosis... but the problem is serious or requires specialized treatment... then it's time to take advantage of a good referral practice.  There's one in nearly every big city ready to team up with you and your local vet to help your cat.  They have the specialized training and equipment to deal with everything from complicated cases of diabetes to lymphoma, irritable bowel disease, auto-immune diseases, cancer, neural diseases and many other problems that can be very difficult for the general practictioner to handle.

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Minor gastro intestinal upset can make a cat act miserable.  On the other hand, cats with serious problems often don't show any outward signs of distress until they're nearly terminal. 
And cats are notorious for not reading the medical text books... they often have diseases without showing any of the symptoms listed in the book!  ... sometimes you might as well read a book on how to be popular with women.  "Beats me".

At any rate, this page is about how most vets approach a case of "just not doing well".

Cat Related Information On Other Pages:

Our home page for cats

Vaccine and other recommendations for kittens

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A Short History of Cats
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Urine Spraying and Marking Behavior in Cats


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Feline Heart Disease

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Tylenol Sensitivity

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Feline Infectious enteritis also known as feline panleukopenia or feline distemper

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Cats That Just Aren't Feeling Well
"Ain't Doing Right"

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