A 12-year-old male castrated Blue Russian cat was presented with a 5-day history of anorexia, lethargy, and vomiting.
Case Description. The owners noted that 9 months ago the cat had become a "picky" eater. Previous blood analysis had revealed elevated liver enzymes. This finding had prompted the referring veterinarian to occasionally give the cat "a shot of something," after which the cat seemed to feel better for a while. One month ago the referring veterinarian had prescribed a "small white pill" as an appetite stimulant, which seemed to be successful. At the current presentation, however, the signs were different (vomiting) and more severe (anorexia).
Examination. The cat was dehydrated and icteric and seemed to be in pain upon abdominal palpation. It was moderately tachycardic and tachypneic and had a rectal temperature of 99°F (37°C). Initial laboratory abnormalities included neutrophilia with a left shift, nonregenerative anemia, elevated liver enzymes and total bilirubin, and a urine specific gravity of 1.009 with 3+ bilirubinuria.