After spending the entire day at the specialist’s office, Grendel is home once again.

Despite all the proclamations of relatively successful diagnoses, the tests today indicate Grendel’s ailment is far more complex than the stones found in his kidney and bladder.  There is agreement that he needs be tested every six months to monitor the stones.  That given, there is no immediately necessary action based on what we learned today.

Endoscopic examination of Grendel’s GI tract indicates something else in his small intestine.  Biopsies were taken throughout the test and results from those should be available next week, but the specialist said there is visual indication in his small intestine that something is seriously amiss.

The first guess is internal bleeding.  Obviously that begs the question of what’s causing the bleeding.

The second option is some kind of bowel disease that may be treatable by steroids.  While I’d desperately prefer to keep him off steroids having already had him on them years for asthma treatment before inhalers were available for cats, I certainly understand that a GI tract problem would only be responsive to oral steroids (generally systemic).  Such treatment increases Grendel’s risk for diabetes, liver and kidney disease, heart disease, and several other problems caused by prolonged use of systemic steroidal treatment.

The third option — I cannot tell you how hopeful I am that this is not the final diagnosis — is a form of lymphoma.  Such a drastic case, which demonstrates throughout his small intestine, would certainly mean significant hardship for Grendel.  It also would mean that his chances for survival drop significantly and abruptly.

As I quietly reminded myself before leaving the specialist’s office, these are guesses.  The list of possible causes easily numbers a dozen.  There’s no need at present to work myself into a panic.  We won’t have the biopsy results until next week, and even then they may prove inconclusive and I will be forced to continue the troubleshooting process.

When I returned home with him this afternoon, I was quite thrilled to see him eventually go to the food bowl and munchingly enjoy a brief meal.  OK, it’s more aptly referred to as a snack in such proportions, but that is far more than he’s done since Saturday.  He minimally licked a spoonful of chicken-flavored baby food yesterday evening, but it was inconsequential when compared to his lack of food in four days.  You can therefore imagine my ecstasy in seeing him sit for three or four minutes indulging his limited appetite and disinterest with a healthy dose of real food.

As I said to Jenny several times over the last four days, it’s another hurry-up-and-wait situation.  Medical care, regardless of the species, is a “guess and test and guess and test” situation.  You merely wait for a test to confirm a guess before taking action.  Failing a confirmation via test, more guesses and tests are in order.  This is true with all animals.  Hell, it’s equally true of plants.  Medicine is an inexact segment of biology where one must pursue religiously and fervently the next best guess.  It’s not impossible to be certain in this science, but it is probable — if not more likely — that you must decide when best to say the odds are sufficient to move you into action without the certainty of absolute diagnosis.  Were that it was always certain.

Grendel’s now resting comfortably on the couch.  He moved there only a few moments prior.  That change of scenery occurred only after he spent several minutes working me for attention.  Even that is a good sign.

I am preparing some dinner and will shortly retire to the couch by his side.  He will rest most comfortably there with the rest of the family.  I’m only working a partial day tomorrow, and that is likely to be in the afternoon, so I will spend most of the day here at home doing chores and monitoring/caring for Grendel.  Should I deem it necessary, I will return him to our regular veterinary office for hydration and any other care he might need.

I’ll keep you posted.