435: IBD or lymphoma? Sorting out the feline GI puzzle

Well, let's start kind of with the basics.

When we hear about, you know, me as a primary care veterinarian, I see a cat that's coming in that could be suspicious of feline lymphoma.

What are some of the clinical signs that we could think of when we see that?

Yeah.

So, you know, when we think of feline lymphoma, you know, the way I try to look at it is I break it into two basic groups.

We have what's called our intermediate to large cell or the aggressive lymphoma.

And then we have our small cell or low grade, less aggressive lymphoma.

So each one kind of presents differently.

What you were alluding to would be the large cell and that's the cat that is doing OK.

And then all of a sudden, isn't it? not eating, having gastrointestinal signs, because the most common form of intermediate to large cell is GI.

So these cats, we don't, it's not like dogs, you know, the golden that's on your schedule, that's coming in for a lump, you lay a hand on them in five seconds, you know, the dog has lymphoma.

Unfortunately, with cats, 80% of them, if not more, are going to be gastrointestinal.

So since it's all internal, that's a big downside we have in cats is we just don't catch it early.

So usually it's going to be loss of appetite, weight loss, vomiting, diarrhea, things along those lines.

And that's going to necessitate them coming in to see the primary care.

On the other hand, the small cell, that in regards to its history is completely different.

You're looking at some signs that are present, but they're present for weeks and months.

So their clinical signs literally overlap and mimic that of IBD.

So a vast difference in presentation.

I wanted to start the conversation because they are very nebulous or very generic signs that we can see with any cat.

Their differentialist can really be pretty substantial with that.

And when we're talking of times of spectrum of care and trying to find the best diagnostic tools for that, what would you say would be the best one to do? Aside from the physical exam where we're kind of leaning towards something's just off with my patient, where would we go next?

Yeah, I mean, I think next will probably be blood work.

Now, blood work, again, it's not going to be an end-all, be-all, here's your answer.

But oftentimes, these guys are going to be anemic and potentially have a leukocytosis.