I hope to help you more with a more complete answer, but can you tell me what tests have been run? Was a CBC, Chemistry including a thyroid (aka t4) run? If so, when? My own cat at a elderly age lost weight and the blood tests didn't change for 6 months and I tested her three times before the changes (kidney in her case) showed up. It does take a 70% change to all kidney function - ie both kidneys, to show up on std bloodwork. Has an ERD test been run on urine? Has urine been analyzed? Thyroid changes can have similar kidney symptoms and cause dehydration which is the major culprit with constipation. ie She may be predisposed to constipation, but something else is making it flare up.
Yes there are feline specialists and they can be found at: http://www.catvets.com/
There are many excellent veterinarians for cats as well that are not listed at catvets.com, so your veterinary office may still be appropriate.
What was the white blood cell count? If you don't have this information, it's alright, as it alone cannot provide a complete picture.
ie it is not standard to check thyroid with all blood tests, so I would assume by your notes that CBC, Chemistry and xrays have been done, but I don't know thyroid nor FeLV/FIV bloodwork status. Having been to the veterinarian 4 times, it is likely those have been evaluated, but we should start there - to know what has been done and when was it done.
Looking forward to your reply,
Dr. Jen
Edits: she now takes cispirade and LACTULOSE and there have been period of time where she would not EAT she never had any trouble drinking.
I have obtained a copy of all the medical records. She did have a t4 test in July. The results were 1.0 which is whichin the normal range.
I can not decipher all the test results but these were the only results which were higher or lower than normal
CA(calcium?) 11.7 (11.5 on 05/21)
Glucose 177 mg/dl (168 in may) I think they said this may be due to stress
NEU was high 14.45 which was normal in may
BASO was 0.14 K which was .05 in May
On the Vetstat her HCO3 and PCO2 were low (17.1 and 33.0 respectivley)
and her tCO2 was low at 18.1, while Na was high at 170, other than tCO2 this was all normal in May.
With the information I have, I would say your veterinarian is likely on the right track. It may take time for changes to actually appear in the lab work.
It seems that your main goal is to get a diagnosis to treat your cat with better targeted therapy. Without seeing the patient and records myself, I cannot say what is best for your cat at this time.
I would ask your veterinarian for a FeLV/FIV test and an abdominal ultrasound (by a qualified veterinarian). Surely one or both of those test will be able to give you more information that may lead to a diagnosis/improved treatment that you are seeking.
In the meantime, the fluid therapy and all that you have mentioned are appropriate. Fluids are economical and extremely beneficial - keep it up!
Thank you for checking on lab tests so you can have some better direction. As mentioned before - even my own cat didn't show up with a diagnosis for quite sometime. You're doing right by your cat.