Dear Dr. John,

      Sadly, we had to put our cat to sleep this week. She was 17 and her demise came rather quickly.

      Only two or three weeks ago, my husband and I came back from a brief trip to find her looking exceptionally round in the belly. Even though she was otherwise acting normally, I immediately called my veterinarian, who decided to draw some fluid from her belly. He said there were several possibilities for the fluid and that further tests might be needed, including an ultrasound and a cardiac evaluation because she also had a heart murmur for the last few years. We had an ultrasound done, which suggested viral and cancer possibilities, but never had the heart checked. One day he drew more than a pint of fluid from her belly, noting she might get dehydrated or fail quickly. She actually rallied for one week and then declined in one or two days with severe shortness of breath that necessitated our putting her down.

      Any thoughts as to causes or other things that might have been done? Thanks.

      — G.F.

      Dear G.F.,

      I’m sorry to hear about your loss. The condition you describe is ascites, which is a fluid buildup in the abdominal cavity. The paracentesis that was done, which is the removal of the abdominal fluid, can be not only therapeutic but diagnostic. In many cases a fluid analysis can be done that may help determine the cause, but the ultrasound seemed to give some direction.

      In the case of a cat, one possibility is feline infectious peritonitis, which is a viral disease. Often accompanied by high fever, it is usually fatal. Your cat’s age makes me think her ascites was probably not due to FIP but rather a liver condition, some kind of abdominal cancer or heart failure. Blood work may have been diagnostic but ultimately either a cardiac evaluation or abdominal biopsies would have most likely given answers. Had the cause been identified, treatment may have consisted of various medications starting with a diuretic, low-salt diet and periodic abdominal fluid removal.

      The problem is that, despite getting answers, sometimes we can still do nothing to improve a situation and that may well have been the case with your cat.

      John de Jong, D.V.M., is the owner/operator of Boston Mobile Veterinary Clinic and CEO/director at Boston Animal Hospital.