Malcolm the stunted kitten
Malcolm was brought in as a 9 week old stray by a member of public as they thought he had been hit by a car. On his arrival it was quickly evident he had no injuries consistent with such trauma. We did notice however he would predictably start to act extremely odd about 30 minutes after every feed.
We became concerned that he may have a portosystemic shunt. This is a congenital abnormality when there is a blood vessel that does not form correctly and takes blood directly from the intestine into the general circulation, bypassing the liver completely. This allows one of the products of food digestion, ammonia, to enter the blood & thus reach other organs directly, before being metabolised by the liver. Ammonia in the blood is toxic to the brain and causes a condition known as hepatic encephalopathy. This would explain odd behaviour especially soon after eating. The condition also causes stunted growth as digested nutrients are not metabolised correctly, and we now also assumed that Malcolm was not as young as his size would suggest.
We tested his blood and found extremely high levels of ammonia confirming our suspicions. The usual treatment for this condition is surgery to ligate the abnormal vessel. This is however a surgery that requires referral to a specialist unit. Malcolm however did not have an owner come forward for him, and thus nobody to pay the referral costs.
Davies Veterinary Specialist's were kind enough to accept Malcolm as their monthly pro-bono case. After being seen for a consult, they agreed to operate on him to fix his shunt. There are considerable risks with surgery, and the operation is not always successful, but thanks to the amazing effort made by the team at Davies he had surgery in December 2013 and is doing well.
Since then he has made good progress although unfortunately he will never be completely cured - but he is managing well and is being looked after and generally spoint rotten by one of our veterinary nurses, Tamsin.