First off, he still lives ... and it was an interesting day.

I gave him half of a 5 mg Valium an hour before the trip to the internist as
the doctor suggested. Didn't work. He was about to kill himself before we
even got in the car, he was fighting the effects so hard. So I gave him the
other half of the Valium, as the doctor said we could do. That held him and
we set off for the internist, 80 miles away. And it lasted until we got
about 10-15 miles from our destination, when he started trying to claw his
way out of the carrier, actually got his claw hung in the bars and I was
driving down the interstate at 70 mph in the pouring rain with one hand and
trying to free his claw with the other.

Anyway, we got to the internist and he did the ultrasound. It showed no
abnormalities at all in the area of the liver. He also did a needle
aspiration test of the liver as well and we'll have the results on that
today (Friday), and it could very well come back indicating cancer, in which
case the rest of what I'm about to tell you will be moot, but his sense ...
and the guy seemed very sharp, like he knew his stuff ... was that this was
not cancer even though the liver enzymes were so high.

What he did notice on the ultrasound was a marked thickening of the bowel.
He said that could very well be cancer as well, the only way we'd know for
sure is to open him up. We're not going to do that, our regular vet has
already said and the internist pretty much concurred that in his present
emaciated state, there's a strong chance the cat wouldn't survive the
surgery. Just as my wife and I had decided that we would put the cat down in
the event of a cancer diagnosis, we're not inclined to subject him to
surgery that would probably kill him either.

However, again the internist's sense of the situation is that while there
could be some other things out of whack, we're looking primarily at a nasty
case of inflammatory bowel disease.

He did suggest that we have the more detailed thyroid test done, the one
where the vet has to send it off for analysis instead of just running a
screen, as well as a pancreatic insufficiency test, because he said a
pancreatic insufficiency could also cause food just to go right through a
cat without providing any nutrition.

Because the Valium didn't really do the job in sedating the cat for the trip
down there, he suggested giving him a shot of something a little stronger, I
can't remember what it was, don't have the paperwork at hand right now but
it was something that started with an "a." I said go ahead and he gave the
cat the shot ... and it put him out like a light, I mean limp noodle, tongue
hanging out of his mouth out. The internist was a little leery of letting
him go home in that condition, so I left him there for a couple of hours,
went and had lunch and bummed around a nearby mall for a while. I got back
and he'd roused himself enough to where the internist thought he could
travel, although he had given him a little bit of subcutaneous fluids just
to make sure he was OK.

So we headed home and when we got back into town, I stopped off at my
regular vet to set up a time to have the recommended bloodwork done. Turns
out things were dead as a doornail there and they said they could work me in
and do the bloodwork right then. Which was really good because the cat was
still sedated and calm, plus one of the tests, I think the pancreatic
function, required a 12-hour fast and the cat had not had anything to eat in
like 15 hours in preparation for the ultrasound, so it all worked out well.

I should have those test results in a few days.

My regular vet suggested that we try something called Metronidazole. He also
prescribed some Science Diet i/d food, told us to feed him as much as he
could eat.

Also, if the needle aspiration test does come back negative today, we're
going to go ahead and try something. I thought of it while I was at the
internist's and asked him about it, he said it was a good idea and that he'd
do it if it was his cat, and my regular vet said "go for it" as well. We're
going to go ahead and treat him as if he did have inflammatory bowel
disease, give him Predinsone, etc., and see if he responds. Now, he may very
well turn out to have a thyroid or pancreas problem, in which case that
wouldn't help and we'd have to go in a different direction. However, it's
not going to hurt him, according to both vets, and if it does turn out to be
inflammatory bowel, again as the internist suspects after having seen the
cat and his ultrasound results, we will have started the process of trying
to do something for him and hopefully he'll respond to it. Because both vets
and I are afraid that this cat is going to starve to death before we figure
this thing out, despite the enormous amounts he eats ... and when we got
home today and I let him out of the carrier, he was still stoned so badly he
could hardly walk, but he fought his way, basically dragging his legs behind
him, to his food dish and ate an entire can of food in about 15 seconds and
promptly puked it back up; we've been feeding him smaller amounts since
then, until he gets his sea legs back, and it's stayed down, the poor thing
was just so hungry after being without food for probably 15-16 hours that he
couldn't help himself ... and we all figure it can't hurt to roll the dice
and try something ASAP.

Will keep everyone posted.

Thanks again for the input.