Emergency

A client showed up yesterday morning with her "crashing" six year-old cat. The cat was vocalizing, in severe pain, was markedly hypotensive (low blood pressure), and had pale gums. The elderly owner lives in an apartment, where there was no possibility of having been exposed to toxins, including rat poison, and no toxic plants which the cat could have ingested. She reported that the cat had vomited a few times the day before and that the vomitus contained blood and blood clots.
The cat was evidently in shock. We treated the cat for shock, provided judicious but important pain control for this poor, painful, kitty, and ran a whole slew of tests and x-rays. Nothing, Virtually nothing. The cat didn't have pancreatitis, which was my top differential. The cat passed away peacefully (she was nicely sedated with opiates) last night, which her owner knew was likely.
The owner declined to have a necropsy performed therefore I can only speculate as to the cause of the cat's death.
Obstruction? Intoxication? Intussusception?
I think it was the latter... but I'll never know.
I was not devastated with the outcome, considering the state the cat was in when she presented. Sad, yes, but not disappointed with our efforts.
I wish my condolences to her owner.

This is what I think happened to the poor kitty.