15 year old cat recently sick - vet says may have irritable bowel disease or lymphoma?

AilenAshFarm

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Sorry in advance for the long post, I wanted to give as much detail as possible but you can skip to the bottom for a facts only breakdown. Can you tell I'm stressed about this? :p

To start, it's just my boyfriend and I living with our cat, Lolly. We don't have children or other pets. Lolly has always been a puker, a couple times a month or week was pretty normal. In the middle of September, we had some family visit for nine days. At the end of their visit, my cat started throwing up more frequently than normal(started on about 9/21). I thought it was because I let her eat some cat grass and shrugged it off, but it continued for a few days even after I took the grass away. I didn’t change her diet and I didn’t notice her eat anything else unusual. We spent most of their visit at our house and when I’m here, the cat is almost always near or on me.

I haven’t brought any new chemicals into the house (unless my family had something on their luggage we didn’t know/think about) and don’t really use a lot of chemicals in general. The vast majority of my cleaning and hygiene products are natural because I have sensitive skin, except for a few but they aren’t commonly used.

She has always been a clean cat, "good" at using the litter box and her box never smelled strong. After a few days of frequent vomiting, I noticed her potty habits were a little odd. She was taking a lot longer in the box, it smelled strong and then one day, she jumped out of the box, ran over to her scratcher, rolled/fell off of it on to her butt in a way that I thought she was having a seizure at first. Thankfully she did not. Instead, it turned out she was trying to violently scoot her butt on the carpet! When I lifted her tail to find out what was wrong, I noticed a little bit of blood on her..for lack of a better description... Anus... I was horrified for her!

The next morning we went to the vet (on 9/25). We live in a small town and with how things are because of COVID, it makes vet care tough to come by here. My cat has had a traumatic past, so getting her in a carrier and taking her somewhere is a challenge and really rough on her. We waited at the vet for a few hours. They took X-rays and blood work, gave her some fluids an antidiuretic under the skin, and sent me home with some medication. They said the X-rays were normal. We gave her the nausea pill, probiotic and antiulcer medication for a few days. The nausea pill helped, but she hated it. The antiulcer medication just made her throw up immediately and the probiotic didn’t seem to do anything, or if it did, I couldn’t tell.

Then I talked to the vet again, they said I can stop the ulcer medication (yay!) and told me her bloodwork came back “unremarkable”. They suspect that she may have irritable bowel disease or lymphoma but are not sure on what it is yet. They had me pick up some steroids to help with inflammation.

She has been taking the steroids for about a week now and is almost done with them but they seem to make her worse! Since starting them, her potty issues have gotten worse (now completely liquid diarrhea that looks orange/light brown), she has almost entirely lost interest in food (I have to cycle through many options just to get her to eat a little), has lost what is a considerable amount of weight (for her, she's pretty tiny to begin with), and is even more lethargic than she was at the start of this. To top it off she is vomiting just as much if not more! I heard from the vet this evening and they asked me to bring her back in for a B12 shot and some more fluids tomorrow morning but I still feel helpless! She is indoor only (I do take her out on the patio sometimes when I can watch her closely but not since she has been sick) and is 15 years old. While she loves people, she HATES other animals so she isn't around any other animals. I have had her almost all of her life except for four years when she lived with my grandparents (this is where the rough past part comes in, but thankfully, that was years ago and is treated like a princess now).

Wondering if anyone else has had this happen with their little kitty? Any ideas on how to help? Am I just stressing myself out or is this as serious as it feels to me? Thanks for reading!

Quick facts only breakdown of the issue:

Vomiting
  • About 3 - 6 times per day on average. She had a couple days where she only puked once or twice and a couple where she threw up more than 6 times. It seems to just depend on the day
  • Throwing up partially digested food or white foamy spit/stomach acid
  • Drools a lot before vomiting (not a normal thing for her)
  • When she is not sick and throws up, it is usually hairballs or completely undigested food like she ate too fast or too much, very different than it is now
Diarrhea/blood:
  • Started out as solid but soft (like peanut butter 🤢), after taking the steroids it on has become a liquid
  • Is an unusual orange color. May be blood, may be from diet change since getting sick, or from the medication?
  • Scooting after going potty each time
  • Seems to be in pain when going potty and has small amounts of blood on anus after (blood may be from going potty or from scooting, I’m not sure what’s causing it).
Appetite:
  • Little to no interest in food
  • Won't eat for a day or two, then eats very little
  • Seems/acts hungry even though she won’t eat
  • I hardly see her drinking water recently but I can get her to drink tuna water sometimes
Mood:
  • Lethargic
  • Sleeps more than normal
  • Grumpy (she growled at me for the first time ever when I had to move her today. She is usually a very happy loving energetic cat)
  • Weird/loud sounds coming from tummy
  • Uninterested when I talk to her (normally she loves to be talked to and sometimes even talks back!)
Environment:
  • No new chemicals
  • Didn't see her eat anything weird/bad
  • No change in pet food until she got sick, now I'll feed her anything(safe) that she will actually eat
  • Has easy access to fresh clean filtered water
  • Indoor only
  • Not around other pets/animals
  • Not around kids
  • Had family visiting when she got sick no other stressors
  • Didn't seem to get to/eat any plants besides cat grass from the store
Vet visit:
  • Xrays were normal
  • Bloodwork was normal
  • Looked visually fine
  • Some weight loss (down to 6.5 lbs from 7.8 may be less now)
Medication:
  • “Pro-Pectalin Anti-Diarrhea Oral Gel”
    • 1cc a day
  • “Ondansetron” (nausea pill)
    • ½ pill 2-3 times a day (only lasted a few days)
  • “Sucralfate Suspension” (used to treat ulcers. It is also used to prevent drug-induced ulcers of the stomach. Only gave this for two days)
  • “Prednisolone” (Steroid)
    • 0.5 ml 2 times a day for 3 days then 0.5 ml once a day for 7 days then 0.5 ml every other day till gone

      Little miss Lolly-Pop:
      20200529_193250.jpg
 

MissClouseau

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Hi there :) Lolly is a cutie. Lovely name too!

I read the whole post. First things first. Her current appetite and seemingly lack of enough hydration is the most troubling thing right now and needs urgent care. Cats can develop fatty liver disease fast from not eating (enough) and that can get fatal. What is the probiotic vet prescribed? It's expensive but Fortiflora is both a probiotic and an appetite enchancer. If possible, I would get that to at least maybe encourage her eat one meal. I mean she needs to eat more, just to say for one of the meals Fortiflora might help. Giving her age, I actually generally recommend giving her probiotics to support the immune system and a supplement with B12. (Your vet can suggest a product.)

What are you trying to feed her with? Lolly always puking frequently sounds like she was having a digestive problem. Cats puking is common, but not normal and is an indication of a problem. Maybe she is intolerant to something in her food(s). Maybe it wasn't food intolerance but she was eating too fast. Maybe it was the portions were too big - small meals throughout the day is easier on their digestion. Frequent puking alone might cause other health problems. At her age it's common to have a digestive issue(s) no matter what anyway, just like humans do too. I say this also because a lot of times there is more than one thing going on and one triggers the other, or just make the treatment get more difficult.

Did they check for worms? I understand she only goes out to the patio but even indoor-only cats might get worms. The timing makes me suspect extra as they are more likely to come across to a flea or other things that might spread worms in the summer.

I don't have experience with "is it IBD or lymphoma?" situation. My understanding is their symptoms are alike early on and further tests needed to check lymphoma. I'm not sure if the bloodwork could be all clear if it was lymphoma though. If I were you I would take the copy of the bloodwork and all the tests done, and get a second opinion from another vet.
 

LTS3

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There's info on IBD here: IBDKitties – Helping Save Lives…One Paw at a Time There's one section specifically titled "IBD or Cancer?".

Another good web site is Feline IBD

A blandish diet with few fillers is often helpful. Look for limited ingredient foods. You don't need prescription food. Here are some brands:

BLUE Basics® Limited Ingredient Cat Food | Blue Buffalo
Limited Ingredient Diet - Grain Free Cat | Merrick Pet Care
Cat Food - Limited Ingredient Diet - Kohapet
Instinct Limited Ingredient Diet | Instinct Pet Food
RAWZ | 100% Rendered Free Cat Food
Grain Free Wet Recipes - NutriSource Pet Foods (not exactly an LID food but some of the canned are novel protein)

Canned is preferred over dry. A raw or home cooked diet are also options to look into.

Chicken is a common cause of tummy issues and IBD cats seem to be especially sensitive to it. Chicken is in a lot of foods even if it's not the main ingredient or hidden under a vague "by product" name. Read labels carefully.

How often do you give meals? Sometimes cats throw up if their tummies are empty for too long.
 

JC fka JClark

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From my own anecdotal experience with a senior IBS/IBD cat and from what I've read cats do not occasionally vomit food unless they've eaten too much. Even hairballs should be rare. So it's possible that the cat was having a problem for a while.

From your post aside from the ulcer* medication your vet seems to be following the typical protocol with B12, steroids, probiotics, etc. The steroids should encourage the cat to eat and reduce inflammation as well. The B12 shot is normal in this case. There are appetite stimulants for cats such as Mirtazapine.

Have you switched the cat to a hydrolyzed protein diet or low carb cat food with a protein your cat has never had (ex, Rabbit, Lamb)? That could help a lot for IBD.

As far as IBD vs Lymphoma. Only a biopsy OR ultrasound can tell you that. The typical progression for this kind of thing. IBS (stress related like a new person OR pet in the house), IBD (autoimmune response to certain animal protein), Lymphoma.


Keep up with the probiotics. It'll help with the change in food.

Oh and last thing. At 15 yrs old the cat is a "super-senior". Quality of life is even more important. My IBD Maine Coon dealt with the condition for about 2 years before he told me enough was enough at age 16.

*Metronidazole the antibiotic is typically given to help heal the gut but perhaps your vet prescribed the ulcer meds because the blood was a darker red.
 
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daftcat75

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Liquid stools and significant weight loss was a hallmark of my Krista's lymphoma. Her stools did not resolve with pred until she also began chemotherapy.

I recommend an ultrasound to confirm "suspected IBD or lymphoma." However, given her appetite issues, I do not recommend a surgical biopsy to tell the difference between the two. I do strongly recommend an internal medicine specialist if that's something that's available to you. If you're not in a location that has one, perhaps you can contact the nearest veterinary school or hospital and see if they can find one for you who can do a remote consultation with a records transfer from your current vet. The ultrasound should be able to tell the difference between IBD/lymphoma and an intestinal mass. Based on that, your specialist could recommend a chemotherapy to try. Chemotherapy in cats is not nearly so miserable as it is in people. Most cats experience few, if any side effects.

I also recommend an appetite stimulant right now. Cats that are fasting or not eating well will continue to do so until some intervention corrects this. Since it's not likely you're going to identify the root cause in the next few days, it is critical that you get her back to eating until you do.

Finally, diet is very important for managing IBD/lymphoma. Whatever proteins she's currently eating, cross those off as "no good" now. Theoretically, a hydrolyzed diet would be best. But they aren't very popular with cats. Your next best bet is a novel protein. It doesn't have to be novel to all cats. Just your cat. Sometimes turkey is novel enough for a cat that's had chicken all her life. But you have to be diligent about not including chicken ingredients. A lot of guardians with IBD kitties resort to homemade (raw or cooked) as they can control the ingredients. Another great food for IBD kitties is the Rawz brand. It's more expensive. But they don't include irritating gums or filler ingredients and they don't mix proteins. Their turkey flavor does not have chicken ingredients. Their rabbit is only rabbit.

Where to Buy | RAWZ

Speaking of that, rabbit is often popular as a novel protein. Krista was stable on rabbit for the last year of her life. The only reason we didn't achieve a remission sooner is that I was giving her pred as pill halves wrapped in inflammatory fish flakes. I didn't know the flakes were inflammatory until I had to shift her to transdermal and we finally achieved remission. But by then, she was too tiny and weak from the weight loss that a bladder infection proved too much for her. But we got two mostly good years since IBD diagnosis. And I think if we started with specialist earlier, well, speculation doesn't change anything now. The point of bringing this up though: You'll need to be diligent even with her treats now that she doesn't get one of the "no good" proteins anymore. Krista loved these as treats when I couldn't give her fish flakes anymore: Feline Natural Booster Lamb Green Tripe Freeze-Dried Cat Food Topper, 2-oz bag - Chewy.com
 
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