Hi, this is my first post and I'm looking for your thoughts on what's been going on with my cat for the past 3 months. I'm pretty overwhelmed and am not sure what to do next.
My 8 year old cat Yogi (black domestic short hair) was diagnosed with presumptive IBD in October of 2018 due to a history of soft stool which he had for a while but when blood and mucus started showing up is when the vet started treatment. I should also note that he had no history of vomiting. My vet prescribed 1mg budesonide per day and he responded terrific and it resolved his issues, from that point on he had perfect stools with no blood. That is until late September of 2019, I started to notice some red blood on the outside of some of his stool about once every 2 weeks or so, his stool was still perfectly formed. After this happened a few times my vet decided to increase his budesonide dose to 1.5 mg per day giving him another half dose in the evening. After a couple of weeks on the increased dose the same thing happened again, so my vet told me to keep him on the increased dose and added tylan antibiotic. Three days into giving him tylan his perfect stools turned soft, and a few days after that he vomited some clear liquid, I discontinued the tylan. like I mentioned before vomiting was never an issue, so at this point my vet referred me to an internal medicine vet wanting to get a definitive diagnosis which to me meant checking for lymphoma. I made the appointment, the soonest the internal medicine vet could see him was 4 weeks out. A week after I made the appointment his stool returned to normal and stayed that way until the appointment but in that time he also vomited twice two weeks apart after his last meal of the day. The internal medicine vet decided to start with an abdominal ultrasound which to my surprise turned out to be completely normal, no thickening of the intestines or anything at all was off. She wrote on the discharge papers that his historical IBD was in remission and prognosis was expected to be good.
Of course 4 days later his stool became soft again and that same day he vomited his last meal of the day. I contacted the internal med vet and she said the next step in endoscopy with biopsy. Ok, I have a lot of issues with this. First and this is where I most need the communities advice, he would have to be off the budesonide for at least two weeks and she is telling me he can be weened off in two weeks! my regular vet had told me in the past it could take months to safely ween him off a steroid after him being on it for so long. I'm very concerned about the safety of weening him off that fast. Second, what do you all think of the chances of him having lymphoma after having a perfect ultrasound? I would think that something would have been off on the ultrasound. I was really hoping that this internal medicine vet was going to be the answer to my prayers on all of this but it's turned out to be very frustrating. She is very hard to communicate with, actually I can't even talk to her she just has a tech call me and answer my questions and it's always a different tech. I feel like I am dealing with a car garage and they look at my cat like he's a buick and not a living thing. My problem is deep down in my gut I don't think this is lymphoma and I feel like if I do the endoscopy and it shows nothing it becomes a slippery slope of test after test and thousands upon thousands of dollars but that is secondary to what I am putting him through. For the past 2 or 3 weeks since the ultrasound his stools are good but he has had an episode or two where part of it is soft but it clears up the next time he goes. There also hasn't been any blood in his stool for weeks.
A couple of things I should mention: right about the time this all started I had a family member in my household diagnosed with cancer and it changed out entire routine. I am very routine oriented and his routine revolves around mine, I live in one part of the house and have family that live in the other almost like separate living quarters. Well when this happened I basically started spending all of mine time in the other part of the house and brought him with me which totally blew up my and his routine. He did seem like he wasn't happy about it. I've also been extremely stressed more so than anytime in my life because of all of this and I'm sure it is affecting him but could it affect him enough to cause all of these issues? I don't know, I feel like there is a chance that my actions and behavior on top of carting the poor little guy to 7 vet visits in 3 months could causing his problems.
It doesn't help that I don't feel very comfortable with my regular vet at this point she says she can't do anything else and that is why she referred me to the internal med vet and I don't feel very comfortable with the internal med vet because it seems so hard to communicate with her and her answer to everything seems to be more tests without brainstorming what could actually be going on here, she is 100% clinical. I did go to another vet who was recommended for a second opinion before I went to the internal med vet but she didn't seem any better for a variety of reasons. So what am I supposed to do at this point?
right now I am weening the extra budesonide dose back down to the original dose. I didn't occur to me that until this past weekend that the only problem he had before increasing that dose was the intermittent blood on the outside of his stool, the occasional soft stool and vomiting showed up shortly after increasing the dose. I wouldn't think increasing the dose would cause these issues but at this point I may as well ween the extra dose back down to the original dose and see what happens, so far so good I have been giving him half of that increased dose for about 5 days now and there has been no soft stools or vomiting (knock on wood). There hasn't been any blood
So what do you all think? there are more aspects to this over the past 3 months but I wanted to cover the main issues and not get to long winded which I probably already have (sorry). I'm just exhausted and feel like a crime detective going over the same things looking for something I'm missing and feel as though I'm not getting my support from all of the vets I've taken him to. I'd like to hear from anyone with advise on everything but specifically what you all think about him having a flawless ultrasound just to have them want to do more testing that would further stress him out. I should mention that his blood work is all good and he lost a tad bit of weight at first because I started to feed him about an ounce less a day thinking it would help rest his system but I then started feeding him his regular amount and he gained most of it back. He lost less than a pound and then gained all but a couple ounces back within the two weeks I started feeding him his normal amount. I should also add that two different vets (not my normal vet or the internal med vet) that he has seen since this all started said based on examination and his physical condition they wouldn't suspect lymphoma at this point.
Thanks for any responses in advance
My 8 year old cat Yogi (black domestic short hair) was diagnosed with presumptive IBD in October of 2018 due to a history of soft stool which he had for a while but when blood and mucus started showing up is when the vet started treatment. I should also note that he had no history of vomiting. My vet prescribed 1mg budesonide per day and he responded terrific and it resolved his issues, from that point on he had perfect stools with no blood. That is until late September of 2019, I started to notice some red blood on the outside of some of his stool about once every 2 weeks or so, his stool was still perfectly formed. After this happened a few times my vet decided to increase his budesonide dose to 1.5 mg per day giving him another half dose in the evening. After a couple of weeks on the increased dose the same thing happened again, so my vet told me to keep him on the increased dose and added tylan antibiotic. Three days into giving him tylan his perfect stools turned soft, and a few days after that he vomited some clear liquid, I discontinued the tylan. like I mentioned before vomiting was never an issue, so at this point my vet referred me to an internal medicine vet wanting to get a definitive diagnosis which to me meant checking for lymphoma. I made the appointment, the soonest the internal medicine vet could see him was 4 weeks out. A week after I made the appointment his stool returned to normal and stayed that way until the appointment but in that time he also vomited twice two weeks apart after his last meal of the day. The internal medicine vet decided to start with an abdominal ultrasound which to my surprise turned out to be completely normal, no thickening of the intestines or anything at all was off. She wrote on the discharge papers that his historical IBD was in remission and prognosis was expected to be good.
Of course 4 days later his stool became soft again and that same day he vomited his last meal of the day. I contacted the internal med vet and she said the next step in endoscopy with biopsy. Ok, I have a lot of issues with this. First and this is where I most need the communities advice, he would have to be off the budesonide for at least two weeks and she is telling me he can be weened off in two weeks! my regular vet had told me in the past it could take months to safely ween him off a steroid after him being on it for so long. I'm very concerned about the safety of weening him off that fast. Second, what do you all think of the chances of him having lymphoma after having a perfect ultrasound? I would think that something would have been off on the ultrasound. I was really hoping that this internal medicine vet was going to be the answer to my prayers on all of this but it's turned out to be very frustrating. She is very hard to communicate with, actually I can't even talk to her she just has a tech call me and answer my questions and it's always a different tech. I feel like I am dealing with a car garage and they look at my cat like he's a buick and not a living thing. My problem is deep down in my gut I don't think this is lymphoma and I feel like if I do the endoscopy and it shows nothing it becomes a slippery slope of test after test and thousands upon thousands of dollars but that is secondary to what I am putting him through. For the past 2 or 3 weeks since the ultrasound his stools are good but he has had an episode or two where part of it is soft but it clears up the next time he goes. There also hasn't been any blood in his stool for weeks.
A couple of things I should mention: right about the time this all started I had a family member in my household diagnosed with cancer and it changed out entire routine. I am very routine oriented and his routine revolves around mine, I live in one part of the house and have family that live in the other almost like separate living quarters. Well when this happened I basically started spending all of mine time in the other part of the house and brought him with me which totally blew up my and his routine. He did seem like he wasn't happy about it. I've also been extremely stressed more so than anytime in my life because of all of this and I'm sure it is affecting him but could it affect him enough to cause all of these issues? I don't know, I feel like there is a chance that my actions and behavior on top of carting the poor little guy to 7 vet visits in 3 months could causing his problems.
It doesn't help that I don't feel very comfortable with my regular vet at this point she says she can't do anything else and that is why she referred me to the internal med vet and I don't feel very comfortable with the internal med vet because it seems so hard to communicate with her and her answer to everything seems to be more tests without brainstorming what could actually be going on here, she is 100% clinical. I did go to another vet who was recommended for a second opinion before I went to the internal med vet but she didn't seem any better for a variety of reasons. So what am I supposed to do at this point?
right now I am weening the extra budesonide dose back down to the original dose. I didn't occur to me that until this past weekend that the only problem he had before increasing that dose was the intermittent blood on the outside of his stool, the occasional soft stool and vomiting showed up shortly after increasing the dose. I wouldn't think increasing the dose would cause these issues but at this point I may as well ween the extra dose back down to the original dose and see what happens, so far so good I have been giving him half of that increased dose for about 5 days now and there has been no soft stools or vomiting (knock on wood). There hasn't been any blood
So what do you all think? there are more aspects to this over the past 3 months but I wanted to cover the main issues and not get to long winded which I probably already have (sorry). I'm just exhausted and feel like a crime detective going over the same things looking for something I'm missing and feel as though I'm not getting my support from all of the vets I've taken him to. I'd like to hear from anyone with advise on everything but specifically what you all think about him having a flawless ultrasound just to have them want to do more testing that would further stress him out. I should mention that his blood work is all good and he lost a tad bit of weight at first because I started to feed him about an ounce less a day thinking it would help rest his system but I then started feeding him his regular amount and he gained most of it back. He lost less than a pound and then gained all but a couple ounces back within the two weeks I started feeding him his normal amount. I should also add that two different vets (not my normal vet or the internal med vet) that he has seen since this all started said based on examination and his physical condition they wouldn't suspect lymphoma at this point.
Thanks for any responses in advance