Almost 18 Year Old Kitty With Possible Ibd/scl , Please Help :(

[kittybella]

I would really appreciate any help!!! My poor almost 18 year old kitty has a myriad of issues. She has CKD as well as hyperthyroidism. Her thyroid has been difficult to get control of, started using the gel in ears for a year or more, and then switched to pills...apparently she has trouble absorbing the gel I feel since starting the pills her health has declined and possibly some of her symptoms are from this? LONG STORY! She also started receiving Adequan shots for arthritis in her hip and rear leg/legs. I could swear she's been worse instead of better after the shots started. She's had 4 so far and I think I will discontinue. I can't find anything negative online about it in regards to cats, so maybe her issues are coincidence? On top of all this, she likely has dementia A lot, isn't it??? Ok, well this leaves me to her new situation. About a month ago or so, she started to throw up a bit, but only in the morning and then she would seem fine and eat, etc. Well at some point, she started throwing up multiple times a day but would still eat. I was having suspicions over the new Tapazole pills although her initial vomiting started after her gel prescription had gone up just prior to switching to the pills. Anyway...stared her on Pepcid, didn't seem to help and got some Cerenia and although she was eating less and seemed weaker ( which my suspicion is on pills or Adequan ) she was eating. Then she started to eat less, on top of looking 'not right' etc and she wasn't "going" although other than a recent memory of a couple of bouts with constipaiton and vomiting...she seemed to now just not be going without even trying..so maybe no urge even? She's eventually gone, and no issue was found in that area.

Well, with all of this going on, my vet wanted an ultrasound for her, which we did. This leads me to my current dilemma. The Doc who did the ultrasound came back and said she has thickening of the abdominal wall. I can't remember exactly where but apparently an endoscopy could get us a biopsy. She either has IBD or SCL. At first she told me it is a 50/50 chance for either one. At some point however, I said something to her where she admitted that she was leaning towards cancer. Mind you, she said it may also be another type of cancer and that she was only going with the most common ones first Well, we can't even do a biopsy until we have her thyroid under control and can see what her kidneys are truly up to. Ok, so let's say I manage to keep my kitty going with Cerenia, food stimulant's, etc and then I get a biopsy and we find out it's SCL. Ok, so then we do chemo, etc. My problem is....with all of her other issues, would any of it be worth it? She said the hopes would be to extend her life 6mos to a year. She also said there is no way to know how her kidneys or thyroid would even react to the chemo. So it seems there are too many unknowns.

I'm so confused. Like I mentioned , my kitty is about 18 years old. Seems like a lot to put her through. If it is cancer, and I don't have a biopsy and I put her on steroids, my regular vet said that while the steroid could help for a bit, she would have a relapse at some point and that would be a good indicator that her issue is indeed cancer. He did mention Leukaran (?). I know once we put her on steroids that she can't have the biopsy unless she was taken off for a few weeks. I guess what I'm trying to sort out is that if I decide to just help her by starting steroids ( because she does need help asap ), am I making the wrong decision? I know that chemo for a cat is not the same as it is for humans, but with all of her other issues, wouldn't it be too much for her regardless? Let's not forget the cost of it all!! Believe me when I say that I would go broke to save my kitty's life, but at the age of 18, it could end up being more stressful for her no matter what any proper diagnosis could bring. Please, am I thinking correctly here? I'm just so overwhelmed and I could use some help sorting it all out. OH, and did I mention she has a bad tooth! Oh boy, it never ends. Now having said all that you may think she's looks scary, but other than her shaved belly, she is an 11lb calico cutie. She does seem irritated over something most of the time, but that's to be expected with all of her issues as of late!! Anyway, any thoughts or ideas would be greatly greatly appreciated! Thank you for taking the time to read this!!!

I'd like to add that I don't want her to suffer and my goal is to make her feel as good as possible before I would have to let her go

 

[Furballsmom]

Gracious sakes what an armful of things for you and your furbaby.

First things first, until it's confirmed it is cancer, in my opinion everything else is worth it, because it might NOT be cancer.

we can't even do a biopsy until we have her thyroid under control and can see what her kidneys are truly up to.

Can you try making a list of priorities, ie, what's most painful, the tooth?
What, after that is most necessary - ie; eating? Then the thyroid, then the kidneys.

Then try and work out where/when do the steroids fit in, if at all vs a biopsy. What would a relapse look like?

What is perhaps not so near the top of the list, such as the Adequan?

Also, what about foods to entice her, including toppers such as bonito flakes and fortiflora, although you might want to check with your vet regarding any probiotics.

How To Get Your Cat To Start Eating Again
Inflammatory Bowel Disease In Cats
Arthritis And Joint Pain In Cats

 

[Cara80]

I'm going through the same issue. My cat is 17.5, he has CKD, hypertension and now we're dealing with thickened intestines due to IBD or lymphoma. I briefly thought about doing the biopsy and possibly chemo. I just kept thinking about whether I would want to put my senior cat through all those extra vet visits, more pills, nausea from the chemo and risk of infections all for just another 1-2 years with him.

Did your vet mention small cell lymphoma? It's a slow growing, less aggressive cancer and my vet said the steroids should help although only temporary if it is indeed cancer (3-4 months) and then symptoms would return. Right now, his appetite isn't so great so I decided to just go with the steroids and I really hope it helps.

I'm really sorry you're dealing with this too. It's so tough having such loving little creatures in our lives for so long and then dealing with illnesses that come with old age. I think no matter what you decide, there really isn't a right or wrong decision. Maybe take a few days to think everything over

 

[Furballsmom]

Just in case you-all aren't familiar, here are a couple other websites;
Tanya's Comprehensive Guide to Feline Chronic Kidney Disease - Everything You Need to Know to Help Your Cat

IBDKitties – Helping Save Lives…One Paw at a Time

feline ibd

 

[kittybella]

I'm going through the same issue. My cat is 17.5, he has CKD, hypertension and now we're dealing with thickened intestines due to IBD or lymphoma. I briefly thought about doing the biopsy and possibly chemo. I just kept thinking about whether I would want to put my senior cat through all those extra vet visits, more pills, nausea from the chemo and risk of infections all for just another 1-2 years with him.

Did your vet mention small cell lymphoma? It's a slow growing, less aggressive cancer and my vet said the steroids should help although only temporary if it is indeed cancer (3-4 months) and then symptoms would return. Right now, his appetite isn't so great so I decided to just go with the steroids and I really hope it helps.

I'm really sorry you're dealing with this too. It's so tough having such loving little creatures in our lives for so long and then dealing with illnesses that come with old age. I think no matter what you decide, there really isn't a right or wrong decision. Maybe take a few days to think everything over

Cara80, sorry to hear about your situation. It is so very frustrating and sad! I think I will go ahead as well with the steroids. It does seem like an awful lot to put such a senior kitty through. My main goal is to have her feeling good again, if only for a short time.

The doctor who performed the ultrasound did tell me that the most common type of cancer is SCL, so yes I am aware of all the possibilities. If it is not SCL but a different type of cancer , this could be a far worse situation...imagine that! There seems to be more of a chance that is cancer over IBD, but in terms of quality of life and even just time left, I'm not seeing the benefits of biopsy/chemo etc. I may just get 6 mos ASSUMING all goes well and her cancer is treatable. With steroids alone I may get a few as well. Doesn't seem right to put her through all of that at this age. Would be much easier to do steroids and hey, we may get lucky and it turns out it's IBD!

All we can do at this point is shower our fur babies with loads of love and attention and be grateful that we had them with us for this long. Good luck to you and yours. Thank you for responding.

 

[Cara80]

kittybella, I'm really hoping it's IBD for both our cats. but I did find a couple threads here where members cats had small cell lymphoma and even just treating with steroids the cats lived for another 6-7 months.

I started the steroids yesterday, so far no weird side effects and he's even eating better already. So if you definitely decide just treating with steroids, I wanted to let you know they do seem to act fast

 

[kittybella]

kittybella, I'm really hoping it's IBD for both our cats. but I did find a couple threads here where members cats had small cell lymphoma and even just treating with steroids the cats lived for another 6-7 months.

I started the steroids yesterday, so far no weird side effects and he's even eating better already. So if you definitely decide just treating with steroids, I wanted to let you know they do seem to act fast

Cara80, thank you for the update! Yes, I have decided to treat with steroids. With everything that is going on with her, I really don't have too much time to waste. We are seeing the vet tomorrow to begin treatment. She seemed a bit better yesterday afternoon until she threw up I thought I had more time before giving her another dose of Cerenia, but apparently I didn't. She pretty much went downhill after that, even on the Cerenia. Today she is out and about looking to eat, but continues to turn her nose up at everything. I am about to give her a food stimulant...but I was hoping by now she would eat on her own. Is your kitty having any bowel issues? Constipation or diarrhea? Sweetie "went" a short bit ago and I've noticed lately that it looks kinda ropey. I don't know if that means anything. I do have a bad feeling that it's cancer as I remembered why I eventually got the vet to say she was leaning that way. Apparently, it's because of how much thickness of her abdominal wall there is. She still couldn't say for sure of course, but in any case my decision has been made.

 

[Cara80]

I have felt the same way, like I didn't have time to waste either. My cat's appetite issues started 6 weeks before we were even able to get him on steroids and there were days he was obviously not feeling well because he would spend the entire day hiding under the bed covers, he would eat about 50% of what he should and then i'd syringe feed him. Waiting for biopsy and potentially other tests wouldn't have been a good idea. I really wished my vet told me right away why the ultrasound was important and that she suspected a GI issue.

I haven't noticed any issues with his bowel movements, they look healthy but he does spend more time in the litterbox, I assume the inflammation is putting pressure on his bowels making him think he has to go when he doesn't.

I really do believe my cat has cancer, the hiding under covers some days and not wanting to eat much I think are signs. Seems like IBD more or less is a reaction to food that includes vomiting and potentially diarrhea, Buddy doesn't have that.

This is all too much, I keep thinking how long can I keep a cat with me if he doesn't want to eat much? The steroids seem to help, but he's still not eating enough. Yesterday Buddy ate 3oz of wet food, 1/4 cup of dry and a slice of turkey lunch meat. I hate watching my poor cat go through all of this. If he doesn't continue to improve with the prednisolone, I feel as though we'll have to make a decision to help him cross over. I really hate to think about it though because he still has some really good days and is pretty active

please keep me updated on your kitty

 

[kittybella]

I have felt the same way, like I didn't have time to waste either. My cat's appetite issues started 6 weeks before we were even able to get him on steroids and there were days he was obviously not feeling well because he would spend the entire day hiding under the bed covers, he would eat about 50% of what he should and then i'd syringe feed him. Waiting for biopsy and potentially other tests wouldn't have been a good idea. I really wished my vet told me right away why the ultrasound was important and that she suspected a GI issue.

I haven't noticed any issues with his bowel movements, they look healthy but he does spend more time in the litterbox, I assume the inflammation is putting pressure on his bowels making him think he has to go when he doesn't.

I really do believe my cat has cancer, the hiding under covers some days and not wanting to eat much I think are signs. Seems like IBD more or less is a reaction to food that includes vomiting and potentially diarrhea, Buddy doesn't have that.

This is all too much, I keep thinking how long can I keep a cat with me if he doesn't want to eat much? The steroids seem to help, but he's still not eating enough. Yesterday Buddy ate 3oz of wet food, 1/4 cup of dry and a slice of turkey lunch meat. I hate watching my poor cat go through all of this. If he doesn't continue to improve with the prednisolone, I feel as though we'll have to make a decision to help him cross over. I really hate to think about it though because he still has some really good days and is pretty active

please keep me updated on your kitty

It is a lot to deal with, for sure! I just started the prednisolone today. I asked for it in pill form because Sweetie gets way too stressed when anything is squirted into her mouth, and besides that she is a pro at turning her head so as part of the liquid usually escapes onto me!!! Is your kitty on Cerenia? How about any vitamin B shots? Sweetie got one yesterday and it seemed to perk her up a bit. Not sure if we need to continue with that or what. My vet did mention that it can still take a week or two to see the appetite return to normal with the steroids, so maybe that's what is going on with your kitty? I'm so anxious to see if any of this helps. Sweetie also goes in the pan and does nothing. I agree it is just a sensation to go, rather than having to go. I really hope things turn around for our kitties. I'm in no rush to make any "decisions". Trying to focus on the long ( hopefully great ) life she's had and the fact that she made it this far is a great thing in and of itself. Also, has your vet mentioned Luekaran to you? They usually try that down the road at some point if your kitty stops responding to the steroids. Doesn't seem like I need a biopsy for my vet to use it as I asked him about it and he said we'll discuss that when or if it's necessary. It's way to early to start talking about that with all of her other issues at play. One step at a time, you know. It's so stressful though!! GRRRR!!! I'll keep you posted, please do the same.

OH, I forgot to mention...are you using an food stimulants? There is a new one making the rounds called Entyce. Right now, only my local Animal Hospital has it, but it works well. I will say that there seems to be a window of time shortly after giving it, where she will pretty much go to town with her food. When I have given it to her, she will eat about 2 1/2 small cans of food in a short amount of time. Maybe it's worth asking about?

I haven't been giving it to her on a regular basis yet as I've been waiting to see if her appetite would come back on its own. Since it hasn't, I'll probably give it to her for now on a regular basis..at least for a few days or so and then hope that the steroids kick in. This really all came to a head when I originally posted. Still too many watch and wait things as you know.

 

[Cara80]

You're right, I feel so guilty even thinking about making the decision to let my cat go. I should at least give him more time on the steroids and keep in touch with my vet. The spending so much time under bed covers is really concerning, but I guess he could just be tired or some days not feel well. I really just do not want him to ever suffer or feel any pain.

My cat is on cerenia, but what I find odd is that when I ask for a refill from my vet she only will give 8 doses at a time. I haven't been offered b-12 or talked about leukaren. I've decided to just buy some b12 to add to his food, although I know it's not as effective as the shots, at least it's something. I have mirtazapine, but my cat gets hyper on it and I worry about that since he already has high blood pressure, which he's on medication for. If Buddy's appetite isn't improving much, i'll ask about entyce or another appetite stimulant. Right now he's getting 200 calories a day and he's 10lbs, so not horrible but would like to see him eat a little more.

What food do you feed your cat? Also, do you use a phosphorous binder?

 

[Cara80]

oh, just thought of another question. is your kitty on a tapered dose of steroids? My cat is on prednisolone 0.4ml 2x a day for a week, then 0.4ml daily the 2nd week and then will get the steroid every other day

 

[kittybella]

oh, just thought of another question. is your kitty on a tapered dose of steroids? My cat is on prednisolone 0.4ml 2x a day for a week, then 0.4ml daily the 2nd week and then will get the steroid every other day

Sorry for not getting back to you sooner! It's been a busy weekend. Unfortunately, Sweetie's appetite hasn't improved on her own and even with the Entyce she is eating less Entyce definitely has a certain amount of time where the hunger kicks in, but it doesn't seem to build up with daily use...at least not in my kitty. I may ask about Mirtazapine, although I'm nervous about trying it on her due to side effects She isn't improving or getting too much worse, it's like she's just in limbo and nothing is having any effect on her. I don't think the Cerenia makes her feel necessarily better either. She hasn't been on her thyroid meds in over a week and we know her thyroid is high, but that isn't even enough to get her appetite going ( hyperthyroid kitties tend to eat a lot ). We were hoping her appetite would be back by today so I could resume her thyroid treatment, but now I'll have to contact my vet and ask about it. Obviously, we can't leave her thyroid unchecked. Too many issues!!

I asked for the steroid in pill form because it's easier to administer to her, and was given 5mg of Prednisilone to be HALVED and given ONCE daily for now and then eventually tapering off with signs of improvement. So far no improvement. She was puking yesterday from trying to "go" uneventfully. Today she is not trying, and I'm wondering if it was just a sensation or what?

What has your vet said about kitty not eating enough? I so worry about Hepatic Lipidosis I just don't know what to do at this point. I want to give her a fighting chance, but it's hard to see her not be herself for this long. How is your baby doing? Any improvement yet???

 

[LTS3]

You might want to give the liver shake a try: "liver Shake" Recipe For Inappetant Cats

Ask your vet before trying it.

Cerenia should be given on an empty stomach. Maybe give that a try to see if it works any better? Are you using Pill Pockets or other pill dough to make sure the pils are getting into the cat and not spit out under the bed or something?

Cyproheptadine is another appetite stimulant you can try. It doesn't have the side effects of mirtazapine.

 

[Cara80]

I was hoping your kitty's appetite improved over the last few days. 2.5mg prednisolone, could that be too low of a starting dose? Buddy's bottle lists a 1ml dose as 5 mg. Last week he was getting .4ml 2d daily so that comes out to 4mg per day for a week and he's how on 2mg daily.

Seems like the steroids eventually started to kick in, somehow yesterday has been his best day so far despite being the 1st day on the 2mg dose and he ate around 250 calories.

Could you try miralax mixed in your cat's food? And then maybe ask for a different anti nausea med and appetite stimulant? my bottle of cerenia lists decreased appetite as a possible side effect, i've read some cats do better on odansteran(zofran?)

 

[1 bruce 1]

C Cara80 , K kittybella we're kind of in the same boat. Our cat has had chronic IBD symptoms and it was never biopsied to be sure but he did well for a few years on a diet change and frequent meals. Last fall he developed asthma and the IBD symptoms worsened, prednisolone has helped give him a better quality of life.
I feel for you both!! I hope for some good updates soon.

 

[kittybella]

Unfortunately, my kitty is still not doing so great We upped her steroid dose to 5mg 1x a day. Maybe it will start to kick in? I don't know Wonder how high we can go...what if it's just not the right dosage? Also, I wonder about starting Luekaran? Where does that fit in? Is the point moot since the steroids haven't helped her at all yet? Ugh. Maybe I should start a new thread asking about prednisilone dosage, etc?

She still needs Cerenia, along with an appetite stimulant on a regular basis. The problem is that she just doesn't look like she feels good. If she would at least perk up more, then all the meds would make sense. My vet is discouraged, but still lets me believe there is hope. We will see how she is by next Wed. I really pray things turn around for her. C Cara80 , how is your baby doing? 1 bruce 1 , I'm glad your kitty is hanging in there!

C Cara80 , I was able to give her Mirilax yesterday and today...hope it kicks in. She was just so sick Wed night from trying to "go" . She threw up all the food she had eaten and she was walking around with drool around her mouth, just feeling awful She never really got much out and hasn't tried to "go" since. I really hope the Mirilax will help soon as I do not see myself being able to give her Lactulose any time soon It's just too much goopy syrup and she already has meltdowns and starts drooling and freaking out just from knowing she's about to get something squirted into her mouth

 

[1 bruce 1]

Unfortunately, my kitty is still not doing so great We upped her steroid dose to 5mg 1x a day. Maybe it will start to kick in? I don't know Wonder how high we can go...what if it's just not the right dosage? Also, I wonder about starting Luekaran? Where does that fit in? Is the point moot since the steroids haven't helped her at all yet? Ugh. Maybe I should start a new thread asking about prednisilone dosage, etc?

She still needs Cerenia, along with an appetite stimulant on a regular basis. The problem is that she just doesn't look like she feels good. If she would at least perk up more, then all the meds would make sense. My vet is discouraged, but still lets me believe there is hope. We will see how she is by next Wed. I really pray things turn around for her. C Cara80 , how is your baby doing? 1 bruce 1 , I'm glad your kitty is hanging in there!

C Cara80 , I was able to give her Mirilax yesterday and today...hope it kicks in. She was just so sick Wed night from trying to "go" . She threw up all the food she had eaten and she was walking around with drool around her mouth, just feeling awful She never really got much out and hasn't tried to "go" since. I really hope the Mirilax will help soon as I do not see myself being able to give her Lactulose any time soon It's just too much goopy syrup and she already has meltdowns and starts drooling and freaking out just from knowing she's about to get something squirted into her mouth

Sending lots of support.
Our guy has been on varying doses of prednisolone for months. I hate it, but I hate what happens if the dose is too low more.
When he was constipated enough that he just "quit trying", he went 48-72 hours or so without attempting a BM then it happened. It was runny, it was HUGE...and hoo boy, it stank!!!!!!!!!!
Miralax is gentle, and gentle sometimes is slow acting. Just don't be tempted to with hold food, just offer a little as she'll eat and as often as you can (2-3 hours isn't a stretch) to keep things working right.
Our guy took pred in food for quite sometime. But he stopped doing so, and ate half or a bit more/less of his food and knowing what dose he got was impossible so we started syringing. We do this first thing in the morning to get it out of the way.
Our vet recommended a wonderful pharmacy that is happy to compound these meds for pets in flavors. He still doesn't "love" it, but it seems to be taken much better by mouth.
The only downside is a 2 week supply is about $35USD

 

[Cara80]

kittybella, I was hoping your kitty was feeling better I don't know much about steroid doses, since this is the first time I've had a cat that needed them.

Buddy is 10lbs and started at 4mg prednisolone per day and is now on 2 mg. I did some reading, and it does look like some cats with IBD do need a much higher dose at first before tapering over a very long period.

One thought I had is maybe taking her off thyroid medicine is making her feel ill? I have hashimotos (an autoimmue thyroid issue) and when i'm hyperthyroid, I feel sick to my stomach and don't want to eat as much.

I think starting another post on steroid dosage is a good idea. I'm betting the 2.5mg dose for the first week was just too low. Seems like a large enough amount of members here have experience with steroids and can help out

 

[kittybella]

C Cara80 , how are things going with your kitty?

Sweetie has been doing better since I upped her steroids to 5mg a day. Luckily, I haven't had to give her a food stimulant either! She will at least eat one small can a day, sometimes about 2. Her poop is softer now with the Mirilax as well. The one thing that doesn't want to go away is the vomiting If I give her Cerenia she won't vomit, but I was hoping the steroids would help in that area. I will say that she only threw up a little amount yesterday morning sans Cerenia, and this morning, she meowed as if she was going to throw up, but never actually did. Maybe that is a good sign? I'm holding off giving her the Cerenia just to see what happens. For all I know, it is contributing to her puking! I have noticed though that she seems to eat less on days the Cerenia is not given. I'm only letting a few days go by to see how she does, but of course I will continue with it as needed. I understand that even if she doesn't puke, she may feel nauseas.

As far as her behavior goes, I'm on the fence. She does come out more ( when she's not worried I'm going to pill her ), but I can't say she looks particularly happy. She does get interested in catnip and will purr from time to time, but I just don't know how she's really feeling. Do I want her to feel blah everyday, all day? I'm hoping things will become clearer to me soon.

 

[Cara80]

Sounds like some good news, since she's eating better. my cats behavior was off the first week or so on prednisolone, he was either pacing and chugging water or hiding under blankets and not wanting to be pet. I'm not sure, but sounds like the steroids might affect their mood until they adjust.

Hang in there, maybe you just need some medication adjustments to get your kitty feeling better. She could need a higher dose of cerenia (1mg per pound is the new recommendation even though many vets still prescribe the 1/4 pill) or you could try zofran.

Buddy is doing ok, he's not 100% better. He eats well, is doing ok in the litterbox, and he seems happy, enjoys time on the porch and likes to snuggle. But he does tend to need time alone in a room by himself sleeping, which is something he's never done before. When he first got sick in late March, there were days he'd spend 90% of the time alone under blankets and now it's maybe 1-2 hours a day.

I do wonder if our cats are going to take a while to heal, because i'm sure inflamed intestines affect food absorption so they may have been a bit malnourished for some time.