Biopsy/endoscopy

maggie101

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I took Maggie to the vet today. He suggests a biopsy to see what's causing her diarrhea,appetite loss, throws up bile,and weight loss then fine and starts again. He said it will cost thousands of dollars. Is a biopsy safe?
 

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I had an endoscopy/biopsy done on one of mine about 8 years ago. I was a nervous wreck, but he did great!
I would recommend doing pre-op blood work to make sure things inside are in working order, and make sure to ask the vet about how long to withhold water and food beforehand. I don't remember my total bill, but "thousands" seems high, yet, inflation... :(
Unfortunately, all the vet found was "inflammation." From the amount of vomit I was cleaning up, I could have told them that! But it ruled out scarier things, which was a relief.
 

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A biopsy is invasive surgery and will require recovery time afterward. An endoscopy is less invasive, as it is running a flexible scope into the esophagus, stomach, and sometimes beyond. Doesn't always provide a definitive diagnosis, or at least less likely to than a biopsy. Both require anesthesia.

The biopsy, depending on what is done, can be as high as $5K, particularly if exploratory surgery is needed. The latter can run anywhere from $800 to $2K. These are just generalized estimations.

Get your vet/specialist to give you an itemized estimate of the costs so you can see what all is entailed.
 
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maggie101

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A biopsy is invasive surgery and will require recovery time afterward. An endoscopy is less invasive, as it is running a flexible scope into the esophagus, stomach, and sometimes beyond. Doesn't always provide a definitive diagnosis, or at least less likely to than a biopsy. Both require anesthesia.

The biopsy, depending on what is done, can be as high as $5K, particularly if exploratory surgery is needed. The latter can run anywhere from $800 to $2K. These are just generalized estimations.

Get your vet/specialist to give you an itemized estimate of the costs so you can see what all is entailed.
Thanks! That helps alot
 
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maggie101

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A biopsy is invasive surgery and will require recovery time afterward. An endoscopy is less invasive, as it is running a flexible scope into the esophagus, stomach, and sometimes beyond. Doesn't always provide a definitive diagnosis, or at least less likely to than a biopsy. Both require anesthesia.

The biopsy, depending on what is done, can be as high as $5K, particularly if exploratory surgery is needed. The latter can run anywhere from $800 to $2K. These are just generalized estimations.

Get your vet/specialist to give you an itemized estimate of the costs so you can see what all is entailed.
For now she's on purina en and likes it if the can is just opened. How long can I leave it on the counter with a cover? I do not want to take her off prescription if it helps stop her from having diaheria,etc and sees the specialist.
 

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For now she's on purina en and likes it if the can is just opened. How long can I leave it on the counter with a cover? I do not want to take her off prescription if it helps stop her from having diaheria,etc and sees the specialist.
You mean leave it out of the fridge with a cover because she doesn't like it cold or warmed up? I may be on the lenient side of this, perhaps because Feeby has a pretty good digestive 'constitution' (so far, knock on wood), but I personally feel 8 hours from time of opening the can is 'safe'. I do think keeping it covered helps out with it lasting longer.
 
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maggie101

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You mean leave it out of the fridge with a cover because she doesn't like it cold or warmed up? I may be on the lenient side of this, perhaps because Feeby has a pretty good digestive 'constitution' (so far, knock on wood), but I personally feel 8 hours from time of opening the can is 'safe'. I do think keeping it covered helps out with it lasting longer.
I feed her 8am,4pm,and 10. Her last meal is in my bedroom so I assume she will eventually eat it. I plan on trying to put a cup with water In the microwave,empty,put food in then add to bowl if it's refrigerated. Hope that worrks!
 
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maggie101

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You mean leave it out of the fridge with a cover because she doesn't like it cold or warmed up? I may be on the lenient side of this, perhaps because Feeby has a pretty good digestive 'constitution' (so far, knock on wood), but I personally feel 8 hours from time of opening the can is 'safe'. I do think keeping it covered helps out with it lasting longer.
I am going to try blue buffalo vetenary gi gastrointestinal for a change. It has more fat,fiber,calories,protein, and less carbs. Hope my vet agrees. He is unsure what's going on. So how can he be sure what food to feed? He seems to be very cautious,not make things worse
 
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For now she's on purina en and likes it if the can is just opened. How long can I leave it on the counter with a cover? I do not want to take her off prescription if it helps stop her from having diaheria,etc and sees the specialist.
I use washed out gelato containers with their screw lids to keep a can of food outside the fridge because Betty doesn't like warmed up leftovers either--and I don't like leaving a can of food sitting in its can. Also, those 3 oz cans her I/D stew comes in seem to be a tough find for a lid that fits. Let me think here. I think the longest I leave a can out of the fridge is the six-ish hours from when I open breakfast can at 5:30ish to when I serve lunch near noon. She always makes lunch disappear eventually--add another two or three hours from plating to when clean plate--and doesn't seem to have an issue with this.

I'm concerned your vet is skipping a step. I know ultrasounds are usually vague and inconclusive. But they can confirm the presence of inflammation, they can tell you where it is which in turn would tell you whether an endoscope could even reach that far, and an ultrasound can rule in or rule out scarier stuff like masses/tumors and other organ involvement. If the inflammation is beyond the reach of the endoscope, then you have no choice but a surgical biopsy. Maybe the specialist already suspects this, and is already planning on an ultrasound-guided surgical biopsy aka he'll do the ultrasound and the surgery at the same time. If your cat is otherwise stable besides the diarrhea, I would expect her to come through the surgery rather well. It may take a week or two and you may need to feed her a recovery food like A/D to keep her eating through her recovery--and I would recommend only mixing A/D with something else since it's rather rich unless the A/D is all she wants to eat. If she's not stable, if she has vomiting, nausea, appetite issues, if she's losing weight, these are all good reasons to have second thoughts about a surgery that's going to come with some recovery time.
 
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maggie101

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I use washed out gelato containers with their screw lids to keep a can of food outside the fridge because Betty doesn't like warmed up leftovers either--and I don't like leaving a can of food sitting in its can. Also, those 3 oz cans her I/D stew comes in seem to be a tough find for a lid that fits. Let me think here. I think the longest I leave a can out of the fridge is the six-ish hours from when I open breakfast can at 5:30ish to when I serve lunch near noon. She always makes lunch disappear eventually--add another two or three hours from plating to when clean plate--and doesn't seem to have an issue with this.

I'm concerned your vet is skipping a step. I know ultrasounds are usually vague and inconclusive. But they can confirm the presence of inflammation, they can tell you where it is which in turn would tell you whether an endoscope could even reach that far, and an ultrasound can rule in or rule out scarier stuff like masses/tumors and other organ involvement. If the inflammation is beyond the reach of the endoscope, then you have no choice but a surgical biopsy. Maybe the specialist already suspects this, and is already planning on an ultrasound-guided surgical biopsy aka he'll do the ultrasound and the surgery at the same time. If your cat is otherwise stable besides the diarrhea, I would expect her to come through the surgery rather well. It may take a week or two and you may need to feed her a recovery food like A/D to keep her eating through her recovery--and I would recommend only mixing A/D with something else since it's rather rich unless the A/D is all she wants to eat. If she's not stable, if she has vomiting, nausea, appetite issues, if she's losing weight, these are all good reasons to have second thoughts about a surgery that's going to come with some recovery time.
She has had an ultrasound that showed some thickening and a radiograph that showed possible pancreatitis and ibd. That was months ago so he might do it again. I still have some a/d I used when she had struitive crystal's
 

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She has had an ultrasound that showed some thickening and a radiograph that showed possible pancreatitis and ibd. That was months ago so he might do it again. I still have some a/d I used when she had struitive crystal's
Alright. So the vet knows where the inflammation is. Did he tell you whether he believes an endoscopic biopsy is an option or does he want to perform a surgical biopsy? Possible pancreatitis could make her recovery from a surgical biopsy possibly that much harder. My preference would be for an endoscopic biopsy, if that's an option given where the inflammation is observed. If an endoscope won't reach, you could discuss treating this empirically if you're concerned about the surgery and recovery. That would be having a discussion with your vet basically saying, "Let's try IBD treatment first. But please consider adding chemo to her treatment if the steroids don't work. I understand that we're going to treat it like cancer without a diagnosis." Because, depending on whether she is stable enough for a surgery and its recovery or not, the drug may be less risk than the diagnosis.

Oh duh! You mention endoscopy in the thread title. 🤦‍♂️ I'm just going to leave all the surgical stuff there for future reference. An endoscopic biopsy should be minimally invasive and low risk even if she's not particularly stable. There isn't a recovery period to get her through like a surgery. She may be off for a day or two just from the anesthesia. That's when you can mix some A/D into her regular food or offer it on its own just to keep her going until it's passed.
 
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maggie101

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Alright. So the vet knows where the inflammation is. Did he tell you whether he believes an endoscopic biopsy is an option or does he want to perform a surgical biopsy? Possible pancreatitis could make her recovery from a surgical biopsy possibly that much harder. My preference would be for an endoscopic biopsy, if that's an option given where the inflammation is observed. If an endoscope won't reach, you could discuss treating this empirically if you're concerned about the surgery and recovery. That would be having a discussion with your vet basically saying, "Let's try IBD treatment first. But please consider adding chemo to her treatment if the steroids don't work. I understand that we're going to treat it like cancer without a diagnosis." Because, depending on whether she is stable enough for a surgery and its recovery or not, the drug may be less risk than the diagnosis.

Oh duh! You mention endoscopy in the thread title. 🤦‍♂️ I'm just going to leave all the surgical stuff there for future reference. An endoscopic biopsy should be minimally invasive and low risk even if she's not particularly stable. There isn't a recovery period to get her through like a surgery. She may be off for a day or two just from the anesthesia. That's when you can mix some A/D into her regular food or offer it on its own just to keep her going until it's passed.
Thanks! I have thought duh! Many times. My vet suggested endoscopy where they simply put something down her throat I think. He is a googler and has a cat!
 

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I have had 2 cats, which have endoscopies. I Kind of well understand IBD..
You can go ahead and have an ultrasound, first.. to get a general idea of what to expect.. although, it may not show anything abnormal.

I would try a novel protein diet.. one made without chicken, and contains a protein source which you cat has never eaten; as in: venison, duck, quail, rabbit, buffalo, alligator, etc..... Most are prescription.. but there are some good OTC brands--expensive, but good.
Personally, I would stay away from all foods without chicken. I have had 2 cats with allergies to it. If I feed it, they almost immediately vomited.

Endoscopy sounds scary.. At least it was for me. Not the idea of it, because I have had one myself; but just putting my baby through one.
My cost was around $1500-1600 or a bit more.. They estimated it to be up to $2200.

The recovery period is different for each cat. For Artie, it was at least a couple of weeks.. For Geoffrey, not bad at all; it seemed to be just a few days. Artie was 12 when he had it; Geoffrey was 7..

As far as keeping cat food out.. I used to keep it out for a few hours, in a dish. For an opened can, I am not sure if I would leave it out any longer than a couple hours.. I worry about spoilage. I have a bugaboo about leaving food out, especially for a kitty who has GI issues. I have been fortunate; my cat eat food right from the refrigerator.. do not mind it at all.
If there were an issue, I would add a bit of water, and nuke it for a few seconds, to get the chill out, and to get it more appetizing. Not enough to warm the plate.. that would be too warm.

I wish you luck.. there are so many avenues to follow.. but I would not hesitate to have an endoscopy done.. even to ease your own mind...
If you have insurance, they may pick up a good portion of the bill. You may have to pay up front, but you could be reimbursed for a good amount.

((hugs))

Hope this helped.
 
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maggie101

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My appointment is Thurs. It may be just be an evaluation or keep her over night. Today she did a very normal poo. I almost wanted to take a pic! Though she also got small diaheria. Couldn't see it til I scooped. I have tried duck,rabbit,lamb,venison for a long time nothing works so just 7 more days of prescription food. If what I've tried doesn't work but prescription does, it will have to be that. How is geoffrey?
 

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Thank you for asking. The heat is getting to him.. on the whole, he is handling the 'new' normal. Some fur loss from the prednisolone, eating like a piggy.. Still not playing, running away from me..
Next blood test is tomorrow---Wednesday..
 
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maggie101

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I just noticed that her prescription,unlike blue Buffalo prescription, has inulin,a prebiotic though I am also giving her optagist, so maybe she doesn't need optagist. My old cat,josie, was on prednisolone for 5 years.her weight drastically reduced and hair losJosie, had triiditis and more. I should have taken her to a different vet then. Vets have learned more now. My vet now gave me a liquid med to gain wait which has only been around 2 years.. wish I could remember the name. Starts with an e
 

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I just noticed that her prescription,unlike blue Buffalo prescription, has inulin,a prebiotic though I am also giving her optagist, so maybe she doesn't need optagist.
The inulin in her food is probably not a significant amount, but your best bet is to ask the vet about this overlap. You might also check the quantity of inulin in each and read up on any possibility of excessive doses. It might be that any excess is expelled through either her stool or urine.
Inulin cats dogs Veterinary What is it used for? | Elicats.com
My vet now gave me a liquid med to gain wait which has only been around 2 years.. wish I could remember the name. Starts with an e
Elura? It works like mirtazapine, but is processed better by the body and less likely to produce side effects.
Capromorelin (Elura) For Cats: Dosage, Safety & Side Effects - All About Cats
 
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maggie101

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The inulin in her food is probably not a significant amount, but your best bet is to ask the vet about this overlap. You might also check the quantity of inulin in each and read up on any possibility of excessive doses. It might be that any excess is expelled through either her stool or urine.
Inulin cats dogs Veterinary What is it used for? | Elicats.com

Elura? It works like mirtazapine, but is processed better by the body and less likely to produce side effects.
Capromorelin (Elura) For Cats: Dosage, Safety & Side Effects - All About Cats
Yes,I ment elura. I had trouble giving Maggie liquid because my hands shake
 
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