Constipation questions - IBD or cancer

[DesperateMistrustful]

All of the mobile vets in my area are only doing telemedicine for current patients but they're definitely worth a try as well. Good luck, I hope you have lots of good days left and won't have to do it soon.

 

[desertcat]

Thank you so much for the scoring idea. I think I will start doing that every day and see how it goes. One thing that's interesting is that, even though the prednisolone is not helping to stop the cancer, it has given him quality of life. This morning, he was up on the highest perch of his cat tree, looking out the window in the sunlight. It's been a long time since he climbed that high, and it made me happy that he's feeling good enough to do that again. So, his score is high today.

You are right that cats are resilient, and I'm glad Krista has done so well. I pray that my cat will surprise us all and keep going for a long time to come.

My cat before Krista, Cabernet, I came home to her foaming at the mouth. That was a Sunday. She had a tumor removed from her mouth and biopsy on Mon or Tuesday. By Friday, I got the terrible news that it was malignant (cancer.). That weekend I searched Yahoo or Alta Vista (this was 14 years ago and I’m not sure if Google was the dominant one yet.). The best advice I found was give your cat daily “cat scores.” How much is he acting like a cat’s cat? Does he eat? Does he enjoy time in the sun? Or staring out the window? Does he want to be with you? Or be in his favorite spots doing things he enjoys? When his scores are consistently in the toilet such as spending most of his time under a bed or in hiding, doesn’t eat, doesn’t want to be with people, doesn’t want to do many or any of his previously favorite things, that’s about as objective as you can make this difficult decision. Only you can decide what your score cut-off is and how many days to give him at that score. For Cabbie, she spent that weekend under the bed or in the dark bedroom rather than with me or sitting in the sun. I’m not sure how much she ate that weekend. But not very much. I knew much less about cats back then to monitor her eating. I just saw several days at “3” or below and changed her oncology appointment that next week to a different kind of appointment.

I don’t know about your current vet or the hospital that did the ultrasound. But Krista’s vet makes an exception to “no parents allowed” for euthanasia. They understand how important it is to both parent and animal to be with each other in those last moments. I hope when it’s time, they’ll make the same exception at your facility.

But until that time that his scores are consistently low, don’t underestimate just how resilient cats can be. I thought Krista wouldn’t make it another couple weeks so many times over the last couple of years through pancreatitis, liver disease, her teeth, when she was pooping liquids for months, and lost all this weight. But she just keeps going and doesn’t show any sign of wanting to give up. I finally stopped trying to make that decision for her and trust that she’ll tell me when it’s time. Until then, I kid with my friends and family that she just may be immortal and outlive us all. She’s been through so much and keeps on going. I hope yours proves to be that resilient too.

 

[desertcat]

Tonight, I am struggling with feelings of guilt. There is a big part of me that wants to see if I can scramble together $5000 to pay the treatment center and get him started this week. It is so hard for me to see my cat so happy and full of love, but know that he is slowly dying. It feels like a betrayal to let this happen, but the logical part of me knows that there is the potential I could spend the money and still lose my cat. My husband's job stability is rocky right now because of the pandemic, and it's hard to justify spending so much money on something that may not work or may make my cat feel worse.

I have had to euthanize other pets, but this situation is a bit different because I actually have the potential to help him. In the other scenarios, it wasn't really possible. I just want to make everything better for him, but I'm afraid to spend the money when we may need it for ourselves in a few months. I'm sitting here in tears feeling very helpless and sad at the moment.

 

[daftcat75]

Only you know your financial situation and can make that call. But...this is a big decision that could have quality of life implications. Is there any way you can get a second opinion even if it's a tele-medicine call with some vet willing to review the ultrasound notes and the specialist recommendation? He may agree with the specialist or he may have his own ideas.

I know it's not anywhere the same thing. But it took three vets to find one who recommended the pancreatitis test for Krista. Once that was identified as a complicating factor in her "IBD or possibly lymphoma" diagnosis a couple of years ago, we had a treatment plan and she was on the mend in a couple of months. Sometimes vets get locked into what they want to see and how they want to treat it that they don't necessarily consider all possibilities. Heck, even Krista's current vet didn't want to start her on chemotherapy without a very risky diagnosis. Fortunately the owner and founder of the practice was available to consult with and agreed with me that the diagnosis was riskier than the drug.

Even if the second opinion agrees with the first on the diagnosis, he may recommend increasing rather than decreasing the pred dose to keep his quality of life as high as possible for as long as possible. At this point, it doesn't sound like you have to worry about the long-term effects of steroids if he isn't being given a long-term prognosis.

So sorry you and he have to go through this!

 

[desertcat]

Thank you, daftcat75. I was able to talk to my regular vet today. She agrees with the specialist that there is little that can be done about my cat's case due to the type of cancer they suspect (adenocarcinoma). The preferred treatment would normally be surgery, but that is no longer possible for him because of the size of the tumor. She said that keeping him comfortable with prednisolone is the best idea going forward. She was surprised about the specialist cutting the dose, so she is supposed to get back to me about that. I am hoping that she will advise to increase it if there's any chance it might give him a few more happy days with us. I may still seek out a tele-vet just to see what their opinion is.

From what I read this afternoon, a cat that is diagnosed with adenocarcinoma typically has a matter of days or maybe a couple of weeks if the tumor is not removed. It could spread to other organs easily on top of the problems it causes in his intestines. I think the prednisolone is the only thing keeping him going now. I may also try CBD oil as some have said it helped their cat to feel better.

My cat has had a good day today, thankfully. He started the day off by being a bad boy and got into his sister's supply of dry food. He actually managed to pop the top on a plastic canister to get the food. The prednisolone munchies are strong. He threw it all up about twenty minutes later, which is probably a good thing so he won't get constipated. He later ate his own food without a problem. Otherwise, he's been social and also spending time in the window.

 

[daftcat75]

Be careful mixing pred and CBD as they both get metabolized by the same enzymes in the liver. They could synergisticly interact causing a greater reaction to the each than either alone. I would err on the low side of CBD oil until you've seen how he reacts to the two of them together. If you're not getting it from a marijuana dispensary, if you are getting a pet store preparation, buy the big dog version so you don't have to give as much. It's the same oil, just more concentrated for a larger animal. Always look for a CBD oil that is "full spectrum" rather than just isolated CBD compound. There are other medicinal molecules in full spectrum oils that can be helpful together ("entourage effect") with CBD.

And if you are getting the CBD oil from a marijuana dispensary, a little bit of THC is not a bad thing. Make sure it's a pet preparation with a minimum 20:1 ratio or higher (20 parts CBD to 1 part THC.)

 

[desertcat]

My cat threw up his dinner a little while ago and then a few minutes later started having those stomach spasms again. Normally, he seems to like it if I pet him after they stop, but this time, I put my hand on him and he let out a loud meow, like he wanted to tell me to stop it. This is new and makes me think that things are moving more rapidly than I expected. He rested for a few minutes, then came to sit by my feet and started purring. Now he's eating what little is left in his food bowl. I hesitate to medicate him tonight because he hates it so much, even the flavored stuff, but I'm going to try it.

Obviously the process of eating is changing for him, as he's thrown up twice today. I'm going to make his meals smaller to see if it helps over the next day or two.

 

[desertcat]

Daftcat, I wanted to add that I am really appreciating your scoring system right now. I think it's going to help me in the next few days to make decisions for my boy. I was feeling the dread setting in earlier tonight, but right now, he's acting okay - not great, but okay. He just had a large bowel movement (large for him), and that may have been part of what was causing the extra discomfort tonight. It was not a pretty color, but at least he passed a good amount and may feel some relief overnight, I pray.

Bowel movements, even though they are always soft now with Miralax, still seem to cause him so much straining and discomfort. But when they're out, he looks like he feels better for a while. The pattern I am seeing with the spasms is that they tend to happen about 30-60 minutes after eating, and before he has a bowel movement. The ones before the bowel movements seem worse and more intense, like bad cramping.

I am starting to lose a lot of sleep over this, which is not good for either of us. I worry about every little noise he makes throughout the day and night, and I'm constantly checking him. I'm working from home, so if I have a minute for a break, I follow him around the house I'm probably starting to annoy him, but there are few things worse than seeing a pet in pain, and I'm starting to obsess over him. I have a dread that something will happen while I'm sleeping, so I've had trouble falling and staying asleep ever since this all started weeks ago. My husband loves our cat, too, but he has a much easier time accepting this as nature's course. I know it is nature and part of life, but this cat is family and it's extremely difficult to see him deteriorating.

 

[Elbee]

You are not obsessing, you are taking care. You are doing just as you should right now. Remember to do a little self care for yourself. Many of us here on the site have been just where you are and made it through. But damnation, it is horrible. And with what is going on right now, it does make things all that harder. You are doing a great job.

I hope you have some lovely times with your boy.

 

[desertcat]

Thank you, Elbee. That means a lot and it helps.

My vet prescribed pain medication today to see if it helps with the painful spasms. Ever since Monday night, they've obviously gotten more intense, but since they're only happening like that at night when it's time to have a bowel movement, I feel like it's worth seeing how he does for a few more days. If tomorrow comes and the pain meds aren't helping, then I'm going to make the call for euthanasia immediately. Even if they help, however, my husband and I have decided that it needs to be done by this weekend. I know that at some point very soon he will be beyond pain medicine. The tumor is gradually blocking his intestines, and soon he won't be able to defecate, even with the laxatives. I do not want him to experience that horrible feeling or strain himself to the point he hurts himself further. He has already passed a few drops of blood. It is also likely to spread to other organs very soon if it hasn't already.

I have made my peace with this decision, and I can say that if I were facing such an end, I would want someone to help me pass peacefully. The specialist advised that he would prefer to euthanize now and skip the pain management issue, but I told him that I'd like to at least try to give him two or three more happy days with us. If I can make that happen, I will get some kind of peace from knowing he enjoyed himself at the end and had his pain under control. So, I am praying the pain will be eased by the medication tonight.

When he was a young cat, he used to love cheese crackers. He would beg for them. I have to go out later to get his medicine and also buy some groceries. I am going to buy a box of cheese crackers and give him a couple per day until it's time. I know they aren't good for him right now, but I will wet them with water or tuna juice to make them easier to get down. I want so badly to spoil him, but it's hard to do that when we're dealing with an intestinal cancer and he's sensitive to food.

One thing I've noticed is that, for the past couple of nights, he goes and sits by the front door and just stares up at it. I had never seen him do this until now. He's a true housecat and has never had any interest in going outdoors. Last night, he walked over to it and sat there for a good thirty minutes, just staring. It really makes me wonder if he's sensing that he's about to leave our home and take the big journey. If that's the case, it makes me feel better about the whole thing, because he doesn't seem afraid at all. He has two cat "brothers" and one dog "brother" waiting for him there, too.

 

[Elbee]

It is great that you have some support and are able to be with him. xo

 

[desertcat]

Today is a hard day. We have scheduled my cat to be euthanized tomorrow morning. I am racked with guilt right now, but I do not know what else to do. He has been on pain medication since Wednesday, which has been helping, but I can still see that he has episodes of pain. He has also been extremely gassy since yesterday. This is a new thing.

He has had a peaceful day and has been relaxing in the window. This is what makes it so hard to know if I am doing the right thing. He still enjoys his life...until the pain hits him from time to time. I keep thinking about rescheduling the procedure, but I know that I will just be rescheduling it in another week or so. It is a horrible feeling.