GI lymphoma/IBS in elderly cat, when to let go...

[demitraO]

I have an 18, closer to 19 year old tabby named Ronnie. He has been very healthy all is his life. About a month and a half ago he started vomiting and having soft poo that turned into diarrhea. I took him to the vet, they did blood work and an X-ray. Those tests were normal. They sent me home with a steroid and anti diarrheal. The vet suggested doing an ultrasound to get a better look. The vet told me to give him a sedative the night before and the morning of his appointment but the stress of travel and just being at the vet overpowered the medicine. The ultrasound was not done. They suggested fasting him and bringing him back and they would sedate him. I asked the vet what we were looking for in an ultrasound. She said that it could be IBS or a GI lymphoma. Not uncommon in cats his age. I asked what the treatment would be and she said steroids for both. Considering his age and the stress for him I opted not to do the ultrasound. At his age I wasn't going to start him on any chemo or do any biopsies/surgeries. I just want to keep him comfortable, which I feel like has been a challenge. The vomiting has subsided considerably, but he still has diarrhea. I have tired the anti diarrheal, which makes him nauseous and curbs his appetite, slippery elm, a probiotic, making my own bland cat food. I have continued to keep him on a low dose of the steroid, which has its own set of issues.

I know I'm not alone in this situation and I am doing the best I can for him, although sometimes I don't feel like I've done enough. He has lost a bit of weight and has started to seclude himself. Some days are better than others. Its like he has aged 10 years in 2 months. I feel like I need to consider making the difficult decision that I don't want to make. But I know that he isn't living his best cat life right now.

What have your experiences been? How do you really know when? The thought of "setting a date" is very unsettling for me. I don't want to be selfish and keep him here just for me but I don't know what else I can do for him

I appreciate whoever takes the time to read this.

Thank you,
Ronnies mom Demitra

 

[Furballsmom]

Hello, I'm so sorry .

"liver Shake" Recipe For Inappetant Cats
Syringe feeding can be tough, but my vet suggested using a tongue depressor. Scoop a little food on an end and gently scrape it off in his mouth. I found this method better and it got more calories in.

This may also be helpful;
When Is It Time?: Making The Difficult Decision On Euthanasia - TheCatSite

 

[happilyretired]

I faced this problem many years ago with my first cat who at age 19 was 'failing'--although she had no specific terminal illness; it was age-related decline. My wonderful vet told me that the criterion should be her 'quality of life,' which, he said, is very important to the cat. I finally realized that I was keeping her alive for me, rather than for her. When I read online about others' experience with euthanasia, the only people who expressed regrets were those who felt they'd waited to long.

I'd suggest really focusing on your cat. Mine actually seemed to convey a sense that she was ready to go.

 

[FeebysOwner]

Hi, and welcome to TCS. There are tons of cats whose owners on this site have chosen both steroids (Prednisolone is common, but there is also Budesonide that works weill with some cats) and chemo (often Chlorambucil) for suspected IBS/lymphoma, without an actual diagnosis. When some end up responding to your post, they will tell you that chemo is tolerated quite well by most. The doses are not like what is done with humans - as the goal is not to try to cure them, but to slow down the progression and add quality of life.

Many of these cats are also given B-12 shots, as it seems both IBS/lymphoma can cause malabsorption issues which the B12 can help with - it might even help with the diarrhea. And, it isn't unusual for the cats to receive an appetite stimulant, sometimes along with an anti-nausea med to counteract any possible nausea. These are options that could make him more comfortable.

I don't know what anti-diarrheal you tried that caused nausea, but there are numerous other options to try. Odds are you used metronidazole, which doesn't agree with some cats. Tylosin powder is another option, but there are others like psyllium husk, for example. It is probably a case where experimenting with a few things might be the best approach. Similarly, there are a number of probiotics that could be experimented wtih as well.

You should discuss all of this with your vet and see what they think, especially telling them about what issues you feel the steroid is causing.

If you can find a mixture of meds/supplements that work for him, you may find that you can put off considering euthanasia, ideally for a long while.

I will add my 'disclaimer' just so you know where I am coming from - I have a 19+yo cat, with multiple illnesses, currently on a regimen of treatments that allows her to live comfortably. As long as they work, she and I agree that neither of us are ready to let go.

 

[fionasmom]

My Chelsea was no where near as old as Ronnie when we realized that she had SCL (GI lymphoma). We started with pred, but I refused to do any invasive procedures because she was very hard to handle, being an ex-feral who retained more of her "feralness" than other cats I have owned. I asked the vet to start chlorambucil which she did and Chelsea tolerated it well. I should add that some vets will probably not do that without doing more testing.

Given Ronnie's age, I certainly agree with you that it was wise not to do any testing which would cause discomfort and which might not change your plan of action. My cat vet will not do surgical procedures on very old cats as she feels that the outcome is too questionable.

I would not worry about the use of pred. A previous cat who had SCL years earlier was only on pred and did well for a length of time. Budesonide is certainly another option to the pred.

 

[demitraO]

Hello, I'm so sorry .

"liver Shake" Recipe For Inappetant Cats
Syringe feeding can be tough, but my vet suggested using a tongue depressor. Scoop a little food on an end and gently scrape it off in his mouth. I found this method better and it got more calories in.

This may also be helpful;
When Is It Time?: Making The Difficult Decision On Euthanasia - TheCatSite

Thank you for the information. I will check both out

 

[demitraO]

Hi, and welcome to TCS. There are tons of cats whose owners on this site have chosen both steroids (Prednisolone is common, but there is also Budesonide that works weill with some cats) and chemo (often Chlorambucil) for suspected IBS/lymphoma, without an actual diagnosis. When some end up responding to your post, they will tell you that chemo is tolerated quite well by most. The doses are not like what is done with humans - as the goal is not to try to cure them, but to slow down the progression and add quality of life.

Many of these cats are also given B-12 shots, as it seems both IBS/lymphoma can cause malabsorption issues which the B12 can help with - it might even help with the diarrhea. And, it isn't unusual for the cats to receive an appetite stimulant, sometimes along with an anti-nausea med to counteract any possible nausea. These are options that could make him more comfortable.

I don't know what anti-diarrheal you tried that caused nausea, but there are numerous other options to try. Odds are you used metronidazole, which doesn't agree with some cats. Tylosin powder is another option, but there are others like psyllium husk, for example. It is probably a case where experimenting with a few things might be the best approach. Similarly, there are a number of probiotics that could be experimented wtih as well.

You should discuss all of this with your vet and see what they think, especially telling them about what issues you feel the steroid is causing.

If you can find a mixture of meds/supplements that work for him, you may find that you can put off considering euthanasia, ideally for a long while.

I will add my 'disclaimer' just so you know where I am coming from - I have a 19+yo cat, with multiple illnesses, currently on a regimen of treatments that allows her to live comfortably. As long as they work, she and I agree that neither of us are ready to let go.

Thank you for all of this information. My vet didn't really offer me a plan other than giving the steroid and anit diarrheal, which was the metronidazole. I have some liquid cat B12 that I have tried giving him. I would like to continue to do my very best for him. I still see a light in his eyes and he shows me that he really isn't ready. I appreciate you responding

 

[demitraO]

My Chelsea was no where near as old as Ronnie when we realized that she had SCL (GI lymphoma). We started with pred, but I refused to do any invasive procedures because she was very hard to handle, being an ex-feral who retained more of her "feralness" than other cats I have owned. I asked the vet to start chlorambucil which she did and Chelsea tolerated it well. I should add that some vets will probably not do that without doing more testing.

Given Ronnie's age, I certainly agree with you that it was wise not to do any testing which would cause discomfort and which might not change your plan of action. My cat vet will not do surgical procedures on very old cats as she feels that the outcome is too questionable.

I would not worry about the use of pred. A previous cat who had SCL years earlier was only on pred and did well for a length of time. Budesonide is certainly another option to the pred.

Thank you. I agree with the no surgeries, its risky at his age. I hope your Chelsea is doing well.