IBD and possible lymphoma, my cat is crashing

[Ocean Planet]

My cat is on that same dose and has experienced (to my knowledge) no nausea. I don’t know if me telling you that is helpful, but perhaps it does take time w/ some kitties. The pooping is still OK?

Oh yeah, bathroom habits are definitely 10000% better. A month ago it was pure liquid up to 15 tries a day on the worst days.

Now it's once a day. Normal shaped plops. ha ha. Zero blood. You wouldn't question it.

Margot Lane Your kitty takes it every every two weeks as well?

 

[Ocean Planet]

Well, I'm not sure what is going on but after a good week he is nauseous again Saturday and not eating as much. Clueless why this randomly hit today. I thought he was feeling OK at dinner and gave him his pred pill in a pill pocket. He threw it up 10 minutes later and I see the pill came back up.

I guess I'll wait a couple hours and try some a/d food with some cernia chips in it and wait this out. Hoping it passes.... I'll have try his pred again later since the first attempt came out. I guess it only gets worse from here trying to balance this out. Keeping him in remission vs. nausea and not eating... blah

 

[daftcat75]

Are you giving Cerenia daily or just around chemo doses? Whether it's Cerenia or ondansetron, both are safe enough and more effective if given regularly (once a day for Cerenia or twice a day for ondansetron), rather than "as needed." Have you tried cutting up his pills and putting them into capsules before using pill pocket or A/D? Maybe he threw up the pred if he bit into, and tasted the pill itself? Some cats have appetite dips with Cerenia. You might want to try ondansetron instead if you want to rule that out.

 

[Ocean Planet]

Are you giving Cerenia daily or just around chemo doses? Whether it's Cerenia or ondansetron, both are safe enough and more effective if given regularly (once a day for Cerenia or twice a day for ondansetron), rather than "as needed." Have you tried cutting up his pills and putting them into capsules before using pill pocket or A/D? Maybe he threw up the pred if he bit into, and tasted the pill itself? Some cats have appetite dips with Cerenia. You might want to try ondansetron instead if you want to rule that out.

I was only giving the cerenia 'as needed'. So on days he ate and drank fine, I didn't give it since learning that it tastes bad and was avoiding the hassle of administering.

I tried putting some into a capsule since my last post and put it on carpet with some A/D. He still manages to get everything around the pill. And then what happens is he eventually gets tired of the A/D and walks away after 3-4 tries. He won't have no more of it after that point. So I don't think he got all of his pred dose tonight..... Sigh... I know I have to keep practicing but I'm trying not to burn him out on the A/D and pill pockets. Then I'll be in big trouble!

 

[daftcat75]

It took some doing for Betty to eventually get the scoop and swallow instead of the lick and flick. It takes a lot less A/D than I thought to get her to take the capsules up. I also warm it up slightly. I put a spoonful on a small tray and microwave it two seconds, flip it, and another two seconds. The idea here is not to warm it up. That only makes it harder to coat the pill. But simply to take some chill off it.

 

[Margot Lane]

Oh yeah, bathroom habits are definitely 10000% better. A month ago it was pure liquid up to 15 tries a day on the worst days.

Now it's once a day. Normal shaped plops. ha ha. Zero blood. You wouldn't question it.

Margot Lane Your kitty takes it every every two weeks as well?

O sorry: just saw this 5mg pred each day, chlorambucil every 3rd day. I keep asking my vet: “Shouldn’t we taper?” And she keeps saying staunchly: “No. I’ve had too many kitties do worse when you mess w/ the dosage.” I write that w/ a caveat though: every kitty and every vet is different, so, listen to your vet, not mine! Esp. if you trust them.

 

[LTMommy]

That dose for Prednisolone for this problem is low. My cat started at 10 mg a day and was on it for months and months before I could reduce it. She is now at 5 mg every other day. She also gets the Chlorambucil once every three days. She gets Cerenia on the days she gets Chlorambucil.

The Chlorambucil isn’t just for lymphoma. It is also used, with Prednisolone for tough cases of IBD.

My cat started on 7 mg of Prednisolone per day (5 mg in Am, 2.5 mg in evening) for IBD 3 weeks ago. I've seen some improvement, but not a night and day difference. The vet seems to think we should see a more dramatic improvement by now. I'm curious to know how long your cat was on the 10 mg/day before you notice a major improvement in symptoms? Also, was she on the Chlorambucil every 3 days the entire time she was on the Pred, or was the Chlorambucil added later?

 

[silent meowlook]

Hi. I started the Chlorambucil, Prednisolone, Cerenia, Famotadine, and a limited antigen diet, as well as Vitamin B12 injections and SQ fluids all t the same time. It’s hard to say if one thing or the other helped. It took about 3 weeks if I remember before there was improvement. The improvement wasn’t anything dramatic either. She is not how she was before. She has momentary bursts of energy, but she is not the healthy crazy kitten/cat she was before. I think the meds keep everything from getting worse as quickly, but there is no cure. She was also diagnosed with hyperthyroidism shortly before all the other problems, and she had been asthmatic about a year prior.

Her quality of life is ok I think. But, like I said, not like before.

I do wish I had started the Prednisolone when I was advised to, a year prior, when an abdominal ultrasound showed thickened intestines. But, I didn’t. I wasn’t thinking about the chronic inflammation leading to lymphoma.

Her current meds are Methimazole 1.25 mg twice a day (sometimes skipped when I find a pill in her bed) Prednisolone 5 mg. Every other or every third day. Chlorambucil 2 mg. Twice a week. She still eats the limited antigen canned diet.

 

[Ocean Planet]

Hi. I started the Chlorambucil, Prednisolone, Cerenia, Famotadine, and a limited antigen diet, as well as Vitamin B12 injections and SQ fluids all t the same time. It’s hard to say if one thing or the other helped. It took about 3 weeks if I remember before there was improvement. The improvement wasn’t anything dramatic either. She is not how she was before. She has momentary bursts of energy, but she is not the healthy crazy kitten/cat she was before. I think the meds keep everything from getting worse as quickly, but there is no cure. She was also diagnosed with hyperthyroidism shortly before all the other problems, and she had been asthmatic about a year prior.

Her quality of life is ok I think. But, like I said, not like before.

I do wish I had started the Prednisolone when I was advised to, a year prior, when an abdominal ultrasound showed thickened intestines. But, I didn’t. I wasn’t thinking about the chronic inflammation leading to lymphoma.

This is where I am. My guy started having more frequent blood in his stool around Sept of 2022. I first noticed a little red in June but it went away for a while. If I acted faster this may not have progressed so bad. I had no idea IBD could turn into that.... no clue at all...

I know this doesn't add anything but the guilt has been getting me down pretty bad these days.... the 100% my fault feeling is very real in this situation.

One month check up tomorrow.

 

[BellaBlue82]

I know it is easier said than done, but try to take it easy on yourself. I had major guilt after Nico passed... What ifs abound. But in the end, I only did as much as could with the guidance of the vet. She keeps telling me I went above and beyond her other normal patients, and sometimes things work and sometimes they don't. Nico was just one of those cases where it got bad quick, and there is no stopping a bullet train like that.

Sending both of you hugs, and know that you are the best kitty parents ever!! You do everything possible for your babies (and yes, they are still our babies even when they are old lol.)

 

[LTMommy]

This is where I am. My guy started having more frequent blood in his stool around Sept of 2022. I first noticed a little red in June but it went away for a while. If I acted faster this may not have progressed so bad. I had no idea IBD could turn into that.... no clue at all...

I know this doesn't add anything but the guilt has been getting me down pretty bad these days.... the 100% my fault feeling is very real in this situation.

One month check up tomorrow.

I know how you feel, but you shouldn’t feel guilty about not knowing that IBD could lead to lymphoma. Why would you know that, right? I didn’t know it either, not even after speaking with my regular vet about my cat’s possible diagnosis. It was more like “it’s probably one of the other” not “one can progress to the other.” It wasn’t until much later when speaking with an internal medicine specialist when they mentioned sort of in passing that it can morph.

I feel like we as cat parents are sort of left to figure out a lot of this on our own. I’ve learned far more about IBD from reading threads here and researching elsewhere online, reading peer reviewed articles, etc. than I have from any of the vets my cat has seen since these issues started for him.

I try to tell myself I’m doing the best that I can, especially with what I feel is relatively limited guidance and help from a vet (in my case, the internal medicine specialist has prescribed Prednisolone but beyond that they’re not really suggesting anything else - didn’t even think a change of food was worth a try).

From everything you have posted, I think it’s safe to say you are doing the very best that you can and hopefully you can find some comfort in that.

 

[Ocean Planet]

Thank you all. I try to keep strong and keep the good moments going, even though the past month has taken a toll on me mentally. Since this all happened I pretty much focus on my two buddies and spent at least a couple hours each evening with them now after work..... Playing or chilling out. The vet doctors have told me that my kitties are lucky to have me as an owner as I'm definitely in the highly dedicated crew as far as their well-being.

Will update tomorrow how his first checkup goes!

 

[fionasmom]

The vet is right about that!

 

[Ocean Planet]

My buddy had his one month follow up and I’ll let the doctor report speak for itself:

“He is responding very well to treatment with clear signs of remission”

Finally, some good news!

1. He has gained weight again (12.7 pounds! He was 11 back in January). The doctor immediately commented how heavy he was in the carrier.
2. His bloodwork had all perfect levels across the board. His red and white blood cells are still regenerating at a good level with the current chemo dose.
3. He could feel his lymph nodes on the first visit but could not feel them on this visit.

It was very impressive that he responded so well in just a month and the doc said it is very encouraging for long-term treatment. He said that I did amazing getting him medicated and the efforts definitely showed. After a week we are going to try to drop his prednisolone from 5mg to 2.5 and see how things go. The doctor doesn’t want to see him for 2 months!

The main current challenge is keeping the nausea at bay. It seems he may have that 3-4 days out of a month but overall, a small price to pay to continue living a spoiled life. He smells cerenia no matter how I package it or make the chunks smaller. The doctor mentioned he could have a place make compounded cerenia treats. Might have to give that a try next… Going to see how this and the next dose play out.

Of course, credit goes to many people here too. Thank you to everyone who has responded and offered tips and tricks for medicating over the past month. 2023 has been a nightmare. It’s nice to finally breath for a weekend.

I told the doctor I beat myself up over the situation a little bit and he said, “look, there are people who have dogs and cats that get these diseases and many don’t even realize there are specialists and oncology departments for animals. The fact that you’re taking these steps is leaps and bounds above what most of the population would do. Remember that”

The thought stuck with me all night. Maybe it will help someone else going through anything similar to pass along....

 

[fionasmom]

Your doctor is right again about the care that you have provided. It is wonderful to read that it all appears to be working and we appreciate the update. Please post any time that you would like as it is a huge help to other members who might face the same thing.

Maropitant Oral Oil Suspension
One place that compounds Cerenia

 

[Ocean Planet]

Your doctor is right again about the care that you have provided. It is wonderful to read that it all appears to be working and we appreciate the update. Please post any time that you would like as it is a huge help to other members who might face the same thing.

Maropitant Oral Oil Suspension
One place that compounds Cerenia

Cool, thanks for the link! I'll keep this handy. Surprisingly his Friday dose he didn't get sick. But I did slip in very small cerenia pebbles into his pill pocket. The doctor said even a small dose can be helpful.

 

[Ocean Planet]

Well, I tried to lower his steroid dose from 5mg down to 2.5mg daily. His symptoms came back in a week Back to mush and diarrhea and looking sad/isolating. Probably has stomach cramps again. This while on the maintenance dose of S Boulardii too. I wrote the doctor to see if he is good putting him back on 5mg a day again to stabilize him. I hope it works. I guess he needs that much I know you need to try but damn..... Maybe he can't be that low when the chem dose is every 2 weeks... I'll see what he says.

Nasty disease... i hate this.... its like starting over.

 

[Ocean Planet]

So after trying to lower the prednisolone to 2.5mg per day and it not working out, his oncologist agreed to definitely put him back on 5mg a day. So he has been back on 5mg per day for a week and a day and there has been some improvement but his bathroom habits still are not perfect like they were a few weeks ago before lowering.

It's not total liquid at least. Most times he'll start out going normal for the first 60-70% and then a bunch of mush/pudding/liquid for the last part.

Good news is he only goes once per day (a day or two maybe twice but it's 10-14 hours apart). More good news is that his attitude improved and he is more playful than when we tried the 2.5 dose and he still eats and drinks excellent. (I swear he could be pushing 13lbs)

So I updated the oncologist the other day on this and he said when this happens the stool is the slowest symptom to improve and could take a full 2 weeks or so to be all solid again. I hope this is true and the steroid at 5mg hasn't lost its effectiveness? I tried giving extra S. boulardii and it doesn't seem to be making a dent that much. I know steroids take time.... i'll just keep trying to be patient.

Not sure if anyone else tried to lower a dose for their cat and had to go back up like this too? It makes me regret lowering his dose, but I know we had to try....

 

[fionasmom]

I think that the oncologist is telling you the truth; the pred had to build back up. Even a probiotic will need time to become effective. While pred gets a bad rap, when it is needed, as in cases like this, it is needed. It seems like everything is improving for him, so you must be on the right track.

 

[Margot Lane]

I went through this—- trying to lower the dose and then going back to 5mg. That’s what my vet said to do, said she’s tried tapering w/ cats and gets better results (poo wise) when she doesn’t. Seems like a lot but, after 2 years, my boy is still here!