IBD Help- Treatment plan?

[The Practical Cat]

It's been awhile since I've been on these forums, but you all were very helpful a few years back when Pandora was diagnosed with mammary cancer. Fortunately she had surgery to remove her lump and that is behind her, but unfortunately she has a new issue, which is IBD and severe weight loss. She's also an old kitty at 15.

She's been to the vet multiple times, we've done blood work and x-rays. Nothing notable on either. She's currently taking prednisilone and has at various points taken cerenia, stool softeners, and B12. She's also eating Royal Canin Hydrolized Protein prescription food. The vet also recommended an ultrasound but was going to charge $400 to sedate and do the exam so I chose to hold off because I am currently unemployed, though I may consider this option if necessary.

Her main problems are that she throws up frequently and she eats very very little. She's lost probably 2lbs over the past several months. The vet has given a grim prognosis of 6-12 months left and seems to just want to try to keep her comfortable, but I'm worried we're overlooking options. I've read about trying antibiotics as well as doing stool testing to look for parasites. I plan to discuss this with the vet when he's in this week. We may also put her back on cerenia long term but the cost is a bit prohibitive so I'm trying to work something out with them. Anyway, for others with IBD kitties what did your treatment plan look like? How did your cat handle meds like antibiotics or anti parasitics?

 

[FeebysOwner]

Hi. So sorry about Pandora's condition. You've been on this site for a while, so you may already know to do a search looking for other posts about IBD. But, in case you haven't done so, here is a link (see below) to some of them where you might find some helpful information. I have no first hand knowledge, so all I can do is offer good wishes to Pandora and you, and my hope that some of these members will soon see your post and share their experiences with you.
Search Results for Query: IBD

 

[Furballsmom]

FeebysOwner has, as always, given you good help
These might give you some information as well;

IBDKitties – Helping Save Lives…One Paw at a Time

Feline IBD

and here are these in case anything here is useful;
(apologies for any broken links);
Financial Assistance – Day By Day Caregiver Support Inc.

Financial Aid for Pets

No Money For Vet Care? How To Find Help And Save Your Cat's Life

About Waggle | Vet Financial Assistance | Financial Aid For Pets

 

[LTS3]

Treatment varies among IBD cats depending on symptoms and what the vet feels is best.

My IBD cat started with a bunch of meds: Cerenia, pred, antbiotics, acid reducer, B12. I added probiotics and S. boulardii as supplements. The vet recommended Z/D junk but I just continued to feed raw but in a novel protein. These days the IBD is managed with just the raw diet, B12, and occasional course of pred.

Ask your vet to check the cat's B12 levels. IBD cats often have low B12 levels which causes weight loss. Injections of B12 is needed to keep levels normal. I give my cat injections monthly.

Many of the meds IBD cats take can be compounded into another form like a liquid or flavored chew treat. I had one of the antibiotics compounded into a fish flavored chew treat. For pred and Cerenia pills, I use a bacon flavored pill dough.

 

[daftcat75]

An ultrasound would confirm IBD -or- lymphoma. It can’t tell the difference between the two. A biopsy can do that. But unfortunately, you’d have to taper her off the pred to get a clear result. And some biopsies are more invasive than others depending on where the ultrasound indicated the abnormal tissue resides.

You can save money and skip both ultrasound and biopsy. But that means you’re flying blind guessing what might be going on. Because she’s already on pred and still having issues, you may discuss with your vet the possibility of adding chemotherapy. The trouble with this. Without the ultrasound, you don’t know if the chemo drug is appropriate. It may simply be IBD and you haven’t eliminated the trigger foods yet. Or it could be lymphoma but the more aggressive kind that needs a more aggressive chemotherapy. I would discuss all of these options with the vet.

In my Krista, her IBD was well-managed through diet alone. Until it wasn’t. When she started pooping liquid for months and nothing including pred was helping, I convinced my vet’s boss (because my vet didn’t want to do it without a diagnosis) to add chemotherapy without confirming via biopsy. In her case, several ultrasounds had already ruled out the more aggressive large cell lymphoma and it was only a question of small cell lymphoma or IBD. I discussed the options with the owner of the practice and we agreed that given her age and condition, the drug was less risk than the diagnosis. The improvement was nearly overnight. But the remission wasn’t complete until I discovered I was still giving her an inflammatory trigger food each night to get her to take her pred: I was wrapping her pred in fish flakes. When I switched from wrapping her pill in fish flakes to giving her transdermal pred in the ear, her remission was miraculous. Still waiting on the weight gain. But the poops have finally cleared up. No more soft stuff. No more bonus rounds. No more barfing afterwards.

 

[The Practical Cat]

Thanks everyone for your responses, I will take a look at those links!

I spoke to the vet, we're doing a stool test to rule out parasites and I've started her on metronidozale in addition to the prednisilone, and we're also adding back cerenia which has controlled her vomiting in the past. Before she started the new drugs she developed a difficult new symptom, very loose stools, and I've been having to clean her up every morning . The vet said the metronidozale will hopefully help with that so we'll see. Fingers crossed, I guess.

My IBD cat started with a bunch of meds: Cerenia, pred, antbiotics, acid reducer, B12. I added probiotics and S. boulardii as supplements. The vet recommended Z/D junk but I just continued to feed raw but in a novel protein. These days the IBD is managed with just the raw diet, B12, and occasional course of pred.

Ask your vet to check the cat's B12 levels. IBD cats often have low B12 levels which causes weight loss. Injections of B12 is needed to keep levels normal. I give my cat injections monthly.

Many of the meds IBD cats take can be compounded into another form like a liquid or flavored chew treat. I had one of the antibiotics compounded into a fish flavored chew treat. For pred and Cerenia pills, I use a bacon flavored pill dough.

She was getting B12 pills but I was noticing she threw them up immediately every couple of days so we're giving her a break from them for a bit. She got a B12 shot from the vet about a week ago, he recommended weekly then going to monthly shots unless I can get her to take the pills. I'm hoping the cerenia will help her tolerate them again.

What do you mean by feed raw novel protein? Can you give me examples of this?

Pandora is extremely picky so I've had to pill her unfortunately. Not ideal as this is stressful for both of us. If I could get a wet food that would hide the taste/smell of medicines I could crush them up but unfortunately the food the vet has her on currently only comes in dry. Where do you get the chew treats made?

You can save money and skip both ultrasound and biopsy. But that means you’re flying blind guessing what might be going on. Because she’s already on pred and still having issues, you may discuss with your vet the possibility of adding chemotherapy. The trouble with this. Without the ultrasound, you don’t know if the chemo drug is appropriate. It may simply be IBD and you haven’t eliminated the trigger foods yet. Or it could be lymphoma but the more aggressive kind that needs a more aggressive chemotherapy. I would discuss all of these options with the vet.

In my Krista, her IBD was well-managed through diet alone. Until it wasn’t. When she started pooping liquid for months and nothing including pred was helping, I convinced my vet’s boss (because my vet didn’t want to do it without a diagnosis) to add chemotherapy without confirming via biopsy. In her case, several ultrasounds had already ruled out the more aggressive large cell lymphoma and it was only a question of small cell lymphoma or IBD. I discussed the options with the owner of the practice and we agreed that given her age and condition, the drug was less risk than the diagnosis. The improvement was nearly overnight. But the remission wasn’t complete until I discovered I was still giving her an inflammatory trigger food each night to get her to take her pred: I was wrapping her pred in fish flakes. When I switched from wrapping her pill in fish flakes to giving her transdermal pred in the ear, her remission was miraculous. Still waiting on the weight gain. But the poops have finally cleared up. No more soft stuff. No more bonus rounds. No more barfing afterwards.

The vet did mention chemo pills, I was kind of freaked out by the idea of giving her chemotherapy but I guess I need to do more research. Did your cat have any bad side effects from it? That's of course my main concern. She's 15 and pretty thin and weak at this point, I worry she couldn't handle it.

I'm unclear on how to eliminate trigger foods. The vet says the diet she's currently on is hypoallergenic, though. She's currently eating Royal Canin Hydrolized Protein.

 

[LTS3]

She was getting B12 pills but I was noticing she threw them up immediately every couple of days so we're giving her a break from them for a bit. She got a B12 shot from the vet about a week ago, he recommended weekly then going to monthly shots unless I can get her to take the pills. I'm hoping the cerenia will help her tolerate them again.

B12 injections are preferred. It's not a big deal to give it at home.

What do you mean by feed raw novel protein? Can you give me examples of this?

I feed my cats a raw diet with rabbit as the protein. Chicken gives my IBD cat a flare up. Novel proteins are things like duck, rabbit, venison, goat, etc, proteins not typically found in commercial cat food. Many IBD cats do well on a raw or home cooked diet or a bland-ish commercial novel protein preferably canned food.

Prescription hydrolyzed foods are typically chicken based which may cause a flare up in sensitive IBD cats. It's ok to feed your cat something else. My vet wanted my cat on Hills Z/D junk but I continued to feed the same brand of raw food.

Where do you get the chew treats made?

At a compounding pharmacy. You may have a local compounding pharmacy in your area. Wedgewood Pharmacy is a popular online place for compounded medicines, Pet Medicine for Pets and Pet Meds for Horses - Wedgewood Pet RX Not all medicines can be compounded.

 

[daftcat75]

Chemo won’t make her weaker like it does with humans. The dosages are different and cats tolerate chemo better. I’m pretty sure Krista would not still be with me if it weren’t for the chemo. Now if only I had eliminated the fish flakes months ago, she might be well on her way to putting on weight again. She’s 16 and very skinny!

Is the RC a wet food or dry food? Wet is better. Does she get any treats or any other food (table scraps?)? As I find out with Krista, even the three or four tuna flakes per day that I was using to get her to eat her pred pill was enough (plenty!) to cause problems with her.

Your best bet to finding trigger foods is finding single protein cat foods that have low or no carbs. Carbs can be irritating in their own right and make it difficult to tell the difference between a carb intolerance and a protein reaction. Hence if she’s eating the RC dry right now, my first recommendation would be to switch her to the wet.

Rawz makes some very good single protein, low carb/no carb foods. They aren’t cheap and they’re difficult to find. But the same can be said for quality healthcare. If you find a food that makes her IBD go away, that’s worth the extra cost and trouble, right?

 

[The Practical Cat]

I feed my cats a raw diet with rabbit as the protein. Chicken gives my IBD cat a flare up. Novel proteins are things like duck, rabbit, venison, goat, etc, proteins not typically found in commercial cat food. Many IBD cats do well on a raw or home cooked diet or a bland-ish commercial novel protein preferably canned food.

At a compounding pharmacy. You may have a local compounding pharmacy in your area. Wedgewood Pharmacy is a popular online place for compounded medicines, Pet Medicine for Pets and Pet Meds for Horses - Wedgewood Pet RX Not all medicines can be compounded.

Oh ok, thanks for all the info!

Chemo won’t make her weaker like it does with humans. The dosages are different and cats tolerate chemo better. I’m pretty sure Krista would not still be with me if it weren’t for the chemo. Now if only I had eliminated the fish flakes months ago, she might be well on her way to putting on weight again. She’s 16 and very skinny!

Is the RC a wet food or dry food? Wet is better. Does she get any treats or any other food (table scraps?)? As I find out with Krista, even the three or four tuna flakes per day that I was using to get her to eat her pred pill was enough (plenty!) to cause problems with her.

Your best bet to finding trigger foods is finding single protein cat foods that have low or no carbs. Carbs can be irritating in their own right and make it difficult to tell the difference between a carb intolerance and a protein reaction. Hence if she’s eating the RC dry right now, my first recommendation would be to switch her to the wet.

Rawz makes some very good single protein, low carb/no carb foods. They aren’t cheap and they’re difficult to find. But the same can be said for quality healthcare. If you find a food that makes her IBD go away, that’s worth the extra cost and trouble, right?

I'm glad to hear your kitty is doing better on the chemo. Which drug is she on?

The RC is a dry food. She typically prefers wet so I would prefer to feed that but a wet version wasn't available and it's what the vet wanted me to stick to. I'm open to exploring other options at this point though, she's very weak and thin .

She doesn't get any table scraps. The only possible thing she could be getting is tiny bits of my other cat's wet food which is just standard IAMs. They are fed separately but I've caught her licking them up if there are teeny leftovers after so I need to be more diligent about cleaning the bowls immediately I guess.

I'll look into Rawz but I see it's around $45 for 18 cans on Amazon. Where have you been able to find it and was it any less expensive? I'd love to do everything I can for her but as I mentioned, I'm currently unemployed .

I do have some Purina Pro Plan wet food for sensitive skin and stomach left over from before I started the Royal Canin prescription. It's Arctic Char. Eating it didn't stop her vomiting, but she was also eating a dry version at the time too (dry in the morning wet at night). Would this type of food be recommended or is it not stringent enough?

 

[daftcat75]

Oh ok, thanks for all the info!



I'm glad to hear your kitty is doing better on the chemo. Which drug is she on?

The RC is a dry food. She typically prefers wet so I would prefer to feed that but a wet version wasn't available and it's what the vet wanted me to stick to. I'm open to exploring other options at this point though, she's very weak and thin .

She doesn't get any table scraps. The only possible thing she could be getting is tiny bits of my other cat's wet food which is just standard IAMs. They are fed separately but I've caught her licking them up if there are teeny leftovers after so I need to be more diligent about cleaning the bowls immediately I guess.

I'll look into Rawz but I see it's around $45 for 18 cans on Amazon. Where have you been able to find it and was it any less expensive? I'd love to do everything I can for her but as I mentioned, I'm currently unemployed .

I do have some Purina Pro Plan wet food for sensitive skin and stomach left over from before I started the Royal Canin prescription. It's Arctic Char. Eating it didn't stop her vomiting, but she was also eating a dry version at the time too (dry in the morning wet at night). Would this type of food be recommended or is it not stringent enough?

She takes chlorambucil (generic for Leukeran) as a compounded and concentrated anchovy flavored oil suspension. I mix it with a little salmon oil and about a spoonful of food. When she's made that disappear, she gets a breakfast directly after it. We started at twice a week and now we're doing every two week dosing.

You can get Rawz from Incredible Pets. They have 18 can cases for $35 and free shipping over $50. This is the rabbit flavor that Krista eats. It's a novel protein so she's not likely to have developed a sensitivity to it:
RAWZ 96% Rabbit Cat Can

Dry food has too many nonsense ingredients that don't belong in cat food. You can't make a shelf-stable dry food without them. But it's not what's best for cats either. Fish can also be inflammatory. I would recommend the Rawz in a non-chicken/non-fish flavor she hasn't had before (turkey, rabbit, duck, or beef perhaps) and stick to it without any other proteins or treats. Rawz will send you samples if you write them.

 

[shebaa]

it was never confirmed but my kitty has it. just too expensive for test. although we did an ultrasound, nothing showed. i feed my kitty natural balance venison. it has helped. she still throws up but not as much as before. wont spend $1000+ for other tests just for it to tell us what we already suspect.vet said out of all of the novel type of proteins, says she sees better results in venison diets, so she was happy that i was already feeding her that.

 

[cataholic07]

I would look into getting an ultrasound done at the very least to confirm if it is ibd/ lymphoma. My first cat had a small mammary tumor removed then almost 2 years later was diagnosed with GI lymphoma, small cell that turned into large cell.

If she has IBD she can not be on any dry food at all, wet food only and it can not have carrageenan or gums at all in it. Which generally rules out vet food and certain wet foods. Rawz, koha, houdns & gatos, instinct, are all good. You can check out catfooddb.com for a list of cat foods to see if you can find ones in your price range that has neither gums or carrageenan. You can also look at aafco balanced raw as some cats do great on it.

 

[LTS3]

Independent pet stores often sell higher end brands such as Rawz. You can look on the Rawz web site for a local store and authorized online sellers (Amazon is NOT one): RAWZ | Where to Buy

Rawz is awfully expensive. A 5.5 oz can can cost as much as $2.99 You can try limited ingredient diet brands of food that cost less.

 

[The Practical Cat]

Thanks, everyone! Since going on the metronidozale and cerenia Pandora hasn't been throwing up or had any diarrhea. For those of you who give your cat metronidozale how long did you give it? I thought it was a long term drug but the vet only prescribed 15 days worth. We're doing cerenia long term as it seems to be the only thing that stops her vomiting, and she's still also currently on prednisilone.

She still wasn't eating, so I'm trying Blue Buffalo Basics Duck wet food. This one was more affordable than some of the others. She seems to like it a lot more than the dry food. She's still not eating a lot but she's eating significantly more than she was (which was maybe 2-3 bites a meal). I'm hoping she won't have any adverse reactions to it and that she will start to eat a little more, but it is encouraging to see her eat with a little enthusiasm again.

 

[kittymama18]

For those of you who give your cat metronidozale how long did you give it? I thought it was a long term drug but the vet only prescribed 15 days worth.

I have this question too.. vet just RX 7 days of it for my kitty!