Ibd ? Hiding

[Allyocean]

My boy Max has had 3 ultrasounds in a year and I've been told by the surgeon he believes it's IBD and doesn't recommend a biopsy. We have tried pred, tylosin,metronidazole and now a few days on kittybiome gut restore. He's getting worse it seems. Now he's hiding intermittently and ravenous all the time. No energy. We've done allergy testing and diet changes and now we're doing the ibdkitty homemade meals. Also weekly b12 cerenia as needed.. I'm unable to find a solution. I believe I'm going to schedule his biopsy today. Not sure if it should just be endoscopic or complete? It's 4800 for complete and 3200 endoscopic. And how much do I put him through? I'm so sad. Just like everyone here probably feels about their cat...I love him! I'm not finding many long term ibd kitty success stories. Hoping someone can tell me this is normal and he will be fine. My heart is breaking. He's been through so much. Flutd and seizures both now are managed with accupunture and homeopathics. Last June he was diagnosed with pancreatitis and its been a year of cycling symptoms that just keep coming.. in the last 3 weeks. No good days.
I just needed to talk. My heart hurts

 

[LTS3]

My cat has had IBD for a few years now and is pretty well managed with diet and a low dose of pred. Every cat is different so it may take trying different things to find what works best for your cat. Have you seen these two web sites?

IBDKitties – Helping Save Lives…One Paw at a Time
Feline IBD

daftcat75 may have suggestions for other things you can try.

 

[Allyocean]

Thank you for that but I've exhausted all the options they give except doing the empirical chemo

 

[Allyocean]

My cat has had IBD for a few years now and is pretty well managed with diet and a low dose of pred. Every cat is different so it may take trying different things to find what works best for your cat. Have you seen these two web sites?

IBDKitties – Helping Save Lives…One Paw at a Time
Feline IBD

daftcat75 may have suggestions for other things you can try.

Did your kitty seem to just feel horrible during trial and error phase? He is hiding intermittently and very lethargic for past 2 weeks plus. Is this normal whilst figuring out what works?

 

[LTS3]

He actually felt fine in the beginning. His symptoms were mainly vomiting and not quite diarrhea. Since then, he's had a few flare ups where he's clearly uncomfortable (crouching, not eating, squinty eyes). Those were caused by eating something that didn't agree with his tummy.

 

[Allyocean]

He actually felt fine in the beginning. His symptoms were mainly vomiting and not quite diarrhea. Since then, he's had a few flare ups where he's clearly uncomfortable (crouching, not eating, squinty eyes). Those were caused by eating something that didn't agree with his tummy.

Did you confirm ibd with biopsy?

 

[LTS3]

I did. I don't recall how much it cost but it was probably $2K or so.

artiemom recently had a biopsy done on her cat and it turns out her cat has small cell lymphoma which is being treated with chemo and a few other medicines. There's a thread about that: Geoffrey Small Cell Lymphoma

 

[artiemom]

Yes, I think I ended up paying 1900 for the endoscopy with biopsy. I did get a fair reimbursement from the insurance company---not all, but a fair amount. I expect the premiums to sky rocket next year due to all the claims I am submitting.

 

[daftcat75]

My boy Max has had 3 ultrasounds in a year and I've been told by the surgeon he believes it's IBD and doesn't recommend a biopsy. We have tried pred, tylosin,metronidazole and now a few days on kittybiome gut restore. He's getting worse it seems. Now he's hiding intermittently and ravenous all the time. No energy. We've done allergy testing and diet changes and now we're doing the ibdkitty homemade meals. Also weekly b12 cerenia as needed.. I'm unable to find a solution. I believe I'm going to schedule his biopsy today. Not sure if it should just be endoscopic or complete? It's 4800 for complete and 3200 endoscopic. And how much do I put him through? I'm so sad. Just like everyone here probably feels about their cat...I love him! I'm not finding many long term ibd kitty success stories. Hoping someone can tell me this is normal and he will be fine. My heart is breaking. He's been through so much. Flutd and seizures both now are managed with accupunture and homeopathics. Last June he was diagnosed with pancreatitis and its been a year of cycling symptoms that just keep coming.. in the last 3 weeks. No good days.
I just needed to talk. My heart hurts

Is he losing weight and is he able to regain lost weight? If you opt for a surgical biopsy, there’s going to be a recovery period where he may lose more weight. If his weight isn’t currently stable or he cannot regain lost weight, I am not sure I would recommend a surgical biopsy. Instead, you have an informed consent discussion with your vet where you say, “I believe the diagnosis is riskier than the drug. I would like to try adding chemotherapy even though I do not want to subject Max to a biopsy.” An endoscopic biopsy carries less risk and is less invasive than a surgical biopsy. But it has its limitations. The endo can only reach so far. If his infiltration site is further inside his small intestines than the endo can reach, the biopsy may not grab any useful data. It’s also not entirely without risk itself. My Betty had an endo biopsy. Two days later she was looking and feeling awful and barely eating. I spent a whole other endo’s worth of vet bills on more tests and imaging to find out why Betty was doing so poorly after her endo. In the end, she was prescribed antibiotics and that turned her around. But not before spending another $3000 on emergency vet bills and additional imaging (X-rays and ultrasounds.) In the end, the biopsy pretty much confirmed what I already suspected. Betty is able to regain lost weight. That’s usually not possible with lymphoma. The biopsy did not reveal any cancerous cells.

If Max is losing weight and unable to regain weight, that’s a strong suggestion of lymphoma. I would strongly discourage a biopsy and instead beg and plead to try chemo without the diagnosis. If Max can regain lost weight, then it’s not likely to be lymphoma and I would save your money and spare him the trouble.

The Gut Restore Supplement takes awhile to help. I believe it was a couple weeks before I started to see improvements in both appetite and hairball frequency (Betty’s only symptoms.). Have you ordered a Gut Biome Test? If you haven’t, I strongly recommend that. It’s going to be so much cheaper than a biopsy or an ultrasound and it will give you a starting baseline to measure the effectiveness of the Gut Restore Supplement. There’s so much interesting data in those reports along with many helpful recommendations. The testing will also reveal just how unbalanced his gut may be. For particularly severe cases, you may need to give two capsules a day. Betty’s reports say that she has a mild to moderate imbalance. After one month, we saw improvement. But a ways still to go. Betty is now on her second course of those pills. And because she needed antibiotics to get over her endo, she’s also on the Gut Maintenance pills too. She takes a Gut Restore in the morning and a Gut Maintenance in the evening. AnimalBiome support told me to finish the GMP bottle to help correct the effects of the antibiotics. She probably still has another week left on her second course of Gut Restore. I have ordered her third course. I plan to keep giving her both pills and repeating the tests until the reports don’t show imbalance. Though even if I give these the rest of her life, if it spares her from steroids, and so far it has, that’s fair and far preferable to starting such a young cat (5 years) on what could become a lifetime of steroids. Betty’s report strongly suggests that she was a kibble addict before she came to me and that she may have been presenting IBD symptoms before I got her. I suspect it may have even been a part of the reason why her previous owner surrendered her.

Finally, because youre trying everything and still he is struggling, I would look into supplements from Vitality Science. You can look at the TRV or TRDV combo protocols or individual supplements. They even have a Finicky Cat Trial pack so you can try samples of certain supplements.

 

[Allyocean]

Did you confirm ibd with biopsy?

Can't get it done till August 17. Spent night in ER..pancreatitus again they believe.

 

[Allyocean]

Is he losing weight and is he able to regain lost weight? If you opt for a surgical biopsy, there’s going to be a recovery period where he may lose more weight. If his weight isn’t currently stable or he cannot regain lost weight, I am not sure I would recommend a surgical biopsy. Instead, you have an informed consent discussion with your vet where you say, “I believe the diagnosis is riskier than the drug. I would like to try adding chemotherapy even though I do not want to subject Max to a biopsy.” An endoscopic biopsy carries less risk and is less invasive than a surgical biopsy. But it has its limitations. The endo can only reach so far. If his infiltration site is further inside his small intestines than the endo can reach, the biopsy may not grab any useful data. It’s also not entirely without risk itself. My Betty had an endo biopsy. Two days later she was looking and feeling awful and barely eating. I spent a whole other endo’s worth of vet bills on more tests and imaging to find out why Betty was doing so poorly after her endo. In the end, she was prescribed antibiotics and that turned her around. But not before spending another $3000 on emergency vet bills and additional imaging (X-rays and ultrasounds.) In the end, the biopsy pretty much confirmed what I already suspected. Betty is able to regain lost weight. That’s usually not possible with lymphoma. The biopsy did not reveal any cancerous cells.

If Max is losing weight and unable to regain weight, that’s a strong suggestion of lymphoma. I would strongly discourage a biopsy and instead beg and plead to try chemo without the diagnosis. If Max can regain lost weight, then it’s not likely to be lymphoma and I would save your money and spare him the trouble.

The Gut Restore Supplement takes awhile to help. I believe it was a couple weeks before I started to see improvements in both appetite and hairball frequency (Betty’s only symptoms.). Have you ordered a Gut Biome Test? If you haven’t, I strongly recommend that. It’s going to be so much cheaper than a biopsy or an ultrasound and it will give you a starting baseline to measure the effectiveness of the Gut Restore Supplement. There’s so much interesting data in those reports along with many helpful recommendations. The testing will also reveal just how unbalanced his gut may be. For particularly severe cases, you may need to give two capsules a day. Betty’s reports say that she has a mild to moderate imbalance. After one month, we saw improvement. But a ways still to go. Betty is now on her second course of those pills. And because she needed antibiotics to get over her endo, she’s also on the Gut Maintenance pills too. She takes a Gut Restore in the morning and a Gut Maintenance in the evening. AnimalBiome support told me to finish the GMP bottle to help correct the effects of the antibiotics. She probably still has another week left on her second course of Gut Restore. I have ordered her third course. I plan to keep giving her both pills and repeating the tests until the reports don’t show imbalance. Though even if I give these the rest of her life, if it spares her from steroids, and so far it has, that’s fair and far preferable to starting such a young cat (5 years) on what could become a lifetime of steroids. Betty’s report strongly suggests that she was a kibble addict before she came to me and that she may have been presenting IBD symptoms before I got her. I suspect it may have even been a part of the reason why her previous owner surrendered her.

Finally, because youre trying everything and still he is struggling, I would look into supplements from Vitality Science. You can look at the TRV or TRDV combo protocols or individual supplements. They even have a Finicky Cat Trial pack so you can try samples of certain supplements.

We did order the gut restore starter kit and did 1 dose now the pancreatitis so I feel like I should hold off till this resolves but will check with internist Tom. He hasn't lost but 1/2 lb in a year but we also switched to a homemade diet after finding he's allergic to 14 foods! But not poultry! He's 14.6 lbs. Not fat he a very large cat. We are on metronidazole and vet said to continue while on gut restore.. I didn't do the test because he was constipated and I just wanted to begin but I will next poop. Do you think I should get the endo or start chemo drugs? I really don't want the complete biopsy since he has had bad reactions to everything they give.

 

[daftcat75]

We did order the gut restore starter kit and did 1 dose now the pancreatitis so I feel like I should hold off till this resolves but will check with internist Tom. He hasn't lost but 1/2 lb in a year but we also switched to a homemade diet after finding he's allergic to 14 foods! But not poultry! He's 14.6 lbs. Not fat he a very large cat. We are on metronidazole and vet said to continue while on gut restore.. I didn't do the test because he was constipated and I just wanted to begin but I will next poop. Do you think I should get the endo or start chemo drugs? I really don't want the complete biopsy since he has had bad reactions to everything they give.

If he’s not losing weight, it’s probably not lymphoma. Not yet anyway. I would skip the biopsy. I would focus on the pancreatitis. That’s more acute. As long as he’s on metro, I would order the Gut Maintenance Protocol pills from AnimalBiome. The GMP will help protect against the negative effects of antibiotics. You may want to hold off on the Gut Restore until he’s finished the metro. I would also open a dialog with AnimalBiome. They can be very helpful. As a company, they are likely newer than anyone’s education on your team. In other words, it’s surprising if anyone on your team is familiar with them and what they do. So until more vets become actively aware and familiar with the AnimalBiome protocols, AnimalBiome would be the best ones to talk to about their products. They are very knowledgeable and return emails quickly. [email protected]

 

[Allyocean]

I think what you're saying makes total sense. Thank you. He has been so miserable off and on since original pancreatitus last June. He even looks different. Uncomfortable all the time. Of course my heart is bracing for the worst but still searching for answers. Hearing from you makes me hopeful. How long was your journey to the right combo?

 

[Allyocean]

If he’s not losing weight, it’s probably not lymphoma. Not yet anyway. I would skip the biopsy. I would focus on the pancreatitis. That’s more acute. As long as he’s on metro, I would order the Gut Maintenance Protocol pills from AnimalBiome. The GMP will help protect against the negative effects of antibiotics. You may want to hold off on the Gut Restore until he’s finished the metro. I would also open a dialog with AnimalBiome. They can be very helpful. As a company, they are likely newer than anyone’s education on your team. In other words, it’s surprising if anyone on your team is familiar with them and what they do. So until more vets become actively aware and familiar with the AnimalBiome protocols, AnimalBiome would be the best ones to talk to about their products. They are very knowledgeable and return emails quickly. [email protected]

I will reach out to animalbiome again. His internist was the one that recommended. In my few interactions I haven't found them very helpful. Did you email or call?

 

[silent meowlook]

I didn’t read all the replies. Has he been checked for hyperthyroidism? Depending on his age he should be checked.
My cat has hyperthyroid and had IBD and now we suspect lymphoma. I chose not to do biopsies, and just treated as if it is intestinal lymphoma. I treat with Chlorambucil which is chemo. It is one tablet every other day or three times a week. She gets Prednisolone and Methimazole for thyroid. I feed a limited antigen canned food diet, venison, Royal Canin. She is doing well for the last year on this. I tried giving probiotics and other supplements but she wouldn’t eat. When I did give the probiotics consistantly for several months, I didn’t notice a difference. I give her Vit b 12 every other week.

With the biopsy, you don’t always get an answer. There is also the added stress of anesthesia. Endoscopy inst as invasive but you don’t get good samples so you can wind up with results that show inflammation, but don’t tell what’s really going on. With surgery, you can get full thickness samples but still can get an inconclusive result and the amount of stress and pain for your cat can make them far worse after.
Basically IBD can become intestinal lymphoma from the chronic inflammation. An experienced board certified internal medicine vet should be able to give you a pretty good idea what is going on from an ultrasound. Not invasive at all. They can see if the intestinal muscular layer is thickened and if the lymph nodes are enlarged. You can make a decision on treating with chemo off of that.
My cat had no ill effects from chemo. It improved her quality of life. It also isn’t expensive since I have it compounded through a pharmacy.

 

[daftcat75]

I think what you're saying makes total sense. Thank you. He has been so miserable off and on since original pancreatitus last June. He even looks different. Uncomfortable all the time. Of course my heart is bracing for the worst but still searching for answers. Hearing from you makes me hopeful. How long was your journey to the right combo?

Betty is a much different case. I got her six months ago. Shelter thinks she is five years old. I’m not convinced that she has IBD. Or if she does, it’s a mild case. Or so I think. I’m not an expert on IBD. IM says she has significant inflammation in her gut. But the only symptoms I ever saw was nausea and hairballs. She doesn’t throw up food. And she doesn’t have any poop issues. She’s had several ultrasounds that say inflammation and a biopsy that did not suggest lymphoma. The AnimalBiome test results seem to suggest that she was a kibble addict before she came to me. It’s possible that she was maybe throwing up more in her old home; perhaps a contributing factor to her surrender. When I brought her home, it took a month or so to figure out what to feed her. Then a disastrous food transition left her nauseated and barely eating all the time. Oh! And when I say she has hairballs, they were not one and done affairs. They would tear her up for half a day. It was on one of these days that she got down to the pink spits that I took her to an urgent care. There they gave her prescriptions for sucralfate, Pepcid, mirtazapine, and Cerenia. I asked my regular vet for ondansetron instead. Ondansetron is more effective against nausea while Cerenia merely short circuits the vomit response. She was also sent home with Hills I/D in both the stew cans and pate cans. She didn’t like the I/D pate but she loves the stew. Since her appetite was still lagging, I needed something to mix with the I/D to get her up to enough calories to regain lost weight and maintain her weight. I got her Hills A/D recovery food and she loves it. But it’s too rich. And she doesn’t eat enough of the A/D alone. So for a month or two, I kept tweaking until we landed on a ratio of I/D to A/D and a feeding schedule that works for her. She took Pepcid and ondansetron twice a day and the mirtazapine gel in her ear once a day. We hovered in a holding pattern like this for almost two months waiting for the initial specialist appointment. We did the endoscopy and biopsy. I wasn’t so concerned about lymphoma because she was able to regain lost weight. But I wanted to 1) humor the IM because she’s still young and I don’t want to simply put her on steroids and hope for the best, but 2) more importantly, I wanted to rule out a stomach ulcer since she did have those pink spits on hairball days. As soon as we ruled out an ulcer, I dropped Pepcid from her meds.

It was while we were waiting for that initial appointment that I also got her started on the AnimalBiome Gut Restore Supplement for one month with before and after tests. We finished that first month and sent in a sample for the after test. We did not immediately start a second month. In the time that we were waiting for the after report, she started backsliding again. So I ordered her another month of pills and contacted AnimalBiome by email. I have a dialog going with a helpful and knowledgeable woman there named Alex with the title of Chief of Staff. If that’s not who you spoke with, maybe you could ask for her.

After her endo, she felt very poorly. She didn’t eat well and looked awful. So two more urgent care visits later, more X-rays and ultrasounds, the IM wanted to start her on steroids saying that should shore up her appetite. I pushed back and said, if there’s an infection here, should we start her on an immunosuppressant? That was the right question to ask. He gave me a prescription for antibiotics. It literally turned her around overnight. Alex told me about the protective effects of the GMP supplement since we were already a month and a half into restoring Betty’s gut and I didn’t want the antibiotics to throw out all that progress.

So Betty is still on mirtazapine and ondansetron. She takes the mirtz pill (quarter of a 7.5 mg pill) every other day and the ondansetron twice a day. She may or may not need the ondansetron anymore. But I’m afraid to take her off that one. She also takes a Gut Restore in the morning and a Gut Maintenance in the evening. Alex told me to finish the GMP bottle to make sure nothing undesirable takes residence in the void the antibiotics left.

Two weeks ago I ran out of the Hills AD I buy directly from the vet and opened a case that I ordered through their mail order service. That case was no good. The food looks too soggy and she barfed food for the first time in a very long time. The only other times she had barfed food (rather than hairballs) was during failed food transitions. I got her another case from the vet’s office. But she doesn’t care for this one either. Thankfully she still takes her meds coated in the AD. But thanks to the AnimalBiome pills, her appetite has gotten better and she can now eat enough of the I/D alone. So we’re on day three or four of just the I/D. She’s eating it well enough to hit her calorie target.

So where does Betty stand now? She still has the occasional hairball. But instead of it being a weekly affair, she can sometimes go two or three weeks between them. And instead of her hairballs being all day affairs, they last couple have been one and done. So maybe the ultrasound may still show thickening, but so far Betty has been able to avoid steroids with the AnimalBiome pills. Because her symptoms are improving, I’m not going to put my wallet through another ultrasound. The specialist wants to see her on a follow up in early August. I’m nearly inclined to push him off and go back to my regular vet. But he is the specialist. And she has been on medication for a long time now. So I’m going to humor him once more and allow a physical and lab work. But no more imaging for now. I also want to consult with him about how to wean her off the mirtazapine. She gets so crazy on mirtz nights and I would love to get her off it already. But since she’s been on it for so long and because it is an antidepressant (with a munches side effect), I need professional guidance on how to get her off it. Simply stopping would be very hard and potentially dangerous on her.

I’m still waiting on the latest Gut Health test I sent in directly after she completed her antibiotics. I really wanted to see what antibiotics would do to her microbiome. She’s nearly finished her second month of Gut Restore and I’ve already received her third bottle. I plan to keep her on these and do regular testing as long as her reports say she needs it and as long as she’s making progress. My only criticism of the AnimalBiome products and protocols is just how long the turnaround is on the tests (2 to 3 weeks.) But in the two reports I’ve seen, she made great progress on her first bottle. It’s a relief to see that the reports confirm what I’m seeing empirically. She is doing better than where she started from. It likely took many years for her gut to get as imbalanced as it was. So I think it’s reasonable that it may take several months of the Gut Restore to fix it. And even if it becomes an ongoing part of her treatment, I still much prefer these pills and tests to steroids and ultrasounds.

So that’s Betty. Much different than your guy.

Krista, my IBD cat before Betty, was a whole different story. She had a much more classical case of IBD: chicken and fish intolerances. She vomited food as you would expect from IBD. She didn’t have poop issues until it had progressed to lymphoma. She also had tooth resorption and eventually had her remaining teeth extracted (after many prior rounds of extractions.) I stupidly let her have as much tuna food as she wanted to help her through her mouth recovery. I called it tonsils out protocol: all the ice cream she wanted. Well tuna was a trigger food of hers and two weeks eating that much tuna sent her gut inflammation into overdrive. Her IBD progressed to lymphoma. Maybe the lymphoma was already simmering. I first had to start her on steroids. To get her to eat her pill, I wrapped it in tuna flakes. I called it our devils bargain. But that was another mistake. It kept the inflammation burning. With Krista, her lymphoma was diagnosed empirically: we tried steroids. It wasn’t working. She was losing weight despite eating more than enough. She wasn’t in good condition for a biopsy and I had to go over my vet’s head to the owner of the practice to beg for chemo without a biopsy. The chemo helped. But she didn’t reach full remission until I took out the fish flake wrapped pred pill and changed her to transdermal pred. It was too little too late. She was much too tiny and her immune system suppressed for too long. She would only enjoy one month of remission before a bladder infection would prove too much for her.

Two very different IBD cats!

 

[Allyocean]

What a journey! I've done much of what you've done. I feel like Max has elements of both your babies. Now with the pancreatitis again I'm hesitant to do either biopsy. I really only want to do the animalbiome products but I'm concerned with him suffering while it's taking effect. I already sent an email immediately after you.mentioned it so I'll see how they respond. He responds so horribly to steroids, pain meds ...everything but what if I don't try chemo.? My gut tells me it will be a disasterfor him like every single pharmaceutical has been....there must be something I can do to help him! something I'm missing.

 

[daftcat75]

I recommend a food journal if you aren’t already keeping one.

I have a Google Sheets spreadsheet. Each tab is a new week. Each week has the seven days starting on Sunday. There’s three columns per day. Grams of food. Calories per gram. Calories for that meal. I use the Comment feature on individual cells to make notes like how she ate, how she looked after, if she left a remainder, etc. If she has an incident, I color fill that cell and make a note. I also add an (I) to the tab name so I can see which weeks she had incidents. Then I can see at a glance by the colored cell when the incident occurred. In this way, I can easily look for patterns. I have found that Betty starts to leave remainders before she’s going to hairball. I can also use her food journal to plan out calories especially when she’s had a hairball. Finally, once a week, on Sundays, I use a little bit of kibble (the only time she ever gets kibble) to lure her onto the baby scale for a weekly weigh-in.

I use purple on the days to tell me which days she gets mirtazapine. I also have an Apple Calendar event with every other day repeat. This is by far the easiest way for me to remember which days she gets it. The blue meals mean I plated them but didn’t book them when she finished. Those should be white because she didn’t leave any remainders.

 

[Allyocean]

Really clever! Me I use a notebook going on 4 years and record similar notes. It's been invaluable. I noticed his voice has changed last 2 days and he sticks his tongue out frequently. Never did. Also he has like congestion sounds when breathing. After hearing about Cole, who looks just like Max, and how his lymphoma metastasized now I'm worried. He's ravenous 98% of time. Eating like a champ and isn't putting on weight. But I removed kibble too. He's just not moving much. Could be but but I'm terrified

 

[silent meowlook]

Have his thyroid checked.