IBD or? 6yo female spayed kitty with high creatinine, normal BUN and SDMA

[kittymama18]

A few weeks ago my kitty started throwing up horribly. She's an outside kitty (in a fenced yard with my chickens, dog, and other cats; no other animals can get in) so I don't know if she had been throwing up before and I just didn't know it, but when this started it was bad. I brought her inside and put her in the bathroom (she is not reliable with a litterbox) with food w/ forti-flora and water. She didn't want either, just started getting weaker, throwing up bloody watery stuff, and I popped her in a carrier and zipped her to the emergency vet. (it was late evening on a Friday) About a thousand dollars later, I found out that it wasn't pancreatitis, she didn't have a blockage, and although her white count was a little high and her intestines were a little inflamed, there was nothing obviously wrong with her. They said possibly GERD or IBS and gave me cerenia for nausea and sent me home with direction to see her regular vet if she didn't bounce right back. Well, she didn't bounce right back, so after syringe feeding her bone broth with chicken pureed in it all weekend (bc I had a kitten with digestive issues a long time ago and the vet threw up her hands after giving him everything under the sun, so I syringed him with bone broth for a few weeks, and he recovered and she got worse every time I tried to give her canned food in water) I brought her to the regular vet. 1500$ more in testing and 3 days of hospitalization later, I learn that she probably has GERD or IBS (sigh) and they sent her home with metronidizole (SP?) and amoxicillin and prednisolone and sucraflate for stomach upset and mirtazipine to stimulate appetite. It's been a week, and every time I try to give her any store-bought cat food (including the RX stuff the vet sent home, and even the latest stuff I got at chewy that's literally just meat and vitamins plus rice) she gets sick again. So I've been giving her home-made bone broth with the meat from the chicken diced up in - which she happily eats and is putting weight back on after losing so much when she wasn't eating for so long. I was also supposed to start weaning her off the prednisone today but when I didn't give her the AM dose she started going downhill again so I called the vet and they said go ahead and give the dose since kitty is coming back in tomorrow for a follow-up anyway. She perke right bck up in few hours but the vet is reluctant to keep her on prednisolone for more than a week without weaning her off. But I was reading that cats with IBS are sometimes on these meds for months. If anyone has any suggestions, I would be SUPER grateful, including anything to ask the vet while I'm in there, bc I don't know even what to say. Both the ER vet and the regular vet said 'GERD or IBS' but they hinted 'cancer' and said an ultrasound would be needed to see more clearly - and I read online that a biopsy would be necessary to know for sure anything- but I'm more of a mind to say 'hey, just give me enough pred. to last a few months, and every few weeks I try to skip a dose and see what happens.' I have an autoimmune condition and there was a YEAR when I literally couldn't get out of bed without prednisone every AM. Anyway, I was hoping someone here with an IBS kitty or a GERD kitty or anything could give me some ideas. Right now her symptoms are "I am a happy playful and energetic kitty as long as I get homemade bone broth with homecooked chicken, tilapia or turkey diced in three times a day and my prednisone am and pm but if I get canned food of any kind, I get lethargic and lose my appetite, same if I miss a dose of prednisone." She is eating and drinking and pooping and urinating just fine - and happy as anything... as long as she is eating very simple bone broth and diced meat, and getting her 2x a day prednisolone. Sorry for the ramble, I'm at a loss I guess. Thanks in advance!!!

 

[Sajast]

Have the vets mentioned a prescription diet? My girl started vomiting quite a bit this past summer and was put on a hydrolyzed protein diet. She struck out on any novel protein I tried but some IBD cats can have their symptoms completely controlled through diet alone. She also has elevated eosinophils and inflammation in her intestines. We tried treating it like it was just IBD but a follow up ultrasound showed increased thickening so she just had biopsies done (she’s only 4). B12 injections seem to make the most difference for her - which makes sense as her intestines might not be absorbing it well enough from her diet and B12 deficiency can cause nausea. That being said, she has cerenia pills on hand and takes famotidine (Pepcid) daily while we wait for her to recover from surgery.

 

[LTS3]

Two web sites with more info on IBD and lymphoma:

IBDKitties – Helping Save Lives…One Paw at a Time

www.ibdkitties.net

Feline IBD - Healing can happen!

Address the root cause of IBD in your cat. Treat inflammation and gut dysbiosis with proper tools to restore health, not just manage symptoms.

www.rawfeedingforibdcats.org

IBS is different from IBD in cats, though. I think they're mostly both treated the same way.

as long as she is eating very simple bone broth and diced meat, and getting her 2x a day prednisolone.

What is in the diet? Just bone broth and meat? That's not a complete diet. But you can turn it into a complete diet by adding a pre-mix such as EZComplete. Instead of water, just use the bone broth to mix everything together. The pre-mix contains all the vitamins and minerals a cat needs.

daftcat75 will likely be along with a novel with tips and suggestions

 

[Mikalix]

What can you afford? If you can afford more tests, get the ultrasound first, as it will give you direction in what tests might be needed next. Biopsies are the only way to definitively diagnose IBS/IBD, and sometimes cancer. But maybe the ultrasound will send you in a different direction. If you can't afford more tests, then you basically have to go with trial and error using your and your vet's best judgement.

My cat has IBD, and the vet said it's likely she will be on prednilosone for the rest of her life. How long they are on pred for depends on the severity of the symptoms. It increases cats' risks of getting diabetes and infections when used for extended periods of time, so vets are understandably reluctant to prescribe it for longer than necessary. I have a couple threads on my own cat's journey to her IBD diagnosis, feel free to go to my profile to find them.

 

[kittymama18]

Have the vets mentioned a prescription diet? My girl started vomiting quite a bit this past summer and was put on a hydrolyzed protein diet. She struck out on any novel protein I tried but some IBD cats can have their symptoms completely controlled through diet alone. She also has elevated eosinophils and inflammation in her intestines. We tried treating it like it was just IBD but a follow up ultrasound showed increased thickening so she just had biopsies done (she’s only 4). B12 injections seem to make the most difference for her - which makes sense as her intestines might not be absorbing it well enough from her diet and B12 deficiency can cause nausea. That being said, she has cerenia pills on hand and takes famotidine (Pepcid) daily while we wait for her to recover from surgery.

Yes, they gave her Purina OM weight management formula - but she wouldn't touch the stuff, and the ingredients are garbage - she didn't start to recover at home till I stopped syringe feeding her the RX food and just gave her bone broth and chicken. She got b12 injections at the vet, and famotidine at the vet as well but it didn't seem to make a difference. She doesn't show any signs of nausea or pain or anything - as long as she's getting her 2x a day prednisone and meals of bone broth + home cooked meat.

 

[di and bob]

I reduced a cat with cancer down to 1/2 pill of prednisone daily from a full pill twice daily, and he did fine for over two years. Maybe after a year or so you could try 1/2 pill every other day, etc. Run this all by your vet and see what they say. Many people commented on my giving prednisone for so long, he could hurt his kidneys, etc., but without it, he was a drooling, miserable mess. With it, he was playful, alert, and clean. But I always told them, it is QUALITY of life that counts, not quantity. There was no cure for his cancer, he was dying. He was SO miserable without it...........

 

[kittymama18]

Two web sites with more info on IBD and lymphoma:

IBDKitties – Helping Save Lives…One Paw at a Time

www.ibdkitties.net

Feline IBD - Healing can happen!

Address the root cause of IBD in your cat. Treat inflammation and gut dysbiosis with proper tools to restore health, not just manage symptoms.

www.rawfeedingforibdcats.org

IBS is different from IBD in cats, though. I think they're mostly both treated the same way.




What is in the diet? Just bone broth and meat? That's not a complete diet. But you can turn it into a complete diet by adding a pre-mix such as EZComplete. Instead of water, just use the bone broth to mix everything together. The pre-mix contains all the vitamins and minerals a cat needs.

daftcat75 will likely be along with a novel with tips and suggestions

Yes, it's not complete as a permanent diet- At first I was just trying to keep her alive... Then I was expecting it to just be what I feed her till I get the fancy food in the mail. I got some tiki cat food as well, but now I'm afraid to try it on her, lol. I did also buy a pre-mix because after this I'm planning to cook all my cats' food myself again (I've done it in the past but during the move it became a huge ordeal - at one point it was all RAW feeding, and can I tell you, that doing raw food for that many cats was horrendous.) and will be putting some in at some point. She was literally on death's door 2 weeks ago, so I wasn't really worrying toooo much about long-term nutrient deficiencies. Although, in retrospect, I was giving her nutrical in her syringes with the broth, so I guess I was worrying about nutrition to some extent, lol!

 

[kittymama18]

What can you afford? If you can afford more tests, get the ultrasound first, as it will give you direction in what tests might be needed next. Biopsies are the only way to definitively diagnose IBS/IBD, and sometimes cancer. But maybe the ultrasound will send you in a different direction. If you can't afford more tests, then you basically have to go with trial and error using your and your vet's best judgement.

My cat has IBD, and the vet said it's likely she will be on prednilosone for the rest of her life. How long they are on pred for depends on the severity of the symptoms. It increases cats' risks of getting diabetes and infections when used for extended periods of time, so vets are understandably reluctant to prescribe it for longer than necessary. I have a couple threads on my own cat's journey to her IBD diagnosis, feel free to go to my profile to find them.

Thank you. I worry about the u/s and biopsies more for the distress to kitty than I do about the money. I've already spent 2500$ on this illness. It just seems like to me - hey, this is working, do we really need more testing? If she were not getting relief from any treatment, then I would want to figure out another option, but it seems like prednisolone is the answer for now, and if it ain't broke, don't fix it, kwim?

 

[kittymama18]

I reduced a cat with cancer down to 1/2 pill of prednisone daily from a full pill twice daily, and he did fine for over two years. Maybe after a year or so you could try 1/2 pill every other day, etc. Run this all by your vet and see what they say. Many people commented on my giving prednisone for so long, he could hurt his kidneys, etc., but without it, he was a drooling, miserable mess. With it, he was playful, alert, and clean. But I always told them, it is QUALITY of life that counts, not quantity. There was no cure for his cancer, he was dying. He was SO miserable without it...........

I agree 100% it's quality of life. Thank you very much. Poor boy - I'm glad he had you making those decisions, I'm sure he appreciated those pain-free days.

 

[kittymama18]

Back from the vet - her creatinine is off the charts but BUN and SDMA are normal. Vet is perplexed but afraid kidneys are failing bc of creatinine even though the other values are fine. Switched from prednisolone to gabapentin based on that concern. Kitty is not thrilled, but isn't too bad, still eating and drinking fine. I'm so confused.

 

[kittymama18]

I have a 6yo spayed kitty who has been dealing with labs and vet visits after a terrible vomiting episode abt 2 weeks ago. They thought maybe IBS or GERD, she's been on antibiotic and steroids for about a week. Brought her in for checkup today, she's fine as long as she gets her steroid 2x a day - vet did bloodwork and it came back with very high creatinine and normal BUN. They repeated the bloodwork thinking there had to be something wrong - creatinine came back at the top of the measured range - BUN unchanged. They checked SDMA nd it was normal. They're sending the labs out to another lab to double-check bc the vet has never seen elevated creatinine but normal BUN/SDMA. She's perplexed but gave kitty a ton of subq fluids, and is having me bring her back tomorrow for labs again, with the thought that if the creatinine levels are still this high kitty will be looking at kidney failure. Any thoughts on this would be very much welcome, it seems crazy to go from IBS to kidney failure in a week.

 

[FeebysOwner]

Any chance the vet considered pancreatitis? I have heard that can elevate creatinine without necessarily raising BUN. That might also explain the thought about your cat possibility having IBS. If the vet ran a full chemistry profile, you might see a high Precision PSL and/or amylase. However, a more specific test can be run to better confirm or deny pancreatitis, it called Spec fPL.

 

[kittymama18]

Any chance the vet considered pancreatitis? I have heard that can elevate creatinine without necessarily raising BUN. That might also explain the thought about your cat possibility having IBS. If the vet ran a full chemistry profile, you might see a high Precision PSL and/or amylase. However, a more specific test can be run to better confirm or deny pancreatitis, it called Spec fPL.

That was the 1st thing they checked when we went to the emergency vet - they thought it might be pancreatitis. The labs came back clean, though.... She's not nauseated at all anymore - for 2 weeks on Thursday night: no vomiting, no diarrhea - just normal eating and drinking and pooping and urinating.

 

[Antonio65]

Any chance your cat may be dehydrated? Dehydration can cause Creatinine to go high. Does your cat drink enough water?
What does she eat?
Dry food only provides little moisture and cats are known for drinking very little.

Also, my vets always asked me to fast the cat for at least 8 hours before the bloodworks, so I wonder whether your cat had been fasting (if your vet requires it).

 

[FeebysOwner]

That was the 1st thing they checked when we went to the emergency vet - they thought it might be pancreatitis. The labs came back clean, though.... She's not nauseated at all anymore - for 2 weeks on Thursday night: no vomiting, no diarrhea - just normal eating and drinking and pooping and urinating.

None of what you are describing would suggest kidney failure, IMO. But the steroids could be masking something, as they apparently are working - and, I have read about cases where those can also alter creatinine levels. Ask what the next tests would be and if she needs to be off steroids to give those tests a better chance of identifying some underlying cause.

Maybe you just need to give her (and, you) a break, for now?

 

[kittymama18]

Any chance your cat may be dehydrated? Dehydration can cause Creatinine to go high. Does your cat drink enough water?
What does she eat?
Dry food only provides little moisture and cats are known for drinking very little.

Also, my vets always asked me to fast the cat for at least 8 hours before the bloodworks, so I wonder whether your cat had been fasting (if your vet requires it).

She's been drinking a lot, I was worried about dehydration when she wouldn't eat or drink for days (before she got mirtazipine) and was giving her bone broth mixed with water, which she LOVES and she drinks a cereal-bowl sized bowl 3x a day with her chicken. I was actually worried about giving her so much water but they said her electrolytes and everything were fine, no worries about too much water, and they even gave her a TON of subq fluids as well. Looked like she had saddlebags on either side of her shoulders, poor thing. She hasn't had any dry food since the day she got sick, almost 2 weeks ago -and even then I always soak dry food in water for my kitties. It makes a sort of cat-food soup, lol and they love the 'gravy'. (I throw in some broth or a can of wet food to make the gravy more tasty) Plus it swells up so big they feel like they're eating more, lol! (I have some rescues that are piggies and would vacuum up all the other kitty's food if they could!) No, kitty wasn't fasting, she ate big bowl of chicken and broth before we went to the vet. I read that about fasting too, and am going to bring her in fasting tomorrow, even though the vet didn't ask me to.

 

[kittymama18]

None of what you are describing would suggest kidney failure, IMO. But the steroids could be masking something, as they apparently are working - and, I have read about cases where those can also alter creatinine levels. Ask what the next tests would be and if she needs to be off steroids to give those tests a better chance of identifying some underlying cause.

Maybe you just need to give her (and, you) a break, for now?

Good point! They said no more steroids at all, just in case it is kidney failure. Gave her gabapentin for pain, in case the pain gets bad enough to keep her from eating/drinking...
Thank you for saying this, it eases my mind a little. I think tomorrow they're just going to repeat the same tests to see if it was a fluke, and go from there. The thing that's hard is - I feel like I just want to let her recover, like she had a bad bout of food poisoning or something, who knows, and she is getting better now. But they are so worried about the labs, bc her white count kept going up and now the crazy high creatinine - I feel like they were saying before,'you have to take action early in case it's cancer' and now it's like 'you have to take action early in case it's kidney disease'- and the pressure of 'you have to take early action or she'll DIEEEEE' is stressing me out! I'm going to de-stress by cuddling her some, lol, because she apparently doesn't realize she's sick and should be feeble, so is playful, cute, and adoring like she always has been.

 

[kittymama18]

Last night she pulled out a ton of fur, there were little poofs all over the bathroom. She hasn't pooped since they took her off prednisone but yesterday evening, 2 drops of what looked like oil drips under an old car in the litterbox. Little black shiny drops. I scooped them out with toilet paper and (gross I know) smooshed them with the paper and they made normal poop-color smears on the TP but in the box they were black as tar.
And she's bouncing around and chirping and purring and wanting to play.
It's not like I want her to feel sick, it's just confusing. How can she have so many bizarre symptoms but act normal?

For the mods - I made 2 separate threads bc the vet is no longer concerned about IBD etc, and is focusing on the creatinine as 'OMG she has kidney failure' so it's really 1 cat, 2 different health issues. Like -"does she have IBD or something else?" AND "does she have kidney disease or something else?" -- unless IBD can cause high creatinine levels? Her creatinine was so high, the vet was basically saying the IBD doesn't matter, given that kitty is on the verge of complete kidney failure/death.

 

[kittymama18]

No new news- apparently the vet didn't send off their labs in time so they won't be back till monday, backup vet isn't concerned, and they'll call on Monday. So I am changing to the vet I used to use (hard to get in, they're alway backed up) - I was able to get kitty in on Monday, so will hopefully have something new. She's pooping nasty stinky black-looking puddles, but is happy, eating, drinking, playing, cuddling. I'm giving her forti-flora and and bone broth with boiled meat still, which she loves.
I think the fur pulling might be that she picked up a flea at the vet. She's allergic to fleas. I gave her a capstar, and she was biting and scratching for a while (while the flea(s) died?) but hasn't pulled out any hair since. So all that's left is scary poops, I guess. I'll give her some slippery elm too, I think, and the vet had me pick up some omeprazole which will hopefully help.
Any thoughts would be welcome!

 

[kittymama18]

And she’s throwing up again. I had a tablet of cerebra left and googled the dosage - the er vet had me giving her 16mg - she weighs about 6lbs. According to google her correct dose is muuuuch smaller. So I gave her half a tab instead and she hasn’t thrown up since thankfully. Still dripping black poop. Still happy in am and lethargic in evening. I forgot to mention before that her wbc came back as normal early this week so at least thats better. The fur pulling has slowed but not stopped. I wonder how long an allergic reaction to a flea bite lasts after the flea is dead.