Ibd Or Lymphoma - Should I Biopsy Or Not?

Bookgirlac

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Hi all. I'm new to the board but hopeful I can get some feedback from those of you who have been through a similar experience with their cats.

I found this forum by looking at this topic:
IBD or Small Cell Lymphoma - To biopsy or not to biopsy

I have a similar experience to the one in the thread above, with some differences. My cat, Dusti, is approximately 13. She is my baby. Around seven months ago now, I had some major life-changing events. My elderly father, who lived with me and Dusti, experienced poor health, almost died, and has been in nursing care since. My job has been demanding and stressful for me, along with the stress over my father, so it was about four months ago when I noticed Dusti — who was a hefty 16 pound kitty who needed to lose weight — began losing weight, I put it down to stress and her new diet (I suspect my father fed her treats all day while I was at work).

Almost two months ago, I realized I could feel her ribs, and she began vomiting when she ate. Occasionally, she wouldn't eat at all. So I took her to the vet in mid-June and she weighed 8.6 pounds, down from 16 pounds in November. Her bloodwork showed a high white blood cell count and elevated lymphocytes and liver enzymes. Her kidneys were fine. Her vet worried she had fatty liver disease, or another liver disease, so she was put on oral nausea medicine and antibiotics. She took the nausea pill at first and began eating again without problems, but she vomited after every dose of the antibiotics so I didn't give her any more. She gained half a pound back within a week or so. She stopped taking the nausea pill (sneaky devil would spit it out) and began experiencing vomiting again. Her weight continued to fall on weekly checks. They tried to give her fluids via IV, but she fought them, and they did a subQ-IV instead with nausea medicine and an antibiotic. She did well for about a week, and then the vomiting started again. They ordered some nausea medicine for me to give by rubbing it on her ear, along with some anxiety medicine to ease her stress when I take her in for weight checks and to see the vet. It all helped, but although she was eating ferociously, she was still losing weight. They gave her more fluids and nausea medicine last week, and when I brought her home, she would no longer eat at all (before the visit, she was eating like a horse). She had some vomiting and began drinking water like a fish.

After three days of not eating on her own and vomiting up bile, I took her to the emergency vet last night. They repeated her bloodwork and did Xrays. Her liver enzymes were perfectly normal now. Her white blood cell count is slightly elevated, and her lymphocytes are still elevated. The Xrays showed no obtrusion and "a lot of gas throughout her intestines." She was given more fluids and nausea medicine along with a prescription of prednisolone. The emergency vet said I should consider a GI biopsy because her belief is that Dusti has Inflammatory Bowel Disease or GI Lymphoma. Even though they gave her nausea meds through the IV, she still vomitted this morning and wasn't eating. After one dose of the prednisolone, she has started eating and, as far as I can tell, hasn't vomited again. I consulted with Dusti's vet this afternoon. She, too, recommends a biopsy, but I've been reading about them online and am worried, especially about the cost. I'm not sure Dusti could handle the stress of a biopsy. She runs when she sees me now and is very aggressive if she thinks I'm trying to pick her up. Previously, she was always a cuddle bug and easy tempered.

I'm worried I will have to have her put to sleep because I don't want her to suffer; however, I don't want to give up on her if there's a chance she has something she can overcome. If anyone has any advice on whether or not to do the biopsy, I'd appreciate it. I've read so much online that recommends against doing it, I'm truly torn.

Thank you for your feedback.
 

catcrazycanuck

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So sorry to hear what you're going through. It sounds quite similar to my ordeal except until now the weight loss wasn't as extreme and when he ate regularly again he put it back on.
Seems you have had success with the nausea meds. Can i ask what you used? I have had luck with Cerenia injections, mostly, but not always.
As for the biopsy that is a tough one. If they can do it by fine needle aspiration during ultrasound the risk is lower than surgery but seeding is a possibility. Depends where they want to biopsy from. I was told that in order to access the small intestines it can only be by done surgically. At least there is no mass or amemia so it sounds like IBD and not lymphoma or other cancer. On one hand it's good to know for sure but there is also recovery from surgery by a weak and ill cat. That was my concern and why i didn't do it.
If you want info about treating with diet, supplements and homeopathic remedies I am happy to discuss. If not, no offense taken. Since it gave my cat his life back I just want to try to help others through such a horrible illness. Big hugs to you.
 
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Bookgirlac

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So sorry to hear what you're going through. It sounds quite similar to my ordeal except until now the weight loss wasn't as extreme and when he ate regularly again he put it back on.
Seems you have had success with the nausea meds. Can i ask what you used? I have had luck with Cerenia injections, mostly, but not always.
As for the biopsy that is a tough one. If they can do it by fine needle aspiration during ultrasound the risk is lower than surgery but seeding is a possibility. Depends where they want to biopsy from. I was told that in order to access the small intestines it can only be by done surgically. At least there is no mass or amemia so it sounds like IBD and not lymphoma or other cancer. On one hand it's good to know for sure but there is also recovery from surgery by a weak and ill cat. That was my concern and why i didn't do it.
If you want info about treating with diet, supplements and homeopathic remedies I am happy to discuss. If not, no offense taken. Since it gave my cat his life back I just want to try to help others through such a horrible illness. Big hugs to you.
Thanks for responding. The nausea med Dusti has been on, first as a pill and now as a transdermal compound I rub on her ear (from Wedgewood Pharmacy), is Famotidine 2 mg. When they've done the SubQ IV, they've given her cerenia as an injection.

I'd be very interested to get your info on treating with diet, supplements and homeopathic remedies. The vet did mention today that she was concerned because Dusti was anemic, which I didn't understand but I guess it could indicate lymphoma. I'm quite ill with worry over this, so if you have any advice on what worked homeopathetically for your furbaby, please pass it along. Thank you!
 

mewcatmew

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A good number of vets will give chemotherapy based on ultrasound alone. If it is IBD, your cat would be on sterioids, with cancer it would be steroids + a chemotherapy pill. The diagnosis of cancer vs IBD is expensive and will cost a couple thousand dollars. You can ask your vet about the option of just going ahead with treatment. I don't see if they did an ultrasound. GI lymphoma/IBD look very similar, but if it is one of those two, it would show a thickening of the intestinal layers. That might be enough to say it is indeed IBD/Lymphoma, and they may go ahead with treatment. Ask your vet about that.
 
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Bookgirlac

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A good number of vets will give chemotherapy based on ultrasound alone. If it is IBD, your cat would be on sterioids, with cancer it would be steroids + a chemotherapy pill. The diagnosis of cancer vs IBD is expensive and will cost a couple thousand dollars. You can ask your vet about the option of just going ahead with treatment. I don't see if they did an ultrasound. GI lymphoma/IBD look very similar, but if it is one of those two, it would show a thickening of the intestinal layers. That might be enough to say it is indeed IBD/Lymphoma, and they may go ahead with treatment. Ask your vet about that.
Thank you. I will speak to her vet about an ultrasound and treatment tomorrow. She has eaten very little today and won't come to me for cuddles or affection. My brother is staying with me and she's affectionate with him, just not me at the moment. She sees me and runs. That is hard to experience. I can't afford the estimate they gave me for a biopsy, which would be an endoscope. I'm not sure what options I have left at this point. I'd really hoped she would be eating more today but not even the prednisilone has increased her appetite. I'm feeling heartbroken and hopeless at the moment.
 
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