IBD Treatment

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tahnyuh

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Hey everyone! Although I've passively used the forum as a resource for years, this is my first post.

My 9-year-old Nebelung, Bear, was diagnosed with severe IBD last month. We had every blood test done and then an ultrasound with a specialist to figure out why she was throwing up so frequently and losing weight. We were told she had severely thickened intestines.. so bad that it might be cancer :-(

She was prescribed Hill's gastrointestinal food, Orbax antibiotics, budesonide anti-inflammatory, cyproheptadine appetite stimulant and B12 vitamin tablets.

She stopped throwing up, but she's completely disinterested in food.. when she used to be obsessed with it. We are broken and feel like we're watching her waste away.

So.. I did my homework. I spent hours and hours trying to understand cat IBD - the causes, the symptoms, what she was feeling, treatment, everything. Nearly everything I read said that cats with severe IBD should take prednisolone for 2-4 weeks, then move to budesonide. And they can't absorb B12 vitamins so they need injections.

I called the vet and politely said that she's not eating and that I read prednisolone could help. I asked why we didn't try this three weeks ago and she said because of the side effects, which are long-term kidney problems if taken for an extended amount of time. The vet said that it won't hurt as she may only have weeks left to live! ... This doesn't make sense to me. And in the confusion and frustration, I forgot to ask if she should continue the cyproheptadine and if she should have B12 injections because the vitamins likely aren't working.

I've had a few odd experiences with this vet in the past (forgetting to give her medicine and chasing me on the way out, not having a record of teeth removal surgery).. and now I'm definitely feeling like I don't trust her. I know that vets get an unfair bad rap, but this is strange to me.

My question to you fellow cat people: Is this weird? Do you think I'm getting bad care? What would you do? Feeling desperate :-(
 

Betty Smith

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Sounds like there's a couple things. I was a nurse for 30+ years. It's not uncommon for those with family members who are dying to read up on their conditions and interject themselves in front of the doctors who are very familiar with the diseases. It's a means of going the distance for someone you love, sometimes inapropriately. If you don't trust your vet, who knows everything there is about your pet, then sit down and consider WHY you don't trust her. Doesn't sound like anything life threatening! Take a deep breath and think about what is best for your kitty!
 
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tahnyuh

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Thanks for this!

I am looking into different vets (asking around, looking at reviews). One question I had was - do we have to start from scratch if we switch vets? We've spent about $2000 in the last few months on the tests and medications. So if we paid $600 for an ultrasound, is there a way to transfer that record to another vet?
 
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tahnyuh

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Appreciate your reply Betty... like the article Furballsmom sent says "Be as proactive as you can and learn as much about Feline IBD as possible."

What I'm struggling with is that every credible source (Tufts vet school, veterinarian blogs) say that the first step of severe IBD is a specific medication and that B12 tablets cannot be absorbed by ingestion. When I questioned my vet -- politely -- her answer didn't make any sense.
 
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tahnyuh

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P.S. It is life threatening. She's is literally not eating.
 

Betty Smith

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Yes. Just have the Secretary at the vet's office send the records. Also, make sure the new vet is well versed in IBD treatments. You know that your current vet is. I'm not in favor of changing!
 
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tahnyuh

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You are confusing me too. My whole worry is that my current vet is not well-versed in feline IBD issues. She told me that my cat's IBD is so severe that she might have cancer and then gave me mild treatment and vitamin tablets that in all likelihood cannot be absorbed.
When I questioned this...
Me: Why didn't we go for prednisolone first?
Her: Because of the side effects.
Me: What are the side effects? (having already read up on them)
Her: Organ failure
Me: But that's long-term right? What if we give it to her for 2-4 weeks since her IBD is so severe?
Her: She might not have 2-4 weeks, like I said, it's severe, so yeah, it couldn't hurt.
Me: What is the alternative?
Her: Yeah, okay, like I said, it couldn't hurt.

I came to the forum to see if that struck anyone else as odd and get the gut reaction of other cat owners who would do anything for their cat's health.
 

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PS: Your current vet knows it's life threatening! Prednisone is one of the worst meds out there for long term use. It has such severe side effects! Probability of B12 tabs absorbing with the thickening of intestines is not very good. Shots are the best option. Just let your vet be your vet! If you change now, yes, you'll be starting over. The outcome may not improve by changing vets and you'll have to adjust to a new vet during a very stressful time.
 

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Having trust in one's veterinarian is almost more important than anything else.

Here is something that might help;
Some articles to help you choose the best veterinarian for you.

How To Choose The Best Veterinarian For My Cat?

How To Talk To Your Vet

This link will take you to a site that has a search engine to find one in your area.
Find a Veterinarian and Practice | The Cat Community

and this post might help - I've also read that bland commercial foods are sometimes ok for IBD kitties. I'm not sure if there are foods listed here that might not be good for an IBD cat.
Anemic Cat Won't Eat
 
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tahnyuh

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I just don't see how you can tell someone their cat's IBD is so incredibly severe / could be cancer and not prescribe the most common medication (for the usual 2-4 week period) referenced in nearly every vet college article about IBD... and not have a valid reason for not doing so. And then casually say 'okay sure yeah' when brought up. I just don't get it.
 

Betty Smith

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For even a few weeks, prednisone can cause all sorts of problems. Sorry, I'm not trying to confuse you. I just had to put my dog, Maggie, down. It's been painful. The only thing that helped was having a long relationship with my vet really helped! I've had times I wanted to slap him silly, but he is good with my animals.
 

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So if we paid $600 for an ultrasound, is there a way to transfer that record to another vet?
I would think so, yes, along with all your cat's other records so that you do not have to start from scratch.

I've moved my Poppycat's records three/four times, and have copies at the house.
 
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tahnyuh

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Thanks you guys. And thanks for understanding that this can all get very emotional!

I'm going to continue with the prednisolone / current vet for now - because it seems dire - and look for a new vet with special expertise in feline IBD.

P.S. This is Bear. She was a foster that was too shy to get adopted.
 

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My 9-year-old Nebelung, Bear, was diagnosed with severe IBD last month. We had every blood test done and then an ultrasound with a specialist to figure out why she was throwing up so frequently and losing weight. We were told she had severely thickened intestines.. so bad that it might be cancer :-(

She was prescribed Hill's gastrointestinal food, Orbax antibiotics, budesonide anti-inflammatory, cyproheptadine appetite stimulant and B12 vitamin tablets.

She stopped throwing up, but she's completely disinterested in food.. when she used to be obsessed with it. We are broken and feel like we're watching her waste away.

So.. I did my homework. I spent hours and hours trying to understand cat IBD - the causes, the symptoms, what she was feeling, treatment, everything. Nearly everything I read said that cats with severe IBD should take prednisolone for 2-4 weeks, then move to budesonide. And they can't absorb B12 vitamins so they need injections.
I've not had a cat with IBD, but thought that cancer could only be diagnosed through a biopsy. Not sure, though.

As for Bear not eating, ...it may be the change to Hill's food, (since my previous rainbow CKD cat Spotty did not like certain brands of prescription Vet foods, and only seemed to be okay with the Hill's kidney chicken flavour.)

Also, perhaps the antibiotics are changing the taste of the food, and may cause Bear to not be able to taste it properly.
Some antibiotics do that, and some have strong side-effects that affect our animals differently.

It is really important for Bear to eat, so if you can find a food similar to what she liked, ..but with a novel protein...one in which she has never eaten it before, then it might help with her IBD...if it is related to food sensitivities.
An LID diet is what I have read, in threads, that might help.

It's like you're at a rock and a hard place...you have to get Bear to eat...but don't want to cause her more pain, or inflamed or irritated intestines.
The vet said that it won't hurt as she may only have weeks left to live! ... This doesn't make sense to me. And in the confusion and frustration, I forgot to ask if she should continue the cyproheptadine and if she should have B12 injections because the vitamins likely aren't working.
Try to remember to Write everything down, in numbered lists....so that you could go through your list,...while you talk to your Vet over the phone.
Keep a daily diary of what Bear is eating, medication times given, results, and how her drinking, and litter-box use is.
You might see a pattern.
I'm going to continue with the prednisolone / current vet for now - because it seems dire - and look for a new vet with special expertise in feline IBD.

P.S. This is Bear. She was a foster that was too shy to get adopted.
My question to you fellow cat people: Is this weird? Do you think I'm getting bad care? What would you do? Feeling desperate :-(
tahnyuh tahnyuh ...You're cat Bear is beautiful! Such gentle eyes and big front paws!

I definitely would look into finding a different Vet and asking for a second opinion.

All the records and tests that you paid for at the original Vet would have to be faxed over,...for a second opinion.
You would not have to re-do them, or pay for the same exact tests.
(Vets are professionals, ...good Vets should not get offended if you need a second opinion, for your own peace of mind.)

And you can also ask for copies for yourself, to keep at your home, since you paid for them.
(I always just tell my vets, that I like to keep all my cats' medical results, in a file.)
Right now, all this should be able to be sent to you, through email, too.

Finding a new Vet with extra expertise in treating feline IBD is what I'd do, too,..and there is no harm in phoning and asking around.
If you can ask the Vet Specialist, who did the original ultrasound, or other Vet Specialists that deal with IBD, ...depending on where you live, this may help, too.
Vet universities may help you find one, as well.
Email, phone, ...do whatever it takes.

I'd also do what you decided, in the meantime, and continue with your current Vet and try the prednisolone, since time is critical.

You're doing an amazing job, ...so please remember to also take care of yourself, get enough sleep/rest, and eat/hydrate properly.
I know that taking care of a sick cat is so stressful, ...so remember to look after yourself, while you're looking after Bear.

Furballsmom Furballsmom gave you some excellent resources, above, so really take a look into them, ..post #2 and post #10.
And what you are doing in reading online reviews for Vets is good, too. You get a lot of useful perspectives there.
 
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LTS3

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I think you need a second opinion. You just ask the front desk to fax / email your cat's records over to the other vet, preferably ahead of the appointment so the vet has a chance to review everything. Your vet can also request a courtesy consult from any vet school and some vet hospitals.

Every IBD cat is different. My IBD cat has always eaten a raw diet and continues to eat it but now only in rabbit since chicken gives him flare ups and the brand doesn't have any other protein. The vet prefers that I feed Hills Z/D junk. Commercial limited ingredient diets, raw, and home cooked diet are also options. The blander the food (ie, few fillers), the better it seems for most IBD sensitive tummies.

In the beginning, the vet put my cat on a bunch of different medications: Cerenia, Pepcid, an appetite stimulant, antibiotics, prednisolone. My cat is currently not on any medications other then injectable B12 which he gets monthly.

Long term use of steroids such as prednisolone can cause diabetic-like symptoms which is generally temporary. Slowly stopping the steroid use will make the diabetic-like symptoms go away. In some cases, a cat may develop diabetes while on long term steroid use. My cat tends to get diabetic-like symptoms on a fairly high dose of prednisoline. I just monitor him and keep the vet updated. I have tested his blood glucose levels and they're only slightly elevated so not too concerning. Many IBD cats need a short course of prednisolone before they can be weaned off it, a couple of weeks or so. My cat occasionally needs to restart prednisolone if he starts vomiting frequently. He usually only needs to be on the prednisolone for a few weeks.
 
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tahnyuh

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That's immensely helpful. Thank you!

She's on day 2 of prednisolone and.. I may be imagining things, but.. I feel like she's already slightly better. She ate a little bit of boiled chicken today and seemed more relaxed when she was snoozing.

Bear mostly eats wet food and it's typically fish, chicken or turkey. Today I bought some cans of rabbit, lamb and duck pate so she can have novel proteins. I also saw kangaroo, but that seemed a bit wacky to me! :lol:

BTW - I emailed the vet about taking cyproheptadine at the same time as prednisolone (she said it was fine) and if B12 tablets were definitely being absorbed. A receptionist called me back and said that the B12 tablets and injections were the same. Of course I said "but if her IBD is so severe, wouldn't she need injections?" but the girl didn't know how to answer.

I live in Manhattan and found an internist, but COVID-19 is making it tricky. Hours/available appointments are limited :confused:
 
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