IBD vs EPI ???

[Pawsings]

Over the last five months my cat has experienced weight loss, excessive appetite, super smelly orange liquid diarrhea, rough coat, dandruff, lethargy, muscle wasting, etc. Metabolic panel was normal. G.I. panel showed "critically low unreadable "B12, Folate normal, fPL high at #4, TLI low at #10. Test was considered inconclusive for EPI, but it still could be. My vet suspected either EPI or IBD and gave me the choice to treat either first to see what happens. I chose EPI.

Five weeks ago treatment began with Cali was starting on weekly B12 shots, probiotics (Nutramax Proviable and S. Boulardii) and powdered cow pancreas. The vet prescribed Pancreved (digestive enzymes), but Cali wouldn't eat it. I bought OTC powdered cow pancreas and I have been guessing the dosage, mixing it in her food, waiting 20 minutes and serving it to her twice daily. (I don't even know what is in powdered cow pancreas!)

Cali has made a complete turn around and all symptoms have resolved, except her large appetite. Her appetite has decreased by about 30%, but still not back to normal. If she has EPI I'm only giving her enzymes with two meals and she's eating about 8 meals daily. So she's eating meals that aren't being digested properly. The vet didn't know how to adjust the instructions of twice daily enzymes to accommodate Cali's multiple meals and excess hunger. I assumed that if she actually had EPI and I successfully treated it with enzymes, that her appetite would quickly return to normal and she'd be satisfied with 2-3 meals with enzymes twice daily.

My questions are: Should I be giving her enzymes with all her meals? Is it possible she also has IBD and that's what's causing the excess hunger? Should I try a course of Prednisolone for IBD to see if her appetite decreases and returns to normal? Cali was negative for hyperthyroidism, diabetes and renal disease. Thank you in advance for your thoughts and suggestions!

 

[Furballsmom]

Hi

The vet didn't know how to adjust the instructions of twice daily enzymes to accommodate Cali's multiple meals and excess hunger.

Can your vet consult with a university medical veterinary department, to determine this, and to help answer your other questions?

Was her Free T4 tested regarding hyper-T?

 

[silent meowlook]

Hi.The pancreazyme digestive enzymes should be given with every meal.Just take the amount you are supposed to give and divide it into each meal. So, if you give one scoop a day, still give one scoop daily in multiple doses.Hope that makes sense.

 

[mrsgreenjeens]

I'm thinking you could at least TRY giving the bovine pancreas with every meal. From what I have been reading on line at various sites, I don't think it can hurt to give more, especially since you've been guessing at the dosage. I did read on one site where they said to feed 1 teaspoon per 20 kg of weight per MEAL for felines, and they didn't specify "up to X meals per day" so I took that to mean as many meals as they eat. But that was the initial dosage, then was to be decreased when symptoms went away. Treatment at the lower dosage is life long. Naturally, now I can't find where I read that initial dosage .

Gosh, I have never heard of increased appetite with either EPI or IBD. Your Vet is absolutely certain nothing else is going on? I get it that she would be losing weight with EPI, but now that she's eating and theoretically getting some nutrients, I don't understand the appetite. Is she gaining some weight back?

BTW, powdered cow pancreas should be just that. Powdered cow pancreas and nothing else. Look at the ingredients on the label. There should be nothing else in there.

 

[Pawsings]

Hi.The pancreazyme digestive enzymes should be given with every meal.Just take the amount you are supposed to give and divide it into each meal. So, if you give one scoop a day, still give one scoop daily in multiple doses.Hope that makes sense.

Thank you Silent. Yes, that makes perfect sense.

 

[Pawsings]

Hi

Can your vet consult with a university medical veterinary department, to determine this, and to help answer your other questions?

Was her Free T4 tested regarding hyper-T?

Free T-4 wasn't tested, so I will discuss with vet. Thank you.

 

[Pawsings]

I'm thinking you could at least TRY giving the bovine pancreas with every meal. From what I have been reading on line at various sites, I don't think it can hurt to give more, especially since you've been guessing at the dosage. I did read on one site where they said to feed 1 teaspoon per 20 kg of weight per MEAL for felines, and they didn't specify "up to X meals per day" so I took that to mean as many meals as they eat. But that was the initial dosage, then was to be decreased when symptoms went away. Treatment at the lower dosage is life long. Naturally, now I can't find where I read that initial dosage .

Gosh, I have never heard of increased appetite with either EPI or IBD. Your Vet is absolutely certain nothing else is going on? I get it that she would be losing weight with EPI, but now that she's eating and theoretically getting some nutrients, I don't understand the appetite. Is she gaining some weight back?

BTW, powdered cow pancreas should be just that. Powdered cow pancreas and nothing else. Look at the ingredients on the label. There should be nothing else in there.

Mrs GreenJeens, thank you so much for responding with your thoughts and suggestions. I started giving Cali the enzymes with every meal and she's tolerating it well. However, she is still eating eight times a day. She has gained maybe a pound since I started her on the enzymes, probiotics and B12 five weeks ago. Her poop and her behavior are all back to normal. All the symptoms she had while she was starving, have disappeared, except for the increased hunger. It's very perplexing. For the first time yesterday I saw her going through trash bags looking for food.

According to the label on the pancreas powder bottle, the only ingredient is cow pancreas, however there is no nutritional label that details exactly what is in the powder. I just don't know what else is in it besides digestive enzymes, because the pancreas produces other hormones. I don't know if any of those hormones survive being cooked and turned into powder, the way the enzymes do. Does that make sense? Prescription digestive enzymes contain only the enzymes - lipase, protease and amylase. Since Cali won't eat them, I use the OTC pancreas powder, which she loves. It smells like barbecued steak!

I will follow-up with the vet again soon and ask about the increased appetite. Maybe repeat the thyroid test and include the free T-4. Thanks again for sharing your knowledge and experience with me!

 

[silent meowlook]

Hi. If she has IBD, it means that the GI tract is not using the food properly. So, he body tells he she is hungry but she isn't getting the nutrition that she needs from the food. It is important to continue with the small frequent meals.