I'm at a loss with my cat's GI issues - need advice!

[freddie.and.ramona]

I’m at a loss and need some advice and/or any insight anyone may have.

I have a 6 year-old male Devon Rex named Freddie with (what I’m guessing) is IBD. Him and his sister (litter mates) have always been very picky with food and prone to throwing up but he is much worse off and has more chronic issues with it than she does.

Throughout his life, he’s had phases where he throws up frequently and has inappetence but it always seems to last a few days/weeks and then improves. He also has had loose stools most of his life. He has been to the vet, I would guess, at least 5 times regarding this exact issue and every time they can’t figure out what’s going on so they say it’s likely IBD purely through process of elimination. He’s had bloodwork, x-rays, ultrasounds, and stool tests all which come back normal.

This past October, Freddie had a very severe bout where he threw up everything he ate for 2 days straight and then started to refuse to eat anything. We took him to the emergency vet after hours because he vomited some blood and his stools were red. We waited 5 hours in the waiting room and gave up, and went to his regular vet in the morning. All the tests (x-ray, bloodwork, stool test) came back normal except an elevated white blood cell count. They basically said they can’t figure it out and gave us some sensitive stomach food and anti nausea medication. He of course refused to eat the food but he seemed to slowly improve with the meds. He seemed pretty ok for 2-3 weeks and was eating and not throwing up very often.

I had researched novel protein diets and raw diets for cats with IBD and wanted to give it a try, since I figured he may have a food allergy/sensitivity. Up until now he was eating Weruva wet canned food in all kinds of flavors. I slowly transitioned him to Stella & Chewy Freeze Dried Raw over the course of 8 days. He was very enthusiastic about the food (which is super rare for him) and his stools were solid for the first time in years so I was feeling very hopeful.

He’s been on this new diet for about 3 weeks and now he’s vomiting every single day again. It almost always happens within 30 minutes after he eats, despite me feeding him very small amounts at a time and him eating it slowly.

I have absolutely no idea what to do now, I feel like I’ve tried everything and he just keeps reverting to being sick and throwing up daily. I feel horrible because he’s not getting enough food/nutrition and he seems so uninterested in eating despite loving the food at first.

If anyone has any advice, I would love to discuss. And please refrain from suggesting I take him to the vet again, because I’ve done it over and over and it doesn’t seem to get us anywhere.

TIA!

 

[Furballsmom]

Hi, Just to ask, have you been seeing the same vet every time?
What about sending a stool sample to a university medical veterinary department?

 

[gitabooks]

My Noxie was diagnosed with IBD through process of elimination also. She is fairly young (she probably started around 3 years of age?). It got to the point that she was vomiting blood and having bloody diarrhea. She went to the vet as an emergency and was kept there for two days on fluids, an appetite stimulant, antibiotics, anti-nausea medications, and a de-wormer just to cover all basis.

What really helped was keeping her consistently (for over a year now) on cerenia. For cats with IBD, letting their GI tract get inflammed can lead to a flare-up that lasts for days or weeks. Catching it early is the key. Noxie gets cerenia every other day unless she shows signs of a flare-up (shivering, lower appetite, stinky litter box, etc).

When a cat gets nauseous on food their brain tells them to avoid it from then on to stop getting sick. This is why they love a food for a while and then stop liking it. Cerenia can help prevent this and appetite stimulants during flare-ups can as well.

Other things that can help include regular probiotic use (proviable is the one often suggested for IBD cats), novel protein, avoiding gums and thickeners, etc.

Each cat is different, but Noxie seems to do best on gravies and pate (not shredded chicken, dry food, or other large chunks). She also really enjoys strong smelling foods, like duck.

Keep up the small portions, that really seems to help. You can try warming the food up and mixing it with a little water so that it is gentler on the stomach.

I'm sorry things have been so hard. Keep us updated! Hopefully things get better!

 

[mrsgreenjeens]

Is he throwing up after every meal of the Stella and Chewy, or only after certain ones? Are you feeding him a variety of S & C, or just one protein? (meaning, do you feed Venison, rabbit, turkey, chicken, lamb, etc?) Could it be that he is throwing up certain proteins and not others? Are you rehydrating the food, or feeding it dry? If dry, is he drinking a lot of water either right before or right after?

Have you tried using any digestive enzyme with the raw food? I know when I first started feeding my guys raw, I added digestive enzymes (Prozyme) and probiotics to their food to help with the transition.

 

[silent meowlook]

Hi. Unfortunately there is allot to know about cats with GI issues and often regular veterinarians don’t have the knowledge to handle it and sadly don’t refer to a specialist when they should. This is definitely a case for a specialist. I would ask for a referral from your regular vet.

There is additional testing that should be done. A fecal PCR will test for Protozoa and bacteria not picked up in a standard fecal. A GI panel will test for pancreatitis as well as the ability for the GI tract to absorb nutrients. An endoscopy will give the specialist an ability to actually visualize the GI tract as well as the stomach. Biopsies can be obtained this way but can be inconclusive. The down side of this procedure is that they need to be anesthetized. Same with an exploratory surgery with full thickness biopsies which may yield better results than endoscopic biopsies, but of course there is a surgery involved.

I am not a vet and am only giving this information as it pertained to my cat. Maybe my cats story will offer some insight.

My cat had a rough start in life as a feral found in a dried up water well stuck for 3 days.
She did well to begin with but by 3 years of age she was vomiting regularly on dry food. The vet she saw said that cats vomit allot and left it at that. All blood work was normal. X-rays were normal except for a bronchial pattern in the lungs. The vomiting continued for years. She saw many vets that dismissed it as not knowing why, but not a big deal.

When she was around 8 I started working for a feline only vet. She told me it is absolutely not normal for cats to vomit. I brought her in about 6 months to a year later because at the time I was dealing with end stage renal failure in my other cat.

When I brought Cheetah in her weight was good and she looked good. Full body X-rays showed feline asthma. She had started coughing but I thought it was a prequel to vomiting. It wasn’t. Her blood work was okay. She was started on a novel protein diet of raw rabbit by Darwin’s. It was a mess and hard to feed due to her appetite not being great and you can’t leave it sitting out. I tried that food for about 6 months, maybe more. The vomiting did improve but Cheetah was becoming so hyperactive and just “ weird”. I thought this was behavioral due to her cat friend, the only other animal in the house being euthanized. I even did behavior consults regarding her.

About a year after that she was getting thinner. I switched her to the Royal Canin canned rabbit diet. It took a while to get her to eat it, but she did. I brought her back in for an exam and blood work and some additional testing. She was diagnosed with hyperthyroidism. Her pancreatitis test was normal. X-ray showed her lungs were worse do we sent out specific tests for heart worm and a fungal panel. Everything cameback as normal except some dehydration. Did an abdominal ultrasound and it showed signs consistent with IBD. A thickened intestinal lining. I was prescribed steroids to give her. I also started her on Methimazole for the thyroid. I gave the Methimazole but didn’t give the steroids. I can’t tell you why, I just didn’t want to. I thought the diet was enough.
The thyroid was tested at a good level a month after that. So I continued the Methimazole.
About another year later, she was still slowly losing weight and I would find spots where she had vomited in the house. I had an inhaler for albuterol to give her for asthma attacks and one for steroids. I used the albuterol as needed about once a month.

I brought her back and lungs were worse. Blood work was the same, thyroid was under control. Did abdominal ultrasound and it showed signs consistent with GI lymphoma. Thickened intestinal mucosal layer throughout the intestines. Enlarged lymph nodes, and a space occupying mass where the stomach empties into the intestines.

At this point she was not a surgical candidate and honestly I don’t really like to subject my own cats to anesthesia unless there is no alternative. So I opted to treat as GI lymphoma without doing biopsies first.
Her meds following were:
Food continued the rabbit canned food.
Cerenia tablets for vomiting daily
Famotadine injectable for Acid reflux every morning
Prednisolone at a high dose initially then taper down.
Chlorambucil every other day after the cerinia
Methimazole twice a day for thyroid
Mirtazipine trans dermal for any decrease in appetite
Odansetron injectable for any break through nausea due to the chemo
Vitamin B12 injection weekly
Probiotics Visbiome to give daily on food
Lactated ringers fluids to give as needed for dehydration
Continue with the albuterol as needed for asthma attack.
She also suffered from continuation so I had lactulose to give and miralax to put in the food. I could never get either one into her.

This all seemed to help after about 2 weeks she was doing better. But, it wasn’t all that noticable at first, just gradually noticed no more vomiting and no more weight loss.

it took about a year before I could reduce the Prednisolone dose but now she is on it every other day. The Chlorambucil she now gets every 3 or 4 days. I rarely give cerinia and still give the Methimazole at twice the original dose because her last thyroid test was high.
I still feed the Royal Canin rabbit canned. I stopped all other meds as I started to realize some just weren’t making a difference. I sill give fluids and the vitamin B12 injection once a month. I use the inhaler as needed.

She is doing well. This is about 3 years from the lymphoma diagnosis. I have a prescription for buprenex for pain for her but have only had to use it twice.

So, that is what I went through and continue to witness my cat go through.
My point is that you must advocate for your cat and find help. I got lucky with the feline specialist in that she could handle this more advanced conditions. Many cannot. It almost always takes a specialist to figure out what is going on. You are not committed to doing everything they suggest. I knew anesthesia would be to hard on my cat and surgery I felt would kill her.
The plan I have for her now seems to work. I do wish I had started the steroids back when it was IBD as maybe it wouldn’t have progressed to lymphoma.

I hope you are able to find something helpful in this massive amount of text.

 

[freddie.and.ramona]

Is he throwing up after every meal of the Stella and Chewy, or only after certain ones? Are you feeding him a variety of S & C, or just one protein? (meaning, do you feed Venison, rabbit, turkey, chicken, lamb, etc?) Could it be that he is throwing up certain proteins and not others? Are you rehydrating the food, or feeding it dry? If dry, is he drinking a lot of water either right before or right after?

Have you tried using any digestive enzyme with the raw food? I know when I first started feeding my guys raw, I added digestive enzymes (Prozyme) and probiotics to their food to help with the transition.

No, that's why it's so frustrating. Some days he eats rabbit the entire day and likes it and doesn't throw up. The next day, he gets rabbit and immediately throws it up or doesn't want it. I've been rotating through every flavor that S&C carries, which is about 10 or so. I am rehydrating every meal so he gets enough water!

I haven't tried enzymes but I'm about to order some probiotic and pray that he eats it...

 

[freddie.and.ramona]

Hi. Unfortunately there is allot to know about cats with GI issues and often regular veterinarians don’t have the knowledge to handle it and sadly don’t refer to a specialist when they should. This is definitely a case for a specialist. I would ask for a referral from your regular vet.

There is additional testing that should be done. A fecal PCR will test for Protozoa and bacteria not picked up in a standard fecal. A GI panel will test for pancreatitis as well as the ability for the GI tract to absorb nutrients. An endoscopy will give the specialist an ability to actually visualize the GI tract as well as the stomach. Biopsies can be obtained this way but can be inconclusive. The down side of this procedure is that they need to be anesthetized. Same with an exploratory surgery with full thickness biopsies which may yield better results than endoscopic biopsies, but of course there is a surgery involved.

I am not a vet and am only giving this information as it pertained to my cat. Maybe my cats story will offer some insight.

My cat had a rough start in life as a feral found in a dried up water well stuck for 3 days.
She did well to begin with but by 3 years of age she was vomiting regularly on dry food. The vet she saw said that cats vomit allot and left it at that. All blood work was normal. X-rays were normal except for a bronchial pattern in the lungs. The vomiting continued for years. She saw many vets that dismissed it as not knowing why, but not a big deal.

When she was around 8 I started working for a feline only vet. She told me it is absolutely not normal for cats to vomit. I brought her in about 6 months to a year later because at the time I was dealing with end stage renal failure in my other cat.

When I brought Cheetah in her weight was good and she looked good. Full body X-rays showed feline asthma. She had started coughing but I thought it was a prequel to vomiting. It wasn’t. Her blood work was okay. She was started on a novel protein diet of raw rabbit by Darwin’s. It was a mess and hard to feed due to her appetite not being great and you can’t leave it sitting out. I tried that food for about 6 months, maybe more. The vomiting did improve but Cheetah was becoming so hyperactive and just “ weird”. I thought this was behavioral due to her cat friend, the only other animal in the house being euthanized. I even did behavior consults regarding her.

About a year after that she was getting thinner. I switched her to the Royal Canin canned rabbit diet. It took a while to get her to eat it, but she did. I brought her back in for an exam and blood work and some additional testing. She was diagnosed with hyperthyroidism. Her pancreatitis test was normal. X-ray showed her lungs were worse do we sent out specific tests for heart worm and a fungal panel. Everything cameback as normal except some dehydration. Did an abdominal ultrasound and it showed signs consistent with IBD. A thickened intestinal lining. I was prescribed steroids to give her. I also started her on Methimazole for the thyroid. I gave the Methimazole but didn’t give the steroids. I can’t tell you why, I just didn’t want to. I thought the diet was enough.
The thyroid was tested at a good level a month after that. So I continued the Methimazole.
About another year later, she was still slowly losing weight and I would find spots where she had vomited in the house. I had an inhaler for albuterol to give her for asthma attacks and one for steroids. I used the albuterol as needed about once a month.

I brought her back and lungs were worse. Blood work was the same, thyroid was under control. Did abdominal ultrasound and it showed signs consistent with GI lymphoma. Thickened intestinal mucosal layer throughout the intestines. Enlarged lymph nodes, and a space occupying mass where the stomach empties into the intestines.

At this point she was not a surgical candidate and honestly I don’t really like to subject my own cats to anesthesia unless there is no alternative. So I opted to treat as GI lymphoma without doing biopsies first.
Her meds following were:
Food continued the rabbit canned food.
Cerenia tablets for vomiting daily
Famotadine injectable for Acid reflux every morning
Prednisolone at a high dose initially then taper down.
Chlorambucil every other day after the cerinia
Methimazole twice a day for thyroid
Mirtazipine trans dermal for any decrease in appetite
Odansetron injectable for any break through nausea due to the chemo
Vitamin B12 injection weekly
Probiotics Visbiome to give daily on food
Lactated ringers fluids to give as needed for dehydration
Continue with the albuterol as needed for asthma attack.
She also suffered from continuation so I had lactulose to give and miralax to put in the food. I could never get either one into her.

This all seemed to help after about 2 weeks she was doing better. But, it wasn’t all that noticable at first, just gradually noticed no more vomiting and no more weight loss.

it took about a year before I could reduce the Prednisolone dose but now she is on it every other day. The Chlorambucil she now gets every 3 or 4 days. I rarely give cerinia and still give the Methimazole at twice the original dose because her last thyroid test was high.
I still feed the Royal Canin rabbit canned. I stopped all other meds as I started to realize some just weren’t making a difference. I sill give fluids and the vitamin B12 injection once a month. I use the inhaler as needed.

She is doing well. This is about 3 years from the lymphoma diagnosis. I have a prescription for buprenex for pain for her but have only had to use it twice.

So, that is what I went through and continue to witness my cat go through.
My point is that you must advocate for your cat and find help. I got lucky with the feline specialist in that she could handle this more advanced conditions. Many cannot. It almost always takes a specialist to figure out what is going on. You are not committed to doing everything they suggest. I knew anesthesia would be to hard on my cat and surgery I felt would kill her.
The plan I have for her now seems to work. I do wish I had started the steroids back when it was IBD as maybe it wouldn’t have progressed to lymphoma.

I hope you are able to find something helpful in this massive amount of text.

Thank you so much for sharing! This is all really insightful and I'm so happy to hear your cat is doing well now. IBD progressing to cancer is what really scares me and why I am motivated to figure this out. I think I will schedule a consult with an internal medicine specialist for him in the next few weeks. Thank you!

 

[freddie.and.ramona]

My Noxie was diagnosed with IBD through process of elimination also. She is fairly young (she probably started around 3 years of age?). It got to the point that she was vomiting blood and having bloody diarrhea. She went to the vet as an emergency and was kept there for two days on fluids, an appetite stimulant, antibiotics, anti-nausea medications, and a de-wormer just to cover all basis.

What really helped was keeping her consistently (for over a year now) on cerenia. For cats with IBD, letting their GI tract get inflammed can lead to a flare-up that lasts for days or weeks. Catching it early is the key. Noxie gets cerenia every other day unless she shows signs of a flare-up (shivering, lower appetite, stinky litter box, etc).

When a cat gets nauseous on food their brain tells them to avoid it from then on to stop getting sick. This is why they love a food for a while and then stop liking it. Cerenia can help prevent this and appetite stimulants during flare-ups can as well.

Other things that can help include regular probiotic use (proviable is the one often suggested for IBD cats), novel protein, avoiding gums and thickeners, etc.

Each cat is different, but Noxie seems to do best on gravies and pate (not shredded chicken, dry food, or other large chunks). She also really enjoys strong smelling foods, like duck.

Keep up the small portions, that really seems to help. You can try warming the food up and mixing it with a little water so that it is gentler on the stomach.

I'm sorry things have been so hard. Keep us updated! Hopefully things get better!

Is the cerenia in tablet form? Freddie has gotten week prescriptions of cerenia and he is absolutely impossible to pill so that makes me hesitant. If I do somehow manage to get it down his throat, he sometimes vomits it up. I can't hide it in his food either cuz he can smell it... Wondering if they have an injectable?

 

[gitabooks]

The cerenia is in tablet form but I put it in a capsule to hide the smell and taste. That being said, there are injectable forms of it that I've seen the vet use. Not sure if that is available for owners to use at home?

 

[silent meowlook]

I’ve used the injectable at home. It’s expensive and it burns. You can get it in liquid form.

 

[three4rd]

Gosh. Starting to think that, (for at least some), cats and vomiting seem to go together like peas and carrots. Can't recall that my previous cat had vomting issues, but the one I have now has a history of it. It's more than frustrating at times.

 

[stephanietx]

I would definitely ask your vet to run the pancreatitis test. It can be done in-office and takes 45 mins to get the results. It sounds like there's a lot of inflammation going on.

 

[freddie.and.ramona]

I would definitely ask your vet to run the pancreatitis test. It can be done in-office and takes 45 mins to get the results. It sounds like there's a lot of inflammation going on.

I've never considered pancreatitis but that is very similar to his recurrent symptoms, I will definitely ask them to run this test! Thank you