Lymphoma or IBD

TonkasMom

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Hello! I'm feeling a little overwhelmed and I'm hoping for a little advice from someone who has gone through a similar situation...
My 15 year old kitty, Tatonka, started having a lot of GI issues about 3 months ago (throwing up a lot, constipated often, a little bit of weight loss). Blood work was perfect, but after an xray showing some backed up poop and foam in the stomach we started him on Miralax (1/8t twice a day) and Prilosec (1/2 tablet once a day). That definitely helped with the constipation issue but the throwing up continued and then progressed to a lack of appetite as well. He had an ultrasound this evening and that showed thickening in the small intestines consistent with either IBD or lymphoma. The vet gave us the option to start down the route of further diagnostics with a biopsy with a specialty vet or to start treating with Prednisolone today. She said the Prednisolone would be the way they would treat the IBD and also part of the treatment if it was lymphoma (but also with chemo obviously). Because he is 15 (and also already has arthritis) I don't really want to put him through the surgical biopsy. She also gave him a B12 shot and has recommended Royal Canin i/d wet food as well as pumpkin. I'm open to different diet ideas or supplements once he starts feeling better and eating more. If it is lymphoma and not IBD, will diet change and Prednisolone even help? Google is just a bit of an overwhelming place to start! Thanks in advance for any help!
Oh and also, any advice on how to get the ultrasound gel out of his fur without giving him a bath? He's a maine coon mix so there's A LOT of fur to clean!
 

Heart For Cats

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Welcome to TCS. I know you will get help from experienced cat parents here because this is a common problem.

If Tatonka was much younger, a biopsy would make sense. For a 15-year old cat I would be against that because of the anesthesia risk.

Cats stop having iBD symptoms with high quality regular wet food, not the prescription diets sold by conventional vets (which I know all lack pumpkin because money is what those manufacturers care about).

I have no idea what ultrasound gel is. So far I have had three cats endure abdominal ultrasounds and none of them came home with gel in the area.
 
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TonkasMom

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Welcome to TCS. I know you will get help from experienced cat parents here because this is a common problem.

If Tatonka was much younger, a biopsy would make sense. For a 15-year old cat I would be against that because of the anesthesia risk.

Cats stop having iBD symptoms with high quality regular wet food, not the prescription diets sold by conventional vets (which I know all lack pumpkin because money is what those manufacturers care about).

I have no idea what ultrasound gel is. So far I have had three cats endure abdominal ultrasounds and none of them came home with gel in the area.
Thank you so much for the reply! What brands of food would be considered high quality?
 

Heart For Cats

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Thank you so much for the reply! What brands of food would be considered high quality?
The key is what they do not have: carraggeenan, gum, clay, wheat, soy, corn, milk, meat byproducts, anything artificial, and meat from animals that are not specifically identified. If you see "poultry" or "fish" it is not a high quality source of protein. You cannot avoid all of them without feeding a homemade raw diet exclusively, but some brands that make wet cat food are close. When I am not tired, I will do some research and post my favorites.
 

daftcat75

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Hello! I'm feeling a little overwhelmed and I'm hoping for a little advice from someone who has gone through a similar situation...
My 15 year old kitty, Tatonka, started having a lot of GI issues about 3 months ago (throwing up a lot, constipated often, a little bit of weight loss). Blood work was perfect, but after an xray showing some backed up poop and foam in the stomach we started him on Miralax (1/8t twice a day) and Prilosec (1/2 tablet once a day). That definitely helped with the constipation issue but the throwing up continued and then progressed to a lack of appetite as well. He had an ultrasound this evening and that showed thickening in the small intestines consistent with either IBD or lymphoma. The vet gave us the option to start down the route of further diagnostics with a biopsy with a specialty vet or to start treating with Prednisolone today. She said the Prednisolone would be the way they would treat the IBD and also part of the treatment if it was lymphoma (but also with chemo obviously). Because he is 15 (and also already has arthritis) I don't really want to put him through the surgical biopsy. She also gave him a B12 shot and has recommended Royal Canin i/d wet food as well as pumpkin. I'm open to different diet ideas or supplements once he starts feeling better and eating more. If it is lymphoma and not IBD, will diet change and Prednisolone even help? Google is just a bit of an overwhelming place to start! Thanks in advance for any help!
Oh and also, any advice on how to get the ultrasound gel out of his fur without giving him a bath? He's a maine coon mix so there's A LOT of fur to clean!
Yes. Diet change and pred will be helpful even if it is lymphoma. It will be an incomplete response. But still beneficial. Often times it is this incomplete response that convinces vets to try chemotherapy when the patient isn’t a good candidate for a surgical biopsy (which is most of them due to age and health concerns.) Instead of the biopsy, I would recommend picking up a baby scale off Amazon and monitor his weight. No more than once a week, preferably the same time and location each week. As long as his weight is stable or he can gain weight, it's probably not lymphoma. Lymphoma is marked by dramatic and relentless weight loss even with an adequate or more than adequate amount of food.

Regardless of whether he's taking pred or pred plus chemo, food will be his best medicine. The drugs will only do so much if his diet keeps the inflammatory fires burning. If he's eating any dry food, I would work towards eliminating that. There are just too many nonsense ingredients in dry food to conduct any kind of meaningful food trials. Give the I/D food a try. If that doesn't work or he doesn't like it, Rawz is pretty much the gold standard for IBD kitties and food trials. Simple recipes. Single protein pates in several novel proteins like turkey, duck, and rabbit. No gums or grains or other nonsense that is often found in other "Limited Ingredient Diet" foods like peas and cranberries (looking at you, Instinct. 😾 )

I'm surprised they didn't shave his belly. Or did he get gel in the remaining fur? I suppose you could try Pet Wipes. But my Krista never much cared for those. 🤷‍♂️

You may need anti-nausea or appetite stimulant prescriptions at first to get him eating/keep him eating until you figure out a food that doesn't give him grief. Ultimately, you want to manage his IBD with food. Prescriptions are there to help. But finding the right food that doesn't upset his gut or butt will be much more helpful in the long-term.
 

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daftcat75 daftcat75 had great advice. Our kitty Trin had either IBD or lymphoma as well. He was 10, and we opted not to do a biopsy. We assumed IBD and gave him prednisolone and B12 shots until that wasn’t helping. Then we assumed lymphoma and tried chemo.

He was a hard cat to treat - he was a healthy 14 lb tabby and strong. He wouldn’t eat wet food at all and fought pills like mad. We ended up going with liquid meds for everything. He was a bit grumpy on the chemo but generally he dealt with them pretty good.
 

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My Chelsea is being treated for intestinal lymphoma. She was much younger than your cat at diagnosis, a semi feral indoor only with feline hyperesthesia, so subjecting her to a number of vet visits, along with medications, was alway questionable. At the advice of daftcat75 daftcat75 I asked the vet about starting chlorambucil without a biopsy of any kind. We had already been doing pred for a while. The vet agreed and that is what I have done.

I have another cat who has frequent ultrasounds.....he never came home with anything on him as they shave his belly. The US gel should be water soluble, if that helps.
 
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TonkasMom

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Yes. Diet change and pred will be helpful even if it is lymphoma. It will be an incomplete response. But still beneficial. Often times it is this incomplete response that convinces vets to try chemotherapy when the patient isn’t a good candidate for a surgical biopsy (which is most of them due to age and health concerns.) Instead of the biopsy, I would recommend picking up a baby scale off Amazon and monitor his weight. No more than once a week, preferably the same time and location each week. As long as his weight is stable or he can gain weight, it's probably not lymphoma. Lymphoma is marked by dramatic and relentless weight loss even with an adequate or more than adequate amount of food.

Regardless of whether he's taking pred or pred plus chemo, food will be his best medicine. The drugs will only do so much if his diet keeps the inflammatory fires burning. If he's eating any dry food, I would work towards eliminating that. There are just too many nonsense ingredients in dry food to conduct any kind of meaningful food trials. Give the I/D food a try. If that doesn't work or he doesn't like it, Rawz is pretty much the gold standard for IBD kitties and food trials. Simple recipes. Single protein pates in several novel proteins like turkey, duck, and rabbit. No gums or grains or other nonsense that is often found in other "Limited Ingredient Diet" foods like peas and cranberries (looking at you, Instinct. 😾 )

I'm surprised they didn't shave his belly. Or did he get gel in the remaining fur? I suppose you could try Pet Wipes. But my Krista never much cared for those. 🤷‍♂️

You may need anti-nausea or appetite stimulant prescriptions at first to get him eating/keep him eating until you figure out a food that doesn't give him grief. Ultimately, you want to manage his IBD with food. Prescriptions are there to help. But finding the right food that doesn't upset his gut or butt will be much more helpful in the long-term.
Thank you so much for all the advice, very helpful!
 
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TonkasMom

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One more question…since we’ve never fed exclusively wet food, how much wet food should he be optimally eating? He is about 13lbs right now but is normally around 15lbs without the current weight loss.
Thanks so much to everyone for the replies, I really appreciate it :)
 

Heart For Cats

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I like to feed 1/4 of a 5.5 ounce can 3 times a day if my cat will eat that much. On some days I noticed my cat only wanted two meals. Of course your cat's activity level is a factor in how much he wants to eat every day.
 

LTS3

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One more question…since we’ve never fed exclusively wet food, how much wet food should he be optimally eating? He is about 13lbs right now but is normally around 15lbs without the current weight loss.
Thanks so much to everyone for the replies, I really appreciate it :)
Roughly 20 to 25 calories per pound of body weight daily. A 13 pound cat may need as much as 325 calories daily. Adjust as needed to prevent weight gain and underfeeding. Calorie content is listed on the can label. Many 5 oz cans are in the 150 calorie or so range. 3 oz cans tend to be way less, usually under 100.
 
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