Lymphoma or Inflammatory Bowel Disease

alana0011

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Cullen has been at the vet's for a week, and his stools are still watery. The vet has done tests, etc, and even an x-ray, which showed a very thick intestinal wall. She thinks it might be lymphoma or IBD. He is on prednisone and is not showing much improvement, which might suggest lymphoma. She wants to do some sort of panel that will test his diarrhea for other problems, but it's sort of expensive and I'm not sure I want to put him through that. He is 11.
Any ideas are appreciated.
 

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There's info here: IBD or Cancer? – IBDKitties

A biopsy would confirm IBD. It is expensive. Some people opt to do a lesser expensive ultrasound and then treat the cat for possible IBD but I don't know if that is an option for cancer.

Diet can cause flare ups in IBD even if pred is being given. What is your cat being fed at the vet? I'm guessing most likely a prescription food like Hills Z/D. The canned version is usually better than the dry so ask if your cat can only be fed canned.
 

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Personally I’d get whatever tests they suggest, as knowledge is power. That being said, tests are freaking expensive. Could they offer you some kind of health insurance? There are other threads on this site that list health insurance for pets w/ the various rates and what they offer.
 
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alana0011

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I don't even know how much his stay will cost, so I didn't necessarily want to add another expense to the bill, but I might. He is eating a special canned food and the vet said he seems content and is meowing, etc. I may go visit him tomorrow. I think it's probably lymphoma since he isn't responding well to the prednisone. Thank you so much for your feedback.
 

daftcat75

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Personally I’d get whatever tests they suggest, as knowledge is power. That being said, tests are freaking expensive. Could they offer you some kind of health insurance? There are other threads on this site that list health insurance for pets w/ the various rates and what they offer.
No insurance will issue a policy to help with the tests or treatment now that the illness is on his record. Even without a definite diagnosis, everything diarrhea-related (and anything else in his health record for the past year) will be considered a pre-existing condition including whatever the eventual diagnosis may be.
 

daftcat75

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I don't even know how much his stay will cost, so I didn't necessarily want to add another expense to the bill, but I might. He is eating a special canned food and the vet said he seems content and is meowing, etc. I may go visit him tomorrow. I think it's probably lymphoma since he isn't responding well to the prednisone. Thank you so much for your feedback.
There's a diarrhea PCR test that won't put him through any additional stress. It can be collected from a poop sample rather than having to do anything with him or to him. Even though it is expensive, that's probably the last test I would order before putting him on chemo. Indeed, chemo is less risk than prednisilone. You could start him on chemo first and do the diarrhea PCR on a parallel track.

Speaking of a parallel track, FMT (fecal microbiota transplant) won't cure his IBD or lymphoma. But it may help with his symptoms. A LOT! FMT is essentially poop transplant from carefully screened healthy donor cats. It helps correct the microbiome imbalances that are at the heart of both IBD and lymphoma. It's not a cure. But it's a whole lot better having his gut microbiome working to support him rather than working against him. I'm still winding my way through the diagnostics with my Betty who may be IBD or pre-IBD. She has frequent hairballs (approx. one a week) but she doesn't vomit food or have any poop issues. When she was taking the poop pills, the hairballs almost disappeared. I was waiting to see what her "after" report looked like. But since the hairballs have returned, we're starting another bottle of the poop pills tomorrow. The testing takes about 3 weeks. Betty is scheduled for an endoscopy next week. We will be starting a new bottle this weekend so that we don't put the endo appointment at risk with the possibility of her next hairball.

When I say these are poop pills, they really do contain dried poop in them. If you cannot get these pills into your guy whole, don't bother ordering these. You cannot open them into his food and he certainly will not appreciate it. For Betty, she's a pro taking her own pills. I simply coat them in the smallest amount of food to make them look and taste like a morsel of her food and place the capsule on the carpet. This greatly reduces the lick and flick that happens with a pill on a plate. She has to pick it up to "eat" it. And she only bites once or twice before she swallows it. Of the 30 capsules from the last bottle, she only managed to open two of them. While she was taking them, her appetite greatly improved. Her nausea greatly lessened. And her hairballs almost completely disappeared.

Restore Cat and Dog Gut Health - AnimalBiome
 
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alana0011

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There's a diarrhea PCR test that won't put him through any additional stress. It can be collected from a poop sample rather than having to do anything with him or to him. Even though it is expensive, that's probably the last test I would order before putting him on chemo. Indeed, chemo is less risk than prednisilone. You could start him on chemo first and do the diarrhea PCR on a parallel track.

Speaking of a parallel track, FMT (fecal microbiota transplant) won't cure his IBD or lymphoma. But it may help with his symptoms. A LOT! FMT is essentially poop transplant from carefully screened healthy donor cats. It helps correct the microbiome imbalances that are at the heart of both IBD and lymphoma. It's not a cure. But it's a whole lot better having his gut microbiome working to support him rather than working against him. I'm still winding my way through the diagnostics with my Betty who may be IBD or pre-IBD. She has frequent hairballs (approx. one a week) but she doesn't vomit food or have any poop issues. When she was taking the poop pills, the hairballs almost disappeared. I was waiting to see what her "after" report looked like. But since the hairballs have returned, we're starting another bottle of the poop pills tomorrow. The testing takes about 3 weeks. Betty is scheduled for an endoscopy next week. We will be starting a new bottle this weekend so that we don't put the endo appointment at risk with the possibility of her next hairball.

When I say these are poop pills, they really do contain dried poop in them. If you cannot get these pills into your guy whole, don't bother ordering these. You cannot open them into his food and he certainly will not appreciate it. For Betty, she's a pro taking her own pills. I simply coat them in the smallest amount of food to make them look and taste like a morsel of her food and place the capsule on the carpet. This greatly reduces the lick and flick that happens with a pill on a plate. She has to pick it up to "eat" it. And she only bites once or twice before she swallows it. Of the 30 capsules from the last bottle, she only managed to open two of them. While she was taking them, her appetite greatly improved. Her nausea greatly lessened. And her hairballs almost completely disappeared.

Restore Cat and Dog Gut Health - AnimalBiome
 
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alana0011

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That is wonderful information! Thank you so much. If I can get him better, I'm willing to try almost anything.
 

daftcat75

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That is wonderful information! Thank you so much. If I can get him better, I'm willing to try almost anything.
You should certainly do the diarrhea PCR panel now. That will tell you if he has a gut bug or overgrowth. I spent a summer fighting liquid stools in my angel (avatar) kitty, Krista. My vet (when I finally took her in) had the sense to run a diarrhea PCR and we discovered a clostridium overgrowth. It wasn't a worsening of her IBD like I had thought. Two weeks on metronidazole (an antibiotic) did nothing for it. But about a month of giving her saccharomyces boulardii finally cleared it up. Several months later when the liquid stools returned, I spun my wheels on s. boulardii for a few stubborn weeks before finally getting another diarrhea PCR. No clostridium this time. So on to the ultrasound where we discovered thickening in the intestines. We tried prednisilone and it helped. But not enough. It was at this time that I had to go over my vet's head to owner and founder of the practice because my vet was unwilling to prescribe chemo without a biopsy. I was unwilling to put my 16 year old who was wasting away under my hands through any procedure that might come with a recovery period. I discussed her situation with the owner and founder of the practice. After he gave me the informed consent talk, ("we're trying this with your understanding and consent that we haven't diagnosed it and it may not work") she finally got a prescription for chemo and her liquid stools firmed up almost overnight.

My point is that I was wrong twice--first, I thought it was IBD, and the second time, I thought it was a return of clostridium. I lost time that could have been spent on treatment and recovery. If your vet wants to run the diarrhea PCR, let him. It's not going to put your cat through anything he's not already doing (e.g. pooping.) Once you've ruled out an overgrowth like clostridium, then what you're left with is probably lymphoma. But I would hate to see you spin your wheels on pred and chemo if it's something like clostridium.

The poop pills (AnimalBiome) would help either situation. But obviously, you're going to want him to come home before you can start him on them.
 
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alana0011

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You've given me such great information, and it is appreciated. I will let her do the test.
 
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alana0011

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Cullen has been home for a few days, and the diarrhea panel was done. We're waiting to hear the results.
He is extremely vocal, and a few minutes ago, as he was resting on the couch, he meowed, and I don't know if he is uncomfortable or not. I worry about this. He is still on prednisone twice a day.
I've seen his stools, and they are very loose, but they're not watery. Just a little while ago, he was trying to have a bowel movement on the carpet, and he would always use the litter box. Nothing came out.

I'm not sure what to do at this point. The vet wanted me to keep him on the special food, which he ate at there. It's really hard to do that with my other cats. It seems here, he knows he has choices, so he prefers Friskie's.
 
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