Musiaka's journey with IBD and liver issues

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Musiaka

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Well, the vet didn't tell us anything new, just gave a shot of cerenia, sub-q etc, anything else will be prescribed after Musiaka's ultrasound scheduled on Friday. She also recommended Enzyme Miracle powder, which contains cellulose. We will see on Friday if Musiaka will be put on any meds. The vet won't sedate him for the ultrasound.
Musiaka is eating well (now that I might have found a cannee food he likes... a canned food from a grocery store) and seems in a good mood, but today he pooped outside of his litterbox and dragged his butt over the floor. I can't see any impaction in his anal glands like the last time. The poop was of a regular consistency, neither lose nor hard
 
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Musiaka

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Bissell makes fantastic mess cleaners. I like the Pet Stain Eraser for small jobs like a hairball. But for poop (which because of Krista's lymphoma was nearly a daily dropping outside the box), I use a wet vac upright like the Revolution. Hopefully, there will be no repeat incidents. But if there are, like their new tag line says, "Live in the moment, not the mess."
Hello daftcat, you mention here that your cat used to poop outside the box, could you please describe it in more details, if you have time?
Musiaka strated pooping outside the box. It looks like he doesn't wait for the poop to come out and starts scooting on the floor, so there's a smushed poop and a smear from his butt. I'm wondering if it's a new ibd symptom
 

daftcat75

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Hello daftcat, you mention here that your cat used to poop outside the box, could you please describe it in more details, if you have time?
Musiaka strated pooping outside the box. It looks like he doesn't wait for the poop to come out and starts scooting on the floor, so there's a smushed poop and a smear from his butt. I'm wondering if it's a new ibd symptom
I don’t know that you can diagnose anything from poop issues alone. It could be an IBD symptom. Or it could be another butt or gut issue. Whatever makes pooping less straightforward for the cat runs the risk of the cat blaming the box. Krista would always put the first poop in a litter box. But when her poops came in multiple rounds, all bets were off whether all or any of the subsequent rounds made it to a box. I don’t think she was vindictive. Rather I believe she was miserable and fed up with every poop being a multi-round affair for months.

Basically, Musiaka pooping outside the box is his way of saying, “I’m tired of this 💩. This isn’t normal.”

Did he get an ultrasound yet? With an ultrasound, you can stop guessing whether he has IBD and start treating it. Though meds will only go so far. You’ll still need to sort out the food triggers.
 

daftcat75

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It doesn’t help you to match Musiaka’s experience against Krista’s. Each IBD kitty’s struggle is unique. Each recovery is also unique. Some broad strokes are common such as the presence of butt and gut issues and perhaps accompanying weight loss. And IBD cats typically get similar treatments: ultrasounds to diagnose, steroids, B-12 shots, sometimes chemo if they have lymphoma. But the devil is in the details: the specific foods that trigger the inflammation. These triggers can be proteins—chicken or fish being most common but sometimes pea or other plant proteins. Or it can be the biologically inappropriate ingredients that their carnivore bodies never evolved to eat like the starches, grains, fruit, veggies, gums, and thickeners. But regardless of what those triggers are, you will only get so far with medication. Those triggers need to be identified and removed from his diet. In other words, if you get a prescription for steroids tomorrow, he still won’t be better until you’ve taken the fire out of his belly that’s coming from his food (or treats.)

I recommend keeping a food journal. I recorded what I fed to Krista and how much she ate (weighed the food going onto the plate and coming back when she was done.) If she had a butt or gut episode, I recorded it in the journal nearest her last meal completed (understanding that the look back period for a poop issue can be up to a day or more depending on how frequent the cat normally poops.) In this way, you should hopefully see patterns emerge.

Unfortunately, diversity and variety is the enemy of food trials. You’ll almost certainly need to eliminate the dry food if you haven’t already. And you’ll need to be able to try him on a single wet food for several weeks to be sure of the “good” foods. Bad foods shouldn’t take very long to be sure. Hopefully you’ll be able to build a rotation of good foods. But you may not. Krista was limited to one or two foods in her final year. It will be a lot easier to figure all of this out with less variety in his diet. And if you give him treats, you’ll need to cut those out too to start. Find a healthy baseline for him that doesn’t make him pop from one end or the other. Then you can test new foods and treats against that baseline.
 
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Our cat cat kept throwing up hairballs - turns out he had pancreatitis! I never knew it could be a sign of that, but it was.

Good luck to you, we have our "special" cat here too.
 
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An update
We went to a new clinic and did an ultrasound and a blood test. There are some good news and bad news.
The good news are that Musiaka's liver has healed itself and the enzymes were completely within norms. Other things like creatinine and glucose were came back normal as well.

The bad news are that the ultrasound has shown stones in Musiaka's gallbladder. The vet said that we have two options - either to remove the gallbladder or try a medication that melts them down, but that comes with great risk that a bit of a stone will get stuck and cause a lot of pain. Musiaka would need frequent ultrasound checkups.
His liver was a bit enlarged also, even though the enzymes came back normal. We got SAM supplement for the liver. Some thickening on the stomach lining as well, but she thought it might be due to an ongoing inflammation due to frequent vomiting.

This vet doesn't think that Musiaka has IBD. She said there is a slight possibility that it's IBD, but it's super rare for an IBD cat to never have diarrhea (the issue with butt dragging has disappeared once we changed the type of sand we were using).

So I don't know what to do. I did get the medication for melting down the stones, because removing the gallbladder sounds so extreme, but the risk is really big... Maybe there are some less risky options for us?
 
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Nothing is working for us...
Musiaka still refuses any monoprotein or hydrolized protein foods and won't eat an adequate amount of it. He will take a bite and leave and in this heat wave I cannot let him stay without food, so I am forced to give him what he will eat. He would get dehydrated otherwise, as our apartment is hot and without a/c. Purina's Gourmet canned he eats without much problem, although his appetite is low during the hot days.

SAMe supplement gives no improvement. I even think I saw better results on milk thistle supplement than on SAMe, but the vet says milk thistle is not clinically proved to improve liver function while SAMe is.

Musiaka still vomits 1 or 2 times a week, sometimes a hairball, other times just acid or bile. He is not a good candidate for a gallbladder removal surgery. His gallbladder is not calcified yet and also things can become much worse after it's removed. Also he would have to be om a strict diet and with Musiaka's unwillingness to eat most foods that aren't specifically made to be tasty I can't see how we'd manage. Also, he would have to be on kibble! I haven't talked to a single wet who understands the harm of kibble yet!!

I don't know what to do, I'm about to give up and just continue injecting cerenia and go with it. It just feels hopeless and that we will never find a sollution :(
 
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Musiaka is not doing so bad actually. The vomiting is down to 4 times a month, usually he throws up and the does again in a few days and then we have a 14-20 days break. He has a big appetite, poops a lot, gets zoomies and runs around for a bit everyday. When he vomits, it's just yellow-orange clear liquid, no food, sometimes a bit of hair, but not much lately. He poops out most of the hair. After vomiting the clear liquid, he goes on as if nothing, eats, interracts.

I give him daily Epato (includes silymarin, M.O.S, liver flour and yeast) and he's on a wet-food only diet. I think Epato helps a lot, been giving it for two months straight now.

I wonder if a weekly shot of Cerenia could help us control the occasional acid throw up? Usually it gives Musiaka a longer lasting effect rather than just 24h. The acid throw mostly happens during the day/evening, after Musiaka waking up from a nap, never during the night. Is frequent Cerenia harmful?
 

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Glad to hear he’s doing well.

How many meals a day is he eating? It could be that his acid barfs are just the result of going too long between meals. You might use timed feeders to add extra meals or snacks when you might not be around to prepare and serve them.

I like these clamshell feeders more than the wheel feeder. No time limit on a portion. I also like to split the feeder portion across two feeders in case one fails to open. This is a very rare event: 1 in a 1000 (?) uses in my experience. But when the price of a feeder failure is an acid barf, a second feeder is well worth the minimal extra effort and cost.

PAWISE Automatic Pet Feeder for Dogs and Cats, 1.5 Cup Food Dispenser Feeder with 48-Hour Timer - Single https://www.amazon.com/dp/B07FT93YM2/?tag=thecatsite
 
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Musiaka

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Glad to hear he’s doing well.

How many meals a day is he eating? It could be that his acid barfs are just the result of going too long between meals. You might use timed feeders to add extra meals or snacks when you might not be around to prepare and serve them.

I like these clamshell feeders more than the wheel feeder. No time limit on a portion. I also like to split the feeder portion across two feeders in case one fails to open. This is a very rare event: 1 in a 1000 (?) uses in my experience. But when the price of a feeder failure is an acid barf, a second feeder is well worth the minimal extra effort and cost.

PAWISE Automatic Pet Feeder for Dogs and Cats, 1.5 Cup Food Dispenser Feeder with 48-Hour Timer - Single https://www.amazon.com/dp/B07FT93YM2/?tag=thecatsite
I feed him very frequently actually, small meals throughout the entire day, as I am home all the time, but he still manages to throw up sometimes after his naps. I often wake him up to feed him, but there's never a way to tell when he's gonna wake up nauseus. He wakes up, throws up the yellow liquid and then goes on as if nothing, unless he eats grass - then his stomach gets upset.
I think it's connected to his gallbladder, as he has stones, probably triggers his stomach acids.

I was considering a surgery, to remove the gallstones, but I am just not sure. I found some specialists but there's always some terrible reviews among the good ones. Musiaka is not of any fancy breed, there are thousands of cats exactly like him living on the streets, I'm afraid the surgeon won't try his best with him, with such a precise surgery. And removing the gallbladder is even more complicated. His life quality might worsen... I'd rather symptom manage for now :(
 

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I am glad to hear that there has been some improvment and he sounds comfortable. You know best what decision to make about surgery, but I would hope that any surgeon whose services you are using would follow his medical oath to the utmost and do his best. It does not make any difference if Musiaka is a dime a dozen or one of a kind. All patients deserve the same care.
 
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I am glad to hear that there has been some improvment and he sounds comfortable. You know best what decision to make about surgery, but I would hope that any surgeon whose services you are using would follow his medical oath to the utmost and do his best. It does not make any difference if Musiaka is a dime a dozen or one of a kind. All patients deserve the same care.
The negative reviews scare me. Musiaka is everything to me. But in my country even people are mistreated due to medical recklessness, so I am afraid to try. Will probably take it as last resort sollution.
Would be great to find a relief to those acid pukes though
 
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There has been an increase of these acidic-bilious vomits lately which is very unfortunate. It's always during the day for some reason, never ever during the night or early morning.
We will probably try Ursodiol after all, just going to talk to one more specialist on Monday to see if she recommends to get surgery directly or go on Ursodiol first.
I'm very scared to put Musiaka on Ursodiol! If he gets a biliary obstruction, we will have to get to another city asap, which won't be easy cause I don't have a car. But none of the articles I read on Ursodiol mention that it's very likely, only that the drug is not recommended to cats with a history of obstructions. So maybe he will be fine.
Unless the specialist I'm gonna talk to on Monday is going to advice against Ursodiol. I'm gonna ask if obstructions are frequent while on this drug.
 

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I have never used ursodial on an animal but it seems that the bottom line for you is whether or not an obstruction is possible. Stress to the vet that if this happens you will not be able to get immediate care for Musiaka. Ask if there are any other rule out conditions that Musiaka might have. Having said this, I certainly see your point in wanting to try it.
 

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Krista took urso without a complication. But that’s just a sample size of 1. 🤷🏼‍♂️ Yes, please discuss your concerns with the vet before trying it.
 
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I talked to the vet surgeon from a different clinic.
She is pretty sure Musiaka has triaditis, she even said we can skip the bloodtest for chronic pancreatitis and just try treating Musiaka's condition as triaditis, cause we already have the ibd and cholangitis parts of it.
So Ursodiol is one of the options in this case, but she recommends to start with a course of antibiotics and b12 supplementation. Apparently it's essential for Musiaka to be on a b12 supplement. If antibiotics don't help she would put him on prednisolon + liver antioxidants (Musiaka already is on milk thistle, but she recommends to add SAMe as well) and b12 in any case.
She doesn't recommend a gallbladder surgery as there is a lot of inflammation in Musiaka's body due to ongoing ibd and liver flareups, so he's not a good candidate.
Of course, there was a lot of talk of Musiaka's diet. She recommends a hydrolized protein diet for him. The problem is that Musiaka only eats what he finds tasty. I don't know which is worse, him eating an innapropriate food for his condition (he only gets canned food, Purina Gourmet Gold) or him not getting enough nutrition daily, cause he is stubborn enough to nearly starve himself if he doesn't like the food.

In any case, we will start with antibiotics + b12 + continue on milk thistle + adding SAMe. Then maybe prednisolon and if nothing works Ursodiol.
 
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Ah, and also I am giving him a liquid supplement called VetGastril, it is supposed to coat his stomach lining and defend it from the gastric acids. Maybe will also add probiotics, but not sure if it's not too much at once
 
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We're not doing good today. Musiaka vomited two times, a huge bunch of clear brownish liquid and later just yellow liquid. No hairballs, nothing. He is clearly nauseus and doesn't feel good :( We have an appointment for another ultrasound and bloodwork tomorrow and that's when he's supposed to start the antibiotic treatment. I am thinking of a plan on how to change his diet. Really not looking forward to him refusing food and having to syringe feed him. Wish at least that part would be easier, cause we do have a selection of ibd friendly foods, but making him eat it is mission impossible.
 
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Ordered Specific FDW Food Allergy Management wet food, it's with hydrolized lamb and rice. Please God make Musiaka eat it... He did eat Specific Digestive Support food for some time in spring and it was looking very promising, but then he suddenly started refusing it completely to the point of me syring feeding him. Then I tried all kinds of foods looking for a healthiest option, but had to land on a store bought Purina canned food. It's the only thing he eats with an appetite. But it is nowhere near suitable food for ibd.
 

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I hope that Musiaka feels better by now as the day has progressed; let us know what the vet says.
 
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