My cat is having an ultrasound tomorrow with fine needle aspiration. The vet is concerned about GI lymphoma.

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Pat N

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Thank you. I'm so sorry about the loss of your cat.

Rachel's vet (who is reported to be very good with doing ultrasounds) said he doesn't see anything that suggests other than IBD but, of course, will follow up. Rachel was hospitalized for a day and a half, given iv fluids, appetite stimulant, Cerenia and Pepcid AC. All blood work comes back normal except for high neutrophils but not so high that it can't be attributed to a stress reaction. He would like to start her transitioning to Hill's Z/D. Right now, he's suggesting Cerenia tablets and Pepcid. He doesn't want to start her on Pred yet based on his ultrasound findings and wanting to see how she does with a new diet. All this is traumatic for cat and me. As of today, Rachel can't get enough of her food - no vomiting so far - no itchiness either (which has been an on-going issue with her. I guess Cerenia helps with that somehow.

Were your cats prescribed Cerenia?

I guess we're in a waiting game to see if the new diet will help. If Rachel has symptoms return then we're back to the vet asap to talk next steps. I so much would like Rachel to have the experience that your 15 year old cat has!
 

daftcat75

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I’m not a vet. But I don’t think the Pepcid is necessary. Cats need stomach acid. Better for acid control would be smaller meals more frequently. If you’re feeding twice a day, try the same amount of food over four meals. Two breakfasts and two dinners is okay. The meals don’t have to be symmetrically spaced around the clock.

I like your vet’s plan (other than the Pepcid.) Always safer to start with the more conservative treatments first.

Get yourself a baby scale. They are about $60 on Amazon. Weigh Rachel no more than once a week. Preferably the same day and time each week. As long as she’s maintaining or gaining weight, it’s probably not cancer. If she’s losing weight, take her back to the vet and have your plan reevaluated. There are other conditions that can cause weight loss. You don’t want to immediately assume it has progressed to cancer. But you do want to get her rechecked.

A couple of my biggest regrets with Krista were not seeing a specialist for her IBD/lymphoma and not taking her in more frequently when she either wasn’t responding adequately to treatment or things changed and I thought I could handle those changes at home on my own. You may end up doing a lot of reading on sites like IBDKitties – Helping Save Lives…One Paw at a Time. But use what you learn to discuss with your vet rather than trying to replace your vet.
 
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4horses

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What sort of itchiness is your cat having? As my cat who passed away had that as well. His was facial pruritis.
 

4horses

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My vet said IBD is impossible to tell apart from Lymphoma based on an ultrasound. Both look like thickened intestines.
 
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Pat N

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I’m not a vet. But I don’t think the Pepcid is necessary. Cats need stomach acid. Better for acid control would be smaller meals more frequently. If you’re feeding twice a day, try the same amount of food over four meals. Two breakfasts and two dinners is okay. The meals don’t have to be symmetrically spaced around the clock.

I like your vet’s plan (other than the Pepcid.) Always safer to start with the more conservative treatments first.

Get yourself a baby scale. They are about $60 on Amazon. Weigh Rachel no more than once a week. Preferably the same day and time each week. As long as she’s maintaining or gaining weight, it’s probably not cancer. If she’s losing weight, take her back to the vet and have your plan reevaluated. There are other conditions that can cause weight loss. You don’t want to immediately assume it has progressed to cancer. But you do want to get her rechecked.

A couple of my biggest regrets with Krista were not seeing a specialist for her IBD/lymphoma and not taking her in more frequently when she either wasn’t responding adequately to treatment or things changed and I thought I could handle those changes at home on my own. You may end up doing a lot of reading on sites like IBDKitties – Helping Save Lives…One Paw at a Time. But use what you learn to discuss with your vet rather than trying to replace your vet.
Just a follow up. Rachel's vet has confused me.

He does not now want to start her on new diet right now. He had prescribed only Cerenia tablets for 2 weeks when she left the clinic. I gave her Cerenia tablets for 4 days after her return from the overnight at the clinic. She either had a strange reaction to the Cerenia (very sedated) or she was still recovering from sedation. However it had been about a week after she was sedated for ultrasound. Because she had a reaction to gabapentin a few weeks ago (very rare I understand) that I didn't want to risk having that experience with Cerenia. She's never had a reaction to Cerenia when it's been given intravenously.

In conversation with the vet I told him that I stopped giving her Cerenia. It's been a week and Rachel has not vomited. Her appetite has been good. Her energy has been good. Her vet still doesn't want to try a diet change and has now prescribed prednisolone 5 mg twice a day. Does that seem too much for her since she isn't vomiting or having diarrhea? I would go for a second opinion but don't want to stress this cat out anymore for right now. Rachel had been treated for allergies by another vet a couple of years ago and put on 10 mg. pred daily. At that time it was too much for her.

Please be frank, am I being overly concerned with everything or should I look for a second opinion? Covid makes things so difficult in having communication with vets. I want to keep Rachel's stress level at a minimum since she's had so many vet appointments this month so I'm hesitant to take her to another vet.
 

daftcat75

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What's his end goal with 10 mg pred? She's not vomiting or having diarrhea so why prescribe the pred? Yes, 10 mg seems too much. But if he's got a plan to induce an anti-inflammatory response, and then quickly taper, you could give it a try. But if he just wants her on pred the rest of her life, go find another vet. Or a specialist. Before you start her on that dose, tell him you have concerns, she's reacted poorly to that dose before, and you'd like to try a smaller dose for a short period of time. You do not want to her on steroids daily for the rest of her life. Especially at that high a dose. Maybe he has a two week or one month plan. Get him to clarify that.
 

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Having said that, if you already started her on the pred, talk with the vet before you change her dose or discontinue it. Unlike Cerenia or gabapentin, you can’t just stop it because you’re concerned. Once started pred needs care to be stopped. Stopping it suddenly can cause her harm. In every case, you should be consulting with your vet before deviating from his instructions. None of us are vets here.
 
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Pat N

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Thanks again. The prescription we picked up has 60 pills/1 month. I appreciate your caution about reducing pred. However, she was on pred off and on for allergies for a couple of years so I learned that tapering the drug was done under vet supervision. I'll try to get an answer to his plan tomorrow but it does look like this is for 1 month.
 
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Pat N

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Thank you for your comment.

I am not comfortable with the 10 mg a day but I read Introduction to Steroids IBDKitties article. In it it says "Dosages of prednisolone typically start out at a higher level and are gradually tapered down... it's common for a 10 pound cat to receive 5 mg of prednisolone twice a day for the first two weeks and 5 mg. once a day for another two weeks..". We have another cat who was diagnosed with IBD in November 2019. He responded well to the pred and to diet change. He has been off pred now for 5 months with no flare ups so far. His symptoms were much worse than Rachel's.

I have sent an email today to the vet (best way to get a recheck appointment - that clinic is off the charts busy). Hopefully I will hear tomorrow from staff at his office about scheduling an appointment. In the email I mentioned that Rachel did not tolerate 10 mg. a day when given that for allergies several years ago.

Thanks again.
 
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