Short bouts of craaaaziness, crying, pooping, and sometimes puking

[Elvgrengrl]

Hello! My 17-year old cat randomly has these 'outbursts' where he'll poop many times, howl, cry, run rampant, sometimes vomit and then after 1-1.5 hours will settle down and act normal. I've taken him to the vet a few times, and even an ER once. It's been going on for a couple of years now and happens about once a month - maybe twice. Tests have revealed slightly elevated creatine (2.0), slightly plumped kidney, and some thickening of the intestinal wall. We're also trying to correct his constipation so he's on Miralax and RC Fiber. Anyway, I know those imaging results could mean IBD or Lymphoma and the only way to confirm is with biopsy. I'm wondering if these bouts he has + the rotating constipation is a symptom of one of those two conditions? I know only a specialist can really guide me, but in the meantime I thought I'd ask y'all. Thanks!

 

[Furballsmom]

where he'll poop many times,

Is this a lot of small poops and he's straining really hard? He's not constipated all the time and he has a more normal tootsie-roll type of poop otherwise? Has he been prescribed any pain meds?

How much miralax are you giving daily?

Are you working to get more water in to him? Hydra Care could be helpful, as well as the things in this article (my Poppycat especially likes the baby food soup).
Tips To Increase Your Cat’s Water Intake – TheCatSite Articles

 

[FeebysOwner]

Hi. Not sure if you can specifically say those bouts and intermittent constipation is directly tied to either IBD or lymphoma, as it would seem symptoms can greatly vary from cat to cat. Sounds more likely that the bouts are directly due to constipation issues, as mentioned above. Dry cat food can contribute to constipation in a cat that is prone to the condition, so if there is a canned version of this RC food, you might want to see if your cat will eat that. Otherwise, maybe the vet can recommend a comparable food that comes in a canned version. Or, you could try adding water to the RC food to help with moisture intake, if he would eat it that way.

It would seem because these bouts aren't more often, there is some change to something in his food/environment that might be provoking them - maybe some occasional treat or human food that doesn't agree with his system? See if you can keep a bit of a diary about what is going on before a bout comes on to maybe help identify some potential causes. Perhaps it is tied to hairballs?

You can ask your vet if during another ultrasound they can perform a fine needle aspiration (FNA) cytology on any of his intestinal tissue - not as accurate as a biopsy but might shed some light on whether or not it is IBD or lymphoma. If the FNA would indicate 'suspicious' cells, an additional test called a PARR assay can be done on the cells and could confirm or rule out lymphoma.

 

[daftcat75]

Every cat is different.

Every IBD cat is a different case.

That said, this sounds a lot like my angel Krista. When her IBD progressed to lymphoma, she had irregular poops that came in multiple rounds of increasing liquidity. The more rounds she would have for a poop session, the more likely it was being deposited on the carpet. First poop was usually solid and left in a box. Second poop was less solid and 50/50 whether she would leave it in a box. If her poop took three or more rounds, those were going on the carpet. Sometimes after the second and if she went to three, always after the third, she would throw up. It sort of presented like both constipation and diarrhea.

I would definitely recommend an ultrasound for your guy. If they can do an fine needle aspiration biopsy, do that too.

How is his weight? Is he maintaining his weight? Usually (but not always) the ability to gain and maintain weight is the difference between IBD and lymphoma. But it’s not always a binary choice between IBD and lymphoma.

Or it may be neither of those.

You should start with an ultrasound if you want to continue the investigation.

 

[Elvgrengrl]

Is this a lot of small poops and he's straining really hard? He's not constipated all the time and he has a more normal tootsie-roll type of poop otherwise? Has he been prescribed any pain meds?

How much miralax are you giving daily?

Are you working to get more water in to him? Hydra Care could be helpful, as well as the things in this article (my Poppycat especially likes the baby food soup).
Tips To Increase Your Cat’s Water Intake – TheCatSite Articles

Hi.. When this happens it's a lot of soft fluffy poops. Otherwise he tends towards either hard or sticky stools that he can't get out completely.

The vet upped his Miralax to 1/4 tsp twice a day and we changed him from a UR formula (had crystals a while back) to Rpyal Canin Fiber Response.

I've tried a lot to get him to drink more water. He doesn't like anything 'watered down', tuna juice is a no-go. He's not interested in a water fountain. I'll look into the Hydra Care. Though, he does tend to drink a lot of water which is why we check him for diabetes often.

 

[Furballsmom]

goodness, poor guy Bless your heart for working so hard to figure things out for him!

 

[Elvgrengrl]

Every cat is different.

Every IBD cat is a different case.

That said, this sounds a lot like my angel Krista. When her IBD progressed to lymphoma, she had irregular poops that came in multiple rounds of increasing liquidity. The more rounds she would have for a poop session, the more likely it was being deposited on the carpet. First poop was usually solid and left in a box. Second poop was less solid and 50/50 whether she would leave it in a box. If her poop took three or more rounds, those were going on the carpet. Sometimes after the second and if she went to three, always after the third, she would throw up. It sort of presented like both constipation and diarrhea.

I would definitely recommend an ultrasound for your guy. If they can do an fine needle aspiration biopsy, do that too.

How is his weight? Is he maintaining his weight? Usually (but not always) the ability to gain and maintain weight is the difference between IBD and lymphoma. But it’s not always a binary choice between IBD and lymphoma.

Or it may be neither of those.

You should start with an ultrasound if you want to continue the investigation.

I'm so sorry your Krista has these bouts too. It does sound similar. My guy makes it to the box but the poops definitely start off normal-ish then get looser. He can go up to 7 times. Sometimes there's vomiting. It's the crying that breaks my heart. This has to hurt him. And it goes on nonstop for the whole hour to hour and a half that these take to work through. I did rush him to an ER during one of these that was really bad and the ultra sound showed some thickening of the intestines and they sent him home with a probiotic and said only a biopsy would need to be done to see what was really going on. I've read those are invasive and expensive. I just worry that I'm going to continue to take him in (which is a battle) and continue to come home without answers or any money in my account. Sadly, too, he won't come out for anyone so if whatever this is has to be managed with daily medication then I don't know what I'm going to do since I live alone and he won't show himself to anyone else. For my own sake and mental health that sounds incredibly debilitating.

 

[Furballsmom]

It can work - there are medicines that can be made into gels that are rubbed onto the ear, etc. Hang in there!

 

[Elvgrengrl]

It can work - there are medicines that can be made into gels that are rubbed onto the ear, etc. Hang in there!

That sounds great except for when I take vacations. He hisses and darts at people who try to look at him in his hiding places when I'm gone.

 

[Furballsmom]

You'll be able to figure things out as they come along - you've done so well so far

 

[daftcat75]

I'm so sorry your Krista has these bouts too. It does sound similar. My guy makes it to the box but the poops definitely start off normal-ish then get looser. He can go up to 7 times. Sometimes there's vomiting. It's the crying that breaks my heart. This has to hurt him. And it goes on nonstop for the whole hour to hour and a half that these take to work through. I did rush him to an ER during one of these that was really bad and the ultra sound showed some thickening of the intestines and they sent him home with a probiotic and said only a biopsy would need to be done to see what was really going on. I've read those are invasive and expensive. I just worry that I'm going to continue to take him in (which is a battle) and continue to come home without answers or any money in my account. Sadly, too, he won't come out for anyone so if whatever this is has to be managed with daily medication then I don't know what I'm going to do since I live alone and he won't show himself to anyone else. For my own sake and mental health that sounds incredibly debilitating.

Thickening is better than a mass/tumor. A biopsy is the only way to know for sure whether it’s IBD or lymphoma. But for practical purposes, you can treat it like one and if that doesn’t work, add in the therapy for the other. You’ll need a vet willing to work with you on this though. You’re essentially asking him to prescribe drugs without a clear diagnosis. But, depending on where the thickening is and what kind of biopsy they think is appropriate, the diagnosis may be more risk than the drugs.

How’s his weight? If he can maintain or gain weight, that’s usually (but not always) leaning more towards IBD than lymphoma. If he’s losing weight despite eating enough or more than enough, that sounds like lymphoma (assuming you’ve ruled out other reasons for weight loss like hyperthyroid.) Steroids and chemotherapeutic drugs can be compounded into ear gel and flavored oils and other convenient formulations.

In the meantime, there may be some supplements on Vitality Science that can make it easier for him to go. But you still need to treat the root cause. I view these as add-ons rather than substitutes.
Vitality Science | Natural Remedies For Dogs And Cats

 

[daftcat75]

You don’t need to repeat the ultrasound. Ask the ER vet that performed it to send their records on to your regular vet. Your regular vet should be able to prescribe steroids (prednisilone or budesonide) based on those findings. The hard part will be convincing him/her to try chemo if the steroids don’t provide enough relief. But because there’s almost always a diet component to bowel diseases, you may have to try a diet change. Something with few to no carbs (get him off dry food if he isn’t yet) and a single protein source, preferably not chicken or fish. If he’s food reactive, he’s probably already keyed in on those.