Suspected IBD and frequent vomiting- need advice please!

[leeann77]

Hi, I have a 13 year old cat that I'm pretty sure has had IBD her entire life. It was never formally diagnosed, didn't want to put her through invasive scopes. She has never been a great eater and would vomit occasionally. The last 3 months she has gotten way worse- hardly eating enough and now she vomits in the middle of the night, sometimes 2 or 3 times every night. It's sometimes food, sometimes just hair. I brush her like crazy to try and help. I'm trying to switch her food to duck but it's really hard to switch when she barely eats. At this point I am letting her eat whatever she can, she likes canned people food chicken or turkey, which I know shouldn't be a long term food.

I took her to the vet recently and she said it could be IBD and it could have turned into lymphoma. Her blood tests look good. I asked about trying prednisolone but she said it can mask if it's lymphoma. But she doesn't say anything about what to do if it IS lymphoma! She basically talked me out of trying the steroid, esp if I will be taking her to a specialist.

The specialist just called- no openings for 1 1/2 months! I don't know what to do, I can't leave her go that long. I need to get her to eat and stop vomiting. Should I look for another vet or specialist? Should I ask for the steroid again? I am at a loss and could really use some advice. I'm just not ready to give up on her, i don't think 13 is super old. Help!!!

Thanks,
Lee Ann

 

[denice]

I think I understand what your vet is saying, she could've explained it a bit better.   With taking your kitty to a specialist your vet wants to leave the option of doing a biopsy open.  A steroid changes the nature of the cells that are looked at from a biopsy and will skew the results.

I think if your kitty is at the point where her food intake is really low then something needs to be done.  My IBD kitty started with flares when he was 18 months old.  I did the vet hopping thing and he ended up with fatty liver 4 1/2 years ago from not eating enough.  Is the vet aware of how long the wait is for the specialist and how little your kitty is eating?  If not I would make her aware of both.

 

[leeann77]

No, I haven't told the vet because she really doesn't have suggestions for me. I feel like the specialist is going to be a waste anyway because I don't want to put her through anesthesia. I'd like to try the steroid but she did say not to do it before the specialist. Do you think they can determine anything without the scope? Did you have it done? Does your kitty eat normally now and if so, what helped?

I hate to just let her suffer for 1 1/2 months but not sure what to do next.

 

[denice]

I didn't get the biopsy done.  If you choose not to have the biopsy done then I really don't see any reason why the steroid can't be started. 

When you talk about a specialist is it an internal medicine specialist?  Do you have any certified feline specialists or cats only vets in your area?  If your vet is unwilling to prescribe the steroid without the specialist's okay then I would look into a second opinion preferably from a feline specialist or cats only vet.

 

[leeann77]

Yes, internal medicine. We have a big specialty vet hospital here in Pgh. I feel like I should wait to at least talk to them, if I can get my kitty to hold out a little longer. Maybe I'll look for another vet that is available sooner.

Did you use the steroids? They say there are side effects but it doesn't seem worse than what she already has. Sorry so many questions, I don't have anyone else to talk to about this and I'm kind of losing my mind.

 

[goholistic]

Hi @LeeAnn77. I'm sorry your kitty isn't doing well. 

I agree that if you've already decided you do not want to do a biopsy, then I don't see why your vet wouldn't let you proceed with the next steps (whatever that may be). I have a cat with chronic pancreatitis and IBD. I didn't get a biopsy done either. He may have lymphoma now, but we don't know and won't know. I've accepted that.

Another option is to consult with a holistic or TCVM vet (can be local or long distance) and see if they have any recommendations until you can get into the specialist. They will usually agree to do consults over the phone or via email as long as you are working closely with a local vet and provide proof of care (copies of recent blood work results, doctor's notes, etc.).

Either way, I would think the goal at this point should be to reduce inflammation and address symptoms to improve quality of life. She may need an anti-nausea medication like Cerenia and potentially an appetite stimulant.

 

[leeann77]

Oh thank you for the advice! I found an internist at another place that could see her next week, I'm going to ask my vet tomorrow for a referral. I agree- I need to treat the symptoms she has now and worry about lymphoma later, it sounds like they can't diagnose it anyway. Poor kitties, this is a terrible affliction and I often wonder if someone else were her owner, would she have made it to 13?

You guys are the only ones who understand my situation, everyone else just says "she'll eat when she gets hungry". Drives me nuts!!!!

Thank you!!! [emoji]128571[/emoji]

 

[denice]

One non invasive thing you could have done is an ultrasound.  Some kitties need a sedative because they are stretched out on their back for it but it isn't anesthesia.  My IBD kitty is fine without the sedative but he is exceptionally laid back.  Someone experienced can tell a lot from an ultrasound even though they cannot make the call between IBD and small cell lymphoma with an ultrasound.

 

[leeann77]

I think that's what I'll do! Got an appointment for next Tuesday, I read the internist's profile and she seems really knowledgeable. I'm feeling encouraged- thanks again!

 

[goholistic]

@LeeAnn77, how did the appointment go? How's your kitty?

 

[leeann77]

Oh, thank you for asking! I meant to post an update but it's not good. They did an ultrasound and she has a mass in her stomach, they think it's lymphoma. The lymph glands are enlarged as well. I opted not to do chemotherapy- not because of the money ($5000!) but it would only buy her a year at most and I'd have to traumatize her with the IV treatment once a week.
We're trying a steroid and Pepcid but she really isn't eating much at all. I've been forcing canned and baby food in her mouth when I have to. She still vomited a few times.

I'm not ready to let her go yet! she still acts ok except she hides a lot because I constantly give her medicine. I asked the vet when I'll know it's time and she just said "you'll know." I'm just so sad!!!

Thank you so much for thinking of me. [emoji]128049[/emoji]

 

[blueshockey24]

I'm sorry to hear about your kitty.  We have a 12 year old Siberian cat that had similar vomiting issues.  She ate well although she is very picky (aka won't eat her food if a cat had is in it picky), acted normal but started vomiting daily.  We took her to our main vet and 2 different specialists multiple times over 12 months.  Blood tests, ultrasounds, etc and the diagnosis was anything from behavioral issues to IBD.  We tried different foods, medications, etc and finally took her in for a scope after 12 months with no answers.  The scope came back with combination small and large cell lymphoma in her stomach.  We are currently treating her with chemo and she is on our 3rd week of it and she is doing awesome.  They gave her 6 to 10 months which is a kick to the gut and we are struggling with it as she acts completely normal now.  She hasn't vomited in roughly 4 weeks.  The main reason i provide this information is if i could do it over again (and everyone's situation is different) knowing what i know now i would have gotten her scoped up front.  Best case at the time it was IBD and worst case it was small cell lymphoma.  which cats if treated can live 2 to 4 years according to the oncologist.  I'm in the frustrated stage right now of dealing with it all as we all love our pets so much and she means the world to us.  I'm frustrated that if i would have done the scope up front i could have not only made her feel better sooner, know what the issue was as well as extend her time with us.  From what i understand small cell can be treated with orals and may not require iv chemo treatments.  So while she acts 100% normal, eating, going to the bathroom, playing, and being the loving cat she has always been I feel i failed her as a parent.  Hindsight is pretty clear and is full of what if's.  The anesthesia while isn't ideal i wouldn't hesitate to have her brother same age scoped if he ever has any issues based on this experience.  

Both of her ultrasounds didn't show anything.  She is now on a compounded prilosec and pred in her ear once daily.  The cernia shot and or tablets worked well for her but now doesn't need either.  

Just wanted to share my experience.  Also in my situation the scope was about 2300 including the biopsies which included upper and lower.  The 12 months prior cost me int he range of 8,000 and i honestly knowing nothing more than the first day i started taking her in saying something is wrong.  The money wasn't as big of deal as the frustration i dealt with for over a year of trying to make her feel better.

Good luck with your kitty and i wish you the best.  

 

[leeann77]

Wow, thanks for sharing your story- I learn a lot listening to other people! I'm so glad you're having good luck! It sounds like your kitty is enjoying an extended life.
I will ask the specialist about the pill for chemo, I thought I had read about it in other places. I took her off of the new appetite pill and went back to her old cyproheptadine- she ate more yesterday than she has in days, but today not so much, it's hard when I'm not home to constantly put fresh food out during the day.

So today the vet emailed to ask how she's doing and said that the radiologist thought he saw a nodule in her chest and she said it's probably part of the "disease process". So I'm thinking that I might not have as much time with her as I thought. I want to do everything I can but I don't want her to suffer. I guess they aren't doing a scope because the mass in her stomach was so obvious on the ultrasound. She seems ok, but spends so much time hiding under the bed because she doesn't want a pill. I just hate this- I think about it everytime I look at her and she's SO thin. I guess I'll see what the vet says in 1 1/2 weeks.

Thank you for writing! Good luck with your kitties. [emoji]128049[/emoji]

 

[blueshockey24]

Hope your next visit goes well!  Definitely stressful and emotional times when something isn't going well with a pet.  Hope your next appointment goes well and good luck with your kitty as well.  This week was week 5 of Chemo and Jynxie is still doing good.  Maintaining weight, eating (while i feel the chemo has changed her taste as she hasn't been eating her go to food much lately but eating others), playing and acting like nothing is wrong which is pretty awesome.  

 

[leeann77]

Thank you for your well wishes- unfortunately I hate to say that she was put to sleep 2 days ago. She completely stopped eating on her own, even with the steroid and two different appetite pills. I was force feeding her 3-4 times a day just to make it to the vet appt. I really struggled with whether I was doing it too soon, but the vet said it was just a matter of when. That was the worst thing I've ever had to do and I'm still crying everyday.
I meant to post an update but I've just been too upset, I miss her so much.

But that is wonderful news about Jynxie!! Playing and eating are great signs, I am so happy that she's feeling ok! That must be a great feeling, seeing the treatment working. I would give anything to have had more time with Hannah. I know you are appreciating every second of it!

Take care, good luck and keep us updated!

Lee Ann

 

[lisahe]

Lee Ann, I'm very, very sorry to hear about your cat. She was lucky to have you caring for her -- the dilemmas of IBD/lymphoma are just heartbreaking.

 

[leeann77]

Thank you! I was looking at her records and had taken her in 7 years ago for ultrasounds, etc. So she was able to have 7 years of happiness and health, which I'm thankful for.

It really is a horrible disease and unfortunately you don't always realize they have it until it's too late. So this forum is just a great support network!

 

[denice]

I am so sorry.  When you feel up to it you can post a tribute to her in the crossing the bridge forum..  http://www.thecatsite.com/f/19/crossing-the-bridge

 

[betsygee]

So sorry to read this news.  We will lock the thread now out of respect for your loss.  As mentioned above, we invite you to post in our Crossing the Bridge forum.

RIP, little Hannah.