Thick intestine walls - lymphoma / ibs - Food help

FeebysOwner

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You can have an endoscopic biopsy done--- not a Fine Needle aspiration (FNA). The FNA would have to be targeted to one spot. The endoscopic one can see if there are many areas of suspected IBD in the stomach. Yes, thickened walls of the intestine is a sign of IBD and/or SCL.
It is true that the FNA can generally only be done if there is suspicious tissue to be aspirated. But, endoscopic biopsies can be just as easily ineffective, as they do not always collect the correct tissue. There have been numerous posts on this site to that effect. Not only that, endoscopic biopsies are considered invasive (albeit 'minimally'), are limited to the proximal gastrointestinal tract (meaning they will not normally include the colon - that is a separate procedure called a colonoscopy biopsy), require anesthesia, and usually mean some recovery/down time. I am not suggesting NOT to do an endoscopy, but the OP needs to know the differences and weigh the risks/odds.

I will point out that steroids can also skew the results of an FNA too.

The thing about all of this is that treatment usually ends up just about the same one way or the other - dietary changes, various meds to help control the effects of IBD, steroids, and chemo if steroids don't make enough of a difference. Some forge ahead administering chemo concurrently with the steroids, just because the type given to cats are usually tolerated well. Of course, this - like anything else - depends on each individual cat.
 

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What I had mentioned before about the old notes that stuck in my head.
  • Clostridium perfringens enterotoxicosis
Both my 6 year olds have a slight thickening of the intestinal wall but haven't displayed any symptoms yet, so the vet thinks ultrasound twice a year is a way to go for now, and the only way to find out for certain is via endoscopic biopsy under anesthesia. So I asked if the FNA was an option but the vet said no. I forgot the reason but will ask next time.

We also had PCR diarrhea panel and they were positive to C. perf as well. Again, no symptoms so the vet is reluctant to use antibiotics, but she said it was possible that their intestinal walls were slightly thickened due to bacterial presence. In our case there's also Campylobacter jejuni, so we will use kitty biome's gut microbiome health test to investigate further.

Since your girls have already shown symptoms, identifying the cause with biopsies sounds like the next step like artiemom artiemom did with her boys. I would too even for my asymptomatic kitties if anesthesia wasn't required...
 
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I could only suppose the food she is eating is causing belly aches - or, there is a dental and/or throat issue. But, if I recall correctly, they checked her throat and nothing was identified. Kind of leads me to think it is the food, or a coincidental change in her possible IBD. You might tell the vet about it and see if they think an antacid or similar type med would be worth a try.

I hope you find some helpful information in the link you were given!
Thank you.
My next question was going to be , she does need dental work. It was brought up last year and got put on hold. They are saying now she will prob lose teeth and it needs to be done now.
this was right before US.
they day before the US I had some back and forth emails with the vet about her stress levels and she said , let’s let her settle just a bit before starting the work.
should I go forth with the dental work ?
 
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Cat.mama

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Wow.. It sounds as if you are really going crazy with all of this stuff going on. I get it.. I had one guy with IBD; the next with IBD/SCL (small cell lymphoma). Both had endoscopic biopsies. The one with questionable lymphoma-- seen on the sample, automatically had PARR testing to confirm the diagnosis of SCL. I know what you are going through.

With Artie, it was diarrhea and vomiting, which did not change with any different foods I chose for him. Finally went to RC prescription Rabbit, both wet and dry. After diagnosis, he was on a lot of meds for IBD.

Geoffrey: sigh.. After having Artie and his diagnosis, I immediately knew Geoffrey had IBD--- vomiting and diarrhea. Did the food swap immediately, to RC Rabbit. his diarrhea stopped, but the vomiting never did. Took him to the Internal Medicine Vet, who did the biopsy.
Shocked about the SCL diagnosis. It was an easy treatment; regular IBD meds, plus a chemo capsule every other day.
~~
It is kind of strange that both your kitties have issues; and many. My thoughts would be to take them, and all their records to an Internal Medicine Vet, and not fool around with a General Vet.

The advice you have received is excellent. You can have an endoscopic biopsy done--- not a Fine Needle aspiration (FNA). The FNA would have to be targeted to one spot. The endoscopic one can see if there are many areas of suspected IBD in the stomach. Yes, thickened walls of the intestine is a sign of IBD and/or SCL.

Curious to note that you were feeding Purina food. Recently, there have been a lot of reports of cats becoming sick from the Purina food. Just a thought.
Also, the fact that they are not drinking water--- weird. Are you living in an area where there may be contaminated water? or just the chlorination? Stick to bottled water or filtered water.

As far as keeping the wet food in the refrigerator: I only kept a can for a couple of days--- then I threw it out. The texture changes, and it seems to smell different. My guys could always tell the difference. Yes, you could try the duck or the venison to see if that would help, also. It has to be a protein which they have not had before.

Also, what you describe as coughing, could actually be them trying to vomit.. I think the belly soreness, the diarrhea, different colored stools, blood in the stool, the hard swallowing is all from pretty bad IBD. Please go to an Internal Med Vet; for the sake of your babies. They must be in such pain.

One thing to remember: IF you are thinking of having a biopsy of any type, Do NOT start steroids! Steroid will skew the diagnosis. You can start them AFTER the biopsy.


I may sound as if I am rambling, but I am doing this from memory...
It is a lot to comprehend...
Good Luck...
Gosh that sounds like quite a road you’ve been down. I’m sorry all that happened.
I’m writing all these notes down to bring up with the vet. Everything is helpful and it’s so comforting not to be just … in the dark reapproaching the vet.
What is the chemo like for the cat? This was the very first thing I thought about. Treating vs easing pain. my parents had a cat that went thru chemo . Don’t know remember for what for, this was 15 years ago at least. I remember it being very hard on her. She lost tons of weight. For better for while but everything spread in liver ect . This was something more extreme. But with those memories, I don’t know what would be right to do.

Purina . Yes . That is an internal battle I have fought . They didn’t have symptoms for many years. Issues surrounded around moldy fancy feast in the beginning and thrn again now when Purina had changes. I try not to think about that as it has driven my crazy since October. At this point I have let go of - did it cause or not and focus on how to fix . The biggest struggle was finding a healthy food to switch them to, that they would eat, and this is solving that dilemma.
So… just trying to focus forward on that one.

The water . Yes it’s a location thing . When I moved to this house , they would smell the bowls / fountains and walk away. They only get bottled water but I guess they can smell the washed dishes. They did go for long periods in their life previously where they were not drinkers. Started and stopped due to dirty fountain. (Ashamed yes, but it happens, cat litter dust happens really fast in the fountain when your cats drink with their feet)
Only my old lady drinks. She doesn’t care if it’s the bottom of the sink , or her bowl.

I dont see that they have venison as a flavor. I’m also not being able to get the duck.
 
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Cat.mama

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It is true that the FNA can generally only be done if there is suspicious tissue to be aspirated. But, endoscopic biopsies can be just as easily ineffective, as they do not always collect the correct tissue. There have been numerous posts on this site to that effect. Not only that, endoscopic biopsies are considered invasive (albeit 'minimally'), are limited to the proximal gastrointestinal tract (meaning they will not normally include the colon - that is a separate procedure called a colonoscopy biopsy), require anesthesia, and usually mean some recovery/down time. I am not suggesting NOT to do an endoscopy, but the OP needs to know the differences and weigh the risks/odds.

I will point out that steroids can also skew the results of an FNA too.

The thing about all of this is that treatment usually ends up just about the same one way or the other - dietary changes, various meds to help control the effects of IBD, steroids, and chemo if steroids don't make enough of a difference. Some forge ahead administering chemo concurrently with the steroids, just because the type given to cats are usually tolerated well. Of course, this - like anything else - depends on each individual cat.
this cat is very sensitive, to almost everything.

nearly every vax , she gets nerve damage and gets drop leg. We end up having to go back and do rounds and rounds of laser.

She always gets better. This cat literally jumps off the walls. She is the only girl I have ever seen that can do backflip , does complete 360s from stand still and kick flips crazy flips off the walls from stand still position! Sorry I just love her so much!!

forgot where I was going with this..

Treatments , she has not really had many, at all but she just takes things roughly.

I even worry so much about putting her under for her teeth. I think I would lean towards a less invasive treatment on biopsy if that was best.

I’m also seeing my vet is not at all in a place to handle this type of stuff and I’m not sure if they would try to take this stuff on. I would not want them to.
I’m in a small city. It’s very hot where I live. It would be close to 2 hour dive to a known ER .
she pants like a princess when she’s in the car over 5 mins!! But, so do I, that’s how hot it is. I think to reduce stress of heat if we are going to travel it needs to be when it’s cooler.

I wonder if vets are open to televisits : video visits with their mamas to discuss histories and what’s going on before hand to see if they are a good fit for seeing their pet? Is this a good idea or no??
I only ask because several years ago when I lived in a previous city, I drove my 15 year old pup to an allergy specialist over 7 hours round trip drive. He was big boy . They didn’t do anything other than put a piece of scotch tape on him! I just don’t want to put her thru a long drive for nothing.
 
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There are a couple of things you should be aware of.

If prednisolone is used then biopsy loses its accuracy / screw up results. Even though mine could benefit from prednisolone we have held off for that very reason.

As for FNA and PARR, FeebysOwner is right, you can detect from that. Here's the problem. That method does have some room for error. I believe it's 90% accurate but has the chance of giving a false negative. Often the choice of FNA with PARR is done if the wee one is older, or really not in great shape to go for the biopsy.

When one of mine was in that spot FeebysOwner FeebysOwner let me know about that option - my vets never even mentioned it - and it was so helpful to know as that option was never presented to me and my girl was in no condition to be put under a biopsy. It was too risky. So it's good to have the info in your back pocket.




You're welcome.I have three not well cats. I know what it feels like to feel like you're just drowning.

Fear is natural and okay - try not to let it over take you though. It can stop your thinking mind. Also make sure you are taking care of yourself too. Lots of water, eating and rest.

There is a lot going on with them.

I would suggest getting the notes and copies of tests if you don't have them already. Ask for SOAP notes too. Read them slowly. There is often a lot of things vets don't' tell you, or things you don't quite hear right in a visit and sometimes errors too caused by miscommunication and interruptions.

Make yourself a food chart too if you can, all the trials you might end up doing you think you'll remember, but over time you forget who tried what food and which one liked and hates etc.
Somehow I missed this with all the messages, I am sorry !
I’m also very sorry to hear you are going thru similar issues with three of your babies.
Thank you for the kind words.

I am doing just as you said. Trying to take notes every day on how their feeding habits are going. I do have all their medical files.
One thing that got me on the US report was IBS was not the first impression from the US team.
However I know from my own medical stuff , it’s always up to the doctor to determine what Radiology comes back with. Kind of , and no , but when there are multiple diagnosis, yes.

I hope you are finding ways to cope with everything that’s going on in your world.
 

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Am catching up on this thread & am very glad I asked about the water. Some cats, but not all, like running water, and many people here use cat fountains (usually bought from Chewy, where, I think, you can also get an online vet to talk to you). However, it sounds as if you have one: if the bowl were elevated she might not be able to drink with her feet? (Or perhaps, there is a kitty litter less likely to stick to her paws?). You asked about affording it all—- aren’t vets expensive? There are various pet insurance companies out there, but for older cats it might prove more difficult to get them. A vet offered me a sort of temporary pet insurance just out of kindness to help with the immediate bills: you could see if there is something like that you could ask about. I am glad some of your cats do at least drink from the sink: especially as they get older, hydration is key. Some cats have to have IVs for water if they don’t hydrate, so getting them to drink would certainly be cheaper and less time consuming. GOOD LUCK! ❤
 

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I'm late to the party, but I just lost my kitty to IBD a couple of months ago.

Food--You want something with no gums (guar gum, carrageenan, and etc) and something that's not chicken as chicken is a big problem for many IBD kitties. Try turkey, duck, venison, or lamb. We fed RAWZ turkey and duck and ZiwiPeak lamb. Instinct also makes a couple of good options. Really, what food works best depends on the cat.

US vs Biopsy--The biopsy usually tests for cancer. The US is the beginning point and if normal IBD treatment isn't working, then you can proceed to a biopsy.

Additional meds--The common full treatment of meds is probiotic (s. boulardii, Proviable DC, or Gut Soothe from Adored Beast), B12 injections to help with nutrient absorption, steroids, anti-nausea meds (Zofran/Ondansetron). Sometimes pain meds are given.

Water intake--We add a teaspoon or so of water to wet food at each wet food serving, which is twice a day.

There's a great group of Facebook for IBD kitties, Cats with IBD. It's a great resource, has supportive and knowledgeable people, and there's food lists in the files section of the group.

Lastly, and this is the most frustrating part of IBD, it's not an easy road. It's frustrating and it seems like it's one step forward and two steps back. Know you're not alone in this journey and there are many who are walking or have walked the same path.
 

artiemom

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The chemo for SCL is just a capsule. You keep it refrigerated, use gloves when pilling. I used a pill gun and gave some water, in a syringe, immediately after pilling...

Good Luck...
 
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Cat.mama

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Am catching up on this thread & am very glad I asked about the water. Some cats, but not all, like running water, and many people here use cat fountains (usually bought from Chewy, where, I think, you can also get an online vet to talk to you). However, it sounds as if you have one: if the bowl were elevated she might not be able to drink with her feet? (Or perhaps, there is a kitty litter less likely to stick to her paws?). You asked about affording it all—- aren’t vets expensive? There are various pet insurance companies out there, but for older cats it might prove more difficult to get them. A vet offered me a sort of temporary pet insurance just out of kindness to help with the immediate bills: you could see if there is something like that you could ask about. I am glad some of your cats do at least drink from the sink: especially as they get older, hydration is key. Some cats have to have IVs for water if they don’t hydrate, so getting them to drink would certainly be cheaper and less time consuming. GOOD LUCK! ❤
Hello. So it’s been about two years ago I had a fountain and maybe 3 bowls . The older cat only used fountain , the twins used both. At the time after clean out , I moved the fountain from the counter to the floor. (It would get a full clean out / filter change once a month. ) On maybe week two I noticed them walking away from it, took a closer look and it had a ring of litter.
I took down the fountain completely for awhile, one of the twins continued to drink from bowls and eventually the second started again.
As soon as I moved to this house - they stopped. I did try a fountain again - but the older kitty was making the water turn sticky / foamy within a day so I felt more comfortable being able to change her water daily in the bowl.

I actually just purchased a new one and I’m going to try again and see what happens. My older cat is in renal failure and drinks a ton of water. She is always in the sink - I know she will at least enjoy it.

For a time I was adding water to their food - I don’t know why I stopped. Once we get situated with a food swap , I will get back to that habit. Thank you
 
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I'm late to the party, but I just lost my kitty to IBD a couple of months ago.

Food--You want something with no gums (guar gum, carrageenan, and etc) and something that's not chicken as chicken is a big problem for many IBD kitties. Try turkey, duck, venison, or lamb. We fed RAWZ turkey and duck and ZiwiPeak lamb. Instinct also makes a couple of good options. Really, what food works best depends on the cat.

US vs Biopsy--The biopsy usually tests for cancer. The US is the beginning point and if normal IBD treatment isn't working, then you can proceed to a biopsy.

Additional meds--The common full treatment of meds is probiotic (s. boulardii, Proviable DC, or Gut Soothe from Adored Beast), B12 injections to help with nutrient absorption, steroids, anti-nausea meds (Zofran/Ondansetron). Sometimes pain meds are given.

Water intake--We add a teaspoon or so of water to wet food at each wet food serving, which is twice a day.

There's a great group of Facebook for IBD kitties, Cats with IBD. It's a great resource, has supportive and knowledgeable people, and there's food lists in the files section of the group.

Lastly, and this is the most frustrating part of IBD, it's not an easy road. It's frustrating and it seems like it's one step forward and two steps back. Know you're not alone in this journey and there are many who are walking or have walked the same path.
I’m so sorry to hear that.
Thank you for the info on the food. My vet has only provided info for prescription diet brands. all of your information is extremely helpful.
This thread has given me so much info and better explained or prepared me for what’s ahead. Thank you to everyone
 

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How do yall afford this?? What is the secret ??
I feel you here.

Somehow I missed this with all the messages, I am sorry !
No need to be sorry - there was a lot of info and posts coming at you. All great info too!

I’m also very sorry to hear you are going thru similar issues with three of your babies.
Thank you for the kind words.
Thanks and you're welcome. It's all about coming together to help each other help these babies and support each other while we do it. XOXOX Best community ever.

I am doing just as you said. Trying to take notes every day on how their feeding habits are going. I do have all their medical files.
One thing that got me on the US report was IBS was not the first impression from the US team.
However I know from my own medical stuff , it’s always up to the doctor to determine what Radiology comes back with. Kind of , and no , but when there are multiple diagnosis, yes.

I hope you are finding ways to cope with everything that’s going on in your world.
Glad you are noting as it's really easy to think you'll remember but with all you have going on, it'll be so much easier on your brain and stress to do that. This way if the Docs ask you something - you don't have to go swifting through your memory. You'll just have it.

Good you have all the files. :cool:

Yeah multiple and differential diagnosis. Then trying to find the culprit or culprits and heal it. It's a journey for sure.

I am thank you.. as I hope you are too. XOXOX


I'm late to the party, but I just lost my kitty to IBD a couple of months ago.
😢 :hugs:


Water intake--We add a teaspoon or so of water to wet food at each wet food serving, which is twice a day.

Lastly, and this is the most frustrating part of IBD, it's not an easy road. It's frustrating and it seems like it's one step forward and two steps back. Know you're not alone in this journey and there are many who are walking or have walked the same path.
*nods* on the water.... and on how frustrating it can be.

and yes, you are not alone.
 

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Hi. The resolution to food is a trial and error. Mostly folks use limited ingredient foods - novel proteins, and those without a lot of fillers/gums. I am sure others will come along with some ideas on things for you to try, as just was done by the above post, but it still will be a trial and error situation, as all cats respond differently to foods of any kind.

As noted above, IBS/IBD can lead to cancer due to the ongoing, never ending inflammation. While the supposed ideal way to determine if it has led to lymphoma is a biopsy, if there is tissue that can be gathered through a fine needle aspiration, followed up by a PARR Assay, if needed - all done non-invasively during a US - there are cases of lymphoma being identified without biopsy.

Nonetheless, the standard treatment for IBS/IBD and even lymphoma is usually defaulted to food changes and steroids - Prednisolone, or a more specific less systemic steroid known as Budesonide. Those changes can be followed with chemo - which is nothing like what you might think it is for a cat - mostly done if lymphoma is confirmed, or greatly suspected.

The reasons for the US other than her poo and anal glands may actually be relevant. So, it might be a good idea to explain more about that.
Without going into too much detail , because there are so many…

One of my girls recently had an US for reasons other than her multi colored poo and anal gland issues.



The ultra sound resulted showing 2.5 thick intestine walls. I was told this is ibs that leads to lymphoma. We can’t rule out lymphoma without biopsy.



Vet wants to switch to ZD diet to ease inflammation. I think She says this will stop the progression. It was all so fast I didn’t really process information.



Her litter mate shows stronger symptoms and has for much longer. We are pending her US. I fear the worst but I am hopeful.



My girls are so picky. We tried the ZD with no success



I tried 3 cans- morning and night mixing 1 spoon or less only. I already knew by seeing the loaf texture it was not going to work for them.



The next trial - this week has been RC select protein RD. Day two, they eat some in the morning but are mostly refusing. After a couple of hours I pick it up and feed them their normal food with no medicated. The vet also ordered duck flavor, hopefully will be in a couple of days. This texture is much better than the loaf. One cat actually ate a good amount of her plate tonight however it’s not the cat with confirmed issues. She ate nothing.



My late pup of 17 years , towards the last years of his life gained severe skin allergies. Missing hair , itching like a mad man. RC is actually what he ate.



My cats do not have skin allergies. They do not itch. We have been rocky with food quality changes and their poo is multi colored. Two years ago I had issues with gray poo, diarrhea , and blood, but , it’s been two years since I’ve seen those issues. They resolved when I switched to Purina. Came back last October. They also get hairballs.



I’ve been trying to research food , but this is impossible to understand.



I saw hills d/d that looks like it has more flavors, but looks like it is more for skin allergies? Are these the same thing ? Or must it be digestive food? Two years ago I had semi success with gastrointestinal in the shredded but ended up adding it in as a hard food supplement. I stopped that long ago. My girls don’t drink water and one is over weight. I didn’t see the benefit.



I honestly don’t really understand what is wrong with my girls and how thick walls lead to lymphoma. I didn’t ask questions when the vet initially called with the results. I was just beside myself. Inflammation? Can this get better or do we just stop it from getting worse?

I’m not asking a medical diagnosis for my pet, I’ve already got it. Just trying to better understand. From what I understand a change in diet is the only way to save her?


Trying to better understand all the options of food. I’m not even sure the office understands all the options of foods. What exactly am I looking for or what am I looking to avoid?
 
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Just an update. I got results back for second kitty and she does Not show thick walls and has been cleared.
It’s kind of mind blowing that we did an US on the first cat only mainly because unrelated X-rays showed a possible growth in the stomach.
it’s been years since she’s had diarrhea and no vomit other than hairballs. Multicolor poo was the biggest thing that stuck out.

But this is where we are. I’m having an extremely hard time with switching over the food. We were on a roll but when I upped to half a can of RD AND spoonful of Purina, they just pick out the Purina now. I’m still feeding the second cat the mediated. A couple years ago it was suggested to switched her to renal food , which I never could. I think I’m going to venture on that for her at this time since we are already in the process of trying to change.

there were several days I fed them only their old food. I noticed a tiny bit of diarrhea in the boxes. Not sure if it’s related

The cat that does have ibd/ibs she is acting like she does not feel well. She runs from me if we meet head on and sometimes hisses. She still comes for loving on the couch at times. I’m not sure if it’s stress from the appt and then seeing her sister leave for the vet too. She did have her leg hurt during the US. She’s been walking kind of funny and I see her shaking that leg out. I had been holding out to see if it would get better but I guess it’s time to set up some laser

I wanted to ask. For those who had cats with this. How fast did it take to progress? I feel like I have this ticking clock of getting her the right food. I wonder , she’s acting /seeming worse behavior wise than before we ever went to get scans. Could this food be not good for her?

Both of their poo has changed color. It’s now a burnt charcoal color. To me that’s strange as the food is light brown. It also smells bad! These are all things I had planned to go over with the vet yesterday but I missed her call.
 
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if anyone is still following this can I ask for recommendations on specific food names you have tried.

I am no longer having success with the Royal canin. Maybe I tried to fully transition too fast, idk. We have been back to eating Normal food for a couple weeks. It started way better than I expected. I tried 1/4 can medicated with 1 full can normal for sometime. All was good. Moved to half a can and half a can , things still pretty good. Eating less, sometimes picking out the Purina.
Stayed with half medicated (as this should be all they get in one feeding) with one spoon of regular she stopped eating all together.
Went back to normal food a couple days and tried 1/4 again and she wouldn’t eat at all.

When I reached out to my vet , her response was much different. Initially she said we would try until we found something that worked. When I messaged asking if we could try the next option as we declined in progress , I was told the only other option , Purina, only had hard food. She said it’s okay if it takes time to transition to this current food . However we got to the point where she was eating nothing. She still refuses her normal food it was mixed with, I’ve had to change her to a different formula of regular Purina. The vet didn’t give any other options.

If there is no other medicated food, what other food can I try.

Something else I found interesting. Since she does not have diarrhea or vomiting, the typical signs of this disease, I asked if her issues from the past caused this. She said probably not. Someone asked if I thought Purina food issues could be a cause , I didn’t think so, It makes me wonder now about the Purina food causing her colored stool and if it indeed played a part.
 

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My kitty was on RC gastro for most of his 14 years of life. I think they changed the recipe or suppliers because he also started not eating it and it wasn't helping his IBD. This is what we tried, with success, except for the rabbit.

RAWZ turkey, duck, rabbit
Instinct venison, rabbit
Ziwi Peak lamb

Many owners have good success with rabbit. It made my boy have worse diarrhea.

Chicken and fish are common irritants as are fillers such as guar gum and other gums as well as carrageenan.
 
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My kitty was on RC gastro for most of his 14 years of life. I think they changed the recipe or suppliers because he also started not eating it and it wasn't helping his IBD. This is what we tried, with success, except for the rabbit.

RAWZ turkey, duck, rabbit
Instinct venison, rabbit
Ziwi Peak lamb

Many owners have good success with rabbit. It made my boy have worse diarrhea.

Chicken and fish are common irritants as are fillers such as guar gum and other gums as well as carrageenan.
Thank you ! I have gone thru all the limited ingredient cat foods at petsmart snd all have gum gar. I think I had skipped instinct becuase of the peas but I’ll give it a go.
I’m going to buy some turkey breast this week too to bake for her and try using as a topper. They love baked chicken. I’ve never tried turkey.
I’ve done a lot of reading this weekend on what not to feed them. Their regular food is chicken and top 5 ingredients has wheat gluten corn starch and by product . Also soy and glycerin,
It’s very difficult finding foods without these

I’m reading conflicting things on liver. Do you have an opinion on this?
 

stephanietx

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We don't feed plain liver on its own. We always blend in another food if we feed it. Try something that doesn't contain chicken and see how they do.
 
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