Feline Triaditis. My experience and concerns/questions

Jim, I'm so sorry to hear this about Noelle. Have you had a recent ultrasound done? She does sound like she's in pain and pancreatitis can certainly do that. 

Hi Jim, just wondering whether you have had any progress with understanding Noelle's current condition re. sporadic flare ups. I'm taking my girl Olympia to her vet for her routine ultrasound in the next few days... She suffers triaditis but is relatively younger than many of the cats I see on these posts; it saddens me but at least she bounces back quicker than others can.

Anyway, if you could suggest any enlightening questions to ask my vet during our checkup, I'd really appreciate it. My vet quite literally specialises in this area.

I really wish you and Noelle's all the best; I hope the flare ups are going away.

Take care
- KM

Jim  and kimberlou, , im so sorry to hear about your cats.. I hope they feeling better now. My cat Portia was diagnosed with pancreatitis last december, developed Hepatic lipidosis after and is currently experiencing another flare up of pancreatitis. Your description of Noelle's behavior is very different from how Portia behaves. She never really gets better by herself and once her appetitie begins to drop, its stays low for a while. Maybe, you could get some blood work done on Noelle to get a better idea? Do you think maybe she has an infection from the raw food? Ive never fed Portia raw but I've read that that is a possibility.

When you say your cat was diagnosed with triaditis, what were the tests you did? The reason I ask is because I dont know if Portia has it or not. We know from her spec fPL tests that she has pancreatitis, but the last time we did her blood work in Janurary her folate and cobolamine levels were normal and an ultrasound did not show any bile obstruction on inflammation in her intestines. I want to know if there is test we can do (that perhpas Noelle or Olympia had) to diagnose IBD or triaditis in Portia. Does the treatment change if its only pancreatitis or if its triaditis? Im going to try switching her over to IAMS low residue diet for now till her pancreatitis subsides (as recommended by the vet) and then maybe to a better brand. I've been told Nature's variety or Natural blend are both good but if it's high on fat, that may not be the best for a cat with diagnosed pancreatitis (although I know the literature about food fat and pancreatitis in cats is a little weak).

Noelle is doing fine now that she is back on the pred every night, but it's been two weeks and my vet wants to taper back to every other day again to give her a rest from the medication. I also eliminated the digestive enzymes from her diet and instead of using pill pocket treats to give her pills, I now pack the pills in a bit of her food and she gobbles them right up! My thought is that I remember her getting sick after giving her treats a long time ago, so maybe an ingredient in the pill pockets is contributing to the flare ups. Only time will tell I suppose. I have an appointment Monday morning to get her blood work done and see how everything is doing. 

Portia, when Noelle got sick back in 2011 and needed her bile duct rerouted from the obstruction she had, they did biopsies of her liver and pancreas I believe and they diagnosed her that way. My vet said there is no surefire way of diagnosing pancreatitis and this whole triaditis problem is relatively new to doctors so they don't have a good grasp on it... I don't know how I feel about iams. All that commercial stuff is crap, especially dry food, which I am confident led to Noelle's problems to begin with.

Kimberlou, how old is Olympia? 

So Jim, is she doing better since last we talked? 

Yeah! She's been great! I'll Facebook message you

Hi Jim, that is so wonderful. I'm glad to read that Noelle has been well

(To answer your previous question- Olympia is 2 years old. The vets were surprised at her diagnosis at the time. I agreed to pay for her vet ( a feline specialist) to do whatever was best practice; to make sure we were on the right track early in... So far, so good. My little one is bigger and stronger than ever!)

From looking at yours and others' threads I fear that we'll be riding a long-term emotional roller coaster ride. So confusing and scary, but great to see that people such as yourself will do what it takes for your feline family. I'm so glad i joined TCS- Go Team!!!!

I am one of those roller coaster riders too, it's beginning to look like. We rescued Spencer from our local shelter because as an advocate, I was afraid he'd get sick if he stayed in any longer. He did. But URI is very treatable so we brought him home.

The trouble showed up when we couldn't get him to eat. Nasal passages were working (he would sniff the food & make licking notions in the air, but not eat) so we took him in to our vet for further examination. Not to get too long winded, he ended up in critical care with a tube in his neck to his tummy....the premise was once the appetite stimulants kicked in, he would start to eat. That hasn't happened & we're frantic to stop administering 9 meds plus food down this tube three times a day! The poor little guy hates us on sight! All we represent to him is pain, forced feeding & nastiness.

My question I guess, is has anyone else had to do this & if so, how long did it take for your kitty to start eating on his/her own? We have bought all different types & flavors of food, we have watered it down, we have tried hand feeding. Nothing is working!! I fear they are going to tell us after all this that he has to be put down. We have spent $6000.00 to date & are no closer to having him well than we were a month ago.

This is Spencer with his feeder tube in.


I sure could use some encouragement that this will all come to a happy end. Spencer is an adorable boy & we want him to be well & happy!!
Thanks
~Ginger~

I have done this as have several others.  Recovery time seems different for different cats, I tube fed Patches for 3 weeks and he was hospitalized for almost a week before he came home.  He was actually tube fed for almost a month, others have been several months.  

Patches didn't have the pancreas involvement so it wasn't the full triad.  He has IBD which turned into fatty liver.  He wasn't on as many medications as your cat but that may be because of the pancreas.  He was on prednisolone and flagyl.  He was never given an appetite stimulant.  I just tube fed him until he started eating enough on his own.  The vet also put him on a supplement that contains SamE and Milk thistle to help his liver heal.

I have read that recovery from Fatty Liver when a feeding tube is used is close to 90 percent.  Cats do get over this it's just a long haul sometimes.   The fatty liver part is a disease caused by not eating so the next step is to figure out why he wasn't eating.  It all could have been caused by the URI and being in a shelter where his food intake wasn't being monitored.

Thanks so much, Denice, for your speedy response & encouragement. I'm pretty sure Spencers problems are directly related to his weight which when he was brought into the shelter topped the scales at 22.46 pounds! He was incredibly obese plus he'd lived with the same family his entire life. So! Trauma, then stress...he quit eating. The shelter did not care...did not even report it & when we finally went to get him, as stated he was sick with a kitty cold & down to 17.2 pounds. This basically knocked the spit out of his liver & we just averted that fatty liver problem narrowly. They have checked him for that as well as cancer. No signs of either. He went in for a second look today & they told us his skin is losing the yellowness it had so that indicates the liver is being helped by the meds too. Phew!

When we started out, I was syringe feeding him...or trying to. That didn't work well at all. He either gagged or fought the syringe. This was why Critical Care entubed him...everything can go down the tube & he's no wiser. They said today they would try adjusting his meds too & maybe eliminate some since the liver is getting better, but I won't know more til hubby comes home with our patient.
I promise I will update & then if anyone else can think of ways to lure this boy into eating, I'm all ears!

I tried the syringe feeding with Patches and he still went into fatty liver disease.  Some cats are easier to syringe feed than others.  Patches is easy to pill but not to syringe feed which is really odd.  An overweight cat is more prone to fatty liver problems than one that is normal weight.  Patches wasn't overweight and a vet, not the one that I take my cats to now, told me that fatty liver wasn't a concern because he wasn't overweight.  I waited too long before taking him to another vet and he had fatty liver.

I have to say, the only time Noelle won't eat is when she Is having a flare up. Her flare ups thankfully only last a couple of hours and trust me even that feels like an eternity. We have her on 2.5 mg prednisolone daily again since every time I taper her to every other day she has issues. I pray that it never gets to the point where she needs feeding tubes so I will continue to make sure she gets plenty of water in her raw diet and stays with her meds and her herbal pills. The worst she has been since going on her every day dose is occasionally she will look a little uncomfortable but it may just be the way she likes to sit lol. There has been no vomiting while on prednisolone and her appetite and weight have been great. I plan on bringing in her for routine blood work every 3 months as long as no other issues arise to ensure her liver and glucose stay normal.

Patches has been on a steroid for a little over 2 1/2 years.  I know it's not the best solution, wish it weren't that way but he has only had two short mild flares since he has been on the steroid.  Both were in the spring so I think it is the extra hair that he is swallowing during shedding season.

I think Gingerjake's cat probably quit eating because of the URI and being in a shelter no one noticed that he wasn't eating.  He is also an overweight cat which means he is more prone than average to liver problems from not eating.  Hopefully it's just a one time thing.

Denice said:

 
I tried the syringe feeding with Patches and he still went into fatty liver disease.  Some cats are easier to syringe feed than others.  Patches is easy to pill but not to syringe feed which is really odd.  An overweight cat is more prone to fatty liver problems than one that is normal weight.  Patches wasn't overweight and a vet, not the one that I take my cats to now, told me that fatty liver wasn't a concern because he wasn't overweight.  I waited too long before taking him to another vet and he had fatty liver.

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Denice - we learned that Spencer wasn't going to eat after we had him about 5-6 days so syringe feeding was the first thing we tried after all 'tempting foods' failed. Since I've never had to deal with anything like this before, other than my two day-olds being bottle fed, this was all trial & error for me...mostly error because he couldn't/wouldn't swallow the food. I feared shooting it down his throat for fear of it going into his windpipe or lungs...

His second look today resulted in the vets being a little annoyed that we haven't been forcing him to eat the full 90ml of food at one time. We tried to plead our case that when we did, he vomited...so it was a waste of time & he got upset. We have decided on our own to feed him less more often even if it means getting up in the night to do so. He has dropped 7oz since they saw him a week ago & they don't want any weight loss...sigh.
On a positive note, the ultrasound shows the pancreas is less inflamed & his liver looks better too. His skin isn't as yellow & the best news is that his blood sugar levels are leveling quite quickly...small mercies.
He is home now & very happy to be. Tonight we will feed him his full quota of food because he'll be sleeping thru' the night we hope. [emoji]9829[/emoji]

Jim Peterford said:

I have to say, the only time Noelle won't eat is when she Is having a flare up. Her flare ups thankfully only last a couple of hours and trust me even that feels like an eternity. We have her on 2.5 mg prednisolone daily again since every time I taper her to every other day she has issues. I pray that it never gets to the point where she needs feeding tubes so I will continue to make sure she gets plenty of water in her raw diet and stays with her meds and her herbal pills. The worst she has been since going on her every day dose is occasionally she will look a little uncomfortable but it may just be the way she likes to sit lol. There has been no vomiting while on prednisolone and her appetite and weight have been great. I plan on bringing in her for routine blood work every 3 months as long as no other issues arise to ensure her liver and glucose stay normal.

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Jim - Spencer is taking a pain med as well but I'm not sure what it is. I will try to find out what it is. It's a tiny pill that we have to crush into powder & then add water & administer that way.

You're so fortunate your little girl hasn't had to be entubed. The spot where Spencers tube goes into his neck has to be watched & cleaned carefully & the bandage around the tube changed every day. He DOES NOT like that! The collar he wears holds the tube relatively flat tho', but it still does wiggle I'm sure.

The whole thing that's happened with Spencer has been caused by trauma & depression according to the vets at Critical Care. He was a spoiled fat cat who was dumped into a noisy, stinky shelter full of strangers. We're starting to see trust for us now but it gets undermined every time we have to take him back to the vets. He adores my husband & follows him around like a lamb, so we're trying to make sure this trust doesn't get shattered.

My cat Jojo was diagnosed with triaditis a little over a year ago (she is 7). Symptoms were very much the same as Noelle with the same awful liver panel results and an ultrasound showing pancreatic involvement. Her doc put her on Prednisolone and Metronidazole to treat the inflammatory aspects, and on Cerenia for the nausia and Buprenex for pain on a symptomatic basis as needed.   Jojo also has asthma, and so has been on Prednisolone for 5 years (albeit at a lower dosage until this later diagnosis) and an inhaler for asthma control. Since asthma is also an inflammatory disease it is my opinion that these are all related.  Once she is on the mend from her episode we cut back on the pred and cut out the metronidazol, but every time I try and take the pred down below 40ml/day she begins to lose appetite almost immediately and within a couple of days has spiraled down into a full-blown episode. I worry about having her on such a high dose over a long period but it seems to be a pay me now or pay me later situation.  We have controlled the disease to the point where she only episodes every 3 months or so.  

As we who live with feline triadid know, diet is critically important for a triaditic kitty. When we first received the diagnosis my vet recommended a very high end premium canned food, but it was so expensive that I couldn't see a way to add it to the budget. After doing extensive research and in consultation with my vet, I started making my own cat food using information and the recipe from Dr. Lisa Pierson: http://www.catinfo.org/?link=makingcatfood.  I don't do fully raw as my vet was concerned about bacterial infection, so I cook it about 1/2 way. I remove 3/4 of the skin to reduce fat content because of the pancreatic involvement. I believe this is integral to controlling the disease. I use chicken that is both hormone and antibiotic free.  I make 18-20 lbs at a time which is enough to feed both Jojo and her (healthy) sister for a month.  I am convinced that this diet is key to controlling Jojo's disease, and in fact her sister Petey has improved her weight (dropped 2 lbs without restricting food intake) has increased her energy level, and her coat is glossier and softer than it ever was before we started feeding home-made. It takes one afternoon a month and is about 40% less expensive than a premium canned diet like Blue or Wellness Core.

My dilemma at the moment is whether to treat a sinker or wait 'til it turns into a full-blown episode.  This morning Jojo didn't wake me up (when she is feeling ok she always comes and lets me know when it's breakfast time), didn't come down to eat and when I brought food to her ate a bit but not with any enthusiasm./ She's not vomited but isn't up and about - just stationary at the end of the bed and not looking very happy.  I've decided to treat this as a triaditic episode and started her on increased Pred and on Metronidazole immediately.  I hate to over-medicate, but my thinking is that if I can catch it now then she won't go down entirely and I won't have to add in the nausea and pain meds.  If anybody else who is contributing has any insight I'd surely appreciate it. Thanks.

We lost our Jojo this week to ongoing inflammatory issues that included but were not limited to triaditis. She developed asthma at 15 months, inflammatory bowel at about age 4, all the triaditis symptoms at age 6. We treated her with increased pred, metronidazole, buprenorphine and cerenia, as well as hydration when necessary.  In the last 3 months she developed urinary cystitis...yet another inflammatory issue...and her triaditis flares...vomiting, pain, total inertia...got closer together.  When we could no longer keep her pain-free for the most part, we did the only kind thing.

Steph Bader said:

 
We lost our Jojo this week to ongoing inflammatory issues that included but were not limited to triaditis. She developed asthma at 15 months, inflammatory bowel at about age 4, all the triaditis symptoms at age 6. We treated her with increased pred, metronidazole, buprenorphine and cerenia, as well as hydration when necessary.  In the last 3 months she developed urinary cystitis...yet another inflammatory issue...and her triaditis flares...vomiting, pain, total inertia...got closer together.  When we could no longer keep her pain-free for the most part, we did the only kind thing.

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I am sorry you lost your Jojo.  These inflammation issues are so unpredictable as far as both severity and what parts of the body they affect.  I have a kitty that started with IBD when he was 18 months old.  He has had inflammation in his liver with one flare.  He has recently developed an allergy to chicken.  My other kitty is the same age, they will both be 11 this year, and hasn't had any inflammation issues yet.

Well I am hoping the internet G-ds are looking out for me.  My cat was just diagnosed with triaditis yesterday.  She has had thyroid disease for the past 3 years and went from 13 pounds to now 5 lbs.  She was a feral I domesticated 17 years ago and came inside knocked up and later had a litter of 7 kitties.

Anyway, considering her age, I don't know what to do.  She has never been the easiest with any meds and my income is limited.  Right now the vet is doing IV fluids, pain meds, Pepcid and antibiotic.  She says they should know if that will work within 48 hours.  Oh they also said when they took her blood sample they noticed jaundice. 

She is still bright with big green eyes and eats like there is no tomorrow but vomits quite a bit and now has started not using the litter box to pee.

What would you do?

Beaches, are you on Facebook? If so join the pay IBDKitties. That's a group of us who really help each other out and you may get some good feedback when you share your story on there. What are you feeding your kitty? I've had one cat who was hyperthyroid but I did the radioactive iodine to cure it and my other girl has triaditis and has done well on a raw diet, probiotics, digestive enzymes, prednisolone and herbal meds. It's a tough road to go down but keep fighting for her. Definitely join that Facebook group tho