Toby vomiting and losing weight, fine otherwise

I would be extremely irritated that my holistic (??) Vet referred you to the surgeon asa to what foods to feed because his test resuts are more recent.  What kind of excuse of that?  And what kind of holistic or homeopathic or whatever Vet prescribes Pepcid and Covenia shots?  I mean, a traditional Vet would definitely prescribe Pepcid, but not someone who claims to be homeopathic.  Wouldn't they have prescribed Slippery Elm?  

Oh Barb .  At first I was ecstatic when you said they called and said it was NOT lymphoma, but now you say they said it still might be.  What the ?????   Now my joyful cheers have turned to to ALL the doctors involved.

As Laurie said...

LOL Mrs. Green Jeens! I do that too.

Barb I will tell you that if he did have lymphoma the treatment likely be prednisone and that's usually the same treatment for IBD and any inflammatory disease really. You will have to decide on the biopsy. It can give you a better perspective but I'll also tell you that they are not 100% conclusive. Most of the time I have seen them give results of exactly what is going on and in hindsight I wish I had done that early on with Alex. We went pretty blindly into her treatments but at the same time, I had never even heard of IBD before she got it. So as they say hindsight is 20/20.

Well this morning the surgeon said "the good news it, it's not lymphoma".

But this afternoon when I said what about an MRI, the surgeon said it is just a clearer ultrasound, or cleared x-ray and we can only rule out cancer with a biopsy. He said it could even still be lymphosarcoma, just not in that lymph node. This seems like a stretch to me, since we first took Toby in for his condition back in mid-November where he'd been vomiting and lost his voice, and wouldn't he be sicker by now?

I'm just so frustrated because it doesn't seem like anyone is looking at the big picture except us. I do want to rule out cancer though, so we may just take him in for the surgery to get the biopsy. It just really upsets me that we have to do it without stronger evidence that he may have cancer. 

This is a cat who is still running around and has normal energy other than throwing up and losing weight and gurgling. He is not lethargic at all, aside from after we take him to the vet for these various tests where he is anesthetized. 

finnlacey said:

HOLD ON!!! Covenia shots? Oh lord. Covenia is WAY overused and is supposed to be used as a last resort: http://www.catinfo.org/convenia.php

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Yeah, that is exactly what I thought too at the time. Not at all happy that they gave him that shot, not one little bit. But he got it before I knew about it. 

Well if that's the case, then honestly I don't know what a biopsy NOW would prove. IBD has the potential to turn into lymphoma at any point in time. That's not to say it will because more cases than not, do NOT turn into cancer. But I guess my point is what if you need to do a biopsy later on? Would you put him through that right now just to have to do it again possibly? I would weigh the options well first. If he doesn't appear to have cancer now then doing a biopsy may or may not show anything at all. It could still be inconclusive and then later on you may need to do it if the inflammation becomes too much of a problem. I think you are making yourself crazy with the "needing to know everything right now". Because I will tell you that IBD is a shape-shifting trickster and even if you get answers right now, before you know it, the disease changes faces again. The big picture with IBD never stays the same Barb. That's what I want you to remember. If you haven't read my Living with IBD page on my site, please take a look at that. It explains a lot of this. Not trying to sway you either way at all and no matter what you decide to do, we are all here for you with big shoulders. There is no wrong or right decision, I just want you to know ahead of time in case you do it and it still comes back inconclusive. I don't want you to be surprised. 

We scheduled Toby's surgery for Wednesday with the caveat that we will bring him earlier if anything about his condition worsens between now and then. We picked Weds because it gives us more time to care for him one on one after he is back home. 

This is all very frustrating. I guess I understand but part of me doesn't understand!

Meanwhile I'm going to look at switching him over to the foods recommended. Today I've been doing this other stuff all day just hoping there would be a way to see if this could resolve without surgery,

Man, sometimes you really have to hate vets. Honestly, that's why we do so much learning, and have to ask so many questions, and advocate for our kitties ourselves. :heart3: Yes, the internet can have all kinds of misinformation. But there's good information to be found, and thank GOD for communities like TCS!!!!!!!!!

BarbB said:

Well this morning the surgeon said "the good news it, it's not lymphoma".

But this afternoon when I said what about an MRI, the surgeon said it is just a clearer ultrasound, or cleared x-ray and we can only rule out cancer with a biopsy. He said it could even still be lymphosarcoma, just not in that lymph node. This seems like a stretch to me, since we first took Toby in for his condition back in mid-November where he'd been vomiting and lost his voice, and wouldn't he be sicker by now?

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Not necessarily that you would see. Lympho doesn't even always show up in the blood work - ever. With Lazlo, we thought in Nov/Dec 2010 that he was having his usual issue with hairballs. We did our standard grease-treatments, and it seemed to help for a while. Then the problem came back, so we hauled him back to the vet in January. He had an x-ray then, and it showed nothing. So we continued to treat him for hairballs. It seemed to clear up, and he seemed fine. Then in June, the problem came back again. This time we took him to the holistic vet. That was the end of June or the beginning of July. And we had blood work done again - and this time, it showed he was anemic. BUT... the ONLY reason it showed that - with 20/20 hindsight - is because he had bleeding ulcers. If his lympho wasn't in his stomach and didn't cause bleeding ulcers, we STILL would not have known there was a problem. Our holistic vet gave him a shot of convenia (to treat the anemia and gingitivitis) AND a shot of depomedrol - again, to treat the anemia. We went back after two weeks, and tried another round. But at that point, Lazlo WAS acting sicker - he was losing weight, having trouble with his appetite, and not as active. But AGAIN - this was because he was nauseous because of the ulcers. If he didn't have those... ????? Who knows? So at the end of THAT two weeks, we took him back. And even though he'd "just" had x-rays in January, they took more x-rays. And that is how they found the tumor in his tummy. X-rays the first time were at the beginning of January. The 2nd time, the end of July. It took 7 months for that tumor to grow like that - and lympho can be without a specific-site tumor. At that point, the holistic vet referred us to an oncologist. However, she did provide supporting herbals that we used with the consent of the oncologist. Some of the things she wanted to use were powerful anti-oxidants, and he said those can interfere with chemo. So we stuck with the blood-building stuff and the herbal to treat his gingivitis (which WORKED really well!!!).

But for a holistic vet to refer you back to the specialist for diet recommendations? :dk: Sorry, but that really doesn't sound right. I can see running supplemental herbal or anti-oxidant support by the specialist - but diet recommendations? Aw hun, I'm just so sorry!

I really don't know what I'd do in your shoes. I'd want a clearer understanding of what toll it may take on him to have the surgical biopsy done. I'd probably do it. You can confirm (or not!) that he has IBD (make SURE that's part of what they check!!) and/or some type of cancer, and if so, what type.

Either way... it seems he should be on a low dose of prednisolone, and (I sound like a broken record here :anon: ) a low-carb, grain-free canned diet or raw. It will help with both or either condition. :heart3:

Just mega !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! :grphug2:

BarbB said:

We scheduled Toby's surgery for Wednesday with the caveat that we will bring him earlier if anything about his condition worsens between now and then. We picked Weds because it gives us more time to care for him one on one after he is back home. 

This is all very frustrating. I guess I understand but part of me doesn't understand!

Meanwhile I'm going to look at switching him over to the foods recommended. Today I've been doing this other stuff all day just hoping there would be a way to see if this could resolve without surgery,

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We were posting at the same time.

Personally, I would do this. He's relatively seemingly healthy right now - and will probably recover more quickly because of it. :nod: If it is cancer, you need to know if it's treatable with chemo.

If it's not, you can treat him as if he had IBD, and get him on an anti-inflammatory diet with supporting supplements, and perhaps PREVENT cancer from occurring. :heart2:

finnlacey said:

Well if that's the case, then honestly I don't know what a biopsy NOW would prove. IBD has the potential to turn into lymphoma at any point in time. That's not to say it will because more cases than not, do NOT turn into cancer. But I guess my point is what if you need to do a biopsy later on? Would you put him through that right now just to have to do it again possibly? I would weigh the options well first. If he doesn't appear to have cancer now then doing a biopsy may or may not show anything at all. It could still be inconclusive and then later on you may need to do it if the inflammation becomes too much of a problem. I think you are making yourself crazy with the "needing to know everything right now". Because I will tell you that IBD is a shape-shifting trickster and even if you get answers right now, before you know it, the disease changes faces again. The big picture with IBD never stays the same Barb. That's what I want you to remember. If you haven't read my Living with IBD page on my site, please take a look at that. It explains a lot of this. Not trying to sway you either way at all and no matter what you decide to do, we are all here for you with big shoulders. There is no wrong or right decision, I just want you to know ahead of time in case you do it and it still comes back inconclusive. I don't want you to be surprised. 

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I totally agree with you. It is the surgeon and vet who are pushing the surgery, with the vet's staff even saying they wouldn't know what they were treating him for in the absence of a biopsy. They really want us to do this biopsy. Wednesday is best for us for his surgery, and it also gives us time to think about this overall. Plus we can do a consult with the vet on Monday, altho I think she will continue to push for surgery. Even so, I am going to make a list of questions all directed at what we are discussing right here and now. Like, why can't we start treating for IBD and get him gaining weight, look at his stool and at that mass again via x-ray and then do a biopsy later?

Barb I have to ask you something. Please check the page of my site that says Studies/Trials. There is a study going on at UC Davis that we desperately need cases for. All your vet has to do is submit bloodwork with a form that I email to you. That's it! It's got instructions on it as to what they need. They are trying to develop a blood test that would do away with the need for biopsies for this reason. The blood needs to be taken during the biopsy (it's over my head, medical stuff) and BEFORE any medications and steroid treatments are started. If you're interested in participating please let me know. This is a very important study that could help others not have to go through this same thing. I wish I could post about it here in it's own thread but I fear I'd get booted off the site. 

LDG said:

We were posting at the same time.
Personally, I would do this. He's relatively seemingly healthy right now - and will probably recover more quickly because of it.

If it is cancer, you need to know if it's treatable with chemo.
If it's not, you can treat him as if he had IBD, and get him on an anti-inflammatory diet with supporting supplements, and perhaps PREVENT cancer from occurring.

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What you and Lisa are saying is EXACTLY what John and I have been talking about. We feel like we run the risk of overlooking something if we do not do the biopsy, versus cutting into him in a situation where there may not be any cancer. 

There is definitely something there in the xray and ultrasound. It is a mass and it looks to be about the size of a child's fist. It is distinctly square on one corner and his bowel is going around it and loops/distends on the other side of it. If you were looking at an x-ray of a person standing up with a tube from their neck to their colon, Toby's tube takes a sharp left turn, distends and goes further down, then goes back right, and back to his colon. Apparently it is supposed to be a gentle curve on a cat but in his case it is pushed to his left wall. 

What they don't know is what that is, whether a tumor or lymph-something, or whatever else. And they cannot reach it from his stomach via needle biopsy. Argh. 

Hun, it's a lot. You're frustrated, you're fed up, you're tired. Like you say, it's not scheduled until Wednesday, and you can always cancel.

Sleep on it a few nights. Play with and love on Toby. Talk to him, tell him how much you love him, and ask him what he wants to do! Maybe somehow you'll "feel" an answer. Do your best to clear your mind. Maybe you and John should go out to a movie or dinner - or both.

Take a few deep breaths, clear your mind, go for a walk.... try to have a wonderful weekend. :heart2:

See the vet Monday, ask the questions. :grphug2: :grphug2: :grphug2:

finnlacey said:

Barb I have to ask you something. Please check the page of my site that says Studies/Trials. There is a study going on at UC Davis that we desperately need cases for. All your vet has to do is submit bloodwork with a form that I email to you. That's it! It's got instructions on it as to what they need. They are trying to develop a blood test that would do away with the need for biopsies for this reason. The blood needs to be taken during the biopsy (it's over my head, medical stuff) and BEFORE any medications and steroid treatments are started. If you're interested in participating please let me know. This is a very important study that could help others not have to go through this same thing. I wish I could post about it here in it's own thread but I fear I'd get booted off the site. I 

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I will absolutely do that. I love UC Davis and all the good work they do. I'm happy to participate. 

Good, Take a look at the page and then email me at [email protected] for a form. If you decide not to do the surgery now, that's fine too. This is about you and Toby so if you decide not to do it, don't worry at all about this other stuff. 

Meanwhile we are going to give him some raw salmon with his fancy feast dinner seeing as how we eat that ourselves. Tomorrow we will go to Animal Feeds and Needs and check out the appropriate raw food. I may have some nutrients for him also by tomorrow morning latest from 2 docs pet wellness, I need to take a look. 

Tomorrow will be all kitties too! I have to pick up Curly in the morning because he isn't doing ok at his other foster home, he is chasing the girl kitties. And then I have to take Prada, my non-FIV+ foster girl to her temp-to-perm foster home about 45 miles away in Joliet LOL.

Curly will be here with Dinah our other FIV+ girl in their foster room, so they will be happy. The fosters haven't had a lot of attention lately sorry to say, but they are enjoying the weather thru the window along with birdies, squirrels, butterflies and their soundscape music. 

Since i last posted, I have to say Toby has done very well with the raw salmon. I stopped giving him pepsid and I have been religious about giving him the 2docs pet wellness GI defense together with the laxatone and raw salmon together with his fancy feast fish food. 

I read that I'm not supposed to give raw fish but I know from the past that he really likes it and I'm trying to slowly introduce raw into his diet along with his other food based on stuff he likes. 

So far, amazingly, there have been NO throw-ups and hardly any stomach gurgling. We are not giving him any crunchies at all and that also seems to be fine with him. 

I also spoke with a friend who also has many years in rescue and she gave me her best ever vet. I have an appointment with the vet on Tuesday afternoon. I have to pick up his x-rays before then and they are requisitioning his records from the original vet. 

I don't want to trash the original vet, you know, sometimes it is just not the right fit. I think a lot of vets are maybe dog-oriented or maybe they are good for bandaging knees and simple stuff, and they just don't get any farther than that. Yes I'm surprised that my vet has not done one single homeopathic or holistic thing while recommending pepsid and laxatone for Toby, even before his x-ray showed a mass. I think she must have compartmentalized her homeopathic medicine somehow to where it never occurred to her to think that way for Toby.

I think this is why she isn't the right vet for my cat. His issues call for someone who can bring all their experience to bear on a situation and to consider everything including history. Anyhow all is well for the moment. Toby's fur is still icky but otherwise today he is happy and running around, great appetite. LDG I am taking your words to heart and will continue with the surgery. Unless he can get diagnosed before then thru the other doctor, I have to assume he is lymphosarcoma or something equivalent and the hammer just hasn't completely fallen yet :-(. He is great but not even close to the cat we had a year ago weight and eating-wise.

I did give Toby a pepsid again tonight, together with everything else above. Laurie I remembered what you said about ulcers in your kitty and I thought you know it can't hurt- everything else is helping and so can the pepsid. 

Barb, I'm so glad he liked the raw salmon! It's also GREAT to hear he's feeling so well!

And I think getting a 2nd "regular" vet opinion at this point is a FABULOUS, fabulous idea. We work with three vets and three different practices. One just has an "instinct" about animals, and has saved the life of two of our cats when the regular vet we work with just.... didn't have that instinct to know how to properly proceed. I love our local vet - but as you say, they're great for just regular stuff. And then we have the holistic vet. Thankfully, she hasn't compartmentalized - but she's not as experienced as our amazing "instinct" vet. :lol3: They all know we work with all of them, and we keep the records of our kitties with all of them current. :nod:

You'll get a feel right off for the new vet because you've got a lot of questions, and trust your instincts. If she doesn't think the surgery is necessary, then don't do it. If she thinks it's important to get the biopsy, then I'd go ahead. I completely understand what Lisa (finnlacey) is saying about IBD morphing... but your Toby does have a mass and they don't know what it is. If it's something that can likely be resolved by anti-inflammatories and diet, then that would be the best of all worlds! But if they don't have any way to know until there's a biopsy, then... I'd want to know. Of course, the suggestion may be to treat IBD, and keep an eye on the size of the mass by x-ray. Our Spooky has a couple of stones in her bladder. The vet suggested that we check back in on those via xray to see if the raw diet acidifies her urine enough to dissolve them. If not, she'll need surgery to remove them in a few months.

One thing for sure? Toby is in amazing hands, whatever happens. :heart2:

Continued !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

Just checking in and sending more .  So glad Toby is eating well, and liking the raw salmon.  I bought some salmon yesterday and the entire time I was cutting it up and packaging it for the freezer, NONE of my cats expressed any interest in it at all (and they are all ON a raw diet...although I haven't ever fed them any raw fish)

I went shopping for raw food today. Animal Feeds and Needs did have Primal, Stella and Chewy's, plus Nature's Variety. But there was no way to tell how much bone was in the other two and Laurie said NV had 15%. So I took a pass and decided to see if I could find out online before buying it. Plus they had no fish altho it looks like I can special order feline salmon variety. I do have nutritional additives from 2 docs that I can serve Toby with his salmon so I will do that. Meanwhile Toby has eaten several times today, and ate all of his GI defense additive with his wet food, plus ate his laxatone with no protest, and took his pepsid the same way so that was really good to see. I hope he is doing it because he has started to feel better and has made a connection to the stuff he's getting! 

I took a little video of him just now, since he was sitting on my computer. At the end he says thank you to everyone on this site. I thought I was going to pick him up and take him for a nap, but instead when I got up he ran down the stairs. I think he wanted MORE food actually. So I'm going to go cut up some raw salmon for him. I'm worried if I give him too much he will vomit again. He is such a sweet boy! 

Here is his video