To give a little backstory, we had two 4-year old sibling cats, a male and a female.  Both have always been healthy.

2 months ago the male started peeing inappropriately.  We took him to the vet, did a urine test, found crystals and bladder wall cells in his pee, no active infection.  The vet gave him precautionary antibiotics, anti-inflammatories, and switched him to prescription urinary canned food (they both came to us as "kibble" cats, so that's what we had been feeding him).  He was happy with the canned food; his sister was interested too, and no longer wanted kibble, so we got Wellness canned for her, and transitioned him over to it too when his symptoms improved.

A month after that the female stopped eating.  We took her to the vet, she had fatty liver disease and went downhill quickly.  Blood tests didn't find any underlying issue, and we elected not to pursue further testing and treatment because she had worsened so quickly the prognosis was poor.  We had her put down.

Faced with a sad, lonely cat, and 2 sad kids, I went back to the rescue group we got these guys from and found a 4-month old female kitten with a good temperament.  The male took to her right away, they were playing together, curling up together, grooming each other.  She (of course) was a kibble cat, we have been transitioning her over gradually, but as soon as the male got wind of her food he wanted nothing to do with his canned (at least we thought that was why).

He started not eating properly, which of course freaked me out given our experience.  I caved and bought him some Wellness dry, and fed both dry and canned to both cats.

He still wasn't eating properly, and it became obvious that something was wrong.  We took him to the vet, did bloodwork (liver, kidneys, pancreas all looked ok), x-ray (no blockages), and repeat of the urine test (that was ok too).  We tried a couple of appetite stimulants, and force fed him for a few days while we were waiting to see if they would work.  

He was still very obviously unwell, so we took him for an ultrasound.  Bowel is thickened, and lymph nodes are enlarged.  The vet felt that IBD or possibly small cell lymphoma were the most likely diagnoses.  We aren't going to biopsy and do chemo, so she felt the medical treatment would be similar for both.  He is now on prednisone, metronidazole, and famotidine.  

He is his old self again and eating just fine.  The vet's office had given him the medi-cal gastro high energy food, and he willingly ate that, so that's what we brought home and fed him.  

My dilemma now is that between feeling better, and the meds, he is now hungrier than what he *should* be eating.  I know that IBD cats generally should be on canned food, but I must admit I am spooked that this whole nightmare seemed to start when we switched both cats from kibble to canned.  I don't know if I should be keeping him on the high energy kibble and just letting him go hungry at the end of the day, or switching him to a lower energy kibble, or trying again with canned.  I can talk to the vet and get their opinion, but I guess I am looking for information to form my own opinion.

Sorry for the novel  Any thoughts would be appreciated.

Edited to add:  I'm not sure that switching him to canned is even an option.  When I give canned to the kitten, I let him sniff it, and he runs away like I'm trying to poison him.  I've tried him with a full range, from expensive no-grain food to fancy feast, even meat baby food, and he wants nothing to do with it.

That's so odd that your vet felt that treatment would be the same for IBD and small cell lymphoma. Small cell lymphoma has an excellent probability of going into remission with chemotherapy. (One of my cats is a cancer survivor. He had large cell lymphoma, and a "massive" tumor in his stomach. The medication leukeran is administered (a pill, at home). Without treatment, the lymphoma will progress unchecked. Yet IBD is not at all life threatening when properly managed.

Here is a site that may help you: http://www.ibdkitties.net

But with his former problem with crystals, and his special needs as an IBD kitty (or with lymphoma - either way), I'd want him on a high protein, low carbohydrate diet. Both diseases are best managed with the most species-appropriate diet possible, and cats are obligate carnivores with no need for carbohydrates of any kind. This is best for IBD kitties, and is considered a "cancer starving" diet. Further, meat is naturally acidifying, and helps promote the proper bladder environment to prevent crystals.

At a minimum, I would start him on a salmon or krill oil supplement, 500mg a day, though because of the potential IBD, I would begin with just a few drops a day, and work up to the full thing (unless you just have to pill him with it). I use NOW Neptune Krill oil for my Lazlo; I use Pure Alaska Omega (salmon oil) for (most) of my other cats.

Thanks for your response.

I should have been clearer - doing surgery/biopsies to check for lymphoma or to confirm IBD isn't an option financially.  So in the absence of a confirmed diagnosis & chemo, the vet felt that the medical treatment would be the same.

My gut feeling is that it's not lymphoma.  He is only 4, is FELV and FIV negative, and all of his symptoms developed after a change in diet and a course of antibiotics.

He is still turning his nose up at canned food, but hopefully he will eventually relent (we give it to the kitten daily).  For now I will try transitioning him onto Innova EVO dry since that seems to be the lowest carb.

I will take a look at the oil supplements, thanks.

Yes, the EVO dry is high protein, low carb, and one of the best dry foods to fit that bill. :nod:

If you would like tips on transitioning to wet, we can help with that. You can start a thread in the Nutrition forum. In the meantime, I'll PM a TCS member that has posted links to good transition instructions. (I didn't bookmark the links :anon: ).

In the meantime, here is one guide: http://www.catinfo.org/docs/Tips for Transitioning PDF 1-14-11.pdf

dahlialia said:

My dilemma now is that between feeling better, and the meds, he is now hungrier than what he *should* be eating.  

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Another factor could be that with the thickened intestines, he isn't absorbing all the nutrients he needs. Has your vet mentioned vitamin B12 (cobalamin) injections? They might help, and they certainly can't hurt. I wouldn't even bother with the blood test to check for serum B12 levels. A vial of B12 is cheap and since it's water soluble, any excess would just get peed out anyway. Here's a link with more info:  http://www.cvm.tamu.edu/gilab/research/cobalamin.shtml

As for more tips on transitioning to better food (is raw an option for you? It's a life-saver for many cats with intestinal issues: http://www.catnutrition.org/ibd.html), here are a couple of really good videos by Dr. Karen Becker that you might find helpful:

How to Win the Healthy Food Battle with Your Fussy Feline - Part 1…

How to Win the Healthy Food Battle with Your Fussy Feline – Part 2

Another link that talks about switching to raw, but with canned as an intermediary between it and kibble, so there are some good tips even if you don't go raw: http://feline-nutrition.org/nutrition/how-to-transition-your-cat-to-a-raw-diet

 

Thanks, yes he is getting weekly B12 shots for 6 weeks (he's had one so far).  

I certainly could contemplate preparing or buying a raw-food diet, but similarly to canned I'm concerned about transitioning him.  Before getting sick he'd willingly eat some canned food, or meat, but now he won't even consider it.  He will happily let me shove 12 pills down his throat in a day, but giving him just a whiff of anything other than kibble sends him running from the room.

We have started the transition process gradually, but I will do some more reading about the raw options and see if that might work for him.

dahlialia said:

Thanks, yes he is getting weekly B12 shots for 6 weeks (he's had one so far).  

I certainly could contemplate preparing or buying a raw-food diet, but similarly to canned I'm concerned about transitioning him.  Before getting sick he'd willingly eat some canned food, or meat, but now he won't even consider it.  He will happily let me shove 12 pills down his throat in a day, but giving him just a whiff of anything other than kibble sends him running from the room.

We have started the transition process gradually, but I will do some more reading about the raw options and see if that might work for him.

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The key for a successful and safe transition is a very slow one, at the kitty's pace, that doesn't stress the little one.....
I transitioned my three to raw - two used to eat wet, one from kibbles straight to raw. One had severe IBD.
The die-hard free-fed kibble addict took a lot of work, and a long time to transition, but with patience she got there..... She never stopped eating, and I would never do that to her :heart3:
All my cats are WAY healthier on raw, and all IBD issues are completely gone from day 1 on the raw diet (he is 100% meds free, and raw was the only thing that worked for him...)- something to think about.....
If you need help, open a thread in the raw forum, we will help you to do it in a safe way - it CAN be done :rub:

hi there. i have just lost my 12 yr old cat with ibd issues. it's been a long struggle (started getting sick last january with soft stools and yeast on skin and itching ++). he'd had bouts of diarrhea in the last few years but that lasted only a day or so. but in january it was constant. he had been on dry prescription formulas for his 12 yrs and never was keen on soft food. he used to eat a lot weighed 16lbs at one time and at his death weighed approx 6-7 lbs. he'd had a bunch of tests done. a nodule was found on pancreas in march and biopsy which was inconclusive for cancer but which radiologist strongly believed was benign neoplasm which is just as deadly as a cancerous one unless removed (extremely risky and poor prognosis). we then switched him to natural diets kibble (evo, then nature's variety) which helped him tremendously but worsened his yeast problem. all i can tell you and anyone else who has a cat is to stay away from the prescription diets that you get from vet even the hypoallergenic ones. they are filled with cheap fillers, a lot of them have corn, rice as their main ingredient which eventually could take a toll on your little guy. i believe my cat's pancreatic problem came secondary to ibd due to him being fed these foods all his life(a terrible regret of mine). i also believe that rabbit is the best meat (soft or raw) you can offer your cat. it is lean and a good hypoallergenic meat source. this seemed to be the only thing that was tolerable to my cat in terms of his ibd and yeast problem. we had him on raw rabbit for awhile which helped him tremendously but then he got very constipated and almost obstructed probably due to the low fiber and difficulty digesting the already ground bones. he would have required a fiber source (for example slippery elm) to help him pass the stool easier. dry kibble are very convenient but the stuff used to make it kibble/hard is not necessarily good for our pets. nature's variety has a great rabbit food in cans (which he loved), but unfortunately it is often on back order as they have difficulty meeting the demand for it. i also think the b12 injection is a good idea (i wish i had given it to mine) and vitamins. all the best and good luck to you

Dan, I'm so sorry for your loss.

You're right. Cats - and especially kitties with IBD - do best with a species-appropriate diet: moist food, high protein, moderate fat, and very low-fiber. Simple ingredient lists help, and raw food is best, as so many commercial canned or kibble foods have ingredients that may further upset an IBD kitty's system. I'm so sorry you didn't find TCS to help you earlier. :grphug2: IBD can be a very difficult and very cruel disease. There are case studies at http://www.ibdkitties.net that indicate ground bone can be difficult for IBD kitties, so if feeding raw, it's best to use a calcium supplement rather than the ground bone. Once their systems heal a bit, some can then manage the ground bone. But if the IBD has progressed or been present for some time, it can be so difficult to manage. :rub:

Constipation on raw typically means that the bone content is too high. If you were using Nature's Variety, they typically target 15% bone content, which is too high for most kitties. 8% - 10% is ideal. But the Calciumhosphorus ratio is much easier to control when using either bone meal, freeze dried bone, or calcium carbonate (such as from powdered eggshell), and easier for them to digest.

Again, I'm so sorry for your loss.

Dan Groulx said:

hi there. i have just lost my 12 yr old cat with ibd issues. it's been a long struggle (started getting sick last january with soft stools and yeast on skin and itching ++). he'd had bouts of diarrhea in the last few years but that lasted only a day or so. but in january it was constant. he had been on dry prescription formulas for his 12 yrs and never was keen on soft food. he used to eat a lot weighed 16lbs at one time and at his death weighed approx 6-7 lbs. he'd had a bunch of tests done. a nodule was found on pancreas in march and biopsy which was inconclusive for cancer but which radiologist strongly believed was benign neoplasm which is just as deadly as a cancerous one unless removed (extremely risky and poor prognosis). we then switched him to natural diets kibble (evo, then nature's variety) which helped him tremendously but worsened his yeast problem. all i can tell you and anyone else who has a cat is to stay away from the prescription diets that you get from vet even the hypoallergenic ones. they are filled with cheap fillers, a lot of them have corn, rice as their main ingredient which eventually could take a toll on your little guy. i believe my cat's pancreatic problem came secondary to ibd due to him being fed these foods all his life(a terrible regret of mine). i also believe that rabbit is the best meat (soft or raw) you can offer your cat. it is lean and a good hypoallergenic meat source. this seemed to be the only thing that was tolerable to my cat in terms of his ibd and yeast problem. we had him on raw rabbit for awhile which helped him tremendously but then he got very constipated and almost obstructed probably due to the low fiber and difficulty digesting the already ground bones. he would have required a fiber source (for example slippery elm) to help him pass the stool easier. dry kibble are very convenient but the stuff used to make it kibble/hard is not necessarily good for our pets. nature's variety has a great rabbit food in cans (which he loved), but unfortunately it is often on back order as they have difficulty meeting the demand for it. i also think the b12 injection is a good idea (i wish i had given it to mine) and vitamins. all the best and good luck to you

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I am so sorry for your loss
Yes, pancreatic problems seem to be secondary to IBD problems, although I am not sure about benign neoplasm.... The constipation issues, like Laurie (LDG) mentioned, is due to too much bones in the diet - I am not sure if you were feeding Nature's Variety, but since it is a very popular rabbit commercial diet and one with a high amount of bones in it, I am inclined to believe it probably was.... It is usually the case, as opposed of fiber.... I don't know if there was much that could be done for your sweet baby at that point with the neoplasma though
I have seen cases where bones push the pancreas for severe IBD cases, and supplemented diets are more easily digestible for those cases, which is why I chose that route for my Bugsy....
I am so so very sorry again for your loss