Granuloma/CKD??

Hello All, 

I am new to this forum and I am hoping to get some insight from other cat lovers. Sorry for the extremely long post but my poor kitty has had a long run so far.  I have a neutered male tabby who is 1 year and 5 months old. He is strictly an indoor cat. Kitty "Bunz" first starting having issues around 6 months of age. He would get swollen paw pads which would start on one paw then the next time he had a "flare up" it would be a different paw. I brought him in to his vet the first time this issue happened and they suggested he stepped on something or his paw somehow got punctured by a foreign object and got infected and put him on antibiotics. (can't remember the name they were the little green pills) That cleared it up pretty quickly and once the antibiotics were done it took all of but 3-4 weeks for another flare up. This time it was a different paw. They thought the same thing, he must have injured his paw some how. Put him on the green pills of antibiotics again and he was fine shortly after. Well, not long after that came  his third flare up. This was a different kind I hadn't seen with him yet. He started drooling a lot, shaking his head and breathing with his mouth kind of open. So, needless to say I brought him in yet again. They found an ulcer on his tongue and said he also was dehydrated this time so he got sub Q fluids and a different antibiotic (clavamox). They thought he had swallowed a string that wrapped around his tongue which caused an infection. They also said I was really lucky because most cats who swallow strings end up needing expensive surgery as the string messes up the intestines. At this point I really started thinking there was something more going on with my cat...even though he is curious he couldn't possibly be injuring himself all the time. The Clavamox and Sub Q fluids made Bunz make to normal after a couple days. I think this time it was a good couple months before his next flare up. I was petting him one day and felt his lymph nodes were swollen and also a bump on his cheek area. I opened his mouth and saw another ulcer forming on his jaw by the lower set of teeth, all the way back. Another trip to the vet and another couple hundred bucks finally shed a little more information this time. His vet said she thinks he has something called Feline Eosinophilic Granuloma Complex. From my understanding it's an underlying allergy to something that causes Bunz to flare up, whether it be his paws or the rodent ulcers. Great, finally something that makes sense right??  This time he was sent home with the green antibiotics and something new, predisolone (a steroid). Per usual, he was back to his happy little self for a couple months and was slowly weened off the preds. His next flare up was his paw again, so he was put on straight prednisone this time and we started under going a food trial. We put him on Hills z/d and the canned hills z/d variety as well. (I normally fed him Iams Veterinary Health and canned fancy feast prior to the hills z/d.) He never really touched the dry variety of the z/d, he hated it so he was getting all his food intake from canned food. Well things were going smooth as usual, then he started getting a swollen lower lip, so more prednisolone this time for my poor boy and the vet said he might have to be on steriods for life. Then came something terrible. i woke up one morning and there was white frothy vomit all over the floor. I am talking like 35 small little piles and Bunz laying there listless almost like he was dead. He did get up and move around but couldn't move much without vomiting. The days leading up to this Bunz was acting normal, which normal for him is curious, happy and full of energy. That was an emergency trip to the vet for that one. At first they thought it was a blockage, didn't feel one then took a blood sample. His kidney values were extremely messed up and she said it wasn't looking good. They weren't able to get a urine sample right away due to severe dehydration and was asking me what he could have gotten in to and there was nothing I could think of. At this point she was thinking he ingested something poisonous. I buy all green cleaning products now cause of my sensitive little guy and there's no chemicals laying around, he does not go outside AT ALL and I have no house plants. She told me he needed IV fluid therapy and even that was a 50/50 chance he'd pull through. Given his medical history I was to the point I almost was going to put him down but I just couldn't bring myself to do it and signed off on the $850 estimate for fluid therapy, etc. Thankfully they let me make payments else I could have never afforded the treatment and I have spent over $1000 at the vet on him previously. With money aside, I just could not put him down and live with it knowing he could have pulled through...which remarkably after a million prayers is what he ended up doing. He only needed 2 days of fluid therapy. The vet called me and said I had a Halloween miracle kitty and all his values were normal again. She said when they were able to get a urine sample they did see a small inclination that there was a small UTI but it would not have caused this and upon further looking at urine they did find crystals in it but not a toxic amount and that a lot of cats have crystals present in urine anyway. I am just getting scared I might need a second vets opinion because all they do is make me feel like my cat is getting in to harmful things when it really could be something else. I am over strict on what is laying around the house and cat proofed anything and everything from the 2nd time he ever had a flare up. She said it was acute rather than chronic so something attacked his body quickly. I am just wondering if any of you had this experience and is there anything I could be missing or any advice?? It would be greatly appreciated because I really love my cat and want to see him live a healthy full life. He is experiencing another flare up as I type this, where his bottom lip is a little poofy but I am NOT putting him on steroids ever again and he is fine otherwise. He also was switched by his vet to the Royal Canin brand of hypoallergenic dry food and he LOVES that kind, and is also getting canned food daily as well. Please help!!

Hi, and welcome to TCS. I'm so sorry it's a problem that brings you, but let's see if we can help.

Just FYI, I suspect there are no replies, because it is VERY hard to read a post that is one big huge block of words. I'm going to copy it into a word document and add some paragraph breaks. Hopefully I'll have some thoughts.

First of all, I'm so sorry for all your kitty has been going through, and you're an awesome mum for sticking it out! Allergies in cats can be extremely frustrating. I rescued an FIV+ kitty that had major allergies. His showed up as horrible, seemingly unsolvable diarrhea and those rodent ulcers your kitty gets in his mouth. Because his immune system is already compromised by the FIV, steroids were not an option. When our traditional vets were unable to help him (and we tried those hypoallergenic foods too), I found a holistic vet.

My cats used to free feed the dry prescription food. The first thing the holistic vet did was ask about diet. The answer, of course, was simple. We left out dry food for them to eat. And then we got our first lesson in feline nutrition. And it all makes sense - I mean, diet is the foundation of health, right? I have allergies and very sensitive skin, and I do much better eating less processed food - whole grains, fruits, veggies, etc. Well, the equivalent in a cat is raw food. It's funny that it's even a strange concept at first. But if you stop to think about it - well - what do cats in the wild eat? They hunt - and what they eat are small mammals. They don't eat corn, they don't eat wheat, and people don't put up fences around their gardens to prevent cats from raiding them. :lol3:

She wanted us to put Chumley on a raw food diet. This is easy to do, there are a lot of commercial raw foods available now. It's also not complicated to make your own homemade raw food (which is what I do now). But we weren't comfortable with the idea of raw (at first). So we did take our cats of kibble, and switched to high protein, low carbohydrate, grain-free, limited ingredient wet foods. But this did NOT resolve Chumley's problem. His body needed unprocessed food. And I suspect that is what your kitty needs too. :rub:

Our holistic vet did prescribe supplements that resolved his problem - but he would have to remain on them forever. When we switched to raw food in January of this year, it was only a matter of weeks before he started refusing to eat the pills he happily ate before. And we discovered - he no longer needed them.

So I know your Bunz loves his prescription Royal Canin food, but clearly it's not what he needs if he's still having problems with allergic type reactions.

This site will help you understand the importance of not feeding kibble to your cat: http://www.catinfo.org (It is written by a vet). It also helps to understand what a species-appropriate diet means. She feeds her cats homemade ground food. I don't have the kitchen space for that and didn't want to invest in a grinder, so I feed a different kind of homemade raw food (it's called prey model raw), and it requires no grinding.

I'm also going to ask another TCS member, Whollycat, to check in. She has a kitty with EGC. For her kitty, the key to health was an unprocessed species-appropriate diet. She makes homemade ground raw food for her kitties.

One thing you can do immediately is provide an omega 3 supplement. This is anti-inflammatory, and it may help - and it is good for his kidneys. I use 500mg of NOW Neptune Krill Oil daily for two of my kitties.
Vibes for you and Bunz!

Thank you so much for a reply! I guess looking back at it now, my first post was VERY hard to read... so if you did manage to get through it all, I really appreciate it lol.

I honestly was thinking Bunz's issues were more on the diet related side. After the food trials his vet has put him on with no success I am thinking an unprocessed diet/raw would be best for him. I will look more into this and an Omega 3 supplement. Thanks again and if anyone else has experienced similar with their kitty I would love to hear what's worked and/or working for you now. 

I am really looking forward to getting to the bottom of his allergy and not having to go to the vet every other month and keep having him take so many meds :-( 

LDG said:

I'm also going to ask another TCS member, Whollycat, to check in. She has a kitty with EGC. For her kitty, the key to health was an unprocessed species-appropriate diet. She makes homemade ground raw food for her kitties.

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And here I am, Laurie.

LeAndra11, Laurie (LDG) gave you some great advice. I'll share my kitty's story with you in hopes it will help.

Maxie is my Maine Coon bubby. After getting him from my breeder as a wee kitten--clear across the country from us--Maxie was doing great. Until he wasn't. A year to the day that Maxie came here on Thanksgiving day of 2004, I noticed that he was making a strange noise and eating with his head tipped to the side. Well, since he's a MC, I just chalked it up to how they can have different behaviors than moggies. At the next meal that day, the same thing, only worse. He wouldn't/couldn't eat. Since it was Thanksgiving (2005), I called the next day and got an appointment right away. I figured it was a tooth problem. Boy was I wrong.

At the vet appointment (not our regular vet at this practice--I say this because our regular vet(s) know how I roll ), the vet looked in his mouth and said, "It's Eosinophilic Granuloma Complex." He might as well have been speaking Greek. He went on to explain EGC to me. The more he talked, the more scared I was for Maxie. It was devastating. I mean, he couldn't eat (and being such a large MC boy he has a huge appetite)! He went through a spiel about giving him steroids. That he'd probably need to be on them for life. Well...here's how I roll, which this vet didn't know...

Being a woman that leans more toward alternative [natural] treatments for kitties, I told him I'd have to do some research because I wasn't keen on using steroids knowing how detrimental they can be for kitties over the long term.

So research I did. Exhaustively. Like Laurie, I believe that diet is the foundation on which their health is based, so I started there. I found a holistic online kitty forum, joined, and posed my questions for help there. I was desperate. Maxie hated being assist fed via syringe. He hated novel protein canned foods. He was having to eat foods that only made his EGC worse, but he had to eat something. After getting many replies in which it was suggested I try a balanced raw diet, I was off to the races to get everything I needed, grinder included. In the interim, while waiting for the grinder, I started cutting up chicken into little pieces and feeding that until I could do it the right way (it was only a few days).

After trial and error with our new raw diet, much sweat and tears, Maxie (and Abby) were transitioned in a very short amount of time to our ground raw diet. And I do mean I really pushed this new diet on my boys because time was of the essence for Maxie. Within that first week I noticed marked improvement with Maxie. By the end of the second week into the third week, NO problems eating. From my experience some kitties may take a little longer to respond fully, or be harder to transition, so I feel lucky that Maxie got better so fast and the transitioning was pretty speedy. (I was a woman on a mission!)

I did find out that he can't eat any type of processed canned food (grain-free, novel protein, etc.-- I won't feed kibble). None, or his EGC will flare up. Found this out when I was a tax preparer, busy, fed canned for a week, and he flared up worse than before--from inside his mouth to up into his eyes and nasal cavity. He was so miserable, and this mama felt so awful.

So, maybe give a balanced raw diet a try to see if it might help your Bunz? Preparing a raw diet isn't rocket science, but there is a bit of a learning curve. We can help if you decide to go this route. I know how devastating and awful this disease can be--and how helpless you can feel. I'm so glad you found TCS!!

P.S. Another benefit that has been great: Abby is now 16-years-old and pretty darn spry and active for his age. Izzy joined us when I'd already been feeding raw for a few years.

Thanks for sharing your story with me WhollyCat! I wish I had been more adamant to my vet about how I felt about the endless meds and "prescription" diets and how they weren't getting anywhere for Bunz. I thought they knew better than I did so to just roll with what they say. They told me that it takes a couple months to see a difference when doing a food trial and also told me to feed him less canned food and that they'd ultimately like to see him on dry food only. I am thankful I never quit giving him canned food at least...but I do see some big changes on our horizon as far as his diet goes!

Laurie, the catinfo.org site you shared with me has me literally jaw dropped. It is all making a lot more sense to me now as what could have been causing Bunz's allergies/flare ups/etc.

Have you guys started any threads that already go over the raw diet process? Or is there any commercial diets you could recommend? 

What was he eating before this all started?

LeAndra, I know how you feel! :lol3:

Well - there's a raw feeding forum on TCS. http://www.thecatsite.com/f/65/raw-feeding-for-cats

And the raw resources thread: http://www.thecatsite.com/t/240809/raw-feeding-resource-thread

But a great place to start is just by googling "holistic pet store" or even just "pet shop" and see what locally-owned stores are in your area. You may see reviews or they may have websites - or you can just call them to see if they carry any commercial raw foods. It's definitely easiest to start with a commercial raw, especially since your kitty really needs something quick, you know? You get comfortable with the process while you learn how to make your own, if you want to go that route. :nod: One of the more expensive foods, but one of the best, is Rad Cat. It's not widely distributed though. (It can be ordered online for delivery, but shipping can get expensive for frozen raw). One that's usually available is Nature's Variety frozen raw, and it's a perfectly fine starter food. :nod: If you want more info, transition tips, etc. please feel free to start a new thread in the raw forum.

LDG said:

But a great place to start is just by googling "holistic pet store" or even just "pet shop" and see what locally-owned stores are in your area. You may see reviews or they may have websites - or you can just call them to see if they carry any commercial raw foods. It's definitely easiest to start with a commercial raw, especially since your kitty really needs something quick, you know? You get comfortable with the process while you learn how to make your own, if you want to go that route.

One of the more expensive foods, but one of the best, is Rad Cat. It's not widely distributed though. (It can be ordered online for delivery, but shipping can get expensive for frozen raw). One that's usually available is Nature's Variety frozen raw, and it's a perfectly fine starter food.

If you want more info, transition tips, etc. please feel free to start a new thread in the raw forum.

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A quick note from me. During my tweaking of their new raw diet for my kids, I tried various commercial raw. They did not like any of them. Especially Nature's Variety was a big paws down. I think it's the addition of fruits, veggies, and even salmon oil that they didn't like in some of the commercial raw. They also don't like gizzards, which is in some of the commercial raw. And Salmon Oil. No takers. I went with Krill Oil in their diet because of this, and no stinkin' gizzards. RadCat I never tried, but others here have kitties that love it. Bet mine would have too because it doesn't have fruits and veggies in it. Hmmm...but it does have salmon oil, so maybe not if kitties don't like salmon oil.

Something mine will eat is pre-ground frozen (no grinder needed) meats/bones/organs from Hare Today. I get different meats from Tracy to add variety (they love the pheasant, although it is dang expensive!) shipped to me here in Iowa. I just unthaw, mix in any supplements and egg yolk, and portion daily amounts into baggies, then re-freeze. I also get hearts from Tracy and add an extra couple pounds (depends on how large a batch I'm putting together) to the meat/bones/organs because it seems the bone content is too high for my kids and they get constipated.

Just my experiences.

:nod: Yep, mine totally preferred the prepared raw food that had no veggies. In the end, I ended up feeding prey model raw because several of my kitties got constipated on Nature's Variety too, so I started adding meals of just plain meat to balance the amount of bone in the Nature's Variety frozen raw. Then they decided they liked chunks of meat better than ground. :lol3:

I still use some Hare Today ground foods. They eat ground if it's not offered at every meal. (And funny, mine love gizzards! One of their favorite meals! ).

But this is all more appropriate in a thread in the raw forum.

When I got Bunz (he was found outdoors as a stray in a parking lot) they had him eating Purina kitten chow. I switched him to Science Diet Healthy Development dry kitten food as well as the canned version right when I got him. He never was too fond of the dry food but I left it out for him at free will and he'd pick at it in between the wet food feedings which was 3-4x a day. 

Once his flare ups started the vet didn't diagnose him with the granuloma complex until he was seen several times. They kept saying it was something he was getting into (strings wrapped around tongue, stepped on glass, etc)   Once they got that far, they suggested I switch him to Hills z/d dry kibble as well as the Hills z/d canned food saying it was more than likely a food allergy. I had to mix the old canned food with new to get him to start eating it but he really snubbed his nose at both and wasn't eat too much. (although there was no significant weight loss) He continued to have flare ups on that food and it wasn't after he was practically dead with his acute kidney attack before they told me to switch him to the Royal Canin HP. He's been on that since and he really devours that stuff but he's been on that food a month now and his lower lip is poofy, suggesting there is still something in the food he's not diggin. 

I also monitor his urine output daily as his kidney ordeal freaked me out. He seems to have a good amount of urine in his box and goes about 4 times a day I would say. I am going to call around Friday (as I'm sure most places are closed tomorrow) and try to find some pet stores that carry a commercial raw. My friend suggested I try Nature's Variety as they had great results with that food for their dog... but it's a dog lol. I now know a cat should not have any grain, veggies or fruit in their diet. It's pretty common sense I guess, however, it's something I have always over looked. The cats I had growing up were always super healthy and didn't need such a special diet but they were also indoor/outdoors and did a ton of hunting. It's crazy that the vets don't give us this information from the get go when you bring your kitty in for it's first check up!

Unfortunately, vets don't learn much about nutrition in vet school - and what they learn is about vitamins and minerals, and protein sources. It's not presented as "cats are an obligate carnivore, and this is what that means..."

And as practicing vets, they get all kinds of "education" on how to treat diseases - with prescription food! And that "education" comes from... Hill's Pet and Royal Canin. Vets have to lean toward thinking outside the box when it comes to real feline nutrition and its relationship to their health.

As to the Nature's Variety... that's how I started, as mentioned above. It's not the "ideal" food - but it's not highly processed, and it is raw. And that long list of veggies and fruits may be a long list - but it's still just 5% of the food!

Unfortunate indeed! After doing a little bit of searching I found a place that offers a raw diet and is less than an hour drive for me. Would you mind taking a glance at it to see if you think this is something that would be worth a go? http://www.woodyspetdeli.com/deli_menu   

LeAndra11 said:

Unfortunate indeed! After doing a little bit of searching I found a place that offers a raw diet and is less than an hour drive for me. Would you mind taking a glance at it to see if you think this is something that would be worth a go? http://www.woodyspetdeli.com/deli_menu   

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I would want to know the calcium to phosphorus ratio of each recipe. Definitely do not want the ones listed that are just "parts," you'd want to get those that state they are the whole bird. I'd find out what the cahos ratio is for their whole mixes (maybe you could share those here?). Cahos should be in a range between 1.1:1 to 1.4:1. Meat is higher in phosphorus than calcium, and bone is higher in calcium than phosphorus. The higher the calcium amount (e.g. 1.1 ==> 1.4) in the ratio, kitty may get constipated. I would never feed something that has a cahos ratio above 1.4:1, even though some might do this (JMO).

I would not get their supplement mix--besides the unnecessary ingredients (and ingredients that are plant-derived that are of no use for a true carnivore; their bodies can't process these), it contains alfalfa, which is a big no-no for kitties, just like garlic.

Wow - how exciting! It looks VERY promising!

They may not have had their diets analyzed, so they may not know the Ca ratio. What I'd want to call them to find out is (though, of course, it can't hurt to ask if they have the Ca ratio!) :

If they don't know the Ca ratio, the alternate question is:

In the balanced blends, what is the percent of meat, bone, organ, and "other stuff," and what is the other stuff?

This is the basic question for all the foods. When following prey model raw, the guideline is 80% meat, a maximum of 10% bone, and the typical guideline is for 5% liver and 5% "other secreting organ" (kidney, spleen, pancreas, etc.). Green tripe in a food is a good addition too. If there is heart or gizzards, those count toward the "meat" portion, not the "organ" portion. Heart is an excellent source of taurine and another great inclusion in a food. A higher liver content is not necessarily a bad thing, but you don't want it over 15-20%, and you don't want it that high if there is another secreting organ.

The ground whole animals are always a great diet for a cat - and it looks like they have a very nice selection of proteins! You can add your own supplements. You may want to buy some plain meat to cut down on the bone content: whole ground chicken and rabbit (and larger animals) tend to have a higher bone content than a cat needs, so some cats will get constipated unless you "thin out" the whole animal ground blend with a little plain meat. This you can adjust along the way, depending on whether or not kitty gets constipated. :nod: