IBD with possible small cell lymphoma

I have tried both Mirtazapine and Cyproheptadine for appetite stimulation.  The Mirtazapine made my kitties nutso and lasted for days.  The Cypro (even as a ear cream) seems to build up, so after a day or two, it seemed like I could skip a few days inbetween.

Maybe you can double-check your prednisone cream and verify that it is 10mg per dosage.  I have used a few different non-pill type medicines and sometimes you have to do some math to verify what they are getting.  Like Kinney is getting .25ml of a 20mg per ml in a suspension, so his .25ml is actually a 5mg dose.  10mg seems like a lot twice daily unless maybe some is lost in it being a transdermal.  I was never offered the choice of giving pred as a transdermal.  They thought it was important for him to get it orally.

I have found that prednisone in itself was enough of an appetite stimulant and I dropped the Cypro after a few days on the pred.

I started with the pills, two 5mg tabs twice a day, so I was giving him 20mg a day. When I asked for the transdermal gel instead, the dose was the same, 10mg twice per day. I haven't heard of anyone else on this high of dose. Well anyway, I've lowered the dose to 5 mg twice a day. I didn't give cyproheptadine again tonight. He ate enough yesterday, I weighed him and he is back to 12.5 lbs. My husband fixed venison steak tonight and he ate several small pieces (10?) and he has eaten some dry Orijean too. He hasn't had a BM in 30 hours but that is a relief after the horrible diarrhea he had for 5 days after his endoscopy. Now when I look back on the last 8 months, he got picky with his food because he would be in pain after he ate. That's why he would tremble for up to an hour after he ate. I took him to the vet for that but they didn't know what was causing it, did labs and they were fine. I knew it wasn't right though. I hate pilling him ( flagyl) it takes two of us, that's why I always ask for transdermal.

Sounds like he is getting past the real sick part of this.  As long as he keeps eating at least a half can of the A/D everyday he should be okay as far as getting enough calories every day.  

Okay, the horrible diarrhea stopped almost 48 hours ago. He hasn't had a BM yet though, now I'm worried. He's eaten enough that he should have eliminated it. They gave him an enema exactly a week ago and that was what triggered the diarrhea for 5 days. They could feel that his intestines were full of poop. Should I just wait and see? He looked very bright and playful this a.m. Before giving flagyl and 1/8 cyproheptadine. He ate some venison steak and some canned wellness chicken, maybe a tablespoon or two. He had eaten some Orijean dry during the night. Now he's not eating very much like I would expect after giving cyproheptadine.

He got cleaned out real good I don't think it's time to get concerned yet.  I think the diarrhea was a reaction to something in the treatment, could well have been the additive in the enema.  That could be a routine additive and Patches didn't react to it so I never knew it was there.

Sounds like your cat reacts to this stuff the way Patches does by being prone to constipation.  I would continue giving him small amounts of wet food.  If you still have some of the A/D I would use some of that.  I keep coming back to that because it is high calorie so he doesn't have to eat as much of it as other foods to be okay with calories.

This symptom along with it starting when Patches was only 18 months old was why the other vets never considered IBD to be a possibility.  The way the vet that he goes to now explained it to me was that the thickening of the intestines affects motility.  It takes longer for things to move through their digestive system than what is normal for a cat.  If possible I would stay away from dry food and stick with wet food in some form.  The wet food adds moisture to the colon.

If he still hasn't gone tomorrow I would call your vet just to let him know.  You might ask him about Miralax, it was what the vet recommended for Patches.  It doesn't work like other laxatives, it works by drawing moisture into the colon. 

You get the results back the beginning of next week don't you?

Yes, I do get the results then. I'm worried about removing the dry because he wants that the most. I offered a/d again and he doesn't want it. This is such a tightrope I'm walking, damned if I do, damned if I don't. Maybe I should give fluids again. He hasn't eaten anything except a few pieces of venison steak since I gave the little bit of wellness canned early a.m. He's sleeping. Pray for poop! Thank you for your support.

bentley2013 said:

Yes, I do get the results then. I'm worried about removing the dry because he wants that the most. I offered a/d again and he doesn't want it. This is such a tightrope I'm walking, damned if I do, damned if I don't. Maybe I should give fluids again. He hasn't eaten anything except a few pieces of venison steak since I gave the little bit of wellness canned early a.m. He's sleeping. Pray for poop! Thank you for your support.

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Hi,

Haven't been as far as you have with my cat that is three with probable IBD and some sort of allergies .

Mine developed Pancreatitis out the blue about 3 + weeks ago...Started out with this loud meowing in the middle of the night and I would find throw up first thing in the morning..He was treated , taken back, negative for Pancreatitis but x-ray showed some thickening on intestinal wall...Sent us home with RX Z/D which he wouldn't touch dry or canned..He also had a series of b12 injections which I give at home to not stress him out  by taking him to the vet for.

No diarrhea, just a few soft stools when he had the pancreatitis.

I called the vet told her he would not eat the Z/D, they wanted me to try Royal canin Gastro health RX first but I declined since it had corn, grains, etc.. and I don't believe grains are the best for a cat with IBD..

I went out to our local Petco and bought Nature's Variety Instinct LID in Turkey meal and the cans of lid... Plus I bought PURE BITES Freeze dried Turkey and also a small bag of it in chicken.

He loves the freeze dried treats, I also crumble them on his dry and canned food and it usually entices him to eat more.

Please look up Slippery Elm, it is one of the most non toxic herbs that can be given to an animal..I had used it in the past for my cat with CRF,now I have been taking a capsule (equals 1/4 tsp)opening it up add some water (it will thicken up) and filling syringe up to 1/2 teaspon, then giving the other half late in the evening..Slippery elm can relieve diarrhea, constipation, vomiting..it soothes and coats the stomach, plus it has been used for centuries as a nutritional source of food.

Just read up on it, you make the choice..My cat so far with all the changes has not thrown up in over 10 days now..you can buy slippery elm in loose bulk or in capsules at any health food store.(I have for right now Solaray in capsules)

There are a few more suggestions,  THORNE LABS makes two products geared toward gastrointestinal health, one is called Gastriplex , it is a little pricey abt. $48, they also have one I may look into  called GI-encap  $14.99, it has extract of organic aloe, slippery elm, marshmallow root and DGL (deglycerrhized licroice), all of these ingredients are great for healing and soothing the gastrointestinal tract..

I am also going to order Thorne B-Complex VET for animals it has the purest forms of B vitamins, no synthetic..

...

I just ordered some freeze dried treats from "ETTA SAYS", Tail mix chicken and LAMB LIVER..I can give as treats or crumble them up and put over food.

Stella and Chewy's has some great products, I actually just ordered two 3 oz size packets of Tummy ticklin turkey  it is a freeze dried dinner...Don't know if it will go over with my boys or not but anything is worth a try...

Believe me I went through two weeks of worrying, pacing, felt like I was just about to the end of the rope....

With slippery elm if one should decide to try it, it is not to be given at same time with medications, other supplements because it affect the absorption of other meds.

Slippery elm should be given at least 45 minutes before or after any medications...It can also be given on an empty stomach..

I hope your baby gets feeling better and I hope some of this information might be useful to you..

Denice said:

He got cleaned out real good I don't think it's time to get concerned yet.  I think the diarrhea was a reaction to something in the treatment, could well have been the additive in the enema.  That could be a routine additive and Patches didn't react to it so I never knew it was there.

Sounds like your cat reacts to this stuff the way Patches does by being prone to constipation.  I would continue giving him small amounts of wet food.  If you still have some of the A/D I would use some of that.  I keep coming back to that because it is high calorie so he doesn't have to eat as much of it as other foods to be okay with calories.

This symptom along with it starting when Patches was only 18 months old was why the other vets never considered IBD to be a possibility.  The way the vet that he goes to now explained it to me was that the thickening of the intestines affects motility.  It takes longer for things to move through their digestive system than what is normal for a cat.  If possible I would stay away from dry food and stick with wet food in some form.  The wet food adds moisture to the colon.

If he still hasn't gone tomorrow I would call your vet just to let him know.  You might ask him about Miralax, it was what the vet recommended for Patches.  It doesn't work like other laxatives, it works by drawing moisture into the colon. 

You get the results back the beginning of next week don't you?

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I used miralax with one of other cats who might have had megacolon...Worked like a charm,,,,,but so did slippery elm...My  vet never heard of using Miralax (HMM) I can't remember the dosage I used though...1/8 - 1/4 tsp ???

My vet told me to start with 1/8 teaspoon but the dosage may have to be adjusted.  She said I had to find the amount that took care of the constipation but not so much that he had the opposite problem.  From what I have read here a lot of vets prescribe something called lactolose(sp).  From what I have read here the dosing on that is really tricky, my vet never mentioned it only the Miralax.

One thing I have noticed is that you have been giving him some red meat like venison and you mentioned steak, I don't know if it was beef or venison.  Some cats have problems with red meat.  I know Patches can't tolerate beef, I've never tried venison because of his intolerance of beef.

I know the RAD cat is chicken or turkey but if you were also feeding some red meat that could have been causing problems.  I know you said that he really likes it, Patches ate the beef well also but it didn't agree with him.

Thank you donnajean: I have the Natures Instinct chicken (raw boost), what is LID? I'm not sure what you are referring to. I have some marshmallow root and some slippery elm in capsules. I can put a small quantity in a #4 gel cap and give it to him if I have to but it takes two of us to give him his flagyl every 12 hours. I don't think it would be any easier to squirt it in as a liquid either. Does it taste bad?

Now I find out that the flagyl can also be compounded into a transdermal gel to put in the ear like I'm doing with the prednilisone. I paid 46.00 for the compounded capsules. I'm going to be sure and ask every time a med. is prescribed about the transdermal availability . It is fantastic.

Bentley really gravitates toward food with fish in it whether its canned or dried now. When was feeding him rad cat chicken, he also had Before Grain chicken dry available all he time. I've tried rabbit, duck, beef, turkey and he doesn't like it. I do remember that he liked the sample of the dry duck and green pea but I think it had grains?

Bentley just pooped!!!!!!! Can't believe I'm so happy about poop. It has been 72 hours since the diarrhea caused by the enema stopped. The vet told me yesterday that it can take 72 hours to fill up again after diarrhea. He only pooped a 3 inch long piece but it took quite a bit of effort and the poop was kind of hard when I cut into it to check to see if it was dry, it didn't crumble but was almost like cutting into a tootsie roll, the only way to describe it would be "chewy", gross I know. The litter did stick to it. Oh, he's back in his box, went another three inches, segmented, great difficulty getting it out, grunting. I just left a message with the vet, will need to do something to help, just don't know if he will suggest miralax or what, not sure if slippery elm would help enough right now. We go from one extreme to the other.

I think this is the symptom he has with IBD.  The diarrhea was a reaction to the additive in the enema.  This is really good since he obviously shouldn't get another enema at least not one with an additive in it.

Hopefully he will feel better now and be more inclined to eat.

I called the vet to ask what to do about the constipation and he wants me to discontinue flagyl and give him 150 cc of fluids. I asked about the miralax and he didn't want to use it hoping that the fluids would help.

He also said that the first staining of the biopsy looks like T cell lymphoma but the final staining won't be done for possibly another week. I'm just wondering if there will ever be a definitive answer from an endoscopic biopsy. He also suggested that I start him on the chlorambucil without a confirmed but suspected diagnosis. I reluctantly agreed and he wants him on 5 mg (compounded) dose today with the next dose in one week. I am so fearful that he will stop eating again when I start this due to nausea.

What side effects did any of your cats have with chlorambucil?

Definitive diagnoses with this stuff seems to be very elusive.  From what I understand cats tolerate chemo very well, they don't react in the classic way that people do.  I know it has worked very well for cats here.

I know LDG has gotten chemo for one of her cats that has lymphoma.  You might want to PM her.

I don't really know how to PM people just learning how to use this site. How do I locate LDG? Thanks!

You can go up the Forum Nav drop down.  At the top of the selection list is site areas, the third selection is private messages.  When you go into that on the left hand side is a selection for I believe compose new message or something like that.  Click on that and it will bring up a box like you would get to send an e-mail.

I've been emailing with Lisa from the ibdkitties website, is that who you are referring to?

You know I have no idea, it could be.  I only know the name she uses here.  

I am going through chemo for large cell lymphoma.  I also had a very nebulous diagnosis - we are just proceeding as if it is large cell.  My thread: http://www.thecatsite.com/t/261976/s-o-s-kinney-has-anorexia-anemia

LDG's Lazlo had large cell also.  There is a link to her thread on page one of mine above - about halfway down the page. 

The chemo for large cell is more of what you think of as chemo for humans.  They have to be taken to a hospital for their treatments.  None of it is anything given at home (except the pred), like yours.  Small cell has pretty good remission results with just the Luekeran + Pred.  Pretty easy compared to what I have to go through.

From what I understand, IBD and small cell are often related.  My Kinney never has had diarrhea, but has thrown up almost his whole life.