IBD or Lymphoma

Hi everyone! I had posted about my cat Aries this summer here: http://www.thecatsite.com/t/262146/...stive-issues-not-sure-what-to-do#post_3381649
He's 4 years old now. He is still having intestinal issues. This summer, he was throwing up and lost a lot of weight. I took him to the vet and they did an xray and stool test for parasites. The xray was inconclusive, and the stool test was negative. They prescribed 5mg of prednisolone every other day. They said he probably had IBD, and we could do a biopsy, but it would be very expensive, invasive and possibly would also be inconclusive. 

Over the next few months, he lost about pound again. He's eating a limited ingredient food. He eats most of a normal serving for a cat his size. I was concerned that he hadn't gained weight (and had some other concerns about his vet) so we took him to a new vet 2 weeks ago. They did blood tests and fecal tests, but we still don't know if he has IBD for sure. I am terrified that he could have lymphoma. After the tests came back, the vet prescribed 5mg of pred every day, probiotics, and a B12 injection every week for a month (and then once per month thereafter).

He went to his follow up visit yesterday and he gained a few ounces in the past week - he went from 5.6lbs to 5.9lbs.

I guess I am wondering - if he did have lymphoma, would he have made it this long? His first vet visit for weight loss was in July. I hope he has IBD and we can manage it. I don't know how we'd come up with the money for the biopsy and I would rather not put him through that - and I guess they can't always tell from that anyway. 

Sorry about the long post, but here are his lab results. There are 2 ALT tests b/c the first one came back abormal, then they sent it out to another lab. The outside lab tested it twice and it was normal. 

It is very very difficult to get a conclusive diagnoses with IBD.  I say my cat has probable IBD.  Even a biopsy is iffy and to get the best chance at a good biopsy he would need to come off the pred for several weeks which means he would be sick again.  The pred suppresses the inflammation and those inflammatory cells is what they look at when a biopsy is done.

The line between IBD and small cell lymphoma is a fine one that is blurred.  The best thing you can do is to find the right combination of diet and if needed steroid to control the disease.  Keeping the inflammation in check is the best way to avoid IBD turning into small cell lymphoma.  My cat has been on a steroid for 3 years.  He used to take prednisolone but with the supply problem he has been switched to dexamethasone.  One thing I have found is that cats very often do better on one steroid over another.   

What you are doing now is working, I would keep doing what you are doing rather than getting a biopsy.  The biopsy may still not give you a definite answer especially since he is on a steroid.

Thanks for your reply.  I definitely don't want to take him off of the pred right now if I don't have to. We ran out one time about a month ago, and he didn't get his usual dose for a couple of days, and he started throwing up  again :-( 

Luckily, my vet's supply of prednisolone hasn't run out. But they give him these tuna-flavored chewable pred tablets, and through a process of elimination I think we've determined that Aries is sensitive to fish. So I don't know if I should keep doing that, or try to give him pred tablets. That sounds like no fun for anyone. 

We are able to get liquid prednisolone here, and I get chicken flavored.  :-)  We used to have the pills, but that was a work out getting him to keep them down, neither kitty nor I had fun with that. 

Two of my kitties were diagnosed before I got them with, as Denice says "probable" IBD.  I won't get them biopsies, either, I'm working on controlling their symptoms with diet and steroids.  One is on pred. and the other on budesonide--I guess she didn't do well on the pred.  

So Aries is doing okay on what you're currently doing?  That's good news.

I think this new vet can get the pred compounded with a different flavor - but it's more than twice as much as we are paying now :-( I wonder if you can crush the pills and put them in canned food?

Aries seems to be doing ok on what we're doing. Thanks :-) He's going in for weekly follow-ups for at least a few more weeks, and then if he is ok he'll go in once a month. 

Yeah, the compounded liquids are more expensive.  :-(  I just sucked at pilling a cat, I'd never done it before and it got to where Jake would run when he saw me coming!  I can't blame him, poor guy.  LOL  I know lots of people do it successfully, though.  I don't remember if we tried crushing it up in his food--that's a good question, maybe Denice has thoughts on that?

Haha, yes, I had to give Aries liquid Clavamox (just in case he had an infection) and he'd scoot away from me when he saw the dropper. Poor little guy. I'm glad that's over with. 

Wow....sounds like you are going through what I went through with my Sebastian...and in the same time frame! Sebastian's issues blew up in July, as well, and he had lost quite a bit of weight since last year (16 lbs. to 11 lbs). He had/has chronic pancreatitis and is being treated for probable IBD. Lymphoma is still on the table, unfortunately. I, too, declined a biopsy. Sebastian's bad "flares" display as severe, continuous vomiting, lethargy and anorexia. On occasion he gets short-term "off" times that are more mild. He had the whole gamut of tests and he's on a strict novel protein diet and meds. I recently wrote in Sebastian's thread that I didn't start to see weight gain until I started him on fish oil (omega-3s). I read that omega-3 fatty acids can help with malabsorption, which can be an issue with GI disorders. Sebastian is super sensitive to change, so anything new is introduced very, very slowly - and only one thing at a time.

Sebastian hates any and every kind of pill. He hates the taste and will froth and foam at the mouth and shake his head. It is very stressful for him. So I put everything in a #4 or #3 gel cap, which I bought on Amazon (from the Empty Caps Company). I coat them in Nutiva coconut oil and they slide right down. There's just no way I could pill him every morning and night without this solution.

Before July, I had zero experience with any of this. All I kept reading is that IBD is a rollercoaster. It sure is! Now I have an arsenal of resources from months of research. I truly believe that there is no one solution for every cat. Find what works for Aries.

Hmmm...coconut oil. I actually have a jar of Nutiva coconut oil already (good for terribly dry winter skin). That's an idea. I have never had to pill Aries before. I was thinking of either trying to combine prednisolone with food or with his Bene-Bac gel.

How old is Sebastian? Poor guy - pancreatitis and IBD? I have been reading about IBD every chance I get since his first vet visit about this. IBDkitties.net has been super helpful. Maybe I'll take another look at the supplements on that page and talk to the vet again. I don't know if his (possible) sensitivity to fish would preclude using omega-3, though. 

I don't think the prednisolone is tasteless so I doubt that it could be hidden in food.

sbdavies said:

 
How old is Sebastian? Poor guy - pancreatitis and IBD? I have been reading about IBD every chance I get since his first vet visit about this. IBDkitties.net has been super helpful. Maybe I'll take another look at the supplements on that page and talk to the vet again. I don't know if his (possible) sensitivity to fish would preclude using omega-3, though. 

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Sebastian is 12.  Pancreatitis is a confirmed diagnosis. IBD is suspected as the cause and/or concurrent condition to the pancreatitis. Fish oil does not contain the protein component that causes allergies, so it shouldn't be an issue in that respect.

Denice said:

 
I don't think the prednisolone is tasteless so I doubt that it could be hidden in food.

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Oh :-( Yeah, probably not then.

GoHolistic said:

 
Sebastian is 12.  Pancreatitis is a confirmed diagnosis. IBD is suspected as the cause and/or concurrent condition to the pancreatitis. Fish oil does not contain the protein component that causes allergies, so it shouldn't be an issue in that respect.

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Oh, I'm sorry. Well, I hope he is doing ok now. 

I'll think about the fish oil. Thanks!

Denice said:

 
I don't think the prednisolone is tasteless so I doubt that it could be hidden in food.

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I was wondering if it might be bitter or something.

I remember my vet said the only way she could get it compounded locally was in the melts.  She made the comment that you know how much cats hate the taste of prednisolone.  I am very fortunate that Patches is easy to pill, not to syringe feed, but to pill.  The only pill that I had problems with was the Metro.  The vet that I take my kitties too now always cuts up the metro and puts it in small empty gel caps which makes it much easier to give Metro when he needs it.  Fortunately he only needs that every once in a great while now.

I hate to pill Aries if I don't need to, but with everything going on right now, it might make sense to get the pills instead of the chewables for cost reasons. I didn't think about getting empty gel caps and sticking it in there - that might work. 

sbdavies said:

 
I hate to pill Aries if I don't need to, but with everything going on right now, it might make sense to get the pills instead of the chewables for cost reasons. I didn't think about getting empty gel caps and sticking it in there - that might work. 

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The gel caps are great. I mentioned it above in post # 8. I couldn't pill Sebastian as often as I do without them.

GoHolistic said:

 
The gel caps are great. I mentioned it above in post # 8. I couldn't pill Sebastian as often as I do without them.

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Thank you! What size empty caps do you buy?

sbdavies said:

 
Thank you! What size empty caps do you buy?

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I use primarily # 3, which are the standard "pet size" gel caps.

# 4 is a little smaller and will work if you only have one or two pills.

I ended up buying both sizes.

GoHolistic said:

 
I use primarily # 3, which are the standard "pet size" gel caps.

# 4 is a little smaller and will work if you only have one or two pills.

I ended up buying both sizes.

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Thanks! I think we'll try those :-)