Please help my IBD, Pancreatic, Renal Failure, Arthritic, Geriatric Cat

[if gte mso 9]><xml> <o:OfficeDocumentSettings> <o:AllowPNG/> </o:OfficeDocumentSettings></xml><![endif]Animal: Domestic short hair

Colour: Black

DOB: May 25, 1995

Sex: Male, neutered

Weight: 9.3 lbs (2011), 5.5 lbs (early 2013), 6.9 lbs (today)

Medical Issues: IBD, Pancreatitis, Renal Failure, Arthritis

This is a long read and I do apologize but I believe it better to know too much than not enough.

I was hopeful that some of the people who have been through this will be able to help me manage my cat’s health and keep him happy in his late years. In short the biggest problem this cat seems to have is he throws up every 2 – 5 days and he can have a lot of stomach noise which seems to make him very uncomfortable. He also has attacks without stomach noises but he seems to react the same where he will sit up on his haunches for an hour or two then seems to be normal again. Scratchy was fine throughout his life and when he was 16.5 years old he got in a fight and had a fang broken off and a claw sheath stuck in his side which I could not feel and got infected. He had surgery to have this removed and then recovered from this and started to lose weight slowly. It happened slowly enough that I did not notice it right away and then he started to get picky with his food and then started eating less and less and throwing up. He went to the vet and he was low on B12 and he was dehydrated so he got a sub-q and went on B12 shots (one a week for 6 weeks then 1 a month for the rest of his life). During this time Scratchy stopped eating hard food and would only eat canned so I switched him over to canned and he has been eating it since. He has eaten pretty much nothing but Iams hard food and periodic canned food more as a treat.

After this things started to settle down but he was still throwing up every few days and it was always cat food in some state of digestion and lots of water. His blood tests showed his numbers for Pancreatitis were high normal and his kidney numbers were also high normal. He went in for an ultrasound and his left kidney is 2.96cm in length and the right is 4.40cm in length. The kidneys show a mild increase in medulla echogenicity bilaterally. Few ill-defined nephrolithiasis are noted within the collecting system of both kidneys. There is also mild bilateral pyelectasia in the kidneys.

The small intestinal wall is diffusely at the upper limit of normal thickness measuring up to 2.8 – 3.7mm. The mucosa is mildly more prominent than normal in many small intestinal segments but there is no evidence of jejunal lymphadenopathy. There is fluid and gas throughout the small intestines. His stomach looked fine and his pancreas looked fine on all of his ultrasounds without inflammation or anything odd.

I treat the renal failure by giving him a 100ml sub-q each day which helps keep him hydrated. I can feel the difference in him from the time when he gets a sub-q to the next day in his ribs alone when petting him. Some days Scratchy drinks a lot of water some days and then he can go for days without touching it. Scratchy also has arthritis in his shoulders/hips and takes 0.20cc of Buprenophine twice a day to help with this. Scratch also went through a weekly injection of 0.10cc of Cartrophen for 6 weeks and now he gets the same each month for the rest of his life to help reduce inflammation in the joints.

Because I am reluctant to have a cat his age go through a biopsy to determine if it is IBD he is suffering from my vet has been treating it as IBD. He has been to his regular vet and a cats only vet and both have come to the same conclusion for the same reasons going by blood tests and ultrasound reports. The thing is these treatments don’t really work and it kills me to see him suffering when he has flare ups or is uncontrollably throwing up. I should be more accurate, they do help in some ways but the throwing up and the flare ups don’t stop. When he is on Budesonide or Prednisolone his weight goes up and when he throws up there is a lot less water content but he still throws up and has flare ups. When I take him off of these drugs he can go for 7 – 10 days without throwing up and once he made to 14 days but his overall weight drops down to 2.6 – 2.7 kg and he seems to have less flare ups.

I give Scratchy 0.45cc of Famotidine via a syringe each day, typically in the morning if possible. I have taken Scratchy off of this and his stomach gets much worse so I believe this does help him and he has been taking it daily for a year. To control IBD Scratchy is also getting 1mg of Budesonide each day and he went onto this directly from 2.5mg of Prednisolone twice a day with no changes. My vet is now thinking about laser therapy and Florentero but they have never done the laser thing for treating IBD so I am not so thrilled about that.

I have done a lot of research on this and have raised his food and water dishes and tried so many different foods including prescription food and the only think that seems to work with him is Medleys Chicken Florentine and sometimes their Shredded Chicken meal. He would eat the recovery foods for a short period of time and then stop and I always fall back to the Medleys. I tried the raw food recipe from the IBD Kitties site and he loved that but his stomach did not. I gave him little bits at first and he would gobble it down so I started to introduce small amounts in his food and it gave him massive gas. He was burping up stomach acid and losing weight so I stopped that. When I spoke with the vet she said the food is too acidic for his condition and was not a good idea to feed a cat with a very poor immune system raw food because they would have a hard time fighting anything that may be in there. She said the raw food had burned the flora out of his stomach so he was put on a run of Metronidazole to help rebuild things. In the vets opinion FortaFlora was a better alternative than the human one that is commonly recommended because it was designed for animals so I have kept him on this.

Scratchy is pretty old so he does sleep a lot but he is also active at times and socializes, he still grooms (I take a face cloth to his head because he has a hard time reaching up there), jumps on beds and chairs, and moves pretty fast when he wants to. He is now an inside cat and is stuck on the second floor with a big deck with no stairs or a way to get to the ground level. I keep a very close eye on Scratchy’s weight and revert his food back to Medley’s if one of the foods he is eating is causing him to drop weight. For the most part his stools are well formed and either normal looking or a bit moist. He did have a small problem with diarrhea at first and some food has caused this and he is then taken off of it. This cat also eats a lot of food in a day and puts on little weight for the most part. On average he will eat 4 – 85 gram cans a day which reach as high as 6 – 7 if he is really hungry. I feed it to him a fork full at a time and try to space it out as much as I can so he doesn’t over eat. During the day and overnight I use an automatic feeder so he can have food in his stomach at all times to help reduce acid buildup. I leave a plate with about ½ of a can of food and then another ½ can in each side of the feeder which has two sides. Scratchy has always eaten what he wanted because he has never had a weight issue and the vet said to continue this because his body takes in so little.

If you were caring for Scratchy how do you think you would go about it? I know all animals are different but I was hoping there may be something I didn’t try or something that could be tried again. Scratchy is certainly better than he was a year ago but I have invested well into 5 digits for vet visits last year and was at 2k before January was out this year and he still has the same basic problem with throwing up and stomach issues.

Thanks again for taking the time to read this and thanks for any suggestions that may help Scratchy.

 

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Wow.  Scratchy (love his name!) is lucky to have you taking such good care of him!  I have two older cats with IBD (they are 14 and 11 years old) and an almost 18 year old with kidney disease.  I give them all slippery elm bark syrup every morning with their morning food.  It isn't a cure-all, but has helped tremendously with both vomiting and diarrhea issues.  It's easy to make at home and can be mixed right into his food. 

Here's a link to a thread about it:  http://www.thecatsite.com/t/271684/difference-between-probiotics-and-and-slippery-elm-syrup  which in turn links to other threads.  One thing to keep in mind is that it needs to not be given with other meds as it will inhibit the absorption of other meds. 

I use slippery elm bark for my kidney cat, who also has the early morning throw-ups.  That link that Betsygee provided is a discussion re: constipation, but still should still be applicable, I would think. 

As far as IBD, I've been lucky enough to never have a cat with that (knock wood), but one think I've always heard is that you don't want to feed them grains, and those Medleys and shredded chicken meals  have wheat gluten in them.   I know you said when you tried raw Scratchy still threw up, but have you tried a grain free canned food?  I think you are probably not located in the U.S., but the manufacturer of Medleys here in the U.S. is Fancy Feast and they make a CLASSICS line that is grain free.  The problem with it is it's too high in phosphorus to be good for a kidney cat .  I DO feed it to my kidney cat, but I add in egg whites to counter balance the phosphorus levels. 

As far as giving FortiFlora, to me it barely counts as a probiotic   If you real the above link, you will see some references to other probiotics and can make up your own mind.  My cats take the same ones my husband and I take, and everyone does fine on them.   Some of my cats eat raw and some don't (their choice).  The only one who has any issues is the one with kidney disease, and that's because of her condition.

BTW, it's apparently how deeply you care for Scratchy .  He's lucky to have you

I'll tell you what has been working for my 14-year-old guy (much younger than your guy, obviously).  Last summer he dropped a few pounds suddenly and had some wild vomiting episodes, and got diagnosed with probable IBD after finding an overgrowth of the wrong gut bacteria.  Metronidazole got rid of the wrong guys, and daily prednisolone is keeping both the gut problems and his arthritis in check.  He takes a compounded chicken-flavored pred tablet, now down to 2.5 mg a day.  He's on commercial canned food (various types), and Royal Canin renal kibble, which has gotten his kidney numbers back to high normal.  His weight is back up and he's as active as ever.   No pancreatic problems.

The only thing I can see that we've done that you didn't mention is the antibiotic to clear up what was living in his gut.  I don't know if that might help your guy or not.  Obviously, Scratchy is getting lots of care and love.  I hope you can keep him around and happy a long time.

You are clearly a fantastic owner. Really on top of things. And what a good age your kitty has reached!!

Could he have nausea due to his various issues? I am on the pancreatitis yahoo group, and the anti-nausea drug mentioned a lot on there now is ondansetron (I just started my pancreatitic cat on this). You could perhaps talk to your vet about this possibility.

Thanks for all of the tips,that gives me something to work with, Last night was a bad night for Scratchy, he woke me up yowling and when he came in and jumped on my bed I could hear his guts going at it. I got up and gave him his Pepsin and then waited 30 minutes and gave him his Buprenophine and then he jumped up on one of the dining room chairs and hunched himself up. For the next two hours I hung out with him and kept him company and listened to his inside go. The attacks seem to have three main components, a growling noise like our stomachs when we are hungry, chugging/sloshing sounds which seems to be spasms or something, and a loud gurgling. It is not uncommon for Scratchy to have stomach noise especially after he eats but a lot of time I have to stick my ear against his side and last night it was loud and clear. After an hour and a half of this it started to settle down and get quiet and then Scratchy started to roll on his side and by two hours he was curled up in a ball and sleeping. He didn't really eat anything after 22:00 that night and hadn't eaten by 08:00 the next morning (hadn't moved from the chair either) but all of the food I left out was gone when I got home. The night before this one was similar but he threw up and although he had stomach noises it didn't seem to bother him. He doesn't throw up like a normal cat either, it starts by him licking the roof of his mouth then he throws up with little or no control while standing/stumbling around throwing up all over everything including himself.

I went through most of Scratchy's food and only the Iams (which he doesn't like as much) and the First Choice cat food are grain free. Because he ate the Medleys and maintained & helped stabilize his weight I never thought to see what was in it. He was eating the first choice before but he was throwing up a lot but this was a while ago so I am going to try it again and see if he maintains his weight and doesn't throw up huge amounts of water. I would really like to try him on raw food again because he loved it but I am worried about what happened last time when he had a bad reaction to it. I think the suggestions of a better probiotic and the slippery elm may be the ticket to making raw food work. I have read the success so many people have had with it but it is either his age or condition that stops this from working. After the last run with raw he did go through two rounds of Metronidazole which brought him back to where he was before and he has stayed there since. I was also thinking of trying to move him to a commercial raw food first and then try the home made stuff again. I need to start a thread about this in the raw food forum and see what may help get this guy on raw food without hurting him.

Scratchy also takes 4mg of Cerenia every second day to help with nausea but this doesn't really do much and he has also thrown it up after giving it to him. I feel so bad for him because he looks kind of like a frakencat at times. I was looking at him a little while ago when he was getting water and he has a shaved belly from the last ultrasound, he has a big shaved spot on one of his rear legs from when he had the broken fang taken out (I had to wait 1.5 years for his blood numbers to settle enough before they could put him under because of his age), and a big bump on the side of his neck, and a water bag hanging under his shaved belly from the sub-q. He is an amazing cat, other than refusing to be pilled he takes everything else without a fight. I need to check and see if his meds will be okay with slippery elm, what sized doses, and whether I keep him on the Pepsin or take him off.

My vet, who is young and on top on many things, has been telling me that "grain-free" is overrated.  There's almost always something like potato or pea starch to make up for the grain, anyway.  And if it's solid flesh (like one fish flavor I get), then it's high in phosphorus and screws up the kidneys!

What my vet has suggested instead is to get away from chicken and seafood flavors, for a non-allergenic protein source.  Have you ever thought about food allergies?  They can be impossible to distinguish from IBD without a biopsy, as I understand it.  She specifically mentioned quail as a meat source.  If your research agrees with that, maybe you could check out raw quail as a food for Scratchy?

My heart goes out to you and many praises for the "excellent care" you are providing for your furry family member.

All the suggestions are very good ones, I just want to mention.

I have a cat with probable IBD, allergies... I also  have a cat with Urinary issues (cystitis and prone to struvite crystals)

The only food so far that has helped my cystitis cat is Royal Canin S/O... Yes it has grains, everything my beliefs go against.. I do try to incorporate more of the RC S/O canned, at least it does not have all of the carbs and terrible fillers..

This diet would not be appropriate for your cat however..too high in grains, sodium, etc..

Tricky when you have a cat with clearly Renal issues, probable IBD, prone to pancreatitis...they just don't make an RX diet for all these combined.

For Boo my IBD, allergy boy, he developed pancreatitis as his first symptom and I truly believe it was the Royal Canin S/O that MAY have possible contributed to that (who knows for sure).. Vet said it was fine for all my cats to eat this.. I believe it was the high carbs, grains and etc...

He was then dx'ed with probable IBD and clearly has food allergies.

We went through the suggestions of the vet, their RX Diets for GI health, no go, it was terrible...no improvement, scratching, throwing up, etc..

We finally ended up with a hypoallergenic diet of Royal Canin canned only, Duck & pea, he has been on that for over 5 months now with no throw ups, no diarrhea and gained back a little weight..

He also gets a little dry, Natural Balance LID Duck & pea and even though there are opinions about fortiflora he still gets a fine dusting over his dry as it encourages him to eat more.

Now, I know you can not use this diet for renal issues, as I clearly understand. I just want to make a suggestion based on observation of my cat.

IBD and grains, seems to me to contribute to further problems... All grains, wheat, corn, wheat gluten, rice, etc..soy protein...

A novel protein source, only one protein.... usually a source your cat has never tried before.sometimes works .

With renal issues, you want to keep the phosphorus levels low in food, from what I have read, below 1.0- 1.2 % dry matter not "as fed" or below 250-300 mg/ 100 Kcal., high phosphorus will only make your cat feel bad.

You also want lower sodium, not sure at this time what the proper amount is, you may already have this information.

For kidney health, supplements have been suggested like probiotics(Probiotic Miracle is a good one), omega 3 fatty acids (very important for cats with kidney disease, they need 300-500 mg DHA/ Epa combined everyday here are some tested brands that are great , garden life ocean 3 and Natural factors RX omega 3 factors) you can start out by mixing half of the recommended dose into canned food then gradually work up to recommended dose of 300-500)

, B-vitamins ,.(Boo was getting injections of B12 for awhile IBD cats seem to sometimes become deficient in most of the B vitamins, I am pretty sure your cat was tested for b12 deficiency ?)

I give Boo (IBD) Curcuvet by Thorne Research, you can look it up, it supports the liver, GI tract, helps with inflammation, he has been taking this for a month now.

I also give Boo the fine dusting of Fortiflora over his food till I finish this pack (not sure the sodium content but it may be too high for your cat)

Here is a few foods that you can check out that I have read and researched that may be appropriate for your baby.

Weruva, especially " On the Cat Wok" Low phosphorus, low sodium, no grains, excellent ingredients..

Hound & gatos, canned, especially the rabbit

Tiki Cat, low sodium, low phosphorus

Avoderm chicken

Hi-tor Neo diet (this one may have grains not sure at this time)

And I have also read Friskies Special diet turkey & giblets is  appropriate for renal cats

Hope I haven't confused you, with IBD I feel grains can be a culprit as well as any preservatives... Supplements helpful for IBD , B vitamins, Probiotics, Omega 3

. Renal, you need to find low sodium, low phosphorus foods, supplements like probiotics and omega 3. I have had good luck with the Curcuvet you may want to check out this through Thorne research, worth a read... vet gave me the ok to try...

The slippery elm is great, I have used it on many occasions , just don't give right before meds or up to 2 hours after meds it may interfere with absorption .

Helps with inflammation, diarrhea, constipation, acidic stomach.

If you are thinking raw, here is a list of excellent choices for kidney disease pets ..I did not any luck with Boo on trying raw, but you may..

Nature's Variety

Nature's Logic

Rad Cat

Read Dr. pierson's chart of foods by phosphorus levels..

best of luck to you...

BTW,

Did a little more reading, research on the Curcuvet.... It supports liver, musculoskeltal , Gi and kidneys...it also could be beneficial for arthritis too.You can contact them with any questions about this product...

Boo is not on any prescription meds at this time for his IBD, only the curcuvet and hypoallergenic diet food.

The Royal Canin Duck & Pea (canned), we tried the dry version of this and there has to be something in the dry, he immediately started scratching, that's why I took a chance with the Natural balance LID Duck & Pea dry and so far (keeping my fingers crossed) he is doing well.

The issue we have had with Steroids is strange, almost like a correlation of problems proceeded almost two months, two times after prednisone .

He was on Prednisone for allergies , less than two months later he developed Pancreatitis, he was on Prednisone, month later developed a UTI.

For some reason steroids and him do not get along.

After the Pancreatitis and lack of appetite the vet did prescribe for awhile Mirtazapine, every 72 hours, I do not use it now.

He never has had problems with Diarrhea except when he developed the Pancreatitis and after an antibiotic for the UTI..

The b12 injections the vet let me administer at home after the Pancreatitis and I think it was a total of 6 spread out over a course of time. He is not low according to the vet in B12..

I did purchase and give for awhile Thorne research animal health B-Complex Vet, Sucked it up with some water in a syringe and administered.

He also did really well on Nature's Variety LID Turkey in canned and dry for over 4 months then that fell to the wayside..started scratching, threw up..

I can't find an actual mineral analysis on the Royal Canin duck & pea canned, you could ask your vet, may not be low enough in sodium or phosphorus for the renal issues though.

Boo is only not quite four years old and this has been a real challenge for me, along with my other cat who is about the same age with urinary issues.

I did have a cat with Chronic Renal Failure several years ago, it was awful.. I wasn't educated at all with this, thought my vet at that time knew what was best.

The smallest amount of dry you can feed the better, canned probably is the best route to go..However, you seem to have some good knowledge and perhaps a good vet  who is more up to date on renal. My CRF cat would not even touch the prescribed rx food, she mainly ate Fancy feast turkey & giblets (not the best but she had to eat)...

Just a little more info for you....

Thanks for all of the suggestions from everyone, it gives me a lot to think about. I heard from the vet today and they were thinking about doubling his Budesonide dose to 2mg per day to see if that helps. The problem with me is I am not experienced in these kinds of things so I rely on others who have taken training in these matters. I am basically told that there is no magic fix so you have to try different things and see what works for Scratchy.

Last night was another bad one for Scratchy, he woke me up 02:00 licking the roof of his mouth forcing himself to throw up. He ate well when I got home and as the evening went on he was eating less and less then stopped around 21:00 and just slept. I gave him a small dose of pain killers to help him sleep and recover from the day before. He was deep asleep when I went to bed so I left him and then was woken up with him throwing up. This time it was some food that was mostly digested and a huge amount of water. Just guessing it would seem that his stomach or digestive system is not pushing anything out of his stomach and it just fills up and then he has to purge. After he was cleaned up he went to his cat box under the end of my bed and then was crying so he must of been in pain as well or frustrated. These times are the worst because you can't give him any pain meds so you have to hope the drugs in his system are enough and you can't do anything but pet him to settle down the actual issue that is causing the problem.

He is back on the Medleys again, because he didn't eat last evening and all night to at least the time I left I split up two cans on his plate and feeder and it was gone when I got home. I tried some of the salmon First Choice when I got home and he ate a bit of it and then lost interest. As soon as the Medleys was back on the plate he was back eating more so at least there is something that he will constantly fall back on. I will start going through the thread and making notes on what is here and then research these and see what I can come up with.

That Guy said:

 
Thanks for all of the suggestions from everyone, it gives me a lot to think about. I heard from the vet today and they were thinking about doubling his Budesonide dose to 2mg per day to see if that helps. The problem with me is I am not experienced in these kinds of things so I rely on others who have taken training in these matters. I am basically told that there is no magic fix so you have to try different things and see what works for Scratchy.

Last night was another bad one for Scratchy, he woke me up 02:00 licking the roof of his mouth forcing himself to throw up. He ate well when I got home and as the evening went on he was eating less and less then stopped around 21:00 and just slept. I gave him a small dose of pain killers to help him sleep and recover from the day before. He was deep asleep when I went to bed so I left him and then was woken up with him throwing up. This time it was some food that was mostly digested and a huge amount of water. Just guessing it would seem that his stomach or digestive system is not pushing anything out of his stomach and it just fills up and then he has to purge. After he was cleaned up he went to his cat box under the end of my bed and then was crying so he must of been in pain as well or frustrated. These times are the worst because you can't give him any pain meds so you have to hope the drugs in his system are enough and you can't do anything but pet him to settle down the actual issue that is causing the problem.

He is back on the Medleys again, because he didn't eat last evening and all night to at least the time I left I split up two cans on his plate and feeder and it was gone when I got home. I tried some of the salmon First Choice when I got home and he ate a bit of it and then lost interest. As soon as the Medleys was back on the plate he was back eating more so at least there is something that he will constantly fall back on. I will start going through the thread and making notes on what is here and then research these and see what I can come up with.

Click to expand...

Hello,

Can't stop thinking about Scratchy and the stress you must be under, been there...

I have done a little more research early this AM and made some notes for you to review..

Food : Since your cat has IBD and Renal issues :

The Medley, I know Scratchy has to eat, I know what it is like to have umpteen opened cans on your counter because they have all been rejected..

However, my opinion only, if it is the Fancy feast medley canned I have reviewed the ingredients in just one of the flavor choices and with IBD this food would send my IBD cat into a major flair.

The Wheat Gluten, corn starch, artificial flavors, added color and soy protein can be very disruptive to the GI tract of an IBD cat.

The classic Fancy feast canned of Turkey & giblets pate form is actually the lesser of the two evils with no wheat gluten, no soy protein or corn starch... I have fed this in the past to a diabetic cat I had and my CRF cat that I had. I believe the Mixed grill was acceptable also but don't quote me on that one...

Food: If you would plan for a raw diet please check out petsynergy.com , Dr. Gardner has some great products and you can email her at [email protected] with questions, diet, etc...

          If you are not going raw, for IBD, look for grain free, gluten free cat food, one protein source (preferably one your cat has not had before like Duck, Rabbit, venison, etc..)

          For Kidneys: Make sure the mineral contents are in range for kidney health (lower sodium, lower phosphorus) Protein is not really a major issue as thought in the past .

          You want to take any toxic load off of the kidneys so food without artificial flavors, preservatives, grains, colorings would be beneficial to be Avoided...

          There are some terrific supplements for Kidney function, please check out AZodyl... also Omega 3 fatty acids are suppose to be very beneficial, I came across an unscented salmon oil in a pump called Norway Pure salmon oil  Human Grade unscented for pets I believe the website is at Felineinstincts.com

         If Scratchy is not on an acid controller I would ask Vet about plain old Pepcid AC (famotidine), I have used this on Boo (my IBD cat) they sometimes become nauseated and throw up when their stomach becomes too acidic... this can help alleviate sometimes the use of RX med for nausea.... (the rx med helps to keep cat from throwing up but does not address the reason )

       Signs of IBD:

       Vomiting

       Diarrhea

       weight loss

      normal/increased appetite

      stomach rumbling

      belching

      increased thirst

      abdominal pain

Signs of kidney disease:

Anemia(pale gums and weakness)

dehydration

lethargy

depression

increase urination

loss appetite/ loss weight

vomiting and/or diarrhea

I hope you find some of this information helpful and I hope for better days for you both..

Now, Boo got into my other cat's food in the night, woke up this morning to the bag on the floor, teeth marks and torn open..... This is not good, hope he does not have a major flair !!... gotta love "em !

It's me again with the last of some information for you....

I see that you already give the famodine (pepcid) for acidic stomach, great....

You asked what "we" would do if this was our cat and really you are doing a great job .

I must ask, I am assuming Scratchy was checked by bloodwork for Anemia, low RBC , etc..?

I can't remember as I am writing this Scratchy's age, but if he is over 7, I would not recommend anymore vaccinations, very taxing on the kidneys or any animal that is sick or has health issues... I had a cat with Chronic renal failure and the vet was in agreement not to even give her a rabies vaccination (she was strictly an inside cat also)

What would I do, well I can say this is what I would probably do:

 1) Ask Vet about AZODYL, you can order it online... please read about it many people have had great success adding this supplement on.

 2) Ask about b12 injections (b-complex), this can also help with a cat's appetite, along with replacing lost water soluable fluids due to urination and vomiting.

3) I don't recall what type of dry food you are using and thought you said it is put down at night ? In this case if it is not a grain free cat food I would look for one with limited ingredients such as the Natural Balance LID in either the Duck & pea or Chicken & pea... This is mainly for the probable IBD.. I believe some grains can cause an inflammatory process in animals, especially animals that already have IBD.

I do not know what the Sodium or phosphorus levels are in this dry food, you could e-mail Natural balance and ask. You can mix this into his current and slowly wean off of the old if you fear a digestive upset.. Dry is really not recommended for cats with Renal issues but I know how they can be about their dry food... They think they have to have it....

Remember you must try to keep the phosphorus at a minimum for the sake of the kidneys, less than 1 % is acceptable..

4) Canned food., Tiki cat and Weruva has human grade canned cat food, grain free versions (weruva does have a couple with rice and this should be avoided) The websites show that some of the choices look similar perhaps to the Medley that Scratchy eats, minus all the no nos... These foods also are low in sodium and phosphorus !!!!

5) I have started giving my cats Reverse osmosis drinking water (Aquafina is the only one I could find by research that does not add minerals to their water after the process), I buy the purified drinking water , not their spring water......

6) at a later time, because you do not want to start throwing in and changing all kinds of things, I have learned, you then don't know what is working or not working..... I would add the omega 3 fatty acids, a good one is the Norway pure Salmon oil unscented, it comes in a pump bottle..

7) Curcuvet, I am really impressed with this supplement, great for inflammation, supports the liver, kidneys, GI tract..and helps with arthritis (great alternative perhaps to an RX med) It does state it could be an irritant to the GI tract but I have had no issues as I started out with half of the recommended dosage and after a few weeks moved up to the full dosage.. I also was a little skeptical about the inactive ingredients which I think were in the capsule so I purchased a size "3" gelatin empty capsules (by Now brand , count of 1,000) and put the powdered supplement in them, open his mouth put in the back and he usually swallows with no problem since the capsule is so small.

There is one more pet food that I can only find it to purchase on Amazon, it is by Firstmate.... Excellent.... Grain free, no preservatives, additives, low sodium . The chicken I have read rave reviews on... They are located in British Columbia, you can visit their website at firstmate.com......

Please always ask your vet about any changes before taking the advice or suggestions from anyone....

I am just a long time cat owner who has had cats with special needs and have learned from trial and error and still am.....

Best to you and Scratchy......

Thanks again for all of the information, that is great. Scratchy did really well last night and he has been doing great today and still maintaining his weight overall. I have been feeding him First Mate turkey today and so far he hasn't been turning his nose up to it. He is pretty hot and cold with First Mate, sometimes he really likes it and then other times he wants something else. His biggest issue is digestive issues so one of the things I am really interested in is the Slippery Elm which would help settle his stomach. Then it is a matter of helping his body absorb food so he doesn't have to eat as much. For a cat who is almost 19 he doesn't show it all of the time although there are times when he looks and acts old which is what I am trying to help with.

He hasn't been to the vet since the end of January so I will build a list of questions and see what the vet thinks about them. He has a big bump on the side of his head right under his ear flap where the jam meets the skull which I want to have drained. It has been checked 3 or 4 times and is probably not good news but they can't identify exactly what is draining where.

DonnaJean, that you very much for taking the time to do so much work to help with Scratchy's issues, it really does help. Hopefully Boo didn't cause himself any issues by eating the wrong food because cats are smart and if they really want something they will find a way. It may take them a while with trial and effort but if they are anything they are patient.

Scratchy had a good night and ate most of the food that was left out for him on his plate and in his automatic feeder. He did have some stomach noise when I got up (or when he woke me up, he has decided my pillow is a great place to sleep now) and he went out and ate some grass and then threw it up with a small amount of water and some hair. He wasn't really hungry after this but I got him to slowly start eating and he seems better. I found one of the brands of food DonnaJean suggested and got some 'Weruva' Paw Licking Chicken which he really liked and some Grandma's Chicken Soup & Peking Ducken both of which he hasn't tried yet.

I could find any of the products above that had Oemga 3 in it but I did find Grizzly Salmon Oil which has Omega 3 and 6 in it. I will try him on this and see how well it works for him. I also have to check on the probiotics, some of these use animal based enzymes which the stomach acid breaks down so they are gone by the time they make it to his intestines. I did check with the vet and they thought the FortaFlora was better but they also sell it to me so this may be an issue.

The pet food store I went to that had Weruva food also has cats the local humane society are trying to adopt out and they had this guy who is the spitting image of Scratchy when he was young. http://www.deltacommunityanimalshel...doption/animals/cats-for-adoption/317363.html I am not sure about the write-up because this was one of the more affectionate cats I have seen and if I didn't have so many concerns with Scratchy I would have signed up to adopt him. Scratch had a sister who passed away almost 2 years ago but I am not sure if he would want a buddy or not but I wouldn't want to stress him out.

Signs of IBD:       [if gte mso 9]><xml> <o:OfficeDocumentSettings> <o:AllowPNG/> </o:OfficeDocumentSettings></xml><![endif]

·            Vomiting - Check

·            Diarrhea - Not anymore but it was a problem when he first came down with this

·            weight loss - Check, half his body weight in 1.5 years

·            normal/increased appetite - Big check, eats about 2 - 3 times the suggested food for hi weight

·            stomach rumbling - Check

·            belching - Not always but it happens when he is having a flare up

·            increased thirst - Check

·            abdominal pain - Always hard to say with cats, he doesn't jump away if I probe but he doesn't enjoy it either

Signs of kidney disease:

·          Anemia(pale gums and weakness) - Not sure

·          dehydration - Check, could also be from the renal failure

·          lethargy - Check although he is just about 19 so this is not unexpected

·          depression - Don't think so

·          increase urination - Check

·          loss appetite/ loss weight - No on the lost appetite but check on the weight loss

·          vomiting and/or diarrhea - Yes on the first no on the second

Signs of Renal Failure:

·          Excessive urination - Check

·          Increased thirst - Check

·          Nausea and gagging - Check on the first, no on the second

·          Licking lips - Always after eating

·          Grinding or cracking sound in jaw - No

·          Vomiting (both clear/foamy liquid and food) - Check

·          Drooling - Always has

·          Dehydration - Check

·          Hunching over the water bowl - His dish is raised but he does do this

·          Stomach irritation (uremic gastritis) - Check

·          Constipation - Not often but it does happen from time to time, usually a while after throwing up

·          Loss of appetite - At times when he is not feeling well

·          Weight loss  - Check

·          Muscle wasting  - Check

·          Emaciation - He was pretty bad but has put on a bit of weight

·          Poor hair coat - It comes and goes but it is generally very shiny

·          Halitosis (ammonia smell) - At times, been a while

·          Lethargy - Almost 19 years old, not unexpected

·          Sensitivity to sound - Don't think so, he can sleep beside speakers kicking bass

·          Eating litter - Not that I have seen

·          Weakness - At times but he can still jump on chairs and has tried for a counter a few times

·          Depression - Don't think so

·          Oral ulcers - None so far

·          Detached retinae - Thankfully no

·          Convulsion, low temperature, coma (end-stage) - Thankfully no
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This is a picture of my IBD cat, Boo...

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This is Peanut, he looks like the kitty at the shelter you posted a link to...

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Glad you could find the foods that I mentioned, it is not easy where I live and have to either order off internet or have to travel 45 miles..there are two pet supply stores in my town but neither has Weruva  nor some of the other higher quality cat foods that I would like to try.

 Epakitin,(can be purchased online cheaper than in vet office) it works as a phosphate binder that lowers ELEVATED Phosphate levels in the blood which can help slow down progression of CRF..., manufacturer is Vetoquinol

Has Scratchy been tested for high phosphorus levels ?????

AZODYL, Helps slow down Uremic toxin buildup and prevent further kidney damage... Provides natural Enteric dialysis through the use of beneficial bacteria that supports kidney function.... Manufacturer Vetoquinol  also..

B12- some vets will suggest b12 injections for cats that are prone to pancreatitis for the simple fact that even levels are in "normal " range it is showing what is in circulating blood, not what is being stored in CELLS..

B12 deficiency can cause poor cell formation in the digestive tract and lead to nausea, vomiting, loss of appetitie, poor absorption of food, gas, weight loss, fatique, lethargy, abdominal pain, and /or diarrhea.

Because a healthy liver is able to store b12 for many years , signs of deficiency may not be obvious for a long time...

Anti-acids, H2 blockers and potassium supplements( and many prescription meds) are just a few that can impair the absorption of b12 and also cause a deficiency..

Many vets will suggest injections of b12 at .25 ml.  once a week (I have done this at home, very easy, under skin), however if the animal is found to be very low or not at "normal" levels many vets sometimes will suggest .50 ml.

Hope this day finds Scratchy doing well....

@That Guy, I've been trying to read this thread. The posts are really long and makes my eyes hurt, so that is why it has taken me so long to post.    You're certainly going through a lot with your boy. My Sebastian has chronic pancreatitis (confirmed) and suspected IBD. What gets me is that you say your Scratchy has an increased appetite.    That's usually not the case with IBD, pancreatitis, or renal failure! But perhaps this is the case simply because he can't keep anything down and is continually hungry with an empty stomach all the time. 

Did Scratchy get tested for diabetes and hyperthyroidism?

If I were in your situation, my ultimate priority and focus would be to get the vomiting under control. This is really just happening too much and the constant state of stomach acid coming back up into the esophagus can also cause problems and discomfort. To keep the renal failure [sort of] in check while you address the vomiting, talk to your vet about a phosphorus binder. That way you wouldn't have to worry about finding low phosphorus foods so much, but just ones that he can keep down and won't cause flare-ups / inflammation. Sub-q fluids are extremely helpful for both pancreatitis/IBD and CRF.

To keep my Sebastian feeling good and vomit-free, he gets 1/4 tablet of Pepcid AC twice daily, a maintenance dose of Cerenia Monday through Friday, probiotics, s. boulardii, etc. He's also on fish oil, B12 and prednisolone. It sounds like you are already doing a lot of this already, so the problem could really just be the food itself.

There are two well-known websites that may be of help: www.ibdkitties.net and www.felinecrf.org

Wow, Boo and Scratchy look like they could almost be twins...


I checked Scratchy's last few blood tests and his phosphate levels were around the middle of the normal range so this doesn't seem to be too bad right now.

The vet said Scratchy's numbers were normal for his kidneys on the tests and his biggest issue is being born with one small kidney which seems to be causing issues but not degrading too badly. He's going to the vet on Saturday and I will get them to do another blood test and see how things are looking. He hasn't had a blood test since late November so it would be a good thing.

Scratchy is getting a monthly B12 injection at home and he gets 0.25cc each shot. He gets it on the 25th of each month so I will have them test for this as well and see how his B12 levels are holding up. I went back half a year and he threw up on the 26th more often than not so even with a fresh dose he does seem to throw up. Because Scratchy gets his B12 through a needle I won't have to worry about the antacid in his stomach but I will have to with the other drugs.

I try to give Scratch his pepsin first thing in the morning and this needs to get in his stomach. The first thing I do is give him his Buprenophine in his cheek pouch and let this absorb for about 10 - 20 minutes. The Buprenophine needs to be absorbed through the mouth so it needs to go in a cheek pouch and slowly get absorbed. When I am leaving I give him 0.45cc of Famotidine with a syringe in his mouth and hope for the best.

Signs of Pancreatitis:

• Fever
• Vomiting
• Diarrhea
• Loss of appetite (anorexia)
• Weight loss (more common in cats)
• Dehydration
• Fatigue and sluggishness
• Mild to severe abdominal pain (may become more sever after eating)
• Depression
• Increased heart rate
• Difficulty breathing

Thanks for the input GoHolistic, a lot of what I do at work involves a keyboard so i am proficient at pounding out long replies. From what I have read IBD can cause an increase in appetite because it blocks the food from being absorbed because of the damage to the digestive system. IBD seems to kill the appetite in a lot of cats but for Scratchy this isn't typically a problem except for flare ups when he won't eat anything. Both pancreatitis and renal failure cause a loss of appetite so I guess the IBD trumps the others. The last ultrasound was done at the end of January and his pancreas looked fine at this time and he was throwing up the day before so theoretically it should have been inflamed if this was causing it directly. His renal failure is a mix of being born with one small kidney and age.

Scratchy has been tested both for diabetes and hyperthyroidism and he was clean in late November of 2013.

I am hoping it is the food, he has been exclusively on First Mate food a few times and he still threw up multiple times and this food only has three ingredients.

At this point food is my number one target and I will see how he does on the latest food. I weigh him everyday so it is easy to see when his weight drops and how much it goes down. Scratchy left a poorly formed stool after the new food so I will need to see if this settles down as well, sometimes it doesn't and then I have to switch him back to Medleys to settle him down. So far so good with the Weruva food, he didn't like the peas and carrots in the Gradma's Chicken Soup flavour but he would eat the rest of it without a problem. I also grabbed three different pouch flavours so I am trying them out today and so far so good.

I put a bit of the Grizzly Salmon Oil with Omega 3 & 6 and he would lick this right off of the plate so this looks good. I have to figure out how much to give him each day and whether I just give it to him or put it in his food. I am very scepticle of doing anything with this food because the last thing I want him to do is to stop eating.

I did ask the vet if there was any problem mixing Famotidine with his other drugs and she has said the drugs Scratchy is taking should be fine. I need to check and see if this is the case with slippery elm though, the Cerenia and Budesonide which he currently taking may not be so happy though.

Last night was okay for Scratchy but his stomach started acting up sometime in early morning so when I got up he was in his cat box and I could hear his stomach making from outside the box. His cat box is his safe zone and I never force him out of it so he went the day without pain killers and I really would have liked to have given him his pepsin early because of the stomach noise. He was a little cranky when I got home but he was hungry and ate his fill.

The vet was also mentioning laser therapy so I asked for some information and this is what I got...

I got some information from Yvonne about the laser therapy for Scratchy and thought I'd pass it along to you!
Here are Yvonne's thoughts:

1) It's safe!  NO risks in doing this.

2) It's not painful...in fact, it feels good.  I learned about it when it was used on me when I was in physio several years back.  It made me feel good immediately (warm and soft tingly from the endorphin release) and made me much more mobile all day long.

3) There are many anecdotal reports from vets who use this all the time about use on pets with IBD/cystitis and they often report great results.

4) The ideal way of treating is 3x/wk for the first week, then twice a week for the following week and then once weekly thereafter. As this is not a documented way of treating IBD we won't charge for the first 4 treatments and after that you can decide if you want to continue if it seems to be helping Scratchy.

5) If he was my cat, I'd try as I don't see we have anything to loose.

ONE caveat: if he has cancer, it MAY accelerate the development of signs.  I REALLY don't think he has cancer, as he's been so stable (and improved actually) for the past almost year.  The ultrasounds are stable etc...cancer is an extraordinarily remote chance. I would still think that trying the laser is a good idea.

You can also go to www.litecure.com and check out the info for pet owners to learn more about the laser!

 

ThatGuy,

The laser therapy could be beneficial, noticed some improvement with my Cystitis cat after only one session....

Yes, Boo and Scratchy look so much alike , makes you wonder about that particular breed perhaps and the IBD correlation... My Boo was actually my son's and his financee to begin with.

He was the only one to survive out of a litter of 5 and the mother quit nursing him at 4 weeks. Boo actually looks more brown that black and has some stripes going through his fur that can be seen when he is in the sunlight.

He has always been a long slender cat, never been stocky.

And you are right about the increased appetite, sometimes Boo acts like he can't get enough food and will eat several times a day but this does not happen everyday...

I would try just one protein source, if he likes chicken stick with Weruva, Tiki, some of the canned versions that have no grains, additives, preservatives.

The reason I say this is at least with Boo I he was eating chicken for awhile but at that time it was a brand from Petco called Soulistic. Well it had I believe Tapioca in it as a clumping ingredient so the Tapioca could have been what caused him to throw up and not necessarily the protein source of chicken... It is hard to know when you have a food that has something added like the tapioca to know for sure what the culprit is.

We then changed to Nature's Variety Instinct turkey Limited ingredient diet in the Dry and Canned, he ate that for over four months with no throw ups, no problems TILL we had a tornado go through our town and the sirens went off. It was also the same day that my son moved backed in with us for awhile .

I grabbed him up and proceeded down to our partial basement, which Boo had never been before. He threw a fit, stiffened up, meowed really loud and started digging his claws in me.

I think maybe, just maybe, that the upset and stress of that event started a flair up. The next day I woke up to vomit, then it just started going down hill from there. He started scratching, his ears got red, blotchy a section was swollen.

We are now on the RC hypoallergenic with the Natural Balance LID dry duck & pea.

I do not give him any other protein source but I am looking for different varieties of canned duck that have no added junk to them, I know there are some out there just can't obtain them in any of our local pet supplies stores.

Tried Nature's Variety LID Duck, he would not eat it, Tried Natural Balance Duck & Pea, he wouldn't eat that either or the EVO Duck, picky cat he only likes the $2.80 can of Royal Canin  Hypoallergenic !

I truly don't know if the culprit is a grain or if it could have been the protein source that is where I am lost... I thought he was going to flair after him breaking into my other cat's food as he started a little bit of scratching, acted like he was wired up for a day (acting nervous, alot more pacing around the house)...

I will not tell you what to do, I only voice my opinions based on experience of Boo... I only give one protein source for awhile because IF the culprit is the protein source he is eating within a matter of one day to two weeks he will start showing signs.. The same with grains, I simply skip the grains all together because corn, wheat and rice are  big allergens for cats which can cause an inflammatory process in IBD cats..

If you are dealing with Food intolerance allergies protein sources that are known to cause problems are Chicken, Beef and even fish..

Now the fish oil, I can't say but it is the actual protein, so fish oil may be ok.

We have had good luck with the duck, next I guess will be something else that he has never been introduced to if he flairs again...Don't know what that would be, perhaps quail, etc...

Hope Scratchy is feeling well today, he is lucky to have such a great "parent"......

That;s good advice with the food but I had planned it a little differently. Scratchy has never had duck, I don't care for it so I guess this influences what I buy so by extension Scratchy doesn't either. The plan was to use the Weruva with chicken because they have a bunch of different flavours and one has duck. Because Scratchy hasn't really eaten this then it is unlikely he would have a reaction to it an it gets him used to the taste so if chicken fails it will be an easier transition to the duck. I went back and bought a bunch of food (the 7 month old black cat didn't want to come out, he was busy sleeping) so I am set for food. I am really interested in the slippery elm, this sounds like it is worth a try as long as it doesn't block his drugs or food absorption.

Today was not a good day for Scratchy, when I got up his stomach was making a lot of noise and he only ate part of his food last night (the Weruva food). I was able to give him his Pepsin early this morning but he ended up throwing up an hour and half after I left. His stomach was making noise when I got home but it wasn't too bad and he did eat half a can of food,. He went in the sun for a while and then went and hid in his cat box for about three and a half hours. When he came out for a water break I was able to block his house off so he couldn't get back into because he still needed a sub-q and pain meds. I could see he was really uncomfortable so I hung out with him for a while and then gave him a sub-q. He knows the daily pattern and usually he is fairly easy going and it is easy to give him a sub-q but when he feels crappy it can be a challenge. Today he lost a bit of weight and felt dehydrated so the sub-q will probably help him feel better.

I have used slippery elm bark (SEB) for my cats .

The only cautions would be if your cat has elevated calcium levels.(SEB contains calcium and phosphorus)in minute quantities.

Also you want to administer 1-2 hrs either before or after giving RX meds.

You can give up to 4 times a day.(max dosage)

According to weight, based on a 10 lb cat it is as follows:

a tsp( 5 cc) five min before a meal.

Mix 1/4 tsp SEB with cold water, the loose  bulk form will be fluffy so pack it down to measure

Or to make syrup:

place 1/2 cup water and 1 tsp SEB in sauce pan, whip with fork, bring to simmer. Simmer and stir for 1-2 min. , cool and refrigerate.

Give a tsp or 5 cc for 10 lb cat 5 min before meals.

What I do when Boo acts like he is not feeling well (appetite not as ravenous) I mix up a capsule 1/4 SEB (inner bark, capsules I get already measure out to 1/4 tsp, brand Solaray, 400 mg)) , open it up, add   2  tsp water, mix it up with spoon. this will give me a slightly thick Gruel. This also gives me two doses of 1/4 tsp (1.25 ml) in a syringe for giving once in AM and once in PM. I refrigerate this and if paste is too thick I simply add a little more water before I give last dose.

 Now, it may not be exactly the instructions given but this what I do...

It is best to start out slow, perhaps only giving 1-2 times a day for awhile to see how it is tolerated..

I have never had an issue with Boo when giving him the SEB...

SEB is a "natural Pepto-Bismol) coats, soothes, and lubricates the mucus membrane lining of the GI tract.

Excellent treatment for for ulcers, gastric colitis and IBD.

Can be used to relieve Diarrhea/ constipation. It may have benefits for alleviating nausea and vomiting due to NON GI illnesses, like kidney disease.

It is beneficial for relieving inflammation of virtually "any" mucus membrane. Can be used in place of anti-acids or with anti-acids meds (not to be given at same time though)

SEB contains: Beta- sitosterol, campestrol, calcium, iron, magnesium, manganese, potassium, selenium, zinc, beta-carotene, B1, B2, B3 & vitamin C.