The well-known problem of IBD or lymphoma and pancreatitis

You guys. Every post I read about Leukeran is not good. Seems that it does worse than good

Can I butt in here to get some IBD advice? I'm trying to decide whether to get my cat an ultrasound Thursday, but she's already been on steroids almost a week. Her situtation is described in more detail here:

http://www.thecatsite.com/t/310152/...ive-my-cat-steroids-prednisolone#post_3881973

samus said:

 
Can I butt in here to get some IBD advice? I'm trying to decide whether to get my cat an ultrasound Thursday, but she's already been on steroids almost a week. Her situtation is described in more detail here:

http://www.thecatsite.com/t/310152/...ive-my-cat-steroids-prednisolone#post_3881973

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Hey, so i've been through the entire IBD disease with one of my cats, start to finish, biopsies, ultrasounds, treatments, the works.  I read your post in the link, and some of the other posts.  Ideally you would have had the ultrasound before starting the steroids, but there are still things the US can reveal including thickening of the intestinal wall and loss of layering.  This can still exist even while the cat is on steroids.  What is less likely to exist is microscopic information that a surgical biopsy would reveal.  My cat was on steroids for almost 18 months and while this thickening would reduce over time, it never went away 100%  The US could also reveal a mass if the issue isn't IBD.  Your cats first symptom was loss of appetite which can be a symptom of IBD, but much more common symptoms are diarrhea or vomiting. An US can also reveal an inflamed pancreas or inflamed lymph nodes.

if it was me I'd get the US.  The only thing to lose is money, and there are still things to gain.  My cat probably had 5-6 US's over the course of his illness.  When IBD is severe, its war.

The bigger issue is the treatment plan to get your cat into remission.  If you don't get her into remission (remember IBD isn't curable) then she dies.  It is not a disease that has a history of responding to holistic treatments,  It is a very complex and serious disease that typically responds to a wide combination of treatments, and yet can by itself can lead to more illnesses like pancreatitis, small cell lymphoma etc.

When the disease is at a serious stage it generally requires a full frontal assault, and then you hope for the best for as long as you can.

I recall you being concerned that if you started her on steroids she would likely be on them the rest of her life.  Probably true but that means she dies later, not sooner.  And some types of IBD (there are different types but they can only be determined via biopsy) allow a tapering of steroids in some cases.  You may be able to experimentally try tapering in the future.

Bottom line, if you and your vet believe you are dealing with a serious case of IBD then her future is some combo of diet, steroids, B12, pepcid, Flagyl, cerenia, appetite stimulants, new steroids (look at budesonide), and finally Leukeran, a fairly mild "chemo" that gets a lot of bad press in threads but actually works with about 80% of cats, or at least doesn't cause bad reactions in 80% and can help them if nothing else will.  And then you run with all that for as many plays as you get, then you throw a few hail mary's, and you get as much time as you get, hopefully a long time.

Thanks, Stephen. It's so frustrating, my partner doesn't even realize how close our cat is to dying. She's been eating about 50 calories a day and it's a miracle she doesn't have hepatic lipidosis yet. I'm scared to feed her too much at once because up until Saturday she was vomiting. Maybe I'll get to 70 calories tonight. By Dr. Pierson's "15 cal/lb to avoid hepatic lipidosis" she needs like 100...

samus said:

 
Thanks, Stephen. It's so frustrating, my partner doesn't even realize how close our cat is to dying. She's been eating about 50 calories a day and it's a miracle she doesn't have hepatic lipidosis yet. I'm scared to feed her too much at once because up until Saturday she was vomiting. Maybe I'll get to 70 calories tonight. By Dr. Pierson's "15 cal/lb to avoid hepatic lipidosis" she needs like 100...

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Is she on Cerenia?

arinlars said:

You guys. Every post I read about Leukeran is not good. Seems that it does worse than good

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@arinlars, people are more likely to tell about their negative experiences online, so its kind of skewed. There are plenty of people who have had positive results with Leukeran. Even after hearing all the good and the bad, my ultimate decision was not to pursue it. I don't really know why. Strong intuition?     You just have to take all the information you have, talk to your vet, and do what you think is best for your kitty.

@samus, I'm sorry about your cat. Can you syringe feed her? I've been down a similar road as @StephenQ, but I didn't get a biopsy. I have had success with holistic treatments, but they're not used alone. My cat Sebastian likely has small cell lymphoma and gets a combination of Western/traditional medicine, Chinese medicine, general holistic, homeopathy, and even a natural chemotherapy. I'll also second StephenQ's question about Cerenia. Sebastian couldn't be without it. Perhaps I should be posting this over on your thread...    

Hi,

I would opt for the ultrasound because it's non invasive, the cat won't feel a thing and it will get a nice soft shaved belly also, and it's waaaay better than to have an endoscopy or even explanatory surgery where the cat will have much pain after for healing. And you will know more or less what you are fighting. I agree with everything StephenQ.

Give the kitty toppers if she won't eat, fish flakes or give her even ANY food if she won't eat. She must eat something. Also baby food the Gerber with chicken only (blue lid) is helpful or even syringe feed her. Put the food in the syringe and give it to her slowly. Do all this with approval from your vet.

Cerenia is a drug that stops vomiting and nausea. Steroids are not the same for animals as for humans. She won't beef up, it will just suppress the inflammation.  

Now to Mimi's update:

I talked to the internist vet. The had to consult 4 times to reach to an opinion. They told me Leukeran is aggressive and not preferable for IBD only when the cats condition is serious. Mimi:

-is playing (not so much because she is also 13),

-she has appetite (she eats all through the day but she always did)

-and she is energetic, again not as she used to be because she is old.

Due to those facts, she is not a good candidate for Leukeran and that the diarrhea stopped and the vomiting is not persistent, they suggest to continue with 5mg every day for the prednisolone and give her Cerenia for vomit, Tylan for diarrhea and also Famotidine. If Tylan ends then we start with Metronidazole (only if she has diarrhea). I feed her pork Dehydrated raw from Primal which also has mormolite clay which helps with diarrhea (I noticed that in the limited ingredient NV also). If she pukes again, then I will give her beef and so on. 

For diarrhea it helped A LOT to give her, per wonderful suggestion, S. Boulardii.

So we will go this route and pray. Then if it gets worse we start Leukeran. By worse I mean diarrhea, loosing more weight and feeling crappy. I noticed Mimi is calm sometimes but then again she sleeps near the nice heater, anyone would be. And also at night she gets frisky and plays around. When I give her pills and then reward her with bonito flakes, man, she goes NUTS she purrs rolls around. 

Well that's my update. I hope she will get better. The only thing that makes me worried is after she eats she sits in loaf position for 5-6 minutes then she goes with her day. So is she in pain or nauseous? I don't know and it breaks my heart.

Haha I know about steroids for humans, I was on prednisone for a while.... made me super bloated and moody. I cried from particularly emotional commercials. My friend called it "preggers zone." Unfortunately I can't find ANY baby food in this country with JUST meat, only meat and rice and that might have been causing the diarrhea, because it stopped when I stopped the baby food. (I looked in so many stores, and even on Amazon...)

My cat overgrooms her stomach, so they might not even need to shave. Actually, that should have been my first sign that it was coming back, because her hair was growing back for a few months and then all the sudden it was gone again. So many signs I should have noticed...

Do you pill your cat with the S. boulardii? Mine haaaates it when I sprinkle it on her food and I could only find giant human sized pills. I hate looking at my cat and knowing she's in pain. Sometimes I give her catnip when she meatloafs and she eats it and sits up straight again. It's actually pretty effective at stopping her from vomiting when I hear her heaving. But when she was doing really bad last week she wouldn't even look at it. I think the smell of ANYTHING made her nauseous.

Which country are you in ? I bought the gel capsules #3 from Amazon . I put the SBoulardii in the small capsules and give it to her then give her a little treat like bonito or dried fish flakes . There are YouTube videos how to pull a cat safely.

Did you try the raw or dehydrated raw ? Natures variety instinct ? Did you try novel proteins ? If she doesn't eat at all go to the vet to try and syringe feed the cat or give appropriate meds

samus said:

 
Haha I know about steroids for humans, I was on prednisone for a while.... made me super bloated and moody. I cried from particularly emotional commercials. My friend called it "preggers zone." Unfortunately I can't find ANY baby food in this country with JUST meat, only meat and rice and that might have been causing the diarrhea, because it stopped when I stopped the baby food. (I looked in so many stores, and even on Amazon...)

My cat overgrooms her stomach, so they might not even need to shave. Actually, that should have been my first sign that it was coming back, because her hair was growing back for a few months and then all the sudden it was gone again. So many signs I should have noticed...

Do you pill your cat with the S. boulardii? Mine haaaates it when I sprinkle it on her food and I could only find giant human sized pills. I hate looking at my cat and knowing she's in pain. Sometimes I give her catnip when she meatloafs and she eats it and sits up straight again. It's actually pretty effective at stopping her from vomiting when I hear her heaving. But when she was doing really bad last week she wouldn't even look at it. I think the smell of ANYTHING made her nauseous.

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Fortiflora is very tasty probiotic that many cats enjoy sprinkled on their food.

Fortiflora will work for a couple days, and then she gets bored of it I guess. She looooves bonito flakes, but I'm pretty sure she has a fish allergy and that this was all caused by the brand I was feeding her suddenly deciding to put salmon oil in the recipe. I tried freeze dried chicken treats and she doesn't even acknowledge they're food.

I'm in Germany and the options for cat stuff are pretty narrow. You can find all kinds of frozen raw dog food, but I think the raw trend is in its infancy for cat food here so it's hard to find anything. I have tried giving her little nibbles of raw or slightly seared meat when I cook for myself and sometimes she licks it. That's about as far as I've gotten with trying to do raw. I don't have the freezer space, anyway, my freezer is a tiny shoebox sized thing which might be... a week of food? And it freezer burns everything, pretty sure that wouldn't help with the trying to convince her it's food. It's a bummer, though, because I really think the canning process does something to the meat that encourages the wrong bacteria to grow. I posted this on here somewhere else before, the canning/cooking process doesn't destroy taurine at all, but it creates some compounds that really boost the growth of taurine eating bacteria in the gut so the cat doesn't get to use it. I'm thinking these taurine hungry bacteria probably encourage inflammation, leading to problems like IBD.

Now she's eating Vet-Concept horse (and today, rabbit), hopefully she won't develop an allergy to that. I've been syringe feeding her, but not nearly enough. I'm scared if I give her too much at once she'll vomit, so it's been like 10 ml at a time. I feel like I'm only interacting with her to shove food in her face. Hope she doesn't hate me.

I used to live in Germany for years. I know they don't have much selection. Have you tried to make your own raw? Just one batch per week. For testing if anything. They have great recipes online. Or just make one batch and give it to the kitty directly to see if she likes it.

Horse is a rare meat and she could tolerate it well. Also play more with her! After I give Mimi pills I always say nice things to her and give her treats, then we play a bit with a laser pointer ! I'll also PM you for some more info 

samus said:

 
Fortiflora will work for a couple days, and then she gets bored of it I guess. She looooves bonito flakes, but I'm pretty sure she has a fish allergy and that this was all caused by the brand I was feeding her suddenly deciding to put salmon oil in the recipe. I tried freeze dried chicken treats and she doesn't even acknowledge they're food.

I'm in Germany and the options for cat stuff are pretty narrow. You can find all kinds of frozen raw dog food, but I think the raw trend is in its infancy for cat food here so it's hard to find anything. I have tried giving her little nibbles of raw or slightly seared meat when I cook for myself and sometimes she licks it. That's about as far as I've gotten with trying to do raw. I don't have the freezer space, anyway, my freezer is a tiny shoebox sized thing which might be... a week of food? And it freezer burns everything, pretty sure that wouldn't help with the trying to convince her it's food. It's a bummer, though, because I really think the canning process does something to the meat that encourages the wrong bacteria to grow. I posted this on here somewhere else before, the canning/cooking process doesn't destroy taurine at all, but it creates some compounds that really boost the growth of taurine eating bacteria in the gut so the cat doesn't get to use it. I'm thinking these taurine hungry bacteria probably encourage inflammation, leading to problems like IBD.

Now she's eating Vet-Concept horse (and today, rabbit), hopefully she won't develop an allergy to that. I've been syringe feeding her, but not nearly enough. I'm scared if I give her too much at once she'll vomit, so it's been like 10 ml at a time. I feel like I'm only interacting with her to shove food in her face. Hope she doesn't hate me.

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Hey

you may want to start your own thread at this point so we can discuss issues specific to you.

I would get more vet advice, see if you can get her on Cerenia daily as per protocol and feed her in larger quantities and see how that works.  Also you could discuss a short course of mertazapine as an appetite stimulant.

@arinlars, sounds like Mimi is doing okay right now. I hate the meatloaf, though. I think sometimes with these IBD kitties, they almost do feel kind of "off" after eating. Just a guess. Sebastian was doing a similar thing and would meatloaf for maybe 5 minutes after eating a serving of food, but then start happily grooming and come back in the kitchen for some pets and lovin'. 

Does anyone's cat seems some days out if it ? Some day Mimi
Doesnt purr or play, she is just not doing much . Only sleeping .. I think it's the famotidine. Husband says that cats sleep (especially older ones ) 17-20 hours a day.

And did anyone see increased appetite and weight gain with mitrazapine?

My cat's out of it most of the time these days. But she's also feeling like crap and barely getting any calories in, so it's probably that.

I gave Mimi some food with syringe when she didn't eat enough and she got mad lol

Haha so did Samus. She's hanging out with my partner more than me these days because I'm likely to catch her and squirt food in her mouth or jab needles in her. Poor kitty. It's gotten easier to syringe feed her, though. I experimented with wrapping her in a towel, I could get about half a syringe (6 ml) in before she made me rewrap her. I started just covering my lap with a gross blanket and holding her on my lap without wrapping her up and it seems to work better. I also found I can't squirt in more than 1 ml at once or she'll spit half of it out anyway. (I keep reading that you can feed 3-5 ml each bite. Not with my cat!!)

No I'm scared to feed her more than 1 ml I am scared she'll get chocked so I put 1 ml x7-8 times. But I'm not sure how much do they need per day . Can someone enlighten me ? She also ears on her own but not that much .this is only at her sick days . She usually eats the whole can.

1 ml seems to be best for my cat, I've tried 2-3 a couple times and it always seems like half of it comes back out so I don't think doing more worth the worry of choking.

I go by what Dr. Pierson at catinfo.org says about amount:

 
Hepatic lipidosis can also develop when a cat consumes 50% or less of his daily caloric requirements over a period of many days.   The definition of "many" varies from cat-to-cat.  For this reason it is important to understand that you need to have some idea of the calories from canned food combined with the calories from dry food that your cat is consuming on a daily basis while you are implementing the transition to canned food. 

I have never seen a cat develop hepatic lipidosis when consuming at least 15 calories per pound per day.  This number is figured on lean body weight, not fat weight. 

If your cat weighs 18 pounds but really should weigh 12 pounds, please make sure that he is consuming  ~180 calories per day.  (12 pounds lean body mass X 15 calories/pound/day = ~180 calories/day)

In reality, the cat in the above example would probably be completely safe at only 150 calories per day.

If you have a small female cat that should only weigh 9 pounds, please make sure that she is consuming at least 135 calories per day.

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So I use that for my minimum. If your cat's eating a can a day and not gaining or losing weight, then I would probably make sure it has at least half a can on the sick days (more if possible). My cat is a little more than 3 kg (a bit less than 7 lb) and I have to try really, really hard to get her to eat  100 calories. I don't think we're going to do it today because she vomited earlier.

I'm really obsessive and I have a little scale I weigh her food bowl on before and after she eats to see how much she really eats so I know how much I have to force feed her. She's only eating about 5 g at a time on her own right now. Supposedly you can feed up to 60 ml in one sitting, but I've never made it that high. I fed 40 today and she vomited, but that might be from other reasons. Usually I can get in 15-20 ml per meal (but after 6 or 7 ml she always starts fighting more and after that is harder).