Boo has Cholangitis and cholangiohepatitis, probable IBD

Well, yesterday morning didn't start off too well for me as my ISP had to send a repairman out to find problem with my internet . He was here for two hours and then one hour later Boo comes flying down the stairs and proceeds to throw up all over. He then gets in the litter box and has a normal bowel movement.

After that he was acting like he was in pain (tail thumping, curled up in a chair that he normally doesn't lay on.)

called vet said I was bringing him in......Three hours at the vet, physical exam, x-rays... Vet showed me something that looked suspcious to her an wanted to do a sono of gallbladder and liver.

Results showed enlarged gallbladder with "sludge" and liver looked to be inflamed.

Blood work showed an ALT of 891, ALB, ALP, AMY, TBIL, BUN, CRE, LYM, MON, NEU,EOS , red and white blood cells all in Normal Range.

She said to Boo he was lucky to have such a good mother that we got him there in time. he was given an injection of medications for nausea and pain and given Sub Q fluids.

Bad news, he bit the tech and they by law, have to fill out some form and I have to take him back in 10 days for "observation", even though he is up to date on his Rabies vaccine ...

Plan of action: Clavamox twice a day for 6 weeks, Buprenorphine liquid, 0.15 ml, twice daily till gone, Ursodiol (Actigall) 1 ML once a day for 3-6 months, 5 mg pepcid once daily.

Boo has probable IBD (inflammatory bowel disease), he has been on Royal Canin canned Hypoallergenic Pea & Duck, he also has Natural Balance Duck & Pea dry...

Problem is he has been on it for about 6 months and I feel it has worn out it's welcome and do not have a clue what to try next.

He has been Nature's Variety Instinct LID in Turkey before that but after 5 months he starting throwing up, was diagnosed with Pancreatitis.

I want him to eat canned, tried Nature's variety Instinct Rabbit, nope, tried their Duck, nope, tried the venison, nope... tried Hill's Hypoallergenic Rx canned in duck, no way. He settled on the Royal Canin Duck in canned but what in the world do I do now ?

Yesterday early evening and later in the evening he ate very well for me but this morning it was touch and go, no canned but did eat enough dry so I could give him his meds....

he is acting fine, up and about, alert, just the appetite !

he has been fine, yesterday morning before the throw up he had been in the bathroom and shredded a roll of Toilet paper, jumped up into the bathroom sink, ate well, nothing appeared to out of the norm.

I also have to sprinkle some fortiflora on his dry, it seems to entice him, but even that is not a given today.

He will turn 4 the end of June and that seems so young to have all of these medical issues.

Any suggestions ?? Raw is out, he won't touch the stuff..

he also had been getting a probiotic and Curcuvet once daily but as of yesterday I am only giving him the probiotic, especially since he is on an antibiotic.

Also my cat Spook is having a cystitis "flair", probably because I slept upstairs last night with Boo to monitor and because he smelled that Boo had "other scents " on him after returning from the vet... Sad, but yes, this is all it takes sometimes for this cat to have a flair, a little change in routine, something slightly out of the norm, he flairs.....

What to do people ?????????? anyone ?????

I don't remember from your last post if a steroid has been tried.  Often with inflammation a steroid is the quickest way to get it resolved.  Young kitties can get this stuff too.  My kitty had his first IBD flare when he was 18 months old, I just didn't know until several years and vets later that it was an IBD flare.  Unfortunately what you are describing with the food happens a lot with this stuff.  A food makes them feel bad or it coincides with a flare and they won't eat it anymore.

Prednisone is something we feel we need to stay away from for the simple fact that Boo has had it twice and both times a few weeks later he has developed Pancreatitis once and developed a UTI once , coincidence ?, maybe but I think he and that particular steroid don't get along well.

vet is looking into possibly another type of steroid for she feels we may need to go to something to treat his IBD...

Eating well now since vet suggested giving him an appetite stimulant, 1/2 tab every three days... Hope he keeps his food down...

Thanks

DonnaJean said:

 
Prednisone is something we feel we need to stay away from for the simple fact that Boo has had it twice and both times a few weeks later he has developed Pancreatitis once and developed a UTI once , coincidence ?, maybe but I think he and that particular steroid don't get along well.

vet is looking into possibly another type of steroid for she feels we may need to go to something to treat his IBD...

Eating well now since vet suggested giving him an appetite stimulant, 1/2 tab every three days... Hope he keeps his food down...

Thanks

Click to expand...

The pancreatitis and the food he was eating at the time is a mystery since he also was taking a steroid ..so to play it safe we switched protein source from turkey to duck...

She is probably looking into Budesonide.   More of it stays in the digestive system rather than going into the rest of the body, it's even thought of as a topical steroid for that reason.  It is unusual for a kitty to not tolerate the Prednisolone at least short term but I am sure there are kitties who don't tolerate it well.

I am glad that he is eating.  Hopefully it will stay down and he continues to eat.  This chronic digestive stuff is frustrating and the solution isn't the same for all kitties.  You said you tried the Nature's Variety LID, did he not care for it or did it disagree with him.  To be honest my kitties don't eat it as readily as some of the other foods.  Wild Calling makes some decent foods in unusual proteins like pheasant and buffalo.

Yes, I think it might be the medication you posted about.

She said although a steroid it does not have the side effects like other steroids.

Boo ate the Nature's Variety Instinct LID in Turkey (turkey only, rest he did not like), only switched because when he got sick last time figured it was time to change protein source.

he has been holding down the food, I am thankful for that.

RC makes a Hypoallergenic RX diet in Rabbit but their dry has Soy Protein listed in the 3rd or fourth ingredient and although soy usually isn't a big threat, never than less it could be a potential allergen.

Why would they put soy protein in their hypoallergenic diet ??? Doesn't make sense.

The canned version doesn't appear to have soy protein.

Too bad Natural Balance doesn't make a dry and canned in Rabbit, only Duck or chicken and the same for their canned but venison has been included, just not in the dry.

I would love to go to canned only but he is insistent on having a little dry.

So my problem is finding a good hypoallergenic dry and canned in something other than chicken, turkey or duck that does not have soy proteins, no coconut oil, etc.., which right now I am at a loss... Back to scouring the internet ....

Yes, I really have a gut feeling that the steroids he had been on twice before does not agree with him, just like humans there are certain meds that we are sensitive to and can not take.

What do you think about "Addiction" hypoallergenic cat food ?

They have a dry and canned in Venison and since I would only want to give one protein source at a time these are the only two that come in dry & canned.

problem is, he would probably eat the dry but the canned is what I am worried about.

Also I really wanted to stay away from Guar Gum, the venison in the canned has Cassia Gums, wonder since I have looked it up yet if it is the same as "guar Gum " ?

Almost all canned with very few exceptions has Carregean (sp ?) and Guar gum, which I think can also be not too good for cats with IBD and allergies...

Addiction is a good brand and all three of mine ate their rabbit in some quantity, but I can't offer it to Sebastian anymore because of the guar gum. To avoid both guar gum and carrageenan makes for very little options to choose from. Its very frustrating.

Just a comment on the Clavamox...it can cause an upset tummy and/or vomiting in some kitties. The antibiotic that Sebastian was on was metronidazole, which is commonly used for GI issues.

@DonnaJean, when it comes to gall bladder, liver and pancreas issues, one can affect the other.

From http://www.marvistavet.com/html/body_feline_cholangiohepatitis.html:

In one study, 80% of cats with cholangiohepatitis also had inflammatory bowel disease and 50% also had pancreatitis. Feline anatomy is a little different from that in other species. In the cat, the pancreatic duct, which delivers digestive enzymes to the intestine, opens into the same “pore” as the common bile duct. Both ducts share a “doorway” to the intestine. This means that if bacteria invade the doorway, both the liver and pancreas are at risk for infection.

Click to expand...

Thanks,

Boo is on the Clavamox and the Metronidazole was added on 5 days ago....

Vet is ok with trying Addiction rabbit & Blueberries canned and I have ordered from my pet supplies store nature's Variety Instinct LID Rabbit in dry since he still eats a little dry with the fortiflora sprinkled over it.

We also started Boo on S. Boulardi, I had the vet research it and she called me back to say it may be beneficial...

We have spread out the Clavamox , instead of one tab twice a day it is half dosage 3 times a day.

He is doing well, keeping food down so far and acts like he is feeling better.

The Actigall, it is a liquid, unflavored but he really likes it ....he will need to be on it for 3-6 months according to the vet.

She also would like to test his b12 level and see if he may be low and could benefit from injections.....he had them before when he had pancreatitis...

She said she wants to not start any steroids at this time ....

Now I am having issues with Spook, he had a flair last night of his Cystitis, brought on probably from anxiety of Boo stalking him and the grandson is here for the weekend.

I actually gave him 1mg of Valium, he had a script for it for a flair he had before and I had one left, this seems to relax him and then he gets in the litter box and urinates a normal amount instead of sitting in the litter box for 10 minutes and only producing a drop....

He is on unfortunetly, Hill's Multicare stress urinary health RX which has done nothing for his anxiety..and RC s/o canned.

Still nothing out there for his issues that does not have corn in it and other ingredients that I am not pleased with but I do not want to see him block again either.

I am thinking about purchasing again Feliway plug in, the spray and bach rescue remedy, I am at a loss as what to do for him...

Glad to hear Boo is eating and acts like he feels better! B12 injections are a good, safe thing to add to his regime. We started Sebastian on B12 injections before he even had the test done.

I'm sorry about Spook.