Obi has an appt. with internal medicine today - He has Pancreatitis

Obi, as you all know, throws hairballs.  I have him on a regiment for them. I would say he is better than he was but is still throwing up hairballs, irregulalrly.  Sometimes he goes more than a week with none; sometimes it is twice in two days, so it really is too often no matter what.   However, today  I had the occasion to speak with an oncology tech at the UW Madison Vet School.  She has had cats with lymphoma, and said that it started with vomiting.  Well, Obi doesnt vomit per se, he vomits hairballs.  Once in a great while, some food comes up, a small amount.

So, I am on the fence.  When I google for symptoms of small cell lymphoma ( I already am pretty certain he does not have large or medial cell), he does not show those symptoms.  If an ultrasound was not hundreds of dollars, and did not require that he be stressed, I would probably go ahead and do it.  But is is pricey, and I have to have his belly and sides shaved, and that makes me sad.  I realize it is part of t he price of the procedure, and what matters is his health.

I know no one can tell me what to do, but what would be the differentials if this was your cat?

The way I understand it to be right now I would probably just continue doing what you are doing.  His history does sound like there is probably some kind of IBD/IBS going on that is causing motility issues.  He is eating well and not loosing weight I probably wouldn't get the ultrasound.  When my kitty had one done he was in a severe IBD flare that had gone into fatty liver.  

If his appetite falls off, he begins loosing weight, or starts with actual vomiting then an ultrasound would probably be a good idea.

Thank you, Denise.  I appreciate your input.

I would hold off on the ultra sound, not just because of the cost but because of the stress.  One of my cats is having to go in for one tomorrow and I know it will be stressful for him and for me.  If Obi isn't showing any other symptoms you can probably wait and see.  You might want to talk with your vet about why he has so many hairballs as their might be some other condition that is causing him to groom more often and so he is ingesting a lot of hair.  I have heard that adding a small amount of olive oil to their food can make it easier for the cats to pass the hairballs through the intestinal tract rather than having to 'vomit' them up.  One thing I would look at is when the small amount of food came back up had he recently eaten, if not that might be a warning sign of something.

Not that the tech you spoke to is wrong, but one thing to remember that just like human doctors and nurses when someone specializes they often begin to see the world through their specialists glasses and even minor issue take on greater meaning.

I know the deciding factor for me would be a totality of 'symptoms' maybe it would help if you wrote down all the little things you notice and if they start to form a big picture you will know better what your heart and gut are telling you to do.

Hi

An ultrasound is not going to tell you if your cat has lymphoma or IBD. It can show if some of his intestines are thickened. It will also show what the liver, kidneys, pancrease (sometimes), gall bladder and lymph nodes look like, but it will not give you a definitive answer. The only way would be to do an endoscopy with biopsy. If you are going to do that it would be best you use a specialist for that.

If is was my cat I would not do either right now. As long as appetite is good an everything else is fine I would wait. I would however implement a hair ball preventative and start a daily brushing routine with your cat. Look into the furminater for cats. It is a pricey tool but well worth it as it lasts and lasts and the amount of hair you get off of the cat is amazing.

Hi, Quiet:

Thank you so much for your input.  I bought a furminator a while ago, and Obi HATED it, I could not get that sucker near him.  but, I have been brushing him with a wire brush when he is eating, and he is used to that, as is my other cat.  But - I just found my Furminator, and used it on him while he was eating - and WOW.  Yeah.  Amazing.  Its the furminator from now on.

Hi, Enypath, and thank you.  The tech I spoke with had 2 or three cats with lymphoma, and it started with hairball and other vomiting.  Obi rarely vomits food.  Just hair clots. 

The only definitive symptoms I see are the hairballs, and overgrooming (not severe) of the lower abdominal area.  His attitude is good, his appetite is good, no diahrrea, playful for a 15 year old, no hiding.  He is on 2.5 mg of predisolone, but I think that if he was more ill, that small an amount would be insufficient to maintain a healthy appetite.  As far as I can tell, he is not losing weight.

Its just that so many people here and elsewhere equate chronic hairballs with lymphoma.

Just trying to think of things you can do that will help if it is just furballs from over grooming or having that kind of hair. They also make these gloves that are kind of a mitten that is made out of rubber and has little nubs on it. I have a horse that hates brushes and I use it for her. It works great. There are no sharp parts to hit bones and sensitive areas. Some animals are much more tender skinned than others. (Even my horse). I have seen the glove at tack and feed stores for about $ 4 or $5 so I am sure they make one for cats, but if it costs more then check a feed store for one. Another thing that helps is a damp towel. Barely damp and get one of those silly microfiber plain white towels. They sell them in Kmart for around $5 a 5 pack. I rinse them and wring them out till just barely damp and it picks up cat fur like a champ.

Not that you asked for budget cat care, I just hate seeing a towel like the one I mentioned above at a pet store half the size being called a "Feline Fun  Furry Towely" and costing $10. Or seeing the same thing at an equestrian supply place and them calling one of them 1/4 of the size "THE DRESSAGE DRIER COTURE 100% MICRO FLUFFCICLE FIBEROPTIC FOOFOO FOR THE FACE" and charging $50.

Sorry I digress. I sure hope everything goes well. And also are you giving anything for the hairballs to help them pass  through?

A mention on stress. Stress is so bad for cats. I think it is great that you are considerate of your cat's feelings and reactions to stress. Many people, vets included overlook that. The diagnostic should never harm the cat.

Take care.

Quiet:  I had one of those gloves, and I did toss it.  I guess I should not have; the key to grooming my cats seems to be to do it when they are eating, which I implemented rather recently.  But I do have microfiber towels, and have seen them also in the hardware store and the dollar store.  I have used baby wipes but those dont do much.  I think re-discovering the furminator is really helpful.

I have been around the block - several times with hairball remedies.  At present, he is getting slippery elm syrup three times a day; 1/2 capsule of powdered egg yolk lecithin twice a day, and 1/2 tsp probiotic once a day.  Need I say more.  What we do for the love of our animals.

Yes, in relation to an ultrasound, stress is definitely a consideration.  Also he has to be shaved - a lot.  I dont think Obi would like that.  Dont get me wrong, I would do it in a heartbeat if it was going to give me conclusive information, but several posters here, and a conversation I just had with my vet, affirms that an ultrasound does not differentiate between IBD and lymphoma. 

myrnafaye said:

 
Quiet:  I had one of those gloves, and I did toss it.  I guess I should not have; the key to grooming my cats seems to be to do it when they are eating, which I implemented rather recently.  But I do have microfiber towels, and have seen them also in the hardware store and the dollar store.  I have used baby wipes but those dont do much.  I think re-discovering the furminator is really helpful.

I have been around the block - several times with hairball remedies.  At present, he is getting slippery elm syrup three times a day; 1/2 capsule of powdered egg yolk lecithin twice a day, and 1/2 tsp probiotic once a day.  Need I say more.  What we do for the love of our animals.

Yes, in relation to an ultrasound, stress is definitely a consideration.  Also he has to be shaved - a lot.  I dont think Obi would like that.  Dont get me wrong, I would do it in a heartbeat if it was going to give me conclusive information, but several posters here, and a conversation I just had with my vet, affirms that an ultrasound does not differentiate between IBD and lymphoma. 

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Nope, correct, it doesn't My vet said the same. He said you'd have to go with an endoscopy and even then it can be hard to distinguish between cells. So at least we have vets with a similar mindset on that one. I guess with the ultrasound, we could at least have confirmation that the intestines are thickened so we'd know for sure if there are motility issues with our cats. I guess I would like to know that but the stress factor for my Grace is a big consideration for me too. She yowls pitifully just to go 10 minutes down the street. I can imagine what a 45 minute car ride would do to her, along with being shaved and held down. Just know I am offering my continued support for you and Obi. Hopefully we can both get through this with our cats and find a regiment that works. Meanwhile I am going to get one of those brushes too to now use along with the EYL.

Late to this thread, but I agree with the others. If Obi is eating and otherwise behaving normal, I'd skip the stress of the ultrasound and continue to work on identifying triggers, if possible. I don't think it will tell you much at this point compared to the cost to your bank account and cat.

Hi, A&T:  thank you for your input, and you are not late, I just posted this yesterday in frustration and anxiety.  Obi is eating well, and maintaining his weight.  He is a little more quiet than usual, and that worries me.  Not out and around much but not hiding, and there is the overgrooming of the belly area.  I guess I should have mentioned these 2 issues when I first posted, so for those who are following this thread, if this changes your thoughts or adds to them, Please do let me know.  My big worry is about the possibility of lymphoma. Obi is 15.

I would also ask: Would a diagnosis of lymphoma change how you are managing him? If not, then my advice is the same. If so, I'd continue to watch and wait a little longer to see if he bounces back or worsens.

And I am really scared.  And worried.  He threw up hair yesterday and today, and is not screaming for food this morning.  (he cannot have food just in case we decide to do an ultrasound).  Its just too hard to have him throw up hairballs, and this morning also some "spit"; and to feel this helpless.  I just hope it is not going to cost a fortune, and that I have some answers.  Most of all, I hope it is not lymphoma.

Poor guy. Here's hoping they can provide some answers and help manage and control his hairballs. Please let us know how it goes!

I hope you get some answers. 

Thank you both.  I will.  I just know they are going to want to do an ultrasound.  I am worried about the cost.  And they will probably want to do more lab work.  Obi is 15.  I am afraid of bad news.

Obi had a long consult and work up today with Internal medicine at the local emergency clinic.  I chose not to have him ultra sounded.  We ran a chem panel and a PLI;  I did not do the test that provides high or low values, but just a positive or negative.  I left with panicure to rule out parasites; I will re-start him on metaclopramide; and he will be on bupronorphine.

My questions:  I have had him on EYL, slippery elm bark syrup  and a probiotic for his chronic hairballs.  The vet - who was wonderful - did not know if he should continue with the supplements.  Do folks out there have thought, facts, or opinions about the supplements?  If your cat has pancreatitis, what do feed him?  what supportive therapy do you provide?

And, does your cat with pancreatitis throw hairballs frequently?

All Obi's values on the chem panel were normal.  However, the vet did not say she could rule out lymphoma.

Comments, thoughts and support much appreciated.

The slippery elm bark  might interfere with other medications being absorbed, so I would not give it at the same time as the other meds. 

I'm glad you have some sort of diagnosis.  Not knowing is worse I think.  Maybe in the future you can get the other test run/sent off so you can better manage/monitor his progress.

Hi, Peaches:

Yea, I heard that about the slippery elm.  But when I first read up on it here, it sounded like it was great for a whole lot of things.  Now it sounds like I have to choose between medications, and slippery elm.  I am not happy about that.

What do others think?  should I stop the slippery elm altogether while he is getting his medications?