Newbie w/ 1.5 yr old w/ chronic long term vomiting... IBD, lymphoma??

Hi everyone. I spent much of yesterday reading health related posts here and countless articles online trying to educate myself and make some hard decisions regarding my lil Peanut. Yes... I had to post her picture to try and lure you in to helping us out.   I have been slogging through tons of info about inflammatory bowel and intestinal lymphoma lately and I saw there are lots of people with experience in this area posting here.

A little non-medical background since this is my very first post....sorry if it is tedious. Can skip to the medical info below in bold  (also a bit tedious) if not interested.  I had not had the pleasure of kitties in my life since childhood (over 20 years) until a sickly looking cat started hanging around our yard stalking me. She seemed pretty feral but in need of some help. I made a winter shelter for her and soon found out she was not alone. There was quite a feral cat population in our neighborhood with several pregnant females.  To fast forward and make a long story a bit shorter... With the help of a local TNR group I got her (now named Jess) and one other adult female spayed along with their combined six kittens. TNR group said they had already done like 50 in the area, and there are still more.

Jess actually had her four kittens in our garage and I was able to start socializing them soon after they were born. I initially had no plans to keep them due to it being a very stressful time with family illness. I was just socializing and fostering them so they would not end up feral and homeless. I got lots of help along the way from the TNR group.  The kits were such good therapy during a hard time even with the extra work that we decided to keep two... which quickly turned into three! So now we have Miss Peanut, and her two brothers Tubby and Red. I still miss their other brother, but I know he was adopted to a good home. Their mom still sleeps in our garage, but has let it be known that she is not ready to be anybody's indoor pet. My three pet kitties are indoor only because I don't want them out there with all the ferals and busy streets. This did not make their mom very happy at all when I separated them post neutering even though I waited until they were 15 weeks old to do it. She was extremely upset and so on the recommendation of the TNR group I let her spend time with them and continue to nurse them in the garage on and off for a couple more weeks to ween her off of them. I still have guilt about separating them, but I think it was for the best.

Medical Info

Before vetting, officially adopting the kittens, and bringing them indoors, I got assistance with their medical needs from the TNR group. The kits and their mother had problems with diarrhea and went through several rounds of treatment for various parasites. I was giving them both dry food free fed and meals of wet food. I took them to the vet myself for a checkup when Red was not doing well and eating poorly. After some sub-q fluids, b-vitamin shot, and syringe feeding he greatly improved. When they all were deemed healthy enough everyone including mom made the trip to the non-profit to get a checkup, fixed, rabies and FVRCP vaccines, FeLV/FIV test, injectible wormer, a dose of Revolution, microchipped...the whole-shebang. They got all their follow-up boosters and due to some continuing issues with diarrhea possibly caused by those few extra weeks of mommy visits, more wormer (pyrantel pamoate). They all were now gaining weight, doing well, and now my indoor kitties.  

Then this spring around their first birthday I started waking up to find the occasional vomit with a lot of hair in it. Didn't think much of it other than to start brushing more and try some hairball remedy. It took awhile to figure out the vomit was mostly from Peanut. Even with the extra brushing and hairball treatment the vomit continued. At the first vomit related trip to vet in May of this year was told overall she looked really great even though she was a little thin and not gaining weight as much as her brothers. I asked about food changes and was told it wouldn't be food allergy at only a year old. They said I could worm everybody again just to be safe. I also mentioned that she had started obsessively licking the bare meal rust spots on dog crate and stove burners. I thought maybe she was anemic and looking for iron. But they said it was just a quirk and she didn't look anemic at all.

Few months later... still finding vomit, but no hair in it. Take them for their first annual vet visit for booster shots and was told again that she looked really great, but that chronic vomiting is often later linked to IBD or cancer and if it increases or she loses weight, we need to do a full GI checkup. I started keeping track of the vomit on a calendar and tried some canned food instead of their usual dry which didn't go well (they were finnicky with wet food as kittens).  I started reading up on IBD and contemplating a raw diet, which the vets weren't too keen on. I tried different treats and food and just plain baked chicken several times. I thought I finally figured it out when I cut off her access to the aquarium water she had been sneakily drinking every night while I slept. But then a week and half later the vomiting continued. Later she had a bad case of diarrhea and had diarrhea shoot out one end while vomit came out the other, which was scary. That was a little over a week ago and I made another appointment asap to start the GI workup.

The vet gave her a quick checkup and said overall she looked really good and had actually gained about a pound (up to 9lbs) since her annual exam in August. She took an x-ray and said that there were no blockages or anything real obvious, but that she wanted her to fast 12 hours and take another x-ray and draw some blood for a extensive GI blood panel sent out to a lab in Texas. So after the fasting x-ray she calls me in and says her stomach wall looks abnormally thick, she is thinking either severe inflammation from IBD, lymphoma, or some overgrowth of stomach tissue.  She feels an ultrasound ($350) or exploratory surgery ($1,000+)  would be more helpful than GI bloodwork ($200). She put a hold on the bloodwork and we scheduled the ultrasound for the next day requiring another 12 hour fast. She gets the results from both the sonographer and an internist who evaluates them. Neither saw any signs of the stomach issue. One said the intestines looked a little inflamed, and the other said she saw a little inflammation of the lymph nodes. No consensus, not very helpful, and not diagnostic since all those things can be caused by either condition. Now vet is recommending a surgical biopsy to determine IBD, or lymphoma. No bloodwork has ever been done yet still. Shouldn't the blood be checked to rule out infection, other parasites, kidney, liver, etc. Or is the fact that this is so chronic, enough of an indication to the vet that it is IBD or lymphoma?

After all my reading it seems it is very difficult to diagnose these things and the treatments are so similar that people often just go ahead and start treatment. Also it seems what starts out as IBD can turn into lymphoma over time anyways. The vet said if this was a 15 year old cat she would just go ahead with treatment and not put her through anymore, but since she is so young a firm diagnosis would be best. If it is cancer she would start with the chemo drug in addition to the steroid which would be a better treatment and let her live a "long time".....up to 2-3 years. To me that is not a long time for such a young cat and would be devastating, especially if those 2-3 years were not good ones. The decision for surgical biopsy is not just a financial one. I have read it does not always give a firm diagnosis and it is still major surgery. Plus Peanut does not do well with the trips to the vet, they're very stressful for her. If it was a surgery to remove a mass or something that would giver her immediate relief I would definitely do it. But this would just be a "maybe this well tell us something that might change our treatment plan a little" type of thing. I saw a lot of people going through this, but they all seem to have much older cats. I don't know what to do. Peanut is active, not losing weight, no chronic bad diarrhea, good appetite, and seemingly not very distressed by the vomiting. In fact when I actually see her vomit she wants to play or goes and eats again right after. But, something is definitely wrong. Sometimes she will vomit one time three or four days in a row, sometimes she can go over a week with no vomit, rarely she will vomit two times a day. I still don't know what caused the horrific diarrhea recently that lasted several days either. Same condition or did she just eat something she shouldn't have?

She has not been on any medication yet. I think the vet is thinking the surgical biopsy is the way to go and as I understand it starting a steroid can make a biopsy a false negative. Vet brought up an anti-emetic drug briefly saying "we didn't try that yet did we ?" She said I could take some time to think it over since overall Peanut's condition is good, not vomiting every day, no weight loss, etc.  Any advice from anyone who managed to read this far?

My Miss Purdy was feral and moved in with me at 18 months. She vomited every day but never acted sick. I wormed her again and started using revolution drops for fleas and worms. I took her off all dry food. I then whittled it down to grain free canned only. She eats rabbit, duck and chicken. Originally gave her Vets best hairball relief tabs, they taste like treats. They help with digestion containing slippery elm and psyllium. This slowed down the vomiting. I then figured out she could not digest grains, fish beef. Now she no longer needs the tabs and never vomits. I feed her pride by instinct Rockstar Rabbit, nutro natural choice chunky chicken, merrick duck pate or chicken pate and tiki cat puka puka chicken. If I feed her any dry or treats or canned with grain like rice she vomits.

bonepicker said:

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• bonepicker
• Nov 9, 2014

My Miss Purdy was feral and moved in with me at 18 months. She vomited every day but never acted sick. I wormed her again and started using revolution drops for fleas and worms. I took her off all dry food. I then whittled it down to grain free canned only. She eats rabbit, duck and chicken. Originally gave her Vets best hairball relief tabs, they taste like treats. They help with digestion containing slippery elm and psyllium. This slowed down the vomiting. I then figured out she could not digest grains, fish beef. Now she no longer needs the tabs and never vomits. I feed her pride by instinct Rockstar Rabbit, nutro natural choice chunky chicken, merrick duck pate or chicken pate and tiki cat puka puka chicken. If I feed her any dry or treats or canned with grain like rice she vomits.

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Try removing dry and grain, and fish it could not hurt. My cat is 6 1/2 years old and no issues or meds.

All of these digestive things are so difficult to diagnose.  My kitty had his first flare when he was only 18 months old, his symptoms were anorexia, vomiting bile, and lethargy.  I then began the vet hopping thing which included two hospitalizations, an emergency vet visit, and numerous x-rays.  Given his age and no diarrhea the first thought was always a foreign object.  Six years after all this began I finally went to a clinic with a certified feline specialist but at this point he had fatty liver.  I can only tell you what was done for Patches.  He had the complete bloodwork including sending blood to Texas A & M.  The blood that goes to A & M is a check for pancreattis.  He also had an ultrasound, no masses seen, so he was started on the steroid which he still takes.  There were some additional things like a feeding tube because of the fatty liver but we went right to the steroid after the ultrasound.

She's gorgeous!!  What have you been feeding her?  It could be a sensitivity to one (or more) of the ingredients and very easy to correct with dietary changes.

The dry foods they have been on since kittens are the two grain free kinds of Earthborn Holistics. They are "Primitive Feline" and "Wild Sea Catch". They both contain poultry and fish meals... just in differing amounts. They don't technically have grain, but use potato and pea protein as a filler I imagine, along with small amounts of fruits and veggies.  I initially got it because it was for all life stages with small kibbles, and one of the few affordable grain-free ones I could find.

I tried various wet foods on and off, but ended up eventually stopping after wasting so much. I tried EVO chicken, Wellness & Blue Wilderness grain-free poultry varieties, a few others I can't remember. I even got the Evanger's little tins of meat and water only from the dog food section in rabbit, duck, quail, or turkey.

They always get real excited about the smell of the wet, but often start eating it and only get in a teaspoon or so before walking away to groom themselves. Mr. Tubby tries to cover it up like it is crap, just like he does with my morning coffee! I don't know if they have an aversion to the pate texture that all cat food seems to be or what. Or maybe the crunch and magic flavor additives in the dry food have turned them into addicts.

They did enjoy the little bit of baked chicken thigh and each ate about 1/6th of it, but I'm afraid that may have been what gave Peanut the terrible diarrhea.

Perhaps the only way to get them to eat wet food is to not leave dry food out all the time. The reason I have been hesitant to try that method is that Peanut eats very small amounts more frequently and I didn't want her to lose weight. Her brothers would probably be ok with it and it might even help the overweight Tubs to lose some weight.

They only get on average two tiny treats a day of these Bench & Field. They do have fish meal and brown rice, but the amount would be so tiny I would think. They must have something in them they like because they are like kitty crack. I tried some of the freeze-dried meat treats too which went over well but are pricey.

All three vets I have seen in that practice that I have asked about food seem to think it would not be a problem. They said they were too young for food allergies. When I was worried about the quality of the food and mentioned I was thinking of trying raw, the one vet discouraged me and said it was a good way to give them salmonella. She said to change their food often and that they weren't like dogs who needed to transition gradually. She also told me not worry about finding the best food because most cats are fine on the cheaper stuff. She said that just like with people we would all eat better quality food in an ideal world, but often whatever cat food you can afford that makes your life easier is good enough.

Bonepicker, thanks for the list of foods and treats. I will have to look into them. I saw that Tiki cat mentioned many other places too.

Denice, did you ever get a for sure diagnosis of IBD for your cat based on the ultrasound and bloodwork, or was it just an assumption good enough to start the steroid? Did the steroid alone give improvement or were there diet changes too? I'm slightly worried that if I do both and see improvement I won't know if the steroid is still necessary or not. Also did that bloodwork sent to Texas cover everything, or was it just pertaining to digestive issues?

I just can't help think the vet is jumping the gun a little with wanting the biopsy, unless there is something she isn't telling me. I understand surgery is not as big of a deal to vets as cat owners. It seems all the sites I looked at written by and for vets really push hard for biopsy. My gut is telling me to do the bloodwork too since she has never had any ever, and we may be missing something. Then as long as that shows no other cause, to just treat it as IBD with diet, steroid, and maybe some more holistic stuff. Does that seem reasonable, or am I not being aggressive enough?

Just an update, for anyone following. We did a fecal test that was for sure her's this time, and it was negative. We did a cbc/superchem blood test to check for anything else out of the ordinary too, and everything was totally normal. The vet did give us some ondansetron to try for nausea, but we did not try it yet since she seems to be getting better with the other changes I've been making. I'm attempting to transition all the cats from free fed kibble to meals of canned and home-cooked, possibly leading up to raw food one day. I also started giving her the Vet's Best Hairball Digestive aid that was recommended. Sometimes 1x day, sometimes 2x. She absolutely loves them and would rather eat them than her food! I think that is helping a lot.

The food transition is very slow going. I have been trying to get many of the foods suggested here. No grains, low carb and trying to avoid fish, beef, and carageenan. I started giving them small amounts of cooked meat and organs. Then I made a big batch of bone broth in the pressure cooker and have been giving them all that. It is supposed to help heal inflammation in the digestive tract. Now I got some Alnutrin with eggshell calcium and am starting to make them some more balanced home-cooked recipes.

They still are hooked on the kibble though, but I am slowly trying to reduce the amount of it fed. I did switch to the Nature's Variety Limited Ingredient Turkey though. It just has the one protein source and no potato like the other kibble I was giving. It used tapioca as a binder I guess instead of grains or potato because it is hopefully less allergenic.

So overall it is going well with less vomiting and no weight loss so far. Hopefully I will be hanging out more on the nutrition and home-cooked/raw forums than the health ones for a good long while.

Mine had negative stool sample but I had the vet give something for tapeworms because I thought I saw something in the vomit. I then went with all canned and vets best and it stopped. I tried reintroducing a kibble meal and vomiting started again.