IBD vs. Lymphoma...now "just" vomiting hairballs

Hey everyone...I need some additional information so here I am back to you.

BACKGROUND...I have 6 cats, all rescues that have shown up at my door.  Due diligence searching for the owner, posters put up, vets questioned, microchip checks, etc. etc...and the conclusion was that the were all "throw aways" to someone.

After a terrible experience with Blue Buffalo, I began searching for another grain free food that worked for them all (ages 2-14) and went through several and I'm sure I wasn't using the right process of transitioning them from one brand/flavor to another..  The last one I had them all on was Fromm's Salmon Tuna and Anchovy (and now I understand fish is one of the top causes of food allegories in cats).

About two months ago I noticed when cleaning house that there were some spots on the floor and under the bed and I could tell that a cat had thrown up.  After a couple of weeks, I was able to identify who I believe the culprit (at least one of them) was when I noticed he would throw up in the morning when we would get up.

It was time to take them all to the vet for a check up and when we did his weigh in, the vet noticed that he had lost 1.1 lbs since his last check up.  I told him about the vomiting and he said that since I was having his teeth cleaned, they would do an ultrasound while they had him under.  The ultrasound did show a thickening in the small intestine and he began speaking of doing a biopsy to determine whether it was IBD or intestinal lymphoma but after further questions and more blood tests to eliminate other things, he said he just doesn't think he has lymphoma and wanted to change his diet.  He prescribed him Royal Canin PR and I ordered both cans and kibble.  He did not prescribe Metronidazole.

I changed the diet about 5 weeks ago and the morning throwing up did stop.....but now he is just throwing up hairballs.  He had gotten to the point that he hadn't thrown up for 6 days when I read online about the importance of wet food vs. dry for cats with IBD so I increased his wet food and started giving it to him in the morning.  Within a few days, he started throwing up hairballs 3 days in a row.  Back to do more research and I found that Royal Canin wet food contains an ingredient (carrageenan...red seaweed used as a thickener) which is a definite NO-NO for people or animals with IBD.  More research and I found Nature Variety Instinct in rabbit (the RC he's eating is rabbit) and have started transitioning him over to that 3 days ago.  After beginning the transition, he  went three days without throwing up but did throw up a hairball this morning.  He is still eating the Royal Canine PR kibble.

I do have another cat  (stray who showed up about a year ago) who had AWFUL, stinky poo and I noticed within the last 6 months that it had also started to have mucus and some bright blood...but he had not lost any weight so the vet thought it could be hemorrhoids.  At my insistence, the vet did prescribe Metronidazole (0.85 cc for a MONTH) for him and within 2 doses, the blood had stopped and I haven't seen any yet. 

Last thing and then to the questions...we have only 1 indoor/outdoor cat who we began giving Temptation treats to when she would come inside when called.  I think the normal dosage is like 2-3 treats a day.  Well she comes in and out a LOT so they were all getting treats  and probably up to 10-15 a day.  If you look at the ingredients, you'll faint...HORRIBLE, HORRIBLE, ingredients. 

So my question...

1.  for those with cats "just" throwing up hairballs but more than considered normal and diagnosed with IBD, what did you do?  Was your cat prescribed Metronidazole?

2.  once someone did transition their cats to a new diet, how long did it take before you saw a 100% improvement. 

3.  what diet do you use?  I have read excellent things about Nature Variety Instinct and would like to transition his kibble to that before I move to the raw.   Experience?

4.  Any of you initially have cats diagnosed with IBD that turned out to be Lymphoma?

5.  Could the cat with the stinky poo had a bacterial infection that has spread to the other cat and caused the vomiting?

Any news you could provide would be greatly appreciated.  I have been reading so many websites and some of them have scared me to death, others make me think that all is not lost.

All my best to you and your furbabies.....

mphscat said:

 
Any news you could provide would be greatly appreciated.  I have been reading so many websites and some of them have scared me to death, others make me think that all is not lost.

All my best to you and your furbabies.....

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One of my cat has battled IBD for years, and about a year ago it took a turn for the worse and became a severe case with weight loss being the tip off and an ultrasound showing thickening bowels.  IBD/SCL (Small Cell Lymphoma) is almost like one disease with IBD being phase one, and if not controlled it can progress to SCL which in a sense is phase two.

IBD is a very complicated disease and there is no one single treatment/food/procedure that will work for every cat, and not all treatments that do work will work forever.

Changing to a novel protein diet is usually step one, and it attempts to find a protein that the cat isn't allergic to.  B12 shots can also help.  But as the illness progresses, and at some point it often does, more aggressive therapies get pulled into play, the most common being Prednisolone, which for most IBD cats is nothing short of a miracle drug, at least for a while.

The conundrum is that if you want to distinguish between IBD and SCL (usually this question comes up when a cat is losing weight to IBD) you have to do some sort of biopsy, and that has to be done before you start Pred.  The next big issues is that since the initial treatments for advanced IBD and SCL are the same, Pred is step one, Leukeran is a drug which is step two, and you don't need to technically distinguish between IBD and SCL in order to give these treatments. However, if you ever wanted to pursue more aggressive treatments (which you might not) you would need a definitive diagnosis of SCL in order for a vet to authorize those treatments, and if you don't do the biopsy you won't get that diagnosis (and you might not even if you do).

So if you can control it with diet change then great.  If that doesn't work or stops working then you have to consider other therapies and diagnostic techniques.  My understanding is that if the food works, it should work fairly quickly, but i'm not sure how quickly.  My cat didn't do well on special diets and when the time came, we went on Pred, B12, and Probiotics.

Thank you so much for your answer. What were your cat's symptoms, if any, besides weight loss?? (and, yes, I realize they can be varied).

I have read that a diet change can take weeks to a couple months and we're on week 5. And you may have to change diets more than once, I've read.

I have also read what you said...that if you start steroids for IBD and then get a diagnosis of Lymphoma, the steroids could have a negative impact on the success of the cancer drug if given before you start the cancer protocol.

My cat for now at least acts fine. If it wasn't for the weight loss and the occasional hairballs now, I'd have no idea anything was wrong. I haven't weighed him since the diet change but both my boyfriend and I don't see any further weight loss visually or by picking him up. We'll be going to the vet in 2-4 weeks for a check up.

My best wishes to you and your kitty with prayers that he has a long life yet to life.

mphscat said:

Thank you so much for your answer. What were your cat's symptoms, if any, besides weight loss?? (and, yes, I realize they can be varied).

I have read that a diet change can take weeks to a couple months and we're on week 5. And you may have to change diets more than once, I've read.

I have also read what you said...that if you start steroids for IBD and then get a diagnosis of Lymphoma, the steroids could have a negative impact on the success of the cancer drug if given before you start the cancer protocol.

My cat for now at least acts fine. If it wasn't for the weight loss and the occasional hairballs now, I'd have no idea anything was wrong. I haven't weighed him since the diet change but both my boyfriend and I don't see any further weight loss visually or by picking him up. We'll be going to the vet in 2-4 weeks for a check up.

My best wishes to you and your kitty with prayers that he has a long life yet to life.

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Hey

It's not that the pred changes how the other drugs work or not, they are often used with each other, its that the Pred by putting the illness into remission prevents an accurate diagnosis by biopsy or endoscopy.  If oyu were determined to biopsy after starting pred, you'd have to stop the treatment for several weeks risking a relapse which you never want.

My cat's first symptoms, were occasional vomiting and loose stools.  This was like that for years, kept at bay with Tylosin, and antibiotic that re-balances the gut.  This more or less worked for a number of years, and then we had unexpected and consistent weight loss which indicates mal-absorption of nutrients.  That's when it became serious.

I recommend that anyone with a cat who has been having weight loss due to IBD invest in a baby scale, an example at the link below.  He is likely going to need regular weighing for the rest of his life and its easy to do at home.  He can loose a pound and you'd never see it visually.  A cat who's gaining or stable in weight is beating the disease.  The moment they are loosing weight, even if slowly, they are loosing the battle and the ooner you can intervene the better.  See what your vet says after this checkup and consider getting a scale.

If the vet wants to put him on Pred, make sure its Prenisolone not prednisone, and discuss the options and pros/cons for a biopsy prior to adding the Pred.  There are good arguments on either side and its a personal decision taking into account many factors including your cat.

Thanks for the good wishes, we're enjoying every moment with him, if only it would be for longer.

Thanks, Stephen. When you say "occasional", how often was that? Twice weekly? Weekly? And was it bile, food, hairballs or a little of it all?

I had purchased a scale, then decided to take it back until after his next check up. I knew I would drive myself into a frenzy with worry, constant weighing and it wouldn't be good for me or him. If the next check up does show weight loss, then yes, I will get one. I'm not living in denial..

Did your vet ever give a round of antibiotics before starting the steroids? I've read that is a frequent option as well though my vet hasn't prescribed that...yet.

mphscat said:

Thanks, Stephen. When you say "occasional", how often was that? Twice weekly? Weekly? And was it bile, food, hairballs or a little of it all?

I had purchased a scale, then decided to take it back until after his next check up. I knew I would drive myself into a frenzy with worry, constant weighing and it wouldn't be good for me or him. If the next check up does show weight loss, then yes, I will get one. I'm not living in denial..

Did your vet ever give a round of antibiotics before starting the steroids? I've read that is a frequent option as well though my vet hasn't prescribed that...yet.

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Well its been a while to go back in time and remember but he would vomit like once a week or maybe not quite that often, but it would change. Sometimes more sometimes less.  Sometimes, hairballs, sometimes bile, sometimes food.  But if i had a new cat who vomited more than one every 1-2 months I would start working them up to see if there is a developing issue.  I no longer believe in the adage "cats just throw up."

Re: the scale, it's important not to obsess and not to weigh too frequently.  Once a week is max, as you don't want minor daily fluctuations to drive you crazy.  Pick one day of the week and be religious about it.

We have done antibiotics at various points, starting with Tylosin as a daily medication, and later a few rounds of other common ones to try and re-balance the bacteria and bacterial load, but when you have inflamed intestines, generally you are ready for Pred.  Yes Metronidazole has some anti- inflammatory properties but only to a degree.  

Thanks for your patience, Stephen, and the time you take to answer my questions.

Rube was throwing up bile daily (and sometimes food...but with 6 cats, can't be 100% sure...but haven't found food in quite some time). Since the diet change only + probiotics, he just throws up hairballs (yes still a problem) but hopefully they'll continue less and less. I'm hoping this latest diet change and getting him off anything with carrageenan in it (the vet prescribed a royal Canin PR had it in the canned) will help.

Thank you so much for your information, Stephen. Knowledge is power and I'll be able to better speak to my vet and make decisions with more info.

All my best wishes to you and your kitties.

mphscat said:

Thanks for your patience, Stephen, and the time you take to answer my questions.

Rube was throwing up bile daily (and sometimes food...but with 6 cats, can't be 100% sure...but haven't found food in quite some time). Since the diet change only + probiotics, he just throws up hairballs (yes still a problem) but hopefully they'll continue less and less. I'm hoping this latest diet change and getting him off anything with carrageenan in it (the vet prescribed a royal Canin PR had it in the canned) will help.

Thank you so much for your information, Stephen. Knowledge is power and I'll be able to better speak to my vet and make decisions with more info.

All my best wishes to you and your kitties.

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I'm happy to help.  Having 6 cats obviously makes it more challenging.  There is also evidence now in the vet community that throwing up hairballs often (a possible sign of decreased motility in the intestines - the ability of intestines to move things along so to speak) has been linked to developing IBD in the future.

I know you've seen articles so here are some that I like and i find to be solid in their info:

http://www.vet.cornell.edu/FHC/health_resources/brochure_ibd.cfm

http://pets.webmd.com/cats/inflammatory-bowel-disease-cats

http://www.halopets.com/pet-education/pet-articles/Inflammatory-Bowel-Disease-in-Cats.html

Thank you again for your kind thoughts!

Stephen

Just an update for everyone. Rube went back to the vet and the ultrasound showed that his intestines were no longer enlarged. I have had him on slippery elm + probiotic for a month. When I asked the vet if I should continue, he said "How can I tell you to stop if it seems to have worked". I will be keeping him on a limited protein diet (rabbit) and will take him back in two months for another weigh in just to make sure things are continuing on the right path.

I am still beyond convinced the trigger of the IBD was the a Temptation treats. My best friend's cousin's cat is going through the exact same thing in Dallas and I just think it's too much for coincidence.

My best wishes to everyone and their kitties.

mphscat said:

Just an update for everyone. Rube went back to the vet and the ultrasound showed that his intestines were no longer enlarged. I have had him on slippery elm + probiotic for a month. When I asked the vet if I should continue, he said "How can I tell you to stop if it seems to have worked". I will be keeping him on a limited protein diet (rabbit) and will take him back in two months for another weigh in just to make sure things are continuing on the right path.

I am still beyond convinced the trigger of the IBD was the a Temptation treats. My best friend's cousin's cat is going through the exact same thing in Dallas and I just think it's too much for coincidence.

My best wishes to everyone and their kitties.

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That's great news.     Let us know how he's doing in a couple of months.  

Just an update. I took Rube back to the vet for a check up and he has gained two pounds and intestines show no thickening. He hasn't thrown up a hairball in over a week. . He never throws up any food and has no issues with diarrhea.

So just to recap what has worked for ME to combat the hairballs:

1. Novel protein. I rotate between Nature Variety's rabbit, turkey and pork
2. Brush him EVERY day. EVERY day.
3. 1/4 tsp SEB + 1/4 digest enzymes + 1 capsule probiotic + 1 capsule egg yolk lethicin + 10cc warm water mixed into a slurry and given by syringe 30 minutes before eating EVERY day
4. Vet's Best Hairball remedy, 1 tablet twice daily. I break them in to pieces and he loves it.
5. Small meals every about every 6 hours (and yes, that may mean getting up at 3am but I do it).

Hopefully this will help someone else.

Best wishes to all of you and your fur babies.

Hey! I know this thread is from a few months ago. I was wondering how long it took for your Kitty to start showing progress?
I've been going through a bit of testing and different foods with my 2.5 year old baby. I am absolutely terrified that his issues are lymphoma and not just IBD. Everything started June 26th, which was a little over a month ago. I'm going to make a post myself, but I was just wondering if it took you the 5 months from this post to see solid results.

Well with IBD, there are ups and downs. But no downs enough that I've had to result to steroids....YET. Right now he hasn't thrown up a hairball for weeks and weeks but he's thrown up a quarter size of bile 3 mornings in a row. Then that will stop. But to answer your question, it took about three months with the diet change to see an improvement.

That makes me feel a bit better. What further testing and questions helped your vet rule out lymphoma? My vet initially said he didn't think it was likely Meeko has lymphoma, though we can't totally rule it out without biopy or further testing.
I just have anxiety issues and can't hear cancer without being totally freaked out.

nauletto said:

That makes me feel a bit better. What further testing and questions helped your vet rule out lymphoma? My vet initially said he didn't think it was likely Meeko has lymphoma, though we can't totally rule it out without biopy or further testing.
I just have anxiety issues and can't hear cancer without being totally freaked out.

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THE IBD/Small cell lymphoma continuum usually is a long progression that starts as IBD, sometimes stays IBD, but in time and over time can change into Small Cell Lymphoma. Generally speaking, if you can control it with diet and minor drugs like Tylosin (an antibiotic that helps regulate the biology of the gut) or probiotics in other cases, then it isn't lymphoma as lymphoma can't be controlled that way.  If nothing controls the IBD and the vet now suggests a steroid (which can control severe IBD and  SCL up to a point) that is usually thhe decision point to try and figure out if its IBD or if its morphed into SCL which can benefit from additional treatments.

Note that SCL is a not a mass type tumor but a change to the cellular structure of the intestines and can be pout into remission with drugs.

I agree, start your own thread ok, and its premature to panic, and not helpful to your cat.   IBD is a long term illness that will benefit from many treatments, monitoring and adjustments along the way and you can expect many happy years with your cat.  And this early into the issue, he may just have a food intolerance.  Stay calm for him, he needs you.

Thank you so much! I'm trying to be positive and stay calm about it, But i am such a nervous and worrying person by nature. I also dont have much patience, so not knowing a diagnosis is kind of killing me.
However, my vet doesn't seem super concerned. When I brought him in last week, the Dr commented on how good he looks, and how he wouldn't think anything was wrong based on examining him and palpating. It's pretty much the same at home, he's currently laying belly up in the sun.
The internet is a blessing and a curse. Just researching everything my vet is gome over gives me panic attacks, while posting and reading comments makes me feel a bit better.
He's also only 2.5 years old, and only started showing symptoms recently. He also seems to have am appetite, just not for what we want him to eat.

you might want to consider getting a baby weight scale to keep your cats weight under observation. If your cat's weight is stable, that's great. If there is a weight loss, that would help the vet know to look elsewhere.

The last time I had taken Rube in, he had gained almost 2 pounds back so I got a baby scale and keep a log.

Like Stephen says, don't panic!! I panicked initially too because the IBD vs Lymphoma debate is hard but your cat is VERY young and this just started so you have a great chance of getting it under control.

nauletto said:

Thank you so much! I'm trying to be positive and stay calm about it, But i am such a nervous and worrying person by nature. I also dont have much patience, so not knowing a diagnosis is kind of killing me.
However, my vet doesn't seem super concerned. When I brought him in last week, the Dr commented on how good he looks, and how he wouldn't think anything was wrong based on examining him and palpating. It's pretty much the same at home, he's currently laying belly up in the sun.
The internet is a blessing and a curse. Just researching everything my vet is gome over gives me panic attacks, while posting and reading comments makes me feel a bit better.
He's also only 2.5 years old, and only started showing symptoms recently. He also seems to have am appetite, just not for what we want him to eat.

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Ok so my suggestions, start a new thread, and stop researching on the internet.  If you like your vet talk to them, trust them to advise you.  In your new thread, please describe the symptoms and what the vet has said and done so far.