Wet food diet, strange feces, mild pancreatitis

I'm going to *try* to not get long-winded here.

My 14 1/2 year old cat Edwin was losing weight.  He's normally a big boy- in weight and stature- was 18 pounds at his heaviest.  He's now down to 10.  He had a full blood panel done, all was normal.  He began vomiting, wouldn't eat, went back to the vet, had an ultrasound and pancreas snap test done.  All organs looked fine, thyroid was fine, but his stomach looked strange, and he has mild pancreatitis.  The vet said she could do a surgical biopsy of his stomach, but that in 85-90% of the cases, it's stomach cancer. 

Brought him home, put him on strictly wet food, dosed him with Cypro and Cerenia, and things started looking up- I honestly thought he only had a couple of weeks left in him- the vet thought maybe two months.  I tried several different foods, and he really liked Wellness Core kitten wet.  All was great until he seemed to develop a urinary issue, which he has a history of.  He normally eats Blue Buffalo Wilderness wet and dry, and has done great on it for several years with no urinary problems.  I think the kitten food threw a monkey wrench into the works.  I gave him a dose of Metacam, and miraculously he came out of it, but no more kitten food for him.  Put him back on BB wet strictly, and he will barely touch dry food anymore.  As a side note, he gets 1/8 tsp. Miralax in his food for constipation issues, but I quit giving him that when he was on strictly wet food because I didn't think he needed it anymore.  After a few days of soft stool, everything leveled out, and he was pooping like a champ.

He really started perking up- started playing again, bathing himself, picking on other cats, etc.  We had a few nice days here in NE, so I took him into the backyard on a harness, and that seemed to have worked miracles on him- I mean that seriously.    I was starting to wonder if he actually doesn't have stomach cancer (holding onto that 10-15% ), and that his symptoms are more the pancreatitis.  He's been vomiting a lot of hair lately- A LOT.  I thought maybe it's because he's bathing more now that he's feeling better.  I can barely walk to the kitchen without him flying off his perch wanting fed.  On his best days he goes through three 5.5oz cans of food, and seems to be gaining weight.

Then this morning I found about a 2" poop on his blanket.  It was light beige, and looked like it'd been there for a week (which it hadn't).  Threw it away, washed his bedding.  Later I found a small piece in the litter box with mucous-y blood on it, but the feces looked really old, so I picked it up and pressed it between my fingers, and it was like barely compressed sawdust.  It was dry as a bone, and just crumbled.  He had a bad day of vomiting today as well.  I need to add that he drinks a lot of water, and I add water to his wet food as well, so as far as I can tell, he's not dehydrated.  His blood sugar levels were fine when he had his panel.

I did a bunch of reading on the internet, and found out that when a dog/cat is fed a high protein diet, and especially a raw diet, this is typically what their feces looks like.  I later found another large BM in the litter box that I know was his because his are GIGANTIC (side note- we have several cats, lots of cat boxes around the house, so trying to catch someone using one is difficult without following them all day).  I picked it up and again examined it.  It was closer to normal in color, still on the dry side, but not like the other I referred to. 

I should also add that the timeline between him being diagnosed and today is exactly three weeks.

My questions are as follows:

-Has anyone had a cat with pancreatitis that also had urinary issues and couldn't eat regular food, and if so, what did you feed to mix it up?

-Has anyone on strictly high-protein wet food diets experienced this type of sawdust feces?

-Has anyone had a combination of stomach cancer and pancreatitis?

-Is there anything I'm missing here?  Any help/advice?

I feel like I have more questions I want to ask, but it's late and my brain is fuzzy.  I have an almost 20-year-old cat that's trying to check out on me, and between the two of these guys, I'm emotionally exhausted.  Thank you in advance to all that reply- I welcome all of your experience.

I have a kitty, Spooky, with small cell intestinal cancer that is on leukeran (chlorambucil). She is on a high protein, low-carb diet and she is having issues with very dry stool that is difficult for her to pass. In fact, we were at the vet last week, I thought she was going to need an enema. (She didn't, the stool was right at the end, a bit sticking out, in fact, and the vet was able to remove it manually. No, not fun for anyone, but better than an enema. Took x-rays to make sure that was it).

I also had a kitty with a massive mass in his stomach, though no one called it stomach cancer. Large cell lymphoma - which starts with thickening of the stomach lining but grows into a mass. He received chemo treatment, and we just celebrated 3 years in remission (knock wood!).

I feed all of my cats a homemade raw diet (I started this after Lazlo was diagnosed with the cancer) - other than Spooky, as she refuses to eat it other than very specific ground whole animal stuff I source from Hare-Today, but that has too much bone for her, so she gets ground raw and canned food now. And all of my cats on raw do have dry stools, but they are not that crumbly - and they are small. Very small. And they pass stool every 2 or 3 days (there is so little waste from eating the food). I would imagine it's uncomfortable passing a large stool that is that dry.

Here is the major red flag for me: your kitty weighs about 10 pounds now, but is eating almost THREE 5.5 ounce cans of food a day - and is hungry. When you were at the vet, was he tested for exocrine pancreatic insufficiency? And was the GI panel (cobalamin / folate / fPLI) run? It sounds to me like he needs pancreatic enzymes - not at all the same as enzymes we buy at the pet food store. Of course, this could just be some serious malabsorption issue if there is stomach cancer and GI inflammation (which often extends beyond just the pancreas).

One thing you need to know - the SNAP PLI test is for DOGS. It is not for cats, and will usually report a positive. I understand many things we give cats are off-label and developed for dogs. But this SNAP test is unreliable in cats. That said, even the spec fPLI sent to Texas A&M isn't conclusive - it is only accurate about 74% of the time, if I recall. Pancreatitis in cats is actually very common - and the chronic vomiting would seem to point to that to me, anyway. :heart2:

First thing I'd do is get the EPI test done. If your vet won't prescribe B12 shots without the GI panel being run, then I'd do that too. This malabsorption can potentially be related to low B12 levels. Here are two articles that should be helpful to you: one on pancreatitis in cats and one on EPI in cats (far more frequent than previously thought).

On Pancreatitis (note the prevalence in cats!) http://www.2ndchance.info/pancreatitisdogXenoulis2008.pdf

On EPI in cats: http://veterinarynews.dvm360.com/ex...ficiency-cats-more-common-veterinarians-think


Here's what I do / would do (and of course, it's always best to discuss everything with your vet. Thankfully, my traditional vet is willing to research the alternative treatments I prefer to use. I also consult a holistic vet, but she is farther away and costs more. ):

Get the EPI test run. I highly suspect your kitty needs pancreatic enzymes - which are by prescription. They are mixed with food prior to feeding, and they start to predigest the food, basically. Now - many kitties do not like them and refuse the food. In that case, the next best thing is mixing it with a little food, letting it "marinate" that 15 - 20 minutes, then syringing it and immediately feed the meal. But the enzymes must be given with every meal.

B12 shots. Your vet should give you scrips so you can do this at home.

Sub-q fluids - not a lot, just 50ML three times a week. Again, you can do this at home. Fluids are not only used for hydration - they keep the organs flushed, and often make a "flat" kitty feel much better. :rub:

Cerenia daily for the pancreatitis. While cerenia is technically an anti-emetic, recent research indicates that it is an anti-inflammatory that acts throughout the GI system, specifically on the pancreas, and many are now using it for bladder inflammation, so this is one your cat should be on daily (which is an off-off label use of it. Actually, it may make more sense to use the higher dose in the five days on - two days off method). How much was prescribed and how often was it given?

Have the cypro on hand to use as needed

I additionally give the kitties 1/4 egg yolk mixed into food every-other-day for so many reasons. It helps prevent hairballs, it helps with the dry stool, and it is just plain super nutritious.

Are you giving any omega 3s? These are indicated for just about any inflammatory condition. I can't afford krill oil for all 10 of my cats, but for those that need it the most, I give 500mg (one NOW krill oil capsule that I buy on amazon) daily. One eats it when punctured with a thumbtack and squished on food, one won't, so I pill her with it. If you can't afford krill, use salmon oil. But as I've used both, I can definitively say that the claims about the bioavailability or benefits of krill oil being higher or better than salmon oil are absolutely true.

For your stomach cancer boy, I'd consider using 1/16th teaspoon of a Longvida curcumin daily (such as NOW curcubrain, which is one of the products I use). Forget the "organic" stuff - it is the type of processing used for the curcumin manufacturing that matters, because turmeric often contains lead and arsenic, so you WANT the properly processed stuff. It also has very low bioavailability - it moves through the system too fast to have any impact. The processing or combining it with either Peperine (BioPerine, a black pepper extract) or phosphatidylcholine (certain component of a specific type of fat) slows it down so it can act in the body. Feel free to google it, but there is research on it for IBD, pancreatitis, and most importantly, cancer. Here is material I put together on just the GI research: http://www.thecatsite.com/t/282828/curcumin-in-treatment-of-ibd The MAIN point is that all of your kitty's symptoms are the product of inflammation - and this is a very powerful anti-inflammatory with other benefits for each condition. Most of my cats just eat it sprinkled on their food. I use empty #3 gel caps for the one that won't (and it's just a little bit in the capsule, LOL).

To help Spooky and Lazlo with their GI issues and dry stools, I now add 1/2 teaspoon of George's Aloe Vera Juice to their food daily. This is also anti-inflammatory in the GI tract, and very soothing.

If you aren't using a probiotic, consider using one. L. acidophilus plays an important role in the uptake of B vitamins from amino acids, and your boy clearly needs help metabolizing his food. If he were processing food normally, he'd need maybe one 5.5 ounce can of food a day. I use Nexabiotic (that I buy on amazon), and I give 1/2 capsule 2x a day, but you may need something with more L acidophilus in it. Here is an article on probiotics with links to various products: http://www.ibdkitties.net/Probiotics.html Most vets are not very familiar with probiotic use in pets, and even less are familiar with human grade being recommended by vets that DO know probiotics in pets: it is both an issue of quality and quantity. The reason many do not see benefit from various probiotics in pets is because the quantities in pet products just are not enough.


I note: I keep cypro and cerenia on hand for Spooky and Lazlo. But I suspected Lazlo had a chronic pancreatitis after his chemo given his issues with ongoing nausea, even though ultrasound or the spec fPLI did not confirm it. Rather than use cerenia all the time, I opted for high CBD hemp. This is working REALLY well for his pain and nausea. He is acting like a kitten again, in fact. This is the product I use, the vets there are REALLY awesome: http://www.cannaforpets.com/ I can't remember the last time I used cypro or cerenia for him. I started the Canna Companion last ... August? Maybe longer ago. But with suspected cancer and pancreatitis, I think pain management of some kind may be indicated - and this might be an option to consider. Please do note: there are no studies of the use of this product in dogs and cats, and even research in humans is nascent.


If the B12, fluids, probiotic, egg yolk and George's Aloe Vera Juice (has to be this brand, as the latex is distilled out, and that is toxic to cats) don't help with the constipation, consider adding 1/3 teaspoon of pumpkin to a meal daily. But please, please do follow up on the potential EPI. There is something *really* off with the amount of food your boy is eating!

LDG-   First, thank you for that amazing response.  I am calling my vet Monday morning to schedule a follow-up exam, and I'm taking your reply with me.  I will report back what I find.

I have him back on Miralax mixed in his food, and he passed a normal-but-soft stool this morning.  I have both Cypro and Cerenia for him already, and will talk to the vet about the rest you spoke of (which I know how vets can be with holistic meds, and will take that into consideration).  I've tried raw for him before, and he didn't care for it.  With him being so picky now, I know there's no way I'd get him to eat it.  I switched to the NV wet and dry, but he formed crystals on it, which is when we first switched to C/D, until I realized what crappy food that is (in my opinion), then put him on BB, and he's been fine since.  This urinary issue really makes variety difficult.

As for his 'stomach cancer', it's more like you described- no clear tumors on the ultrasound, but more a thickening of the lining of his stomach.  I'm going to have her show it to me and explain it again.

Again, thank you for taking the time to respond so informatively. 

Yeah - at times like this, feed him what he likes and will eat. :rub: I only mentioned the raw because of the question about stools and texture, and I have experience with canned-fed stools and raw-fed stools, which is why it was relevant to mention it.

Yes - the miralax is a good idea for now. I don't know how much you used, but if it was the normal 1/4 teaspoon, given the stool was a little soft, consider using 1/8th teaspoon on an ongoing basis - unless you want to try some of the other suggestions. FYI, and I didn't mention this - I think it is best to change just one thing at a time. Introduce new things slowly, work up to the amount you want to use over a few days, see how kitty reacts for a few days, and then add something new.

Keep us posted! I do hope you can make him comfortable - that is what's most important at times like these.