12 year old Tonkinese, with IBD/ colon wall inflammation

Hi all, I'm new here, and it seems there's a lot of good people and support over here. So, here's my story. Thank you in advance for reading as this has been a really hard and long struggle. A few years ago, I inherited a great Tonkinese cat named Isabella (Iz). She's a real piece of work, loves to give affection, get it, and is generally energetic. However, she has a pretty bad case of IBD. It started when her previous owners ( close friends of mine) had her and she would eliminate (just poo) outside the box (the problem got a little worse when a baby came into the picture, but i know that happens sometimes). When I inherited her ( due to a few things, not really relevant here), the same thing started happening. She was on a dry diet, but after the problem got bad, I switched to purely grain free wet food as I wasn't aware of the dangers of dry diets (nor were her previous owners), and commercial foods ( I sure know now. I should get a side gig as a cat nutritionist!). I learned quickly and only feed her the limited protein. Through a few vet visits, she has been on the following over the past 2 years or so.

Flagyl (a few different cycles)

Prednisone (a few different cycles)

Budesonide (this was used in conjunction with Flagyl)

Dexamethasone injections (this was recent, but they had no effect really except for one day where it made her throw up a lot)

B-12 (currently once a week)

Pancrezyme: (recently, no effect)

Zofran ( recently, no effect)

Tylan powder ( about a year or so ago, not much effect)

Slippery Elm in food 

Vitality Science's products (still administering)

And a few other probiotics, etc that haven't done much at all (Fortiflora gave her the runs a while back too). Recently I changed her diet to Royal Canin Rabbit and Pea, and that was a complete disaster, we're talking exploding randomly, straining, cramping (by her meows I could tell) even peeing a bit on the floor. I tried the dry version of it and things were even worse. I know diets take some time to take effect but I've since stopped it because it was just too much and put her back on Natural Balance Duck and Green Pea. To add, last weekend I even tried Pride by NV - the Duck kind, she loved it but afterwards it looked like a tar machine ran through my apartment. 

Things have improved, although they still aren't good, she's still having the runs, and going on the floor, although not nearly as much. She's been on other diets as well but the Duck and Green Pea seems to "agree" with her the most at the moment. I was thinking of trying Nature's Variety as well. I don't want to try anymore prescription food as at one time I tried the RC Gastrointestinal food and that didn't agree with her in the least ( there's grains and crap in there too).  So my question here is and my internist (referred from my regular vet) agrees and thinks that it's possible that there's too much scar tissue in her GI to be responsive to any therapies at all. I have not done a biopsy, but have done a few ultrasounds (one very recently). I was thinking to try a holistic route as I found some stuff online that seems decent enough but i'm always wary of a company (Pet Wellbeing for one) where they have reviews on their site that are glowing across the board. I've since bought them and have been trying, but no real changeOverall, she is a fairly happy cat, but when it comes to bathroom habits and her GI, it's fairly severe and it's something that I am having a really tough time with anymore. The amount of cleanup I've done in the past few years has been pretty unreal, and I've done so much to try to help her, i don't know what else to do. It was at a point recently that it was so bad and I felt she was suffering so she almost met her maker but she seems to bounce back and then I want to give her another fighting chance.

I want to try to help her, but if she doesn't improve or gets much worse, I'm not sure what else I can try or do. My vet who is amazing even said "I don't know how you've done this for so long, you are one of the most patient people I've ever met" ha. That's not a boast, but just to give you the idea of what I've tried to conquer with this. I am sorry this is so long but I really am looking for anyone to give insight. 

I know a raw diet would probably be worth trying at this point, the real problem though has been that that's a steady slow change, and things haven't been steady enough to even try that transition. But I might just do it now. I've known this cat since she was a kitten, she is amazing but I just want her to feel better and have a better life. 

.Thanks again for reading.

-Eric

I have an IBD kitty but his issues aren't as bad and they are well controlled with Prednisolone.  Have you tried any other proteins or is the duck the one that she tolerates the best?  

I don't know what you have access to in the way of meats where you live, I know here duck is pretty much only available during the holidays.  If you can get duck and that seems to be the protein she does best on, I would try a few days with just cooked duck.  A kitty can go 5 to 7 days on an incomplete diet with no negative effects.  If she gets markedly better on just the duck that will give you something that you can build on.  There are any number of things that can cause issues, some kitties have issues with peas and with the thickeners used in canned food.  Feeding just the cooked duck for a few days will eliminate all of those things from her diet.

Yea, I tried the RC rabbit and that was no good for her. Duck seems to be the one that she tolerates remotely. Thanks for the advice on the duck, I live in NY city so I have access to a lot of stuff at least. I can maybe try that. I also looked at Primal Freeze Dried Raw as my pet store has it. I don't like all of the vegetables in it, but maybe I'd have some luck with that as well. Thank you for responding.

A probiotic called S boulardii has helped many, many IBD kitties: http://www.ibdkitties.net/Probiotics.html

This is why: http://www.thecatsite.com/t/283161/saccharomyces-boulardii-use-for-diarrhea-and-gi-disease-incl-ibd

And this post outlines my thinking on IBD, for whatever it's worth: http://www.thecatsite.com/t/278273/the-well-known-problem-of-ibd-or-lymphoma/90#post_3576295

Thanks for the advice and articles. I will read through all of what you sent

eshans said:

 
Thanks for the advice and articles. I will read through all of what you sent

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How's her weight? Steady or changing?

She has always been a small cat, but she is definitely thinner than she used to be. She's under 5lbs.  She's definitely lost weight slowly, she's under 5lbs now. At one point she was between 6-8.

You can always try injecting as many of the meds as you can with a needle instead because some cats don't absorb things properly once IBD sets in and does its damage. My guys is like this and I had good successes by injecting drugs in with his daily sub-q but you don't need a sub-q for this. For my guy food didn't make too much difference but getting the drugs into him in a way he could absorb it and keeping him hydrated made a difference.

Ok well as someone who has an IBD cat with every possible complication I'll just add that a cat with ibd who is losing weight is in a more serious situation than a cat with stable weight. Obviously you have tried a lot, have you discussed a biopsy?  Weight loss and resistance to meds could mean the disease has progressed to something worse, but treatable in another way.  Small cell lymphoma is a possibility, and the normal treat ment for that would be Leukeran, which many vets will try even without a biopsy as it also works with severe IBD.

StephenQ said:

 
Ok well as someone who has an IBD cat with every possible complication I'll just add that a cat with ibd who is losing weight is in a more serious situation than a cat with stable weight. Obviously you have tried a lot, have you discussed a biopsy?  Weight loss and resistance to meds could mean the disease has progressed to something worse, but treatable in another way.  Small cell lymphoma is a possibility, and the normal treat ment for that would be Leukeran, which many vets will try even without a biopsy as it also works with severe IBD.

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Thanks for your reply. We did discuss a biopsy, but it would be a 2000.00 procedure, plus fairly invasive and the vet said basically it could still be inconclusive. I don't really have that kind of $$ either and to do it for a 'might be' outcome, I just don't feel it's worth it. We also spoke of Leukuran, might be my next step, but she's been pumped full of meds  and steroids the past few years and I'm starting to feel helpless. I did give her a dose of flagyll today b/c she had about 5 bouts of diarrhea on the floor in the past 12 hours.  This is a very tough disease obviously, but I really just want her to be happy, but having this many accidents outside the box has to be embarrassing for her as well as frustrating for me.

Right I hear you on all that. Leukeran is the drug of choice when all else fails. 80% of cats can tolerate it, and if yours can't then you just take them off it. I understand your reluctance to subject your cat to more treatments but you may have run out of options. Leukeran could work. The alternative sounds based on what you're described is a downward spiral. IBD in the early stages can respond to a lot of things but when it gets bad then little tweaks are unlikely to help.

I'm sitting at my vet office while I type this , you really have my sympathy

StephenQ said:

Right I hear you on all that. Leukeran is the drug of choice when all else fails. 80% of cats can tolerate it, and if yours can't then you just take them off it. I understand your reluctance to subject your cat to more treatments but you may have run out of options. Leukeran could work. The alternative sounds based on what you're described is a downward spiral. IBD in the early stages can respond to a lot of things but when it gets bad then little tweaks are unlikely to help.

I'm sitting at my vet office while I type this , you really have my sympathy

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Thank you. Yeah, I'm running out of options at this point. I'd like to try the raw diet as I know it's helped greatly but my fear is that it will be a shock to her system and any slight diet change I've made at this point has caused real havoc and unsustainable conditions. I live alone too, so I have no other real help to manage this and makes it that much tougher.

eshans said:

 
Thank you. Yeah, I'm running out of options at this point. I'd like to try the raw diet as I know it's helped greatly but my fear is that it will be a shock to her system and any slight diet change I've made at this point has caused real havoc and unsustainable conditions. I live alone too, so I have no other real help to manage this and makes it that much tougher.

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sorry, should say "I know that it's helped other IBD cats greatly"

Have you tried pumpkin in her food?  That can sometimes help with diarrhea or constipation.  Here's a thread about it:  http://www.thecatsite.com/t/244415/canned-pumpkin

betsygee said:

 
Have you tried pumpkin in her food?  That can sometimes help with diarrhea or constipation.  Here's a thread about it:  http://www.thecatsite.com/t/244415/canned-pumpkin

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Thanks. I have used "Firm Up" in the past - I might give it another go.

I would use just regular canned plain pumpkin--organic if possible. 

betsygee said:

 
I would use just regular canned plain pumpkin--organic if possible. 

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ok, thank you. 

LDG said:

A probiotic called S boulardii has helped many, many IBD kitties:

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I just wanted to reiterate this. Unlike pumpkin that treats a symptom, this treats the condition in the intestines and helps restore normal functioning. It is not digested, it acts in the lumen. It promotes growth of healthy bacteria, prevents unhealthy bacteria from populating, and helps reduce inflammation.

The addition of an L. acidophilus - based probiotic will, given a little time, help her gain weight. I'll post the study when I'm on the laptop and have access to my bookmarks.

http://www.amazon.com/gp/product/B0013OVW0E/?tag=&tag=thecatsite

http://www.amazon.com/gp/product/B0042L1S1S/?tag=&tag=thecatsite

IBD has been definitively linked to gut dysbiosis. If probiotics have been tried and failed, that is because they were the wrong strains or not enough live CFU. It is an area of nascent research, but we know from published research that probiotics play a role in helping heal the intestines in IBD. And there is anecdotally a rapidly growing number of IBD cats benefiting from this particular combination. Of course each cat is an individual, but the potential benefits: better nutrient absorption, weight gain, and no more diarrhea far outweigh the risk (which so far have been it didn't work to stop diarrhea, and that in a serious minority of cats).

eshans said:

 
Thank you. Yeah, I'm running out of options at this point. I'd like to try the raw diet as I know it's helped greatly but my fear is that it will be a shock to her system and any slight diet change I've made at this point has caused real havoc and unsustainable conditions. I live alone too, so I have no other real help to manage this and makes it that much tougher.

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Not withstanding all the good suggestions above, there can come a point with severe IBD that little things like diet change as an example, just don't work.  Raw is a way to go, although i hear your concerns, Stella and Chewies is raw but pressure pasteurized so no risk of salmonella or e-coli, and it comes freeze dried which is very convenient.  A baby scale like from amazon can help you track your cat's weight very precisely and if you note continued weight loss then in the words of my vet, "our pet is loosing the battle"

The weight loss isn't because of the diarrhea per se, its because her intestines are inflamed to the point that she can't absorb nutrients.  I would suggest a heart t heart discussion with your vet about Leukeran, and while a biopsy may be out of the question financially, an ultrasound is much less $$$ than a biopsy and can still give you a lot of info, and can be diagnostic of many things.  So to sum up, if you haven't has an ultrasound recently i would urge that as well as a discussion of Leukeran.

LDG said:

I just wanted to reiterate this. Unlike pumpkin that treats a symptom, this treats the condition in the intestines and helps restore normal functioning. It is not digested, it acts in the lumen. It promotes growth of healthy bacteria, prevents unhealthy bacteria from populating, and helps reduce inflammation.

The addition of an L. acidophilus - based probiotic will, given a little time, help her gain weight. I'll post the study when I'm on the laptop and have access to my bookmarks.

http://www.amazon.com/gp/product/B0013OVW0E/?tag=&tag=thecatsite

http://www.amazon.com/gp/product/B0042L1S1S/?tag=&tag=thecatsite

IBD has been definitively linked to gut dysbiosis. If probiotics have been tried and failed, that is because they were the wrong strains or not enough live CFU. It is an area of nascent research, but we know from published research that probiotics play a role in helping heal the intestines in IBD. And there is anecdotally a rapidly growing number of IBD cats benefiting from this particular combination. Of course each cat is an individual, but the potential benefits: better nutrient absorption, weight gain, and no more diarrhea far outweigh the risk (which so far have been it didn't work to stop diarrhea, and that in a serious minority of cats).

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Thank you very much, I will purchase this today from Amazon and start her on it. It seems like it can't make things worse and anything to not make it worse is certainly worth trying.