Prednisolone for IBD or Small Cell Lymphoma

So grateful for this wonderful site!
As this is a common topic here I thought it would be useful to share our experience with this.

Cat -  approx. 12 years old has had a LONG history (9 years) of constipation.  He would refuse to eat wet food, not even raw in past trials.

Had one UTI, and on Royal Cannin S/O for years - but 2 years ago had a terrible bout (first ever) of diarrhea. Bad batch of food?  We don't know.

Our vet had us buy Eukaneuba dry - apparently it can help, and it did the trick and no more diarrhea. He is on that food 3+ years now.

Recently he started crying from the litter pan on occasion and we would find hard/dehydrated stools.  Constipation back with a vengeance. 

In past 6 months he is eating A LOT more and even waking us to eat.  Tried many different foods, canned and no go.

Tried adding Miralax (vet recommended) to food - no go, he knows.
Tried pumpkin - failed.

Laculose, impossible.

Weighed him - down nearly a pound from 1 year ago.  Weight loss is gradual - most in past 4-5 months.  

Took to vet concerned he had hyperthyroidism as he was also more active, waking me, hungry, weight loss and attacking the 3 others.

All labs and urinalysis normal.  She suggested an Ultrasound - unexplained weight loss never good.

Ultrasound doc said "probably" small cell lymphoma but "could be" IBD -  the common response.

However she stated that as a result of his history of chronic constipation she leans towards lymphoma - but to have a biopsy to confirm.  She felt if we would not use chemo - no biopsy as it is too invasive.  Love an honest dr.  Only symptom thus far - weight loss and seems hungrier.

We were recommended Royal Cannin Fiber Response for his constipation - worked like a charm in under a day. 
Unfortunately the other cats wanted it too and we don't need that at $45/bag. 
He lost nearly another pound in 3 days, he was THAT backed up but it has since evened out.  Or maybe part of the loss was his shaved belly.  This food has made him feel SO good that we really "hope" he needs nothing else. 

Our vet called to follow up with the report - she said in her cat she would not biopsy just treat with prednisolone 5mg to start.  We picked up liver chews as medicating him is torture. I asked if the meds could mask lymphoma and she said yes but we will re-weigh him and can always follow up with another ultrasound.  I did not want to start the meds because i wanted to see if JUST this diet helps him put the weight back, because he has NO other symptom aside from the weight loss.  Her thought was he will likely become more symptomatic....probably should treat but up to me.

I feel so fortunate to have found our incredible honest animal hospital that thinks of kitties first, as with 4 cats it can be tricky.

Clearly there are varied opinions on how to treat.  My biggest concern is that we are going to not treat the cancer "if" that is what it is.
Ultimately I am curious if anyone experienced constipation and slow gradual weight loss (few months) with no other symptoms and IBD vs SCL?  
And treated with diet alone before Pred?  Or Pred alone and regretted?
Thanks in advance!

I should share that my vet disagreed with the ultrasound vet/specialist (at another location with specialists) said with constipation it is more likely the lymphoma.  She was surprised she said that.  That is why further confused.  Thank you!

My kitties IBD included constipation.  He had the same inconclusive results from ultrasound.  I took him to the vet clinic that finally diagnosed him when he was having a severe flare and she could actually feel the thickening in his intestines.  He has been on prednisolone for 4 1/2 years and no more severe flares.

I chose to go ahead and start the pred rather than having the biopsy because he was so sick, he had gone into fatty liver.  His symptoms with a flare mimicked foreign body ingestion and he had his first one when he was only 18 months old.  He would be constipated, anorexic, and dry heaves with vomiting bile.  The last several years, it took 6 years to finally get the IBD diagnoses, the bile would be bloody.  I assume the bile was from his esophagus being irritated.

He was underweight and would get down to skin and bones when he was having a flare.  It's difficult to say if the nausea, anorexia, and dry heaves was solely from the constipation or was a combination of the constipation and IBD.

Thanks for sharing Denise!  What great news about your baby!
I am concerned as both veterinarians have said the pred could mask SCL and I would hate to avoid treating him with Leukeran "in time".

Poor baby, he was really struggling.
Mine seems great thank goodness, yet the crying from the litter pan continues and we are sure it is his belly.

I am concerned he should be on another diet "if" SCL but he must be able to go easily.

Best of luck and love to your guy!
 

My kitties IBD included constipation also. We were constantly going to the vet to get her cleaned out. She would go through periods of not eating and vomiting. This all started in 2010 when she was 3 years old. Finally a vet mentioned possible IBD and we started her on Prednisolone August of 2014. She was also put on Royal Cannin Fiber Response food.

She has not been back to the vet for constipation in almost a year now. She is doing much better but she still has other things going on including being allergic to so many things in canned foods. She gets tired of eating the same canned food day after day but if I put Purebite treats on the canned she will eat it.

The only time she throws up is if I have tried a new food and she is allergic to something in the food. She has maintained her weight for several months now.

She gets 0.18ml of pred. every other day.

I am a bit concerned that they started my guy on 5mg of pred yet it is likely proactive given the concern of small cell lymphoma.

5 mg is indicated here https://s3.amazonaws.com/assets.pro...40005056ad4734/file/PV2013_Al-Ghazlat2_CE.pdf  along with leukeran.  However, my vet is not discussing the chemo med "yet" and my concern is we could be overlooking a cancer.  Sure hope not!
 

Have any of you noticed cat being more active, vocal or eating more on the meds?  My concern is that he is already eating a lot and losing weight, and is already aggressive to other cats.  Day 2 of pred and already he seems like the boss again, lol

Thanks!

Sorry to learn about your kitty @Snugglecat  !  Glad she is doing well!  Did your kitty have weight loss?
Are you still using the fiber response food?  My concern is that he will want to eat more on the pred and it also makes them drink a bit more.  Plus, he is active and sort of aggressive, not sure if it could make things worse.  She started him on 5mg chewable and I suppose we will taper if he gains weight. 

As mine just had weight loss and increased appetite with constipation we are just really hopeful it's not SCL but hate to wait too late to treat.  Not sure any signs will show if he is on the meds.  

Peaches was losing some weight but her biggest problem was vomiting and constipation. The vet was not concerned if she gained because she needed to gain some weight.

She started out on a high dose for 2 weeks and then went to a smaller dose for 2 weeks and then she was on 0.18ml for 2 weeks and now she takes 0.18ml every other day. I tried going every 2 days once but she started having issues right away. I wanted her on the lowest dose possible but still be working for her. She also gets Vitamin B12 injections when I can afford it.

Peaches did eat a lot more in the beginning and she drank water but she was not getting enough water in her so for her it was a good thing. I also think it has helped with her constipation issues. She is at a healthy weight now and has maintained her weight . She still drinks water but not huge amounts and she is still on mostly canned with 1/8 cup of the Fiber Response . I put Miralax in her canned food twice a day. She has not had any problems with constipation for almost a year.

Like I had said before she only vomits if I have given her a food she is allergic too. My kitty mostly goes to the vet now when she needs her anal glands expressed which is usually once a month. I'm really happy with the results of her being on the Pred. I was against putting her on this but she has become a totally different cat. I was also against trying the dry food but it has helped her and she gets such a small amount so I'm okay with it.