13 y/o cat with IBS. Vet recommending euthanasia

I know this will be long, if you can read it and offer advice, I would be grateful.

My 13 year old cat Niko has IBS.  She was officially diagnosed about 3 years ago, although she has had vomiting and diarrhea pretty much as long as I can remember.  It was always manageable before.  She was a little messy in the litter box area, so we had to clean it sometimes twice a day.  We added additional litter boxes so she had a place to go if one was dirty.  We eventually invested in two litter robots so that she would always have a clean litter box.  The vet always assumed that she had IBS, but we managed it with good food and probiotics.  About three years ago, it started getting much worse.  A biopsy confirmed the IBS diagnosis.

She had always had loose stool, but it began to become pure liquid.  over the years it has gotten worse and worse till now she goes about 10-20 times a day and it's nothing but foul smelling liquid coming out of her.  About two years ago, she stopped using the litter robots.  Since they were smaller, she would get liquid feces on her paws and she obviously did not like this, so she began going on the floor all over the house.  We switched back to a regular litter box and that seemed to have solved the problem, but only for a while.  About six months later, she began using the floor again.  She isn't burying her liquid poo, so if there is any in the litter box, she won't go in there.  I have been cleaning the litter box 3-4 times a day for the past year while we tried to deal with this and it has not stopped her from going on the floor pretty regularly.

As far as healthcare, she has seen 4 different vets (including a specialist).  We started with diet and probiotics when she was about 5.  This helped until about three years ago.  In the last three years, we have tried 6 or 7 different types of canned and dry food, every protein combination, gluten free, grain free, all natural, pretty much every option.  We had her on three different steroids for two years and they did nothing to help her.  her symptoms did not change or improve at all in the past three years.  So over the last six months, we went holistic.  We contacted Vitality Science and got the entire spectrum of items from them.  for the past few months we have been giving her Feline Comfort Plus, Luxolite, and the GI Distress Remedy in increasing dosages and it has not improved her symptoms in any way. 

We have had to replace the carpet in our new house once already, and are in the process of replacing the floors again because of the odor and feces staining.  We have had to lock her in one room in the house to keep her from getting on the furniture and counters at night as she always has feces on her feet or rear/tail area.  She has lost almost 4lbs in the last 6 months and drinks about a half gallon or more of water every day.  We clean up after her many times daily, she is locked in a small room in the house for 17+ hours a day.  She isn't eating very much and is slowly loosing weight.  After three years and over $7500 in vet receipts, I know one thing for sure, we are not going to be able to improve her health at this point.

The vet has recommended putting her to sleep.  We have literally exhausted every other option.  She is still very affectionate and even runs and plays sometimes when I get out her favorite toy.  Some days you can tell she is hurting more and she sleeps and lays around a lot.  She spends most of the evening crying because we can not leave her out.  she is skinny and yellow and molting a bit, but she still seems like the Niko I know.

I'm having a hard time deciding if it's the right thing to do for her.  I know neither of us want to live like this, but when I look at her, she doesn't seem that sick.  Not sure what to do.

--Shawn

I am so sorry you are going through this.  I too have an IBD kitty that started with flares very young, 18 months.  He has responded to steroids fortunately.  He had different symptoms, his were anorexia, vomiting bile and constipation.  He would flare rather than be constant.  I went through 6 years of multiple vets and hospital stays before he was diagnosed.  I tried one more vet before giving up and by then he was in fatty liver but got a good diagnoses and pulled through the fatty liver.

I too had tried many  different diets which didn't work for him.  I have my doubts that his IBD was diet related.  The theory behind diet related IBD is prolonged exposure to a protein that kitty becomes sensitive to.  At 18 months old I doubt that was what was going on with him.

I know you said he didn't respond to steroids, was a high dose tried initially?  Sometimes a high dose is necessary to get the inflammation controlled and then tapered down to a maintenance dose.  Have you asked about trying Leukeran?  It is considered a chemo drug but is actually an immune suppressant.  Some vets will give it for severe IBD along with Prednisolone.

As far as Euthanasia I can't really comment.  That is a personal decision that each person has to make in conjunction with their vet.

One thing you can be assured of if euthanasia is your decision you  have done everything for your kitty.  You have went above and beyond what many would do.

Thanks for the reply.  Never had a vet recommend something like this, but he said IBS is very painful and even though she may not look like she's in pain, she is.

We did do a loading dose of steroids both times that we tried them.  Not sure if we tried Leukeran specifically, I can check her records.  However, we did try an immune suppressant of some sort with the steroids the second time around.  It didn't make much change in her feces, other than it was a bit less stinky and less green during that round of steroids, so we didn't keep her on it long.  The vet was concerned about compromising her immune system if it wasn't affecting her IBS in a positive way.

Could you try a raw food diet? I have a kitty, mine is Cookie and he would have loose, liquid, mustard like stool, sorry for the graphic description but no rx diet, no variety of commercial food would work.It would literally drip out of him. I use Dr. Pierson's recipe. If you could try chopping up a raw chicken breast or a partially cooked one and see if Nikko would eat it? it would be worth a shot. Here is the link for it. http://catinfo.org/?link=makingcatfood

One of Pierson's cats',his name is Robbie had much trouble as mine but I doubt as badly as Nikko. I do hope you can work something out for her, please feel free to pm me for advice on the food making. You've done a lot for her already but I know its hard, especially with chronic conditions.

Hi Shawn.Do you belong to the IBD group at Yahoo? here is there link.If not pls join and post in big letters new Member vet recommends euthanasia Pl help Ok?

https://groups.yahoo.com/neo/groups/felineibd1/info  Wishing a great outcome ..i once read from the lymphoma group at yahoo the specialist there mentioning getting barium & giving a dose of that.That you can actually buy barium.Also have you tried slippery elm?? If not I do have some recipes.LMK C. When was your kitty diagnosed with IBS 7 was there biopsies taken.if so when? IBD Or OBS or Mega Colon,long term constipation sometimes can change to small cell.not saying your baby has that at all.But I have over the last 12 or so yrs on yahoo read alot of posts.Have you tried the actual basics?100% canned pumpkin or digestive enzymes? My late boxer Bella was born without an anal opening.She was brought to my vet to be put down as a very small pup.the vet couldn't do it and id three surgeries to give her an anus.i had just lost my German Shepherd and he mentioned her to me.he told me of the surgeries & said she can never become constipated.use pumpkin.She also had to be on a special vet food that was over 100 bag.otherwise any other food projectile to a point of bleeding.the i found a company called Vetform.I am in BC Canada.Vetform digestive enzymes.you can google them.1/8 tsp added to any dogfood & Bella Had a perfect stool every time.I never fed her crap but $100.00 per bag which is now around $150.00.this product was excellent.they are very personable there.they do ship .And you can go online I believe & read the ingredients.All plant matter.Amazing stuff for 8yrs. Vetform digestive enzymes. C.I did speak with the lady there & she did say if Bella has ulcers this product would make her worse.She, I think her name was Shelley who makes her own food knows the ingredients of every product they make & how or if it may help.

She was initially diagnosed about 9 years ago, but it was manageable at first with probiotics and special diet.  Biopsies were done about three years ago when she started getting worse, and the treatments we had been using stopped working.  The biopsies verified IBD. 

We have tried several different types of enzymes, not specifically the vetform, but we have done a lot of enzymes with no effect.  We had her on enzymes between the steroid treatments, so about 90 days.  It's not an enzyme problem, two different vets said she is producing the correct level of digestive enzymes.  It's an inflammatory issue, we can't get the inflammation to go down long enough for her to heal.  She has had this problem so long now, the vet is concerned about scarring in the intestine and the possibility of renal failure or cancer developing.

Have not done Slippery Elm.  we used to give her a liquid that coated her stomach and intestines, like a pepto kind of thing, but not slippery elm specifically.  Can I give her the same stuff that humans take?  Can I just pick some up at Walgreens?  Or do I need a special pet formula of that?  If so, I will get some tonight and start her on that.  Is there a specific dosage I should follow?

We can't get her to eat the raw food...she won't even eat flaked tuna.  It took us months just to get her to eat the canned food she is on now, she didn't eat for about three days and literally started to starve and ate it simply because its all we gave her.  The vet has her on a no chicken diet right now (we feed her mostly duck and some venison), so I'm not sure if chicken breast would work either.

Thank you guys for the feedback.  At this point, I'm not sure if we can make her 'better'.  There isn't much we haven't tried in the past three+ years, but I'm up for exhausting every available option.

There is a yeast based probiotic called s.boulardi which people have had great success with as far as treating a number of GI issues.  http://www.thecatsite.com/t/283161/saccharomyces-boulardii-use-for-diarrhea-and-gi-disease-incl-ibd   has a lot of good info about it.   In particular you want to look at LDG's posts, I think she has some more info on down in the thread past the initial post.

I hadn't used the slippery elm but yes it's the same thing that is sold for humans.  The way I understand it you make it into a tea.   I do know that if your kitty is on any medications there needs to be two hours separating the slippery elm and the medication.  The coating on the intestinal walls can affect the absorption of medication.

Has your vet given B12 injections?  I know some kitties have had a lot of improvement with those.

Hi Squidz.

Yes I have had one member purchase the seb from a health store.I believe capsules but not sure of the dosing.I believe Not the whole capsule.Her boy became like a young boy again she said.He is 15 yrs old.

MY computer for some reason won't let me paste the link I have for recipes.There was some info on Tanya's site.Not sure if you have ever been there.Huge read.Very informative info.But last time it i tried clicking on it it went no where.But give it ago or google slippery elm bark recipes & look for the header being tanya's comprehensive site.www.felinecrf.org .It has slight diuretic properties so hydration has to be watched.But with diarrhea all the time which is so dehydrating I'm sure you are doing something to get fluids into your babe.Cat's hate having diarrhea & I feel for you.. Rather than prednisolone have you tried budosemide? which is for cats that can't take pred? Duck btw is not classified as a "Novel protein" as per my Internist.Too close to the poultry family.Even pheasant is.You should join the group Squidz as this is all they deal with & have for yrs with kitties all over the world.They are doing faecel transplants now too.Vit B injections I gave to my boy who was a CKD too.they have dilute urine and B's are peed out so they are lacking in that dept.he weighed about 8 lbs.One bottle of cyanocoblamin injectable was around $20.00 from the vet.Lasts about 100 yrs .Maxwell's dose .25cc once a month injected with a diabetic 1cc needle 25 guage.The oral form is better methylcobalamin but with gut issues sometimes going to injectable & bypassing the gut is better.Also have you tried Flagyl or what is called metronidazole.my late tabby at 15 yrs had a pancreatic flareup.Major diarrhea & weight loss.Flagyl helped her tremendously.Very powerful anti biotic.Stopped the diarrhea.Also if you want to read about how a cat's gut works & what can go wrong my Long time friend wrote a book

wwwfelineconstipation.org                      By Pat Erickson.Super gal!!! HTH C. I agree with Denice seb can affect certain meds being absorbed.Some time frame in between.But I honestly think your babe is having trouble absorbing period.Only a folate /cobalamin blood draw would tell you.

Hi Shaun and welcome to the forum !

Up front, I want to share with you my own reaction to your story. First, your efforts at finding a solution really hit home with me from one personal experience with a different feline condition, so I really empathize with what you're going through. Secondly, I find it unsettling that the ONLY best/next option on offer is to let her go....that should explain what I am sure will sound 'edgy' - just know it's not in any way directed at you.

squidz said:

 
There isn't much we haven't tried in the past three+ years, but I'm up for exhausting every available option.

Click to expand...

Well, there is something that you......make that your "4 different vets (including a specialist)" seemingly haven't tried OR suggested - and, I'm pointing a finger directly at them for apparently not even being aware of the existence of this treatment, because it's been common knowledge in human medicine for the last few years...and, more so, because there's a Veterinarian who has been offering this treatment for some time.....which, makes me question whether/not those people are tuned into current developments in Vet medicine, and several other related questions.

The treatment? Have a read of this: When Medicine Is Crap: Fecal Transplants in Veterinary Medicine

Want more reading? Copy and paste this (including quotation marks & comma) into Google: "using fecal bacteria to re-populate,cats"

Where would I start to explore this further? Probably by putting this in front of the crowd that have already taken $7500+ from me and assessing their reaction, then asking them whether/not they are members of any online Veterinary community (there are TCS-like forums for Vets.....one is this:  VIN - For Veterinarians, By Veterinarians)....and,  then asking if fecal transplantation has been discussed there/other forum. I would be extremely surprised if it has not.  (Of course, the larger question is: WTH are these people unaware of FT - ?)

I'd also be looking around for Holistic Veterinarians, then speaking directly with them to find out whether/not they're familiar/have used this therapy. Here's the national association's website....you'll see the red "Find a Vet" button prominently featured there: (btw, I see that there are 2 feline-only members there....if they're not close by, perhaps you could contact them to see if they're familiar with FT's): American Holistic Veterinary Medical Association

My goal would be to find a competent feline Vet who would be willing to  try FT with Niko in consultation with this Dr.Margo Roman (unless, of course, I were close by her practice M A S H - Main Street Animal Services of Hopkinton   - btw, here's the particular therapy: Micro Biome Restorative Therapy or MBRT/Fecal Transplantation

I'd also be joining the specialized online support group that MomofMaxwell recommended t you in post #5 above (people have no idea about the wealth of knowledge/info available from these specialized communities - until they join up. They really are/have been lifesavers for zillions of cats.)   I'd be asking that group about experiences with fecal transplantation.

Just a few other thoughts: There should be no surprise that she's consuming a "half-gallon" of water - she's in a constant state of ongoing dehydration, making that completely understandable (and a lesson for people who believe that cats have little/no thirst drive!). Two, if she were here and, if FT were to be successful, I'd be giving her (because she's resistant to raw food) the 'purest' meat + a tinch of fiber canned diet that I could find.  Third, no more vaccinations for her - period. Fourth, no more antibiotics, unless it's a case of life/death. Fifth, I'd be skeptical of recommendations for ongoing "supplements" of any kind....but open to using only if recommended/justified by Dr. Roman. (IMO, except for specific age-related supplementation such as Vit B and Omega-3's, there's no need for most of the fancy-pants new-age supplements...but, justify one and I'll accept it).  Six, if you have read very, very carefully, you will have seen that donor cats for FT therapy are those with minimal vaccination and no antibiotic history - I'm mentioning this in case someone suggests using transplant matter from "any" cat.

Finally, if you decide to pursue FT, please commit to keeping us updated. There has only been one other instance on this forum where FT was actually recommended by a Vet (and declined by the "owner") - so we and our cats would really benefit from any experience you might offer.

I hope something there helps !

Hi Squidz.

There is currently on the IBD group at Yahoo a kitty having a fecal transplant being done.I agree with Alpha Cat but by no means want to ram any idea down anyone's throat.I did have a link from Australia but went into cyber space.  .I emailed the friend that sent it to me yrs ago.He will get back to me.When we see Euthanasia we freak at some point.You being the owner of your babe is already walking on thin ice with every emotion I'm sure.As to why don't vet's know more about it? Because they don't care.They make enough at their practice to suffice their fancy lifestyles..Only very few are still in it for what they began to go to veterinary school for.The love of Animals.The others have been drowned out by $$$$$$ So when i get the link I want to send   I will forward it along to you.In the meantime on the IBD group under their search engines one member had a link so I'll give this one to you.  http://eatsh-tandlive.com/ > It may be the same as what Alpha cat sent you.I don't know.When my friend in Australia posted this link to the IBD group no one said a word.It was not saved in any files or links in that group & it should have been.Actually their links are from the stoneages.I feel for you as we all do.So true to get feedback from members having certain surgeries,new type of procedures & hearing how all is going.Good & bad.I too on the MC group am asking all the time.But to be honest our links are in the stoneage as well.And people most of them do not get back to us.I understand where Alpha Cat is coming from and like she said don't take it personally.Hard not to.But try not too.I have my rants from now and again just out of caring & come across in a demanding way.When in reality I really care.So does Alpha Cat & everybody else.So hopefully I sent that link to you properly as I am not a computer savvy person.I am a mechanic of 30 yrs and will flourish with a wrench.But do love Kitties /Animals period.HTH Honey C.Hugs to your babe

https://groups.yahoo.com/neo/groups/felineibd1/info

Sorry Squidz & the Forum NOT Alpha Cat White Shadow I think it was.LOL C.I guess you become an Alpha cat after posting so many posts or what have you.No idea.I am a kitten & honestly love to think of myself as a kitten and not the old bag i really am.

I'm so sorry to hear you are having to go through this.  Please keep us updated on your fur baby's condition.  Mine came home from a hospitalization today with an IBD diagnosis and I want to know what is and is not effective for others.  Prayers your way. 

Hi squibz.Thought i would get back to you about your kitt.I recommend you join this group not the ibd group.The pancreatitis group at yahoo has members there who deal with inflammation all over the bodies of cats.Their knowledge is far superior to any yahoo group I belong to.They should have Dr. in front of their names.They will want to know all the details.The more the better.Meds etc.OK? Worth a try. Their link is https://groups.yahoo.com/neo/groups/Feline_Pancreatitis_Support/info  Please post New Member urgent diarrhea for yrs vet saying euthanasia.Something like that ok? Hugs C.

Hi Squidz.i have some information on diarrhea etc.A member from the CKD group told me her kitty had chronic diarrhea for months.She was told by another member to try Twin labs apple pectin.She said it comes in capsule form.She said it is all natural but bitter.What she did was take babyfood chicken & mix a pinch of the capsule in with it & syringe it to her girl.Multiple times a day.Using up a capsule per day.It stopped her diarrhea in it's track.Now she said that won't help the healing process inside that is where you would want to introduce Seb.Now there was a member I deal with who bought capsules for her cat at the healthfood store.Unfortunately her email is no longer.So i don't know the dosing she was using but I know she was sprinkling it into her Moomoo's food.I only know of Tanya's site for SEB.  www.felinecrf.org  Here is a study done in Germany on children who had diarrhea real bad.

http://www.ncbi.nlm.nih.gov/pubmed/16889120

Hope that may be of help for you if she is having projectile. HTH C

Hi Shaun.i have the links for slippery Elm Bark now to give to you.the one by Little Big Cat talks of the Capsules for the health food store & what to do.Some of these links may be repeats fo what you already have.Alos SEB can elevate levels of calcium in the blood.And it can have slight diuretic properties to it.you you'd have to keep an eye on both.Also nothing is instant as I'm sure you already know.But here you go:

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Here you go,

Slippery Elm Bark info:

http://www.felinecrf.org/holistic_treatments.htm

http://www.littlebigcat.com/health/slippery-elm/

Information on SEB, watch potassium in blood:

http://suziqi.nl/2013/03/21/health-benefits-of-slippery-elm-bark/

http://www.webmd.com/vitamins-suppl...dientId=978&activeIngredientName=SLIPPERY ELM

http://www.articlerich.com/Article/How-to-Make-Slippery-Elm-Syrup/793942

http://www.felinecrf.org/holistic_treatments.htm

HTH Honey Hugs C.

So I found out that we have been giving her Slippery Elm, it is one of the ingredients in the Vitality Science we have been giving her.  We took her to another specialist and we may be too late.  They did tests on her today (she is still there) and she may be in early stages of cancer.  They won't know for sure without a biopsy, which I don't really want to put her through again.  She has lost another two pounds over the last few weeks.

We have tried everything we can think of to help her for well over two years now.  I think we may be at the end of this road.  She's almost 13 years old, and has had a wonderful life with me and my wife and her brother, Shadow.  It's just hard for me to let go, but it's not fair to keep her if she is in pain just to make myself feel better.  Thank you all for your suggestions and support.

I am so sorry.  Cancer is always in the back of our mind with an IBD kitty.  I think this is especially true when they are young when the IBD starts.  I know with Patches his started when he was only 18 months old and I never did find a dietary trigger for his flares.  I think there are a multitude of causes for IBD.  Sometimes we can only do what we can do.  You have hung in there and got her all the care that veterinary medicine has to offer.

I am very sorry to hear your news, @squidz, I've been following your thread. Our previous cat also had IBD and, most likely, cancer, but we also couldn't put her through the testing because she was so frail from other illnesses. A lot of what you write is painfully familiar, including the rapid weight loss for the cat and the horrible difficulty for the people to let go. I'm glad you also had many good years with Niko. You've obviously been through a lot with her over the years and taken fantastic care of her.  She's a very lucky cat.

Hi squidz I'm sorry to hear your kitty is till unwell.Did you have an ultra soound done now?To look at inflammation in the gut etc? Or have you had many as your kitty has certainly had this for a very long time.I personally don't want to say i'm sorry as to me your kitty is young.Iread daily of kitties going under the knife way older than your and on death's door.Was endoscopy discussed with you?.Depending on the 5 layers of the small instestinal wall where they see inflammation on the ultrasound will give them an idea if endoscopy is an option.With my boy @ 15 the Internist felt where the inflammation he had it was not reachable as per the tool they use to grab a sample.Too far to the outside layers.Depends on where they are seeing it.I have also seen  many a kitty diagnosed with small cell and 24 months later doing very well.It is the slowest growing forms of cancer there is.Unless something has really changed with your kitty as per symptomology in the last year i find it highly ulikely.But I am not a specialist taking samples.I did not go the chemo route with my Maxwell who had small cell and he died one yrs post diagnosis.BTW he never had diarrhe ever in his life.That being said severe cases of IBD which I believe could be possible with your baby and introduction of chlorambucil(Leukeran) is not hear of at all.I thought I'd send you some links.I'm sure you have read everything there is but maybe not.I do not know if you went a white diet dealing only with one protein as per food & did that for at leas t3 months.I do not know if you are at max doses of pred or you have tried budesonide instead.As per SEB depending on what amount as per dosage of seb is in the proviable would tell if it is the same amount as giving just seb on it's own.I don't know if you have had a folate/cobalamin test via blood draw to show inadequate absorption in the B vitamins.I do not know if you are supplementing your kitty with Vit B's and have been all along.I do not know if you have had fecal smears & testing done.I know a lot of I don't knows.I believe your kitty to be young.Just what i think.You have been through it all.Your kitty dealing with all kinds of things.

I'm hoping every option has been exhausted before you make that decision.Every single one.I do not know if you are supplementing with subq fluid therapy daily as dehydration would be huge.Here are the links.Hugs to you & your Babe.Cindy

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5.4pt;mso-para-margin:0cm;mso-para-margin-bottom:.0001pt;mso-pagination:widow-orphan;font-size:11.0pt;font-family:"Calibri","sans-serif";mso-ascii-font-family:Calibri;mso-ascii-theme-font:minor-latin;mso-fareast-font-family:"Times New Roman";mso-fareast-theme-font:minor-fareast;mso-hansi-font-family:Calibri;mso-hansi-theme-font:minor-latin;mso-bidi-font-family:"Times New Roman";mso-bidi-theme-font:minor-bidi;}</style><![endif]Fighting Feline IBD with both a Traditional and Holistic Approach

Enough options have been exhausted that I'm not putting her or me through this anymore.  It's been almost three years.  A vet and a specialist have now told me that we are looking at some form of cancer.  Niko is miserable and I need to let her go.