Cancer or something else?

Sorry this will be long.

I have a persian cat named Muffins, she will be 10 years old on Saturday.  From the time I brought her home from the breeder she has been of less than perfect health.  She had a cold she could not seem to knock and was eventually diagnosed with herpes.  She had issues with corneal sequestrums when she was younger but went a long time without any issues...last year she had another but with eyedrops we managed it.  She's not an outgoing cat...she will usually stay upstairs when company comes and really only likes attention from me or my husband.  

I noticed the first bit of strange behavior from her when I was about 7 months pregnant...she started staying put when people came by and if they approached her to pet she would smack at them.  People found it sort of humorous that she would sit there on the table and stand her ground...and I would have to tell people...please don't antagonize her, she's an older cat so she's probably just gone a little grumpy.  Then we had the baby and she's been an angel about him...she has only smacked at him a couple times and he's 14 months old.

Around his 1st birthday when he was starting to try and walk, she was acting somewhat funny...seeming like she could not get comfortable to lay down at night, and she was yelling a few times up in the bed and I had to run up and check on her.  Took her in for bloodwork and it was fine.  He gave her some antibiotics and a shot of steroids I believe because the steroids had always helped her to feel better in the past when her herpes was bothering her.  She seemed to be ok after that for a little bit.

Sometime in late August I noticed that she was not eating her favorite treats, the Temptations.  This cat is obsessed with Temptations.  She would beg for them day and night.  She has never been a big wet food fan, mostly licking it...she would eat dry food some but she ate a lot of treats.  She loved drinking water out of my cup at night also, so much so that I could not keep her off me until I let her drink from my cup.  At some point in August I switched to a water bottle because it was easier...and figured she drinks from her water bowl and she will be fine.  So when I noticed the treat problem...she would pick them up in her mouth then drop them.  I kept an eye on her and it continued...I also realized I have not seen her at the water bowl in a while either.  

I took her back to the vet again for a dental...convinced that a 10 year old cat probably has some teeth issues.  Here is where my issues started with the vet.  I LOVE the regular vet I see...but during this ordeal I dealt with mainly techs and the other vet.  The tech who took Muffins mentioned to me it looked like she had stomatitis...started talking to me about removing teeth and I gave permission.  Said it looked like she had a sore in her mouth.  When I picked her up that evening though they told me another story.  Everything looks great we cleaned her teeth no removals.  So I'm like...well she;s not eating.  I took her home and they said keep an eye on her and let her recover from cleaning and see if she eats.  No eating so we were back in a few days.  She had lost weight and was down to under 6.5 pounds.  

Saw the regular vet I see and he x rayed her and thought he saw some stomach inflammation...she got some subq fluids and he gave me the A/D food to help her gain weight...she ate a little there in the office so we thought ok try new food.  Took her home.  I'm a little shaky on dates because there were so many appointments but he may have mentioned cancer at this point.  Basically...we got an ultrasound next. I had to wait until a Friday for the guy to come in who does ultrasounds.  I was so worried.  He did a full body and came out and told me that he saw nothing out of the ordinary!  I left her for IV fluids and went home.  When I picked her up I spoke to another tech who started going on about IBD.  What?  No doctor gave me this diagnosis but she told me to try the I/D food again and I started syringe feeding her at home.  I had no clue and was given zero guidance so I was given the tiny 3cc syringes and was feeding her with those...she was getting about 30cc per day plus some pedialyte.  Fluids continued twice a week for a couple weeks and I also did some subQ at home which she hated.  She just came home every day looking stressed out and miserable.  She DID eat a couple times on her own...some chicken but it would be one day then she would go back to not eating.

It reached a breaking point after the 4th IV fluids where I realized after reading online that I need to be feeding her a LOT more...and I just was not sure I believed the IBD diagnoses as Muffins has never had big issues with her bowels or vomiting.  I was so mad at spending all this money and not even speaking with a vet...so I called and told them I will be treating her at home.  The vet I don't usually deal with called and told me to text him if I had any issues or needed any questions answered.  I started feeding her 25cc of food 4x a day with some water mixed in.  She's not a fan of it but I have no choice.  

She came up with a bad URI about a week later and I went to the vet and picked up antibiotics...her eye looked terrible and I asked about that and they gave me neopolydex.  I asked them...I have read that steroids should not be used in herpes....and the front desk girl said...that's what we give my moms cat with herpes.  The tech told me, this is what she's had in the past...its ok.  So I gave to her for about a week.  The eye did clear up and the URI faded.  She's getting 2 doses of lysine daily in her food.  

Her behavior has improved...she seems happier.  Last week I got some of those new treats which are like a string and she got so excited playing with it that she started eating it...ate another whole one then actually ate a Temptation...it was huge!  Then she stopped again.  Sunday she drank water out of my cup but then the next day she wouldn't.  She gets excited when I touch the food bag and sometimes sits and begs for treats but when I throw to her nothing.  

Last trip to the vet which was a week (I took her in because she was having a problem pooping and threw up for the first time) ago she was down to 5lb 10 oz.  .  You can feel all her bones BUT she felt like she had gained a tiny bit of weight to me so that was a big blow.  Vet is convinced cancer.  Asked about quality of life.  He said I could take her to a specialist but we both agreed that they would just do all the same tests which would mean more money and for what...a cancer diagnosis?  I don't want to put her through chemo just for a few painful months.  I brought her home with lots of tears and decided to keep trying with the food and if she threw up again maybe it was time to think about the worst.  I had requested mirtazapine for her from the vet, because she hated cyproheptadine....and I think she's a little neurotic to begin with so the antidepressant might put her over the hump...and maybe this is all stress.  The first night was rough, she did not look good.  I was so worried. Then she bounced back and has seemed ok since.

I keep holding on to hope.  The weight loss after feeding her more than I'm sure she used to eat...it was bad.  I thought though...back last time they weighed her she was being pumped full of fluids and so that must have inflated her weight.  It's possible her weight dropped below 5lb 10oz and she was in fact on a small rebound?  I mentioned fatty liver disease to my vet cause I'm SURE she has it because she did not eat for longer than 48 hours when we were clueless what was going on.  He said oh they would have seen it on ultrasound.  I asked for blood tests...it showed elevated liver...on the borderline to ok...which to me says she did have FLD but maybe its getting better because of my feeding her.  Her lipase was high but not her anylase.  

Basically my plan is to keep feeding her and loving her and see what happens. I just added fortiflora to her diet and she gets supplements of nutrical as well.  I guess she's eating about 150 kcal a day.  She's soooooo skinny but she can jump in the bed on her own and go up and down stairs.  The last couple nights she's been SO cuddly at night which is not that normal for her...she wants to be in my lap being petted.  

I think my next step is to go to an actual pet dentist to have x rays done, as I'm not convinced there's nothing going on with her mouth.  When I syringe feed her she grinds her teeth about half the time...which sounds awful.  Her kidneys are fine.  I wonder if its just the syringe feeding messing with her jaw or if this has been going on?  I feel like we need more answers on the mouth.  SHe has a small bump on the side of her throat which could be a lymph node...showing an infection...nothing funny on the bloodwork indicates an infection.  Fecal was negative but we gave her a dewormer just in case.

So sorry that was very long...this has just been going on a while.  Am I wrong to think that untreated lymphoma would have killed her by now??  Also how long would it take for a just under 6 pound cat to gain weight?

Her eye has a spot on it again and I'm just giving her the full dose of lysine...I'm hesitant to use the neopolydex drops on her.  SIGH.

I would go to another vet.  The big tip off for me is giving a steroid for herpes.  A steroid suppresses the immune system which is not what you want to do when the body is fighting a virus.  

I would not jump to the conclusion that this is cancer, it could well be IBD.  Kitties with IBD often do not absorb nutrients well because of inflammation in the intestines.  There is a blood test that is done at Texas A&M that checks absorption.  There is also a more definitive test for pancreatitis that has to be sent out.  Do you have any cat's only vets in your area, better yet would be a certified feline specialist.  The certified specialists are few and far between, there are only around a hundred of them.  A vet school clinic would be another option if that is available.  They are staffed by students but professors oversee the care.

I am in the DC area not far from Annapolis.  I am going to look around.  Is it pretty normal for IBD cats to stop eating?  I changed her diet to grain free wet food from the local holistic pet food store.  I have tried different types like duck and whatnot.  Will the fortiflora help do you think?  After spending $4000 it's not that money is an issue, but more like I don't want to spend a ton more and not have a diagnosis.  My vet wanted me to just keep bringing her for fluids twice a week at $280 a pop and had zero interest in what or how much I was feeding her...their lack of guidance over the couple weeks when I was clueless could have killed her and that upsets me.  The bill showed fluids as well as IV antibiotics (which upset the stomach), some outrageous cost for IV pepcid, 2 charges for Vitamin B12.  It was just sort of crazy and the thought of having to do that twice a week was awful...she was so miserable.  Her behavior has been amazing compared since I started treating at home.  I'd love to diagnose this and be given some solid advice on how to continue treating it from home.  Her last labwork showed that she was hydrated so I'm not worried about that anymore.  

Here is where you can search for a certified feline speciaist  http://www.abvp.com/diplomate   There is both a canine/feline speciaist and a feline specialist.  I would go with the feline specialist is possible.  I did the vet hopping thing with my IBD kitty for six years trying to get a good diagnoses before I finally got one.  I was also shelling out big bucks for basically just supportive care.

@Denice  has many years of dealing with IBD, and I must say as I read your first post, that IBD struck me also as being very possible as her issue.

It is painful for them, although of course they are masters at hiding their discomfort too.

Had anyone discussed just how IBD requires a different way of feeding/diet?

Basically the main overview is to look at what the food contains that she has always eaten, what is the main source of protein, chicken? Fish?

Does it have grains, etc.

You eill need to take this away and switch to a food that is completely different like Natures Variety Instinct limited ingredient diet, and choose the protein that she has not been exposed to.

STOP the temptation treats entirely. These will set off a flare up fast. (I know, kitty crack, irresistible)

In other words, I have been able to treat my cat entirely with changing her food to turkey limited ingredient food, including her treats.

Her sensitivities are chicken and fish.

Denice said:

 
Here is where you can search for a certified feline speciaist  http://www.abvp.com/diplomate   There is both a canine/feline speciaist and a feline specialist.  I would go with the feline specialist is possible.  I did the vet hopping thing with my IBD kitty for six years trying to get a good diagnoses before I finally got one.  I was also shelling out big bucks for basically just supportive care.

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None in my area, surprising.

What do you guys think of prednisolone in low dose to treat the IBD? Would that be terrible with her herpes?

catwoman707 said:

 
@Denice  has many years of dealing with IBD, and I must say as I read your first post, that IBD struck me also as being very possible as her issue.

It is painful for them, although of course they are masters at hiding their discomfort too.

Had anyone discussed just how IBD requires a different way of feeding/diet?

Basically the main overview is to look at what the food contains that she has always eaten, what is the main source of protein, chicken? Fish?

Does it have grains, etc.

You eill need to take this away and switch to a food that is completely different like Natures Variety Instinct limited ingredient diet, and choose the protein that she has not been exposed to.

STOP the temptation treats entirely. These will set off a flare up fast. (I know, kitty crack, irresistible)

In other words, I have been able to treat my cat entirely with changing her food to turkey limited ingredient food, including her treats.

Her sensitivities are chicken and fish.

Click to expand...

Yes she's not a big eater so as bad as it is I feel like Temptations have been a big part of her diet for a long time...she never had digestive issues before so I gave them to her...probably in excess.  She used to just scream and scream at me until I'd give her as many as she wanted.  The cats all free feed RC Urinary S/O as well because my other persian Nannerpuss had UTI issues.  Nannerpuss and Gordon will eat fancy feast daily in the morning, my husband gives it to them and Muffins will lick a little bit of it and walk away.  We give a variety of flavors but stopped doing seafood ones a while back because it seems to upset Gordons tummy.  

Since this started Muffins is not eating (or drinking) on her own so the food I am syringe feeding her is all food from the holistic store like EVO/Wellness/etc.  I am sure they would have the Natures Variety at the store and i can check it out.  I've bought duck/venison even freaking kangaroo.  lol.  

There have been a few instances in which she has ate or drank on her own.  One day it was after coming home from an all day IV fluids.  She ate some chicken I put on a plate for her that we had had for dinner.  Last Sunday she was showing interest in my water...she used to always drink out of my icewater cup, so I kept leaning it over for her.  She seemed like she had almost forgot how to drink at first...then she'd take one lap...then another then she went to town on it.  Since then though we are back to not wanting to drink.  

The last few days though her spirits seem very well and she is almost like the cat she used to be....behavior wise.

gbgirl79 said:

 
The last few days though her spirits seem very well and she is almost like the cat she used to be....behavior wise.

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Alot of that is likely from the fluids, anytime cats get sub-q'd they seem to perk up and gives them some relief.

gbgirl79 said:

 
Yes she's not a big eater so as bad as it is I feel like Temptations have been a big part of her diet for a long time...she never had digestive issues before so I gave them to her...probably in excess.  She used to just scream and scream at me until I'd give her as many as she wanted.  The cats all free feed RC Urinary S/O as well because my other persian Nannerpuss had UTI issues.  Nannerpuss and Gordon will eat fancy feast daily in the morning, my husband gives it to them and Muffins will lick a little bit of it and walk away.  We give a variety of flavors but stopped doing seafood ones a while back because it seems to upset Gordons tummy.  

Since this started Muffins is not eating (or drinking) on her own so the food I am syringe feeding her is all food from the holistic store like EVO/Wellness/etc.  I am sure they would have the Natures Variety at the store and i can check it out.  I've bought duck/venison even freaking kangaroo.  lol.  

There have been a few instances in which she has ate or drank on her own.  One day it was after coming home from an all day IV fluids.  She ate some chicken I put on a plate for her that we had had for dinner.  Last Sunday she was showing interest in my water...she used to always drink out of my icewater cup, so I kept leaning it over for her.  She seemed like she had almost forgot how to drink at first...then she'd take one lap...then another then she went to town on it.  Since then though we are back to not wanting to drink.  

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I have actually had people say that they would swear the temptation treats are what caused their cat's IBD.

I don't know about that, but it's possible too. There is so much crap in treats, worthless for any nutritional value, but we all do it! They LOVE them!

My Simone who is not IBD still gets friskies party mix beachside crunch but Krissy who is IBD can not have them, so it wasn't easy finding a bedtime treat that she would like.

Since her diet is solely turkey, Blue Buffalo limited dry food turkey and fancy feast turkey pates, also blue buf limited turkey treats and she likes them well. I just recently added Instinct raw dehydrated turkey treats and she likes those, and turkey pure bites freeze dried treats but they are not cheap! Actually none of Krissy's treats are unfortunately.

You are feeding her good food, however they are not limited ingredient, and also are giving her a variety of proteins, and you really should work on staying with one, one she is not accustomed to having in her old food, chicken and fish are the most commonly used, and lamb somewhat too. So choosing what she will like more, turkey, or rabbit, or freaking kangaroo, whatever it is that you can get in canned and dry if she likes dry too, and stick with only that.

Read labels, do not go by the title on the can either, often turkey food has chicken in it also, and as I said, chicken and fish being the most commonly used, are big culprits of starting IBD when it is caused from an acquired food reaction/allergy from exposure over the years.

Thanks. I have to buy more food Monday so I'll check out labels and stick to one type of food!! I did buy some Orijen dry but she's not eating on her own hardly at all so dry isn't helping.

She's 5 lb 10oz and was close to 7 before this...any suggestion on how many calories I should feed to promote weight gain? It's been 2 weeks of feeding around 150....should I not worry that she's still super skinny? I am in this for the long haul of need be. My biggest worry is we typically go to Ohio the day after Christmas for a week...and obviously if this keeps up I won't be able to leave her. I thought about a pet sitter but I doubt anybody is willing to come 4x a day...unless I hire someone to basically live in my house.

That's a ways off though so I try not to think about it. It wouldn't be a big deal to cancel the trip but we have a 14 month old my husbands side of the family doesn't get to see much so Christmas week is a big deal...I'd hate to miss it but I'd stay home if she's still on the syringe.

You've got a good amt of time between now and then, I would certainly hope she is off the syringe before then!

Dry won't be a problem, start with the canned foods with limited ingredients, find the single protein you are going to use, and stay with only that to get her eating again, the dry will match but can be added later if she normally eats it too.

I just picked up some Natures Balance Duck and Pea.  I take a can, add 2 tbsp of water and mix it up...and then keep that in the fridge.  She gets 25cc 3-4x a day of that plus some nutrical and 2 squirts of lysine.  

I can call the vet to ask about prednisolone but what do you all think about her taking this along with having herpes?  It seems as if prednisolone is a very big part of overcoming the IBD.

Update on Muffins - 

We went to see a vet dentist in early November and she saw what looked like tooth resorption.  Scheduled dental surgery a couple weeks later and they removed 2 teeth.  One towards the front due to resorption and one in the back that was broken.  Came home and they said she could have hard food after a week.  I am still syringe feeding her...it's been about 5 months now.  She weighed 5 pounds even at the vet dentist, which is not great but hey...at the rate she was losing at the end of the summer, she'd be gone by now if it had continued...so she can stay at 5 pounds as long as she stays there.

She LOVES the pull and play string treats or whatever they are...they have replaced temptations as her go to food.  She still gets her duck and pea food in the syringe and she never throws up, has normal poops.  Her behavior is as it always was...she seems comfortable at night when she sleeps as opposed to "meatloafing" all night long.  

So the fight has been...eating hard food.  This cat is very sensitive...forms strong associations.  I know she is afraid to eat the hard food.  She seems way less interested in the temptations now that she has her string treats.  I went and bought her fancy feast dry since she used to eat it when she was younger and seemed to really like it.  Put it in our bedroom bathroom, because the other 2 cats are not allowed in there and they know it.  I think she likes to have some privacy.  Well...my husband reported to me yesterday that she was eating the dry food that morning when he was getting ready for work.  I did not necessarily trust it...so I have been stalking her and have not seen it myself.  I was putting our son down to bed tonight and he came in and said "she's eating again".  I went quietly back into the room and she was near the bowl but had moved onto a string treat.  This time though he was wide awake so I know he was not mistaking her for our other persian (they look similar..and he gets them confused sometimes if its just a quick glance or he's tired).  So I'm SUPER excited but I would love to see this happen with my own two eyes. 

We ended up going away for Christmas after all.  I hired a fantastic pet sitter who fed her twice a day and sent me pictures every time she was there.  It was amazing and such a load off my shoulders.  

So I'm gonna go ahead and assume this is not cancer or IBD?  I think it was the teeth all along.  I spent about $6000 over 5 months over this.  I'm sort of pissed at my normal vet because the first thing we did was a dental and they missed tooth absorption and a broken tooth??  I spent so much money after that and considered putting my best friend to sleep.  I'm torn on what to do because the whole debacle was handled by the head vet...and very little by the vet we normally see when we go in...and him..I really have loved for 8 years. 

She still has tooth grinding...her left lower canine rubs on the top right..sounds horrible and I know it bothers her...not sure why they did not pull that one also but I may have it done in the future.