Would appreciate guidance on IBD / most likely lymphoma

Hello! I am a first time poster, having only discovered this site recently. I am hoping for some guidance, advice, or any suggestions on how to proceed with my 15 year old tabby cat named Tyger.

About two years ago, Tyger was diagnosed with what my vet suspected was IBD, initially diagnosed as pancreatitis. Early symptoms were frequent vomiting (mostly food but also clear bile occasionally in the morning) and coughing up hairballs. Then he began pooping outside the box in strange places, like on the recliner or on the rug by the door. My vet said it was likely due to a food allergy so advised me to switch him from all dry food to some canned, avoiding fish and beef.

He would do better for awhile, then have a flair up and symptoms returned. I tried different canned foods but they either caused symptoms or he wouldn't eat them. When he began losing weight, I brought him back to an internal vet specialist, who did an examination and blood work and said he likely had IBD. Suggested trying other foods like duck, venison, or rabbit and prescribed Prednisolone. We discussed doing an endoscopy and possibly a biopsy, but agreed to try the Prednisolone first. Also put him on Mirtazapine and Tumil K for low potassium levels.

Tyger's symptoms improved for several months and he gained back a little weight, but then became diabetic. :-( So we took him off the Prednisolone and started insulin. His diabetes went into remission after about 3 months and we took him off insulin. But he continued to lose weight, down from his normal weight of 10 lbs to about 7 lbs.

Vet did an ultrasound along with blood work and confirmed intestinal thickening, along with mild renal issues. Tyger's weight dropped to 6.4 lbs and vet suspected lymphoma. I also found a few drops of blood on the floor on occasion from Tyger straining in the litterbox.

Due to his weight loss, age, and similar treatment regardless of whether a biopsy would show IBD or lymphoma, we decided to forgo a scope/biopsy and instead start him on Lukeran, Mirtazapine, Budesonide (in the hopes it wouldn't trigger his diabetes) and Tumil K.

That was 2 months ago. He showed some improvement in his mood and his appetite, but his weight did not improve. I brought him back to the vet this morning and he is diabetic again. :-( She said based on this and his continued weight loss, that lymphoma is likely and I should seriously consider putting him down. She said we could try taking him off the Budesonide and starting insulin again, but she does not think his health will improve enough to give him a good quality of life, especially since we were not able to successfully manage his digestive issues. She also said this was the first time she has seen him look different, not as responsive as in the past.

I brought him home for the weekend to have time with him and make a decision. I feel she is right but at the same time I look at him sleeping peacefully, purring when rubbing against me, and eating and going to the bathroom normally. He does not appear to be in pain,though he does show some difficulty lying down, which she thinks could be due to arthritis. He still greets me at the door every day when I come home from work, though he stopped sleeping upstairs with me months ago. He does not play or run around, but spends most of his time sitting under his cat tree by the slider door during the day and sleeps by himself on the couch at night.

I guess I'm wondering if anyone else has had a similar experience and whether there is anything left to try that might turn this around, or if it would only buy him more time, but not quality time. I am heartbroken and feel so much guilt that I didn't research his condition more thoroughly to learn how to manage his diet better to avoid this. I don't want to add the guilt that I put him to sleep prematurely without doing my best to help him, but I also don't want to wait until he is suffering.

I should add that this all started even earlier when he became hyperthyriod about 5 years ago. He was on medication for a year until he had the iodine radiation treatment that cured him, so he has been through a lot, my poor little guy. :-(

Michelle

Hi Michelle, I am a relative newbie to all of these issues, but I have an 11-year-old with pancreatitis and suspected IBD who also went through the blood work, ultrasound, food trials, and is now 6 weeks in to Prednisolone. I feel like I've learned a lot in a short period of time about these diseases in cats, how to manage them, and how to cope on a day-to-day basis from reading these threads. There are a couple of people on here who have extensive experience with these issues and will hopefully weigh in on Tyger's situation; but since it's a weekend I thought I'd just write something quickly here, to let you know that I can empathize with what you're going through.

I think the decision of when to put your cat to sleep is such a personal one, and only you really know when you've reached that point. I know your vet said that Tyger's seemed "different" the last time, and that may be true - but he may have been fed up with vet appointments, or just having a bad day. The fact that he is relatively comfortable at home, purring and spending time with you downstairs, is really encouraging I think! My cat is not quite "the same" since before all of this started, and it took her a while to recover from a string of vet visits, etc - all of that can be really stressful for them. But overall if Tyger doesn't seem to be in pain, I personally don't think it's time yet (just my opinion though!). My parents had a cat with kidney cancer, diagnosed very suddenly and he was only 4 years old. They put him to sleep before he was in obvious pain, to spare him that, and they feel like their decision was premature. The morning of their appointment, he ran upstairs for the first time in weeks, and jumped in my dads lap and purred. So, one never knows what the "right" choice is - but I wouldn't want to see you feel like you took him too soon.

I fully understand how challenging it is to deal with these issues. My heart goes out to you and Tyger! I hope he continues feeling comfortable and maybe even stabilizes a bit. Hopefully some of the others will respond to your thread, but in the meantime try to enjoy some time with Tyger!

Wendy

The decision about when it is time is one for you to make with your vet.  Unfortunately I personally believe that when IBD is at the point of needing a steroid the more holistic remedies usually don't work well.  There are people that disagree with me on that and swear by a raw diet.  I have a kitty who has been on pred for almost five years and fortunately so far is tolerating it well.  I had asked my vet about Budesonide when he first started and she had the same experience your kitty had.  She tried it with diabetic kitties and their numbers did the same thing that your kitty's numbers did.

If your kitty is still eating well and appears to be behaving normally than I wouldn't have him euthanized yet.  There are some medications like cerenia that can give symptom relief for awhile.