Possible IBD, food allergy (or worse)

Hi, everyone, I'm new here. Before I go into the long story of what's been ailing my cat (would like to provide as many details as possible to see if I can get any advice, thoughts, etc.), I first would like to ask about Cerenia, which he's supposed to take for 4 days. I gave him his first dose this morning, but I have trouble giving him pills and he did what he usually does with them, spit it out and I had to try again. I got him to swallow on the second try, but he got a taste of it after spitting it out and within a short while began salivating, so I guess it must have a really awful taste. I did not use a pill pocket because I read online that it is not recommended  for this med. So my question is, can it be given with food then? Can it be crushed (I'm guessing no)? His next dose is tomorrow morning and I'm dreading it. I read somewhere it can be given wrapped in a small piece of ham (I think?) but as of right now his vet suspects a food allergy so I probably shouldn't feed him anything other than his food.

The cerenia is a good anti nausea med and is usually given 5 days on and 2 days off.  Another possibility is to use empty gel caps so kitty doesn't taste the med.  They can be ordered from Amazon.  The Vitamin Shoppe also has them but usually have a very limited assortment of sizes.

Many of us have been through the food allergy or IBD or Small cell lymphoma thing.  I have an IBD kitty that has been on a maintenance dose of prednisolone for five years now.  What works is different for each kitty.

Is your kitty on any other meds and what diet changes have you made?  Some people have also had good luck with a probiotic.

Okay, so my 8 year old cat (going on 9 later this year) started vomiting frequently a couple of months ago and at first I wasn't very concerned, thinking it was just hairballs (he's quite furry); he's always thrown up hairballs about twice a week with no ill effects (meaning acting completely normal before and after bringing up the hairball). This time around I was noticing that there wasn't much hair, just mostly liquid, but he was eating well and acting like his usual self so like I said, I wasn't very concerned. By December, though, the vomiting of liquid became a daily thing and with no hairballs coming up, I took him in to his vet. Now let me explain that this vet (he took over my cat's previous vet who has since retired) is following in the old vet's approach to take the economical route with his clients, meaning he'll usually only do a physical examination and reach a conclusion based on the pet's symptoms (this approach actually worked well for the old vet because he was quite experienced and good); if that doesn't resolve the problem then he moves on to doing tests. So, based on what I told him and the fact he felt nothing abnormal around my cat's tummy, he gave him a dexamethasone injection and sent us home with Amoxidrops and a probiotic. The vomiting stopped for a few days then resumed.

In January I took him back and this time x-rays were done, which showed nothing abnormal. The vet felt that maybe what had stopped his vomiting was the dexamethasone injection and not the antibiotic and began to suspect IBD. He gave us a prednisolone suspension, Panacur for 3 days just in case it was something else and switched him to the I/D diet (he'd been on the c/d since 2009 after a bladder infection, with no flare-ups since then). He also told me that if this didn't improve things, he could refer me to a feline specialist who could do an ultrasound. We have no specialist or ultrasounds for pets in town, so I just hoped it wouldn't get to that point. I'll admit I was afraid to take him off the c/d diet; I know many people will say that the Hill's Prescription foods are junk, but it had worked very well for my kitty (more on that a little later). Anyway, he didn't seem to like the I/D, particularly the dry formula (I feed wet and dry) so I, perhaps stubbornly, left him on the c/d. Also, as I researched IBD in cats online, I started to become afraid and depressed, since the long term prognosis doesn't seem to be very encouraging. I was also wary of the prednisolone, since it suppresses his immune system and can leave him vulnerable to infections plus possible long term effects. It wasn't making a difference, his vomiting continued (once a day and usually early mornings). Maybe because I didn't change the food?

One morning I saw tiny specks of fresh blood in the vomit, panicked and decided to give a different vet a try. She did a CBC, fecal exam, leukemia/FIV/heartworm test and looked at the x-rays he'd previously had done. Fecal exam showed diarrhea (weird, as he'd had none at home), was negative for leukemia/FIV (as I knew he would, as he's an indoors kitty and only goes out to the yard with me on a kitty harness/leash). Also negative for heartworm. His bloodwork showed moderate anemia and while his liver function was still within normal range, it was starting to get low, but she felt that rather than being the reason for his symptoms, whatever disease or disorder he's battling is what was causing this abnormality. He was a bit dehydrated, so he was given fluids with a lactated ringer and an injection of dexamethasone, B12, Convenia and looking at the bill now, I also see MET+CER (not sure what that is). This vet too discussed possible IBD or a food allergy, but she told me to keep him on the same food for the time being and gave us prednisolone in pill form, 5 mg 2x a day and metoclopramide syrup, to be given as needed for vomiting and diarrhea. Kitty was scheduled for a re-check in two weeks. He had no vomiting for the next few days and no diarrhea (despite what the fecal test showed) so after 5 days I stopped the metoclopramide. Six days after that, he had another vomiting episode, so I restarted the metoclopramide; two days later, vomited again and I again saw a couple of tiny specks of blood (this was over the weekend when all vets are closed and we were scheduled to go in on Monday anyway, so I had to wait). 

So, after going in last Monday, vet suspects a food allergy but being that he's an older kitty now, there is also the possibility this could be cancer and she said the only way to know for sure would be to go to a specialist out of town, but tests can run in the thousands, which is out of my range and would be too stressful for my cat (he gets anxious enough on car rides in town to his vets). If it turned out to be cancer I wouldn't want to prolong his suffering anyway; as much as it hurts (and trust me, I've cried a lot of tears the last few weeks) I'd have to make peace with letting go. Oh, she also had his thyroid levels tested and results should be in by probably tomorrow. Would also like to add that he's 11 lbs. now, down from his usual 12.5

He was put on the I/D after I told the vet I'd give it another try (she had also suggested the DM), but I'm finding that kitty is still turning up his nose at the dry form. Cerenia for 4 days and I'm to continue the prednisolone. But if this is a food allergy, wouldn't it be better to try grain free? Any advice on this would be appreciated. I'm willing to try a diet change but if his health continues to deteriorate, then I'll have more reason to suspect cancer.

I would try a food that is a protein which kitty hadn't eaten before, this is what you will often seen referred to as a novel protein.  If your kitty is good about eating wet food I would stick with that for now because it is easier to get a food that is as close to just the meat, liver and  necessary supplements with the wet food.  There are several that are good.  Nature's Variety LTD is good but is pricey.  There are others as well.   Do you have a Pet Store in your area?  If so you will be able to  find  good choices there by reading labels on the foods, you want something with as short a list of ingredients as possible.

I would continue with the prednisolone for now.  After symptoms resolve then your vet can start tapering the dosage.

The blood is really pretty common with IBD so don't jump to the conclusion that this is cancer.  My kitty had the same type of flares with vomiting liquid.  After the first 2 or 3 flares he also had blood in the liquid that he vomited.  Actually fresh  blood is a better sign then black or coffee grounds type of vomit.   It's a sign that your kitty's  esophagus and throat is raw and has begun to bleed.

Thank you and yes, we have a Petco. I know I've seen food there that is grain-free and others that are limited ingredients type, so I'll go check it out. I know they can get pricey, but oh, well, so is the prescription food so I'm used to it.  I guess my concern is getting him off the c/d for fear of a UTI, but I've read that giving them exclusively or mostly wet food actually helps to prevent that? 

The vet actually did say the blood is likely because of irritation. The reason why she mentioned cancer is because with vomiting that's been going on this long in an older cat, well, it's a possibility. Hoping it's nothing like that, of course, but it's been in the back of my mind all along.

I found this article and was wondering if people here would agree with it as far as rotating their food? http://healthypets.mercola.com/site...012/05/07/protein-diets-for-pets-allergy.aspx

I'm not sure why the vet wanted to go with the DM food; my understanding is that one is by Purina and is used for diabetic cats, although Hill's also has one that goes by m/d. Maybe she thinks the low carbohydrate/high protein will help? I'll check with her today and I hope she'll be open to the idea of going with a more natural food. I want to do what is best for my furbaby but I'm also hesitant to go against what the vet recommends because if kitty's issues aren't resolved she could say it's because I didn't follow her instructions. *sigh* Wish we had a holistic vet in town

In time a rotation is a good idea.  Initially though I would feed one food for several weeks then move on to another.  If your feeding a rotation you won't be able to figure out what if anything is causing these issues.

Did your kitty have crystals or was he prone to infections?  If he had crystals then yes you will need to be careful about foods.  

Yes, I read in the article how it's better to rotate every six months or so to prevent them from becoming allergic to the new food.

It was one bladder infection only he had in 2009, nothing before or after since and I had kept him on the c/d since that one incident. Would a high protein food make him more susceptible to those type of problems? I thought I'd read something about that once somewhere, but I'm not sure.

No high protein foods will not cause issues as far as bladder infections go.  There are so many possible causes for cystitis.  With crystals the goal is to keep the urine pH around 6.   There was at one time the theory that low protein foods help kitties with chronic kidney disease, or chronic renal failure but that is different from cystitis.   Many vets don't believe that is true for chronic kidney disease and that the real culprit is the phosphorous content of the food.

Have you talked to your vet about diet.  Many vets really want to stick with the prescription foods.

Yep, she did think it was best to stick with prescription food for now.   I went by the office hoping to speak to her during a break in between patients, but she was in surgery at the time. One of the nurses did get to ask her and said vet recommended the z/d and gave me a sample (they had no samples of the d/m). I looked it up online and some reviews say it did work for their pets. I guess I'll give it a try and if it doesn't work, I can say I tried it her way and saw no improvement in my cat. If it does work at stabilizing my kitty's tummy, I'll have to stick with it for a while and later move on to something better. I haven't given him any dry today so I'm not even sure if he'll take to it. It has a strong smell that might turn him off (if he rejects this one too, another reason to move on to something else). As far as his wet food goes he's accepting the i/d (slowly transitioning from the wet c/d) but again, I would prefer a healthier option now.

They did have the results of his thyroid test and everything was normal.

Thank you so much for your reply on the high protein foods. His next re-check is next Monday. Maybe then I can discuss food options with her a little better.

katlady-18 said:

Hi, everyone, I'm new here. Before I go into the long story of what's been ailing my cat (would like to provide as many details as possible to see if I can get any advice, thoughts, etc.), I first would like to ask about Cerenia, which he's supposed to take for 4 days. I gave him his first dose this morning, but I have trouble giving him pills and he did what he usually does with them, spit it out and I had to try again. I got him to swallow on the second try, but he got a taste of it after spitting it out and within a short while began salivating, so I guess it must have a really awful taste. I did not use a pill pocket because I read online that it is not recommended  for this med. So my question is, can it be given with food then? Can it be crushed (I'm guessing no)? His next dose is tomorrow morning and I'm dreading it. I read somewhere it can be given wrapped in a small piece of ham (I think?) but as of right now his vet suspects a food allergy so I probably shouldn't feed him anything other than his food.

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I'm sorry to hear that your kitty is sick. :-( hopefully, he will get better soon! As far as giving him the medication, in my experience I have found it is MUCH easier to use a (pet piller gun.) you just put the medicine in the end of the gun, it has like a rubber type material to really grip the medicine, then you wrap your kitty in a blanket or towel tightly and if you use one hand to hold his face near the back jawline his bottom jaw will drop open. When his mouth opens you use the syringe type gun to pop the pill into the back part of his mouth.I hope this helps, and I hope it makes sense to you. I am not very good at explaining things, so you can YouTube it.

P.s You can pick one up at your veterinarian's office for literally dollars. They're very inexpensive. I paid $4 for mine. or, you can buy one at a pet supply store. I believe you said you have a Petco? they should have one there too. It may be cheaper at the veterinarian's office, or it may be cheaper at the store. If you have time, I would shop around. Either way, they are very inexpensive and worth it.

by the way, welcome to the site! :-) I recently just joined myself, and I have received tremendous help, and advice! honestly, I don't know what I would have done if not for this site!!!

Thank you, Mukkia.

It's been a nightmare getting him to take the Cerenia and worse is the reaction he has to it--salivating quite a bit, acting afraid of me afterwards. Years ago I had become a pro at giving pills but either I've lost practice or he's become a lot more difficult (probably both, LOL). I've got one more day to go, then he has a re-check on Monday, and after that we'll see if the vet will take him off this med. If she wants to continue it I will definitely need something like what you described, or empty gel caps as Denice suggested.

Okay, so I haven't updated in a while but have kept in touch with some of you through someone else's thread and have given quickie updates there (my apologies to Mukkia, LOL!).

My kitty was put on z/d and taken off all meds (vet feels his problem really is/was a food allergy). He's been better, no more vomiting although on his last checkup over a week ago the vet detected a heart murmur which she said could be due to dehydration from all the vomiting he had before, or age; it got me really down, but we'll see how he is at the next visit in April. I'm hoping that once he's been stable for a while and retaining nutrients from food, this heart issue will be resolved (at his first visit the vet found him to be anemic).

So anyway, two new issues. Issue 1: Kitty has begun to refuse the wet z/d; he liked it at first, but now seems to have lost interest (he's still eating the dry form); I don't blame him because it has a strange, jelly-like texture to it (I have to add water to it to soften it up) but he needs wet food! I'm nervous enough about taking him off the c/d (which he'd been on for almost seven years since getting one bladder infection in '09), can't have him without wet food which I understand can contribute to UTIs/blockages. The z/d wet comes in only this one version, no other variety to choose from. We had also tried the i/d wet which he liked, but refused the dry form. The vet wanted him on either the i/d or z/d, no mixing so she could determine what's helping or not, so he was put on z/d on his last visit. (I know how opposed some people are to any form of dry, but I've been trying to use it as a supplement only and from time to time will need it anyway if I can't be home).

I'm open to non-RX foods, but also afraid at this point because I don't want to do anything that might cause the vomiting to begin again (and, since there really aren't other vets I can go to, I don't want to piss off the current vet). Also, a little history on him to explain my wariness with non-prescription food: During the first year of his life, he was a very finicky eater no matter what I tried. He managed to develop normally and be a very active kitten although I'm not sure how because I'm almost sure he wasn't getting all the nutrients he needed.  After turning a year old I was feeding him Wellness and tried a couple of other high quality foods that were recommended on pet forums but he continued being finicky and eventually developed tummy issues which went on for months; it was either vomiting or diarrhea and despite meds (antibiotics) he was never well for more than a few days. The vet he had back then checked for many things and couldn't find a cause. Eventually he ended up with that bladder infection, which was when I changed to another vet (now retired); he was put on an antibiotic for a month and I was told this same med would help his stomach issues (he thought it was some virus deep in his gut). He was also put on the c/d diet. After that, no more problems! I always credited the med for curing him, but now I see the change in diet is what might've helped. I know the c/d is not for stomach issues, but maybe something in the formula that's different from commercial foods is what helped? Somebody told me that sometimes a different formulation in a food is enough to help with stomach issues (?). I'm well aware many people think prescription foods are just junk and more of a gimmick and I don't mean to argue with anyone, I can only say it worked for us. The c/d was the first food ever he was not finicky about, he loved it, finally had a normal appetite and as I said, his stomach issues stopped. He was finally the healthy cat I always wanted him to be and I stopped being the scared, depressed, stressed out mommy I'd been for such a long time. On top of that it gave me extra peace of mind to know this food could prevent infections and crystals. I had hoped to keep him on c/d forever but of course, that's changed now.

Soooo... as I said, I'm open to suggestions, but at the same time afraid (bear with me, please). I just won't do raw (even more wary of it, sorry) or homemade because I don't cook at all.

Issue #2: I have another kitty I adopted in 2012 and I'd also had him on the c/d all this time. I've been transitioning him to the z/d as well because it would be difficult having my older one from getting into his food. However, kitty #2 has been having loose stools and last night he vomited. I think he just has a really sensitive tummy; when I adopted him, he had a lot of diarrhea and despite trips to the vet and meds and probiotics, it took me a month & a half to finally get his tummy stable. (I've been putting a bit of canned pumpkin in his food but his stools have still been loose and now the vomiting last night.) Hubby says I should just keep this one on the c/d. While I would have one less cat to worry about regarding bladder issues, it would be hard to keep his brother, kitty 1, away from it.

Help? Ideas? Sorry if my post is too long or confusing.

Dont forget to chase any pill or capsule with water using a syringe.  I don't know why animals should be expected to swallow dry pills when humans don't do it.  The pill gun is a good idea to get it in the back of his throat but then chase it with water quickly.   Gelatin capsules are great for biter pills (always taste anything you are giving your cat so you will know what you are dealing with).  Dont try to mix anything bad tasting in the food, it won't work and can create food aversion and distrust of the person feeding him.

As for the worry about the urinary problem recurring, all you have to do is keep the pH slightly acidic (below 7.0 which is neutral).  Studies have shown that feral cats generally have a pH of 6.0 to 6.5, eating a wild diet of whatever they can catch.  You can use pH strips to test his urine (easly available cheaply on eBay), and if the pH rises about about 6.5, there are ways to bring it down again.  I sprinkle a tiny bit of L-methionine on my girl's food and I feed her grain free turkey canned food.  Carbohydrates (Grains, fruits and veggies) raise the pH.. Animal protein and fat do not.  Her pH has been staying at 6.0 to 6.4 for six months just through that very simple diet alone and she has had no return of the crystals that she suffered from for a year before I got her.

Also, the C/D food contains DL-methionine, which is the manufactured version of the amino acid L-methionine, and it makes the urine more acid.  I  bought the natural L-methionine powder (Source Naturals, under $10 for a bottle that is only half gone after 6 mnths) and sprinkle the tiniest bit on her food and mix it in whenever the pH starts to go up and that brings it right back down. Of course I feed her wet food only because dry food does not hydrate them enough. 

Rather than worry about him reforming crystals, I would suggest you get some testing strips and just watch the pH of his urine.  If it stays between 6.0 and 6.5, you have nothing to worry about.  Struite crystals can't form at that slightly acid pH. If it goes above 6.5, start adding a little L-methionine to the food you are feeding.  Be sure to feed him WET food or wet his dry food if you must, because fluids flush out his bladder and keep the urine from being too concentrated.

Thank you, that's all very helpful information. Denice had mentioned the pH but I've had so many things on my mind that sometimes things have to be hammered into my brain before I can grasp them. 

A little something (important) I forgot to mention in my post (I currently can't see the option to edit it) is that thinking back on all the stomach issues he was having all those years ago and the vet not being able to find the problem, I now see that maybe he was suffering from food allergies back then too. I was trying to feed him good quality foods from Petco but nothing was working; I'm not sure if I tried any of the limited ingredient type but I do remember using venison in wet.