inflammatory bowel disease and sudden loss of appetite

Hello everyone,

Thanks in advance for everything.

I have a 14-year-old cat with IBD, who happens to also have kidney disease. I am posting this thread to ask about a very sudden loss of appetite in a cat who was only gaining weight for the first year and a half since being diagnosed with IBD. The vet says this loss of appetite does not have to do with the kidney disease (his numbers are low and he is not vomiting).

I only realized that he had IBD when they did a sonogram to confirm the kidney disease diagnosis. That was in April of last year (2015), and it showed diffuse, mild bowel thickening. 

His second and most recent sonogram was in January, and that showed diffuse bowel thickening (that they no longer called mild) and enlarged lymph nodes.

A vitamin B bloodwork panel also showed that he was folate-deficient.

But that he had high levels of vitamin B12 (however sometimes the body creates extra vitamin B12 to mask folate deficiency).

He has been on a folate supplement ever since.

However, all this time he was continuing to eat like a pig, as he has done all his life. I monitored his food intake closely, and even then he occasionally gained weight!  For instance between January & March of this year he gained an entire pound (the vet had said to allow him to this time, because if he was incapable of gaining weight, that might be indicative of lymphoma).  There was never any vomiting.

I watched his poop closely, and that yielded the only symptom of the IBD: some slight constipation. His poop was broken up and in different places in the litterbox. Sometimes there would be some diarrhea-textured/colored poop stuff surrounding some rock-hard poop. Other than that, there was never any diarrhea.

He has not had a biopsy. Since he showed no symptoms other than slight constipation, and what was showing up on his ultrasounds/sonograms, the vets thought that lymphoma was less likely (you apparently cannot be sure without a biopsy, however).

Around February/early March, I figured out that he was consistently constipated whenever he ate chicken, beef or lamb.

Since March he has only been eating pork, venison, rabbit, buffalo, kangaroo, possum, goat & eel (canned food). Constipation gone! 

In fact, now his poop is rather long and unbroken. A friend who supposedly knows a lot about nutrition said that might not be good either, because it can be a sign that he is not absorbing nutrients.

Then in mid-May, one day he did not finish his food. The day before he'd been a pig, as per usual. After that day, every 2 - 3 days his appetite got worse. Then it was worse every day. Now it's every meal. 

I've been giving him vitamin B, in spite of the high levels of vitamin B in his bloodwork in January. Just to get him to eat! At first that helped. But because of the exponential decrease in appetite, it's no longer helping. What it is doing is keeping him hungry. He tells me he's hungry, but he won't eat.

Does this sound like lymphoma to anyone? Does lymphoma ever look like this, where one day the cat is gaining weight, and then literally that same week he starts losing  his appetite? Can it develop so quickly?

Or could it be that a nutrient deficiency is causing the appetite decrease?

Or something else...?

It is really difficult to differentiate between IBD and small cell lymphoma, sometimes even a biopsy is inconclusive.  Symptoms are identical for both.  IBD can be and often is progressive.  My IBD kitty is on a steroid and about a 18 months ago he began loosing weight with no other symptoms, just a slow steady weight loss.  The diagnostics including ultrasound redone, no biopsy I chose not to have one done he has never had one done.  We increased his steroid dose, still a reasonable dosage but an increase, he regained the weight that he had lost and his weight has stayed steady since.

It is common for IBD to progress to the point that diet alone will no longer control the disease.  Loss of appetite is a very common symptom of IBD.  My kitty ended up with fatty liver from anorexia before going on the steroid.  I know there are issues with a kitty who has CKD going on a steroid.  It might be time to ask your vet about steroids.

Denise, thank you so very much.

Have you or anyone else on this forum seen any/many side effects from the steroids? If so, can I ask what they are like/how intense?

Yes, I suppose I knew that inflammatory bowel disease was progressive. What really surprised me here was the strange, sudden turnaround. Have you ever known/heard of a cat that went from eating like a pig to suddenly very rapidly losing his appetite? I would have expected the progression of the disease to be much more gradual. At the beginning of May he was gaining weight. By the beginning of June he would have lost weight if not for the vitamin B.

Thanks so much again.

IBD can be progressive and can also wax and wane.  My kitty would have flares that would start suddenly.  There can be a variety of symptoms.  My kitty would be constipated, anorexic and vomit blood tinged liquid.  His flares would come on very quickly.  I would go to work and he would be fine.  When I come home from work he would be sick and there would be stains on the carpet where he had been vomiting the blood stained liquid.  

Sounds awful.

Oh I didn't realize it could wax & wane, and so quickly too. Thank you!