Ultrasound Results: Irritable Bowel Disease vs Lymphoma

Hi everyone, my poor cat, Layla, has been going through tests trying to figure out why she is losing weight, depressed, vomiting, hungry but doesn't eat a lot. It started with severe vomiting and diarrhea everyday about a month ago to now no diarrhea and vomiting about twice a week. She lost about half of her body weight in the past year ever since we moved into a new house. The move was really difficult on her and my gut is telling me not to ignore this as a possible cause. We would hear her crying in a room and we'd have to talk to her and coax her to follow our voice to find us.

Her blood results were totally normal, but her ultrasound today reported her liver is enlarged, the walls of the small intestines are thickened and altered in layering, and she has numerous enlarged and irregularly shaped lymph nodes, which they said could be a result of an intestinal disease.

They want to move forward with the endoscopy. This is the specialist's recommendation, but her vet actually said that since she has such a strong appetite and her blood work is normal let's just move forward with the treatment for IBD and see how she does, 80% of the time it is IBD. This also because the endoscopy requires anesthesia and costs $2500, and my cat is 10 years old.

If interested, here's the ultrasound diagnosis:

1. Diffuse enteritis vs neoplastic infiltration.

2. Mesenteric lymphadenopathy is likely reactive and/or inflammatory.

3. Hyperechoic hepatomegaly suggests lipidosis or another hepatopathy.

Has anyone just skipped the endoscopy and gone right to IBD treatment with positive results? 

I didn't get the biopsy done.  I think everyone with an IBD kitty has made this choice.  The thing with an endoscopy it could very well still be inconclusive.  Surgical biopsy is more likely to give conclusive results but that is major surgery.  My IBD kitty has been on a steroid for 5 1/2 years now and his symptoms are well controlled.

Denice said:

 
I didn't get the biopsy done.  I think everyone with an IBD kitty has made this choice.  The thing with an endoscopy it could very well still be inconclusive.  Surgical biopsy is more likely to give conclusive results but that is major surgery.  My IBD kitty has been on a steroid for 5 1/2 years now and his symptoms are well controlled.

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This means so much to me right now. Thank you for your feedback. I didn't know the endoscopy could still be inconclusive. The doctors can be very persuasive especially when discussing the 'c' word. They called me to tell me the results, then called me :30 minutes later asking if I was going to approve the procedure for the same day.

We are moving forward with the IBD treatment. I'm also so glad to hear your kitty is doing well and his symptoms are well controlled. 

My guy has IBD. Yes, I did decide on Having the endoscopic biopsy. I did because I really had to know what it was. I worked in the medical field, so I was familiar with the procedure on humans. 

The plus side of having a definite diagnosis, is that many Vets will not give chemotherapy to a cat who has not had a diagnosis. I do not feel as if I would ever go the chemo route, in the future, if needed, but at least that option is open to Artie. 

The result was positive for proximal intestinal IBD; but forever the reason, the Vet could not get the scope any further, but I am not repeating the procedure. 

Personally, I am glad I have a definite diagnosis---I would never allow him to go through that again. Artie was 11 years old when he had the procedure. He was sick for 2 weeks after it. He was in pain. You could tell. He was immediately given the IBD meds, but he was not himself after the procedure. It took a lot out of him. He was really just lethargic and not really eating much at all, after the procedure. He was just all curled up..the sick cat pose.. and not wanting to be bothered. But once he healed up and the meds took effect, he improved. He had a flare a few weeks ago, and he has really been feeling good since then--fingers crossed...

Whether or not you go through the procedure is a personal thing. The reason why they really do push for it is because once you start giving the steroids, you cannot have the procedure without stopping the steroids for at least a couple weeks. So you will have to see your cat suffer even more, without the steroids. It will mask the IBD. 

I think that is what made more sense to me. I was not ready to really face the possibility of lymphoma and losing Artie so soon. Now, at least I am prepared if the IBD does turn into lymphoma.. 

I am wishing you well with your decision. I really am. I am sorry I did not reply sooner. 

IBD is a very frustrating, unkind, horrible disease; along with the flares which accompany it. 

((hugs))

Thank you so much for this information and sharing your experience. It pains me to not know definitively that we are dealing with IBD, but I have confidence in our vet. And to be completely honest, cancer is a horrible disease and I'm not sure I want to put my girl through chemo.

I placed the order for the pills to start treating the IBD. I've been to 3 vets now, because the first vet, her original vet retired and the new vet was treating her for pancreatitis which fluids and pain meds only masked the symptoms temporarily and I knew I had to get a 2nd opinion. Our 2nd opinion vet had much more confidence and gave us options, but sent us to the 3rd vet, an internal specialist for the ultrasound. Both the 2nd vet and specialist said they believe it's IBD because her hunger is so strong.

I didn't know you cannot get the endoscopy while starting the treatment for IBD, so thank you so much for telling us. At least we have the weekend to talk about this before the pills get in.

The cancer that is difficult to differentiate from IBD is small cell lymphoma. When they look at the sample cells they are looking at the inflamed cells to make the diagnosis The steroids take down the inflammation.

My Krissy also has IBD, her results were worded the same as your cat's, and more.

However the vet who performed her ultrasound did comment that she did not suspect lymphoma, then gave the option of a biopsy for a more definite diagnosis.

I did not have a biopsy done and she is not on meds/steroids.

Every case is different as far as the treatment needed, whatever it takes to get it under control, etc.

I got her tummy settled down with turkey baby food and pepcid for a few days, then got her on a single protein she had not had which was turkey, (not used like chicken is, in just about every cat food made in some form or another), she has been on blue buffalo limited ingredient dry turkey (1/4 cup a day) and fancy feast turkey classic which is grain free and only turkey, and it's been close to 2 years and she is doing well.

Every now and then, maybe every 6 months she has a flare up but gets through it fine, but of course it always scares me. One was several days of vomiting, but other times has been maybe a night of vomiting several times.

I believe because of how she is doing that a diet change is essential in controlling IBD.

Scary how common it seems to be nowadays.

I wonder how I would know if it ever does become lymphoma, but haven't found or heard a cut and dry answer to this.