9 Yo Female Not Eating: Ibd? Lymphoma?

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rubear

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Does anyone have experience with cats with chronic IBD vs. Lymphoma symptoms?

My 9-year-old cat, Ruby, recently stopped eating normally. Usually she eats about a cup of dry food a day and suddenly one week she started tapering off until she wasn't really eating anything. She would still take me to her food dish and act like she wanted to eat, but then wouldn't. I also noticed that her poop had gradually started becoming smaller, darker and harder. I assumed hairballs and constipation (occasional vomiting had preceded this by about  a week). I gave Laxatone and encouraged her to eat wet treats. No response to this.

I took her to the vet who said everything felt normal and blood tests were completely normal. She suspected IBD and noticed a low grade fever. She gave a Covenia injection, an anti-nausea med, and a short acting steroid. Ruby perked up and started eating again, not as much as normal but I was happy to see her eat anything. After a few days though she was back off her food.

I went back to the vet and another Dr. at the same office told me to switch her to a high fiber prescription food. We did and she began eating again and normal poops for about a week or so and then, suddenly, back to not eating.

Today we went back to the vet. She gave a longer acting steroid (Depo) and another Covenia shot just in case we were missing an infection. But she also mentioned that lymphoma could be a possibility, which is scaring the hell out of me. Hours later Ruby is sleepy, disinterested and zero interest in food. Vet says to come in tomorrow for anti-nausea meds if no improvement.

I'm extremely worried now because Ruby has eaten very, very little for almost 5 days and nothing I do or try seems to interest her in food, wet, dry or treats. For now that's the priority. But then, what about the possibility of lymphoma? Should I seek diagnosis of that? We had a bout of these exact same symptoms last year, but they resolved with similar treatment in just a couple weeks. That would make me think it's not lymphoma, but rather chronic IBD. But the fact that symptoms are worse and longer lasting now could maybe point to something worse?

I don't know. I'm a little distraught at the moment and just seeking ideas. I've never had her not eat this long and I'm very worried.
 

bellel

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First of all, IBD is probably the cause. Now I'm no vet, but I just went through this myself with my Tater Tot. Tater had a bout about 2 years ago that took no time to resolve. Then he got pancreatitis about 3 months ago and that's how they found out he had IBD (sonogram, xrays to confirm). His pancreatitis set off his IBD. And this time, his IBD is taking longer to get over. So it is probable that your cat has IBD. Here's the thing: neither vet seems very concerned about your cat not eating. And I say this because it only takes 36 hours of not eating to start hepatic lipidosis (which is a very bad thing). They need to be jumping on this now, not tomorrow. They need to give her anti-nausea drugs and schedule her to be tested for IBD. They need to be offering you options on feeding your cat. That may mean a feeding tube. You have to get your cat to eat now, not tomorrow. Lymphoma is a possibility, but the probability is IBD. Call your vet and tell them you are bringing her in today. Or you might try a different vet to get a second opinion. Whatever you do, it needs to be now.
 

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If you're really worried about lymphoma, then get her tested to put your mind at ease.
 
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rubear

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Thanks for the response. I also feel like it's most likely IBD, considering similar symptoms recurred far enough apart that if it were a more serious condition she wouldn't still be with us. I also agree that the not eating is a primary concern and I'm on top of that.

I should specify that she's not eating normally or her own choice. She is getting some calories. At this point I'm feeding her deli meat, as many treats as she'll eat and hand feeding her dry foods that she'll eat in tiny amounts. It's not ideal food nor as much as she should be eating—she's lost some weight since this all began—but hopefully enough to get her through and back to eating normally.

I'm leaving work early today to check on her. She did eat a couple bites on her own this morning before I left and I was able to hand feed her a full piece of ham and several treats. But if she hasn't started eating more on her own, then I'm calling the vet right away or maybe get a second opinion entirely.

I think a hypoallergenic venison or rabbit food might be an answer once we get over this hump—I just want to keep her safe in the meantime.
 
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rubear

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I think my bigger concerns with lymphoma testing is that the tests are very expensive, invasive and can be inconclusive if the cat is being treated with steroids (which she is). I read that lots of owners in my situation have shelled out thousands for diagnostic tests that were either normal or inconclusive only to find a simple diet change remedied the situation. But we'll see. An ultrasound may be in her immediate future at least.
 

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Yes, once steroids have been started, the tests are void. I encountered the same problem with Tater. We started him on pred before getting any gut tests done. Keep me posted. I will keep you 2 in my thoughts.
 

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So kidneys, thyroid, all normal? The not eating sounds like she's nauseated. Did you ask your vet about something like cerenia to help with the nausea and appetite issues? What about offering her some baby food (without garlic or onions). 

I'm not really sure that based on the info you provided that she has all that many symptoms of IBD. Seems kind of a big jump to make just based on nausea and smaller than normal stools. What other foods have you tried besides kibble? Have you thought about raw or homecooked? There's a lot of evidence that raw or homecooked can really benefit cats with digestive issues. I have an outside cat that gets terrible diarrhea on most commercial foods from years of eating low quality kibble (bless my neighbor, she tried). I put him on a mostly homecooked diet with probiotic added and his stools are normal.

you could also look at giving him some slippery elm syrup. This is a staple in my house. It's good fiber so it should help him poo but it also helps with nausea. You can find slippery elm powder at most health food stores or you can order online. 

http://www.foodfurlife.com/what-is-ibd.html

http://www.littlebigcat.com/health/slippery-elm/
 

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IBD symptoms vary from cat to cat. You don't have to have all or even most to have IBD. Some cats just present with diarrhea. Some cats just present with vomiting. And some cats just present with nausea. Regardless, your cat needs to be given a sonogram and xrays to see if there is a thickening of the intestinal walls. And you need to find out the root cause of the nausea before giving him any OTC products. You could be masking the symptoms of something that could be very serious.
 

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So, IBD is more and more common these days, I'm sure it is due to all of the crap put in commercial foods, my 14 yr old Krissy also has it.

Don't worry about lymphoma, treat it as IBD. Meaning stop ALL food she has been on, including treats, this is very important.

The key is, her body continues to react with inflammation from something in her current food.

Stop all food now, only water.

After 4 hours you will have regular strength pepcid-ac and several jars of turkey baby food.

Warm the baby food for her a bit, add a bit of water too, and that is the ONLY thing she can eat for the next 3 days, and if she does not eat on her own, syringe it to her, she needs about 2 jars per day to prevent liver failure.

Not too much water added, you want the taste to be strong enough to be tempting.

1/4 tab of pepcid twice a day helps her tummy settle too, you can stop after a couple days but with an IBD kitty, it's a very good thing to have on hand.

I changed my girl's IBD just on diet change alone.

It's a limited ingredient diet, that has only 1 protein like turkey, which is not used in standard commercial foods like chicken and fish are, so it will not cause the reaction of IBD.

After 3 days, her body is calmed down and not reacting, so start offering her blue buffalo limited diet dry turkey/potato food, get fancy feast turkey/giblet canned too.

NO TREATS at all unless they are the pricey freeze dried turkey only treats. NO temptation treats.

Bet she gets better :)
 
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rubear

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Thanks everyone for the input. It's so far been a roller coaster. I spoke with the vet and he wasn't concerned about liver failure because all of her blood work was completely normal to start with, she's a healthy weight and I am getting enough food in her that she's getting some food to protect her liver. He also suggested something like Nutrical high calorie paste.

Once the steroids kicked in her appetite improved (though her mood soured). I was still giving her ham and cat treats, but she was also eating some regular dry food. Things were improving steadily and then…I came home last night to find she had vomited everything she had eaten that day. Well over a full cup of vomit. But she also had a nice big well formed poop from the previous day's feasting, so I know things are passing through her. Not sure if the vomit was from too much ham and kitty treats or still IBD flare up. We're getting into a pattern where she improves for a few days and then suddenly vomits terribly and declines for several days. I'm calling the vet (again) tomorrow to talk about an ultrasound to rule out anything worse. We might do Cerenia to make sure it's not nausea.

I suspect it's a food change that will help, but it's going to be a struggle. In 9 years she's never been receptive of wet food of any kind (she immediately tries to bury it). She's not a variety eater. The positive is she doesn't care for people food (except ham and Reddi Whip, which I don't let her have for obvious reasons) but she also won't eat almost any kind of cat food, cat treat or unseasoned home cooked meat. Giving supplements or medications is a big challenge, always has to be by syringe. She did take to the Royal Canin fiber response dry food surprisingly quickly, but it's protein profile is similar to food she's been on for years—chicken. I'm hoping maybe a turkey or rabbit based food will appeal to her. She's also never eaten any foods or treats with fish, so that's an option as well (but again she would never touch them in the past).

My biggest concern is keeping her eating and healthy while we get the symptoms under control. Hopefully the ultrasound will be uneventful and we can dive right into diet modifications. I just don't want to change too much too fast while she's down and out.

With all this worrying I'm going to be the sick one shortly! I have to take a trip in a couple weeks and I have to decide whether to board her at Petsmart (she's usually been OK-ish with this option, but not sure if it's a good idea if there's a possibility she might not eat), board her with my vet (who could syringe feed her if necessary, but she's HATED being boarded there in the past), or take her with (she travels ok but gets stressed away from home). There's nobody that can watch her at home and she doesn't like anyone but me anyway.
 

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You can't just hire a pet sitter to come in once or twice a day? I really don't like boarding cats for any reason unless it's medically necessary because it's VERY stressful on them. Cats are creatures that need to be in a familiar place, and because she's struggling with illness it's even more risky to board her anywhere. It's more important for cats to be in a familiar place than it is for them to be with people they trust. So even if she doesn't like your pet sitter she can hide whenever she likes in the house until the pet sitter leaves.There are lots of good pet sitters online you can find for a more reasonable price than boarding, typically. 

If you're interested, this is a great article about how to transition stubborn kibble lovers onto wet food. It's definetly possible, I did it with a 12 year old cat (well, we we straight to raw because he never took to wet food. He does however like freeze died and raw). 

http://www.catinfo.org/docs/TipsForTransitioning1-14-11.pdf
 
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rubear

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A cat sitter isn't really an option for me at the moment. I don't have anyone close to stop by and I don't want a stranger in my home. I've boarded her with success many times (always at the same place and I think she likes that) and I've traveled with her. She seems ok as long as I keep her in her own safe space and she can sleep and play with me.

But thanks for the article on transitioning. We might start with a novel protein dry food and try switching once we're back in good health. I'm going to consult with the vet before making any changes, but I think that's probably what they'll suggest anyway based on previous conversations.
 

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A cat sitter isn't really an option for me at the moment. I don't have anyone close to stop by and I don't want a stranger in my home. I've boarded her with success many times (always at the same place and I think she likes that) and I've traveled with her. She seems ok as long as I keep her in her own safe space and she can sleep and play with me.

But thanks for the article on transitioning. We might start with a novel protein dry food and try switching once we're back in good health. I'm going to consult with the vet before making any changes, but I think that's probably what they'll suggest anyway based on previous conversations.
Good luck 
 

bellel

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Thanks everyone for the input. It's so far been a roller coaster. I spoke with the vet and he wasn't concerned about liver failure because all of her blood work was completely normal to start with, she's a healthy weight and I am getting enough food in her that she's getting some food to protect her liver. He also suggested something like Nutrical high calorie paste.

Once the steroids kicked in her appetite improved (though her mood soured). I was still giving her ham and cat treats, but she was also eating some regular dry food. Things were improving steadily and then…I came home last night to find she had vomited everything she had eaten that day. Well over a full cup of vomit. But she also had a nice big well formed poop from the previous day's feasting, so I know things are passing through her. Not sure if the vomit was from too much ham and kitty treats or still IBD flare up. We're getting into a pattern where she improves for a few days and then suddenly vomits terribly and declines for several days. I'm calling the vet (again) tomorrow to talk about an ultrasound to rule out anything worse. We might do Cerenia to make sure it's not nausea.

I suspect it's a food change that will help, but it's going to be a struggle. In 9 years she's never been receptive of wet food of any kind (she immediately tries to bury it). She's not a variety eater. The positive is she doesn't care for people food (except ham and Reddi Whip, which I don't let her have for obvious reasons) but she also won't eat almost any kind of cat food, cat treat or unseasoned home cooked meat. Giving supplements or medications is a big challenge, always has to be by syringe. She did take to the Royal Canin fiber response dry food surprisingly quickly, but it's protein profile is similar to food she's been on for years—chicken. I'm hoping maybe a turkey or rabbit based food will appeal to her. She's also never eaten any foods or treats with fish, so that's an option as well (but again she would never touch them in the past).

My biggest concern is keeping her eating and healthy while we get the symptoms under control. Hopefully the ultrasound will be uneventful and we can dive right into diet modifications. I just don't want to change too much too fast while she's down and out.

With all this worrying I'm going to be the sick one shortly! I have to take a trip in a couple weeks and I have to decide whether to board her at Petsmart (she's usually been OK-ish with this option, but not sure if it's a good idea if there's a possibility she might not eat), board her with my vet (who could syringe feed her if necessary, but she's HATED being boarded there in the past), or take her with (she travels ok but gets stressed away from home). There's nobody that can watch her at home and she doesn't like anyone but me anyway.
For supplements and meds, you can always have them compounded into a flavor she likes and syringe them (which to me is way easier than pilling my cats).

Also, I've noticed that because of the steroid, my Tater Tot is eating anything that isn't nailed down. And he sometimes vomits because he ate too much. Do you think this may be part of her vomiting issues?

As for steroids, budesenide is a better one to put her on. It's not a systemic steroid. It only affects the GI tract and it doesn't have the proclivity to cause diabetes like pred does. You might want to try switching her over (once you and your vet feel that she can).

Since you don't feel comfortable having a pet sitter, I would recommend your vet as the place to board her. They know her, her health history, and can be there in a pinch if something needs to change up (like if she needs a dose of Cerenia or something new).

As for getting sick, I totally understand. Tater Tot got sick with pancreatitis and IBD. Then Pepper started having major issues with the arthritis in her knee (to the point that she stopped getting up to go to the bathroom and had to have 2 enemas). Then Pie got a UTI. This was over an 8 week span. When I took Pie in for his diagnosis, I started crying in the waiting room. Knowing how sick my other cats were, they rushed me into a room. Once there I told them "I'm just so sick of coming here" while bawling. I knew Pie wasn't very sick, but I was tired. Tater at one point had to be on 11 different meds, making me get up at 4:00 am to give him his first round. I promise you will get through this. You're doing an awesome job of taking care of her and keeping on top of things. If you need anyone to talk to, please let me know. I am here for you.

Just my two cents. Please keep us posted. I'm interested in keeping up with her.
 
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rubear

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Thanks, it's nice to know other people go through this much worry too, not that I wish it on anyone. The stress is real. It wasn't so bad until the vet tossed out the possibility of lymphoma. It's just me and Ruby and it has been for 9 years, so needless to say just the idea of it led to a full day of crying at work. That's what everyone wants right?

I really do feel like its dietary though and we'll be fine once we get things straightened out. Honestly just a couple years ago I had the same symptoms and ended up having severe food allergies that had caused IBD. I know it's tough to handle in people and it can't be easier in kitties. 

My main concern is her calorie intake and liver right now. I think I'm going to ask the vet for another blood panel to put me at ease on that front. The first one was done a month ago and this has dragged out for a long time. 

Wish us luck!
 

catwoman707

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Blood test is not a good indicator of pending liver failure.

I will explain what Hepatic Lipidosis is about. (HP)

Lack of calories, less than at least 50% of her normal, will cause her body to turn to stored fat for fuel.

While cat's livers are sufficient, they are not overly so, the body takes stored fat and it gets filtered through the liver. When this happens the liver gets bombarded with the fat and will not be able to process it causing it to shut down.

This is when there is big trouble and is life threatening, and often a long haul to recovery.

So it is always the first concern when a cat is not eating enough, that they go in to HP, due to it's seriousness and difficulty to fix it.
 
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rubear

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Today's trip to the vet was not as conclusive or positive as I would have hoped. I can't get in to get an ultrasound until Wednesday. The vet did an x-ray which isn't very clear, but she noted that there could be a mass or some abnormality, but it was hard to tell. We repeated her blood panel. A month ago it was normal, now her liver enzymes are elevated. We did a cerenia shot to see if it would help her eat.

So for now the vet has me watching her to make sure she's eating at least some food until Wednesday when we get more information. If she won't eat at all or takes a sharper decline I am to go to the emergency vet.

The only food I can get her to eat is turkey deli meat. I know it's not ideal, but she will eat it at least. I got one with less sodium and fewer preservatives. She's drinking and urinating normally.

This is very stressful. I've basically been crying on and off all day. I don't know if I'm watching my baby heal or die and I don't know what the best thing to do is. I don't want to put her through the stress of hospitalization if she doesn't need it but I don't want to find out I waited too long. I'm already starting to feel like we've been waiting and watching for too long. If I could just see her walk up to her food dish and eat anything I'd be overjoyed.
 

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Today's trip to the vet was not as conclusive or positive as I would have hoped. I can't get in to get an ultrasound until Wednesday. The vet did an x-ray which isn't very clear, but she noted that there could be a mass or some abnormality, but it was hard to tell. We repeated her blood panel. A month ago it was normal, now her liver enzymes are elevated. We did a cerenia shot to see if it would help her eat.

So for now the vet has me watching her to make sure she's eating at least some food until Wednesday when we get more information. If she won't eat at all or takes a sharper decline I am to go to the emergency vet.

The only food I can get her to eat is turkey deli meat. I know it's not ideal, but she will eat it at least. I got one with less sodium and fewer preservatives. She's drinking and urinating normally.

This is very stressful. I've basically been crying on and off all day. I don't know if I'm watching my baby heal or die and I don't know what the best thing to do is. I don't want to put her through the stress of hospitalization if she doesn't need it but I don't want to find out I waited too long. I'm already starting to feel like we've been waiting and watching for too long. If I could just see her walk up to her food dish and eat anything I'd be overjoyed.
Take a poke around this website and if you'd like more support from hundreds of people who have been through what you're going through join their facebook group. You don't have to feed raw to join and they're not aggressive about it. They truly want to help sicks cats and really, really know their stuff. In fact the mods are former members here and really incredibly helpful and knowledgeable. Send you guys good vibes 


http://www.rawfeedingforibdcats.org/

https://www.facebook.com/groups/RawFedIBD
 

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Today's trip to the vet was not as conclusive or positive as I would have hoped. I can't get in to get an ultrasound until Wednesday. The vet did an x-ray which isn't very clear, but she noted that there could be a mass or some abnormality, but it was hard to tell. We repeated her blood panel. A month ago it was normal, now her liver enzymes are elevated. We did a cerenia shot to see if it would help her eat.

So for now the vet has me watching her to make sure she's eating at least some food until Wednesday when we get more information. If she won't eat at all or takes a sharper decline I am to go to the emergency vet.

The only food I can get her to eat is turkey deli meat. I know it's not ideal, but she will eat it at least. I got one with less sodium and fewer preservatives. She's drinking and urinating normally.

This is very stressful. I've basically been crying on and off all day. I don't know if I'm watching my baby heal or die and I don't know what the best thing to do is. I don't want to put her through the stress of hospitalization if she doesn't need it but I don't want to find out I waited too long. I'm already starting to feel like we've been waiting and watching for too long. If I could just see her walk up to her food dish and eat anything I'd be overjoyed.
I wouldn't think she needs to be hospitalized unless of course she stops eating altogether.

Whatever it takes to get calories in to her right now, that's what counts the most so she does not have liver issues.

If you count the calories she gets, 100 a day should keep her out of HP.

80 at the very least.

If she will not, then I recommend going to a pet food store and buying high calorie canned pate, add a bit of water to it and syringe feed her if need be.
 
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rubear

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I wouldn't think she needs to be hospitalized unless of course she stops eating altogether.

Whatever it takes to get calories in to her right now, that's what counts the most so she does not have liver issues.

If you count the calories she gets, 100 a day should keep her out of HP.

80 at the very least.

If she will not, then I recommend going to a pet food store and buying high calorie canned pate, add a bit of water to it and syringe feed her if need be.
I feel so bad for not seeking that calorie count information sooner. The problem I feel is duration, she's been eating very little or intermittently for a full month now and maybe damage has already been done. I kept voicing concerns to my vet and they kept telling me as long as she's eating some. But for the most part she's only been eating about a tablespoon or less of dry food per day and whatever cat treats I could get her to eat. I've tried to give her Nutri-Cal with a syringe but she's a fighter so I can barely get a teaspoon in her a day and then it only makes her hide. She ate next to nothing Wed-Thurs. Friday and Saturday she ate quite a bit but then Saturday threw everything up and didn't really want food anymore. Sunday I could get her to eat a piece of dry kibble here and there, but no substantial food until about midnight when I gave her about 4 pieces of very thin Deli Meat (only about 60 calories)

Today she was willing to eat as much of the turkey lunchmeat as I would give her so I gave her another 2 pieces at about 5 am and another 3+ pieces  after the vet trip. I tear it up into confetti. She's also had maybe 10-15 pieces of very small grain-free dry food today. She's drinking and urinating normally. I'm happy she's eating something, but I worry it won't be enough if fatty liver has already begun.

The vet said her liver enzymes were elevated and it could be fatty liver, liver disease or perhaps just elevated from the Depo medrol, she really didn't know and suggested I watch and wait for the ultrasound. It's probably sound advice, but I still worry that Im not keeping her healthy or damage could already be done.

She doesn't seem jaundiced that I could tell and the vet didn't seem to notice anything on that front. She's not completely lethargic, she still walks around and wants to play every now and then. FAR less than normal obviously. I can tell she's more tired than usual (although for some reason she's not sleeping at night like she usually does) and she has started complaining if you pick her up but she does still want to cuddle.

I'm probably just being over observant, and I'm sure if the vet saw anything truly alarming in her blood work or appearance she would have told me to go to the ER immediately. Instead she just sort of left it in my court to decide. I have this nagging fear that when I do go they'll say it's too late. I didn't go into this thinking it was as serious as it has become. She has no idea how worried her daddy is. She's just curled up like a Popple next to the heat vent.
 
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