9 Yo Female Not Eating: Ibd? Lymphoma?

bellel · Oct 26, 2016

RuBear said:
I just think the speciality vet wasn't ready to jump to that decision without trying to get her going on her own. Also the pancreatitis was a solid diagnosis it's just "suspect." We're waiting on blood tests to for that.

Interestingly, though we strongly suspected IBD (and it hasn't been ruled out yet) the ultrasound showed the colon being all normal. She thinks the increased liver enzymes might have more to do with secondary cholangiohepatitis caused by the inflamed pancreas rather than fatty liver. Apparently the other enzymes that would likely be high for fatty liver were in the normal range. But I will check out the IBD resources. Even though we don't know if that is the underlying issue it can't hurt to proceed as if it is.

Sorry if I sound like I'm trying to avoid the benefits of a feeding tube—I'm really not and I understand it as a great live-saving tool. I'm very receptive to it but still hoping we can get her going on her own.

Oh, I should've explained. I only recommended the IBD group because they all have lots of experience with pancreatitis and feeding tubes. They can give you lots of info. And they are extremely supportive. Pancreatitis and IBD seem to go hand-in-hand. They will be especially supportive as you begin to figure out what paths to go on. Great sounding board for your thoughts and emotions.

As for tests for pancreatitis, did she not do the SNAP test? That tells you within minutes if your cat has it. Was that not done?

Actually anti-emetics and antiacids help with appetites because they are motility drugs. They help not only reduce acid and nausea, but they move food along. And if your cat isn't eating it's very likely nausea. They don't have to be throwing up. Tater would just sniff at his food and then look at me. He had this look in his eyes that seemed to saying that he wanted to eat but he couldnt. Or sniff and walk away. That was his version of nausea. Nausea is actually hard to detect in cats.

Look, I know I'm being pushy, but I just worry a lot because of what my cat just went through. It's like PTSD. I went through 8 weeks with no sleep (first he got sick, then his sister came down with arthritis so bad that she couldn't get up to eat or use the bathroom. Then Pie, the youngest, got a UTI because Tater's aggression issues were exacerbated by his illness. It was insane.). I'm just worried about your cat and want to help.

rubear · Oct 26, 2016

BelleL said:
Oh, I should've explained. I only recommended the IBD group because they all have lots of experience with pancreatitis and feeding tubes. They can give you lots of info. And they are extremely supportive. Pancreatitis and IBD seem to go hand-in-hand. They will be especially supportive as you begin to figure out what paths to go on. Great sounding board for your thoughts and emotions.

As for tests for pancreatitis, did she not do the SNAP test? That tells you within minutes if your cat has it. Was that not done?

Actually anti-emetics and antiacids help with appetites because they are motility drugs. They help not only reduce acid and nausea, but they move food along. And if your cat isn't eating it's very likely nausea. They don't have to be throwing up. Tater would just sniff at his food and then look at me. He had this look in his eyes that seemed to saying that he wanted to eat but he couldnt. Or sniff and walk away. That was his version of nausea. Nausea is actually hard to detect in cats.

Look, I know I'm being pushy, but I just worry a lot because of what my cat just went through. It's like PTSD. I went through 8 weeks with no sleep (first he got sick, then his sister came down with arthritis so bad that she couldn't get up to eat or use the bathroom. Then Pie, the youngest, got a UTI because Tater's aggression issues were exacerbated by his illness. It was insane.). I'm just worried about your cat and want to help.

And I thank you for your support. This has been a month of hell. I will talk to the Dr. about those drugs. I'm not sure about the SNAP test. She said they took blood to test for pancreatitis but had to send it out for analysis so it was going to be a day or two before we hear.

Ruby has been doing much the same thing. She has eaten a few times tonight on her own, which is good. But mostly she acts hungry, goes to her food, sniffs and then looks at me—just like your cat.

A feeding tube may be imminent. We tried the syringe feeding tonight just to see and even with two people we weren't even able to get a single drop in her. And it would normally just be me and there's no way I'd be able to do it alone. She simply won't have it and I'm too afraid of hurting her in the process. Still hopeful she starts eating on her own in the next 24 hours but I'm less scared now about maintaining the tube. Not sure how I'll manage the midday feedings with work (I'm usually gone from 8 to 8 every day) but I'll figure something out.

bellel · Oct 27, 2016

RuBear said:
And I thank you for your support. This has been a month of hell. I will talk to the Dr. about those drugs. I'm not sure about the SNAP test. She said they took blood to test for pancreatitis but had to send it out for analysis so it was going to be a day or two before we hear.

Ruby has been doing much the same thing. She has eaten a few times tonight on her own, which is good. But mostly she acts hungry, goes to her food, sniffs and then looks at me—just like your cat.

A feeding tube may be imminent. We tried the syringe feeding tonight just to see and even with two people we weren't even able to get a single drop in her. And it would normally just be me and there's no way I'd be able to do it alone. She simply won't have it and I'm too afraid of hurting her in the process. Still hopeful she starts eating on her own in the next 24 hours but I'm less scared now about maintaining the tube. Not sure how I'll manage the midday feedings with work (I'm usually gone from 8 to 8 every day) but I'll figure something out.

Re:syringing her....did you wrap her up like a burrito in a blanket first? Thathe may help until you decide on the feeding tube. Yes, very important to give her multiple feedings throughout the day.

bellel · Oct 27, 2016

But you might be able to play with that schedule.

catwoman707 · Oct 27, 2016

Just a quick tip for syringe feeding an adult cat, which is most definitely NOT easy..

Use a pillowcase! Rather than making her overly anxious with a burrito'd body, her body is free to move around but the open end of the case is held at her neck and gives you full control without being scratched, etc.

Best bet is to offer her literally ANYTHING with calories, every hour or 2, including squirting nutri-cal on her arm she will clean off, try offering a variety of things, if she likes lunch meat or spam, my cats LOVE spam, chop it up and toss in some butter in a frying pan, more enticing.

Warm baby food up, warm chicken broth, anything that gets her to eat.

Good sign that she went for a few bites herself

Have to get ready for work now! I work nights.

bellel · Oct 27, 2016

catwoman707 said:
Just a quick tip for syringe feeding an adult cat, which is most definitely NOT easy..
Use a pillowcase! Rather than making her overly anxious with a burrito'd body, her body is free to move around but the open end of the case is held at her neck and gives you full control without being scratched, etc.
Best bet is to offer her literally ANYTHING with calories, every hour or 2, including squirting nutri-cal on her arm she will clean off, try offering a variety of things, if she likes lunch meat or spam, my cats LOVE spam, chop it up and toss in some butter in a frying pan, more enticing.
Warm baby food up, warm chicken broth, anything that gets her to eat.

Good sign that she went for a few bites herself
Have to get ready for work now! I work nights.

Just be careful with putting the Nutrical on her arm. I did that with one of my cats and she walked around with it on her arm untouched all day. Lol

bellel · Oct 27, 2016

Oh, yes, and they have those "bags" that you can put your cat in that also give them more freedom, too. Something like this:

http://www.fourflags.com/s.nl/sc.2/...bbOkJE9pILbmObykGTZp5PuHpLR8LAhkv2hoCVavw_wcB

rubear · Oct 27, 2016

I got some goodish news today. The specialty vet that did the ultrasound said that her blood work came in much better than it had been when we went, her elevated liver enzymes were still slightly elevated but had fallen greatly from Monday. Her blood work didn't indicate pancreatitis, but she suspects it's a chronic case rather than acute and they sometimes don't show with blood tests. She suspects it's a mild case of triad disease. A biopsy would confirm but it's too stressful to put her through. The only thing her blood work indicated was a B-12 deficiency so we're starting shots tomorrow. I'm nervous about giving them myself, but they assured me it's easy to do.

This is SUCH a relief to hear. I've been fretting over her eating for so long (and I'm going to continue to do so) but it does appear she's been getting enough food to avoid fatty liver. She has been maintaining her weight for a couple weeks anyway. Hopefully with B-12 and the appetite stimulants and, probably most importantly, pain killers she'll be eating more on her own. She has several times today. Basically she only wants cat treats so I mixed them into her food and it seems to be working. The turkey gets her attention as does lactose free ice cream.

Feeding tube is still on the table if things don't improve as is the option of having my vet do a couple tube feedings a week. I'd rather avoid both, but again, her nutrition comes first.

Though the news is mostly good, it's still tough to see my baby just lying on the floor. She doesn't want to do anything else but sit on a blanket in a room she never used to go in before. It doesn't help that the pain meds seem to make her stoned out of her mind and she'll just sort of wonder around and fall asleep in weird places. And she went outside the litter box last night which she's never done before. I think it's when their attitudes change that you really get upset. We've had a 1 on 1 relationship for her entire life, so this has been pretty rough on me and I'm pretty sure everyone thinks I've lot my mind. But I just keep telling myself this is just temporary and when she feels better she'll be back to her old self and we'll start making some changes to hopefully keep this from happening again.

rubear · Oct 30, 2016

I feel like every step forward ends in three steps back. Yesterday she was finally beginning to act like herself again for the first time after receiving a Depo Medrol injection a week and a half ago (the vet swears it doesn't cause this, but her personality changed 100% about 2 hours after receiving the shot—zombie-like, not adhering to her normal routine at all, not interested in any of the things she normally loves, lying around in places she never normally goes). She has been eating semi-decently for a couple days, having normal poop, urinating normally and she was even starting to play and watch birds at the front door again. I was genuinely excited yesterday to see her even a glimmer of her normal self.

Then when I got home last night I found her sneezing uncontrollably. It seems worse when she tries to eat or drink. I noticed she had eaten a lot less yesterday than Thursday and Friday. At about 2 am this morning I woke up to a sneezing fit that turned into a vomiting fit (nothing came up but a little cat food-smelling yellow liquid and froth). Since then she's just been very still and quiet. She hasn't eaten anything today but some ham that I crushed a Cerenia tablet into. The sneezing fits are a little more controlled now but I keep seeing where some tiny drops of liquid are dried on the blanket she sleeps on and I suspect it's nasal discharge (just water though).

SO, it would appear that she's probably picked up a kitty cold at one of the vets' offices (most likely the ER/referral vet). It worries me because she's on steroids (long-acting injection) and I'm afraid that will cause it to drag out. Also she doesn't want to eat again which is a problem that has plagued us now for over a month. I worried a little that she might have aspirated one of her medications that I have to syringe her with orally (it's always a fight) but I don't think pneumonia would present with sneezing and her breathing sounds pretty normal.

Sigh, I'm just so worried and exhausted. I'm tired of these set backs. I know it takes a while to get past and IBD flare up anyway, but I just want my cuddly, playful little girl back asap. She's walked to the door every morning, met me at the door every evening and slept beside me every night for over 8 years—I know she needs some time to heal but I'm missing all of those things dearly right now.

catwoman707 · Oct 30, 2016

RuBear said:
I feel like every step forward ends in three steps back. Yesterday she was finally beginning to act like herself again for the first time after receiving a Depo Medrol injection a week and a half ago (the vet swears it doesn't cause this, but her personality changed 100% about 2 hours after receiving the shot—zombie-like, not adhering to her normal routine at all, not interested in any of the things she normally loves, lying around in places she never normally goes). She has been eating semi-decently for a couple days, having normal poop, urinating normally and she was even starting to play and watch birds at the front door again. I was genuinely excited yesterday to see her even a glimmer of her normal self.

Then when I got home last night I found her sneezing uncontrollably. It seems worse when she tries to eat or drink. I noticed she had eaten a lot less yesterday than Thursday and Friday. At about 2 am this morning I woke up to a sneezing fit that turned into a vomiting fit (nothing came up but a little cat food-smelling yellow liquid and froth). Since then she's just been very still and quiet. She hasn't eaten anything today but some ham that I crushed a Cerenia tablet into. The sneezing fits are a little more controlled now but I keep seeing where some tiny drops of liquid are dried on the blanket she sleeps on and I suspect it's nasal discharge (just water though).

SO, it would appear that she's probably picked up a kitty cold at one of the vets' offices (most likely the ER/referral vet). It worries me because she's on steroids (long-acting injection) and I'm afraid that will cause it to drag out. Also she doesn't want to eat again which is a problem that has plagued us now for over a month. I worried a little that she might have aspirated one of her medications that I have to syringe her with orally (it's always a fight) but I don't think pneumonia would present with sneezing and her breathing sounds pretty normal.

Sigh, I'm just so worried and exhausted. I'm tired of these set backs. I know it takes a while to get past and IBD flare up anyway, but I just want my cuddly, playful little girl back asap. She's walked to the door every morning, met me at the door every evening and slept beside me every night for over 8 years—I know she needs some time to heal but I'm missing all of those things dearly right now.

You know I have to tell you, I can SO relate to you with this.....

I knew nothing about IBD, until it started in my girl Krissy.

Krissy is my love. She came to me at just 4 hours old, in a sad and dark time of my life. She was like a tiny angel that dropped from the sky, sent to bring me smiles, a reason to stay focused and my companion. Before her I was a dog person, but the love I have for her opened my eyes to the cat world, she came to work at my store daily, she never was away from me, she even went on road trips when my Mom lived a state away. Because of her, literally countless cats have been saved. I began TNR'ing cat colonies in town and continued to care for and feed, to this very day still do.

I started a cat rescue group, and have attended many symposiums at UC Davis Veterinary teaching school, to educate myself, have written magazine articles, am on the board for the humane society and their cat adviser/advocate, etc etc.

All due to this little girl.

I am extremely attached to her, and honestly can't begin to imagine life without her. She is now 14 1/2, has IBD and was just diagnosed with hyperthyroidism, now on transdermal med.

Anytime she starts that sleeping in odd spots I start to worry, she has been doing this again for a while now, and I hate it, even though her IBD appears to continue to be controlled.

Makes me wonder why, what is going on that I can't see......constantly preoccupying my mind, day after day.

Just wanted to share, the thought of her being uncomfortable or losing her someday is unthinkable. So I fully relate.

What is the next step with your girl?

rubear · Oct 30, 2016

catwoman707 said:
You know I have to tell you, I can SO relate to you with this.....

I knew nothing about IBD, until it started in my girl Krissy.

Krissy is my love. She came to me at just 4 hours old, in a sad and dark time of my life. She was like a tiny angel that dropped from the sky, sent to bring me smiles, a reason to stay focused and my companion. Before her I was a dog person, but the love I have for her opened my eyes to the cat world, she came to work at my store daily, she never was away from me, she even went on road trips when my Mom lived a state away. Because of her, literally countless cats have been saved. I began TNR'ing cat colonies in town and continued to care for and feed, to this very day still do.

I started a cat rescue group, and have attended many symposiums at UC Davis Veterinary teaching school, to educate myself, have written magazine articles, am on the board for the humane society and their cat adviser/advocate, etc etc.

All due to this little girl.

I am extremely attached to her, and honestly can't begin to imagine life without her. She is now 14 1/2, has IBD and was just diagnosed with hyperthyroidism, now on transdermal med.

Anytime she starts that sleeping in odd spots I start to worry, she has been doing this again for a while now, and I hate it, even though her IBD appears to continue to be controlled.

Makes me wonder why, what is going on that I can't see......constantly preoccupying my mind, day after day.

Just wanted to share, the thought of her being uncomfortable or losing her someday is unthinkable. So I fully relate.

What is the next step with your girl?

Thanks for sharing. That's just the thing. It's just always been me and her for the vase majority of my adult independent life and she's more important to me than anyone's cat probably should be. Even though I think we're just in a bad flare and things will probably be ok once we can get them under control—it's that having to come face to face with their mortality that is so hard. They're like babies that never grow up and seeing them sick and not knowing what to do help is beyond brutal.

I honestly don't know what the next step is. It's like every time we try something we get two or three great days of improvement and then everything gets even worse for several more days. I've missed so much work, I haven't slept more than a couple hours a night in weeks. Everything just seems more hopeless than I know it probably is in reality. Unless things take a nosedive today, I'll call her referral vet tomorrow for advice. I'm going to give her a dose of mirtazipine this afternoon to try to stimulate appetite. We may have to try to switch to a hydrolyzed protein diet before we get her back to eating fully on her old diet just because even on steroids maybe it's possible the old food is still causing inflammation? She's been on that food for her entire life so it's hard to imagine things getting so bad so fast, but I know that's the nature of the disease.

If all else fails, the next step will have to be a feeding tube. I honestly don't know how to accommodate it. I'm away from home 11 hours a day. And even though I know cats tolerate it well, I know she'll hate it. I would force feed her but I'm just not able to do it. Even when it seems like she can barely stand up, she whips that head around and has the jaws of a crocodile when you try to syringe feed. Even the vets have trouble getting her to open her mouth.

It's hard to imagine it being this bad. The ultrasound didn't really show anything thickening in the intestines, just a small spot at the duodenum and some pancreatic inflammation and liver inflammation. Every medication I give her just seems to drug her into a sleepy stupor. My vet and the specialist are in disagreement over overall steroids versus long term injectables. I feel like the depo had a lot of behavioral side effects and the specialist thinks they're less effective for IBD than oral, but her regular vet doesn't seem to agree. Either way the Depo lasts so long we can't try anything else for at least two more weeks. I'm just at a loss. All I can do is keep trying to get her to eat and giving her snuggles, keeping in contact with her vets, and really, really hoping we get another "good day" again soon.

catwoman707 · Oct 30, 2016

RuBear said:
Thanks for sharing. That's just the thing. It's just always been me and her for the vase majority of my adult independent life and she's more important to me than anyone's cat probably should be. Even though I think we're just in a bad flare and things will probably be ok once we can get them under control—it's that having to come face to face with their mortality that is so hard. They're like babies that never grow up and seeing them sick and not knowing what to do help is beyond brutal.

I honestly don't know what the next step is. It's like every time we try something we get two or three great days of improvement and then everything gets even worse for several more days. I've missed so much work, I haven't slept more than a couple hours a night in weeks. Everything just seems more hopeless than I know it probably is in reality. Unless things take a nosedive today, I'll call her referral vet tomorrow for advice. I'm going to give her a dose of mirtazipine this afternoon to try to stimulate appetite. We may have to try to switch to a hydrolyzed protein diet before we get her back to eating fully on her old diet just because even on steroids maybe it's possible the old food is still causing inflammation? She's been on that food for her entire life so it's hard to imagine things getting so bad so fast, but I know that's the nature of the disease.

If all else fails, the next step will have to be a feeding tube. I honestly don't know how to accommodate it. I'm away from home 11 hours a day. And even though I know cats tolerate it well, I know she'll hate it. I would force feed her but I'm just not able to do it. Even when it seems like she can barely stand up, she whips that head around and has the jaws of a crocodile when you try to syringe feed. Even the vets have trouble getting her to open her mouth.

It's hard to imagine it being this bad. The ultrasound didn't really show anything thickening in the intestines, just a small spot at the duodenum and some pancreatic inflammation and liver inflammation. Every medication I give her just seems to drug her into a sleepy stupor. My vet and the specialist are in disagreement over overall steroids versus long term injectables. I feel like the depo had a lot of behavioral side effects and the specialist thinks they're less effective for IBD than oral, but her regular vet doesn't seem to agree. Either way the Depo lasts so long we can't try anything else for at least two more weeks. I'm just at a loss. All I can do is keep trying to get her to eat and giving her snuggles, keeping in contact with her vets, and really, really hoping we get another "good day" again soon.

I did not know she is still eating her old diet. That is why you can't get it under control.

As long as she keeps eating the very thing that is causing all of this, her body will not stop reacting, it has taken many years for this to happen, and while it makes no sense, this is the cause, an acquired allergic reaction to the food, likely a primary ingredient, chicken and fish are at the top, grains, corn, etc too.

I should also add that she won't be able to eat her same food anymore. Her next diet will be grain free, novel protein, limited ingredients, for several months to a year, then you will create the same thing again but yet a diff protein, so you are able to rotate and this doesn't happen again.

My Kirissy is still on the same diet I switched her to, for 2 years now, because the choices are so limited since she needs dry and canned, and will only eat fancy feast canned, her protein is turkey, which works since fancy feast canned turkey does not have other proteins in it and is grain free.

For you, I would suggest feeding her nature's variety instinct since she will only eat dry. Choose the protein she has not had, you can use turkey, or another, but stick ONLY to the one protein source so she settles down.

rubear · Oct 30, 2016

Yeah, I didn't want her eating her old diet either but we were at a point where she wasn't eating any food at all for days at a time and it was easier to convince her to eat something she was used to (or at least food that was mixed with something she's used to) than something entirely new. We were hoping that steroids could keep the inflammation under control long enough to get her eating regularly again and then transition her diet but I don't think that's going to work. I may start her on a hydrolyzed protein diet this week. I've tried a few novel protein diets but she just preferred not to eat.

She had a flare up last year (first time). Unfortunately then I didn't realize what it was. The vet at that time said it was probably hairballs (Ruby never, ever has diarrhea are pretty rarely vomits, so IBD wasn't necessarily first thought) and we got her through it with heavy doses of Laxatone and she's been fine since. I wish I had known the underlying cause last year and I would have transitioned her diet when she was in good health.

missmimz · Oct 30, 2016

catwoman707 · Oct 30, 2016

I did the same thing......

Oh if I had known then......

You know what hydrolyzed protein food is right?

I'm not a fan of it.

It's got all of the crap that she reacts to, but is hydrolyzed meaning broken down so much that her system doesn't recognize it to be what she reacts to.

I suggested natures variety instinct because of the taste, she might love it, and it's exceptional quality ingredients.

It's sure worth a try, and if she refuses to eat it after repeated attempts, including adding a topper that she will go for, it can be returned open, pet stores will take it back.

rubear · Oct 30, 2016

catwoman707 said:
I did the same thing......

Oh if I had known then......

You know what hydrolyzed protein food is right?

I'm not a fan of it.

It's got all of the crap that she reacts to, but is hydrolyzed meaning broken down so much that her system doesn't recognize it to be what she reacts to.

I suggested natures variety instinct because of the taste, she might love it, and it's exceptional quality ingredients.

It's sure worth a try, and if she refuses to eat it after repeated attempts, including adding a topper that she will go for, it can be returned open, pet stores will take it back.

Yeah, we tried one of the nature's instinct foods and she would have nothing to do with it. Maybe I'll try a different flavor.

I know the hydrolyzed protein food is kind of controversial and very expensive. I bought a grain-free food with different protein sources than she normally eats—Purina Pro Plan. I know nobody is a fan of Purina foods, but it's similar in smell to her current food (Purina Naturals) except with different ingredients. She seems interested in it. I've been trying it as a "treat" to gauge interest. My vet also suggested a Purina Focus food that's supposedly been developed for IBD cats but I wasn't able to find that one and the other focus foods didn't look that much different from the regular foods.

catwoman707 · Oct 30, 2016

Whatever works that she will eat!

Purina or other, at this point it doesn't matter, if she goes for it, you will be one step ahead

)

Also meant to add, some cats can't resist food that has fortiflora sprinkled on it. It has animal digest in it which cats can't resist, and very helpful in transitioning and getting a cat to eat.

rubear · Oct 30, 2016

missmimz said:

There is a ton of great information on this site and I've been reading through a lot of it. Part of the problem at the moment is that some of the solutions don't work on a cat who, even when perfectly healthy, doesn't like eating any kind of wet food (including home cooked meats). Her reaction to baby food was "bury it! Bury it! Send it to hell!" I think once I get her feeling better I'll be able to implement some of these. But until then it's just get some food in her stat!

missmimz · Oct 30, 2016

RuBear said:
There is a ton of great information on this site and I've been reading through a lot of it. Part of the problem at the moment is that some of the solutions don't work on a cat who, even when perfectly healthy, doesn't like eating any kind of wet food (including home cooked meats). Her reaction to baby food was "bury it! Bury it! Send it to hell!" I think once I get her feeling better I'll be able to implement some of these. But until then it's just get some food in her stat!

Well part of the plan should be to transition her to wet or raw food, because ultimately kibble is going to continue to make things worse because of all the added unnecessary ingredients. I transitioned a 12 year old all kibble fed his entire life cat straight to raw food because he wouldn't have anything to do with wet food. So it's totally possible. In fact he took to freeze dried raw food the best because I could control how wet it was. You can of course implement probiotics and slippery elm regardless as to what you're feeding. If you're sure she wont touch any cooked meats or any type of wet food it would likely be in her best interest to attempt to put her on RX foods, because as was mentioned by someone else continuing to feed the same food is putting her in a never ending circle. The food makes her sick then she needs more meds and then doesn't get better, you have to break the cycle.

I'd really encourage you to move away from low quality kibbles like purina. All you have to do is scan the ingredients to see they are full, i mean full of fillers like grains, corn, wheat, veggies, the list goes on and on. Remember, cats are obligate carnivores and have no need for those things in their food. Probably the better of kibbles are Orijen, Acana, Instinct, and Ziwipeak, which isn't really a kibble it's more dried meat. If you choose to take on these foods offer them slowly and mix into her old food.

missmimz · Oct 30, 2016

This is a decent limited ingredients kibble, too.

https://www.chewy.com/go-sensitivity-shine-limited/dp/118424

9 Yo Female Not Eating: Ibd? Lymphoma?

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