12 year old Tonkinese, with IBD/ colon wall inflammation

[ldg]

Yes, leukeran is a powerful anti-inflammatory. I know quite a few IBD kitties that used a lower-than-cancer treatment dose for a few months then tapered off. It is well-tolerated by most cats.

Personally, obviously I feel strongly that if the gut dysbiosis has not beem addressed, that should be attempted first. It costs much less and within a week at most one knows whether or not the S boulardii is working (in many cases it has resolved the diarrhea by then). There is so much research and literature on it, and it is used so widely by integrative vets, it is quite easy for a traditional vet to look up its use in cats.

 

[eshans]

 
Not withstanding all the good suggestions above, there can come a point with severe IBD that little things like diet change as an example, just don't work.  Raw is a way to go, although i hear your concerns, Stella and Chewies is raw but pressure pasteurized so no risk of salmonella or e-coli, and it comes freeze dried which is very convenient.  A baby scale like from amazon can help you track your cat's weight very precisely and if you note continued weight loss then in the words of my vet, "our pet is loosing the battle"

The weight loss isn't because of the diarrhea per se, its because her intestines are inflamed to the point that she can't absorb nutrients.  I would suggest a heart t heart discussion with your vet about Leukeran, and while a biopsy may be out of the question financially, an ultrasound is much less $$$ than a biopsy and can still give you a lot of info, and can be diagnostic of many things.  So to sum up, if you haven't has an ultrasound recently i would urge that as well as a discussion of Leukeran.

Thanks Stephen. Agree on the raw. What was so alarming is her awful reaction to the RC Rabbit. I understand that peas and other ingredients might cause issue, but was 10 times a day outside the box. She does better on her NB Duck and Green pea, but not great as evidenced last night and today.

We actually did do an ultrasound in Jan and here's exactly what the internist said.

"Today we performed an abdominal ultrasound to better assess Isabella's

small and large intestine. We found that her colon was diffusely abnormal --> it was much thicker than normal with

loss of layering which indicates abnormal cells within the wall. These cells could be inflammatory or cancerous in

nature and there can also be scar tissue decreasing normal function. Intra-abdominal lymph nodes were mildly

enlarged, consistent with reactive inflammation to the colon."

I feel so emotionally exhausted from this, I just want in the worst way for her to be remotely normal again. Who could be happy in this state? I truly appreciate all of the support here so far.

 

[stephenq]

 
Thanks Stephen. Agree on the raw. What was so alarming is her awful reaction to the RC Rabbit. I understand that peas and other ingredients might cause issue, but was 10 times a day outside the box. She does better on her NB Duck and Green pea, but not great as evidenced last night and today.

We actually did do an ultrasound in Jan and here's exactly what the internist said.

"Today we performed an abdominal ultrasound to better assess Isabella's

small and large intestine. We found that her colon was diffusely abnormal --> it was much thicker than normal with

loss of layering which indicates abnormal cells within the wall. These cells could be inflammatory or cancerous in

nature and there can also be scar tissue decreasing normal function. Intra-abdominal lymph nodes were mildly

enlarged, consistent with reactive inflammation to the colon."

I feel so emotionally exhausted from this, I just want in the worst way for her to be remotely normal again. Who could be happy in this state? I truly appreciate all of the support here so far.

Ok well that result in my opinion as one who has had essentially the same result is consistent with either advanced IBD or possibly small cell lymphoma, and if my vet had the same ultrasound with 1) weight loss and 2) no positive response (ie weight gain) on steroids then we would be looking at starting Leukeran (which we did actually).  For less $$$ than a biopsy you can do a needle aspirate of the lymph nodes and you may get a positive diagnosis this way, or you may not.  Our first was neg and our second was positive finally for cancer, but this was coming out of a year of remission on Pred.

Leukeran treats both advanced IBD and sm cell lymphoma, but in rarer cases it could be a different type of cancer (like in my cat's case mast cell cancer) but that too can be diagnosed by needle aspirate of the lymph nodes.

I would suggest, especially due to the loss of layering noted in the ultrasound, that your cats only real option at this point for a remission is more aggressive therapies.  Alternatively you can try and keep her as comfortable as possible for as long as possible but I think that absent some type of successful treatment you are looking at an illness that will in time take your cat's life.  I regret putting it like that, and every cat is different, but everything you describe is consistent with a spiral downwards and the time remaining to reverse that spiral may be limited.

 

[eshans]

 
Ok well that result in my opinion as one who has had essentially the same result is consistent with either advanced IBD or possibly small cell lymphoma, and if my vet had the same ultrasound with 1) weight loss and 2) no positive response (ie weight gain) on steroids then we would be looking at starting Leukeran (which we did actually).  For less $$$ than a biopsy you can do a needle aspirate of the lymph nodes and you may get a positive diagnosis this way, or you may not.  Our first was neg and our second was positive finally for cancer, but this was coming out of a year of remission on Pred.

Leukeran treats both advanced IBD and sm cell lymphoma, but in rarer cases it could be a different type of cancer (like in my cat's case mast cell cancer) but that too can be diagnosed by needle aspirate of the lymph nodes.

I would suggest, especially due to the loss of layering noted in the ultrasound, that your cats only real option at this point for a remission is more aggressive therapies.  Alternatively you can try and keep her as comfortable as possible for as long as possible but I think that absent some type of successful treatment you are looking at an illness that will in time take your cat's life.  I regret putting it like that, and every cat is different, but everything you describe is consistent with a spiral downwards and the time remaining to reverse that spiral may be limited.

Thanks, this is very helpful. I do know the reality is that she might be beyond repair. We actually thought when she was basically incontinent, that she would have had to go down. It was really bad, and horrible to watch her go through. I will discuss the Leukaran treatment with my internist. I don't feel that great about more medications b/c she's been through a lot. Pred did work for a little while, as well as Budesonide. In the meantime I have to give her Flagyll for a little while since curbing this condition at least a little is needed right now. The vitality science stuff hasn't done much either, but like you said, she might be too advanced to even absorb anything in the gut. Guhhh :/

 

[ldg]

Thank you very much, I will purchase this today from Amazon and start her on it. It seems like it can't make things worse and anything to not make it worse is certainly worth trying.

I'm so pleased you'll give it a try. I don't know how well you know your vet or how closely you work together, but it is always best to discuss treatments with them, especially if you have a mutually respectful relationship.

I understand diet changes have been disastrous. Have you tried just a bland diet? In our FB group, people find us when they are desperate and often when vets have given up. Our standard protocol is to stop what you're feeding and put kitty on a bland diet (not nutritionally balanced, for short term use only) of bone broth and either plain poached chicken or novel protein if there is a known chicken allergy - or Beech Nut turkey baby food. Just plain meat and broth. We find that many IBD cats with advanced problems and inflammation do well with this. It is very easy to digest, and with no thickeners, no additives, no preservatives, etc, it gives their systems a rest and a break. Combined with the probiotic therapy, this often (in the majority of cases) turns kitties around. Depending on how bad things are, it's not always a straight, problem-free change. But with supportive therapy such as slippery elm bark powder syrup, distilled aloe vera, potentially cerenia, an app stim, sub-q fluids, assist feeding if necessary, kitties turn around. :heart2:

Any protein can be used, but the smaller the bones, the quicker it's ready: http://healthypets.mercola.com/sites/healthypets/archive/2013/12/02/pet-bone-broth.aspx

What to feed or how to balance the plain diet - if it helps - can be managed after a few weeks.

 

[denice]

Since duck foods is what you have had the best luck with and if you have access to it I would try the plain cooked duck.  I know many people have had really good luck with a raw diet your kitty may not be able to handle the extra bacteria from raw.  The commercial raw diets that have been pasteurized have the things in them to make them complete rather than plain meat.  You can get freeze dried meat that is actually treats and are just meat.  You really wouldn't be changing her diet just reducing it down to just the meat.  Of course you will have to cope with balancing her diet at some point but now getting symptoms under control is what is needed.

I would also try the probiotics, I haven't used it but I have heard really good things about s. boulardii for intractable diarrhea.  I would also consider the leukeran.  Normally I think it's best to try one thing at a time so you know what worked but in this situation I think getting the symptoms under control is the most important.  Hopefully things will calm down then you can begin experimenting to figure out what works long them, the first being a complete diet.

 

[stephenq]

 
Thanks, this is very helpful. I do know the reality is that she might be beyond repair. We actually thought when she was basically incontinent, that she would have had to go down. It was really bad, and horrible to watch her go through. I will discuss the Leukaran treatment with my internist. I don't feel that great about more medications b/c she's been through a lot. Pred did work for a little while, as well as Budesonide. In the meantime I have to give her Flagyll for a little while since curbing this condition at least a little is needed right now. The vitality science stuff hasn't done much either, but like you said, she might be too advanced to even absorb anything in the gut. Guhhh :/

Ok i wish you and her all the best and please keep us updated . Nothing succeeds like success, and i'll take it in any form it wishes to arrive in.

 

[eshans]

Thank you again Stephen. While I hate to hear of other cats and their owners dealing with this, it's nice to know that there's so much support and people that are willing to help

 

[eshans]

 
Since duck foods is what you have had the best luck with and if you have access to it I would try the plain cooked duck.  I know many people have had really good luck with a raw diet your kitty may not be able to handle the extra bacteria from raw.  The commercial raw diets that have been pasteurized have the things in them to make them complete rather than plain meat.  You can get freeze dried meat that is actually treats and are just meat.  You really wouldn't be changing her diet just reducing it down to just the meat.  Of course you will have to cope with balancing her diet at some point but now getting symptoms under control is what is needed.

I would also try the probiotics, I haven't used it but I have heard really good things about s. boulardii for intractable diarrhea.  I would also consider the leukeran.  Normally I think it's best to try one thing at a time so you know what worked but in this situation I think getting the symptoms under control is the most important.  Hopefully things will calm down then you can begin experimenting to figure out what works long them, the first being a complete diet.

Thanks Denice, I will try one thing at at time food wise. Supplements like the s. boulardii (ordered it on amazon today) I'l start right away. I agree I need to throw a few things at this b/c i feel that time is running out.

 

[eshans]

I'm so pleased you'll give it a try. I don't know how well you know your vet or how closely you work together, but it is always best to discuss treatments with them, especially if you have a mutually respectful relationship.

I understand diet changes have been disastrous. Have you tried just a bland diet? In our FB group, people find us when they are desperate and often when vets have given up. Our standard protocol is to stop what you're feeding and put kitty on a bland diet (not nutritionally balanced, for short term use only) of bone broth and either plain poached chicken or novel protein if there is a known chicken allergy - or Beech Nut turkey baby food. Just plain meat and broth. We find that many IBD cats with advanced problems and inflammation do well with this. It is very easy to digest, and with no thickeners, no additives, no preservatives, etc, it gives their systems a rest and a break. Combined with the probiotic therapy, this often (in the majority of cases) turns kitties around. Depending on how bad things are, it's not always a straight, problem-free change. But with supportive therapy such as slippery elm bark powder syrup, distilled aloe vera, potentially cerenia, an app stim, sub-q fluids, assist feeding if necessary, kitties turn around.

Any protein can be used, but the smaller the bones, the quicker it's ready: http://healthypets.mercola.com/sites/healthypets/archive/2013/12/02/pet-bone-broth.aspx

What to feed or how to balance the plain diet - if it helps - can be managed after a few weeks.

 

[ldg]

As you discussed with Denice, it makes sense to change one thing at a time. And I missed Denice's first post at first - but it would make sense, if you want to try the bland diet, that you use the protein she's doing well with now (Duck). The freeze-dried meat treats do make it easy to create just about any kind of protein in the form of a bland diet - just add water. Or I'm sure you could find a butcher willing to grind some duck for you, then just cook it and include the pan scrapings.

 

[betsygee]

MOD NOTE:  Please remember to review the points here if considering or recommending a raw diet:  http://www.thecatsite.com/t/282314/recommending-a-homemade-diet-hold-your-horses

 

[eshans]

 
MOD NOTE:  Please remember to review the points here if considering or recommending a raw diet:  http://www.thecatsite.com/t/282314/recommending-a-homemade-diet-hold-your-horses

Thank you, very helpful

 

[eshans]

To start,  I started her on Proviable today again, I tried it a while back, but it didn't seem to do much.  Hopefully this is the road to recovery. I also noticed that Stella and Chewy's is sold out everywhere ( the duck kind). I am researching alternatives. I have some Primal Turkey samples, but I'd rather go with something more pure. I don't know, my head is going to explode 

 

[eshans]

As you discussed with Denice, it makes sense to change one thing at a time. And I missed Denice's first post at first - but it would make sense, if you want to try the bland diet, that you use the protein she's doing well with now (Duck). The freeze-dried meat treats do make it easy to create just about any kind of protein in the form of a bland diet - just add water. Or I'm sure you could find a butcher willing to grind some duck for you, then just cook it and include the pan scrapings.

I'm getting the S. Boullardi in the mail today, so I will try her on that tonight. She had a bad morning and her fur isn't looking too good either/and she looks thin.  I also left a message with my specialist today, and also keeping a diary (more like a diarrheay

) of each day and night. Will weigh her too.  Thanks for your advice so far.

 

[ldg]

Oh YES, keeping a diarrheay ( :lol3: - sorry! ) of everything you feed her, give her, when, and what comes out - how and when - can be an AMAZINGLY helpful tool. It can be a PIA, but it is often worth it. :nod: Glad to hear you're doing that! :bigthumb:

Did the S boulardii arrive yesterday? Getting it in them can be a bit of an issue - how'd it go?

 

[eshans]

 
Thanks, this is very helpful. I do know the reality is that she might be beyond repair. We actually thought when she was basically incontinent, that she would have had to go down. It was really bad, and horrible to watch her go through. I will discuss the Leukaran treatment with my internist. I don't feel that great about more medications b/c she's been through a lot. Pred did work for a little while, as well as Budesonide. In the meantime I have to give her Flagyll for a little while since curbing this condition at least a little is needed right now. The vitality science stuff hasn't done much either, but like you said, she might be too advanced to even absorb anything in the gut. Guhhh :/

Oh YES, keeping a diarrheay (

- sorry! ) of everything you feed her, give her, when, and what comes out - how and when - can be an AMAZINGLY helpful tool. It can be a PIA, but it is often worth it.

Glad to hear you're doing that!

Did the S boulardii arrive yesterday? Getting it in them can be a bit of an issue - how'd it go?

Ha, yes, I could never get through this ( or most things!) without some form of laughter. 

It did come today actually. I gave her around 1/3-1/2 of a pill in her food and she seemed to have no issue. I wasn't sure what the dosage was, so like anything I wanted to slowly introduce it. I gave her Proviable in the morning as well as Budesonide. I'll stop there as I don't wanna overload her. Fingers crossed something works! Thank you again

 

[riley1]

Hi,

As most of you know who read Crossing the Bridge my kitty, who started out as IBD 3 years ago, sadly was put to sleep.    What is Leukeran? You said it was a powerful anti-inflammatory but  Is this a chemo drug?  I wonder why this was not offered to me.  People who can make the necessary diet changes are lucky.  My kitty was not going to eat the healthy food/supplements added to his food.  Maybe this would have helped but his IBD was not diagnosed until a year after it started.    My internist said that they would not use any chemo drugs unless I had a biopsy.  This was after saying the biopsy could be neg even though there was cancer.  If the biopsy was neg they really did not tell me a treatment plan after than.   I did not understand why he could not have the chemo anyway because they said there was not much else he could have.    I did all the other tests; some twice & they were all normal.  I was also told that chemo would only keep him alive for 6 -18 months.  Because of this I opted out of the biopsy & chemo.  It was hard enough to give him the liquid meds as it was.

I have heard that some kitties with IBD get better with food changes.  Good luck to you!

 

[eshans]

 
Hi,

As most of you know who read Crossing the Bridge my kitty, who started out as IBD 3 years ago, sadly was put to sleep.    What is Leukeran? You said it was a powerful anti-inflammatory but  Is this a chemo drug?  I wonder why this was not offered to me.  People who can make the necessary diet changes are lucky.  My kitty was not going to eat the healthy food/supplements added to his food.  Maybe this would have helped but his IBD was not diagnosed until a year after it started.    My internist said that they would not use any chemo drugs unless I had a biopsy.  This was after saying the biopsy could be neg even though there was cancer.  If the biopsy was neg they really did not tell me a treatment plan after than.   I did not understand why he could not have the chemo anyway because they said there was not much else he could have.    I did all the other tests; some twice & they were all normal.  I was also told that chemo would only keep him alive for 6 -18 months.  Because of this I opted out of the biopsy & chemo.  It was hard enough to give him the liquid meds as it was.

I have heard that some kitties with IBD get better with food changes.  Good luck to you!

Sorry to hear that. Yea, I think my case is a bit severe and can't just be handled with diet.  Thank you, i need all the luck I can get.

 

[ldg]

A usual dose of S boulardii is 1/2 the cap in the AM and half in the PM. It doesn't colonize the gut, so the split dose is important. Some have found they need to double the dose. But give it a few days to see. And as always with IBD, if it makes things worse, back up, and start over introducing it more slowly.