9 Yo Female Not Eating: Ibd? Lymphoma?

[rubear]

Unfortunately Ruby has developed non-regenerative anemia. It's possible that it's an immune response stemming from IBD and we're hoping steroids will get it under control. It's also possible that the IBD symptoms were actually cancer which is now spreading. She's FeLV negative, so we know it's not that. It's possibly a reaction to her Convenia injections, though we would have expected to see anemia form more aggressively (it's been a slow downward trend and the last injection was 3 weeks ago).

She's responding well mood-wise to the prednisolone and we're hoping to see her hemacrit rise after a week of treatment. We're not down to critically low levels of RBC yet so we're just rechecking every few days.

I've started a new thread on this, but I thought I'd give everyone here an update.

 

[bellel]

Yes, please keep us posted. I totally understand how you feel towards your cat. My Tater Tot and Pepper were rescued and given to me to foster at 2 weeks of age. They had a terrible case of Coccidia and almost died. But I got them, also, at a very bad time in my life and taking care of them really helped me through my pain. I'm keeping you both in my thoughts. And now off to find your new thread.

 

[rubear]

It's been awhile, so I thought I'd update everyone on how Ruby is doing. Unfortunately it's looking like we're dealing with lymphoma. That's not something we can diagnose without a biopsy, but those procedures are invasive and could be very risky at the moment. And I've also decided not to seek cancer treatments should it truly be lymphoma. We'll just manage with prednisolone as long as we can.

Through November I treated her with prednisolone, mirtazapine (appetite stimulant) and B-12 injections, and after the holidays we were doing great. Still not her old self by any means, but she was eating, gaining weight and her blood work was normal. That continued for several weeks and then I noticed a sudden decline again a couple weeks ago. Constipation, occasional vomiting and then she'd stop eating. So, I gave her mirtazapine again and I'd see improvements for a few days and then back into a slump. New blood work indicates there's some loss of nutrient absorption and her liver enzymes are creeping up again and her red blood cells are dropping again.

We've upped the prednisolone to 7.5 mg everyday, hoping to taper eventually. But basically we've fallen into a cycle of slight improvement followed by sharp decline every few days. She's still up and around and she snuggles with me whenever I'm home. But she hasn't played or been herself since this started. Even with meds we can't seem to pull her up out of this and at no point has she been stable enough to initiate any sort of significant diet change (though I did manage to get her to eat a single protein, no grain food, but there was no change from that). Both her regular vet and internist mentioned though that while on prednisone her food shouldn't matter that much, we should see relief from the inflammation even if she were having an allergic response.

Again, I can't know for sure, but my vet says her gut feeling is strongly toward lymphoma. There's not much else I can do but wait and see how she does. I'm doing everything I can to keep her happy and comfortable and loved, hoping maybe at some point she'll turn around but preparing myself in the event she doesn't.

 

[ginny]

 
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

Some questions please.  Is there a reason why you recommend only baby food turkey?  

My situation with Honey is she has been throwing up and not eating lately - yesterday she had X-rays done that showed thickening of the small intestines.  She got a shot of Cerenia and sub-q fluids, a dose of Prednisolone 5 mg - along with a 30 day rx for it too - and all of a sudden was a new kitty.  She ate the food I put out for her last night (and this morning).  But last night afterwards, I saw her at the water bowl hanging her head over the rim like she wasn't feeling well.  She didn't throw up at least.  All night she lay beside me purring at times, just like her old self.  She did eat this morning too.  But when I came in just a while ago, she's depressed, spacey and did not want to eat.  I fed the others and she wanted none of it.  I finally got her to eat some Fancy Feast flaky tuna.  Not the best choice, I know, but better than nothing.  I'll have to get some pepcid tomorrow night after work.  Does this sound like IBD to you or something else plus IBD?  Her labs 4 months ago were perfect.  That's why this same vet did not think it was necessary to repeat them yesterday.  But this same vet doesn't think her food has anything to do with IBD either.  

Before I got her to eat the tuna, I also syringe fed her some baby food turkey which I had on hand, but she struggled mightily.  I got more on her and me than in her.  I also got some pedialyte, unflavored, in her.  Just a few cc's at best.  

 

[catwoman707]

 
Some questions please.  Is there a reason why you recommend only baby food turkey?  

My situation with Honey is she has been throwing up and not eating lately - yesterday she had X-rays done that showed thickening of the small intestines.  She got a shot of Cerenia and sub-q fluids, a dose of Prednisolone 5 mg - along with a 30 day rx for it too - and all of a sudden was a new kitty.  She ate the food I put out for her last night (and this morning).  But last night afterwards, I saw her at the water bowl hanging her head over the rim like she wasn't feeling well.  She didn't throw up at least.  All night she lay beside me purring at times, just like her old self.  She did eat this morning too.  But when I came in just a while ago, she's depressed, spacey and did not want to eat.  I fed the others and she wanted none of it.  I finally got her to eat some Fancy Feast flaky tuna.  Not the best choice, I know, but better than nothing.  I'll have to get some pepcid tomorrow night after work.  Does this sound like IBD to you or something else plus IBD?  Her labs 4 months ago were perfect.  That's why this same vet did not think it was necessary to repeat them yesterday.  But this same vet doesn't think her food has anything to do with IBD either.  

Before I got her to eat the tuna, I also syringe fed her some baby food turkey which I had on hand, but she struggled mightily.  I got more on her and me than in her.  I also got some pedialyte, unflavored, in her.  Just a few cc's at best.  

Yes, symptoms fit and so does the thickening, which screams IBD.

I recommend the turkey baby food because chicken is often times a culprit, as it is commonly used in commercial food.

Her body is still reacting to what she is eating. 

For my Krissy it was chicken and fish, both at the top of the allergy triggers list.

So cerenia is anti-nausea, why she didn't vomit I'd say. and get the pepcid asap, it really does help, part of that nausea is due to excessive tummy acids.

The pred as you know is an anti-inflammatory, it will give some relief but getting to the core naturally is what's needed vs a temp or band-aid fix.

The core being changing up all food. But first you need to get her system to calm down and not react to her food for a few days. 

She won't eat the turkey baby food on her own? Warmed up, or sprinkled with forti-flora helps sometimes.

FF seems irresistible, since it is animal digest, the very stuff that is sprayed on junky dry food to make cats love it. Meow Mix, Kit n Kaboodle, etc.

FYI, even though pediolyte is unflavored, it tastes funny, like how it smells. lol

But a couple cc's helps if you can get that in her now and then if she is not drinking.

If she were eating the baby food she will get a decent amt of water too.

 

[ginny]

The last bag of NVI I got was chicken because they no
Longer carry duck/turkey at pet
Supplies plus or at petco. Will have to order it myself since petco hasn't gotten it yet. I asked them over a week ago . Since she loves tuna and will eat it is there a people brand I can give her that will suffice? Yet she didn't even want the expensive people tuna I got from the health food store last night. (Which she normally likes to eat) last night only el cheapo FF flaky tuna. Difficult to syringe her which may be a good thing I really need a better syringe that doesn't stick and doesnt Require pushing so damn hard that it squirts out too fast. Im afraid I'll choke her. Syringes need to be changed often anyway Because they stick after a few uses. Any good tips there or brands of syringes that work well for you?

 

[ginny]

@missmimz how do you give slippery elm, by syringe or mixed in food. I want to try that.

 

[rubear]

@Ginny  I had great luck transitioning Ruby onto Blue Buffalo Basics grain-free turkey and potato food. She would have none of the baby food, no wet food and I couldn't syringe her either. When we were in crisis mode (back when she wouldn't eat anything) I had a lot of luck getting her to eat turkey or ham deli meat (the good, unseasoned kind from the counter, not prepackaged stuff) when she wouldn't voluntarily eat anything else on her own. It's not ideal, but when calories are critical it's whatever you can get them to eat.

It's also worth noting that I had no luck syringing food and ALL of my vets strongly discouraged syringe feeding vs. other alternatives. The biggest issue is you don't want to accidentally create a food aversion. If they associate the unpleasantness of syringing with eating, they may be less likely to eat on their own. That said, I've heard several people say they've had luck and all cats are different.

The prednisone should increase her thirst and hopefully appetite. If you have lots of issues with appetite ask your vet about mirtazapine. Without that Ruby would have ended up with a feeding tube. She didn't like the liquid form, so I ended up having to get pills which I crush up into whipped cream or a little juice from canned food. It will stimulate appetite in about 20 minutes and last for about 48 hours. I still use it for Ruby, one dose seems to hold her a week or two now.

Consider getting an ultrasound if things continue even after diet modifications. X-rays aren't very reliable for diagnosing IBD and other complications can occur with it—pancreatitis, triaditis, even lymphoma—that don't usually show on X-Rays.

Don't be afraid to push for blood work either. Ruby's blood work was initially very normal, but if I hadn't asked my vet to do follow-up blood work back in November we wouldn't have known she had become severely anemic.

 

[catwoman707]

The last bag of NVI I got was chicken because they no
Longer carry duck/turkey at pet
Supplies plus or at petco. Will have to order it myself since petco hasn't gotten it yet. I asked them over a week ago . Since she loves tuna and will eat it is there a people brand I can give her that will suffice? Yet she didn't even want the expensive people tuna I got from the health food store last night. (Which she normally likes to eat) last night only el cheapo FF flaky tuna. Difficult to syringe her which may be a good thing I really need a better syringe that doesn't stick and doesnt Require pushing so damn hard that it squirts out too fast. Im afraid I'll choke her. Syringes need to be changed often anyway Because they stick after a few uses. Any good tips there or brands of syringes that work well for you?

Pull the plunger out and swipe butter around the rubber tip, it will then slide very easily.

NVI is excellent food but next to it is BB basics which I chose due to the lack of NVI having a turkey canned.

If you can't get her to eat any of the grain free canned novel protein foods then try the dry, at least she will get the calories needed, but stick with only 1 protein, limited ingredient food, and not fish or chicken.

Also, an ultrasound is always best for a full thorough diagnosis yes, but when an x-ray reveals thickening it's a good start and does indicate IBD, US will help show to what extent and other possible organs affected too.

 

[ginny]

I'll just have to get some new ones. This one is a 10cc syringe that came from Walgreens and doesn't even have a rubber stopper. It's just plastic. I have 1cc syringes for nat's phenobarb. Butter only works on those stoppers so many times. In the hospital they were changed every 24 hrs.

NVI does make a LID canned turkey, IIRC, but my kitties didn't much care for NVI. I do have some Fortiflora I can use as a topper to entice them. NVI uses Montmorrillonite clay. I hope that doesn't cause inflammation.

 

[ginny]

@Ginny
 I had great luck transitioning Ruby onto Blue Buffalo Basics grain-free turkey and potato food. She would have none of the baby food, no wet food and I couldn't syringe her either. When we were in crisis mode (back when she wouldn't eat anything) I had a lot of luck getting her to eat turkey or ham deli meat (the good, unseasoned kind from the counter, not prepackaged stuff) when she wouldn't voluntarily eat anything else on her own. It's not ideal, but when calories are critical it's whatever you can get them to eat.

It's also worth noting that I had no luck syringing food and ALL of my vets strongly discouraged syringe feeding vs. other alternatives. The biggest issue is you don't want to accidentally create a food aversion. If they associate the unpleasantness of syringing with eating, they may be less likely to eat on their own. That said, I've heard several people say they've had luck and all cats are different.

The prednisone should increase her thirst and hopefully appetite. If you have lots of issues with appetite ask your vet about mirtazapine. Without that Ruby would have ended up with a feeding tube. She didn't like the liquid form, so I ended up having to get pills which I crush up into whipped cream or a little juice from canned food. It will stimulate appetite in about 20 minutes and last for about 48 hours. I still use it for Ruby, one dose seems to hold her a week or two now.

Consider getting an ultrasound if things continue even after diet modifications. X-rays aren't very reliable for diagnosing IBD and other complications can occur with it—pancreatitis, triaditis, even lymphoma—that don't usually show on X-Rays.

Don't be afraid to push for blood work either. Ruby's blood work was initially very normal, but if I hadn't asked my vet to do follow-up blood work back in November we wouldn't have known she had become severely anemic.

I worry about food aversion too but if I can't get anything in her I will have to at least have a way to give her some calories. Why is Blue Buffalo dry food recommended? Is the NVI just as good?

 

[rubear]

I worry about food aversion too but if I can't get anything in her I will have to at least have a way to give her some calories. Why is Blue Buffalo dry food recommended? Is the NVI just as good?

If you continue to struggle with syringe, do consider the mirtazapine. Doesn't work for all kitties, but it was a huge help for me when she just wouldn't eat. The amount she ate on her own on that med was much greater than I could have gotten in her with a syringe.

I only recommend Blue Buffalo because it worked so quickly for me. Ruby is the pickiest eater I've ever encountered and getting her to even try any other food other than what she had been eating for years was very hard. I tried the NVI because it looked like exactly what I was looking for but she'd only eat a piece or two. I bought almost every LID food the pet store and my vet had and no luck. I put out the Blue Buffalo and she ate the whole bowl and seems to continue to like it. For me that was huge. It's sometimes tough to tell if they won't try something because they don't feel good or they won't try it because they don't like it, and when they're struggling anyway you can't wait a few days to see if they'll take to it. It was a huge relief to see her gobble it up! I think I probably cried.

I also had good luck with Simply Nourish, which is less expensive, but I think it was a fish formula. It was safe for Ruby because she'd never been exposed to fish before. Not sure of its quality but the ingredient list looked pretty clean.

 

[ginny]

So far I think just the Prednisolone is enough to stimulate her appetite and she has been eating.  But I noticed something last night that worried me when she got on my lap.  I counted 52 respirations per minute.  She eased off after a while but the rate remained around the 40's. I noticed the other day at the vet her respirations seemed a little fast but it wasn't labored, just shallow and fast.  The vet didn't say anything about it at all and didn't see anything on the X-rays that worried her about Honey's heart and lungs.  If it's really heart failure then I would think the sub-q fluids would have made her worse not better.  She had much more energy that evening (Mon) after the fluids, but the next night (Tues) she was lethargic.  (And I saw her pee a good sized (not oversized) pee ball in the litter box, that evening.)  That's when I noticed her kind of wobbling as she stood in front of the water bowl.  Now I realize she was breathing harder.  So it seems the fluids helped, but once the fluids were passed in her urine she became lethargic again, walking slower.  So I'm going to call the vet in a minute and see when she wants me to come back with her.  Probably will mean more blood work to see if anything has changed in the past 4 months and it could have.  Now I think I understand why Honey was vomiting up such huge amounts of liquid with digested food mixed in.  I told the vet that, and she just thought Honey was trying to overfill her tummy so she could throw up.  I don't think so.  One thing I don't like about her is she talks incessantly.  I literally have to interrupt her to ask a question.  

This complicates things.  I don't think she's anemic because her gums are red, but it's possible.  Even so I'm going to change her dry food kibble back to the duck/turkey.  

 

[foxxycat]

to count the breathes Ginny we were told to do it when they are sleeping. under 30 is preferred. but some cats breathe faster. My Honeybee before we got her on puffs of Flovent was 45 a minute when she was sleeping. And of course she slept ALOT.

I don't know if it's heart-but the only sure way to tell is an ultrasound of her heart. That should show any fluids and abnormalities to the heart. So very Sorry Ginny!

@RuBear  So glad to hear your girl is handing in there..maybe the spring air will help perk her up?! My girls are anxious for the snow to melt and warm sunshine!

 

[rubear]

 
This complicates things.  I don't think she's anemic because her gums are red, but it's possible.  Even so I'm going to change her dry food kibble back to the duck/turkey.  

It's probably not likely she's anemic, you would notice pale gums, tongue, etc. In Ruby's case her liver enzymes were initially what showed up in her blood work. It wasn't until after we thought we had everything under control that the anemia reared it's ugly head. The anemia is (we're assuming) caused by lymphoma moving into her bones. Without the prednisone she drops to very critical RBC levels and even with it she's extremely low. It has caused her to have an extremely rapid heartbeat and she's lost a significant amount of weight in the last month. Her breathing for the most part has been normal but I notice sometimes she'll take a deep breath/sigh and her voice has gotten very hoarse.

If your kitty has been vomiting, she might have acid irritation in her throat that might affect her breathing superficially. It may also be a good idea to request a GI panel in her blood work. This will let the vet know if she's having any absorption problems and if she's cobalamin deficient. If so, they can start B-12 shots which are super easy to administer yourself and would probably perk her up right away.

 

[rubear]

@RuBear  So glad to hear your girl is handing in there..maybe the spring air will help perk her up?! My girls are anxious for the snow to melt and warm sunshine!

Thanks! She's a fighter and I'm proud of her for hanging in there and very grateful for the time. We thought we had 1, maybe 2 weeks left and it's been over a month! I just weighed her and the poor baby is down to 11 lbs, down from 13.4 a month ago. She's a little wobbly and we've had to replace the litter box with potty pads. But she's still eating, drinking and pooping! Her favorite thing is to have me pour water for her out of a bottle. And she pretty much gets anything she wants right now, ham, egg yolks, ice cream—whatever her little heart desires. I was happy my vet suggested Lixotinic, I really think it has helped tremendously and I would recommend it to anyone who has a kitty that needs an extra boost.

 

[virginiapaige]

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.

 

[virginiapaige]

So I have a 17 in a half yr old cat my 23 yr old passed away but IV had cats my hole life my cat has a hard time eating so this is what I would do take wet food. That has liquid in it and take a blender the little cup blender that you make your eye season blend the liquid cat food together it makes a Milky Saucy drink and your cat will love it i do 2 of the small cans in the morning and 2 at night he eats one and a half in the morning one and a half at night its the only way I can get him to eat because he has stomach problems and his fangs he has no other teeth so you can't shoot a dry no more and when he would try to eat the way he couldn't get it because it would fall out of his mouth so now I blend it and he's doing good so I hope this helps for any one how has problems with there baby's not eating or just drinking the juice from the food thanks

 

[virginiapaige]

Thanks! She's a fighter and I'm proud of her for hanging in there and very grateful for the time. We thought we had 1, maybe 2 weeks left and it's been over a month! I just weighed her and the poor baby is down to 11 lbs, down from 13.4 a month ago. She's a little wobbly and we've had to replace the litter box with potty pads. But she's still eating, drinking and pooping! Her favorite thing is to have me pour water for her out of a bottle. And she pretty much gets anything she wants right now, ham, egg yolks, ice cream—whatever her little heart desires. I was happy my vet suggested Lixotinic, I really think it has helped tremendously and I would recommend it to anyone who has a kitty that needs an extra boost.

 

[virginiapaige]