Cat has either IBD or SCL, need advice and some support

CatEng

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Long story short, one of my cats had bouts of random vomiting for about a year, and about 6-8 months ago started getting bad constipation where he wouldn't go for days, and when he did try to go it'd get stuck and he'd force and vomit and we had to bring him to the ER vet to get cleared out. He was put on PEG 3350 about 5 months ago. He also had bumps on his legs that turned out to be an allergic in nature after biopsy. One of the ER vet mentioned possibly IBD with lowered motility, potentially because of a food allergy, so we excluded chicken from his diet about 6 weeks ago. He's also been doing better with a low fiber diet (the high fiber he was prescribed at first just plugged him up even more).

The lumps on his paws disappeared after the no chicken, and he started to have the urge to go defecate almost every day, so it seems excluding chicken helped wit that, but he kept getting stuck and needing ER help, so we scheduled an appointment with his usual vet. She basically completely brushed aside the hypothesis of food allergy, that nothing pointed to that, and she felt a mass and recommended an ultrasound and implying this was a cancer.

His ultrasound report mentions thickening of the small intestine and some swelling of lymph nodes but no masses, based on his general health (no lethargy or unexplained weight loss) the radiologist tends towards IBD but can't exclude SCL. So, we excluded a mass, but are facing potential SCL. I'm thinking of going to internal medicine directly to get him the proper care but they might not be available rapidly, and I'm just worried a delay of even a few days for treatment could be bad for him.

We got him some B12 drops in the meantime and are changing his food to a novel single protein (rabbit), but any advice would be appreciated. I'm very anxious and spent the weekend thinking this is a death sentence for my baby.

If we get him on pred, do topical formulations work? I've seen conflicting information about that. Can lymph node swelling occur with just IBD or is that a clear 100% sign of SCL?
 

mrsgreenjeens

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Never having had a cat with either IBD or SCL, unfortunately I cannot answer your questions, but until someone comes along who might have those answers, I did do a search on "IBD or SCL" and here are the results: Search Results for Query: IBD or SCL It seems many people have cats that may or may not have one of these conditions, are on Pred, and are doing well, long term. At least on the threads a took a quick glance at.
 

FeebysOwner

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Hi and welcome to TCS, despite what brought you here. I think getting a specialty group involved is a very good idea - one that not only has internal med vets but others such as oncology on staff as well, as they can consult with each other. Any tests that have been run can be shared with them as a starting point. They may also have some opinion about the odds of a food allergy, as I think your vet may not be correct in ruling this aspect out. Also, as far as I know, loose stools are more common with IBD than constipation.

Although, most vets will tell you that IBD can only be properly diagnosed through a biopsy, there are ways to try to confirm/rule out SCL under certain circumstances. One way is when there is an ultrasound done, they can also perform a fine needle aspiration (FNA) on any 'suspicious' tissue, and a swollen lymph node is an excellent source for an FNA. It is no more invasive than the ultrasound itself. It amazes me that not too many vets/IM vets suggest this as a possibility when performing an ultrasound, especially when SCL might be the issue. It only costs more if there is tissue found to do the FNA on, otherwise there is no additional cost above the ultrasound expense.

What was said above is true, most IBD cases - whether or not confirmed - are usually treated with Prednisolone, followed by chemotherapy as necessary. Even some cases are treated with both, whether or not either condition is confirmed. Chemo is often used if Pred doesn't reap good results on its own.

Go with your idea to get a consult with a specialty group. It may take a while to get an appt. scheduled, but I am not sure moving forward with Pred before this can happen is a good idea. I believe your cat would then have to be taken off Pred for a while before another ultrasound could be done. You can get this confirmed when you find a specialty group to make an appt. with. If this would be the case, you're going to have some degree of delay one way or the other.
 
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CatEng

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Thanks for the replies! My local emergency clinic does have both oncology and internal medicine, so that is a plus yes. I'm actually surprised they didn't ask us about doing a FNA when they saw lymph node involvement. When I brought him in I was expecting they would ask us if they saw anything concerning and while I'm iffy about a biopsy I was ready to agree to FNA.

My usual vet's follow up on the report was just asking how he was doing and suggesting a hydrolyzed diet. I asked her about whether it would be wise to start with prednisolone at least for short term inflammation control, I'm awaiting her reply but I think I might have to wait for an internal medicine appointment.

At least he seems to be doing fairly ok today.
 
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