Chronic loose stool caused by intestinal or pancreatic disease?

[cat pal]

In response to my own post, I started Vivian on Metronidazole about 6 weeks ago, and began a food transition to duck and pea a couple weeks after that. Took the transition slow, and she has been completely on the new food for at least a couple of weeks. If there has been any change in bowel movements it may be that they are somewhat less frequent than 4 or more in 24 hrs. and some of them are more formed.

But there is still trouble in the litter box. It is difficult to characterize her stool, because one bowel movement may contain a softly formed stool with loose or watery stool at the beginning and end of it, and fresh blood. I feel like it's time to move forward with treatment or diagnostics.

Originally I (think) I decided against biopsy because of its invasiveness/prep - don't want to put Vivian through that. I thought I would go straight to steroid if and when the time came. Now I have learned that the traveling radiologist (I live very rurally) with the ultrasound machine is coming to my vet's clinic this week for another animal so I could share the cost of his visit. In case someone says consult your vet, I have -

she says the gold standard for confirming IBD or cancer is biopsy but understands why I don't want to put the cat through that. She is very willing to go straight to steroid, but also recommends ultrasound before going to steroid to pick up any tumors that might be causing the bleeding. Originally she said she believed bleeding was from irritation from high frequency bowel movements. Now I don't think she's so sure about that, because she mentioned intestinal tumor. So I need to decide PDQ if I am going to go ahead with ultrasound. As you know, all of these procedures are expensive and like many of you I have spent a boat load of money in the past few months between Vivian's thyroid and then intestinal problems and my other cat's sinus problems. I don't want to do a test that won't change the treatment; on the other hand I don't want to miss an opportunity to get some information that will change the direction of treatment and benefit Vivian. In your experience, can ultrasound alone (without biopsy) detect a difference between IBD and a cancer and is it worth pursuing this instead of just initiating treatment with steroid?

thank you

 

[jdollprincess]

The decision about having a biopsy is a tough one to make. I opted out of an actual biopsy with my IBD cat and put her on pred and then switched to a safer steriod called Budesonide and she's had no flare ups in over a year. Have you had Vivians T4 levels checked recently? I know sometimes if they don't get every little bit of diseased tissue the hyperthyroidism can start to come back.
I think maybe you should go ahead with the ultrasound and go from there. Its good that an actual radiologist will be doing it. Since I work at a general practice vet I see a lot of IBD cats (most go straight to steriods) but I know of a couple of cases that were diagnosed with lymphoma through just an ultrasound. A good radiologist can spot certain characteristics that point to cancer. The specialist my clinic uses lets you be in the room while it's done and explains what he's seeing and will explain it thoroughly. Good luck to you and please keep us updated.

 

[andiat15]

Sounds a lot like what I've gone through with Logan. He's an 8 y/o domestic short hair, male. Nearly a year ago I started a very similar process. Biopsy was discussed but decided against due to the amout of steriod he'd already been on. He is now on Prednesalone once a day and Chlorambucil once a week. The steroid helpled a lot and the "kitty chemo" has kept him relatively heathy for nearly a year now. Good luck!

 

[cat pal]

Vivian will have an ultrasound Thursday, I decided it was an opportunity I shouldn't pass up since she's not all that much improved and the radiologist is only around with his equipment so often. But get this - I told them I would take a few hours off work so I could be with Vivian for the ultrasound (as I had been invited to do a few years ago by another radiologist with my cat Nina) and to have a conversation with the radiologist. So not only does he charge nearly $300 for the ultrasound, and almost another $100 just to travel to the clinic, but if I want to actually speak to him face to face there is another charge!! You have got to be hosing me. That is about the most absurd thing I've heard yet in my experience with the veterinary world. He should be embarrassed. Well I'm not going to pay more money just so this dude will speak to the human with a connection to the animal. I will wait until he writes up a report and gives it to the vet and then she gets to tell me what he said.

Brother. I hope she's ready to do some back and forth between me and the guy who wants to charge me money for a conversation because I WILL have questions that I already know the vet won't be able to answer. Jeesh. You cannot make this stuff up. Anyway, now that I'm over that, hopefully this will provide me with some direction in Vivian's treatment.