IBD with possible small cell lymphoma

[dan32]

Why would he be in pain to eat? Do you think he has a stomach ulcer or something?

 

[bentley2013]

Apparently the inflammation causes pain. The biopsy results from his stomach showed: minimal multifocal lymphoplasmacytic gastritis, with luminal ingesta. I guess as soon as food hits his tummy he is uncomfortable and that is why he trembles after eating. He associates food with pain therefore he doesn't like to eat.

 

[bentley2013]

He's doing better today. Since he was up and down all night i figured he'd be sacked out all day but he's up and around. I may be making a mistake because I am not limiting his food to a hypoallergenic diet. I bought a can of Fromm grain free salmon and tuna pâté and he at a couple of tablespoons as well as some duck/ pea dry food. Still eating chicken breast too but I want to get more nutritionally balanced food in him. Opinions anyone?

Also, the treatment for small cell lymphoma is never a cure, right? Just a remission hopefully for more than a few months?

 

[denice]

Sounds like the anti-inflammatory effect from the steroid and leukeran is kicking in finally. Sometimes it takes longer.  He should improve quickly now.  

I have read so many different things about leukeran you will just have to go by what your vet tells you.  I have read that sometimes it is given the same way as the steroid, the dosage is tapered back to a very small amount and given as a permanent medication.  It's the same idea as the steroid, trimming the dosage back to where it is an anti-inflammatory without suppressing the immune system.  Other cases it is stopped and the steroid is tapered back and then given on a permanent basis.  He will probably be on some kind of medication permanently but it will be just one and a minimal dose.  Patches is on a permanent small dose of a steroid.

Actually remissions where there is no actual tumor but a large buildup of the cells in the digestive tract can last for a very long time.  It's like controlling IBD and the cat lives out his life and dies of another cause including old age.

For the time being any better quality food particularly wet food would be fine.  Since he seems to do well with chicken one of the chicken grain free ones.  One of the ones that my cats like, and they are very picky about wet food is the Wellness chicken.  I wouldn't add too many different types of foods just yet.  Find a couple that he eats and give him those.  He does need to get back to the complete cat food so he can get built back up.

 

[franksmom]

If he only likes to eat homecooked meat you could by something to balance the meat. Here is a post with more information on how to do this (http://www.thecatsite.com/t/263437/creating-a-home-cooked-resources-sticky/60#post_3400979).

 

[dan32]

For gastritis/ulcers, the old people cure is small bland easy-to-digest meals often.  Really often, like every couple of hours.  I would think the pate type foods would fit the bill.  And ones that contained some amount of grain like rice might not be all bad.

Some people here give Pepcid for stomach acid (anywhere from 1/4, 1/2, to a whole 10mg pill), but he sounds like he is just recovering from what he has already gotten in the way of medicines.  Maybe to leave that as a last resort.

 

[bentley2013]

I've decided to go back to the transdermal prednilisone because I read that the pills can cause GI symptoms and that is not what he needs! He looks uncomfortable now, nauseous, swallowing more than normal, refused chicken breast for now. I guess the food he ate irritated his tummy. Such a vicious circle. Maybe I should try some Pepcid? How about Tagamet? I thought I read that it could be used in cats. This is interesting: http://joseph-birch.livejournal.com/22153.html. I just spoke with my vet and he suggested 5 mg fomotidine 2x per day. He said cimetidine would have to be given 4x a day.

 

[denice]

Pepcid is what two vets recommended for Patches.  They both told me 1/2 of one of the regular strength 10 mg tablets a day.  Both of them emphasized the regular strength not the extra strength and continue to offer small amounts of food often.  

The pepcid will cut down on the amount of acid in his stomach.  Some people give a smaller dose more often.

 

[ldg]

Does he have a prescription for Cerenia (for the nausea)? Although Lazlo's chemo was different because he had large cell lymphoma, the Cerenia did more than anything to improve his appetite.

 

[bentley2013]

Yes I have cerenia but was told to only give it for 4 days.

 

[bentley2013]

I have a 10 ml bag of fluids that I brought home from the vet on 8/19. I've given Bentley fluids several times and I still have 5 ml left in the bag. Is there a time limit on how long the fluids are safe to use once rhe bag has been prepared dor use? Just don't want to cause any further problems. I forgot to ask the vet.

 

[dan32]

If I remember right, the bags are marked with an expiration date.

 

[bentley2013]

It would seem that the expiration date would apply to an unopened bag (shelf life). My question is different, the bag was opened (tubing placed) and has been that way for two weeks. Just wasn't sure if that was a problem. I would guess not because for someone who only gives fluids 2-3 times a week. It would take over two weeks to use up a bag. I think too much!! Lol

Bentley was wild about his New York steak last night and again today, still not wanting any canned and only very limited amounts of Dry. Hopefully it will help his anemia too. He is 13 lbs again. He is pooping but not as much volume ( shorter lengths). He left me a present on the floor today and there was no sign of fresh blood or mucous. He would do this occasionally 2-3 times a year) in the past and I would notice the blood and mucous on one end of the very formed stool. He isn't very active, sleeps a lot and certainly his playful self yet.

 

[dan32]

Two weeks should be OK.  Do you refrigerate the bags?  I had used 100ml bags up to a month or more.

Probably there is some recovery time from the chemo he is getting.  Why would there be blood on his stools?  If he had a stomach ulcer, that high up I think the stool would have a blackened look.  If he had recognizable blood, he must have problems further down, like his colon.

He eats kind of weird diet doesn't he - steak, venison, chicken breast?  Human foods?

 

[bentley2013]

No, I don't refrigerate the bag. Yes, his stool is rather dark. He has issues (gastritis) in his stomach and problems in his small intestines. Vet did not do a colonoscopy so I don't know about that part of his digestive system. I'm thinking his hematocrit was 28 after the endo due to the multiple biopsies (bleeding) on top of the possible bleeding from the disease. Just hope the chlorambucil doesn't drop it further.

As far as his diet right now, it's anything goes! He always enjoyed getting meat from our meals but his basic diet was dry, canned and raw when I could get him to eat it. I know we can't go on like this indefinitely, it's working in the short term.

 

[ldg]

Sorry, I never got back to you. Lazlo was on 4mg of oral Cerenia daily for six months (the length of the chemo treatments for him). I'm not sure the cypro and cerenia should be used together? :dk: Did the vet prescribe them to be used at the same time? My understanding is you use one or the other.

Is the stool dark and tarry? A bit sticky? That could be a sign of upper GI bleeding. Ulcers can be seen on ultrasound. Fresh blood and mucus are a reaction to either food or meds.

Our vet prescribed sucralfate to heal his gastric ulcers, and Yunnan Baiyao to help improve his RBC from the blood loss due to the ulcers. It worked quite quickly.

 

[bentley2013]

Bentley had an ultrasound and and endoscopy and there was no mention of ulcers in his stomach or small intestines. His stool darker, formed but kind of sticky when you cut it, not dry like my other cat. Vet did prescribe both anti nausea (cerenia) and appetite stimulant ( cypro) together. I guess he didn't order sucralfate because ulcers were not found. Biopsy showed mild gastric enteritis in stomach so I guess that's causing the pain (the real problem was in his small intestines). What is Yunnan Baiyoa, where do I get it and how is it given?

I have cerenia in 16mg tabs that I was instructed to cut in half. That would have been 8 mg dose! I cut them the best I could into thirds to achieve the more reasonable 5 mg dose.

Thank you for always chiming in with good info. Praying for Lazlo.

 

[ldg]

I'm sorry... how long ago was the ultrasound done?

I wish I knew how to describe Lazlo's stool when he had bleeding ulcers. It was really dark - basically black - and "tarry." It was more than just "sticky."

I would call the vet to ask about using Cerenia and Cypro together - and the dose. We see three different vets, and while Laz was on chemo, there was the oncologist. Every single one of them uses 4mg of Cerenia as the scrip dose (Laz ranged in size from 9 pounds to 12.5 pounds). I buy the 16mg tabs, and break them into quarters. :dk:

I haven't used cypro in a long, long time. I do know it only works for 12 hours, but know nothing about doses. I would think it would be "either Cerenia or cypro," not both but.... :dk:

Is Bentley still anemic? When was his last blood work done? I wouldn't use the Yunnan Baiyao unless his hematocrit is low.

This is Yunnan Baiyao: http://en.wikipedia.org/wiki/Yunnan_Baiyao

This is the one my vet prescribed:
I've recommended it to others with anemic kitties, and it turns out some of them already had their cats on it, even though they aren't seeing holistic vets. It's pretty well known within the vet community.

To use it, the "emergency" tea pill in the middle helps stop bleeding - if there aren't ulcers that you know of, I wouldn't use it. To use the capsules (I had to pill Lazlo, as he wouldn't eat it hidden in food), you give one pill every 2 days for three days, then 1 pill every 3rd day for three days. At that point, the CBC should be run again to see where things stand.

 

[bentley2013]

Bentley wasn't anemic until after his 8/15 endoscopy and non stop diarrhea after the enema on the same day. Probably lost blood with both . His HCT 11days after endo was 28. His ultrasound was on 8/14 showing nothing amiss.

 

[ldg]

Doesn't sound like there's cause to worry about internal bleeding then. :cross:

I do hope you're able to find a combination that helps him feel better.