Lump 9 days after B-12 injection

[FrayedNerves]

I have a cat who for over 2 months has been having problems consistent with protein sensitivity/IBD/lymphoma. She is the light of my life, and I have been going out of mind trying to help her: multiple vet visits, steroids, antibiotics (she's a 7.25-pound cat on 33.3 mg. metronidazole twice a day since 2-11-24), and now, at the vet's suggestion, B-12 injections too.

I was just about to give her her second B-12 injection between her shoulder blades, but I noticed a lump there that I'm guessing was a result of the B-12 injection that I gave her 9 days ago. I felt it and it felt kind of hard, maybe 1.5 cm x .5 cm, and when I rolled it around in my fingers she didn't react as though she was in pain, but I am now really scared. Again.

I'm beyond frayed at this point, and of course it's Saturday night so I can't see a vet until Monday, unless I want to do another emergency visit and pay another $500.

If anyone can help me, I would be beyond greatful.

 

[stephanietx]

We gave our kitty B12 injections weekly for 4 weeks and now we're on the maintenance dose of once a month. I would call the vet's office on Monday and ask them what they suggest.

 

[FeebysOwner]

HI and welcome to TCS. Do you suspect the lump has been there the entire 9 days? If so, I think waiting another day to contact the vet isn't going to be an issue at this point. As long as she is acting/eating/drinking/peeing/pooping normally, the area is not hot to touch, and touching that area is not bothering her, another day isn't likely to make a difference.

I have never had anything like that happen when I have given my cat B-12 injections, so I can't say it is normal. It could be the way you inserted the needle, or that you hit tissue instead of the skin pocket, or she might even be allergic. I would not give her another B-12 injection until you've had a chance to talk to the vet.

 

[catloverfromwayback]

Echoing FeebysOwner here. My Phoebe (ha!) has monthly B12 shots too - she's another probable IBD case - but I haven't had the lump problem. My vet suggested injecting her in the scruff, where there's plenty of loose skin so you can avoid going into tissue (muscle etc) by mistake.

 

[FrayedNerves]

Thank you.
All of you.
I will contact the vet first thing Monday morning.
And I will let everyone know what the vet said.
Your replies were like a life raft for a drowning man.

 

[FeebysOwner]

Yes! Please keep us posted!

 

[FrayedNerves]

It's been 10 days since I gave Hope her last B-12 injection, and this morning when I felt the lump it seemed a wee bit smaller. That said, I called the vet anyway, and I am waiting to hear back from him. I'll follow up here when he does.

But all of this got me thinking of a post from another new member here, their lengthy description of their cat's intensive treatment and multiple medications, how it all doesn't seem to be working, and how some of the good folks on this board expressed their concerns over the intensiveness and abrupt changes of the perhaps-too-brief interventions described. It made me wonder:

How much intervention is too much for Hope?

When the vet first offered me B-12 shots for her, I instinctively recoiled; it felt as if someone was trying to sell me snake oil. But over the next week or so as Hope's symptoms still didn't improve, I became receptive to the idea, desperately wanting to help her and being terrified that if this all went south and I hadn't done everything I could do, I would end up lashing myself for the rest of my life over it.

So I went for the B-12, and you know the result: a lump. Now I am lashing myself for that. This is not to imply that I think the good folks here who give their babies B-12 are doing anything wrong, only that I have decided B-12 for Hope is too much intervention.

Anyway, Hope is no better, but she's no worse. Her litter-box pattern is that she goes three times in the morning, all within a short time frame: The first that comes out is firm-ish to wet, the second mostly to flat-out wet, and the third a very small amount that contains a little mucus and blood. And this is basically the pattern we have been stuck in since December 5 of last year.

She has had an x-ray (thickened intestines?), bloodwork (all normal), fecal float and scope (normal, or so I'm told told) and we are currently waiting on the results of a fecal panel that was mailed to the lab on Friday. Collecting a viable sample was a nightmare, for the wet-ish nature of her stool made that difficult. I had told my vet this, and he said that it was no problem in that he could pull one from Hope. The image of him doing that scared me, and I told him so. But he said not to worry, just bring her down. So I brought her back to the vet on Thursday for him to collect it. BIG MISTAKE. I could hear Hope's repeated cries from down the hallway as the vet did his thing. It was beyond anguishing for me. After I sat for what seemed like forever for him to bring her back safe to me, he reappeared and said he was “giving her a break” and that he would go back at it in a bit. I have never come so close to assaulting someone as I did at that moment. And when he came back the second time, he said that he had basically failed and that if I could bring him a sample from home the next morning he would send that to the lab instead. Oh sure, no problem. So the next morning I got some wet stool she left in the litter box, put in the fridge for 1.5 hours, put on rubber gloves, used a sharp knife to carefully and painstakingly cut off enough of the litter coating, carefully placed it in the corner of a plastic ziplock bag so as not so smoosh it, and brought it to the vet. It was a freaking ordeal, yet it is exactly what I should've done in the first place, for what I subjected Hope to at the vet that day was too much intervention.

She is now on Day 15 of an all-rabbit diet, she has been on metronidazole for 8 days, and 2.5 weeks ago she got a 20 mg. shot of Depo (we already tried prednisolone pills, but every time I tried to give Hope a pill it was terrifying, for both of us). I was supposed to go back to the vet Friday for the second Depo shot, but I decided against it. I will give the rabbit diet more time, keep giving her the metro, and wait for the Depo to clear out, which should be done in no longer than another 3.5 weeks. If at that point we still haven't made any progress, it's scope time. That's my plan.

And if, or when, tomorrow morning I find more mucus and blood in her third poop, I will resist any impulse to give her another B-12 shot, or to take her to the vet yet again, or to add this new medication or that one. That is, I will resist the impulse to intervene. Instead, I will remind myself of the aforementioned plan and of all that I have already done, and take as many deep breaths as needed to ratchet down my fear.

I have got to remember that it doesn't matter how well-intentioned a potential intervention is, for the possibility exists that any intervention could actually make Hope worse.

 

[FeebysOwner]

I'll come back and address the rest of your post after I have had time to digest everything you have shared. But, I can address the B-12. It is harmless in probably nearly all cases. Hope's body will use what of it what she needs, and any excess is peed out. That is how B-12 works. It is generally used to help with food absorption in the intestines. If Hope is allergic to B-12, it would be a very rare thing, and may mean the injection contains some preservative that might be the issue, rather than the actual vitamin B-12 itself. You can ask the vet when they call if these injections contain other ingredients beside vitamin B-!2.

More later...

 

[FeebysOwner]

OK, I read the rest of your post and I am not seeing a parallel between what Hope has gone through and what I believe to be some of the other threads you are referring to. First off, unless the vet told you otherwise, poop that has some litter on it is fine as is - no one needs to cut/scrape off the litter. If that needs to be done, it will be done by the lab/vet/vet tech who runs the lab work.

Secondly, Metro is a commonly used med when cats have diarrhea/loose stools to try to help firm them up. It is typically considered a first line of defense in the hopes to resolve the problem without more extensive meds or tests. It is not, however, always successful. Steroids are given to help with inflammation, which was done because your vet saw thickening in Hope's intestines. It can help but is not a cure-all.

Your cat likely has food allergies or IBS, which can be brought on by food allergies - and each of these can be very hard, if not nearly impossible, to pin down with 100% accuracy. Most of the time, either one of these conditions ends up being a trial-and-error process to try to find the right solution. I think what has been tried with Hope is what I would expect to see happen before it comes down to some sort of scope or ultrasound. And, even then you may not get an entirely conclusive answer.

It is very hard when our kitties are ill and even more so when they need meds, especially when it is difficult to get them to take them. But what you have described that has been done so far by the vet sounds to me like pretty standard protocol under Hope's circumstances.

I would strongly suggest you get copies of all her tests and learn about what you don't already know, by asking the vet more questions and/or doing internet research. And always ask about any meds in terms of what they should do, what to look for, and it doesn't hurt to look them up on the internet too. The better educated you are the better you can serve Hope and feel less pressure about it all because you understand why the vet is doing what they are. I also don't know what all you have tried in terms of getting meds into Hope, so I've included article links below about different tactics you might need to try in the future.

How old is Hope, btw? And, did you talk to the vet about the lump after the B-12 injection?

Pilling Cats [Must-Know Tips For Hiding Pills] - TheCatSite
How Can I Give A Pill To My Cat? [Stress-Free Techniques] - TheCatSite

 

[FrayedNerves]

How old is Hope, btw?

She turned 8 in October.

And, did you talk to the vet about the lump after the B-12 injection?

He called as I was writing this. I asked him about the potential for it being an abscess, considering that Hope is on antibiotics. His delayed "Uhhhh ... well anything's possible" response suggested he did not think it is. He asked me whether the lump was in the skin or beneath it, and I said beneath. He said to watch for it to make sure that (1) it doesn't grow, and (2) it doesn't become painful. Otherwise, he suspects it will go away. He thinks it's most likely an inflammatory response to the injection. And I apologize, for I forgot to ask him about potential preservatives and whether he's ever heard of a B-12 injection that caused a lump. But the vet also told me that the PCR panel results from the second stool sample, which I brought in just 3 days ago and needed to be mailed to a lab, somehow are already in. "Negative across the board."

Now ...

First off, unless the vet told you otherwise, poop that has some litter on it is fine as is - no one needs to cut/scrape off the litter. If that needs to be done, it will be done by the lab/vet/vet tech who runs the lab work.

The vet told me otherwise, and he made no mention that their techs would clean it up. But even if he had said that the techs would do it, if you'd had some of the experiences with their techs as I have, you would also want to do it yourself. Bottom line here is some techs are good/certified, and others, well ...

The better educated you are the better you can serve Hope and feel less pressure about it all because you understand why the vet is doing what they are.

And therein lies one of my problems: I'm having trouble trusting my vet (yes, I'll be going to a different one in the not-too-distant future). Here's a little tale that I haven't shared yet:

My first vet visit regarding Hope's current problems was on Dec. 26, 2023, to a walk-in clinic that I have been going to for about 4 years, and I bad-lucked into a doozy of a vet. I brought in a stool sample (litter-covered and all), and gave it to one their techs. The tech also took a fecal swab, which bewildered me because I had just handed the same tech a bag of fresh cat crap. When the vet finally came in, she looked overwhelmed and dazed, as though she was in the midst of a major depressive episode and hadn't slept properly for who knows how long. She proceeded with "Sorry you had to wait so long." She then said it was a good idea that I had Hope on Metamucil. Problem is, I never told anyone that, and for good reason: Hope has never been on Metamucil. But I didn't correct the vet, instead asking: "So what did the fecal examination show?" She replied with "Ugh ..." and then paused. So I helped her with "Did the fecal exam show any signs of inflammation?" She was again clearly at sea, as though she had no idea that I had brought in a sack of stool and that a fecal swab had also been taken. She seemed to be improvising when she answered "Not really." Not really? Really? She then said she was going to give Hope an injection to settle her stomach, some antiemetic whose name I can't recall. I said no because Hope had given no indication that her stomach was upset and that I wouldn't stick a needle into her without a compelling reason. She then prescribed Hope Clindamcyin, handed me the bottle, and said to give Hope 2 ccs a day. I asked her how long I should do that. Again, at sea. "Ugh ...." Irritated at this point, I blurted out: "What? Two weeks?" "Yeah," she replied, "2 weeks." Problem is, the bottle she handed me was 20ccs. Do the math and you'll know that 2ccs a day from a 20cc bottle will last you 10 days. Last, here, is that my bill showed a charge for a fecal float and scope, and the vet's answers indicated to my satisfaction that either neither had actually been done or she hadn't checked the results. The only thing in the records about it all is "Parasites: negative," and the word "parasites" was not uttered once during our discussion.

Fast forward to this past Thursday, Feb. 15. I have already talked here about how my current vet told me to bring in Hope so he could pull a stool sample from her. Remember that he came back into the room where I was waiting after he'd initally tried and failed and said he was giving Hope "a break" before he tried (and failed) again. it was then that he said he was performing a fecal float and scope. Recall also that I was fighting an urge to punch him at that point (due to my anger over Hope's repeated cries), so it didn't occur to me until after he went back to try again to get stool from Hope that the float and scope were supposedly already done before, or at least that I had been charged for them. So while he was out of the room, I walked to the front desk and asked for a copy of the records from the visit on Dec. 26, 2023. And there they were, and of course I was charged for them. So when the vet came back into the room again (with Hope this time, to my immense relief), I showed him the invoice, and asked him why he was doing what he was doing when it supposedly had already been done. He hemmed and hawed, and then said "I won't charge you for them." Now other than that double-testing, I kind of like that vet, but the double-testing of the precious child of a man who is clearly on the verge of his own nervous breakdown is morally reprehensible.

"But wait a second," you say. "People make mistakes, and your vet may simply have made one." True, people make mistakes. Problem is, some people also make sales.

And yes, I have already done quite a bit of research on all this protein sensitivity/IBD/lymphoma stuff. I won't give you my credentials, but I will say that in my earning them I learned where to look for the right stuff to read and also how to read it.

Finally, a few words about why I am here:

1. I am here to make someone who also loves animals and who's bed is also on fire think long and hard about the risks and rewards of doing an intervention before doing something that might result not only in no good, but in harm. Now please don't get me wrong: What I am saying is not B-12 specific, but general to ALL potential interventions--standard or otherwise.

2. I am here for support. If you knew me at all, you'd know how excruciatingly difficult it was for me to come here. I am an ethical vegan who finds it next to impossible to connect with people. But I am still a person and as such ache for human connection when I am hurting, and I have been hurting badly ever since my beloved cat Dickie disappeared on the morning on July 5, 2023. My only friends are animals, and my family? You guessed it. But they are not simply animals. Not even close. They are my daughters. They are my best friends. Sometime they are my parents, and they are ALWAYS my responsibility. For they have cast their lot with me, for better or worse, and when I look at myself through Hope's eyes when I am forcing liquid medication down her throat and her being scared and her seeing me scared and her not knowing why I am doing what I am doing and her thinking that this is the man who loves me but who is also frightening me, it absolutely rips me to pieces. But I do it anyway, because I have to. As though my own life depended on it.

3. I am here to try to help myself process my agony and the agony that came before. You see, I have lost three cats in the last 6 years, two to suspicious circumstances, and I fear I am losing Hope too. Then there is Mama, the only other member of our family, and she has asthma and is 12. When you hear the noises she makes when she breathes and watch her creak around when she walks, you can't help but fear that her end may be right around the corner too.

The bottom line is that I feel like I am losing my entire family, that I will soon be all alone, that I won't know what to do, that I won't know how to go on.

I am scared to death.

 

[FeebysOwner]

I am sorry for all that you are going/have gone through. And, I hope you didn't take offense to anything I said.

I do think you would do yourself a favor by continuing to look for a vet that you can find confidence in using. With the help of giving meds that you might find in the articles I shared with you, you are doing all that you can for Hope. That is all any of us can do for our furry family members.

You might join some other groups to look for other cat lovers, especially ones who live nearby - Next Door Neighbor is very good for that. I've met up with a few that are in my neighborhood.

 

[FrayedNerves]

I hope you didn't take offense to anything I said.

Not at all. Thank you.

 

[FrayedNerves]

Goodbye.

 

[iPappy]

F FrayedNerves how is Hope doing today?

 

[stephanietx]

Just FYI, Prednisolone can be compounded into a liquid or a treat. We give the treats often as a "reward" for our kitty taking all of his other pills shoved down his throat. I've never tried the liquid, but our vet sells the treats in many different flavors. Weirdly, my guy likes the liver flavor, which isn't their best seller.

My kitty with diarrhea doesn't do well on rabbit, never has. It causes diarrhea. Right now, he's eating a mix of venison, duck, and turkey. So far, so good.

To help with diarrhea, you can give slippery elm bark syrup. Bring 1/2 C water to a boil, remove from heat and stir in 1 t of slippery elm bark powder. Whisk until it's the consistency of a raw egg white. Store in fridge for up to 7 days. Dose is 1/4 t in wet food. Start with twice a day. If you see consistent improvement, back off to once a day.

 

[silent meowlook]

Hi. If you are still with us, please tell us how she is doing?