- Joined
- May 28, 2022
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Hi all! This will be pretty super, extremely long as my boy Neko has a lot of ongoing issues leading up to our current predicament, so apologies in advance for the wall of text.
Neko turned 11 on April 30; he's a big (and unfortunately overweight) boy at about 19.5 pounds. He was diagnosed (via ultrasound) with IBD in April 2016. After a short-course of prednisolone and changing his food to Nature's Variety Limited Ingredient Rabbit Diet (dry kibble - he wouldn't eat wet food), things were fairly resolved. He had a flare-up early in 2018 because his big brother was experiencing his own health problems and I'd been switching foods and giving Neko treats that I shouldn't have, and he ended up with bloody diarrhea and increased vomiting. We changed his food to Royal Canin Ultamino (dry kibble) and he was on 5mg daily prednisolone for several months before being weaned off of it.
Neko unfortunately lost his brother in April 2020, and I brought him to the vet afterwards for a full check-up since he'd been vomiting more frequently, thinking maybe stress was causing an IBD flare-up. An ultrasound showed intestinal inflammation consistent with IBD, but also showed a significant amount of sand and debris that had accumulated in his bladder. He hadn't had any issues peeing that I'd noticed, and with his IBD reasonably well-controlled, we were reluctant to switch him to a urinary diet that would cause intestinal issues. The vomiting continued, so he's been on 5mg daily prednisolone since November 2020, with occasional decreases to 2.5mg daily when he felt up to it. In May 2021, he was in for his check-up and his vet felt bladder stones. Neko was scheduled for a cystotomy, which he had in July. It was a nightmare recovery as his bladder was full of tiny bits of debris and stones that all had to be scooped out. After about 6 weeks, he finally stopped peeing blood and was getting back to normal (happy to discuss his procedure with anyone interested, as it was not like most experiences I've read about online - he seems to have slower recovery times, poor boy). The stones/crystals were calcium oxalate, but we opted to keep him on his Ultamino and add in a potassium citrate/cranberry supplement and hope this was a one-off.
In April, Neko had a little bit of diarrhea, which is unusual for him. He then had intermittent soft stool and regular; he was about due for his annual check-up, and since the diarrhea wasn't chronic, I thought it could wait a bit. Then I went out of town for work for a few days, but when I got back, things seemed off with him (I'm sure most of you know what I mean - something that I couldn't really explain, just different). Then he went from licking his bowl clean and hounding me for food to not being so interested but still eating everything (I thought he was just off his routine since I'd been away), then he started eating about half of what he usually did over two days. He vomited a couple times, and one night it looked like his stool was very dark, and mushy. I brought him to the vet first thing the next morning; his blood tests were fine, fecal exam didn't show anything unusual, and x-rays showed a possible bladder stone and a moderately full bladder. The following day, he went for an ultrasound, which showed some intestinal thickening consistent with IBD (they didn't believe it looked indicative of cancer), but his bladder was again full of sludge and debris, and also large. He hadn't peed while he was at home overnight, and apparently he hadn't peed while he was staying at the vet either. He hadn't even tried to pee - he had ignored his litter box, although the night before he had been drinking a water somewhat aggressively. He'd been peeing up to that day, though. We immediately brought him over to his usual vet, who drained some urine from his bladder to send for testing. We discussed what to do and because of the recent cystotomy and the possibility of a blockage (he couldn't be expressed), we landed on the PU surgery as the best course for him, as the crystals/sludge were likely calcium oxalate (they did turn out to be) and wouldn't dissolve on their own and would cause further blockages without intervention.
I really thought I was prepared for every eventuality after his cystotomy. I checked with his vet and had things all ready for him on his return home: additional prednisolone for inflammation, marbofloxacin for UTIs (he had developed one immediately after his cystotomy and it was miserable, so we started him preemptively), gabapentin for pain, Cerenia for nausea and as a urinary anti-inflammatory, and subq fluids (50ml every other day to help hydrate and flush him out). We were also going to switch him to Hill's C/D, which I was nervous about as it's chicken-based and Royal Canin S/O Calm wet food which is fish-based; his IBD seems to be exacerbated by poultry and fish.
Things went really, really shockingly well the first several days (although he refused to use a litter box that had Yesterday's News or shredded paper in it - he would only go in his usual box that has Pretty Litter). However, he also started holding his urine (he'd go once, maybe twice a day, sometimes it'd be over 24 hours before he'd go). I was in constant contact with the vet and bringing him in often for check-ups on everything (they are a fantastic team), and everything always seemed to resolve although he had a little discomfort and was probably stressed (and I wasn't helping as I was and still am a giant puddle of anxiety). We started him on some prazosin after a few days, which made him pee after 20 minutes the first few times he took it....then he went right back to long instances of not going or even trying to go. His stool, meanwhile, had been a mix of diarrhea, soft stool, mud pies, and normal poo, but the day of his recheck of his sutures (just over two weeks out from surgery), he had diarrhea and vomited. We tried metronidazole for the diarrhea, but after a couple days he was still having diarrhea and vomited again so we put him back on just his Ultamino (and his potassium citrate/cranberry supplement), which stopped the vomiting, and he was acting a little more like himself but still quite subdued. He was on metronidazole for about a week, but the diarrhea didn't resolve. Then I added Fortiflora to his food, which he loves. We stopped the metronidazole and I was hoping that with the Fortiflora, his gut bacteria could restore itself and we'd be back to normal soon. That was about 10 days ago, and we're still having a mix of diarrhea, mud pies, mushy but formed stool, and one lovely instance of a normal solid stool last Tuesday. Now he's started on Tylosin (3x daily). We gave it to him twice yesterday (it's supposed to 1/16 of a teaspoon, but I think he had less because I just estimated and honestly could not eyeball 1/16), and I only gave it twice because I'm concerned his system is overloaded and wanted to start gradually. I have to give it in capsules because he won't eat it on his food and I'm not sure the capsule fits the whole 1/16 teaspoon (they're size 4, and I got a 1/16 measuring spoon to check). Anyway, Neko went about 31 hours without a #2 (when he had been going about 3 times daily), so we were really optimistic that things were firming up, and when he finally went there was a really nice solid piece....and then diarrhea. About 12 hours later, he had diarrhea again.
His personality, aside from before/after he has diarrhea when he gets uncomfortable, is reasonably normal (not quite 100% though) - when he's feeling good, he's chatty, super into eating, drinking out of his fountains, and laying around comfortably in the sun and on his blankets. He will pee once or twice per day, but sometimes needs encouragement to go to the litter box. He seems to have a strong stream when he does go, though, but today it was a little smaller than usual which naturally sends me into a panic (maybe he's slightly dehydrated from the diarrhea).
I am riddled with anxiety so maybe this is more of a vent session, but has anyone else experienced something like this, both the diarrhea issue and the urine holding? Is he just overloaded with antibiotics and between that and the diet change, his tummy is super unhappy? I thought about adding S. boulardii as another probiotic but he's got so much going on, I'm afraid of making things worse. Obviously we just started the Tylosin but I guess I'm looking for immediate gratification when it will likely be a lengthy process to get his system back on track. I'm happy for any/all advice and really I just appreciate you all listening (or reading)! Neko is a sweet boy and he's been through a lot this past year and I want so badly to see him healthy and happy and back to his usual self. Thanks all!
Neko turned 11 on April 30; he's a big (and unfortunately overweight) boy at about 19.5 pounds. He was diagnosed (via ultrasound) with IBD in April 2016. After a short-course of prednisolone and changing his food to Nature's Variety Limited Ingredient Rabbit Diet (dry kibble - he wouldn't eat wet food), things were fairly resolved. He had a flare-up early in 2018 because his big brother was experiencing his own health problems and I'd been switching foods and giving Neko treats that I shouldn't have, and he ended up with bloody diarrhea and increased vomiting. We changed his food to Royal Canin Ultamino (dry kibble) and he was on 5mg daily prednisolone for several months before being weaned off of it.
Neko unfortunately lost his brother in April 2020, and I brought him to the vet afterwards for a full check-up since he'd been vomiting more frequently, thinking maybe stress was causing an IBD flare-up. An ultrasound showed intestinal inflammation consistent with IBD, but also showed a significant amount of sand and debris that had accumulated in his bladder. He hadn't had any issues peeing that I'd noticed, and with his IBD reasonably well-controlled, we were reluctant to switch him to a urinary diet that would cause intestinal issues. The vomiting continued, so he's been on 5mg daily prednisolone since November 2020, with occasional decreases to 2.5mg daily when he felt up to it. In May 2021, he was in for his check-up and his vet felt bladder stones. Neko was scheduled for a cystotomy, which he had in July. It was a nightmare recovery as his bladder was full of tiny bits of debris and stones that all had to be scooped out. After about 6 weeks, he finally stopped peeing blood and was getting back to normal (happy to discuss his procedure with anyone interested, as it was not like most experiences I've read about online - he seems to have slower recovery times, poor boy). The stones/crystals were calcium oxalate, but we opted to keep him on his Ultamino and add in a potassium citrate/cranberry supplement and hope this was a one-off.
In April, Neko had a little bit of diarrhea, which is unusual for him. He then had intermittent soft stool and regular; he was about due for his annual check-up, and since the diarrhea wasn't chronic, I thought it could wait a bit. Then I went out of town for work for a few days, but when I got back, things seemed off with him (I'm sure most of you know what I mean - something that I couldn't really explain, just different). Then he went from licking his bowl clean and hounding me for food to not being so interested but still eating everything (I thought he was just off his routine since I'd been away), then he started eating about half of what he usually did over two days. He vomited a couple times, and one night it looked like his stool was very dark, and mushy. I brought him to the vet first thing the next morning; his blood tests were fine, fecal exam didn't show anything unusual, and x-rays showed a possible bladder stone and a moderately full bladder. The following day, he went for an ultrasound, which showed some intestinal thickening consistent with IBD (they didn't believe it looked indicative of cancer), but his bladder was again full of sludge and debris, and also large. He hadn't peed while he was at home overnight, and apparently he hadn't peed while he was staying at the vet either. He hadn't even tried to pee - he had ignored his litter box, although the night before he had been drinking a water somewhat aggressively. He'd been peeing up to that day, though. We immediately brought him over to his usual vet, who drained some urine from his bladder to send for testing. We discussed what to do and because of the recent cystotomy and the possibility of a blockage (he couldn't be expressed), we landed on the PU surgery as the best course for him, as the crystals/sludge were likely calcium oxalate (they did turn out to be) and wouldn't dissolve on their own and would cause further blockages without intervention.
I really thought I was prepared for every eventuality after his cystotomy. I checked with his vet and had things all ready for him on his return home: additional prednisolone for inflammation, marbofloxacin for UTIs (he had developed one immediately after his cystotomy and it was miserable, so we started him preemptively), gabapentin for pain, Cerenia for nausea and as a urinary anti-inflammatory, and subq fluids (50ml every other day to help hydrate and flush him out). We were also going to switch him to Hill's C/D, which I was nervous about as it's chicken-based and Royal Canin S/O Calm wet food which is fish-based; his IBD seems to be exacerbated by poultry and fish.
Things went really, really shockingly well the first several days (although he refused to use a litter box that had Yesterday's News or shredded paper in it - he would only go in his usual box that has Pretty Litter). However, he also started holding his urine (he'd go once, maybe twice a day, sometimes it'd be over 24 hours before he'd go). I was in constant contact with the vet and bringing him in often for check-ups on everything (they are a fantastic team), and everything always seemed to resolve although he had a little discomfort and was probably stressed (and I wasn't helping as I was and still am a giant puddle of anxiety). We started him on some prazosin after a few days, which made him pee after 20 minutes the first few times he took it....then he went right back to long instances of not going or even trying to go. His stool, meanwhile, had been a mix of diarrhea, soft stool, mud pies, and normal poo, but the day of his recheck of his sutures (just over two weeks out from surgery), he had diarrhea and vomited. We tried metronidazole for the diarrhea, but after a couple days he was still having diarrhea and vomited again so we put him back on just his Ultamino (and his potassium citrate/cranberry supplement), which stopped the vomiting, and he was acting a little more like himself but still quite subdued. He was on metronidazole for about a week, but the diarrhea didn't resolve. Then I added Fortiflora to his food, which he loves. We stopped the metronidazole and I was hoping that with the Fortiflora, his gut bacteria could restore itself and we'd be back to normal soon. That was about 10 days ago, and we're still having a mix of diarrhea, mud pies, mushy but formed stool, and one lovely instance of a normal solid stool last Tuesday. Now he's started on Tylosin (3x daily). We gave it to him twice yesterday (it's supposed to 1/16 of a teaspoon, but I think he had less because I just estimated and honestly could not eyeball 1/16), and I only gave it twice because I'm concerned his system is overloaded and wanted to start gradually. I have to give it in capsules because he won't eat it on his food and I'm not sure the capsule fits the whole 1/16 teaspoon (they're size 4, and I got a 1/16 measuring spoon to check). Anyway, Neko went about 31 hours without a #2 (when he had been going about 3 times daily), so we were really optimistic that things were firming up, and when he finally went there was a really nice solid piece....and then diarrhea. About 12 hours later, he had diarrhea again.
His personality, aside from before/after he has diarrhea when he gets uncomfortable, is reasonably normal (not quite 100% though) - when he's feeling good, he's chatty, super into eating, drinking out of his fountains, and laying around comfortably in the sun and on his blankets. He will pee once or twice per day, but sometimes needs encouragement to go to the litter box. He seems to have a strong stream when he does go, though, but today it was a little smaller than usual which naturally sends me into a panic (maybe he's slightly dehydrated from the diarrhea).
I am riddled with anxiety so maybe this is more of a vent session, but has anyone else experienced something like this, both the diarrhea issue and the urine holding? Is he just overloaded with antibiotics and between that and the diet change, his tummy is super unhappy? I thought about adding S. boulardii as another probiotic but he's got so much going on, I'm afraid of making things worse. Obviously we just started the Tylosin but I guess I'm looking for immediate gratification when it will likely be a lengthy process to get his system back on track. I'm happy for any/all advice and really I just appreciate you all listening (or reading)! Neko is a sweet boy and he's been through a lot this past year and I want so badly to see him healthy and happy and back to his usual self. Thanks all!