The well-known problem of IBD or lymphoma and pancreatitis

[arinlars]

I will call them this week.

 

[myrnafaye]

Vet schools are teaching hospitals, Arinlars.  And often are excellent; there was a doc at the AMC (Animal Medical Center) in NYC who was consulting with me about my cat Kiku, who had terrible asthma.  She was a respiratory specialist.  And here in Madison, WI (we got a School of Veterinary Medicine in the '80's), a world class animal oncologist used to work here until he suffered a sudden and untimely death, Dr. Greg MacEwen.  You will want to be seen in Internal Medicine.  Please post here and keep us in the loop.

 

[arinlars]

Mimi needs to be seen today by her vet. She doesn't eat so I had to syringe feed her. It pains me to do that because she hates it. She is loosing weight every day. She is 6 pounds now, I can feel every bone of hers! I called them and vet finally agreed to give her Leukeran and make another ultrasound. I fear the worst..

 

[myrnafaye]

So sorry to hear this, arinlars..pls keep us posted...

 

[arinlars]

I sometimes bring her food and hold the plate for her to eat cause she is not interested . It's heartbreaking . Then if she doesn't eat I have to give her food with the syringe and she gets all red and sad / angry but when I give her Bonita flakes she will eat them. I swear I opened 8 different cans of food since Monday .

Mimi is my best friend . I have her since she was a kitten. I found her in a field aloneamd we became buffs after that . We traveled the whole world (mainly cause I moved a lot) and she is my first pet. Please pray for my Mimi.

 

[myrnafaye]

Aww, you are sure in good company here...I think everyone understands your love for Mimi.  They fill our hearts.

 

[jenny82]

I am new to this thread but I will pray for you and Mimi. 

 

[arinlars]

Ok my trusted vet said to start mitrapaZine and give her rabbit royal canine . Her pred dosage is ok for her weight so we can't increase it. If she vomits or in a week she is bad again or still the same I have to bring her to the internist to start Leukeran. They don't give chemo drugs here.

She couldn't feel any changes in her belly so is isn't convinced it's lymphoma but if she gets worse we do an ultrasound .

Mimi did urine and blood work and I have to wait for the results tomorrow.

I'm happy that she was seen and convinced I'm not crazy . She was worried for her because we can feel her bones she became tiny!

 

[arinlars]

Mimi is not doing good. Despite the mirtazapine she is not eating and is extremely lethargic and 0 energy.. is that a side effect? I called the vet 2 times and they assured me it's not a side effect, instead hyperactivity is one.

The vet told me to feed her the Royal Canine PR which she did not touch and threw up the dry food which I was hesitating to accept from the vet because.. well dry food. Now what? My husband and I are heartbroken. We hit a wall.. we don;t know what to do. I will syringe feed her tonight but this is the worst she ever was.

Her blood result was fine only her pancreas was not good but the vet said it's normal with IBD cats and because I feed her the pancreatic enzymes... It's so hard.. everytime she doesn't eat I'm crying and begging her and it's me who feels extremely sad after each syringe feeding.

 

[goholistic]

 
Mimi is not doing good. Despite the mirtazapine she is not eating and is extremely lethargic and 0 energy.. is that a side effect? I called the vet 2 times and they assured me it's not a side effect, instead hyperactivity is one.

The vet told me to feed her the Royal Canine PR which she did not touch and threw up the dry food which I was hesitating to accept from the vet because.. well dry food. Now what? My husband and I are heartbroken. We hit a wall.. we don;t know what to do. I will syringe feed her tonight but this is the worst she ever was.

Her blood result was fine only her pancreas was not good but the vet said it's normal with IBD cats and because I feed her the pancreatic enzymes... It's so hard.. everytime she doesn't eat I'm crying and begging her and it's me who feels extremely sad after each syringe feeding.

I've been there, and I know how disheartening it is.  

   From what I read, Mimi was eating well a month ago. A week ago she got diarrhea, and has kind of been downhill from there. 

  Does she still have diarrhea? Are you keeping a log/journal? Is there anything that changed? Food, medication, environment? When was the last time she had an x-ray or ultrasound? Perhaps there have been significant changes in her GI tract. 

  Sorry, lots of questions. I know you said her blood work looked good. That's, at least, a good thing. A lot of possible issues are eliminated with good blood results.

The last time Sebastian was really bad, I thought that was it. I told my BF the time was soon and I was devastated. That was a year ago! I syringe fed him and hand-fed him freeze-dried meat treats and, yes, a little dry food (even though he is a "no dry food" kitty) because that's all he would try to take on his own. Once he got better, we worked our way back to a better diet. IBD kitties can get really bad flares. The key is for how long and can they come out of it with our help.

During that time a year ago, I treated Sebastian at home very similarly as they do when "hospitalized" (medication-wise) under the direction of my vet. No IV, though. I gave him sub-q fluids daily, increased Cerenia dose, added Zofran if he didn't respond well enough to Cerenia, buprenorphine for pain, Pepcid AC as usual, Tylan if bacteria component is suspected, and we sometimes increased the pred dose a little to "nip it in the bud" so to speak and slowly weaned back down to normal dose after improvement is seen. I might be forgetting some things. The main difference with being hospitalized is an IV and most of these things can be given as injections, thus improved absorption and reduced stress from pilling. While I do use a combined approach of traditional and holistic medicine, traditional medicine usually provides more immediate relief in dire situations (thus the treatments above) and holistic for long-term healing.

We did NOT use mirtazapine until there was some improvement. It won't work if they are nauseous and still feeling like crap. Is Mimi getting an anti-nausea medication? And, yes, lethargy is not usually a side effect of mirt, but rather hyperactivity and hypervocalization.

Only lymphomas that produce tumors can sometimes be felt on palpitation. Unfortunately, small cell lymphoma is not something that can be diagnosed via physical exam only, nor are all tumors.

As to food, during a flare I tend to resort to a food that is as plain as possible and not too high in fat - baby food (temporary), plain cooked meat (temporary), Tiki Cat Puka Puka Luau (shredded chicken). Some do well on raw. But of course it depends on what Mimi can have. Are there certain proteins she CAN'T have?

Hang in there! Vibes for Mimi! 

 

[samus]

If she's not eating at all, dry food is better than nothing. Even though it's dry food.... It was so frustrating when my cat wasn't eating, I found one food she would finally eat but it gave her diarrhea and every time I heard her go to the litter box I winced. But she was eating.

Have you been giving her sub-q's for dehydration? Have you or the vet given her any B-12 shots? Has her mouth/gums been checked out? Did you get a chance to go to the cat only vet or is this still the other vet that thinks she's ready to be put down? You can always take all your test results to the other vet. You might even be able to bring all the records (without the cat) to another vet and go over them with the vet to get a second opinion, to see if the other vet agrees with the treatment plan. They'll probably charge something, but less than a full exam with the cat.

You should be shooting for at least 15 ml per sitting, but really more like 30-40 is better. How much total depends on how much calories are in the food (and how much you have to dilute it to syringe feed it). My cat was ok with 70-100 calories a day. Any by ok, I mean she never got hepatic lipidosis, but she was still losing weight. I had syringes from 3 ml to 20 ml and found the 12 ml syringe easiest to deal with. I would fill three of them at once so I didn't have to stop and refill during feeding time. If you're more comfortable with smaller syringes, you should make sure you have enough of them that you don't have to take filling breaks during feeding time. I fed her every couple of hours during the worst part, it felt like all I did all day was prepare syringes and force feed my cat.

I can help you calculate the calories per ml of diluted food if you want. It's easiest with a scale, so you know exactly how much food and how much water you're mixing together.

 

[myrnafaye]

MIrtazipine can be sedating in humans.  Have you tried plain boiled chicken?  or Hills AD, temporarily? I second the B vitamin, .5 ml. at least weekly if not every 5 days.

 

[arinlars]

Hey guys. So 

 Does she still have diarrhea? Are you keeping a log/journal? Is there anything that changed? Food, medication, environment? When was the last time she had an x-ray or ultrasound? Perhaps there have been significant changes in her GI tract.  

  Sorry, lots of questions. I know you said her blood work looked good. That's, at least, a good thing. A lot of possible issues are eliminated with good blood results.

@GoHolistic  She does not have diarrhea but she poops a lot and looooong poop. A lot of stuff changed. First of when she is not eating, I open every emergency food and give it to her and hope she will eat. From baby food to fancy feast. She usually shakes her paw or turns her head so then I syringe feed her with natures variety beef (high calories and it;s healthy). The environment is the safe but we are installing a baby gate to separate the two cats. We noticed she is eating more when the bully cat is not around.

I am scheduling for another ultrasound for this week. The vet said her intestines are not extremely thickened but they are as usual. As the used to be.

Now she is eating the wet and dry food PR from Royal canine rabbit only. That was strict instructions from the vet. To keep her only to this diet so her system would adjust. Then I can slooowly make changes. She eats both that's good. Yesterday I force fed her because she was spacing out.... she was just laying there staring motionless and did not eat. She takes cerenia every other day. I think Mimi can not tolarate chicken but that;s about it. 

She is not dehydrated, the vet told me what to look for (like @samus  ) said to look for the gums etc. and she is drinking a lot of water because of the pred. I give Mimi every month 2.5mg B12 but not sub Q. The vet said she doesn't need it. But how to you guys give it to the cats if not by IV? Just with a shot?

I will call her other vet on Monday, the internist so we can schedule an ultrasound. I hope they won't hung up on me..

 

[samus]

Yeah, I give B12 as a shot. I put the needle into a "tented" skin flap the same way you would for subq fluids. If you give her subq fluids, there's sometimes an injection port on the tube that you can inject into instead (so you only have to stab the cat for putting in the subq fluids). If you give it orally but her intestines are too inflamed, it won't really get absorbed.

A lot of the Royal Canin foods have fish oil, and fish is a common allergen. If the food the vet recommended doesn't help, that might be part of the problem.

 

[goholistic]

She is not dehydrated, the vet told me what to look for (like @samus  ) said to look for the gums etc. and she is drinking a lot of water because of the pred. I give Mimi every month 2.5mg B12 but not sub Q. The vet said she doesn't need it.

I understand. In my experience, fluids can help sick cats to feel better in general, whether or not they are "clinically" dehydrated. Sebastian has been getting sub-q fluids every other day for the last two years, not because he is dehydrated (he's not) or because he has kidney disease (he doesn't), but because the fluids help keep inflammation under control and they replace lost electrolytes from periodic vomiting and/or diarrhea. Fluids are on our "what I couldn't do without" list.

Good luck with the ultrasound.

 

[arinlars]

I'm going next week to the internist and ask her if I could buy iv fluid and the accessories. Does Mimi has to be sedated for ultrasound ?

 

[goholistic]

For ultrasound, usually sedation is not needed unless it is a difficult cat. All three of my cats have had ultrasounds and were not sedated. But their bellies did have to be shaved.

IV (intravenous), meaning through the vein, is usually done in a hospital environment. Sub-q (short for subcutaneous), meaning under the skin, is done at home.

 

[arinlars]

Oohhh now I see! Thank you!

 

[arinlars]

Mimi seems to eat a little bit looses weight rapidly . Her ultrasound is next week along with her internist apt. It looks like nothing is working to make her gain weight ..she is 2.95kg(6 something lbs) now.. Dangerous levels... Her normal level are 8 lbs .

 

[samus]

Are you weighing her food and calculating the calories exactly? You might need to syringe feed her to supplement the amount she's nibbling.

It's hard to find solid numbers on how much calories a cat needs. For my cat (who has a small frame), about 70-80 calories per kg got her from a bony 2.something to almost 3.5 kg.