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What's wrong with my cat?
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Hi there! First of all, I'm so sorry you and Cali are going through this. I can imagine how hard and heartbreaking it is, but I'm thinking of you and hoping for the best. Try Saccharomyces Boulardii, it's a great probiotic and helps especially with kitties suffering from diarrhea.
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- #23
Thank you for your kind words. I just bought that S. Boulardi probiotic. We just got the results from the G.I.panel blood test back today and the only value that was diagnostic was her B12, which was "non-readable", which is very very low. Her TLI was 10. So only a little bit below normal, indicating possible. EPI. Still nothing definitive. Vet is leaning towards EPI based on symptoms and their pattern of onset. IBD is also a possibility, but vet is reluctant to prescribe prednisolone because my cat has a heart murmur. Very frustrating.
Are they doing something to help increase her B12?
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- #25
She starts B12 injections today. Thanks for asking!
That's terrific, it may help quite a lot 
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- #27
Could you please recommend an informative and comprehensive article or website about IBD either here or elsewhere? When I search for IBD there is sooooo much information it's dizzying. The vet and I are still trying to decide between IBD and EPI, although we are both leaning towards EPI due to the presentation of the symptoms. Have a great weekend. Thank you !
These have been recommended by a staff member;
IBDKitties – Helping Save Lives…One Paw at a Time
Prebiotics & Probiotics for Cats: Healing Inflammation and gut dysbiosis
IBDKitties – Helping Save Lives…One Paw at a Time
Prebiotics & Probiotics for Cats: Healing Inflammation and gut dysbiosis
One of the links above has a more specific article related to EPI and a connection to IBD - EPI – IBDKitties, in case that helps expedite you to the right area of that site. This article talks about it being pretty common for a cat with EPI to also have IBD. The thing your vet needs to explain to you is if there are any repercussions in treating this as EPI first, rather than just IBD.
I also know for IBD, Budesonide can be an alternative to Prednisolone as it has less potential negative impacts on the heart, and is less inclined to prompt diabetes. So, talk to your vet about this option too.
The other thing to do is find one 'establishment/source' that has articles on both EPI and IBD and read them each, and make notes - it is easier to see differences/compare analyses when using the same sourcing. Such as -
Exocrine pancreatic insufficiency in cats: More common than veterinarians think (dvm360.com)
Managing IBD in cats (Proceedings) (dvm360.com)
I also know for IBD, Budesonide can be an alternative to Prednisolone as it has less potential negative impacts on the heart, and is less inclined to prompt diabetes. So, talk to your vet about this option too.
The other thing to do is find one 'establishment/source' that has articles on both EPI and IBD and read them each, and make notes - it is easier to see differences/compare analyses when using the same sourcing. Such as -
Exocrine pancreatic insufficiency in cats: More common than veterinarians think (dvm360.com)
Managing IBD in cats (Proceedings) (dvm360.com)
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. I have two hyperthyroid cats currently- the T4 blood test is definitely a "must" to rule out hyperthyroid. If you haven't had blood drawn and tested for T4 and are planning to, you might also ask about an FPL test too, to rule out feline pancreatitis.
My cat lost 4.5 lbs in 6 months - her first round (pancreatitis in cats is usually chronic, but only needs treating during "flares", and they usually get their GI issues sorted along with treatment). Metronidazole is usually given as part of pancreatitis meds, and that helps the GI symptoms. You might ask the vet about whether it could help your cat. I am wary of prednisolone, even though one of my cats has to take it periodically.
Both hyperthyroidism and pancreatitis can cause weight loss and GI issues, but given your cat's increased appetite it sounds more like hyperthyroid. The FPL and T4 results should give you much more info about whether either of these is your cat's issue.
In any case, I surely hope you are able to get answers soon and hope kitty is better soon. Hang in there...
My cat lost 4.5 lbs in 6 months - her first round (pancreatitis in cats is usually chronic, but only needs treating during "flares", and they usually get their GI issues sorted along with treatment). Metronidazole is usually given as part of pancreatitis meds, and that helps the GI symptoms. You might ask the vet about whether it could help your cat. I am wary of prednisolone, even though one of my cats has to take it periodically.
Both hyperthyroidism and pancreatitis can cause weight loss and GI issues, but given your cat's increased appetite it sounds more like hyperthyroid. The FPL and T4 results should give you much more info about whether either of these is your cat's issue.
In any case, I surely hope you are able to get answers soon and hope kitty is better soon. Hang in there...
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- #31
Katlove, thank you so much for responding with such help. Her FPL is slightly elevated. CIBD. saw the vet again yesterday. She lost an additional 8 ounces in only one week, even though I'm feeding her around the clock. The results from the g.i. panel blood test showed her B12 levels "unreadable", so I'm giving her injections now. Her trypsin (TPL) levels were 8, which is considered "equivocal" and not diagnostic for EPI. So she may or may not have EPI. Folate was normal. So the vet doesn't know if Cali has IBD or EPI. I tend to think she has EPI, so we started her on enzymes. I suppose if we don't see improvement in 7-10 days, then we will start treating her for IBS. Cali, who is a Maine Coon, has a heart murmur so the vet is hesitant to use prednisolone to treat it for fear she might go into congestive heart failure. Maine Coons are known to develop cardio myopathy. We also discussed the value of an ultrasound, but the vet said it could show thickened intestinal walls, which could be caused by either IBD or lymphoma.
Needless to say I'm feeling scared and helpless watching my girl starve to death and I don't know how to stop it. Her weight loss of 8 ounces in a week is very alarming. For all we know we're wasting time treating her for EPI and she has either IBD or cancer. Only time will tell as I wait for the enzymes to either make a difference or not. Then we'll start down the IBD road, which is even too overwhelming to think about right now. The vet allowed me to make the decision as to which illness to try and treat first. She thinks Cali has IBD. Two weeks ago I started her on Nutramax Proviable and S. Boulardii probiotics, which dramatically improved her liquid diarrhea. I don't know if that's an in indication of EPI or IBD. Thanks again for your information and suggestions.
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Hi. I am sorry your cat is so ill.
This is a link to an article on IBD.
www.vet.cornell.edu
In regard to the results regarding the kidneys. (Creatinine is one of the tests that is used judge kidney function.) One thing to keep in mind is that if a cat is very thin, the creatinine will be artificially lowered. There must be muscle mass to make creatinine.
IBD cats can have a diet protein sensitivity and sometimes need a novel protein source diet. This diet is fed exclusively with no treats or snacks. There are a few prescription diets to try. Talk to your vet about seeing if this could be an issue.
Feline pancreatitis, I have only seen cats in hospital for treatment. Usually several days of fluids and IV medications. You said your cat was only mildly elevated so that's good.
Feline hypertrophic cardiomyopathy, is seen more often in Main Coon cats. I am glad your vet is careful about that.
There is a blood test that can be sent to the lab or done in house in some hospitals. It is called a BNP test. It is a heart enzyme test to check for heart disease. You would need an echocardiogram with a board certified specialist to actually tell you what is going on with the heart. It doesn't sound like this is the issue that is causing the symptoms . from what you are describing. You would have to talk to your vet about all of this of course. I have seen cats with heart disease present with weight loss as the initial symptom.
Have they checked the blood pressure?
An abdominal ultrasound is a really good idea. Just make sure that if you decide to get one, it is with a board certified specialist. Ultrasounds are very subjective and you want someone with extra training and experience to do it. I know you had mentioned maybe having a specialist come to the hospital for it. The abdominal ultrasound can show what is going on with the internal organs such as the kidneys, liver, pancreas, and the intestines. It can also show if there are enlarged lymph nodes and any masses or tumors visible.
The only true way to diagnose IBD vs Lymphoma is with full thickness biopsies and that means surgery and anesthesia. It still isn't 100% that you will get a diagnosis. Sometimes the tests come back as inconclusive. Frustrating.
Another thing to consider is the stress to your cat. With my cat, Cheetah, she was showing signs of IBD/Lymphoma and also hyperthyroid, and asthma, with nodules in the lungs on radiographs and had an elevated BNP which means heart disease. So obviously not a good surgical or anesthetic candidate. The ultrasound did show thickening of the intestinal wall and enlarged lymph nodes as well as a space occupying lesion in the intestines. I went ahead and assumed it is lymphoma and treated accordingly. This was early 2021, I think. maybe earlier than that. She is still doing okay, and I think her quality of life is good.
You always have to weigh out the good of a procedure or diagnostic with the amount of stress it will cause your cat. Some good questions to ask a vet when discussing diagnostic procedures is:
What will this tell us?
How will we use that information? Will knowing this change the treatment plan or medications used?
How long will the procedure take? Will my cat have to be anesthetized to do this? If so, what kind of monitoring equipment do you use? Who will be with my cat in the recovery phase?
How long will it take to get the results?
What would you do if it was your cat?
If I decline doing this, what can we do?
So, just a few thoughts on this. I hope your cat is doing better.
This is a link to an article on IBD.
Inflammatory Bowel Disease
Suggested Articles Vomiting Diarrhea Constipation What Is There to Treat Idiopathic Megacolon? Gastrointestinal Parasites of Cats Food Allergies The Danger of Hairballs Gastrointestinal Disease Video Feline inflammatory bowel disease (IBD) is a condition in which a cat’s gastrointestinal (GI)...
In regard to the results regarding the kidneys. (Creatinine is one of the tests that is used judge kidney function.) One thing to keep in mind is that if a cat is very thin, the creatinine will be artificially lowered. There must be muscle mass to make creatinine.
IBD cats can have a diet protein sensitivity and sometimes need a novel protein source diet. This diet is fed exclusively with no treats or snacks. There are a few prescription diets to try. Talk to your vet about seeing if this could be an issue.
Feline pancreatitis, I have only seen cats in hospital for treatment. Usually several days of fluids and IV medications. You said your cat was only mildly elevated so that's good.
Feline hypertrophic cardiomyopathy, is seen more often in Main Coon cats. I am glad your vet is careful about that.
There is a blood test that can be sent to the lab or done in house in some hospitals. It is called a BNP test. It is a heart enzyme test to check for heart disease. You would need an echocardiogram with a board certified specialist to actually tell you what is going on with the heart. It doesn't sound like this is the issue that is causing the symptoms . from what you are describing. You would have to talk to your vet about all of this of course. I have seen cats with heart disease present with weight loss as the initial symptom.
Have they checked the blood pressure?
An abdominal ultrasound is a really good idea. Just make sure that if you decide to get one, it is with a board certified specialist. Ultrasounds are very subjective and you want someone with extra training and experience to do it. I know you had mentioned maybe having a specialist come to the hospital for it. The abdominal ultrasound can show what is going on with the internal organs such as the kidneys, liver, pancreas, and the intestines. It can also show if there are enlarged lymph nodes and any masses or tumors visible.
The only true way to diagnose IBD vs Lymphoma is with full thickness biopsies and that means surgery and anesthesia. It still isn't 100% that you will get a diagnosis. Sometimes the tests come back as inconclusive. Frustrating.
Another thing to consider is the stress to your cat. With my cat, Cheetah, she was showing signs of IBD/Lymphoma and also hyperthyroid, and asthma, with nodules in the lungs on radiographs and had an elevated BNP which means heart disease. So obviously not a good surgical or anesthetic candidate. The ultrasound did show thickening of the intestinal wall and enlarged lymph nodes as well as a space occupying lesion in the intestines. I went ahead and assumed it is lymphoma and treated accordingly. This was early 2021, I think. maybe earlier than that. She is still doing okay, and I think her quality of life is good.
You always have to weigh out the good of a procedure or diagnostic with the amount of stress it will cause your cat. Some good questions to ask a vet when discussing diagnostic procedures is:
What will this tell us?
How will we use that information? Will knowing this change the treatment plan or medications used?
How long will the procedure take? Will my cat have to be anesthetized to do this? If so, what kind of monitoring equipment do you use? Who will be with my cat in the recovery phase?
How long will it take to get the results?
What would you do if it was your cat?
If I decline doing this, what can we do?
So, just a few thoughts on this. I hope your cat is doing better.
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- #33
Hi Silent, thank you so much for taking the time to write such an extensive and informative post. Cali was initially misdiagnosed by her first vet with renal disease, so I wasted two months treating her for that. Meanwhile she was malnourished and getting thinner. It wasn't until I read the blood test results myself that I realized Cali was only dehydrated and did not have kidney disease. Then I waited another month to get an appt with a highly regarded vet who is a cat specialist. She immediately ordered the G.I. panel which results I explained previously. I really like this vet. She has spent nearly an hour with us every time I see or speak to her on the phone explaining in detail all the issues you mentioned in your post. She always asks me what I think and what I want to do, after she gives me the many treatment options. Then she tells me what she would do if Cali was hers.Hi. I am sorry your cat is so ill.
This is a link to an article on IBD.
Inflammatory Bowel Disease
Suggested Articles Vomiting Diarrhea Constipation What Is There to Treat Idiopathic Megacolon? Gastrointestinal Parasites of Cats Food Allergies The Danger of Hairballs Gastrointestinal Disease Video Feline inflammatory bowel disease (IBD) is a condition in which a cat’s gastrointestinal (GI)...
In regard to the results regarding the kidneys. (Creatinine is one of the tests that is used judge kidney function.) One thing to keep in mind is that if a cat is very thin, the creatinine will be artificially lowered. There must be muscle mass to make creatinine.
IBD cats can have a diet protein sensitivity and sometimes need a novel protein source diet. This diet is fed exclusively with no treats or snacks. There are a few prescription diets to try. Talk to your vet about seeing if this could be an issue.
Feline pancreatitis, I have only seen cats in hospital for treatment. Usually several days of fluids and IV medications. You said your cat was only mildly elevated so that's good.
Feline hypertrophic cardiomyopathy, is seen more often in Main Coon cats. I am glad your vet is careful about that.
There is a blood test that can be sent to the lab or done in house in some hospitals. It is called a BNP test. It is a heart enzyme test to check for heart disease. You would need an echocardiogram with a board certified specialist to actually tell you what is going on with the heart. It doesn't sound like this is the issue that is causing the symptoms . from what you are describing. You would have to talk to your vet about all of this of course. I have seen cats with heart disease present with weight loss as the initial symptom.
Have they checked the blood pressure?
An abdominal ultrasound is a really good idea. Just make sure that if you decide to get one, it is with a board certified specialist. Ultrasounds are very subjective and you want someone with extra training and experience to do it. I know you had mentioned maybe having a specialist come to the hospital for it. The abdominal ultrasound can show what is going on with the internal organs such as the kidneys, liver, pancreas, and the intestines. It can also show if there are enlarged lymph nodes and any masses or tumors visible.
The only true way to diagnose IBD vs Lymphoma is with full thickness biopsies and that means surgery and anesthesia. It still isn't 100% that you will get a diagnosis. Sometimes the tests come back as inconclusive. Frustrating.
Another thing to consider is the stress to your cat. With my cat, Cheetah, she was showing signs of IBD/Lymphoma and also hyperthyroid, and asthma, with nodules in the lungs on radiographs and had an elevated BNP which means heart disease. So obviously not a good surgical or anesthetic candidate. The ultrasound did show thickening of the intestinal wall and enlarged lymph nodes as well as a space occupying lesion in the intestines. I went ahead and assumed it is lymphoma and treated accordingly. This was early 2021, I think. maybe earlier than that. She is still doing okay, and I think her quality of life is good.
You always have to weigh out the good of a procedure or diagnostic with the amount of stress it will cause your cat. Some good questions to ask a vet when discussing diagnostic procedures is:
What will this tell us?
How will we use that information? Will knowing this change the treatment plan or medications used?
How long will the procedure take? Will my cat have to be anesthetized to do this? If so, what kind of monitoring equipment do you use? Who will be with my cat in the recovery phase?
How long will it take to get the results?
What would you do if it was your cat?
If I decline doing this, what can we do?
So, just a few thoughts on this. I hope your cat is doing better.
We discussed the value of doing an ultrasound and biopsy. I voted "no" for now, as it really wouldn't give us critical information. She discussed the novel protein diet. The vet can't feel any large masses in Cali's abdomen and she's skinny enough that they could be felt if they existed. BNP is new to me and I will mention it to the vet. We also discussed doing an echocardiogram to rule out heart disease.
I started Cali on enzymes two days ago. The vet said if she has EPI we should see improvement in 7-10 days. If she doesn't improve, then we will start treating cautiously with Prednisolone for IBD, along with a novel protein diet and continuing B12 injections for the foreseeable future. She had her first B12 shot on Saturday and there hasn't been any improvement in her mood or behavior. The vet said that the B12 should "perk her up", but it hasn't. She's still weak, lethargic, depressed and sleeps around the clock, which isn't like her. I also give her Mirataz to increase her appetite and probiotics.
I'm a firm believer in quality of life, so I would never perform invasive or stressful tests on Cali or
keep her alive in her current weakened condition because I know she's miserable. I'm hopeful that in the next month we will be able to positively identify and treat whatever illness she has. If we are unable to do that then I would make that very difficult decision that all of us pet owners dread.
Thank you for sharing your story about Cheetah and all the information you gave me. I really appreciate all of it.
Sorry to hear about your kitty. Probably a dumb question, but did they check her for Giardia? I had a female Maine Coon who had food intolerances and we went through countless prescription diets until finally finding Instinct Turkey LID dry and wet. She did really well on it for years and was able to gain weight. Other foods would just run right through her and malabsorption was clearly an issue. She had been on prednisolone a few times in her life for her stomach issues, allergies/ eosinophilic granulomas etc. She did develop hypertrophic cardiomyopathy at age 12. I can't say if that was due to the prednisolone or not as she hadn't had it in several years, or just because she was a Maine coon. Whatever the reason, I understand your hesitancy to use prednisolone. I also had an IBD kitty whose IBD developed into lymphoma. The ultrasound was an important diagnostic tool in her case. She had no detectable tumors but the intestinal thickening. They were able to confirm it was cancer by taking a biopsy of the tissue. Pretty sure they were able to do the biopsy via endoscope in her case, if I am remembering correctly.
I'm not sure if this helps, but my cat has had so many issues with throwing up and not eating, very sensitive tummy. She is 11 and I haven't had many issues lately, when she throws up now and doesn't eat her cat food, I switch her to a completely raw food. I think it is more gental on them and more tasty too. Make sure that the raw chicken or meat is fresh. Also include chicken hearts as they contain taurine. If your cat won't eat if raw and sear it for a bit to make it more flavorful.
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Feline pancreatitis has two forms, acute and chronic. The majority of cases are chronic, per the specialists I've dealt with having had 2 kitties (one is still with me, 17 yo) with chronic feline pancreatitis. Never have I had to hospitalize (knock on wood), but they do tend to have flares, sometimes every few weeks, sometimes maybe once or twice a year. It is under-diagnosed per my current vet, especially in larger practices that deal with many types of animals. She said they're starting to "catch up", but many are still not testing for it regularly and/or prescribing the meds and subq fluids needed to help get through flares.
Acute pancreatitis, otoh, can indeed be life-threatening and require hospitalization.
I found a pretty good article on VCA Pancreatitis in Cats - Pancreas-Specific Lipase | VCA Animal Hospitals
Towards the end, it lays out some of the symptoms.
A couple of points regarding pancreatitis, fwiw- 1)prednisolone should actually help if it's pancreatitis, and 2) per my vet, any value marked high on the FPL test is indicative of pancreas inflammation and likely is pancreatitis (it is a very specific, very reliable lab test).....think about human creatinine results with respect to CKD....certain elevated ranges are staged (Stage 3a, etc.) for the level/degree of illness. My vet says flares of chronic pancreatitis can be mild, moderate, or severe (the numbers would then be higher the more severe the disease).
Just something to keep in the back pocket in case the issues do not resolve.
Fingers (and toes) crossed that you have success in treatment. If not, you might want a second opinion on the labs she's already had.
Acute pancreatitis, otoh, can indeed be life-threatening and require hospitalization.
I found a pretty good article on VCA Pancreatitis in Cats - Pancreas-Specific Lipase | VCA Animal Hospitals
Towards the end, it lays out some of the symptoms.
A couple of points regarding pancreatitis, fwiw- 1)prednisolone should actually help if it's pancreatitis, and 2) per my vet, any value marked high on the FPL test is indicative of pancreas inflammation and likely is pancreatitis (it is a very specific, very reliable lab test).....think about human creatinine results with respect to CKD....certain elevated ranges are staged (Stage 3a, etc.) for the level/degree of illness. My vet says flares of chronic pancreatitis can be mild, moderate, or severe (the numbers would then be higher the more severe the disease).
Just something to keep in the back pocket in case the issues do not resolve.
Fingers (and toes) crossed that you have success in treatment. If not, you might want a second opinion on the labs she's already had.
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I totally forgot to ask you- did the vet change the dry food? If it does turn out to be IBD, getting the correct dry food (prescription) can be life-changing. My younger cat (semi-feral, weaned too early- had soft stool or diarrhea chronically) is on the Royal Canin GI Fiber response (dry). I swear- it worked wonders the first week she switched.
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- #38
Hi jencat, thank you for sharing your experiences and knowledge with me. Cali has not been tested for giardia, but I will mention it to the vet. I will also keep your suggestion of the Instinct food in mind. We've discussed a change in diet and the types of food that would be best. The vet did warn me about IBD turning into lymphoma down the line. We also discussed the value of an ultrasound and biopsy and the challenge in positively diagnosing either IBD or lymphoma because both diseases are diffuse. Thanks again !
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- #39
We haven't changed her food yet because we don't have a positive diagnosis. Despite Cali eating ,4-5 large 5.5oz cans of food per day, she continues to lose weight at an alarming rate. She's also losing her hair, has a rough coat and has developed dandruff. All this because she's starving and she's not absorbing nutrients. We are trying to stabilize her weight before we start trying to change her food. The vet is concerned that if we try and gradually change it now Cali won't eat it or it will make her diarrhea worse because its a new food. I am completely prepared to change her diet once we get a firm diagnosis.
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- #40
Katlove, Cali had the FPL test and her values were listed as "HIGH". I have a copy of G.I. lab report.
Thanks for the info about pancreatitis. Maybe she has both IBD and EPI ?????
