What's wrong with my cat?

[Kat Luv]

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 ?????

EPI sounds like a better fit, other than the fpl (which is very specific for pancreatitis). The symptoms list you mentioned (dull coat, quick weight loss, etc. matches pretty closely to EPI. However, the diagnostic test for epi is fTL/ftli (feline trypsin-like immunoassay), while fPl/fPli is testing for feline pancreatic lipase. fTl is typically low for EPI cats, while fPl is elevated in pancreatitis cats.
EPI cats desperately need enzymes to help them digest and absorb their food (there are some OTC), as they either have too little or the the enzymes they produce aren't working properly.
Pancreatitis cats have an excess of pancreatic lipase (ie, too much of an enzyme).

In either case, the above conditions can cause IBD/IBD-like symptoms. IBD is less specific of a diagnosis than EPI and pancreatitis, and is sometimes harder to control. Ideally, the exact cause is found (too much/not enough digestive enzymes, infection/inflammation of one or more organs in the GI tract, etc.) so that a very specific treatment plan is developed by the vet.
Do you know what the number was for the fPL? Was there also a test for fTL? If so, do you know if it was high or low or normal range?

I surely hope you can find answers soon...you're doing a great job being proactive and helping your sweet girl.
BTW, I had a cat named Cali (calico, of course) when I was little- she lived outside at my grandparents' house and lived to be 21 years old (major accomplishment for an outdoor girl). So you can imagine how much I love your cat's name.

 

[Pawsings]

Cali's G.I. panel:
FOLATE - #10.9 - NORMAL
COBALAMIN - UNREADABLE, CRITICALLY LOW
FPL - #4 - HIGH
TLI - #10 LOW ( Below #8 considered positive for EPI, #10 considered "equivocal".)
I've read more in the last week about EPI and IBD than I ever wanted to know. The amount of information, especially about diets, is dizzying.
Katlove, are you a vet tech? Your Cali girl sounds adorable. I can't believe she lived such a long life as an outdoor adventurer! My girl's full name is Caliber, although she's only been known as Cali or Cali-Girl.

 

[Pawsings]

 

[Pawsings]

These have been recommended by a staff member;

IBDKitties – Helping Save Lives…One Paw at a Time

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Hi furballsmom , silent and furbeesmom,
I have an update and questions about Cali. I hope that you can help me. The vet isn't sure if Cali has IBD or EPI, but she's leaning towards IBD. She left the decision up to me as to which disease we should treat first. We are treating EPI first and just using the process of elimination.

I started her on B12 shots seven days ago and have seen her mood and energy perk up quite a bit. The vet told me this would happen. Since I can't get the prescription enzymes until next week, I started her on OTC powdered cow pancreas. The vet said it was okay to do, but she didn't know the correct dosage. Typically, enzymes are given twice daily with meals, but Cali is sooo hungry that she is eating every two hours. The vet thought that giving her enzymes with every meal, 10 per day, is too much, so I've only been giving her enzymes with 3 meals per day. Thankfully, her liquid orange, super stinky diarrhea has completely resolved, but she still has a voracious appetite and the enzymes are causing her considerable bloating and gas. She also feels like she's gained some weight. Yay!!!

I assume that if the enzymes are working, not only would the diarrhea be cured, but her appetite would normalize since she'd have healthy absorption again. I realize that she may have both EPI and IBD, which might explain the partial recovery. Could it be possible that the enzymes are curing the diarrhea, but not her malabsorption because she has IBD and she's not receiving Prednisolone yet? Is bloating and gas painful to a cat? Is there anything I can treat it with? (She looks like a puppy with a distended belly who just finished suckling!).

Ladies, I'd appreciate any suggestions, thoughts or information that you could give me. The more brainstorming, including the vet, the better. Thank you very much!

 

[AGDonmez]

Hi furballsmom , silent and furbeesmom,
I have an update and questions about Cali. I hope that you can help me. The vet isn't sure if Cali has IBD or EPI, but she's leaning towards IBD. She left the decision up to me as to which disease we should treat first. We are treating EPI first and just using the process of elimination.

I started her on B12 shots seven days ago and have seen her mood and energy perk up quite a bit. The vet told me this would happen. Since I can't get the prescription enzymes until next week, I started her on OTC powdered cow pancreas. The vet said it was okay to do, but she didn't know the correct dosage. Typically, enzymes are given twice daily with meals, but Cali is sooo hungry that she is eating every two hours. The vet thought that giving her enzymes with every meal, 10 per day, is too much, so I've only been giving her enzymes with 3 meals per day. Thankfully, her liquid orange, super stinky diarrhea has completely resolved, but she still has a voracious appetite and the enzymes are causing her considerable bloating and gas. She also feels like she's gained some weight. Yay!!!

I assume that if the enzymes are working, not only would the diarrhea be cured, but her appetite would normalize since she'd have healthy absorption again. I realize that she may have both EPI and IBD, which might explain the partial recovery. Could it be possible that the enzymes are curing the diarrhea, but not her malabsorption because she has IBD and she's not receiving Prednisolone yet? Is bloating and gas painful to a cat? Is there anything I can treat it with? (She looks like a puppy with a distended belly who just finished suckling!).

Ladies, I'd appreciate any suggestions, thoughts or information that you could give me. The more brainstorming, including the vet, the better. Thank you very much!

Hi, I was reading this chain and curious how your cat is doing now, and if you settled on EPI diagnoses, and whether the EPI treatment alone was helpful?

 

[Pawsings]

Hi, I was reading this chain and curious how your cat is doing now, and if you settled on EPI diagnoses, and whether the EPI treatment alone was helpful?

Hello, AGD! I've been treating Cali for EPI for the last few months and all her symptoms have resolved and she's back to her spunky, happy and energetic self. She's also gained back about two pounds, from the four that she lost. She is still on the slim side, which is fine. Initially, I purchased the prescription enzymes, (PancreVed), but she refused to eat it. The powder is extraordinarily expensive. An eight ounce bottle of powder can cost $300-$400. So I went on Amazon and purchased pure powdered cow pancreas, which is inexpensive, and she loves it. It smells just like broiled steak! The vet didn't know how to dose it because it's not the same product as the prescription enzymes, so I just guess on the amount that I give her. It's also important to note that any digestive enzymes have to "incubate" after mixing with the food for 20 minutes before serving, otherwise the acids can burn the animal's mouth and throat. I mix about 1/2-3/4 teaspoon of the powder into all her meals of wet food. She eats about 4-5 times daily, so she's still hungrier than normal. I also give her a B12 shot weekly. Cali will need to be on this regimen the rest of her life. (She's only 7 now.) Initially, I gave her 2 types of probiotics, but I recently stopped those due to cost and there were no adverse effects when I did so. I have not returned to the vet. If you have any other questions please feel free to ask. I'm learning as I go! Take care.

 

[Mac and Cats]

Hello, AGD! I've been treating Cali for EPI for the last few months and all her symptoms have resolved and she's back to her spunky, happy and energetic self. She's also gained back about two pounds, from the four that she lost. She is still on the slim side, which is fine. Initially, I purchased the prescription enzymes, (PancreVed), but she refused to eat it. The powder is extraordinarily expensive. An eight ounce bottle of powder can cost $300-$400. So I went on Amazon and purchased pure powdered cow pancreas, which is inexpensive, and she loves it. It smells just like broiled steak! The vet didn't know how to dose it because it's not the same product as the prescription enzymes, so I just guess on the amount that I give her. It's also important to note that any digestive enzymes have to "incubate" after mixing with the food for 20 minutes before serving, otherwise the acids can burn the animal's mouth and throat. I mix about 1/2-3/4 teaspoon of the powder into all her meals of wet food. She eats about 4-5 times daily, so she's still hungrier than normal. I also give her a B12 shot weekly. Cali will need to be on this regimen the rest of her life. (She's only 7 now.) Initially, I gave her 2 types of probiotics, but I recently stopped those due to cost and there were no adverse effects when I did so. I have not returned to the vet. If you have any other questions please feel free to ask. I'm learning as I go! Take care.

I do not have a cat with these issues, but I so appreciate your update in case I or anyone else find it helpful in the future. I am so happy she sounds to doing better!

 

[AGDonmez]

Hello, AGD! I've been treating Cali for EPI for the last few months and all her symptoms have resolved and she's back to her spunky, happy and energetic self. She's also gained back about two pounds, from the four that she lost. She is still on the slim side, which is fine. Initially, I purchased the prescription enzymes, (PancreVed), but she refused to eat it. The powder is extraordinarily expensive. An eight ounce bottle of powder can cost $300-$400. So I went on Amazon and purchased pure powdered cow pancreas, which is inexpensive, and she loves it. It smells just like broiled steak! The vet didn't know how to dose it because it's not the same product as the prescription enzymes, so I just guess on the amount that I give her. It's also important to note that any digestive enzymes have to "incubate" after mixing with the food for 20 minutes before serving, otherwise the acids can burn the animal's mouth and throat. I mix about 1/2-3/4 teaspoon of the powder into all her meals of wet food. She eats about 4-5 times daily, so she's still hungrier than normal. I also give her a B12 shot weekly. Cali will need to be on this regimen the rest of her life. (She's only 7 now.) Initially, I gave her 2 types of probiotics, but I recently stopped those due to cost and there were no adverse effects when I did so. I have not returned to the vet. If you have any other questions please feel free to ask. I'm learning as I go! Take care.

thanks so much, really appreciate it! I am so happy to hear that your cat feels better with the treatment, and gained some of the weight back. It's heart breaking that she needs this at such a young age, but at least you've properly diagnosed her and treating, which is what matters. I really am not sure if my cat has EPI. She most likely has IBD or lymphoma per the ultrasound, but she was not checked for EPI, which is my suspicion, though I cannot know for sure. Her B12 was normal but folate was very high 2 mnts ago. I asked her vet to check these values again together with EPI this week, so I will take her for more blood work. Because she is so hungry all the time, the HARDEST PART is to fast her 12 hrs. Last time I did this, I was only able to fast her about 11 hours and it was a very difficult experience. How did you do this part, do you recall? My cat goes crazy if she doesn't eat at 3 am and 5 am (her appointment is at 9:00 am). I will give her Gabapentin 3 hours prior, and once she has that in her system, she calms down a bit within 45 minutes. But from 3:00 am to 6:00 am, it's a nightmare. She wakes up the neighbors, too.

 

[Pawsings]

thanks so much, really appreciate it! I am so happy to hear that your cat feels better with the treatment, and gained some of the weight back. It's heart breaking that she needs this at such a young age, but at least you've properly diagnosed her and treating, which is what matters. I really am not sure if my cat has EPI. She most likely has IBD or lymphoma per the ultrasound, but she was not checked for EPI, which is my suspicion, though I cannot know for sure. Her B12 was normal but folate was very high 2 mnts ago. I asked her vet to check these values again together with EPI this week, so I will take her for more blood work. Because she is so hungry all the time, the HARDEST PART is to fast her 12 hrs. Last time I did this, I was only able to fast her about 11 hours and it was a very difficult experience. How did you do this part, do you recall? My cat goes crazy if she doesn't eat at 3 am and 5 am (her appointment is at 9:00 am). I will give her Gabapentin 3 hours prior, and once she has that in her system, she calms down a bit within 45 minutes. But from 3:00 am to 6:00 am, it's a nightmare. She wakes up the neighbors, too.

I know exactly what you mean about the fasting. I knew that I couldn't endure 12 hours of her crying and nagging me, so I boarded her overnight at the vet. They very kindly didn't charge me for the brief stay and I was sooo relieved that I didn't have to watch her starve. I took her to the vet at closing time and they gave her a meal at 6:00 p.m. Then she had the G.I. panel blood work the following morning. I picked her up immediately afterwards and fed her at home. So that part went great. If you're having the complete G.I. panel be forewarned that it's very expensive - $500+. It takes about one week to get the results back from the veterinarian school in Texas. That's good that your cats B12 is normal. My vet told me that IBD and lymphoma look identical in an ultrasound and that both diseases are typically treated with Prednisolone. That's one of the reasons that I decided not to have an ultrasound and to try and treat Cali for EPI first. I wrote about the G.I. panel results in previous posts. My cat's worst symptom was liquid orange diarrhea that smelled worse than a dead body. Within 2 days of me adding the pancreas powder to her food, her diarrhea was improved 75%. After one week her poop was completely normal. So it's a very rapid improvement, if the cat has EPI. It takes much longer to see results from Prednisolone or a diet change for IBD. You might ask your vet about first trying the over-the-counter pancreas powder to see if your cat immediately improves. I'm using "Herbage Farmstead Grassfed Pancreas" - 200 capsules = $28.00 on Amazon. I just open and empty one capsule on her food, mix up, wait 20 minutes and serve. There is also " Ancestral Supplements Grassfed Beef Pancreas" - 180 capsules - $43.00. Much less expensive and more palatable than the prescription enzymes.

 

[AGDonmez]

I know exactly what you mean about the fasting. I knew that I couldn't endure 12 hours of her crying and nagging me, so I boarded her overnight at the vet. They very kindly didn't charge me for the brief stay and I was sooo relieved that I didn't have to watch her starve. I took her to the vet at closing time and they gave her a meal at 6:00 p.m. Then she had the G.I. panel blood work the following morning. I picked her up immediately afterwards and fed her at home. So that part went great. If you're having the complete G.I. panel be forewarned that it's very expensive - $500+. It takes about one week to get the results back from the veterinarian school in Texas. That's good that your cats B12 is normal. My vet told me that IBD and lymphoma look identical in an ultrasound and that both diseases are typically treated with Prednisolone. That's one of the reasons that I decided not to have an ultrasound and to try and treat Cali for EPI first. I wrote about the G.I. panel results in previous posts. My cat's worst symptom was liquid orange diarrhea that smelled worse than a dead body. Within 2 days of me adding the pancreas powder to her food, her diarrhea was improved 75%. After one week her poop was completely normal. So it's a very rapid improvement, if the cat has EPI. It takes much longer to see results from Prednisolone or a diet change for IBD. You might ask your vet about first trying the over-the-counter pancreas powder to see if your cat immediately improves. I'm using "Herbage Farmstead Grassfed Pancreas" - 200 capsules = $28.00 on Amazon. I just open and empty one capsule on her food, mix up, wait 20 minutes and serve. There is also " Ancestral Supplements Grassfed Beef Pancreas" - 180 capsules - $43.00. Much less expensive and more palatable than the prescription enzymes.

Got it, thank you for your detailed response. I unfortunately do not have a chance to board her, she's never stayed anywhere like that before and would freak out a lot, so yes, I will watch her starve an entire night until we arrive to the vet unfortunately and I have done this once before, it was miserable. Her poop is very bizarre, to be frank. Last 3-4 mnts, last portion of her poop is very soft, also very smelly. First part of her poop is usually darker and very well formed, latter portions though lighted in color. The color is also not consistent. Some days, the color is grayish, some days light brown, some days orange brown. We tried prednisolone but she reacted very badly to the first dose (crazy liquid diarrhea!) so I stopped. She reacted the same way to metronidazole antibiotic. I feel like she has also has EPI in addition to IBD, but because both of her vets dismissed my idea of testing her previously for EPI (due to her normal B12), I had given up on that. But I again asked her vet now to test it this time, and they will, so it's just a matter of me fasting her, and her hopefully allowing a blood draw when she is actually at the vet. She hates going into the vet obviously.
So at this stage, I was unable to treat her for IBD, because she reacted badly to the meds given so far. I am not sure what the future holds for us. I will come back to reread your explanations on EPI in case she tests positive for that.

 

[Pawsings]

Okay, I understand things sound more complex. I assume you've had all the standard blood work - renal, thyroid, glucose, etc? Have you tried posting a question here on the site, like I did, describing your cat's symptoms and asking people for their suggestions? There are very experienced and knowledgeable people on this site that can impart new information to you. Unfortunately, Prednisolone often causes diarrhea. The fact that your cat's B12 is normal is good news, but perplexing. Typically, whenever a cat has an intestinal disturbance of any kind, they have difficulty in absorbing B12. It's kind of the tell tale sign of G.I.distress. Did the ultrasound show thickening of the intestinal walls? What are your cat's symptoms and for how long have they been present?

 

[Pawsings]

Do you have a garage that's cool enough that you can put your cat in overnight so that you can't hear her cry for food? Maybe you could ask your vet for a valium. My friend gives one to her cat each evening to sleep because he has dementia and howls and paces at night. She said it lets him sleep all night. I have an idea. What if you feed your cat really early in the morning, 4-5 a.m. Then take the cat to the vet and leave her the there until the end of the day, 12 hours, and then they can do the blood draw before they close. So kitty will be at the vet when she's getting hungry. The vet can also give kitty a valium while she's there to keep her calm. My vet has a "quiet section", just for cats, and they can't hear the dogs bark. They must have the ability to keep cats for the day, like they do after surgeries. Good luck!

 

[AGDonmez]

Okay, I understand things sound more complex. I assume you've had all the standard blood work - renal, thyroid, glucose, etc? Have you tried posting a question here on the site, like I did, describing your cat's symptoms and asking people for their suggestions? There are very experienced and knowledgeable people on this site that can impart new information to you. Unfortunately, Prednisolone often causes diarrhea. The fact that your cat's B12 is normal is good news, but perplexing. Typically, whenever a cat has an intestinal disturbance of any kind, they have difficulty in absorbing B12. It's kind of the tell tale sign of G.I.distress. Did the ultrasound show thickening of the intestinal walls? What are your cat's symptoms and for how long have they been present?

Yes, absolutely I have a long chain on this website about this, let me try to post the link in case you're interested:
Please help! IBD senior cat, but all meds cause severe diarrhea
Her ultrasound showed "Irregular kidneys r/o chronic renal changes. Diffusely thickened submucosal layer of the small intestinal tract r/o IBD vs SCLSA Mild mesenteric lymphadenopathy."

I have done all sorts of blood work on her, and most of everything has been ruled out. She has beginning kidney disease I believe but vet said no meds at this stage.

See, the problem re prednisolone is that I asked her IM specialist twice "do you expect her to have diarrhea?" and the response was that diarrhea is very rare with prednisolone. So I was comforted by that response, but I know my cat, she reacts with diarrhea when there is a minor food change, and with medications too now.

I have Gabapentin, which is what my general vet prescribed for her before vet visits, so I give that to her 3 hours prior to the visit. It however works within one hour after. Since we're going to the big hospital to see the specialist, the blood draw will happen soon after the appointment in the morning. I tried feeding her with both wet and dry food at 10:30 and she did not wake me up until 5 am. So if she does the same tonight, I can administer the Gabapentin around 5:30/6 am. WISH US LUCK!

 

[FeebysOwner]

Hi @Furballsmom, @silent meowlook and furbeesmom, I have an update and questions about Cali. I hope that you can help me... I assume that if the enzymes are working, not only would the diarrhea be cured, but her appetite would normalize since she'd have healthy absorption again. I realize that she may have both EPI and IBD, which might explain the partial recovery. Could it be possible that the enzymes are curing the diarrhea, but not her malabsorption because she has IBD and she's not receiving Prednisolone yet? Is bloating and gas painful to a cat? Is there anything I can treat it with? (She looks like a puppy with a distended belly who just finished suckling!)...Ladies, I'd appreciate any suggestions, thoughts or information that you could give me.

Sorry I did not respond, it wasn't intentional!! But I really know too little to help you with this. I don't believe you can count on Pred to stop malabsorption and/or normalize her appetite. So, I would not assume that not getting Pred is the reason for her current eating habits.

Have you asked your vet if bloating and gas are common side effects when using powdered cow pancreas, or maybe too much of it? At a minimum, at least let your vet know about it and when it started compared to the timing of any treatments she is getting.

 

[Pawsings]

Sorry I did not respond, it wasn't intentional!! But I really know too little to help you with this. I don't believe you can count on Pred to stop malabsorption and/or normalize her appetite. So, I would not assume that not getting Pred is the reason for her current eating habits.

Have you asked your vet if bloating and gas are common side effects when using powdered cow pancreas, or maybe too much of it? At a minimum, at least let your vet know about it and when it started compared to the timing of any treatments she is getting.

Thanks, we have it straightened out now.

 

[AGDonmez]

Do you have a garage that's cool enough that you can put your cat in overnight so that you can't hear her cry for food? Maybe you could ask your vet for a valium. My friend gives one to her cat each evening to sleep because he has dementia and howls and paces at night. She said it lets him sleep all night. I have an idea. What if you feed your cat really early in the morning, 4-5 a.m. Then take the cat to the vet and leave her the there until the end of the day, 12 hours, and then they can do the blood draw before they close. So kitty will be at the vet when she's getting hungry. The vet can also give kitty a valium while she's there to keep her calm. My vet has a "quiet section", just for cats, and they can't hear the dogs bark. They must have the ability to keep cats for the day, like they do after surgeries. Good luck!

We made it to the vet and back. It was hard, and stressful. She also ate a piece of a plant which she wasn't supposed to and threw up, which concerned me the most out of everything that happened today. Vet took a lot of blood to check alot of things, including her kidney functions due to the plant exposure. One positive, she cooperated with all the tests at the vet and received her fluids, too. There have been many times in the past we have been to the vet where they could only get blood and not give her fluids or vice versa. I am glad this part is over and hopefully the plant exposure did not cause any additional issues.

 

[Pawsings]

I’m so happy to hear that things went well at the vet and kitty was able to get her fluids and blood work done. I was thinking about you both today, wondering how your stressful adventure was going. I can understand how you’d be worried about the the bit of plant that she ate, but it’s good news that she threw it up. You’re a good cat mom doing everything possible for her. I wish you the best of luck finding the source of your beloved kitty’s problem.

 

[AGDonmez]

I’m so happy to hear that things went well at the vet and kitty was able to get her fluids and blood work done. I was thinking about you both today, wondering how your stressful adventure was going. I can understand how you’d be worried about the the bit of plant that she ate, but it’s good news that she threw it up. You’re a good cat mom doing everything possible for her. I wish you the best of luck finding the source of your beloved kitty’s problem.

Thank you same to you!