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Arthur (Miss- You!- '93-'09)

Bucket of Fuzz

Purred: Thu Sep 4, '08 3:31pm PST 
So...some of you know that I've been having problems the last few months with severe diarrhea and litter box avoidance. Mom took me to the vet in July. He prescribed an antibiotic (Flagyl) and did some blood tests, which showed low folate and high TLI (trypsin-like immunoreactivity concentration, which shows pancreatic function). He then insisted that the next step had to be biopsies through an endoscopic exam and exploratory surgery.

Well, mom was resistant to this recommendation, partly because of the cost and even more because the procedures were awfully invasive and were not, in themselves, going to help the problem. She knew that other vets are often willing to try to treat IBD by trial and error with different medicines and dietary changes, even without these tests. She suggested to the vet that they could at least try these approaches while she tries to scrape together the funds for the tests (she was downsized from a job earlier this year so money is tight), but he wouldn't hear of it. His attitude seemed to be that I should suffer until mom coughed up the cash.frown

Mom wasn't sure what to do. Since then, she's tried to treat the symptoms at home with OTC diarrhea medicine and a probiotic supplement that she got at the health food store. She tried canned pumpkin but I wouldn't eat it. None of it helped. frown

So today, after I made another mess on the floor, mom decided to take me to a different vet for a second opinion.

The new vet mentioned surgery and endoscopy, too, but she felt that those would be too invasive in a 15 year old cat. Instead, she wants to try steroids, along with a feline-specific probiotic, and a medicine to support liver and pancreatic function. Mom was very relieved!

There is still a slight chance that my symptoms could be caused by an intestinal lymphoma, but even in that case, the vet says that steroids are often a helpful treatment.

So she sent mom home with Prednisolone, Fortiflora, Actigall and another course of Flagyl. She also recommended that mom give me a folate supplement. Mom's going to start me on the medicines tonight.

So I wanted to hear if any other Olde Furts have had experience with this condition and these medicines. Do the drugs help? How are you doing now?


Edited by author Thu Sep 4, '08 4:38pm PST

Hazel Lucy &- Purrsville- Cats

tiny gumdrop
Purred: Thu Sep 4, '08 4:41pm PST 
I've no experience with this, but so glad you went for another opinion.
Hazel Lucy

Flower - Purrecious- Angel

Flowie The- Warrior Queen!- (Thanks, Bugsy
Purred: Fri Sep 5, '08 4:11am PST 
I don't have any experience with IBD either, Arthur. I'm SO happy that you got a second opinion, though! Some vets are in it more for the money than for the animals, I think. There are ALWAYS more options that surgery, especially for kits OUR age! We love you, Arthur and are purring like crazy for you!

Scooter ~- Our Angel

It's all about- 'The Scootster'
Purred: Fri Sep 5, '08 2:41pm PST 
Arthur, I have some experience. Mom has to leave, though, so it will be later before I can get back here. I'll be back as soon as I can.

Jester- (1988-2007)

Purred: Fri Sep 5, '08 3:39pm PST 
I was diagnosed with IBD when I was 18. I didn't have pancreatitis but I was having difficulties digesting fats (pale yellowish poop) which is related. I would often get caught short and had diarrhea for about 6 months.

I was on flagyl for ages while they tried to figure out what was wrong and it didn't work for me. It may have actually made things worse as the antibiotics also tend to kill off the good bacteria in your guts. The probiotic you are on will help with that.

My vet also said that the same drugs you were prescribed were the recommended treatment but I had mild diabetes too and the Prednisone would have made that much worse and they didn't think I would do well on it.

Mum decided to try me on alternative treatments 1st and the vet recommended me to another vet that is also trained in traditional Chinese medicine (TCM). The new vet changed my diet, started me on probiotics (I just used human ones), did accupuncture and gave me a Chinese herbal formula that mum mixed with my food. It took about 2 months before we sarted to see improvements and 3 months before I was back to normal again. I loved the acupuncture sessions and as I started to get better mum could see my poop improving for a few days after each session until I was finally pooping normally again.

I'd definitely recommend you trying this too at least before any of the more extreme things like surgery.

I'll send you some more details over pawmail.

Scooter ~- Our Angel

It's all about- 'The Scootster'
Purred: Fri Sep 5, '08 8:16pm PST 
Very interesting, Jester.

My experience is with traditional medicine. I had chronic diarrhea from presumed IBD and received methylprednisolone injections, which controlled the diarrhea for about 6-8 weeks, then I'd need another shot. Mom became uncomfortable with the vet and with the shots and took me to another vet.

The new vet was a feline-only vet. I had more blood tests, then an ultrasound in August 2005, but that still left IBD and intestinal lymphoma as suspects. The ultrasound vet recommended another blood test and fecal tests. The fecal tests for salmonella and campylobacter were negative. The blood test was the TLI-B12-FOLATE test, which sounds like what you've already had. My folate was low, B12 was okay, TLI was okay (which I think ruled out pancreatitis). That test result says, "Consistent with proximal small intestinal disease."

So the diagnosis was still IBD or mild lymphoma, with biopsy the only way to know for sure. Mom and Dad did not want me to have the biopsy and the vet did not really recommend it at my age, since the treatment for either was the same (steroids), although my vet said if it were known to be lymphoma, the treatment would be more aggressive. The Internal Medicine/ultrasound vet also said diet change (to hypoallergenic) and metronidazole/Flagyl 62.5 mg once daily could be tried. I didn't like those special foods and my vet never prescribed the Flagyl (I don't know why).

So I started on steroids again, in August 2005, but it was liquid dexamethasone this time, .25 ml once daily. The new vet said oral steroids are safer than injections. My diarrhea improved almost immediately and Mom saw none of the bad side effects she had seen with the injections. I took that dose for a while, then my poops became too solid so the dose was cut down to every other day, then twice a week, then I stopped altogether in 3/06 and the chronic diarrhea did not return.

Since that has been 3 years ago, I don't think I have lymphoma.

That seems similar to your recommended treatment, Arthur.

Also, I wouldn't even try the pumpkin back during that time, but now I like it! Has your mom tried adding some to your wet food?

Sally Maria- (Mama's- Angel)

Mama's angel
Purred: Sat Sep 6, '08 12:26am PST 
Hi Arthur! I've been living with undiagnosed IBD since I was a kitten. In April, it made the crossover to intestinal lymphoma, which was confirmed through endoscopic biopsies. My treatment was Leukeran and Prednisolone, but I had to stop the Pred because it caused a dangerous amount of fluid retention because of my heart murmur. I've also heard the Leukeran/Prednisolone protocol is used in cases of severe IBD. I've been on Leukeran for 17 weeks and last weekend my IM vet said he saw no signs of active lymphoma. My intestinal walls were back to normal thickness and my litter box issues and vomiting are almost completely gone. I don't know if your meowmy and vet are willing to go as far as giving you Leukeran, but certainly Prednisone or Prednisolone will help your tummy feel MUCH better.

Another thing that effects most IBD/lymphoma kitties is B-12 dificiency. Because the walls of the intestines are thickened, the body is not able to absorb B-12 properly. I started out getting one shot every week, going to one shot every four weeks. It has done me a world of good. B-12 helped me gain weight, maintain a good appetite and increased my energy level. If your meowmy doesn't mind giving you shots, you can get a vial of B-12 relatively cheap (about $10 I've heard) and it lasts a long time. Injectible B-12 works the best and will make you feel better along with any other meds you are taking.

Good luck! Hope you feel better soon!!

Sally Maria

Scooter ~- Our Angel

It's all about- 'The Scootster'
Purred: Sat Sep 6, '08 7:41am PST 
More interesting info! Thanks Sally Maria and Jester.

Re the B-12: Now Mom remembers that the vet felt sure my B-12 would be low and they talked about B-12 injections, too. I think the vet said B-12 tastes really terrible so the injections are best for that reason, also.

It turned out my B-12 was not deficient. Was yours tested, Arthur? Mine was tested at the same time as the TLI and Folate levels, which you mentioned, but those were a special blood test. Those don't seem to be part of the regular blood tests I get.

Also, I am back on oral (liquid) Prednisolone again but not for IBD now. I went on it for inflammation in my bladder, but it's also a great appetite stimulant for me (I don't do well with Cyproheptadine). I lost a little weight again, so the vet suggested I stay on a low dose of Pred (.15 ml daily) to keep up my appetite (as well as for the anti-inflammatory benefits).

Finally, I wanted to let you know that I went through a lot of ups and downs getting through my worst time with IBD: the diarrhea, tummy pains, not wanting to eat at all, refusing all cat food (I ate chicken for people and chicken baby food for a few months), and feeling like cr*p much of the time. Mom and Dad thought my 17th birthday would be my last, but I'm going on 20 now and doing better in those ways than I was 3 years ago. A vet who's willing to listen to your mom, try options and not poo-poo anything laugh out loud that could help is a great benefit. Whatever methods your mom decides to try, I hope you'll be feeling better soon.

Arthur (Miss- You!- '93-'09)

Bucket of Fuzz

Purred: Sat Sep 6, '08 6:16pm PST 
Jester, thanks for the information on the alternative treatments! I'm in the early stages of CRF and the vet said that if it got any worse, we might not be able to continue the steroid therapy. I'm glad to hear that there are other options available if this one doesn't work out!

Scootie, your experience sounds very similar to what's happening to me right now. I'm glad to hear that your condition improved enough to be off the steroids! It gives me hope, too kitty

They did test my B-12 and it was normal, scratch on wood. Mom hasn't tried mixing pumpkin with my food yet. That's a good idea!

Sally Maria, that's wonderful that the Leukeran has helped you so much! My brother, Max, had a form of lymphoma (he had masses in his abdomen, though, so I don't know if what he had was different from what you've been battling). That also makes me very hopeful, that kitties are benefiting from these therapies. Keep fighting...it sounds like you're winning!

Thanks for the information, my sweet Olde Furts. Love and purrs to you all!

Arthur (Miss- You!- '93-'09)

Bucket of Fuzz

Purred: Sun Sep 7, '08 1:18pm PST 
Oh! I was going to ask...

How long did it take for steroid therapy to begin working for those of you who used it? I've been on the Prednisolone since Thursday night, and I still have diarrhea. It's not as liquid as it was, maybe the consistency of baby food (red face). Does it usually take a while for it t firm up? My vet didn't say, and mom forgot to ask.

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