MD/DC/NOVA vet recommendations please - gastroenterology/digestive health?

[YadaYadaYada]

So glad to read your update! Here is hoping there is continued improvement.

 

[rungirl]

I'm following this thread and sending all good thoughts for you and Jimmy. As a long-time cat owner, I know how heart-wrenching it is to see our fur babies suffering. I hope he continues to improve.

 

[Lookinagain]

That’s hopeful and he definitely looks better than he did. Even baby steps are better than none and often turn into bigger steps!

 

[Cerulean]

Oh, what a nightmare. So, so sorry to hear this.

I've had two cats with mystery digestive ailments. One was gravely ill, and who knows what her long-term prognosis is...the only way to diagnose her issues with certainty is exploratory surgery.

These types of issues seem to be really hard to pin down.

I'm no vet, but it sounds like obstruction. (My first job was at a cat shelter with a hospice, we had our own clinic and saw hundreds of cats).

I wish you were closer to me in the Midwest, or I'd definitely have a referral!

Hope you find out more soon and that your little furbaby continues his uphill climb.

 

[foxinsox]

Oh I wish he was loads better but baby steps is better than worse. All the purry furry paws are crossed here and we’re sending lots of get well wishes to Jimmy

 

[yssie]

Oh, what a nightmare. So, so sorry to hear this.

I've had two cats with mystery digestive ailments. One was gravely ill, and who knows what her long-term prognosis is...the only way to diagnose her issues with certainty is exploratory surgery.

These types of issues seem to be really hard to pin down.

I'm no vet, but it sounds like obstruction. (My first job was at a cat shelter with a hospice, we had our own clinic and saw hundreds of cats).

I wish you were closer to me in the Midwest, or I'd definitely have a referral!

Hope you find out more soon and that your little furbaby continues his uphill climb.

We all kept thinking obstruction too - it sounds SO likely. But nothing showed up on Xrays or US, and endoscopy was clear - definitely a nightmare scenario We started talking about exploratory surgery but he was declining so quickly, the vet didn't think he'd be stable enough for it... And we were terribly uncomfortable with that idea anyway

Best case diagnosis is a really really dreadful episode of IBS. The treatment would be a steroid regimen, and they put him on prednisone for inflammation yesterday... And yesterday he looked truly dreadful, so it seemed very improbable that IBS was the culprit. But today he's genuinely improved - maybe IBS really is a potential diagnosis

 

[Matata]

maybe IBS really is a potential diagnosis

Did they also check for pancreatitis?

 

[yssie]

Did they also check for pancreatitis?

They did. CBC and chemistry. All clean except one anomaly - increased globulin concentration - that has since gone back down to normal, so probably a stress reaction.

We actually do these semi-anually on all the seniors since Gretta, Garett, and Mina all had/have kidney and pancreas issues - all of Jimmy's (he's 9) have always been clean. Thankfully, on the one hand, but on the other that does kind of increase the likelihood of a cancer diagnosis now.

Thanks for the thought though. If you - anyone - can think of anything else we could ask about please let me know.

 

[Matata]

on the other that does kind of increase the likelihood of a cancer diagnosis now

One of mine was just diagnosed with small cell lymphoma. He has had IBS for years and it tends to morph into lymphoma. If your guy has the same, prednisolone will help alleviate symptoms until such time as you decide to do oral chemo. I'm not there yet with my guy as the prednisolone has stopped his symptoms. Both prednisolone and oral chemo carry unpleasant side effect potential but when you're dealing with a terminal illness, there aren't many options, just the lesser of evils. I hope you get a diagnosis soon and that it's not cancer. All digits crossed.

 

[yssie]

One of mine was just diagnosed with small cell lymphoma. He has had IBS for years and it tends to morph into lymphoma. If your guy has the same, prednisolone will help alleviate symptoms until such time as you decide to do oral chemo. I'm not there yet with my guy as the prednisolone has stopped his symptoms. Both prednisolone and oral chemo carry unpleasant side effect potential but when you're dealing with a terminal illness, there aren't many options, just the lesser of evils. I hope you get a diagnosis soon and that it's not cancer. All digits crossed.

Oh no. I'm so sorry, I hope your boy stays clear for a good long time

Garett's chemo was fine... Until we had to increase the dose to the point where the side effects were making him uncomfortable. That's when we knew we had to let him go. It's not like chemo for humans - you can't explain to a cat that feeling like sh*t for a few weeks will be worth decades of happily ever after. They'd just feel like sh*t for those weeks. And they don't ever get decades of happily ever after. Our vet feels strongly that the drugs shouldn't be worse than the disease for more than a day or two. On paper I wholeheartedly agree, and I'm grateful for their strong opinion because it spares me having to evaluate my own morality on the matter when close to home - I suspect it's more flexible than I'd like to think.

I'll update here with what the biopsy comes back with. I'm scared to hope but I can't not. My other half, on the other hand, is doing his best to "be realistic". It's not a great combo. Not knowing what we're dealing with.

We just got the bill for his shindig thus far. The cost of a week in intensive care is - something else.

 

[Cerulean]

One of mine was just diagnosed with small cell lymphoma. He has had IBS for years and it tends to morph into lymphoma. If your guy has the same, prednisolone will help alleviate symptoms until such time as you decide to do oral chemo. I'm not there yet with my guy as the prednisolone has stopped his symptoms. Both prednisolone and oral chemo carry unpleasant side effect potential but when you're dealing with a terminal illness, there aren't many options, just the lesser of evils. I hope you get a diagnosis soon and that it's not cancer. All digits crossed.

This sounds very similar to my girl. She has IBS...or cancer. We won't know without exploratory surgery according to my vet.

We all kept thinking obstruction too - it sounds SO likely. But nothing showed up on Xrays or US, and endoscopy was clear - definitely a nightmare scenario We started talking about exploratory surgery but he was declining so quickly, the vet didn't think he'd be stable enough for it... And we were terribly uncomfortable with that idea anyway

Best case diagnosis is a really really dreadful episode of IBS. The treatment would be a steroid regimen, and they put him on prednisone for inflammation yesterday... And yesterday he looked truly dreadful, so it seemed very improbable that IBS was the culprit. But today he's genuinely improved - maybe IBS really is a potential diagnosis

My girl with IBS was also initially too unstable for surgery..the idea of surgery also made me deeply uncomfortable...and then fluids, feeding tubes, and steroids helped enough so it wasn't worth it.

I am hoping that it is IBS (not a phrase you say every day!)

The mystery illnesses are dreadful. Ugh, I am so sorry! Poor little bean. I hope he keeps responding to whatever is working. <3

 

[Lisa Loves Shiny]

Sending prayers and good thoughts. Such a beautiful sweetie.

 

[Matata]

My girl with IBS was also initially too unstable for surgery..the idea of surgery also made me deeply uncomfortable..

I opted for biopsy via endoscopy. The risk with that is the tissue samples are small and diagnosis may be difficult. When the lab couldn't get a definitive diagnosis via their first round, they asked permission to do a Par stain which showed the positive result.

 

[Matata]

Garett's chemo was fine... Until we had to increase the dose to the point where the side effects were making him uncomfortable. That's when we knew we had to let him go.

Awww, I'm sorry I forgot you'd been through that with him.

 

[yssie]

I opted for biopsy via endoscopy. The risk with that is the tissue samples are small and diagnosis may be difficult. When the lab couldn't get a definitive diagnosis via their first round, they asked permission to do a Par stain which showed the positive result.

Hmmm. Specialist doc didn’t mention the possibility of the tissue samples being too small to us. I’m not too happy about that...

I didn’t say anything about losing Garett here on PS - you didn’t miss that. We were both just totally wrung out from the whole thing, took me a good couple weeks to even talk about him without crying.

Edit - I was worrying that I had missed something off about Jimmy, being so focused on Garett. But I don’t think so. He’s doing this... Burping, gulping, swallowing thing. Seems to be how he’s getting so much air in his poor tummy. I saw him doing that today, when I visited, and - well, I actually noticed this exact thing a few months ago, and brought it up to our usual vet at his routine senior health check. No one thought anything of it back then though, because he was behaving normally and his bloodwork was all clear as usual. It would have been madness to put an apparently perfectly healthy cat under anesthesia to investigate something that didn’t seem to be causing any distress. I totally get that.

But the fact that I recognise it now tells me that whatever is happening isn’t all sudden. That gulping thing was our first indicator. Turns out. And it also gives me some confidence that... Yes, I WAS paying attention to the other babies, even when Garett was declining. So no, I probably didn’t miss anything I shouldn’t have. It helps me sleep better.

My other half and I were arguing about this. I feel we should probably have taken that more seriously and demanded a more thorough check, even if it meant putting him under, because even if it seemed like nothing then - it sure as h*ll isn’t now. Depending on what those biopsies come back as. And he was certainly as low risk for anesthesia-related complications as it’s possible to be. He thinks the risks of anesthesia far outweigh the off chance of finding something that xrays, US, and bloodwork all miss.

Gretta, Jenna, Jeffey, Garett, all gone between 2020 and 2021. Ren needed hip surgery. Alex got cancer and had his leg amputated - that was 2019. Mina has had six pancreatitis episodes since the start of Covid - all caught very early because after years of that nonsense we know what to look for! The pet paranoia is real, lol!!

 

[yssie]

His biopsy came back, sounds almost exactly like your verdict @Matata. Increase in white blood cells in small intestine. He definitely has some gastritis. Could be a sign of small cell lymphoma (treated with oral chemo). Could be #Just gastritis.

They’re going to stain - they can use the biopsy tissue they already retrieved. If the excess white blood cells are all from the same line it’s a cancer diagnosis. If not - nothing to worry about.

That takes about a week. In the meantime he’s improving every day on the steroids and anti inflammatory meds

 

[Cerulean]

His biopsy came back, sounds almost exactly like your verdict @Matata. Increase in white blood cells in small intestine. He definitely has some gastritis. Could be a sign of small cell lymphoma (treated with oral chemo). Could be #Just gastritis.

They’re going to stain - they can use the biopsy tissue they already retrieved. If the excess white blood cells are all from the same line it’s a cancer diagnosis. If not - nothing to worry about.

That takes about a week. In the meantime he’s improving every day on the steroids and anti inflammatory meds

So glad you are getting some tangible information and seeing improvement!

 

[Matata]

@yssie Keeping my fingers crossed for Jimmy. Sending gentle hugs to you.

 

[Daisys and Diamonds]

His biopsy came back, sounds almost exactly like your verdict @Matata. Increase in white blood cells in small intestine. He definitely has some gastritis. Could be a sign of small cell lymphoma (treated with oral chemo). Could be #Just gastritis.

They’re going to stain - they can use the biopsy tissue they already retrieved. If the excess white blood cells are all from the same line it’s a cancer diagnosis. If not - nothing to worry about.

That takes about a week. In the meantime he’s improving every day on the steroids and anti inflammatory meds

This sounds encouraging, is he eatting now ?
I am thinking of you both and naturally hoping for continued improvement and recovery

 

[YadaYadaYada]

Not sure if this is of any real help but we had a cat with intestinal cancer. She never stopped eating but she would go behind the sofa and have bouts of diarrhea (sorry if that is TMI). As with people it can probably present differently between cats but thought maybe that might be some comfort while you wait for results.

Fingers crossed it is treatable and he makes a full recovery. Also glad to hear the steroids are having a positive effect.

 

[yssie]

I’ve been avoiding this thread for a couple of days.

Yesterday - he was doing great, stable, eating around 75% of his calorie needs by mouth. Alert and energetic. We were able to bring him home.



I had wondered if he’d recognize home - he did seem to. We have the spare bedroom set up for animals that need to be separated and he knows the room. Not his first rodeo in there. He wandered around, nuzzled for attention, purred, ate like he hadn’t eaten in days… He was so happy! And we were so happy!

Unfortunately he pulled his feeding tube out after being home about an hour. I won’t go into how. Suffice to say that I was feeling quite murderous yesterday. It’s a stomach tube, so that’s an emergency because stomach contents will leak into the abdomen through the hole and may cause sepsis.

So back to the ER. The ER put a temporary tube in overnight, but when his internal medicine specialists examined him this morning they determined the temporary tube was going to create more problems than it solved. He had surgery today to close the old hole and replace the tube, and this time they surgically sutured the stomach to the abdomen wall to avoid another episode.

He’s out of surgery and stable. He’ll stay overnight at least, and we’ll see how he heals up.

There was some evacuation into his abdomen so they’ve also put a drain in at his old hole site. The skin tissue trauma should heal up without further intervention. The expectation is that the drain will come out in 3-5 days - that won’t need surgery. He’ll have to keep the tube in for two weeks at minimum, which is longer than the minimum required time when it wasn’t surgically placed. Hopefully he goes right back to eating normally as soon as he’s up, and we can get that tube out of him as quickly as it’s safe to.

Really really relieved he’s safely out of surgery today, but mostly just exhausted. Going from super high to super low yesterday was so demoralizing. But I’ll sleep much better tonight.

 

[Lookinagain]

Oh my goodness. I’m so sorry. What an ordeal for all of you. Any definitive diagnosis yet?

 

[canuk-gal]

HI:

Oh my goodness. Hope things settle and heal soon.

kind regards--Sharon

 

[yssie]

Oh my goodness. I’m so sorry. What an ordeal for all of you. Any definitive diagnosis yet?

Not yet! It was narrowed down to either really bad IBS or small cell lymphoma, and we’re waiting on a biopsy stain to tell us which (hopefully! They said they get conclusive results about 85% of the time). That takes 5-10 days though. Sigh.

 

[Lookinagain]

Not yet! It was narrowed down to either really bad IBS or small cell lymphoma, and we’re waiting on a biopsy stain to tell us which (hopefully! They said they get conclusive results about 85% of the time). That takes 5-10 days though. Sigh.

I know waiting that long is torture for you. Let's hope it's 5 days!

 

[OboeGal]

Oh, my - you've all definitely been through it. I'm so sorry, for ALL of it - the lost furry loved ones, their discomfort and suffering and pain, your pain, the worry, the expense - all of it.

That's a particularly frustrating development for Jimmy (and you) - it sounds like he was really on the upswing there, but now this.....it does sound like the steroids are helping and his appetite is returning nicely, and that's important. He looks SO much better in the last picture, too - you can see in his face that he feels a lot better!

We had a kitty who had IBS/IBD - don't know which, because we decided against the biopsy since she responded really, really well to steroids, and we were told that the treatment would be the same for either and that she was young enough that it was unlikely to be lymphoma without prior symptoms. I would say she was about 6 or so when she developed that, and went on the steroids. She did beautifully - other than the daily or every-other-day hassle of getting the pill in her! She regained a major honkin' appetite and was very much the loving, happy little chonk for years and years. Eventually, a few months after her 16th birthday, her condition worsened and it became apparent that, like for Matata's baby, it had transitioned to lymphoma. We had to say goodbye about two months before her 17th birthday. Anyway, my point is that she had a great life on the steroids for more than 10 years, so I'm hopeful that your Jimmy is looking forward to the same!

 

[mary poppins]

Oh man, rough few days there for you and Jimmy. I hope circumstances are improving and continue to do so.

 

[yssie]

Oh, my - you've all definitely been through it. I'm so sorry, for ALL of it - the lost furry loved ones, their discomfort and suffering and pain, your pain, the worry, the expense - all of it.

That's a particularly frustrating development for Jimmy (and you) - it sounds like he was really on the upswing there, but now this.....it does sound like the steroids are helping and his appetite is returning nicely, and that's important. He looks SO much better in the last picture, too - you can see in his face that he feels a lot better!

We had a kitty who had IBS/IBD - don't know which, because we decided against the biopsy since she responded really, really well to steroids, and we were told that the treatment would be the same for either and that she was young enough that it was unlikely to be lymphoma without prior symptoms. I would say she was about 6 or so when she developed that, and went on the steroids. She did beautifully - other than the daily or every-other-day hassle of getting the pill in her! She regained a major honkin' appetite and was very much the loving, happy little chonk for years and years. Eventually, a few months after her 16th birthday, her condition worsened and it became apparent that, like for Matata's baby, it had transitioned to lymphoma. We had to say goodbye about two months before her 17th birthday. Anyway, my point is that she had a great life on the steroids for more than 10 years, so I'm hopeful that your Jimmy is looking forward to the same!

Thank you for sharing that @OboeGal I'm so glad you got so much good time with your girl, she had a long and obviously very beloved life with you. Several more happy years with Jimmy like you had with your girl is everything we're crossing fingers and toes and eyeballs for

 

[OboeGal]

Thank you for sharing that @OboeGal I'm so glad you got so much good time with your girl, she had a long and obviously very beloved life with you. Several more happy years with Jimmy like you had with your girl is everything we're crossing fingers and toes and eyeballs for

I'm crossing everything over here for the same for Jimmy!

 

[Calliecake]

Hang in there Yssie. Sending healing dust to Jimmy and a goodnight sleep for you. I hope your sweet little guy is home with you soon. .