In July 2017, my then 17-year-old cat Romeo began presenting with signs of vomiting, diarrhea, delicate weight reduction, and lethargy. Up thus far, Romeo had been a really wholesome male cat with no medical points aside from a low-grade coronary heart murmur, one eye an infection, periodic dental cleanings, and routine annual checkups to take care of his well being. However issues have been about to vary for Romeo and his cat mother and father.
Involved that Romeo’s diarrhea and vomiting had grow to be extra than simply an remoted occasion, we scheduled an appointment at 4 Corners Veterinary Hospital in Harmony, our trusted vet who has been extremely supportive and a crucial companion in managing all of our cat’s well being through the years. Romeo’s physician did a full bodily examination—palpating his stomach—discovering some thickening of his intestines. He took Romeo’s blood and ran a blood chemistry profile and urinalysis. Then advisable diagnostic checks—particularly an ultrasound that may rule out issues like a GI tract obstruction or stomach mass, however would offer an in depth examination of Romeo’s inner organs from all totally different angles, the sizes of the organs, in addition to their functioning. An ultrasound evaluates the cat’s liver, spleen, kidneys, gallbladder, lymph nodes, small and enormous bowels, bladder and pancreas and is ready to decide the dimensions, form and texture of every—revealing any abnormalities, enlargements, plenty, fluids, stones, thickening, dilation or if any lesions are current. So we ponied up the $450 dollars (on the time) to resolve what was happening with Romeo’s intestine.
The ultrasound findings have been revealing – Romeo had developed immune mediated bowel illness or attainable low-grade emergent spherical cell neoplasia (intestinal lymphoma). His findings additionally supported the analysis of generalized enteropathy, which simply refers to any dysfunction of the intestines. With this discovering, some injury or defects had occurred to the liner of Romeo’s intestines, permitting proteins and different particles from meals to cross by way of to be absorbed by the bloodstream as an alternative of the intestines. Thus, his excessive diarrhea.
Lymphoma is taken into account to be the most typical most cancers in cats, and Siamese cats (which Romeo is half Siamese) are at larger danger of creating lymphoma, and Siamese male cats are predominantly at extra danger. Bingo, that was Romeo. So are Oriental pure bred cats. To definitively diagnose whether or not Romeo certainly had intestinal lymphoma, our vet really helpful an intestinal biopsy for a extra definitive analysis of his GI tract. However since that might require surgical procedure and the ultrasound was already costly, we accepted not figuring out if Romeo had lymphoma at this stage. The outcomes of Romeo’s ultrasound confirmed that each one his organs have been in any other case regular and wholesome—all have been a traditional measurement, form, and texture, however his bowel width was elevated and confirmed thickening. Since Romeo goes outdoors (in our fenced-in yard solely), I had additionally needed to rule out parasites as a explanation for his signs. So I had gone forward and dewormed him with the right deworming protocol of Drontal (from our vet), then one other Drontal 21 days later, to remove the most typical worms – spherical, hook and tape worms, so we might rule this out as a explanation for his signs.
Romeo’s remedy plan on the time included:
- The immunosuppressive corticosteroid Prednisolone, AM & PM, for 4 weeks–tapering right down to as soon as a day
- A eating regimen of novel protein together with duck, venison, or rabbit (dry and moist)—a hypoallergenic eating regimen that incorporates a protein supply that Romeo had by no means been uncovered to earlier than. An alternative choice was a hydrolyzed food plan the place the protein has been hydrolyzed to make digestion simpler
- Day by day probiotics for his moist meals
- Sub-Q fluid remedy to hydrate him – we do ourselves with lactated ringers
- B12 photographs each week for a month, then each different week for a month, then as soon as a month (we do ourselves, it’s less expensive and straightforward to study)
Romeo did very nicely for one yr and responded very nicely to his remedy, which was enough to regulate his illness on the time. However since IBD is just not curable, and signs can and do return—a yr later Romeo’s signs got here again. Now Romeo was 18 years previous, and his signs had returned and began to turn out to be extreme once more. So we put Romeo again on the corticosteroid Prednisolone—twice a day, then slowly tapering right down to as soon as a day once more. However weeks later, once we tried to scale back the Prednisolone to at least one time a day solely, his diarrhea returned. So our vet advisable that Romeo keep on the Pred as soon as a day long-term, which was profitable in managing his signs once more for an additional yr.
Now it’s February 2019, and Romeo is 19 years previous and his diarrhea has returned once more with a vengeance—a number of occasions a day—and clearly the Prednisolone nonetheless given as soon as a day is not sufficient. By this time, Romeo had additionally misplaced virtually two kilos slowly over the previous 1-2 years, and he was displaying dramatic indicators of turning into bodily weaker, slower and extra cautious. My as soon as sprightly, energetic, lively, vigorous, adventurous cat—was beginning to present his previous age and to decelerate. Now, it was time to return to our veterinarian for an additional routine checkup and blood panel to see what had modified and the place his illness was.
It turned out, this time, Romeo was mildly anemic, which was inflicting weak spot and vomiting; and he had a suspected ulcer (some blood in his stool), a bacterial an infection in his intestine, and he had continual low-grade irritation. Wow, it was rather a lot to listen to and I used to be feeling considerably overwhelmed. Romeo was simply certainly one of many cats that I care for every single day.
Following this analysis, in March 2019. we began Romeo on Metronidazole—for the primary time—an antibiotic-antibacterial medicine for bacterial infections. He gave him a prescription of quarter pill within the AM and one within the PM, for 3 weeks, then down to at least one ¼ capsule solely within the evenings. We bumped up Romeo’s B12 photographs to each week once more, and returned to giving him a novel protein weight loss plan in each his moist and dry meals (rabbit, duck and venison), along with sub-Q fluid remedy to maintain him hydrated. Plus to deal with his gastric ulcer, our vet really helpful Sucralfate, a medicine that will get combined with water right into a slurry, and is drawn up in a syringe, then dripped into his mouth, morning and night time, for 2 weeks. Once more, Romeo’s signs subsided for a number of months.
Then 5 months later, in July 2019, Romeo began having a really dangerous flare-up once more. So he’s now again on the Metronidazole two occasions a day, and may have to remain on this drug twice-daily long-term. He’s now much less aware of the Metronidazole than he first was, so his illness is clearly worsening.
Romeo’s remedy routine is now the next:
- Boiled white hen and turkey breast
- Combined with hen or turkey Bone Broth (no sodium, no salt) and diluted with some water
- Gerber’s child meals – turkey or hen, turkey is preferable
- B12 shot each two weeks (we administer)
- Metronidazole (1/four of a 250 mg pill) – AM and PM
- Prednisolone steroid – 1 capsule each PM
- Probiotics given in moist meals day by day
- Fluid remedy given 1-2 occasions per week (lactated ringers 1000 ml) to take care of sufficient hydration
- Digestive enzymes are beneficial, however we’re nonetheless researching to seek out the perfect model for cats solely
Every week later, Romeo’s stools are beginning to agency up, his diarrhea is steadily dissipating, however it’s sluggish to vary this time. Earlier, he was so delicate and aware of the Metronidazole, however not any longer. The change to boiled hen/turkey with bone broth is admittedly serving to—Romeo loves it, he’s lapping it up with fury—and is consuming extra meals in consequence. Perhaps he’ll even achieve weight! However this boiled meat with bone broth won’t present the dietary necessities he wants long-term, it is just to quiet his GI tract down, present an simply digestible weight-reduction plan, and slowly transition him again to some novel protein cat meals, together with some Gerber’s child meals and boiled meat with bone broth for straightforward digestibility. The eating regimen remedy a part of treating IBD is so crucial and can’t be underestimated in controlling this illness, given together with the anti-inflammatory and immunosuppressive drugs.
Our final and remaining remedy plan down the street for Romeo’s Inflammatory Bowel Illness will probably be to attempt the Immunosuppressive chemotherapy drug – Chlorambucil (Leukeran®) subsequent. This can come when Romeo is not responding to his present remedy plan of Prednisolone and Metronidazole. Chlorambucil is often used together with corticosteroids for cats with extreme IBD and the negative effects are minimal, apart from inflicting extreme bone marrow suppression. So Romeo must be intently monitored at that time by our vet. However at his age, and at his stage of the illness, what selection is there? No less than he might proceed to stay longer, be comparatively symptom free, and luxuriate in extra of his life and the issues he loves—till the day when perhaps none of this might be sufficient for his drained physique. However I don’t have to consider that now. I’m targeted on in the present day. In the future at a time they are saying.
Since IBD can’t be cured, the objective is to handle it by minimizing signs, managing the discomfort, and addressing the recurrences as they come up, shortly. To all those that have IBD cats, I hope by sharing this with you, it helps you.
Right here’s to an extended, pleased, wholesome life for all of the cats with IBD or different gastrointestinal illnesses—and to the cat mother and father who’re coping with this illness and treating them. I want you the easiest.