3.15.23 Charlie not eating again. IBS?

Sarah & Charlie-cat

Sarah & Charlie-cat

Member Since 2022
So, Charlie's not eating again. We had a good go and yesterday I skipped his Mirtaz and Cerenia. He ate his snack and then dinner was syringe fed and took almost an hour to get enough food in him that I felt ok giving him his insulin. He ate a little overnight and threw up a few little bits of brown liquid, and a hairball.

Breakfast was syringe fed, another hour-long battle. I got a little more into him this afternoon, but not nearly as much as I would like given his ketones a couple of weeks back were 1.1, 1.2.

It has been suggested perhaps he has IBS, which is why getting him off the pred has led to crazy numbers and these episodes where he won't eat.

If I was going to say one of my cats has IBS, I would go with the one who projectile vomits on my bed at 3 am and can only basically eat one food. And she's always been a puker and is very small. But in the before times, he used to eat 3 kibbles, walk away, come back, eat 3 more, walk away, rinse repeat. Not in the very early days I had him, I don't remember him having any issues with food other than trying to eat all the other, smaller cats' food. He was throwing up and not really eating before his bizarre diagnosis of thrombocytopenia in 2021 (new vet is absolutely convinced he does not have this). And he was occasionally throwing up the fall before his pancreatitis attack and diagnosis of diabetes.

New vet seems convinced nothing is wrong with him other than diabetes. I don't think she does ultrasounds, we would need a referral to the internist an hour away. Although, it looks like from what I found online that you might as well go straight to a biopsy if they can tolerate the anesthesia.

I was looking at the IBS food on Chewy and it seems full of corn, rice, potatoes, peas, so that seems problematic.

Any advice here on getting him to eat or what would help if this is IBS?
 
I don't have any advice or experience regarding IBS but I can empathize because I've had trouble getting my cat to eat too (chronic pancreatitis). I know how stressful it is and I hope Charlie's eating improves! :bighug:
 
An ultrasound can tell a lot. When my cat gave issues last year with eating, I had to travel over an hour for one but I felt it was worth it. It can show if there are thickened intestinal walls, etc. We didn't need a biopsy, thankfully. We also did a GI panel, which is a specific kind of bloodwork that can help them tell more too.
 
Also, my vet at that time didn't think she had pancreatitis either, based on regular bloodwork and physical exam. Not saying at all that your vet is wrong. Just sometimes I feel like vets in general don't always take appetite issues seriously like they should. Cats really need to eat because of the way their livers are. And of course if a diabetic, even more critical.
 
Yeah, no one seemed that fussed that my diabetic cat wasn't eating and his ketones were going up. But clearly that's a problem. Current vet just thinks he's not as hungry on less pred but there's not hungry and licking your little lips and then walking away. It makes me think he's nauseous. And he ate once I got the Cerenia in him this afternoon, as opposed to on him‍♀️

I'm pretty good at getting sick cats to eat. I had two fosters who were so sick and our other boi has tried to die on us a bunch and has multiple surgeries to remove an abscessed tooth. One of the girls had a hole in her face surgically removed and then a tooth out and she reacted poorly to antibiotics for an ear infection. Never had to syringe feed any of them. Patience and chicken baby food were enough. Having to syringe feed him says to me something is wrong.

Everyone I know who has a cat says this vet is the best but her office is perpetually disorganized and they are bad at communicating. So I'm at a loss.
 
Cats don't get IBS, they get IBD. The symptoms could also be SCL (small cell lymphoma). Don't the phrase freak you out, current cat is almost 5 years in remission. And you are correct, a biopsy is needed to differentiate the two, though a novel protein diet can help identify IBD present. However, a cat can have both. Sigh, reference current kitty! I would recommend an ultrasound first. Depending on where the bowels are thickened, you can get away with an endoscopy of surgical biopsy, and that can be easier on the kitty.

Sometimes there are travelling ultrasound vets that visit vet clinics. That's what my current vet uses, though an IM vet and ultrasound vet is on 15 minutes away if I wanted to.

Treating IBD generally means novel protein diet and probiotics. Visbiome is a good one. Novel protein does not mean corn rice potatoes peas. :rolleyes: Lots of options with novel protein meat, which is whatever meat he's never eaten before. That could be rabbit, venison, lamb, goat, kangaroo, buffalo, etc. Lots of information here: https://www.ibdkitties.net/
and https://www.rawfeedingforibdcats.org/

I would strongly recommend also getting ondansetron in your kitty drug arsenal. I find it's the best for nausea. It's a people drug, but the vet has to write a prescription for the pharmacy.

My Neko couldn't take pred due to her heart, so she got budesonide instead. It's an alternative steroid that acts locally just in the gut. For some cats, Neko being one, it doesn't raise the blood sugar, but can help GI inflammation.
 
I would run the SpecFPL for pancreatitis. Max had chronic pancreatitis and his only symptom at first was inappetence. He needed ondansetron for nausea for a few months the first time. I didn’t realize he was nauseous because he didn’t vomit.
 
Sarah & Charlie-cat said:
Current vet just thinks he's not as hungry on less pred but there's not hungry and licking your little lips and then walking away. It makes me think he's nauseous.
Click to expand...

My previous sugar cat, Luigi, also had Irritable bowel and gastric reflux, so I can relate to your struggle.

I would recommend the ultrasound at the least, if they can do the biopsy at the same time, then go ahead and do it.

Luigi never had a biopsy, he had multiple US over the course of 8 years. We used Cerenia, prednisilone, and also famatodine when needed for gastric reflux.

What is his current pred dose?
 
Sarah & Charlie-cat said:
So, Charlie's not eating again. We had a good go and yesterday I skipped his Mirtaz and Cerenia. He ate his snack and then dinner was syringe fed and took almost an hour to get enough food in him that I felt ok giving him his insulin. He ate a little overnight and threw up a few little bits of brown liquid, and a hairball.

Breakfast was syringe fed, another hour-long battle. I got a little more into him this afternoon, but not nearly as much as I would like given his ketones a couple of weeks back were 1.1, 1.2.

It has been suggested perhaps he has IBS, which is why getting him off the pred has led to crazy numbers and these episodes where he won't eat.

If I was going to say one of my cats has IBS, I would go with the one who projectile vomits on my bed at 3 am and can only basically eat one food. And she's always been a puker and is very small. But in the before times, he used to eat 3 kibbles, walk away, come back, eat 3 more, walk away, rinse repeat. Not in the very early days I had him, I don't remember him having any issues with food other than trying to eat all the other, smaller cats' food. He was throwing up and not really eating before his bizarre diagnosis of thrombocytopenia in 2021 (new vet is absolutely convinced he does not have this). And he was occasionally throwing up the fall before his pancreatitis attack and diagnosis of diabetes.

New vet seems convinced nothing is wrong with him other than diabetes. I don't think she does ultrasounds, we would need a referral to the internist an hour away. Although, it looks like from what I found online that you might as well go straight to a biopsy if they can tolerate the anesthesia.

I was looking at the IBS food on Chewy and it seems full of corn, rice, potatoes, peas, so that seems problematic.

Any advice here on getting him to eat or what would help if this is IBS?
Click to expand...
I’m so sorry this is happening. I do have a cat with IBD and it was diagnosed via ultrasound. I see in your signature that he is on steroids. What kind? Normally prednisolone (or in some cases Budesonide) are prescribed for IBD.
 
Prednisolone.

He's on one ml of 5mg per ml. I think. Between the vet that can't communicate and the pharmacy that put it in some wacky click device, not a syringe, not totally sure.

I need to call about getting a script for a Libre to troubleshoot before I have to leave him with a pet sitter in a month (really rethinking the longer trip, even though I'll have to eat a bunch of money if I don't go). I will ask about an ultrasound for inflammation. I'm pretty sure I asked if reducing his dose unleashed another form of inflammation that was ****ing with his numbers and didn't get much of a response.
 
Sarah & Charlie-cat said:
ry and licking your little lips and then walking away. It makes me think he's nauseous
Click to expand...
Yes. That is one of the classic signs of nausea. I would keep up the Cerenia and add in Ondansetron (Zofran). Zofran is very effective against nausea
, although it can cause constipation. In cats with chronic diarrhea (such as some IBD cats) that can work in their favor.
 
Sarah & Charlie-cat said:
Prednisolone.

He's on one ml of 5mg per ml. I think. Between the vet that can't communicate and the pharmacy that put it in some wacky click device, not a syringe, not totally sure.

I need to call about getting a script for a Libre to troubleshoot before I have to leave him with a pet sitter in a month (really rethinking the longer trip, even though I'll have to eat a bunch of money if I don't go). I will ask about an ultrasound for inflammation. I'm pretty sure I asked if reducing his dose unleashed another form of inflammation that was ****ing with his numbers and didn't get much of a response.
Click to expand...
Yeah. They don’t know. But it’s likely.
 
Sarah & Charlie-cat said:
Prednisolone.

He's on one ml of 5mg per ml. I think. Between the vet that can't communicate and the pharmacy that put it in some wacky click device, not a syringe, not totally sure.

I need to call about getting a script for a Libre to troubleshoot before I have to leave him with a pet sitter in a month (really rethinking the longer trip, even though I'll have to eat a bunch of money if I don't go). I will ask about an ultrasound for inflammation. I'm pretty sure I asked if reducing his dose unleashed another form of inflammation that was ****ing with his numbers and didn't get much of a response.
Click to expand...
I would try to get a Board Certified Radiologist to do the ultrasound or someone very experienced. But they can measure the thickness of each layer of the intestines and look all around the GI tract. Treatment can vary depending on which layer is thickened and where else there is inflammation.

I do agree with that even before you have an ultrasound that you should have the Spec feline pancreatic lipase test done. He may actually have pancreatitis that they can’t tell from just a physical exam — unless they did this test already? That is the test most specific for pancreatitis. Regarding IBD, the Texas A&M GI panel can help diagnose IBD as well.
 
If the pharmacy had just put it in the same syringe as the last two years, I could tell you. They were like it would cost 10 more dollars. I would happily pay 10 more dollars to know what the heck the dose is
 
Suzanne & Darcy said:
Regarding IBD, the Texas A&M GI panel can help diagnose IBD as well.
Click to expand...
The Texas A&M GI panel does NOT diagnose IBD, but can tell you if there is a GI disease present. It does include a pancreatitis test. Pancreatitis is fairly common in cats with GI conditions, be in IBD or small cell lymphoma. The panel will also tell you his cobalamin (b12) level. Many GI condition kitties are low in B12, so it could tell you if he needs supplementation.

As for size of dose of prednisolone, it depends what the cat needs. Depending on Charlie's weight, a 5mg dose of pred might be appropriate. I have a cat on 4 mg. I tried tapering down, but she told me she needed the full dose. The pharmacy should be able to put it in a vial, then tell you which syringes to use to draw the dose.
 
I had a 14ish cat on 5 mg of pred, who also had been up to 17lbs at the shelter before I brought him home and put him on a low carb diet.
 
Right, the Texas A&M GI panel will not “diagnose” IBD. It can help in the overall diagnosis of what’s going on in the GI tract. It can kind of point you in one direction or another. From the lab: “to help veterinarians diagnose and treat gastrointestinal diseases in dogs and cats. These tests may help in the management of pets with vomiting, weight loss, diarrhea, loss of appetite, or poor body condition.”
 
Can't sleep. Today wasn't a good eating day and his numbers have been high again.

I'm dreading trying to 1) get through to the freaking vet whose front office is a disaster (cat owning friends agree they have no systems for anything) and 2) convincing her there's something more serious going on. She is like oh you're smart and you read but also she's just like there there dear.

He's had lots of hairballs, nausea, loose stools, he had been throwing up prior to his diagnosis and at the time he was diagnosed with the blood clotting thing (wrong diagnosis but hey, the cure would have helped IBD!), he would eat three kibbles walk away, come back and eat three more. His ravenous steroid hunger was also worse before his diagnosis. Constantly screaming he was hungry. And he has elevated white blood cells and no fever at the emergency vet. Antibiotics have done nothing for anything.

Chewy is delivering a bunch of rabbit, lamb, and duck food tomorrow. Although, I realize he's had duck liver treats and duck tiki sticks, so the duck is probably out as a novel protein, but lately it's been the only treat he wants. So I hope the rabbit and lamb are tasty and he'll eat one of those.

And alas, once can get whole ducks at Whole Foods at least if it came to making food at home for him. I don't know where they hell I would get a rabbit around here. And I definitely draw the line at raising them in the yard. There's a traumatic story about a dumped pet bunny in our yard that died after we caught it. Not to mention our yard fox. You would think you could get venison around here and you would be wrong. The very rugged Nebraskans here actually just want to eat Chick-fil-A and ***** about how cold it is when it's 32 degrees. Even lamb is hard to come by and expensive.
 
Well, left a message with the front desk and they said they would pass that on the vet that has seen him and the other vet in the practice that does ultrasounds and diagnostics for IBD.

Was hoping the doorbell was Chewy, but no it was the Spectrum sales guy.
 
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