07/16 - IBD help for Civie Brother

Kobe (Dean and Lesley)

Kobe (Dean and Lesley)

Member Since 2025
Good morning!

Kobe is doing great, but his brother, Carmelo is in rough shape. We have seen gradually reducing appetite and weight. but this last month, he's dropped half a pound. Weight yesterday was 9.7 lbs.

Yesterday, he was not eating. We took him to vet. Good labs. X-ray showed possible thickening of intestines. Vet thinks it might be IDB. he got a steroid shot (Vetalog-Triamcinalone). We aren't going to continue that shot. We are requesting a prescription for Budesonide pills.

Last night I gave Ondansetron and followed with Mirataz because he wasn't eating.

This morning, he is vomiting and has liquid bile looking stool. I tried giving the ondansetron, but he just vomited the pill up along with everything he ate this morning.

We have Rawz rabbit and duck on hand.
I just ordered Visbiome.

I am freaking out. appetitite is poor and he is vomiting up what he eats.

Carmelo was eating the same food that made Kobe so sick. Carmelo's BG was elevated, just not as high as Kobe's. When we changed Kobe's diet, we changed Carmelo's too. His BG returned to normal quickly (I tested) but he hasn't really been himself consistently. He's had flare ups of itchy face, ears, and neck that we attributed to allergies, but which have likely been tied to a systemic problem this whole time.

I feel so helpless. What can I do for him?

@Wendy&Neko
@Sienne and Gabby (GA)
@squeem3
 
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I’m so sorry Carmelo isn’t feeling great, @Kobe (Dean and Lesley). I don’t really know how to help other than maybe some bland foods? When Pookey had pancreatitis and wasn’t eating regular foods, plain boiled chicken helped get him right. I hope you get some advice from Wendy and the others :bighug:
 
@JoM may be able to offer some suggestions too. I think Karamelle has pancreatitis, not IBD, but they often go together and Jo knows a lot about pancreatitis and GI health as I think she runs the Facebook group.
 
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Carmelo vomited up the Ondansetron that I gave him this morning along with everything he had eaten. He vomited right after I gave him the pill in a little gel cap.

Since then, I got him to eat a little bit of Rawz Duck and Duck Liver pate.

I don't even know if he needs the Ondansetron, but we didn't want to give him the Mirataz if he was nauseated. I haven't seen the lipsmacking that told me Kobe was nauseated, but ECID.
 
Ask the vet for a Cerenia injection and then some pills to give at home. This is wonderful for vomiting and that could help the problem of him throwing up his food and the Ondansetron (which is amazing for nausea). Was he tested for Pancreatitis? Spec fPL test.
 
He wasn't tested for pancreatitis. i am going to the vet now to pick up scripts. i will ask about the cerenia injection and the pancreatitis test. I will update.
 
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Hi @Kobe (Dean and Lesley)! I won't be of much help, but I wanted to say that Jude has the Ondansetron that is the "melting" tablet, and I put it in a little bit of warm water to melt it, and syringe it into his mouth, chased with a little syringe of water. He doesn't like it, but it's such a small amount that we're able to get it into him, and it absorbs quickly since it's not in a capsule.

Good luck with Carmelo!
 
Mary & Jude said:
Hi @Kobe (Dean and Lesley)! I won't be of much help, but I wanted to say that Jude has the Ondansetron that is the "melting" tablet, and I put it in a little bit of warm water to melt it, and syringe it into his mouth, chased with a little syringe of water. He doesn't like it, but it's such a small amount that we're able to get it into him, and it absorbs quickly since it's not in a capsule.

Good luck with Carmelo!
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That's a great idea!
 
JoM said:
Ask the vet for a Cerenia injection and then some pills to give at home. This is wonderful for vomiting and that could help the problem of him throwing up his food and the Ondansetron (which is amazing for nausea). Was he tested for Pancreatitis? Spec fPL test.
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Vet gave me the Cerenia injection to take home. Shocked. I thought they'd insist on me bringing him back in to do it in the office. Have appointment for the pancreatitis test scheduled for tomorrow.
 
Kobe (Dean and Lesley) said:
Vet gave me the Cerenia injection to take home. Shocked. I thought they'd insist on me bringing him back in to do it in the office. Have appointment for the pancreatitis test scheduled for tomorrow.
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Thats great!. It should be kept in the fridge until you give it. Did they give you the pills too. The injection will only last 24 hours.
 
Mary & Jude said:
Hi @Kobe (Dean and Lesley)! I won't be of much help, but I wanted to say that Jude has the Ondansetron that is the "melting" tablet, and I put it in a little bit of warm water to melt it, and syringe it into his mouth, chased with a little syringe of water. He doesn't like it, but it's such a small amount that we're able to get it into him, and it absorbs quickly since it's not in a capsule.

Good luck with Carmelo!
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Not all Ondansetron is disintegrating. Those kinds are usually prescribed to people. You just stick it under your tongue and let it dissolve. I have regular Ondansetron tabs for Karamelle. They probably would dissolve in water if crushed, but they probably wouldnt taste great.
 
JoM said:
Thats great!. It should be kept in the fridge until you give it. Did they give you the pills too. The injection will only last 24 hours.
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I kept it in the fridge like you said. I just gave him the shot. He is very upset. we were going to wait, but he vomited again.

do i need to get Sub-Q fluids from the Vet for tonight? he wasn't dehydrated yesterday, but he has been vomiting and his stool has been liquid.
 
Dean and I took Carmelo to the Hospital last night. He was acting like he might be in pain and he wasn't eating still. Even after Cerenia injection. He is on fluids now and the doctor is using Ondansetron with Cerenia. Also using additional appetite stimulant. Also administering a steroid. Last update is that he has perked up with fluids but hasn't been interested in food yet.
 
JL and Chip said:
Any chance you can get a copy of the bloodwork and post it here?
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All the labs are in this clinical summary from the hospital. He had small panel done at the vet in town before we drove him to the hospital. I must have left them in the car. I will scan them and attach.
 

Attachments

We got Carmelo back from the hospital this morning. The hospital vet gave us a prescription for Hill's zd. He was eating the zd at the hospital. He has had a few bites of the zd, but he seems more interested in Kobe's low carb duck from Rawz. I saw him sneak a drink of water from the fountain. I am at a loss for what to do about feeding him.

Just to be clear, Carmelo is not diabetic. The vets at the hospital are saying that he needs to be on a prescription diet. The protein in Hill's zd is hydrolyzed. We suspected that Carmelo was reacting poorly to certain ingredients in food (we suspected brewer's yeast and chicken???). So on one hand, it would make sense to feed the hydrolyzed protein.

But from this forum it is my understanding that many of the prescription diets aren't great. The carb content is concerning. It seems counterintuitive to feed a cat with an inflamed digestive tract a bunch of inflamatory carbs. :mad: the info I have seen from the IBD support crew does not seem enthusiastic about the prescription diets. It seems like raw or novel proteins???

We just got Rabbit and Duck from Rawz. He and Kobe love it.

What I am seeing right now is that Carmelo is going to his surefeeder, finding the prescription Hill's zd (carb city) and turning his nose up at it. Then he goes to Kobe's feeder (which he can't get into) and is actively trying to break into it to get the low carb Rawz Duck and Duck Liver.

I feel like I am in Bizzaro Land. Why am I not feeding my cat the duck??? Did the vets at the hospital brainwash me? Did I get hit by the Gaslight Express???

I need a REALITY CHECK. Please help!

@Wendy&Neko
@Sienne and Gabby (GA)
@JoM
 
It is more important that he eat, but you have to make sure that the food hes eating isnt giving him any problems. Do you have any more meds to give him?
 
JoM said:
It is more important that he eat, but you have to make sure that the food hes eating isnt giving him any problems. Do you have any more meds to give him?
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yeah, if he was really loving the Hill's zd, and chowing down, I would be like, "Fine. we can worry about the carbs later. He's eating." but he wants the low carb duck that Kobe has. Why am I not giving him what he wants if it's better for him???

I have a Cerenia and Ondansetron to give in about 15 minutes, 2pm CT. We have oral prednisolone. We have a prescription for Budesonide that is getting compounded.
 
Kobe (Dean and Lesley) said:
All the labs are in this clinical summary from the hospital. He had small panel done at the vet in town before we drove him to the hospital. I must have left them in the car. I will scan them and attach.
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Im not as familiar with the catylist test for pancreatitis. I do see its normal. I would love to see a spec fPL, but I understand if you dont want to spend more an another test. It can be quite pricey to run separate. This may just be IBD as that can cause vomiting. I see you were prescribed Ondansetron, Cerenia, prednisolone, Elura and a probiotic. Which meds are you giving currently? Is he still vomiting? Once he is stable, you might try switching the prednisolone to Budesonide, which targets the gut specifically and good for IBD. It doesnt work for all cats unfortunately, but it is a less risky steroid for developing diabetes.
 
Kobe (Dean and Lesley) said:
yeah, if he was really loving the Hill's zd, and chowing down, I would be like, "Fine. we can worry about the carbs later. He's eating." but he wants the low carb duck that Kobe has. Why am I not giving him what he wants if it's better for him???

I have a Cerenia and Ondansetron to give in about 15 minutes, 2pm CT. We have oral prednisolone. We have a prescription for Budesonide that is getting compounded.
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Oh sorry, I wrote that last message before i saw this. Great. Does he seem better? no vomiting? If so try and see if he can tolerate the duck. If not you'll have to find something else he likes.
 
Some vets now have an Idexx Catalyst One In-House Analyzer, they can add a separate pancreatic lipase test and run it immediately in house. It gives you a number, not just a yes/no like the old SNAP fPL they did in-house in the past. For the Spec fPL, they would need to send the blood out for analysis so you’d have to wait for the results. Looks like it was negative for pancreatitis.
 
JoM said:
Once he is stable, you might try switching the prednisolone to Budesonide
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This is the plan! I read that the Budesonide can also have fewer systemic side effects.
JoM said:
no vomiting? If so try and see if he can tolerate the duck.
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He's not vomiting. I gave the duck and a teaspoon of Yound Again Mature Zero LID dry. He ATTACKED it.

Just gave the Cerenia and Ondansatron in a little capsule. First time with the pill shooter. I think it worked. fingers crossed.

Thank you for the reply and your help. I think I got brainwashed.
 
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Kobe (Dean and Lesley) said:
This is the plan! I read that the Budesonide can also have fewer systemic side effects.

He's not vomiting. I gave the duck and a teaspoon of Yound Again Mature Zero LID dry. He ATTACKED it.

Just gave the Cerenia and Ondansatron in a little capsule. First time with the pill shooter. I think it worked. fingers crossed.

Thank you for the reply and your help. I think I got brainwashed.
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Perfect!!! Yay!! ❤️
 
I am looking at how Carmelo's meds are currently scheduled...
6 am: 5 mg Prednisolone and 0.3 mL Entyce (for Appetite)
2 pm: 12 mg Cerenia and 2 mg Ondansetron
2 am: 2 mg Ondansetron

This was great at the 24 hospital where they are up all night, but this has me giving pills 3x a day. one of the times being at 2 in the morning!!!

Does anybody see a problem with this alternate schedule which would would get us to meds 2x a day instead?
6 am: 5 mg Prednisolone, 2 mg Ondansetron, and 0.3 mL Entyce (for Appetite)
6 pm: 12 mg Cerenia and 2 mg Ondansetron
 
Kobe (Dean and Lesley) said:
I am looking at how Carmelo's meds are currently scheduled...
6 am: 5 mg Prednisolone and 0.3 mL Entyce (for Appetite)
2 pm: 12 mg Cerenia and 2 mg Ondansetron
2 am: 2 mg Ondansetron

This was great at the 24 hospital where they are up all night, but this has me giving pills 3x a day. one of the times being at 2 in the morning!!!

Does anybody see a problem with this alternate schedule which would would get us to meds 2x a day instead?
6 am: 5 mg Prednisolone, 2 mg Ondansetron, and 0.3 mL Entyce (for Appetite)
6 pm: 12 mg Cerenia and 2 mg Ondansetron
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You can try that schedule and see how it goes. Ondansetron can be given every 8 hours if needed but 2x may be enough.
 
Sorry you are dealing with kitty GI issues. I personally found them harder to deal with than diabetes.

I would give the ondansetron about 20-30 minutes before Entyce, so it has time to make him not nauseous, before giving the appetite stimulant. There is injectable ondansetron too, if getting pills in is a problem. Ondansetron can be given 3-4 times a day if needed. How much does Carmelo weigh? Sometimes vets underdose and give the injectable dose. He can get 0.5-1.0 mg/kg of cat orally. 2 mg is good for an 8 lb cat.

Thickening of the intestines is usually one of two conditions. IBD being one, small cell lymphoma being the other. Pancreatitis is a common companion to both. I had a cat with both SCL and IBD - she went into remission from SCL, but not IBD, it is lifelong.

Next step would probably be an ultrasound and then likely a biopsy of some kind. Endoscopy is one possibility depending where the inflammation is located. A fine needle aspirate of swollen lymph nodes can be tested by the PARR test, meaning no biopsy needed. You do want to know what condition(s) you are dealing with, as treatments are different. SCL cats treated with novel or hydrolyzed protein and steroids don't live as long as those treated which chlorambucil. My girl had 8 years, which is a bit unusual. Before a biopsy, you don't to be giving steroids, as it can mask the situation. My IBD/SCL girl was on prednisoline to the end after her endoscopy.

If symptoms go away with a novel protein diet, and Carmelo gains weight back, then you can say IBD. My girl was fine for a year on novel protein, then her vomiting started again and endoscopy added SCL to the picture. For SCL only kitties, they can actually eat whatever they want.

If a cat has IBD and you suspect chicken, other bird proteins might cause reactions too. Rabbit, lamb, venison, pork are some good alternatives to try. My girl couldn't do fish or beef (or venison). Fish is hidden in a lot of foods.
 
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Thanks for your response!

The biopsy for diagnosing IBD that my vet described required a pretty invasive surgery and was as costly as a hospital stay, $1500 or more. is there a specific type of bipopsy that I can request that would be less invasive and expensive?

Or... is the biopsy for the SCL less invasive? if it's probably one condition or the other, can we just pick the biopsy that's least awful? it sounds like a biopsy for SCL could be performed during endoscopy rather than surgery...

Are they going to insist on an ultrasound before they biopsy? Probably.

I probably need a specialist.

Wendy&Neko said:
Before a biopsy, you don't to be giving steroids, as it can mask the situation.
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Are you saying stop the steriods before biopsy?

Carmelo is 14 years old and was 9.7 lbs the other day. after not eating much, vomiting, and diarrhea he might be down a few ounces.
 
Neko saw an IM specialist, my other two kitties with SCL the local GP vet, who brought in an endoscopy specialist to do that sampling. The biopsy for IBD and/or SCL is the same biopsy sample. I mentioned the FNA (fine needle aspirate) if a lymph node is swollen, that is the least invasive method. The endoscopy requires anaesthesia, but less than a full surgical biopsy. However it only works if inflammation is in the first part of the intestines. If inflammation is in the bottom third, then the colonscopy (like endoscopy but opposite direction) can take a sample. If only the middle part of the intestine is inflamed or one of the internal layers of the intestine, then a surgical biopsy is required. However, there is also a laparoscopic or keyhole biopsy method that is a smaller opening that can take that kind of sample. But that is not available everywhere and more expensive. Yes on seeing an internal medicine vet, probably the best choice for handling this. Yes on an ultrasound, cause you can't see where the inflammation is without it hence how to take the sample. If the lymph node is inflamed, the FNA can be done as part of the ultrasound. The specialist vet can also advice on stopping steroids and how long before the procedure you have to do that.

The most expensive part of these conditions is the diagnosis, after that things are much cheaper. And repeating what I said before, some people try a novel protein diet first (without steroids) to see if that solves the problem, in which case IBD. Steroids would mask the symptoms of SCL, for a while.
 
Wendy&Neko said:
Neko saw an IM specialist, my other two kitties with SCL the local GP vet, who brought in an endoscopy specialist to do that sampling. The biopsy for IBD and/or SCL is the same biopsy sample. I mentioned the FNA (fine needle aspirate) if a lymph node is swollen, that is the least invasive method. The endoscopy requires anaesthesia, but less than a full surgical biopsy. However it only works if inflammation is in the first part of the intestines. If inflammation is in the bottom third, then the colonscopy (like endoscopy but opposite direction) can take a sample. If only the middle part of the intestine is inflamed or one of the internal layers of the intestine, then a surgical biopsy is required. However, there is also a laparoscopic or keyhole biopsy method that is a smaller opening that can take that kind of sample. But that is not available everywhere and more expensive. Yes on seeing an internal medicine vet, probably the best choice for handling this. Yes on an ultrasound, cause you can't see where the inflammation is without it hence how to take the sample. If the lymph node is inflamed, the FNA can be done as part of the ultrasound. The specialist vet can also advice on stopping steroids and how long before the procedure you have to do that.

The most expensive part of these conditions is the diagnosis, after that things are much cheaper. And repeating what I said before, some people try a novel protein diet first (without steroids) to see if that solves the problem, in which case IBD. Steroids would mask the symptoms of SCL, for a while.
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Thank you for taking the time to explain. I am grateful to you.
 
If Carmelo is wolfing down the same food as Kobe, especially since it's novel protein, I would use the duck. Keep an eye out for any symptoms but if Carmelo is happy with the duck and there are no GI symptoms, it sounds like you're on to something!

One of my kitties, Gizmo, has IBD. Like Wendy noted, how the vet makes a diagnosis depends on where in the intestinal tract the inflammation is. Gabby had a surgical biopsy. That was a long time ago. She's done great. She's had very few flare ups and they were associated with a vet visit where the techs were giving her a ton of treats -- all chicken which sets off her IBD. She's on a very low dose of prednisolone and I feed both her and my other cat novel proteins (raw pork, venison, and rabbit).
 
Carmelo is eating the Young Again Mature Zero LID. He's drinking water. He's wanted to play a couple times. BUT the diarrhea isn't even mushy poo. It is actual liquid. He makes it to the litter box most times, but between trips to the litter box he leaks. His anus is looking red and inflamed.

Just got off the phone with the hospital. Sounds like they want us to try some psyllium husk.

Since we brought Carmelo home, Kobe has not been eating like normal. He mostly stays in one room in a loaf position. He has been eating half pate and half kibbles for a year and a half. Always very kibble motivated. Right now, It's all we can do to get him to eat the kibbles. Tested BG yesterday and I think he was 87? I don't remember what it was but it was definitely "green." Sorry it's not in sheet. There's just been a lot going on. Last night Dean and I decided to give Kobe Cerenia, Ondansetron, and some Gabapentin. I was hoping to see him acting like the meds helped, but I can't tell that they did

I am really struggling to have them both not well like this. I am losing it.
 
Psyllium husk is a good suggestion for a prebiotic. Adding a probiotic, like Visbiome can also help.

As long as his B12 levels are fine, s. boulardii is great for stopping diarrhea. Probiotics – IBDKitties You can buy it at most human pharmacies or vitamin stores so should be able to get some today.

Did both kitties seem off at around the same time? Any chance there is a bad batch of food they are sharing?
 
Yes on all together, I just put them in food. Or Churu. With psyllium husk, make sure they are getting plenty of fluids. And start with a pinch only of psyllium husk and work your way up in dose, or you can get tummy upset. Also go slow the probiotics.
 
Wendy&Neko said:
Yes on all together, I just put them in food. Or Churu. With psyllium husk, make sure they are getting plenty of fluids. And start with a pinch only of psyllium husk and work your way up in dose, or you can get tummy upset. Also go slow the probiotics
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I think this is working. I have been sprinkling some on food, but not so much as to put him off his meal. Been sneaking the psyllium husk powder and the S. Boulardii into the size 3 capsules around his other meds instead of sprinkling on food. Not a lot. Size 3 are pretty small. That prednisolone pill and the half Cerenia pill consume A LOT of real estate in the size 3.

He had one BM on 07/20, and it was milkshake consistency, which, although liquid, was better than the broth consistency where we started Saturday into Sunday Morning.

This AM, 07/21, he had a single tiny firm poo!

Over the last 48 hours, we have seen urine in the litter box, which was absent when the poo was like broth. (around 6 pees)

I see him drinking regularly. He ate around 37 grams of Young Again Mature Zero LID yesterday. maybe 165 Calories.

Inflamation around his butt is improved drastically.

His appointment with the specialist is on Friday. He takes his last Cerenia pill from the hospital script today. I have another couple days of Cerenia from his primary that I BEGGED for. Question is, do I keep him on the Cerenia through the specialist visit? He won't be taking it indefinitely, but how do you know when to stop giving it? I hate to stop it too early and lose all his progress because he's vomiting and not eating again. I have seen no signs of nausea since he's been home.
 
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