12/23 Cosmo AMPS 374, +4 338, +9 389, PMPS 371 ultrasound results

thebigfuzz

thebigfuzz

Member Since 2012
Yesterday:
https://felinediabetes.com/FDMB/thr...1-421-ultrasound-6-139-8-209-pmps-450.240399/

Cosmo is looking good and bright eyed this morning :p He was still sleepy and a bit groggy from the gabapentin when we went to bed last night, but seems it is now out of his system this morning.

We should get the full ultrasound report today and I am headed to work soon. I have vacation time (staycation) booked for mid January, so that’s just a few weeks away now! Yay!
 
Ultrasound results: I haven’t spoken to the vet yet, but sounds...ok? @Wendy&Neko it was Dr. Ranjan FYI.


Opinion & Recommendation
Moderate diffuse small intestinal wall thickening, with prominent small intestinal muscularis layer. Inflammatory bowel disease should be strongly considered. GI biopsies may be warranted.
Mild focal cranial abdominal lymphadenopathy. Reactive lymphadenopathy secondary to gastroenteritis or inflammatory bowel disease should be considered.
No sonographic evidence of pancreatitis, however, this does not necessarily exclude pancreatitis.
Enlarged and diffusely hyperechoic liver, likely secondary to diabetes mellitus. Hepatic lipidosis would be another consideration.
Bilateral mild renal pelvic dilation. This may be secondary to polyuria caused by diabetes mellitus. Otherwise unremarkable
 
I'm not familiar with that ultrasound vet - guess there are a few travelling ones in town.

Sorry about the results, :bighug: I've been down that road a few times now. The best option to figure out what you are dealing with really is a GI biopsy, it can be done either via endoscopy (depending where in the bowel is thickened and the report doesn't provide enough detail) or a surgical biopsy. Was there any more to the ultrasound report? Normally you get measurements for the three sections of the bowel, and possibly the stomach as well. There is also a local travelling vet that does endoscopies who is very good. If IBD, this will be tricky cause it usually means finding a protein he's not used to, and feeding that. Given Cosmo's food limitations, that might be trickier to do.
 
Diagnostic Imaging Report
Findings
Abdominal ultrasound: 41 still images and 6 video clips are provided. Urinary bladder: Unremarkable.
Left kidney: The renal pelvis is mildly distended, measuring up to 2 mm. Otherwise unremarkable. The corticomedullary distinction is satisfactory. The renal length measures 4 cm.
Left adrenal: Unremarkable.
Spleen: Unremarkable.
Peritoneum: Unremarkable. There is no evidence of peritoneal effusion.
Pancreas: Unremarkable.
Stomach: Unremarkable.
Duodenum: Unremarkable. The thickness measures 2.3 mm.
Right kidney: The renal pelvis is mildly distended at 1.9 mm. The renal length measures 4.4 cm.
Right adrenal: Unremarkable.
Liver and gallbladder: The liver is mildly enlarged and moderately and diffusely hyperechoic. The gallbladder is unremarkable. Cranial abdomen: A hypoechoic nodular structure measuring 6.5 mm in thickness is noted near the duodenum.
Jejunum: Mildly diffusely thickened, measuring up to 3.8 mm. The muscularis layer of the affected segments is prominent. Wall layering distinction is otherwise unremarkable.
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Patient: Cosmo (Vermette)
 
Home from work! DH spoke to the vet and she was pretty pleased with the results, keeping his story in mind. So that is good! :) Good news is that he is pretty happy, eating, pooping etc. He has a really good appetite (hence his weight gain :facepalm:)

He has megacolon and digestive sensitivities - which we knew. Makes sense that IBD is in the picture.
He has food allergies, even to the food we are feeding him (mild), which we knew.
His diabetes isn’t well controlled and he bounces to the moon, which puts stress on other organs, understandably.

The vet didn’t think we needed to biopsy, she would really like us to change his wet food (with some gastro kibble) to get his numbers down. That is our conundrum :bookworm: balancing his megacolon, allergies and diabetes.

I see that other IBD kitties often eat raw. We might consider it at this point. I think we need some kind of EZ mix? What is a gentle raw food to try for a sensitive system? Pork? Kangaroo?
 
There are plenty of good raw options made locally. Red Dog/Blue Kat and Natural Instincts are good quality products and there are lot others available. Korna will have a good selection. We did have one megacolon kitty here try raw and the caregiver had mixed results. I was just reviewing Pig's SS, start Feb 12, 2018, Sarah did good comments. Don't be alarmed by the dose, Pig was one of the higher dose acros. He was a Manx so Manx syndrome causing megacolon, and he had bladder leakage issues if constipated. Which raw sometimes did for him. He also had IBD. You can make your own raw if you want, EZ Complete is one but TC Feline is made on Saltspring Island and also good. I used it as a premix for a while. You can also use EZ complete with cooked meat. That might be a gentler way to start.

What meat is he allergic too? Chicken is a good place to start for raw, if not allergic. Leave turkey and beef for later. Some places specializing in raw are really knowledgeable about what meats to feed when.
 
Thanks @Wendy&Neko

The SS seems to be for black kitty rather than Pig, I think?

I am concerned about him getting constipated with any switch in food. The vet (bless her) did say that diabetic food is best, because it is made ‘different’, even if the carb content is the same as his current regular food. Not sure what she means, but I mean to ask her next time I chat with her. We know that most cats here do just fine on non prescription food :)

I think we will still need to keep going with some of the gastro kibble (down to less than 1/8 cup per day, or 90 pieces). I think that is really helping to keep him regular and good in the #2 dept. :p

As for allergies, we think he is allergic to chicken. His current food has mostly pork, but has some chicken and he does get mild skin allergies presently. Not bad though. He had not so good skin allergic reactions when he ate FF chicken and liver, and turkey and giblets. He lost quite a bit of fur on his belly, leg and arms at that time from nibbling and over grooming (stopped feeding it about a year ago). We also stopped giving him freeze dried chicken treats. Now we give whitefish treats, and it seems ok.

I think it will be a post New Years project to find and try something different. I need some time to research.

Cooked meat? Sorry if this is a really silly question, but you mean the ground meat? Is cooking it better? :facepalm:
 
thebigfuzz said:
Home from work! DH spoke to the vet and she was pretty pleased with the results, keeping his story in mind. So that is good! :) Good news is that he is pretty happy, eating, pooping etc. He has a really good appetite (hence his weight gain :facepalm:)

He has megacolon and digestive sensitivities - which we knew. Makes sense that IBD is in the picture.
He has food allergies, even to the food we are feeding him (mild), which we knew.
His diabetes isn’t well controlled and he bounces to the moon, which puts stress on other organs, understandably.

The vet didn’t think we needed to biopsy, she would really like us to change his wet food (with some gastro kibble) to get his numbers down. That is our conundrum :bookworm: balancing his megacolon, allergies and diabetes.

I see that other IBD kitties often eat raw. We might consider it at this point. I think we need some kind of EZ mix? What is a gentle raw food to try for a sensitive system? Pork? Kangaroo?
Click to expand...
My cat has allergies (IBD) and eats horse meat. He used to vomit once every week or every two weeks but now he vomits once per 6 weeks in average. At the beginning, I thought it had helped him with his BG but nothing has really changed - he is bouncing but at least, he must feel better because less pancreatitis episodes. The nutritionist had also talked about rabbit.
 
Marj & Djoko said:
He used to vomit once every week or every two weeks but now he vomits once per 6 weeks in average.
Click to expand...
Luckily Cosmo doesn’t vomit and has a great appetite. He does get bloated from some kinds of foods...and of course, megacolon. Anti jinx, he hasn’t had any #2 issues since July.

Rabbit...interesting.
 
I have both the EZ Complete and TC Feline premixes. I'm trying both out with Butters to get her on a low Phosphorus raw diet.

The EZ Complete can be mixed in with cooked meat, not just with raw meat, to create a balanced meal. If Cosmo has never eaten raw before, you could try him with the EZ Complete and cooked meat first. However, EZ Complete has chicken liver in it. Maybe an issue with a chicken allergy if you're trying to limit his chicken.

TC Feline premixes don't have chicken in them. They have one with cow liver, one without that you add liver to, and then the special formula for CKD.
The one with liver says "out of stock for the foreseeable future", but the one you add liver to is in stock.
 
Lulu just got a scan back which the vet report has indicating pancreas, liver and intestines. I’m not sure that the vet wasn’t just seeing what he thought he was going to see (a previous report showed that and worse when she probably did have triaditis) but FWIW she is on a mostly raw diet and has zero symptoms of any of those issues.
 
I'm no expert in all things mega-colon and ultrasound...that's a lot of info!

I'll send you best wishes and a Happy Christmas Eve though! I do hope he continues to have a great appetite and good pooping skills :)

Have a wonderful evening Tanya!! :bighug:
 
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