? 3/16 Dimmu AMPS: 265, +2.5: 346. Cerenia question. IGF-1 test result: positive

[Dimmu & KL]

3/15

Dimmu came up quite a bit during the night, so we gave him 2.75U this morning, although he didn't really wanna eat on his own. We manage to get some food and water into him, really hope his appetite will return soon, it's so sad to see his greatest joy becomes some sort of torture now....

He stayed in bed the whole night, almost didn't change positions. His hind legs are very weak now because he's not moving much, we are worried about the blood circulation, should we make him move more, massage his legs?

 

[Dimmu & KL]

OK, where to start. First of all, you can't diagnose lymphoma vs IBD with a fine needle aspirate. You have to do either a biopsy or endoscopy. I am sorry they didn't do a biopsy when they did the feces elimination since they would have been right there. GI inflammation can be caused by either IBD or SCL (small cell lymphoma). Due to Neko's heart condition, she could not undergo anesthesia, so could not get a proper diagnosis. Has Dimmu been losing any weight lately? Has the vet suggested a GI blood panel to find out his cobalimin/folate levels?

I read about lymphoma diagnose after they have done the ultrasound, and really regret I didn't know about it earlier to press for a biopsy.
Dimmu's weight is stable, but the nutritionist we saw yesterday said he should lose some weight. We were surprised, Dimmu has no fat on his back, around his ribs and on his hip, he's actually very lean/almost skinny in these areas, but he does have a fatty belly. We were told by all the vets we have seen that he should put on some more weight, the nutritionist is the only person that thinks he should lose weight, and she wanted to put him on Royal Canin Obesity Management wet food (https://www.royalcanin.co.uk/products/cat/feline-veterinary-diet/obesity-management-wet/) which has 19.4g carb in the dry matter. It seems like a lot to me, and I am not convinced of the ingredient list, either. She also said we should only feed him twice a day and totally nothing in between, I smiled and nodded. I agreed that he has to lose the belly fat, but if he is to lose 10lbs as she wanted him to, he'd be super skinny. I want him to lose the fat around his belly, should I start by cutting down a little of his food intake?

The vet wanted to see him back in about 3 to 4 weeks to check his GI health and do another blood work to see if his RBC comes up. Should I ask for a GI blood panel, too? He gets 4mg of B-12/day and is also on B complex, anything else I can do to help his anemia?

Next, the raw food does not contribute to IBD/GI issues. If there are allergies to proteins (IBD), it's the specific protein you need to address. Fortunately with raw food, there are lots of protein options out there. One thing you might want to consider is a raw diet that used eggshell calcium instead of bones. Some cats have problems passing bones. Here's a good web site on raw feeding for IBD cats.

I didn't think it was the raw food that cause the IBD/GI issues, either. But he's on a rotation of many different sources of proteins that it's difficult to tell which ones he might have difficulty with. Maybe I should start with what used to work for him again and slowly add/eliminate other options one at a time. He clearly has problem passing bones because the vet found lots of it in his feces. So will look into the eggshell calcium, too. Another option I am wondering is switching him to wet food for a while until his constipation problem is resolved, and then re-introduce raw back, thought?

 

[Dimmu & KL]

Just got off the phone with the university vet. She did the IGF-1 test when Dimmu was hospitalized because she saw some physical traits of an acrocat. This was done at the University of Liege, she had a very high reading, over 1000 nmol/L (>131 ng/ML). She also mentioned the possibility of a false positive, so suggested we first take care of the constipation, then the anemia then we will address the acromegaly. For the anemia, they think it's a due to chronic inflammation, because Dimmu didn't show any symptoms and was compensating so well. Hopefully with the constipation resolved and a diet change he will be able to bring up his RBC.

 

[Tanya and Ducia]

Good morning,
have you seen the Acro / Iaa subforum? - HERE is the link, you might find very useful info there.
Acromegaly is not as rare in cats as it is thought to be, and we have currently several cats with it on this Forum. Some are getting treated, some not.
I am sure that Wendy will be checking in with guys later on (it's too early here yet) and share her extensive knowledge - her girl Neko was Acro cat. I am sorry about the diagnose.
Sending healing vines and wishes for speedy recovery for Dimmu.

 

[Dimmu & KL]

Dimmu is lip smacking, and almost cant hold himself steady when he tries to walk or move.
Called the vet and she prescribe Cerenia 24mg/day. Looks like a mega dose to me (Dimmu is about 25lbs/11.3 kg), any thoughts?

 

[Tanya and Ducia]

Called the vet and she prescribe Cerenia 24mg/day. Looks like a mega dose to me (Dimmu is about 25lbs/11.3 kg), any thoughts?

It does sound massive - even if factor in his weight...
I give Ducia 1/4 or 1/8 of 16mg Cerenia pill when needed - single dose administration and worked well.
But give a few mminutes - I am going to search for that Cerenia long term v. small doses as needed only basis thread I have recently came across - good info might be there for Dimmu.

 

[Dimmu & KL]

Thank you.
I am on my way out to get Cerenia, will read more and do some more search later, too.

 

[Sienne and Gabby (GA)]

I believe the dose is 1 mg per kilogram (2.2lbs). I recently had Gizmo on Cerenia and he got one, 16mg tablet per day and he was weighing around 12 - 13 lbs.

I just went through the issue of IBD vs lymphoma with Gizmo. I had lengthy discussions with my vet about diagnosis. She felt that a surgical biopsy was the definitive method to get a diagnosis. which is what we ended up doing. The concern with an endoscopic biopsy is that they are not always able to get an appropriate sample (i.e., either the issue is location or depth) so if the result comes back as IBD, there is still a possibility that the cat has lymphoma. It's important to know what you're treating since the treatment for each condition differs.

Raw food is not an issue in general. If your cat's gut is torn up due to inflammation, there's a somewhat higher risk of bacteria in raw food especially if it's commercially prepared. There is an excellent website and Facebook page on Raw Diet for IBD Cats. If there's inflammation going on, you may want to consider supplementing Dimmu's diet with probiotics. The site I mentioned has good information on their use.

What is your vet saying about Dimmu's mobility?

Did the nutritionist understand that your cat is diabetic? It does not sound like you were getting an informed opinion.

 

[Tanya and Ducia]

Sorry , I cannot locate that thread but I think the formula that Sienne posted above is what was said there, too.
There were recent discussions about Cerenia -but more on frequency of administering not the dose amount, like that one.
I give Cerenia in micro doses for my small girl as needed - she does lip smacking or sniffs her food and walks away without eating - there goes in quarter or 1/8 of 16mg Cerenia, just one dose. I crush it to fine dust and mix it into her food. (touching the wood) Hasn't failed me once.

ETA: just had another thought: since Dimmu's eating has been iffy as of late he might be feeling nauseous because of an empty stomach - my Ducia does it and even vomits clear yellowish liquid. In such cases I go for plain acid reducer - again a tiny dose of it in combination with Cerenia - works perfectly well. Just throwing in something to think about.

 

[LizzieInTexas]

Thank you.
I am on my way out to get Cerenia, will read more and do some more search later, too.

The pills may be 24mg - dosage is usually 1/4 tablet 1x per 24 hours. Please verify with your vet.

 

[Dimmu & KL]

The pills may be 24mg - dosage is usually 1/4 tablet 1x per 24 hours. Please verify with your vet.

She first prescribed 16mg and said I could give him 1 pill a day, then decided to up it to 24mg 1 pill/day. I double checked with her that it is indeed 1 whole pill, that's why I am asking for you guys' experience, because it sounds like a lot of Cerenia.

I believe the dose is 1 mg per kilogram (2.2lbs). I recently had Gizmo on Cerenia and he got one, 16mg tablet per day and he was weighing around 12 - 13 lbs.

Sorry , I cannot locate that thread but I think the formula that Sienne posted above is what was said there, too.
There were recent discussions about Cerenia -but more on frequency of administering not the dose amount, like that one.
I give Cerenia in micro doses for my small girl as needed - she does lip smacking or sniffs her food and walks away without eating - there goes in quarter or 1/8 of 16mg Cerenia, just one dose. I crush it to fine dust and mix it into her food. (touching the wood) Hasn't failed me once.

ETA: just had another thought: since Dimmu's eating has been iffy as of late he might be feeling nauseous because of an empty stomach - my Ducia does it and even vomits clear yellowish liquid. In such cases I go for plain acid reducer - again a tiny dose of it in combination with Cerenia - works perfectly well. Just throwing in something to think about.

But if Gizmo is getting a 16mg pill/day for his weight, I think Dimmu should be ok with 24mg/day as an initial dosage and maybe decrease as we go? I will do more reading on the dosage and frequency.

 

[Wendy&Neko]

Oh dear, sounds like you have bad luck with vets. Smile and nod at the nutritionist, and ignore what she says. I would pay attention to the other vets you have seen on whether Dimmu is the right size. A pot belly is a sign of acromegaly, so is weight gain. Think what growth hormones do. Acromegaly is caused by a benign pituitary tumour that sends out excess growth hormones. One in four diabetics has acromegaly. Lots of them here. There is a chance of getting a false negative IGF-1 if a cat is tested within 73 days of starting insulin. False positives, much less likely.

For Cerenia dosing I have seen you can do up to 2mg/kg (1 mg/lb) so the dose sounds like it would be OK. If Cerenia doesn't work, another good alternative is ondansetron (Zofran) which is good for nausea. They target different nausea receptors so one could work better than the other. Some cats need both. I hope Dimmu feels better soon.

Neko's IM vet trained at the University of Liege. He was quite knowledgeable so I think it's a good school.

 

[Tanya and Ducia]

But if Gizmo is getting a 16mg pill/day for his weight, I think Dimmu should be ok with 24mg/day as an initial dosage and maybe decrease as we go? I will do more reading on the dosage and frequency.

IMHO it is easier to increase the dose than start high and cut back...

 

[Dimmu & KL]

I just went through the issue of IBD vs lymphoma with Gizmo. I had lengthy discussions with my vet about diagnosis. She felt that a surgical biopsy was the definitive method to get a diagnosis. which is what we ended up doing. The concern with an endoscopic biopsy is that they are not always able to get an appropriate sample (i.e., either the issue is location or depth) so if the result comes back as IBD, there is still a possibility that the cat has lymphoma. It's important to know what you're treating since the treatment for each condition differs.

Dimmu is very difficult when hospitalized, he refuses to eat or drink, and is terribly hostile. He has gone through so much this week, bringing him back for a biopsy is nearly impossible now. I feel bad about not knowing that a biopsy is the only definitive way to diagnose IBD vs lymphoma beforehand.....

Raw food is not an issue in general. If your cat's gut is torn up due to inflammation, there's a somewhat higher risk of bacteria in raw food especially if it's commercially prepared. There is an excellent website and Facebook page on Raw Diet for IBD Cats. If there's inflammation going on, you may want to consider supplementing Dimmu's diet with probiotics. The site I mentioned has good information on their use.

What is your vet saying about Dimmu's mobility?

Did the nutritionist understand that your cat is diabetic? It does not sound like you were getting an informed opinion.

He got AB's for a week after his dental surgery 3 weeks ago. I doubled his probiotics dosage for 2 weeks. He's back on his usual dose of 2/3 cap of Renewlife probiotics 15 bil twice a day.

Vet thinks the severe constipation+feces elimination+stress from hospitalization all contribute to his weaken mobility, and he will probably need a few days to gain it back. We are just worried about his blood circulation and nerve damage because he'd park his whole body weight on one side for hours without moving.

The nutritionist was well aware of Dimmu's FD, and still she recommended the Royal Canin Obesity Management, her argument being that it has good fiber content, low fat and pretty good protein content. *sigh*

 

[Sean & Rufus]

Rufus is 21.8 pounds and he gets a 16mg pill.

 

[Wendy&Neko]

Has the vet ever thought that Dimmu might have arthritis? It's quite common in older cats.

On the food front, been meaning to ask if you have ever looked into the TC Feline premix. I think it's from Germany. They have one premix that is made with calcium carbonate in place of bones. It's also lower in phosphorus for kidney cats. Neko was on the Canadian version of it for a while. As an aside, Neko's U of Liege trained IM vet was supportive of me feeding her raw. I'm guessing you've seen the Catinfo website, also written by a vet nutritionist. And feeds raw to her cats.

 

[Dimmu & KL]

Has the vet ever thought that Dimmu might have arthritis? It's quite common in older cats.

On the food front, been meaning to ask if you have ever looked into the TC Feline premix. I think it's from Germany. They have one premix that is made with calcium carbonate in place of bones. It's also lower in phosphorus for kidney cats. Neko was on the Canadian version of it for a while. As an aside, Neko's U of Liege trained IM vet was supportive of me feeding her raw. I'm guessing you've seen the Catinfo website, also written by a vet nutritionist. And feeds raw to her cats.

Dimmu has arthritis, it was diagnosed about 2 years ago.

We tried the TC feline premix before on our other cat, but switched to commercially prepared food when we got Dimmu. Good that you mentioned it, I am gonna have a look there again. Dimmu's IM vet at U of Liege also didn't try to convert us back to canned or dry, but wanted us to follow the nutritionist's suggestion....
I have seen the Catinfo website and got a lot of good info, will check out Raw Diet for IBD Cats, too.

 

[Dimmu & KL]

Dimmu was evidently weak in his hind legs since he came home and it’s probably because of lack of movements. The vet asked us to make a video so she can see his walk. In the video, he has lameness in his left forepaw, which is new. He didn’t move so much so we didn’t have a good look until we took the video. We think it happened when he jumped off bed this morning and landed wrong because he’s unstable. We tried to feel his left forepaw and he wouldn’t let us near it, and would growl in pain and protest. Dimmu's regular vet will be here to examine him tomorrow, hopefully it’s a sprain, not a fracture. I can't believe this is happening, as if the poor guy hasn't had enough yet..... I also feel guilty that I didn't prevent this from happening...

He had 24mg of Cerenia about 3 hours ago and showed some interest in food for his PM shot but stopped after 3 bites. He's sleeping deeply now. Does Cerenia make kitties drowsy?

 

[Tanya and Ducia]

Does Cerenia make kitties drowsy?

I t never made Ducia drowsy, and never heard of it.
But ECID.