IBD or SCL? Need specialist help.

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Mustang Sally

Mustang Sally

Member Since 2018
Hi, My Mustang Sally is back in emergency care tonight after only 48 hours at home. Before that she was in treatment for 4 days for ketoacidosis. (Background: she was diagnosed diabetic in April, and relatively stable through the summer, but declined quickly.) While in 4 days of hospital care she got an ultrasound, liver asper, pancreatitis test, GI panel, etc. She's coming back with no pancreatitis, no cancer in the liver, a B12 shortage, and Ultrasound showed a liver shunt and thickened small intestine. While hospitalized, she struggled to get balanced on electrolytes and minerals. We have NOT identified the trigger for the ketoacidosis, and clearly are missing the root cause. Her BG numbers haven't been that low - but still is having huge trouble with general nutrition and the ketones. I'm stumped.

A few questions:
- what is the best resource for understanding the relationship between diabetes and IBD? (sorry don't mean to duplicate questions, but I tried to search for "IBD" but it doesn't work)
- is there a way to tell whether it is IBD or SCL? (they haven't tested for that yet)
- has anyone had luck with dietary changes for IBD? (different protein source, etc)
- is there a good diabetes specialist in West Los Angeles that could help with a better diagnosis?

Thank you - it's not clear where to turn, as the options seems to be closing and I don't want to give up hope for her to pull through with treatment and diet changes.
 
Mustang Sally said:
the relationship between diabetes and IBD?
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They can both involve inflammatory processes. Low grade pancreatitis (or an acute attack) can cause diabetes because it damages the pancreas. Cats who are prone to inflammation can also have IBD or "triaditis". I suggest you Google triaditis because it's a wider inflammation that can involve pancreas, liver, bile ducts and intestine. That might be what your kitty has. There is something called "Pandora Syndrome" (Google it) in which the affected cat has a propensity to develop inflammations body wide. It's complicated.

Mustang Sally said:
is there a way to tell whether it is IBD or SCL? (they haven't tested for that yet)
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Ultrasound can give an indication of intestinal thickening and where it's located. It's not definitive though. If the inflammation is reachable by endoscopy (from either end) it can give a better idea of whether it's SCL or IBD provided the tissue samples are from the right areas. The gold standard for diagnosing SCL versus IBD is full open abdominal surgery where biopsies are done in many places within the GI tract. How far you want to go with diagnostics depends on your finances and what you want to put your kitty through. Many people get the ultrasound done and then treat with diet adjustments and medication. IBD is a relapsing remitting conditon.

Mustang Sally said:
has anyone had luck with dietary changes for IBD? (different protein source, etc)
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Yes, many people try a variety of diets from hypoallergenic food to single ingredient canned food to feeding raw in order to find what works best for their pet. It can take time to find the solution and sometimes food needs change over time.

Mustang Sally said:
is there a good diabetes specialist in West Los Angeles that could help with a better diagnosis?
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If not a diabetes specialist, try a veterinary internal medicine specialist or veterinary gastroenterologist (if they exist). An IM vet is usually good at sorting out multi organ system issues.
 
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