IBD questions

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granadilla

granadilla

Member Since 2015
The vet is starting Marshmallow on budesonide. She threw up liquid over the weekend and she keeps licking her lips like she's nauseous. So that plus the diarrhea has made the vet think it's IBD. Questions...

Is there an IBD forum? I searched for one and only found a Yahoo group that I couldn't access.

She's been on pumpkin puree to control the diarrhea. Should I keep her on pumpkin at the same time as the budesonide? (I asked the vet this in a text message with some other questions and he wrote back one "yes" to all my questions so I don't know if he meant yes to everything. I called to talk to him but haven't been able to get him on the phone.)

I've seen that some cats had to get ultrasounds, endoscopies or biopsies to confirm the diagnosis. The vet said that since the pumpkin controlled the diarrhea, he doesn't think it's cancer. He said "cancer would laugh at pumpkin puree." Do I need to insist on getting one of those tests or is it unnecessary? I don't want to put her through another (expensive) vet visit if it's not necessary.

What else should I know? Thanks!

Shane
 
The lip licking could be dehydration. If mildly dehydrated, unflavored pedialyte is helpful.

Are you going to give Marshmallow budesonide in liquid or capsule form? Best to mix it in with food. If she won't eat it on her own, force it down with a syringe. I don't recommend giving the budesonide liquid alone as she could vomit it up. What dose is the vet starting Marshmallow on?

I'd keep her on pumpkin if it helps with the diarrhea. The question is whether it's irritating her stomach or if safe to give long term. Some members here report it works but it irritates their cats' stomachs while others report their cats are fine on it. When Marshmallow vomited liquid over the weekend, was it clear liquid or any from pumpkin? Bonnie occasionally vomits liquid but usually it's due to a hairball. Before budesonide, she was vomiting up food and liquids a lot. She also had awful diarrhea, especially if I gave her too much canned food. I doubt she would have kept down the pumpkin.

Bonnie never had any tests to confirm diagnosis. Dietary changes to a new, novel protein that she never had before and budesonide were all that were needed. Testing can be tricky and expensive for diagnosing IBD.

Facebook has a "Raw Feeding for IBD Cats" group. I couldn't find any active IBD forums.
 
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Thanks for the feedback. She doesn't seem dehydrated but it could be mild. Her skin seems to have normal elasticity but I'll be the first to say I don't know if I'd recognize dehydration if it was just mild.

The vet said 1 mg capsules and he called the dose into a compounding pharmacy. She won't eat wet food but I could mix the budesonide into some wet food and feed it through a syringe if necessary. I'll probably start by giving her the pills and see how that goes.

The vet said pumpkin is okay for the long term if necessary but I was trying to wean her slowly off it and see if she can handle being off it. Now that we're adding budesonide, I'll keep her on the pumpkin because I don't want to change too many things at once. That way if she has a good or bad reaction, I'll know what her reaction is from.

Her vomit was clear liquid. She's not a puker, she's only thrown up a couple of times in her life and twice was when she was sick so I don't think this was due to a hairball. Then again, it would be just like her to throw me a curve ball. :)

I did read that raw food was good for IBD cats but given how she is with wet food, I don't think I can get her on raw. I just switched her over to Evo dry and her BG levels are nice and low. I can try a novel protein and see if she'll eat it. Can you give Stella & Chewy's as dry food or do you have to mix it with water?
 
Rub your fingers on her gums. Do they feel tacky? That can be a sign of dehydration.

You can try Stella & Chewy's as a dry food. If you do, do it gradually. I add water (room temperature) and then drain out the water. Bonnie has to have it just right or she won't eat it if it's too dry or too mushy. She likes the pieces crumbled up. So picky. But she's a cat....:)
 
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A biopsy is the only way to confirm a diagnosis. It could be IBD or or worse yet small cell intestinal lymphoma. An ultrasounds will show if either is suspect because both cause thickening of the walls of the small intestine.
One can try to get a biopsy via an endoscopic examination but sometimes it is inconclusive. A full-section biopsy is best but that requires surgery.
An ultrasound over a year of my MurrFee revealed thickened walls of the small intestine. I took him in since he vomited, was not eating and was lethargic. The ultrasound also showed pancreatitis.
Since then he has beem on 1/4 or a 250 mg tab of metronidizole twice daily and 1 mg budesonide and 2.5 mg Pepcid AC one daily. I just use a pill poser to give him the meds. I also give a weekly shot of cyanocobalamin b12.
The meds helped with the lose stools but they are still soft and stinky
 
Well the pharmacy compounded it into a liquid (triple fish flavor!) so I guess I'll be using a liquid. I'll try it tomorrow morning and see what happens.
 
Are you starting out with budesonide daily or every other day?
 
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If the liquid doesn't go down easily, getting the tablet version and wrapping it in a bit of processed cheese or even Pill Pocket can work for some cats.
 
I gave it to her last night and she was okay with the liquid. I was going to wait until this morning but then I realized I'd be giving it to her right before I leave for work and I wanted to watch her for a few hours and see how she did. She didn't love it but she didn't run and hide under the bed either. Then she got a piece of freeze-dried chicken as a treat. :)

She didn't miraculously act 100% normal as soon as I gave it to her (I wish) but she didn't throw it up. How long should it take until I see results? I haven't switched her to a novel protein yet, I just ordered some Stella & Chewy's.

I'm giving it to her every day. @Cat Ma, how often do you give it to Bonnie?
 
It takes time to adjust to the medication but it's a great sign that Marshmallow didn't vomit up the budesnoide. I can't remember how long it took for Bonnie but she responded better and sooner than when she was on prednisolone. A change to a novel protein really helps. Introduce it slowly.

Bonnie gets 0.5 mg budesnoide daily. I am guessing dose was based on her weight. She's about 7 1/2 pounds. Since eating Stella & Chewy's, she's not had diarrhea. Hopefully you'll have success with it for Marshmallow.
 
I started the slow transition to Stella & Chewy's Duck Duck Goose last night. That stuff is expensive!! I didn't realize how small the bag was. But obviously I'll give it to Marshmallow if it helps her. I really hope she feels better soon. I have to go out of town next Thursday and even though I have a good petsitter, it's hard when you're not there to monitor them when they're not doing well.
 
Yes, it is expensive. I was shocked at the sticker price. But it's cheaper overall than an expensive prescription diet and needless vet visits. Plus it beats the time spent cooking for your cat. I go through a bag a week or so with Bonnie. Now she sometimes wants it dry, sometimes with water. I hope Marshmallow likes it.
 
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Check with local specialty butchers. You may be able to find some unusual, novel proteins that you can feed if you follow a recipe like the one at Cat Info (and Dr Pierson consults for a fee, too, if you need that recipe tweaked at all)
 
mine has ibd/possible lymphoma.
she's on budesonide and prednisolone. Clay helps with the diarrhea, i'm putting it in small capsules since mine won't eat her food if I put any meds in it. b12 shots once or twice a week.
 
rhiannon and shadow said:
mine has ibd/possible lymphoma.
she's on budesonide and prednisolone. Clay helps with the diarrhea, i'm putting it in small capsules since mine won't eat her food if I put any meds in it. b12 shots once or twice a week.
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Rhiannon, is Shadow on both budesonide and prednisolone at the same time or do you alternate them? I've not heard of giving both steroids together.
 
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@Cat Ma

yes ...she is.
we are tapering down the pred... so she gets that every other day but she's currently getting the bude every day.
We just changed recently.... added bude back after trying 2 months of gengraf ( modified cyclosporin)
 
Marshmallow is doing better! The diarrhea is under control. I'm still giving her pumpkin because I just added new food and meds and don't want to change too many things at once. No puking since Saturday (I started the budesonide on Monday and I haven't seen her lick her lips since then either).

I came home last night from work and her neck was pretty dry!! When she doesn't feel well, she stops grooming her neck. She's a messy drinker: she puts her whole chin and neck into the water bowl. (I've been telling her for 13 years that she has a drinking problem.:)) When she feels normal, she sits up after drinking and grooms meticulously. When she doesn't feel good, she just walks away from the bowl with her neck fur totally wet, leaving a trail of water drops. When I got home last night, I petted her and checked her neck to see how wet it was, and it was almost totally dry! That means that just 3 doses of budesonide helped her. And maybe also introducing a little bit of the novel protein.

She likes the Stella & Chewy's. She's about halfway transitioned. After she's fully transitioned, I'll try slowly weaning her off the pumpkin. I'd also like to try slowly reduce her dose of budesonide from 1 mg to 0.5 mg per day (just because if she doesn't need that much medication in her system, why pump it into her?). But I'm not going to make any other changes for the next week except keep transitioning her food. Right now I'm just thrilled she's feeling better!!

Thank you so much everyone (especially @Cat Ma!) for all the info and advice. I'd never even heard of IBD before I joined this site in June. Then I realized that Marshmallow's symptoms matched a lot of what the other IBD kitties seemed to have. When I went to the vet recently, I took a list of all the things I'd learned about from this site that might explain her symptoms (IBD, EPI, pancreatitis, cancer) and went through the list with the vet. Then when he said she might have IBD, he suggested prednisolone. Again, because of everything I'd learned here, I asked for budesonide instead. Thank you everyone!! And Marshmallow thanks you too. :cat:
 
The digestive tract may be so irritated from the IBD that the normal production of B12 is disrupted. The B12 (cyanocobalamin, not methylcobalamin) help replace it.
 
Great news, @granadilla! B12 shots are good for IBD. Bonnie gets them weekly and it helps with her appetite and energy levels. I am told it also helps with absorption of nutrients because IBD cats can be deficient in that area and become anemic. So glad to hear Marshmallow is taking a liking to Stella & Chewy's and that her diarrhea is under control.
 
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Are there risks in using Metronidazole long term for IBD? The vet prescribed it for Bonnie's diarrhea, though that has been intermittent. The vet mentioned the Metronidazole could help with Bonnie's IBD and inflammation of her gums.
 
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Metronidazole (brand name Flagyl) is an antibiotic given for bacterial infections. It is also widely used to help control diarrhea. However, some cats will have a side effect of throwing up and stopping eating. Thats what happened for Marshmallow. It was the first thing I tried back in January back when she first got diarrhea. But it worked for my cat Cinnamon (GA) like a charm.

I don't understand why it would help with her gums though. Since she's already on an antiinflammatory, I would think the Budesonide would do that. Unless the B only targets the gut?

If her diarrhea is intermittent, could you try some pumpkin purée or Fortiflora? The Fortiflora didn't help Marsh, but I've heard it works for some kitties. Pumpkin is Marshmallow's preferred anti-diarrheal. :)
 
She loves the Evo, Rhonda! More than I think she likes S&C. But to help settle her stomach, I need to try her on a new kind of protein that she doesn't normally eat. So I'm trying Duck Duck Goose. If she doesn't seem better once she's fully on S&C then I'll probably put her back on Evo. She likes it, it's less exorbitant than S&C, and I'm happy with how low her BG has been on it. I may also look into other raw foods. The dance continues.... :)
 
granadilla said:
Metronidazole (brand name Flagyl) is an antibiotic given for bacterial infections. It is also widely used to help control diarrhea. However, some cats will have a side effect of throwing up and stopping eating. Thats what happened for Marshmallow. It was the first thing I tried back in January back when she first got diarrhea. But it worked for my cat Cinnamon (GA) like a charm.

I don't understand why it would help with her gums though. Since she's already on an antiinflammatory, I would think the Budesonide would do that. Unless the B only targets the gut?

If her diarrhea is intermittent, could you try some pumpkin purée or Fortiflora? The Fortiflora didn't help Marsh, but I've heard it works for some kitties. Pumpkin is Marshmallow's preferred anti-diarrheal. :)
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Bonnie has been doing well so far on Metronidazole. She craves Forti Flora now.

Yes, the Budesonide only targets the gut, not the whole body. So if there's other inflammation going on, it wouldn't work for the gums.

S&C's Duck does have turkey in it. Ideally you want one novel protein but if Marshmallow tolerates S&C, I believe it should be okay. Evo is very good because it is a canned food source with extra water and duck is the sole protein. But the important thing is keeping the IBD under control and Marshmallow feeling good.

Thanks for the link!
 
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Another option for the budesonide is to use the compounded pills instead of liquid. I get mine from Roadrunner Pharmacy and Mischief loves them.
 
@Cat Ma, I did notice that the Duck Duck Goose has turkey in it. To be honest, I don't know if it's helping her or not. She was doing well but then she got constipated last weekend. She seemed okay this week and I talked to the vet. He wasn't worried because she's still eating and pooping. But I flew out of town this morning and before I left, I did the skin test. She was definitely a bit dehydrated. A friend is taking her to get fluids tomorrow. I'm also going to ask about B12 shots because they sound really beneficial. I'll put her on Miralax when I get home too. I've been reading tonight about how a IBD kitties can get dehydrated and constipated.

She wasn't super sick when I left, but I am worried because I'm not home to monitor her. I have friends checking on her daily and taking her to the vet tomorrow, but I hate that I can't be there right now.
 
granadilla said:
@Cat Ma, I did notice that the Duck Duck Goose has turkey in it. To be honest, I don't know if it's helping her or not. She was doing well but then she got constipated last weekend. She seemed okay this week and I talked to the vet. He wasn't worried because she's still eating and pooping. But I flew out of town this morning and before I left, I did the skin test. She was definitely a bit dehydrated. A friend is taking her to get fluids tomorrow. I'm also going to ask about B12 shots because they sound really beneficial. I'll put her on Miralax when I get home too. I've been reading tonight about how a IBD kitties can get dehydrated and constipated.

She wasn't super sick when I left, but I am worried because I'm not home to monitor her. I have friends checking on her daily and taking her to the vet tomorrow, but I hate that I can't be there right now.
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Hope the fluids help Marshmallow. How did the vet visit go? It's hard to get enough fluids in if she's eating just Stella & Chewy's unless you're drowning the food in water. Is going back to Evo an option?
 
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She was on dry Evo, not wet. I can't get wet food into her. Sigh.

My pet sitter went over with a vet tech friend and they both swore that Marsh wasn't dehydrated. They said they'd take her to the vet if I still wanted them to. She ate and drank and pooped normally before they got there, so I said let's talk when they go over tomorrow and we'll make a decision then. My guess is that she might not be 100% normal but she sounded like she was in decent shape. She's pretty shy but she came out and socialized with them for a bit, which is a good sign. Thank you for asking!

I think I have to investigate more foods.... I bought some low carb wet flavors she hasn't tried yet (ahem, I mean, that she hasn't turned up her nose at yet) and I'll try them when I get back home. When she was younger, she ate anything!!
 
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