? Malabsorption due to B12 deficiency not resolving

[Marc & Jen]

Our diabetic kitty, FA recently lost a ton of weight. Went from about 13 lbs to under 8 lbs on a few months. Originally we attributed the weight loss to moving from a small apartment to a house where he was much happier and got a lot more exercise and his diabetes was much better controlled. However we finally figured out something must be really wrong when he really began to be ravenously hungry and pooping soft poops like crazy.

We decided to take him to the emergency vet where they did an ultrasound and saw some slight thickening of his intestine and diagnosed either IBD or small cell lymphoma. They prescribed prednisolone however after several weeks we did not see any improvement.

So we took him back and he saw the internal medicine vet that he saw years ago and they ran GI blood work. The vet suspected EPI however it turns out it is a B12 deficiency instead which is leading to the malabsorption - therefore ravenous hunger and lots and lots of soft poop. We began B12 injections a couple months ago and after a few weeks we thought we saw an improvement with his energy/mood and believe he may have gained a little weight back. However he still is really hungry and pooping a lot of soft poops even while still being on the prednisolone.

We go back to the internal med vet in a few weeks but I am very worried as we can’t just keep spending all this money on vet visits, all the extra food and meds. They did mention that we may need to increase the prednisolone dose or do injections instead. So just wondering, has anybody gone through this and what your experience may have been? Is there anything else we can try? What we’re dealing with now feels unsustainable and I worry that FA is suffering

 

[Sienne and Gabby (GA)]

There may be some things you can do regarding food. I would switch FA over to novel proteins. It may not be a "fix" but it can't hurt. Most IBD cats have a less than ideal response to certain proteins. My IBD kitty was on a poultry diet until diagnosed. Now if she eats anything with poultry, even a few treats, she has a problem. I'd also avoid foods that contain gums or carrageenan since they may have an effect on the gut. ZiwiPeak is a great brand of food but is pricey. They carry venison and a rabbit and lamb combination.

Another option may be a raw diet. You have a great deal of control as to what goes into the food with a raw diet. Most of us that feed our cats a raw diet. use a pre-mix. A pre-mix is a powder that contains all of the supplements necessary for the protein you're using to be nutritionally complete. You mix it with water and add it to the protein. This is a great website that contains information about a raw diet. It tends to focus on IBD but there's great information especially about supplements.

I don't know if probiotics would help. The website I linked has information about probiotics.

 

[Howiesmom]

My Howie had a similar issue. He was losing .4-.5 pounds every 4 weeks. We ran the GI panel to check on folate and cobalamine levels. His folate came back at 9.6 when the normal reference point starts at 9.7. My vet did not think I needed to start him on folic acid but I decided to anyway. He gets half of a 400 mg human folic acid tablet each day as recommended from the folks at the Texas lab that runs the test.
Around the same time, many of the experts on here also encouraged me to get an ultrasound on his heart (he has acromegaly and a heart murmur). Heart issues also lead to weight loss. We didn’t find anything from that but did discuss IBD or SCL even though he doesn’t have the typical symptoms besides weight loss. My vet prescribed Budesonide instead of Pred as he didn’t think Pred would be good for Howie. He gets .5 mL each day (compounded liquid that goes in his food).
Last month (a few weeks after starting the folic acid and budesonide), he gained .2 lbs! He goes back on Jan 2 so am excited to see what his weight will be then. I hope this might give you some other ideas to discuss.
Food for thought….

 

[Lisa and Witn (GA)]

My IBD cat has a similar issue. Originally the started him on a hydrolyzed protein diet and improved on it. But since then I switched him over to a homemade food diet and he has been doing great on it. I started with cooking the meat and adding the completer supplements to it after cooking, but since then started using this recipe instead. I am in the process of switching all of my cats to this diet. https://www.rawfeedingforibdcats.org/balanced-recipe-for-use-with-raw-or-cooked-proteins.html

This site has a lot of good information on it.

Two of my other cats seem to recently started showing signs of food allergies to Friskies. I am not sure if Purina recently changed something but it seems a coincidence that both started having issues the same time. I switched both of them over and quickly started seeing improvement in both. I still have 3 others to switch over. I compared the cost of what I spend for canned food each month and there is very little difference between it and making my own food using the recipe above.

 

[Wendy&Neko]

diagnosed either IBD or small cell lymphoma. They prescribed prednisolone however after several weeks we did not see any improvement.

In other words, you do not have a diagnosis yet. The treatments for IBD and small cell lymphoma (SCL) are not the same. Neko was one of 3 of my SCL kitties, the latter one also has IBD. If FA has IBD, then he should respond to a novel protein diet. I'd also suggest some good probiotics (such as Visbiome) and a prebiotic like psyllium husk fiber. You can try a novel protein diet for a couple months and see if it makes a difference. If not, you are likely looking at SCL. To really diagnose between IBD and SCL, you need to get a biopsy done. Depending where the bowel thickening is, it might be possible to do this with an endoscopy. However, FA will have to be taken off of prednisolone for a few weeks before hand, as the pred can mask the disease.

Losing weight is a hallmark of SCL (also diabetes and hyperthyroidism, but I presume hyperT has been tested for). SCL is treated with prednisolone and a mild chemo called chlorambucil. A large percent of SCL kitties go into remission. It can take more than a few weeks for treatment to work.

Getting to diagnosis can be expensive, but the medications to control it afterwards are reasonably priced.