My Siamese Has IBD (Or So Was Told)

in article , Laura R. at
wrote on 5/8/04 11:38 AM:

circa Sat, 8 May 2004 09:16:34 -0700, in rec.pets.cats.health+behav,
Zaida ) said,
Hi Laura ... sorry for the HTML format.

Have you heard of vestibular syndrome? To me, this certainly fits it.
My lymphoma cat had a bout with it early in his illness, and although
some of the symptoms were either the result of his lymphoma or
indistinguishable from the vestibular syndrome symptoms, the
neurological effects you describe do seem to fit vestibular syndrome.

It was mentioned somewhere in this thread or maybe in the
alt.med.veterinary NG. However I look at all the possibilities, it appears
to me that with the exception of vestibular syndrome, lymphoma or IBD are
not acute illnesses. What are the symptoms of lymphoma?

The *exact* symptoms you describe.

Did the vet mention the possibility of cancer, specifically lymphoma?
A thickened digestive tract can be a very strong indicator of such
(along with other causes, but that's just one that jumps to mind that
I didn't see mentioned in your post).

Yes, as a matter of fact, she did. She didn't specifically say lymphoma.
She did say cancer, but if it was, she said cancer of the stomach or its
related structure. Lymphoma is an entirely different illness involving the
lymph vessels, right?

No. Lymphoma is *cancer*. Lymphosarcoma, to be exact.

Ming's vet wanted to go for endoscopy with biopsy to
rule out cancer ... that was the only reason for doing endoscopy, yes. And
as sad as I am to have to say this, I have to reiterate that it is extremely
difficult for me to weigh between my cat's life and the staggering costs.
An endoscopy would put me in another $1K is what I was told by the vet.

Find a new vet. My cat's exploratory surgery and biopsy were nowhere
near that.

That sounds to me like the vet might think it's vestibular syndrome
or something similar. Are you sure she hasn't mentioned this as a
possibility?

Nope. No mention of vestibular syndrome by her.

New vet. New vet. New vet.


To me, this doesn't sound like ulcers, but I'm not qualified to say
with any certainty.

I specifically asked what was found in the ultrasound exam. I
specifically asked if ulcers (ulcerations) were picked up by the test and
she answered positively.

Ulcerations != ulcers. Ulcerations can be caused by things such as
*cancer*. The term "ulcers" usually refers to digestive tract ulcers
caused by compromise of linings and subsequent injury by acids in the
tract.


Honestly, I think it's time for a second opinion and investigating
the possibility of lymphoma as well as IBD.

The old vet is unfortunately out of town (my dumb luck) but since time is
of the essence to maintain Ming's fluids, I have been going back to the same
vet for fluids SQ every other day. And by the way, yes, I have been
force-feeding Ming. Yesterday, I was able to make him take a jar (2-1/2
oz.) of baby food. He hates it, but his stomach hasn't acted up (no
vomitting) and he has used the potty. I'm due for his fluids today.

It's good that you're force feeding and keeping him hydrated.

If this is lymphoma, it
is crucial that you get it diagnosed before the cat has been on
prednisone for any length of time, as use of prednisone can decrease
the efficacy of subsequent chemotherapy. I'm not assuming that you
would choose to go with chemo if this did turn out to be cancer, but
if it did, and if you wanted to explore that option, I'd be happy to
tell you of my experiences with chemotherapy to treat my cat who had
lymphoma. It's much less expensive than you might think, and side
effects are quite low in cats. And lymphoma is one of the most
responsive cancers to chemo.

With this vet, nothing is inexpensive. In the beginning, each office
visit had a charge. My husband was really aghast.

New vet.

All he wanted was a
little show of "humanity" for us; after all, he is hard-pressed for
convincing that all this medical problem with Ming was not triggered by the
vet's ear flush procedure on Ming. If this is vestibular syndrome
("syndrome" to me indicating that a group of symptoms are happening together
to form a pattern), then indeed, all these are HER fault ... at least a
negligence somewhere in the procedure.

Again, vestibular syndrome is generally caused by something other
than an ear flushing. Please google on the syndrome. I know it's
natural to want to blame the vet, but your cat's symptoms are
*exactly* like my cat's symptoms were, and his vestibular syndrome
was caused by his *lymphoma*.


Or it's nausea. All of those behaviors were exhibited by my lymphoma
kitty shortly before and early in his chemotherapy, and it was nausea
(not caused by the chemo). Is he making any chewing motions or
grinding or gnashing his teeth? Those are also hallmarks of nausea.

Ming IS nauseated. He would take a gulp (swallowing motion) and lick his
mouth. His chewing motions do not appear normal to me. I am treating his
ears now with Silvadene.

Please get this cat to a different vet.


Unless it's vestibular syndrome caused by cancer.

Wow. I'm at a complete tizzy here now. Well, this vet did raise the
possibility of cancer. IF cancer has been developing over time, then the
ear flushing to treat his ear infection simply exacerbated what illness is
already underway. IF that's so, then this vet has been right all along ...
???

Well, if she raised the possibility of cancer, then yes, she may have
been right all along. Vestibular syndrome is caused by compromise or
infection of a specific set of nerves- lymphoma can cause this, as
can other infections or injuries.


True, but CNS symptoms *can* appear overnight in a cat that has a
larger primary disease.

But Ming had no CNS symptoms before the ear flushing procedure. This was
an active Siamese that liked getting into mischief. The ONLY discernible
symptom he ever had was his regurgitating episodes of certain foods. That
behavior was consistent with him if he ate wet food. He was fine with dry
food. He was even greater with R/D.

Again, though, just because the symptoms appeared after the ear
flushing doesn't inherently mean that they were *caused* by it. It
may just be coincidence.


Prednisone boosts appetite. I don't think you should be withholding
it, personally, but I do think that before continuing much longer
with prednisone, you need to definitively rule out cancer unless you
have no plans to treat cancer should it turn out to be the cause.

I don't know, Laura. I'm very saddened by all this, yet want to do what's
best for this cat. The diagnostic procedures that this vet requires equate
to a staggering amount that my husband and I can't afford. We are not lucky
in that regard. Ming is 12 years old; still young according to his vet. If
money weren't an object, I would definitely shoot for the moon, no questions
asked.

I honestly think you can get a diagnostic for far less than your vet
is saying it will cost. As I recall, Alex's exploratory surgery and
biopsy was in the neighborhood of $200.


I am sorry you're going through this, but as I said, if this does
turn out to be lymphoma, please post as I can give you information
about my experiences with chemo for my cat, both from a financial
perspective and from the perspective of whether it was worthwhile to
have done it. (In my case, it most definitely was.)

Thank you very much. I will most certainly bring up the possibility of
Lymphoma to her when I see her this afternoon.

Good. Please post back; I'm very interested in this.

Laura

Can't toxoplasmosis also cause vistibular problems?

Karen

"Laura R." wrote in message
.. .
circa Fri, 7 May 2004 12:20:31 -0700, in rec.pets.cats.health+behav,
Zaida ) said,
I will tell you though that I sent him yesterday for
fluids SQ because he needs it (it's the only thing keeping him alive)
....
and I've advocated forced feeding, but this vet has adamantly said NO to
forced feeding because seemingly, Ming's inability/reluctance is
psychogenic in nature now.

I cry "bull****". Utter bull****. Cats don't just become
psychologically averse to eating. They don't eat because of
*physical" causes, and your vet's lack of raising other possible
causes is very troubling to me.


Frankly, I think Ming will die without a second opinion. Prednisone
is a palliative treatment, not a cure, and saying that your cat will
die without it isn't an accurate way of putting it, because
prednisone *mitigates the symptoms of an underlying condition but
doesn't cure the condition*.


Laura
--
A proverb is a short sentence based on long experience.
-Miguel de Cervantes

I agree! This cat needs to be seen by another vet ASAP. Moreover, you have
concerns over finances -- and I think you will find that the rates you have
been charged are excessive. If you think this vet won't give you the
records, ask the new vet to request them directly. And, I would like to
repeat the suggestion I made a few days ago: If possible, contact a
university veterinary hospital. I used Texas A&M College of Medicine. The
staffing, facilities, and care were first-rate -- and the fees were very
reasonable. Make it clear when you call that this is an *emergency* because
it sounds like you may not have much time. If you can't go to a college of
medicine, then at least find another reputable vet and try to get Ming in
immediately.

MaryL

"Laura R." wrote in message
.. .
circa Fri, 7 May 2004 12:20:31 -0700, in rec.pets.cats.health+behav,
Zaida ) said,
I will tell you though that I sent him yesterday for
fluids SQ because he needs it (it's the only thing keeping him alive)
....
and I've advocated forced feeding, but this vet has adamantly said NO to
forced feeding because seemingly, Ming's inability/reluctance is
psychogenic in nature now.

I cry "bull****". Utter bull****. Cats don't just become
psychologically averse to eating. They don't eat because of
*physical" causes, and your vet's lack of raising other possible
causes is very troubling to me.


Frankly, I think Ming will die without a second opinion. Prednisone
is a palliative treatment, not a cure, and saying that your cat will
die without it isn't an accurate way of putting it, because
prednisone *mitigates the symptoms of an underlying condition but
doesn't cure the condition*.


Laura
--
A proverb is a short sentence based on long experience.
-Miguel de Cervantes

I agree! This cat needs to be seen by another vet ASAP. Moreover, you have
concerns over finances -- and I think you will find that the rates you have
been charged are excessive. If you think this vet won't give you the
records, ask the new vet to request them directly. And, I would like to
repeat the suggestion I made a few days ago: If possible, contact a
university veterinary hospital. I used Texas A&M College of Medicine. The
staffing, facilities, and care were first-rate -- and the fees were very
reasonable. Make it clear when you call that this is an *emergency* because
it sounds like you may not have much time. If you can't go to a college of
medicine, then at least find another reputable vet and try to get Ming in
immediately.

MaryL

"Zaida" wrote in message ...
Hi again, Laura. I've done my reading on Lymphoma. Ming's is indicative of
Alimentary Lymphoma. This then explains the vet's need for endoscopy with
biopsy. The ultimate consideration on her part was my unableness to foot
the bill, Laura, if anything; not because she was unwilling to explore all
the possible causes. My husband's determination was to tie up the ear
flushing with the problems that were mediated from a negligent procedure; at
least for the sake of empathy, if not for us, then for Ming. That's all my
husband ever wanted ... *consideration* on her part. But because
consideration was seemingly lacking or half-hearted, the hindrance laid with
our having a very short pocket. :*(

How´s your cat doing now? I suspect she developed labyrinthitis from
the procedure or the procedure hurt her labyrinth. I do not know if
she can recover on her own or if she needs medical care though.

"Zaida" wrote in message ...
Hi again, Laura. I've done my reading on Lymphoma. Ming's is indicative of
Alimentary Lymphoma. This then explains the vet's need for endoscopy with
biopsy. The ultimate consideration on her part was my unableness to foot
the bill, Laura, if anything; not because she was unwilling to explore all
the possible causes. My husband's determination was to tie up the ear
flushing with the problems that were mediated from a negligent procedure; at
least for the sake of empathy, if not for us, then for Ming. That's all my
husband ever wanted ... *consideration* on her part. But because
consideration was seemingly lacking or half-hearted, the hindrance laid with
our having a very short pocket. :*(

How´s your cat doing now? I suspect she developed labyrinthitis from
the procedure or the procedure hurt her labyrinth. I do not know if
she can recover on her own or if she needs medical care though.

in article , Laura R. at
wrote on 5/8/04 5:26 PM:

circa Sat, 08 May 2004 11:54:50 -0500, in rec.pets.cats.health+behav,
Karen Chuplis ) said,
Can't toxoplasmosis also cause vistibular problems?

Yes, I believe so, and I'm not saying that the ear cleaning *wasn't*
the cause of the problem mentioned, but it could *so* be tied to a
more serious disease that I felt I needed to mention it.

Laura

The thing is if it is something like Toxo, it *can* be treated, but you have
to get on the right stuff. It can take a while, but dang, they should at
least look at that.

Karen

in article , Laura R. at
wrote on 5/8/04 5:26 PM:

circa Sat, 08 May 2004 11:54:50 -0500, in rec.pets.cats.health+behav,
Karen Chuplis ) said,
Can't toxoplasmosis also cause vistibular problems?

Yes, I believe so, and I'm not saying that the ear cleaning *wasn't*
the cause of the problem mentioned, but it could *so* be tied to a
more serious disease that I felt I needed to mention it.

Laura

The thing is if it is something like Toxo, it *can* be treated, but you have
to get on the right stuff. It can take a while, but dang, they should at
least look at that.

Karen

How´s your cat doing now? I suspect she developed labyrinthitis from
the procedure or the procedure hurt her labyrinth. I do not know if
she can recover on her own or if she needs medical care though.


Keeping in mind the Prednisone might be palliative (as opposed to
curative), I just wanted to say that Ming took his first meal today. big
smile He ate half a can of his C/D Prescription Diet. No forced feeding
this time. No vomiting either (I monitored for 2 hours - wow). I couldn't
be happier. It could be the Silvadene working (3 to 4 drops that I put in
his ear twice a day since Tuesday). His coordination is way much better.

I know what labyrinthitis is, Liz. I've had it. I know Ming doesn't have
it. My eyeballs had that jerky rolling movement (up to side) and I tilted
towards the side that was affected (it was my right ear then). It was also
the first signs the vet looked for: head tilt, eye roll, so she ruled out
anything affecting the inner ear. If anything, she said possibly a pin-dot
tear at the ear drum. Still that would make me nauseated if that were me.

I called the vet's office to leave a note for her on this. The
receptionist was ecstatic for me. Minutes after I left the message, the
receptionist called back to say the doctor wants me to continue with the
current dosage of Prednisone for Ming. Right now, he's at twice a day.

I'm wondering though if it's necessary to continue with this dosage. I
have been doing more reading on Prednisone and long-term therapy may do more
harm in the long run. I also found this thread on IBD (which describes all
the steps my vet took, so now I'm wondering if I should still seek a 2nd
opinion after this read). Source is a page about IBD from:
http://www.vetinfo4cats.com/cibd.htm...d%20Prednesone

All of Ming's symptoms are described here with the exception of diarrhea.
It is also worth noting that I mentioned before that prior to the beginning
of all this havoc, Ming would regurgitate or vomit after meals, but not all
the types of food he eats. After learning more about IBD, I am becoming
more convinced that he has, all this time, food allergy. That being the
case, I will talk to his vet on Monday and discuss my concern about the
long-term therapeutic use of Prednisone.

_______________________________

Inflammatory Bowel Disease in Cats

Inflammatory bowel disease (IBD) is probably the most common cause of
chronic vomiting or diarrhea in cats under the age of 8 to 10 years. It is
unclear at this time whether this is one condition or several conditions
that appear very much alike. In older cats, hyperthyroidism is also a common
cause of vomiting or regurgitation. This disorder can occur at young ages
but is more common in middle aged and older cats. Many cats do not exhibit
any clinical signs other than chronic vomiting. The vomiting may occur
intermittently and often the cat does not appear to be affected at all other
than vomiting frequently. The cyclic nature of this disease makes it
difficult to evaluate the success of treatment in some cases and causes many
cat owners to put off treatment longer than they should.

While vomiting is the most common clinical sign, diarrhea, weight loss,
depression and behavioral changes can also occur.

This problem must be distinguished from other fairly common causes of
vomiting, including hyperthyroidism, lymphosarcoma, feline heartworm
disease, intestinal parasites, viral illnesses and pancreatic disease.
Testing should be done to rule out these conditions, if possible.

IBD can only be diagnosed accurately from intestinal biopsy samples. The
most common way to biopsy the intestine is through endoscopy. Flexible
endoscopes that can be passed into the intestinal tract are used to
visualize and biopsy the intestine. It is important to rule out the other
possible problems by labwork, if possible, prior to considering intestinal
biopsy. In some cases, it is hard to arrange for biopsy to be done. In this
case, therapeutic trials of anti-inflammatory medications may aid in the
diagnosis.

Once it is established that inflammatory bowel disease is present, there
are several treatment options. Mild cases of IBD tend to respond well to
corticosteroid administration. If caught early, this treatment can eliminate
the problem as a future concern in some cats. In older cats or where the
disease is well established, medication may be necessary lifelong. Other
medications used for this include metronidazole and azathioprine. These
medications can be used in combination in severe cases of IBD.

Some cats may have IBD due to food allergies. It is always a good idea to
consider this possibility and to use a diet free from any ingredients the
cat has previously eaten for a period of several months to be sure that food
allergies are not present. Your vet can help you design a good diet for this
purpose or provide you with commercial foods made to be hypoallergenic.

Curing cats of this condition is not always possible but most will respond
to treatment and be able to live fairly normal lives.

Mike Richards, DVM

How´s your cat doing now? I suspect she developed labyrinthitis from
the procedure or the procedure hurt her labyrinth. I do not know if
she can recover on her own or if she needs medical care though.


Keeping in mind the Prednisone might be palliative (as opposed to
curative), I just wanted to say that Ming took his first meal today. big
smile He ate half a can of his C/D Prescription Diet. No forced feeding
this time. No vomiting either (I monitored for 2 hours - wow). I couldn't
be happier. It could be the Silvadene working (3 to 4 drops that I put in
his ear twice a day since Tuesday). His coordination is way much better.

I know what labyrinthitis is, Liz. I've had it. I know Ming doesn't have
it. My eyeballs had that jerky rolling movement (up to side) and I tilted
towards the side that was affected (it was my right ear then). It was also
the first signs the vet looked for: head tilt, eye roll, so she ruled out
anything affecting the inner ear. If anything, she said possibly a pin-dot
tear at the ear drum. Still that would make me nauseated if that were me.

I called the vet's office to leave a note for her on this. The
receptionist was ecstatic for me. Minutes after I left the message, the
receptionist called back to say the doctor wants me to continue with the
current dosage of Prednisone for Ming. Right now, he's at twice a day.

I'm wondering though if it's necessary to continue with this dosage. I
have been doing more reading on Prednisone and long-term therapy may do more
harm in the long run. I also found this thread on IBD (which describes all
the steps my vet took, so now I'm wondering if I should still seek a 2nd
opinion after this read). Source is a page about IBD from:
http://www.vetinfo4cats.com/cibd.htm...d%20Prednesone

All of Ming's symptoms are described here with the exception of diarrhea.
It is also worth noting that I mentioned before that prior to the beginning
of all this havoc, Ming would regurgitate or vomit after meals, but not all
the types of food he eats. After learning more about IBD, I am becoming
more convinced that he has, all this time, food allergy. That being the
case, I will talk to his vet on Monday and discuss my concern about the
long-term therapeutic use of Prednisone.

_______________________________

Inflammatory Bowel Disease in Cats

Inflammatory bowel disease (IBD) is probably the most common cause of
chronic vomiting or diarrhea in cats under the age of 8 to 10 years. It is
unclear at this time whether this is one condition or several conditions
that appear very much alike. In older cats, hyperthyroidism is also a common
cause of vomiting or regurgitation. This disorder can occur at young ages
but is more common in middle aged and older cats. Many cats do not exhibit
any clinical signs other than chronic vomiting. The vomiting may occur
intermittently and often the cat does not appear to be affected at all other
than vomiting frequently. The cyclic nature of this disease makes it
difficult to evaluate the success of treatment in some cases and causes many
cat owners to put off treatment longer than they should.

While vomiting is the most common clinical sign, diarrhea, weight loss,
depression and behavioral changes can also occur.

This problem must be distinguished from other fairly common causes of
vomiting, including hyperthyroidism, lymphosarcoma, feline heartworm
disease, intestinal parasites, viral illnesses and pancreatic disease.
Testing should be done to rule out these conditions, if possible.

IBD can only be diagnosed accurately from intestinal biopsy samples. The
most common way to biopsy the intestine is through endoscopy. Flexible
endoscopes that can be passed into the intestinal tract are used to
visualize and biopsy the intestine. It is important to rule out the other
possible problems by labwork, if possible, prior to considering intestinal
biopsy. In some cases, it is hard to arrange for biopsy to be done. In this
case, therapeutic trials of anti-inflammatory medications may aid in the
diagnosis.

Once it is established that inflammatory bowel disease is present, there
are several treatment options. Mild cases of IBD tend to respond well to
corticosteroid administration. If caught early, this treatment can eliminate
the problem as a future concern in some cats. In older cats or where the
disease is well established, medication may be necessary lifelong. Other
medications used for this include metronidazole and azathioprine. These
medications can be used in combination in severe cases of IBD.

Some cats may have IBD due to food allergies. It is always a good idea to
consider this possibility and to use a diet free from any ingredients the
cat has previously eaten for a period of several months to be sure that food
allergies are not present. Your vet can help you design a good diet for this
purpose or provide you with commercial foods made to be hypoallergenic.

Curing cats of this condition is not always possible but most will respond
to treatment and be able to live fairly normal lives.

Mike Richards, DVM

Did you leave a message for the vet asking about the possibility of
cancer?

Laura
--
I am Dyslexia of Borg,
Your ass will be laminated.


Hi Laura. Ming has a follow-up on Monday. The vet already told me of a
probable stomach cancer as being the cause of Ming's IBD when I picked him
up last week. That was the last of one of our lengthy conversations; or
better, her best medical judgment given the limitations of what I can and
can't approve for diagnostic exams. She didn't get into the details of the
probable cancer itself; the explanation into that was sketchy though more
was talked about regarding Ming's response to food and medication.

Thinking back now, I must've blocked out cancer as being a primary suspect
even if she did mention it because either I was unwilling to accept the
diagnosis or because I was still stuck with the convinced belief that this
was all caused by his ear flushing procedure. At the very least, my
inattentiveness was also due to the multiplicity of my personal problems at
hand at the same time, i.e. my husband's car accident and how we now do need
a new vehicle (it isn't even an option). At the same time, I was feeling
distraught at my helplessness to make a decision to go for endoscopy (the
vet's next step) or simply "waiting" for a show of improvement with Ming.
And so with all these, the vet knows where we stand. This is why a
discussion of "options" of sorts was never taken into detail. What is
mutually agreed is that my being at such a financial disadvantage could give
way to talks of possible euthanasia in the future ... IF Ming's condition
ever get to that point. That's where she and I left the conversation at
that.

The vet and I will talk about everything on Monday; at least from the
postings and readings that I've drowned myself in, I have a clearer
understanding of the pathophysiology of the possible causes for Ming's
symptoms. I can at least have a better educated talk with her come Monday.
I also have to get from her a copy of his records; lab work, CBC and all.

Thanks so much for everything. I feel your loss; and I feel very
disheartened. Your discourse reminds me to keep an open mind; not to keep
my hopes too high though I know today's a good day for Ming. It's a start.
Tomorrow's another day. Do understand that I feel so bogged down and
overwhelmed by the stark possibilities that I have been dreading to read the
posts lately. But I came here to seek help and I must face all the answers
possible; notwithstanding my limitations in solving this grave problem. You
have all been such a source of tremendous knowledge to me. Thanks again
very, very much to everyone.