Help My Cat Be Comfy

July 25, 2017 6:06 PM

Mr. Whiskers has either IBS or Lymphoma. I want the least intrusive way to make him comfortable.

My cat, Mr. Whiskers, has been diagnosed with either IBS or lymphoma via an ultrasound. He lost 1kg in about a month, about 20% of his body weight. He eats and poops, but he's vomiting every couple of days and when he vomits it smells really bad, almost like feces. My wife and I are meeting with our vet on Monday to decide a course of treatment. I really don't want to put him through a biopsy. He's 12 years old and has had a life full of health problems, and we really can't afford the cost. I would like to know if anyone else has been through something similar with their feline friend, and what their course of action was. When I picked him up at the vet today, the vet mentioned that steroids could make him comfortable for a time, but if it's cancer it won't treat it.

posted by vansly to Pets & Animals (19 answers total)

My late darling Russian-blue-like girl sounds similar, especially the foul-smelling vomit. We went through hell, and her snowshoe bro was battling kidney disease. She went to her reward here at home with a house call vet on the Monday of Thanksgiving week. (The 'shoe went to his reward a year ago next week.)

I haven't worked at all in a long time, but I did everything I could, and then some, for them both. Thousands of dollars and much personal care, and laundry. We had her on prednisone and stool softener.

We couldn't get a clear diagnosis, because she was very traumatized and aggressive at the vet. Doing so, and then doing any treatment if it was cancer, would have just made her miserable. (She was one of their top 3 "difficult" patients.) They were both about 16 or 17 or so.

I am so, so sorry. I agree with not treating -- and please don't feel guilty over it! Spoil him.

MeMail any time if you need.
posted by jgirl at 6:30 PM on July 25, 2017 [1 favorite]

One of mine had the same diagnosis (still don't really know which it was) but the prednisone got her turned around with in a few days. No more vomiting/limited diarrhea and her appetite/weight came back. Def. give it a try.
posted by pyro979 at 6:36 PM on July 25, 2017 [1 favorite]

My late female cat had IBS (and cancer, and renal failure...) towards the end of her life. Prednisone helped, as did prescription food.
posted by thomas j wise at 6:54 PM on July 25, 2017 [1 favorite]

My cat had similar symptoms - vomiting nearly every day, weight loss despite eating tons of food and being hungry all the time - and IBD was a suspected cause after an ultrasound. They wanted to do exploratory surgery to figure out what was going on for sure. I switched him to a raw food diet as a last-ditch effort before having the surgery, and within a few days he stopped vomiting all the time and started putting weight back on. I promise you I'm not one of those people who thinks a weird hippie diet can cure all kinds of ailments, but if the alternative is expensive/complicated medical intervention I think a simple change in food is worth a shot.

ETA: Mr. Whiskers is absolutely darling.
posted by kitty teeth at 7:04 PM on July 25, 2017 [6 favorites]

My late cat started with IBS that was actually pancreatic cancer. Prednisone worked really well for nearly a year, and I don't remember it being that expensive. Unfortunately, my cat was 6 years old, so I put him through a lot of awful treatments and made his last months awful before I discovered his IBS was really pancreatic cancer. I completely agree that palliative care is the most humane thing. If there was one treatment I wish I had done at the beginning, it was an ultrasound. That would have shown his cancer.

My vet also tried an anti-emetic that I can't remember the name of. It was liquid, I think, and it worked okay.
posted by gladly at 7:07 PM on July 25, 2017

This is rough; I've recently gone through similar things with my cat. A higher dose of prednisolone seems to be helping a lot, as is a raw diet (in his case, Rad Cat). My vet said that if it turns out to be lymphoma, diagnosable only through surgery, chemo will help extend his life by months to years. So far he's doing much better with the prednisolone, though like you I don't want to put him through a biopsy at his age. The steroids are definitely worth a try.
posted by whistle pig at 7:11 PM on July 25, 2017

Response by poster: Thanks for all of the responses. Mr. Whiskers is our first fur baby and it's hard to see him getting sicker and sicker.

One question about Prednisone: Mr. W. is on clomicalm due to spraying issues that we have not been able to resolve. Did the steroid increase aggressive behaviour in your cat when they were on it?
posted by vansly at 7:28 PM on July 25, 2017

In our case, having had two cats on prednisolone, it does not negatively affect their behavior that we've noticed.
posted by whistle pig at 7:34 PM on July 25, 2017

Ive had two cats with inflammatory bowel disease, and as your vet has already told you, the differential diagnosis is lymphoma - very similar symptoms. The only way to confirm one diagnosis versus the other is colonoscopy with biopsy. Both of my cats went through that, but they were both young, (2 and 4, respectively). There is some evidence that the constant intestinal inflammation of IBD eventually leads to intestinal lymphoma, and one of my IBD boys did end up dying of lymphoma at 12. The good news, if there is such a thing, is that the treatment for both IBD and lymphoma is steroids, which are tolerated very well in cats. Long-term use can have complications, but I wouldn't hesitate in a 12-year old.

If it is lymphoma, steroids can provide really good quality of life for your cat, for up to two years, or maybe even longer if the cancer is not aggressive. But when they stop working, they stop working very suddenly, and the crash is very fast - as in days. So, all in all, it's not a terrible diagnosis, because with the steroids, your cat should have really good quality of life. And then there will be a very fast decline, so no lingering in pain.

Be sure to discuss steroid options with your vet. They range from short-acting, oral predisolone, which you would have to give daily, to intermediate-length Depo Medrol injections, to long-acting dexamethasone injections (which last a couple of weeks).
posted by ereshkigal45 at 10:58 PM on July 25, 2017 [1 favorite]

Cats that have owned us previously have also faced this exact dilemma. We have opted for prednisone to start. The dose most vets recommend is very low. We did not see aggressive behavior. That would be caused by a dose high enough to stimulate muscle growth (that isn't how it works but it's how dopers talk about it). This would NOT be advisible in a situation where cancer cells are growing, so your vet wouldn't go there.

If you can, try to change Mr. W's diet to something hydrolyzed. These foods are available by Rx. Most cats will eat Royal Canin Hydrolized Protein dry food. There are canned versions in duck, venison, and another unusual protein I can't recall. Another option is Purina Pro Plan HA for Cats. This kibble is shaped like grape nuts; older kitties struggle to adapt to it on occassion.

Definitely mix new foods in with the old. For our boys, these hydrolyzed foods were easier to digest whether they had IBD or not.
posted by Kalatraz at 11:06 PM on July 25, 2017

Karl is 18 and has the same diagnosis. It's been a little over a year of predinsone at night, and things have been pretty good. She had a rough weekend a few weeks back and the vet had us up her dose for a few days and gave her subcutaneous fluids and that helped. She's back to her normal self. I wouldn't say the steroid made her more aggressive.
posted by advicepig at 6:21 AM on July 26, 2017

One question about Prednisone: Mr. W. is on clomicalm due to spraying issues that we have not been able to resolve. Did the steroid increase aggressive behaviour in your cat when they were on it?

There was no increase in aggression, but the prednisone made him eat, drink, and urinate more. In his case, that was good because it helped keep his weight stable.
posted by gladly at 6:30 AM on July 26, 2017

> One of mine had the same diagnosis (still don't really know which it was) but the prednisone got her turned around with in a few days.

Same here. We've got him on a restrictive diet (plus tiny additions to make it palatable for him when he gets bored), and he's gaining weight at a pleasing but not excessive rate (our vet weighs him for free every month—we love our vet).

> Did the steroid increase aggressive behaviour in your cat when they were on it?

Nope, not at all.
posted by languagehat at 7:57 AM on July 26, 2017

My cat had IBS. It was not formally diagnosed because -- expensive, but the vet basically said, if you treat this with steroids and gets better, it gets better. If it does not, then it's something else. The pred will be cheap and relatively easy and will improve his quality of life if it's IBD. If it's not, cats tolerate steroids well.

I wish you and your furkid well. <3
posted by Medieval Maven at 9:11 AM on July 26, 2017

We had two cats. One of them had IBD and possibly lymphoma. We took the best care of him that we could. Less than 2 months after we had to euthanize him, our second cat started vomiting and just couldn't stop. Our vet gave him prednisone by injection and that helped for a time.

We were so heartbroken after losing Pookie that we wanted a diagnosis for Pumpkin as quickly as possible. Luckily our vet's ultrasound specialist is excellent and they were able to get a diagnostic needle biopsy right away.

Pumpkin had large cell lymphoma. We were able to treat him and keep him comfortable for about nine months, but the lymphoma was aggressive and would not stay in remission for more than a month. He didn't always feel his best during those months, but he did enjoy being an only cat and getting all the attention. He eventually made it clear that he didn't want any more needles or fussy treatment so we gave him a really good last weekend and then we had him gently euthanized.

It was really expensive and we did not spend nearly as much as many people do. We could afford it at the time. We couldn't afford it now. Knowing what I know now, I would focus on my cat's comfort and let him go when his quality of life deteriorated.
posted by Altomentis at 1:13 PM on July 26, 2017

Response by poster: Thank you for all of the responses. I was pretty despondent after getting the news yesterday, but hearing what other people have dealt with gives me better perspective on what is going on/what could happen.

Mr. W has had food issues for quite a while now, so we already have him on a prescription hydrolyzed protein diet. The vet has made a suggestion of a diet change, which we will follow through with. We've decided to go with steroidal treatment and hope that helps him comfort wise. We are ready to take the final step when that is necessary.
posted by vansly at 1:20 PM on July 26, 2017 [2 favorites]

My cat had the same cancer or IBD diagnosis last year. He lost a ton of weight, wouldn't eat, and started hiding under the bed.

Since he's an older fella, we were not considering putting him through surgery or chemo. Our vet said that a steroid treatment would ease the symptoms for either diagnosis. We did one pill per day and he immediately pepped up and started eating again. It's been a year and he's officially been diagnosed as having kitty IBD. We do one steroid pill every other day and a grain free novel protein (duck) to help ensure he doesn't have flare ups.
posted by forkisbetter at 3:15 PM on July 26, 2017 [2 favorites]

I have had a cat with IBD and a cat with lymphoma (it was a terrible 18 months or so in my house), and in both cases steroid treatment made a significant positive difference. The IBD cat also had diabetes and had a long, slow decline, developing liver failure, but he was 16 at the end. Our cat with lymphoma lived about a month after her diagnosis---we couldn't afford chemo, and she was 10---but her quality of life for most of those weeks was good. She also got subcutaneous fluids at the vet on occasion during that period. Lots of love on her part and ours. When the change came, it was quick and clear.
posted by percolatrix at 12:32 PM on July 27, 2017 [1 favorite]

My previous cat had IBS and pancreatitis. There was a lot of vomiting and diarrhea involved, and he lost weight dramatically. From 19 lbs to 5 lbs over about 18 months. I gave him prednisone orally per day, syringe fed him when he had pancreatitis attacks, but ultimately it became clear that it wasn't a situation from which he would get better. From that point on, I spoiled the everloving shit out of him and when he was not engaged with life anymore (didn't play, no appetite, couldn't climb stairs or furniture, slept a lot and was very logy otherwise), that was his time. He was 11 when he died.

My current herd of cats, adopted as kittens, show many of the same symptoms. (Sigh) They've been on Royal Canin sensitive stomach food since they were little, and the spoiling started immediately, so at least I've improved my method. But where I worked mainly from home when my previous cat was going through this, now I have less disposable income and I'm at an office all day, so my ability to invest in life-extending treatments is considerably reduced. I have pretty much planned that I will do whatever I can feasibly afford without putting a big dent in my financial security, and their time is their time.
posted by Autumnheart at 4:27 PM on July 27, 2017