3/12 Billie - back from vet - possible IBD or lymphoma, small mass in liver

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Deanna & Billie

Deanna & Billie

Member Since 2014
Yesterday: http://www.felinediabetes.com/FDMB/...7-us-tomorrow-question-about-spec-fpl.134456/

Hello everyone. Billie is at the IM vet. I really like this vet so far. She started with an exam and said that everything on the physical is normal. She did an xray to look for constipation and she said she saw some stool that looks hard, but said she's on the fence about whether or not it's bad enough to be causing the appetite loss and weight loss.

She's going to do an ultrasound and also a b12 test. She said that if we're looking at IBD or lymphoma, an ultrasound may or may not look normal, and a b12 test can give more insight. Has anyone had experience with the b12 test?

They won't do the ultrasound till the afternoon, so poor Billie has to stay at the vet. She was not happy, but she's very brave and very polite. I hope she's okay. She lost another half a pound since her vet visit 9 days ago, which worries me. I guess it makes sense since her appy has been off, but I'm definitely fearing the worst. Constipation would be lovely.

Thank you again for all the vines and support.
 
I don't have an experience with the B12 test, but am sending TONS of vines and prayers for nothing but positive results. We'll be watching for updates - when you have a chance, of course. :bighug::bighug::bighug:
 
B12 deficiency can give a clue as to whether it is an intestinal issue. Did she get insulin this morning? I ask since she won't be eating. Vines and prayers are being sent.
 
Thank you all for the vines and prayers! I gave Billie 0.5u of insulin this morning (a half dose - the vet's recommendation). They said they will keep an eye on her BG while she is there. It made sense to me since even with the full 1u on her low appy days, she has been running high. She usually spikes up from stress too. I hope she's okay...they said she should be done by 4. I contemplated waiting at the Stewart's (ice cream shop/mini mart) down the street all afternoon but then decided that was weird and went home. The vet and tech were really nice and commented on how beautiful and sweet Billie is.
 
I'm sure they will monitor her and for what it's worth I think a half dose was a good idea. No point to skip.
 
Sending more vines for positive results. This is for you Deanna. :bighug::bighug: I hate the waiting.

1/2 dose is usually the recommendation for kitties going for dentals and not eating that morning. I'm sure she'll be fine with them monitoring. When Neko has had dentals, I've asked for what BG values they had (for my records). Just remember to ask what type of meter, in case it's an AlphaTrak.
 
Thank you all so very much for the vines, prayers, and hugs. We are home, finally. The vet was very thorough and gave me a lot of information. I'm also attaching a picture of some of the discharge notes about the ultrasound for anyone who understands the jargon - I'm trying, but I don't know enough to understand the intricacies. Here are the cliff notes...

The vet is suspicious of IBD or lymphoma. The ultrasound showed some inflammation and abnormalities in Billie's small intestine. She wants to wait and see how the b12 test comes back and go from there. They should be back early next week. She said that to properly diagnose either IBD or lymphoma, she would need a biopsy, and based on the location and the lymph nodes involved, she would recommend a surgical biopsy. She thinks that IBD is an allergic disease, and it would make sense with Billie's other issues as an "allergic" cat - asthma, food allergies, flea allergies. I am really hoping for IBD at this point.

Also, there is a "small (1cm) poorly marginated hypoechoic mass lesion" on Billie's liver. I asked if that is something to watch or something to worry about, and the vet said just watch for now because Billie's liver values were all good on her bloodwork last week. Hopefully it is nothing, but it definitely worries me. If we do end up going for a surgical biopsy, the vet would examine that too.

The vet also noted that one of Billie's kidneys is much smaller than the other. She said that could be from past kidney stones or could be a congenital issue, and she didn't seem concerned about that at all since her kidney values were great on her bloodwork.

Question: To address the constipation/hard stool, Billie got fluids, and the vet sent me home with lactulose. I know that most kitties here take Miralax - should I use Miralax instead? I had so many questions for the vet and that was one that I forgot to ask. I did ask if the lactulose would raise BG and she said it shouldn't because of the way it is absorbed.

Aside from all the medical stuff, Billie did great. They said she is one of the best patients they have ever had. She is such a sweet girl. She did not need any sedation for the ultrasound, and she was very nice to everyone all day. I'm glad they like her there - of course, how could they not! She did great in the car on the way home - we got stuck in traffic but she sprawled out in her carrier and looked like she was going to take a nap. As soon as she got home, she dove right into a bowl of FF turkey & giblets, and she ate almost an entire can in one sitting. She was a hungry kitty! She has been back to her bowl to graze a few times as I have been reading over the notes and writing this post. She just jumped up on the bedside table (a favorite hangout spot) to groom her shaved belly.

Thank you again for all of your support. In some ways, I am thankful that Billie is diabetic, because I found this wonderful place. I hope everyone is doing well today...sending lots of vines to the other kitties and beans needing vines.
 

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What a day :bighug:

Wow on such a sweetly behaved kitty. Can I send Vyktor over for lessons, he starts screaming as soon as we get there :oops:

Here's hoping for IBD that you can diet manage.
 
Hi Deanna, we are hoping for the best possible diagnosis and for a condition that is easily manageable. Sending lots of good thoughts for Billie. What a wonderful kitty she is!

Hugs and scritches,

Ella & Rusty
 
As far as a biopsy goes, a really important is question is "Will it change how I treat her?" If not, you may wish not to do it.

I did a biopsy on Spitzer to see if he had IBD or lymphoma. He threw a saddle thrombus (blood clot to his hind legs) within the week, possibly due to the inflammation from whatever causes in his body. I let him go as he had a 50/50 chance of a repeat blood clot within 10 months, no guarantee of recovering limb function, and the possibility of nerve pain from the lack of oxygen to his hind legs.
 
Aw, Billie sounds like the model patient!

I have no lactulose experience, but my civvie, Frankie, gets 1/8tsp generic mirilax BID for her chronic constipation issues, and it helps her tremendously.

It is so hard making decisions for our furbabies....it so hard that they can't talk and tell us how they feel or what they want. BJ brings up a good point about whether or not a biopsy will change how you treat whatever is going on with Billie. Whatever you decide, we are here for you.

I am so thrilled that Billie was a hungry girl when she got home!!!

I couldn't agree more...if Trix weren't diabetic...honestly, after what we've been through this past year...well, I can't imagine it. This place is amazing.

:bighug::bighug::bighug:
 
Dr. Jory on the lymphoma list feels miralax works better even than lactulose and it is better accepted because it has no taste. I mix it in Max's baby food treat after his gel cap. I sent you a PM. I hope it turns out to be IBD.

Without any thickening of the intestines I question whether it would be lymphoma. I wonder if the mass on the liver could simply be a cyst??
 
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Thank you all very much :bighug::bighug::bighug: You are all angels.

I think I will get some Miralax in the morning. I smelled the lactulose, and it is kind of disgusting. It smells like vanilla extract gone wrong. There is no way I can hide it in something, and I don't want to wrestle Billie with a syringe full of yucky stuff tonight. She had a rough day, and she is sleeping comfortably on her favorite couch pillow.

She ate very well tonight - even more since I posted earlier. She is loving the FF, so that is what she'll be getting. I have a thought that if this is IBD and it's based on allergies, I should rotate to a new protein. The allergy vet that we saw a while back said that kitties who are prone to food allergies are likely to develop allergies to their "novel" proteins after a few months when they stop being novel. It's a total guess, but maybe she is starting to react to the rabbit and pork she has been eating. It probably couldn't hurt to switch to a different protein that she hasn't had in a long time. She is favoring chicken and turkey anyway. I'm so glad she is eating.
 
Deanna, haven't posted on your condo before but just wanted to add my prayers and vines into the mix for a good result for Billie, she sounds one sweet little girl.
 
{{{Deanna}}}. I totally understand what you are going through right now. As you may know, I just went through the exact same thing with my Civvie, Harvey. He, too, had to have a surgical biopsy because of the location of the suspicious areas. He came through it like a champ. He does have Lymphoma, and it is being treated with Prednisolone and Chlorambucil (Lukeran). The vet said 50% of kitties with it live up to a year, which means he has a 50% chance of living longer than that. Since he started treatment, he is feeling so much better - eating like a little pig (Pred can increase appetite, although not, unfortunately, always), and he hasn't had the tummy issues that led me to get him checked out. It sounds scary, but it isn't as bad as I thought it would be. So don't despair. Based on my experience, I recommend going for the biopsy if the vet wants to do it.

Sending lots of good vines, prayers and :bighug::bighug::bighug:
 
Thank you for the visits and vines, Tricia and Suki!

@Tricia & Cinco , thank you so much for sharing. I know you have a lot of experience with these issues. I was a bit out of the loop during the beginning of Harvey's journey and didn't know exactly what he went through. I am so glad to hear that he is doing well!! That's wonderful, and reassuring. I found a website where people post stories of their cats' experiences with treatment (can't remember the name but I can look it up later) and a lot of people said that their kitties seemed to feel much better on chemo. I still have my fingers crossed for IBD, but that's all encouraging.

I am at work and didn't have time to post a new condo before I left, but Billie did pretty well with her breakfast and seemed like she felt okay. I tried to give her the lactulose, and she actually licked it up mixed with fortiflora. That was a weird snack because lactulose is bright green and tastes like sugar, but I guess she doesn't mind it. Her BG was bizarre - AMPS 183, +4 106, +5.5 229. She got the lactulose at AMPS. That 106 is her lowest number in maybe two weeks, so I'm thinking the spike at +5.5 could be a freakout bounce? We'll see. I'm nervous to be at work but DBF is going to my place to hang out with Billie for a while, so that's nice.

Thank you again for all the vines!!!
 
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