Trying not to worry but.... (labs added)

Discussion in 'Feline Health - (The Main Forum)' started by SpotsMom, Nov 15, 2018.

  1. SpotsMom

    SpotsMom Member

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    Feb 10, 2018
    Spot had his regular vet checkup on Tuesday and the vet was very concerned that he's having trouble putting on weight. She thinks that his blood sugars are not out of control enough to cause him to be underweight due to the diabetes, and he is eating more than enough, so there has to be an underlying cause unrelated to the diabetes. We recently transitioned over from FF classics to Food Fur Life raw chicken, and he seems to have a better general disposition about him - but he's hungry all the time despite getting more than double the recommended amount. I think something about the FF may have disagreed with him, but not enough to cause any serious symptoms like vomiting/diarrhea. He does have a history of pancreatitis episodes that usually lead to temporary anorexia, but I make sure he gets enough calories per day via assist feeding if necessary.

    All this is to say he's been eating 12oz+ of food per day for months, so based on the calories he shouldn't be underweight. The vet mentioned GI lymphoma as a possible cause so now I'm freaking out a bit.. does anyone have any experience that says this could be anything else?? Or any experience dealing with GI lymphoma that's not going to scare the crap out of me? :blackeye::(:nailbiting:

    I don't have all his blood work numbers yet, but will add to my spreadsheet as soon as I get them. The only thing she mentioned was an elevated BUN, but not worrisome yet.
     
  2. majandra

    majandra Member

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    Oct 11, 2018
    Every cat is different, but my cat is not gaining weight either at similar numbers.
     
  3. Tuxedo Mom

    Tuxedo Mom Well-Known Member

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  4. SpotsMom

    SpotsMom Member

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    Yes, we ran a T4 this time, and also back in April. I can't speak for this time, since I haven't seen the number yet, but she didn't mention a problem. Back in April he was on the low side of normal with 1.4.
     
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  5. SpotsMom

    SpotsMom Member

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    Blood test results have been added to my spreadsheet on the LABS tab. T4 is still normal at 1.7, and BUN really appears to be the only thing I can see that is off. If anyone has anything else to add I'd greatly appreciate it. Spot is up to 16oz of food per day, still following me around begging all the time, and not really gaining... As a comparision for the raw food, his civvie sister is only getting 5oz per day :(
     
  6. tiffmaxee

    tiffmaxee Well-Known Member

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    Nothing in the labs is the least but alarming to me. Is he acting normal? No lose stool? This is really puzzling.
     
  7. SpotsMom

    SpotsMom Member

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    His stools are perfectly normal. Lower in volume since he switched to raw but I’ve been led to believe that’s normal.

    The only way I can describe the way he acts is manic. He is constantly on the search for something to eat... licking dirty dishes in the kitchen, even licking the bathtub drain... following me around the house meowing all the time. This from a cat who has a history of anorexia and has never been a big eater is just a bit concerning.

    It is puzzling... and that’s what worries me.... the nutrients have to be going somewhere! That’s why the vet mentioned the possibility of GI lymphoma. Still waiting on next steps from the vet but for now she has told me to just feed him as much as he wants.... He’s trying to eat me out of house and home :nailbiting:
     
  8. tiffmaxee

    tiffmaxee Well-Known Member

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    My cat with gi lymphoma had loose stool and projectile vomiting but it was intermediate cell. Her appy was fine. I guess with small cell weight loss is possible even with a voracious appy. My first guess was hyper-t but the thyroid number is good and I presume your vet didn’t feel anything when palpating. Did he suggest an ultrasound? If you get one I’d want it done by a board certified radiologist. It would be checking for thickening. I hope you figure this out soon. :bighug:
     
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  9. SpotsMom

    SpotsMom Member

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    Yes she felt around his neck and didn’t feel anything. Ultrasound was on her list of next steps, so that will probably be coming soon. Spot had an X-ray when first diagnosed with pancreatitis in April and nothing abnormal showed at that time, but I understand ultrasound can show different things.
     
  10. tiffmaxee

    tiffmaxee Well-Known Member

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  11. SpotsMom

    SpotsMom Member

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    She didn’t mention that but I will make a note to ask her. I didn’t realize EPI could present without diarrhea. Thank you for the great article!
     
  12. tiffmaxee

    tiffmaxee Well-Known Member

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    Just checking back to see how it’s going and what your vet said. I hope Spot is doing okay.
     
  13. SpotsMom

    SpotsMom Member

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    No change in Spots appetite but his general disposition is still ok. As I started writing this I heard him in the kitchen sink licking up the water in the pot from dinner and had to run to stop him. And he literally just finished his own dinner. Something is definitely going on with him... I have no idea how his BG numbers are not ridiculously out of control recently with as many times as I’ve caught him cleaning up after me :banghead:

    I did ask the vet about EPI. She seems convinced that he’d have diarrhea or at least a high volume of poop if it was EPI but sent me some info about testing anyway. There is a combined folate, cobalamin & TLI test that we’ll be running as soon as I can make the appointment. Probably early next week.

    Thank you for checking on us. I’ll keep you posted :cat:
     
  14. tiffmaxee

    tiffmaxee Well-Known Member

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  15. Wendy&Neko

    Wendy&Neko Well-Known Member

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    My girl Neko who probably had GI lymphoma, did not present with many symptoms. I say probably on the diagnosis because she had an ultrasound, but could not have an endoscopy or biopsy (gold standard for diagnosis), because her heart could not stand the anesthesia. Neko did a bit of acid vomit periodically, which can be a lymphoma symptom, but she also had chronic kidney disease, which has the same symptom. It did not impact her BG. She was 14 lbs and maintained weight on 4 oz of FoodFurLife raw per day.

    The only reason she had the ultrasound was because she went off her food. Turns out the nausea could have been as a result of the heart disease which was diagnosed at the same time. Anyway, I was sure glad we got the ultrasound done so she could be treated.

    Treatment for GI lymphoma, if’s small cell which is the most common kind, is daily steroid, prednisolone or budesonide, and a chemo pill/capsule which can be dosed once every two weeks. I am on my third kitty with this condition. :rolleyes: I get the steroid compounded into a chew treat so easy to give. The majority of small cell cats can go into remission, often for years.

    Generally eating a lot and not gaining weight is due to unregulated diabetes, HyperT or lymphoma. Is Spot maintaining his weight on that amount of food? One other, but slightly less common version of the unregulated diabetes is acromegaly, a benign pituitary tumour that puts out excess growth hormone, causing them to be hungry all the time.
     
    Last edited: Nov 22, 2018
  16. Larry and Kitties

    Larry and Kitties Well-Known Member

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    What I have read is that budesonide is of no benefit for small-cell intestinal lymphoma. Prednisolone is the steroid used except that some oncologists (like my Mario's) would not prescribe it, only used chlorambucil
     
  17. SpotsMom

    SpotsMom Member

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    Yeah he is just maintaining now on 16oz per day. He is holding steady at 9.4lbs the last 2 times I weighed him (the vet had him at 8.7lbs but I think that’s due to different scales). I calculated the calories last night and he is currently getting 400 calories per day. Which seems enormous to me!

    Spot does the acid vomiting every time he has an empty stomach. In the past I just attributed it to the pancreatitis. And now he just vomited up his mostly undigested breakfast 4 hours later.... and was right back up begging for more food. I’m glad he likes the Food Fur Life because I haven’t had to assist feed since he started on it... but man! I wish he’d take a break from the begging o_O

    He’s going in for a dental in a few weeks also so I’m going to ask the vet to do the ultrasound at that time since he’ll be under already. He is not a good patient so if I can save him having to be forcibly held down that seems like a good thing to me. I just really need to find out what’s going on with him :(
     
  18. membeth

    membeth Member

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    I had similar issues with my kitty Pants -- slow weight loss despite being in remission and eating enough to at least maintain her weight. It turned out to be IBD and EPI with B12 deficiency, not lymphoma.

    Pants never had poop issues, despite the EPI, so it's good that you're getting Spot tested for that. Pants did the barfing but then begging for food thing too. Diet change might also help with figuring it out -- a lot of IBD is caused by food sensitivities. Pants stopped barfing as soon as we switched foods.

    An ultrasound can provide a lot of information, but what I didn't realize is that if it shows something, that isn't always a final answer -- both IBD and lymphoma cause inflammation that shows up on the ultrasound. Pants had obvious inflammation, but then the vet had to take a biopsy to get a more definitive diagnosis, and I wish I had known beforehand that I could end up in suspense longer. I thought the ultrasound was THE test, so I wasn't prepared for more waiting afterwards for another round of tests.
     
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  19. Wendy&Neko

    Wendy&Neko Well-Known Member

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    My Neko was given budesonide because her heart could not tolerate prednisolone. Both her IM vet and her oncologist concur with that. Some IM vets will go with budesonide if kitty is diabetic. Budesonide may not have done as good a job as prednisolone, but it did help reduce Neko's bowel inflammation by about a third in a month so was better than nothing. And it did not impact her blood glucose.
     
  20. membeth

    membeth Member

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    Budesonide is also used to treat inflammation from IBD. While it's less likely than pred to raise a cat's blood sugar, it is possible, and steroid-induced hyperglycemia doesn't always resolve on its own. Budesonide knocked Pants out of remission after a vet told me that couldn't happen. Depending on your cat's particular situation, it may be worth the risk, but it really wasn't for Pants.
     
  21. Larry and Kitties

    Larry and Kitties Well-Known Member

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    Budesonide should help the symptoms but really does not affect the actual lymphoma.
     
  22. SpotsMom

    SpotsMom Member

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    Things seem to have taken a concerning turn. About 15 minutes after his dinner tonight Spot suddenly got very grumpy and then combative with the other animals and humans alike. He occasionally gets cranky with his civvie sister but never with me. I picked him up and he freaked out. Started growling and even screamed when I didn’t put him down soon enough. I realized that his abdomen is swollen and hard and he definitely seems to be in pain. I gave him a double dose of CBD oil, then later when that didn’t seem to work I pulled out the bupe. That at least got him to calm down, even if he is high as a kite.

    Of course it’s the weekend so I can’t get him into his regular vet until Monday, so I’m considering taking him to the emergency vet tomorrow if he doesn’t improve (unless he gets worse!). He ate his dinner with his usual enthusiasm and doesn’t seem lethargic.. just grumpy and painful :blackeye:

    Also I have an appointment scheduled for the fTLI but its not until January... which seemed ok last week when he was stable...
     

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