Questions for those who have experience introducing cats? (old question) July Walnut health update!!!

@SaintsManiac , @theluckyrabbit @mom2rtk @TipsyTraveler


HE POOPED!!!!!!!!!!!!! :banana::banana::banana:


They called and he pooped 2 harder ones overnight, then on his own this morning giant soft ones!!! Hes also eating dry food on his own!!!

Vet said this is a much better outcome than she expected and she is cautiously optimistic. She said much more alert this morning.

We can bring him home today. We aren't getting hopes up, but at least something.


Thanks to everyone who commented, read/liked my posts, offered advice and good wishes, I really appreciate it. :)
That's awesome! So happy to hear the good news!
 
Great news! Now that he is stabilizing, is there a GI vet nearby that can take charge of his case? I know that the shelter I volunteer with has seen so many GI issues and, while I do not know the full medical for Walnut, some of the things that the vets have done seem to go against what our specialists have done.

One thing I would ask your vet about, given Walnut's issues with constipation, is can he go on a stool softener? We have a few cats with constipation issues for various reasons, and we use miralax (actually the over the counter generic) with great success for those cats. The one we use is in a powder form and is sprinkled over wet food twice daily. It has no taste or odor, so there isn't any aversion. Also, given his bouts of constipation, look up mega colon in cats. Just something to be informed about, hoping that it doesn't become an issue, but better prepared than caught unaware, imo.

Enjoy having your boy home!
 
Great news! Now that he is stabilizing, is there a GI vet nearby that can take charge of his case? I know that the shelter I volunteer with has seen so many GI issues and, while I do not know the full medical for Walnut, some of the things that the vets have done seem to go against what our specialists have done.

One thing I would ask your vet about, given Walnut's issues with constipation, is can he go on a stool softener? We have a few cats with constipation issues for various reasons, and we use miralax (actually the over the counter generic) with great success for those cats. The one we use is in a powder form and is sprinkled over wet food twice daily. It has no taste or odor, so there isn't any aversion. Also, given his bouts of constipation, look up mega colon in cats. Just something to be informed about, hoping that it doesn't become an issue, but better prepared than caught unaware, imo.

Enjoy having your boy home!

What have your specialists done can I ask?

He's had two ultrasounds already in past month. One showed inflammation of cecum and pancreas. Started on metro and panacur, switching food to novel protein - venison. Good blood work.
2 weeks later seen by internist and had another ultrasound done - clean. Told to come off all meds. Still doing diet transition. Good blood work.
2 weeks later here we are. Liver values off on blood work. Now on metro, prednisolone, liver cocktail. They think a bunch of things honestly - first inflammation and pancreatitis returned and is affecting liver, then FIP but blood values for that (total protein, a/g ratio) always normal. Now possibly back to triaditis. Possibly taken off initial meds too soon.

He's never been constipated before.
 
Okay, we have various issues at the shelter, ranging from food intolerance requiring limited ingredient/limited protein diets to nerve damage resulting in inability to self eliminate or the opposite- nerve damage requiring assistance eliminating, and nearly everything in between.

It just seems that that has been a lot of jumping from one thing to the next. Again, I'm not in your shoes, but my plotting of your kitty's medical journey read like this (and again, this is my easy synopsis, not what may have actually happened): sick kitty, immediately go on meds, try numerous diets, you are stressed, he is stressed. He doesn't eat well, at some point you mention he is on an appetite stimulant as well as a pain med plus whatever else the vets have prescribed. Pain meds often cause constipation. He gets an enema, requiring sedation, sedation also sometimes causes the GI system to slow down=constipation.

Our vets & specialists tend toward a slower ramp up of or changing of medications/foods. Our cats that do go through a diet restriction or change will change immediately to the new diet and stay on one form of that particular diet (be it protein restriction or ingredient restriction) for a minimum of 2 weeks; if no change, another food is considered, if it goes well, it would be another week or more before either the wet or dry variety of that food would be introduced. And for diet restriction, absolutely no treats or other food than the prescribed diet, because sometimes those treats may have a contaminant from a restricted ingredient/protein. Think of it like a kid with a life threatening peanut allergy; a food that doesn't list peanuts in the ingredients isn't enough, it needs to be made in a peanut free facility.

Instead of quitting the all of the meds, a more studied approach might have been warranted. I read, basically, the vet said he's doing great, stop everything (? again, I may have misread) and a weekish you are back at the vet with Walnut presenting other issues. Plus, have they tried expressing him instead of sedating for enemas? Sedating a cat is pretty taxing on his system, which by all accounts isn't running at full steam. We literally express one or more cats multiple times a day at the shelter and this is something that a trained volunteer can manage and isn't painful to the cat if done properly.

You mention that Walnut was given panacur. That's a dewormer. I don't know why a cat who is experiencing significant medical issues, who does not present with indications of internal parasites, would be dewormed in the middle of this process. It doesn't make sense.

Prednisone can be harsh on cats, but unfortunately is often the only real treatment for some conditions both long and short term. It is broken down in the liver, so the liver levels must be checked routinely. It can also cause lethargy, which you mentioned Walnut was experiencing. It can also cause nausea, which will make a cat disinclined to eat, which when added to the general "I don't feel good, my plumbing is backed up, they keep pushing pills down my throat, sedating me, etc" that Walnut might be feeling would certainly warrant at least a good pitty party/general bought of lethargy if not a general hunger strike (because, lets be honest, Fancy Feast is delicious according to 99% of the cats I know and if he's only getting the bland, diet restriction food that might be reason enough to cause a hunger strike).

So, that's my $0.02 worth. If I were Walnut's person, I would find one really great vet, probably a specialist, to be the go to person for his treatment. Some vets are great at thinking outside the box, some have a very specific treatment formula for each case of IBD, fatty liver, etc, no matter the patient and his reaction to the treatment formula. Those last types are fine vets 99% of the time, but for a perplexing case, you need the vet who will do research on their own time, who will think outside the box and will reach out to their colleagues for help and aren't scared to refer you to someone else.
.
 

Okay, we have various issues at the shelter, ranging from food intolerance requiring limited ingredient/limited protein diets to nerve damage resulting in inability to self eliminate or the opposite- nerve damage requiring assistance eliminating, and nearly everything in between.

It just seems that that has been a lot of jumping from one thing to the next. Again, I'm not in your shoes, but my plotting of your kitty's medical journey read like this (and again, this is my easy synopsis, not what may have actually happened): sick kitty, immediately go on meds, try numerous diets, you are stressed, he is stressed. He doesn't eat well, at some point you mention he is on an appetite stimulant as well as a pain med plus whatever else the vets have prescribed. Pain meds often cause constipation. He gets an enema, requiring sedation, sedation also sometimes causes the GI system to slow down=constipation.

Our vets & specialists tend toward a slower ramp up of or changing of medications/foods. Our cats that do go through a diet restriction or change will change immediately to the new diet and stay on one form of that particular diet (be it protein restriction or ingredient restriction) for a minimum of 2 weeks; if no change, another food is considered, if it goes well, it would be another week or more before either the wet or dry variety of that food would be introduced. And for diet restriction, absolutely no treats or other food than the prescribed diet, because sometimes those treats may have a contaminant from a restricted ingredient/protein. Think of it like a kid with a life threatening peanut allergy; a food that doesn't list peanuts in the ingredients isn't enough, it needs to be made in a peanut free facility.

Instead of quitting the all of the meds, a more studied approach might have been warranted. I read, basically, the vet said he's doing great, stop everything (? again, I may have misread) and a weekish you are back at the vet with Walnut presenting other issues. Plus, have they tried expressing him instead of sedating for enemas? Sedating a cat is pretty taxing on his system, which by all accounts isn't running at full steam. We literally express one or more cats multiple times a day at the shelter and this is something that a trained volunteer can manage and isn't painful to the cat if done properly.

You mention that Walnut was given panacur. That's a dewormer. I don't know why a cat who is experiencing significant medical issues, who does not present with indications of internal parasites, would be dewormed in the middle of this process. It doesn't make sense.

Prednisone can be harsh on cats, but unfortunately is often the only real treatment for some conditions both long and short term. It is broken down in the liver, so the liver levels must be checked routinely. It can also cause lethargy, which you mentioned Walnut was experiencing. It can also cause nausea, which will make a cat disinclined to eat, which when added to the general "I don't feel good, my plumbing is backed up, they keep pushing pills down my throat, sedating me, etc" that Walnut might be feeling would certainly warrant at least a good pitty party/general bought of lethargy if not a general hunger strike (because, lets be honest, Fancy Feast is delicious according to 99% of the cats I know and if he's only getting the bland, diet restriction food that might be reason enough to cause a hunger strike).

So, that's my $0.02 worth. If I were Walnut's person, I would find one really great vet, probably a specialist, to be the go to person for his treatment. Some vets are great at thinking outside the box, some have a very specific treatment formula for each case of IBD, fatty liver, etc, no matter the patient and his reaction to the treatment formula. Those last types are fine vets 99% of the time, but for a perplexing case, you need the vet who will do research on their own time, who will think outside the box and will reach out to their colleagues for help and aren't scared to refer you to someone else.
.

Thank you, I appreciate your input. I'm sure my posts don't make sense as I'm frazzled when posting.

Prednisolone, not prednisone. It's for the general returned (assumed at this point) inflammation. The panacur was for the inflamed cecum on first ultrasound as it's usually caused by something bacterial. Prednisolone was a god-send for Cashew's last few weeks and if that's what Walnut needs to start healing, we are okay with it.

He was never on a pain med until this week when diagnosed with liver inflammation/constipation, so if I wrote that before these last couple updates, that was a mistake.

We were doing a slow food change. He stopped having interest in everything, even old food.

He did not have constipation until this past week. The lethargy/decreased eating started before new meds. He was on nothing until constipation and messed up liver values. Reason we brought in again was decreased eating again, which lead to the new blood work up. The enemas/sedation were only performed this week, after constipation/liver issues diagnosed.

We've been to 3 different vets, the internist is a specialist in GI issues and he's the one who said to stop all meds. Current vet is a cat only hospital and where we feel the most comfortable.

As Walnut's people we are doing the best we can. He does have a complex case (as did his brother that we lost) and they have read up on his brother's charts too. I feel these current vets are doing what they can for him. They really seem to have a vested interest and want him to survive. I wish it was just a case of stress/meds/etc but it's not. He's got issues in his belly and these are the treatments for it. Unfortunately just a diet change isn't going to cut it - for now.

He may only be having a good day, but he's home and seems so much more like his old self. We still may be nearing the end, but so happy to have him with us and happy for even jut a few more days.
bubba2.jpg
 
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I don't think the DIS has been so excited about poop before! Yay, Walnut!

When you mentioned the constipation before, I thought of our kitty. He is also on prednisolone as part of his asthma treatment, and he does suffer from bouts of constipation. Although, we do have some miralax from the vet, we are primarily treating it by adding pumpkin to his diet. I didn't want to mention it when everything was so eminently dire. But if Walnut continues to stabilize, maybe it's worth a mention. Not sure if it's something Walnut can have with his other issues, but our kitty thinks the pumpkin is a special treat which may help with the interest in eating, and provide a positive quality of life moment.
 
Just in case anyone's curious, here's the poor guy's medications! :) And thanks again everyone for all your support. Pet people are the best people.

App meds:
Cyproheptadine tablet - app stimulant - 1/4 tab 2x daily
Ondanestron - only if vomitting

Anti-inflammatory:
Metronidazole - .6 ml 2x daily
Prednisolone tablets - 1.5 tabs once a day

Motility meds:
Cisapride - 1 tab 1-2x a day until defecating regularly

Liver/bile/pancreatic disease meds:
Denamarin - 1 tab daily
Ursodiol - 1/4 daily
Veraflox antibiotic - 2 ml daily

Pain (If needed)
Buprenorphine - currently not needed
 
I sorry you are dealing with this now. My Caboose has surgery last April to remove a foreign object and necrotic tissue in his small intestine. Turned out to be a piece of foam mat, You know the kind you put on a playroom floor to make it flat , but soft. He got into a room with a closed door, and chewed and ate some. All while we were away at Disneyland( we figured it was only a day or so before we got back. We tried the enema, with no luck. Hopefully it works bette for Walnut!
 
I was thinking of you today and worried about Walnut.

I am so happy to hear he is home with you and will continue to send healing vibes to Walnut!

I really hope having him home helps him recover.
 
@SaintsManiac , @theluckyrabbit @mom2rtk @TipsyTraveler


HE POOPED!!!!!!!!!!!!! :banana::banana::banana:


They called and he pooped 2 harder ones overnight, then on his own this morning giant soft ones!!! Hes also eating dry food on his own!!!

Vet said this is a much better outcome than she expected and she is cautiously optimistic. She said much more alert this morning.

We can bring him home today. We aren't getting hopes up, but at least something. IF he does okay this week (no setbacks) we bring him back in 7 days to check liver levels. He's on metronidazole, prednisolone and a cocktail of liver meds. Poor guy. They said if this is triaditis/IBD, he may be one of those cats who will have to be on a low dose of metro or pred for rest of life.


Thanks to everyone who commented, read/liked my posts, offered advice and good wishes, I really appreciate it. :)
Hey, I'm not too proud to be excited about some poop! party:

Great update. Fingers crossed that he continues to make progress.
 
Oh, Farro -- Hooray for poop! LOL -- that just seems so funny to type. Our little guy was on Prednisolone, too -- 3 weeks straight (weaning off very gradually) after he came home from the hospital. Not fun at all, but necessary. And it made his immune system tank -- he caught a nasty URI which put him back in the hospital for observation. But, thankfully, we were able to help him through that without any harsh meds. So glad Walnut is home -- that must feel so good to him! -- and we'll keep praying for him and you! Hang in there!
Our other cat has always had a tendency toward constipation so we put one capsule of psyllium (basically that's unflavored Metamucil) -- NOW brand -- in her wet food every day. Does the trick -- no constipation as long as she gets her probiotic and psyllium daily.
 
One thing I would ask your vet about, given Walnut's issues with constipation, is can he go on a stool softener? We have a few cats with constipation issues for various reasons, and we use miralax (actually the over the counter generic) with great success for those cats. The one we use is in a powder form and is sprinkled over wet food twice daily. It has no taste or odor, so there isn't any aversion. Also, given his bouts of constipation, look up mega colon in cats. Just something to be informed about, hoping that it doesn't become an issue, but better prepared than caught unaware, imo.

Enjoy having your boy home!

This is what I would be thinking too. Our cats have a few drops of lactulose in their food each night because both (but particularly our boy) have had constipation issues and it’s helped immensely.

Twice our boy had extremely bad bouts where there was nothing much going in and nothing coming out. This is TMI but we could actually see how inflamed he was around his butthole. We ended up having to (with rubber gloves!) put a dab of haemorrhoid cream with an anaesthetic in it on him - the first time we did it you could see the look of horror on his face instantly turn into relief. Both times within a day or so he has then done a rock hard poo that must have felt more like laying an egg! It seems to act like a plug and after it comes out he is fine again. We think it was very painful to poop and so reducing the inflammation around and numbing the exit route h

After the second time we decided to take our cats off dry food entirely and he hasn’t had another incident since and it’s now been a couple of years.

Hopefully Walnut continues to improve!
 
Oh, Farro -- Hooray for poop! LOL -- that just seems so funny to type. Our little guy was on Prednisolone, too -- 3 weeks straight (weaning off very gradually) after he came home from the hospital. Not fun at all, but necessary. And it made his immune system tank -- he caught a nasty URI which put him back in the hospital for observation. But, thankfully, we were able to help him through that without any harsh meds. So glad Walnut is home -- that must feel so good to him! -- and we'll keep praying for him and you! Hang in there!
Our other cat has always had a tendency toward constipation so we put one capsule of psyllium (basically that's unflavored Metamucil) -- NOW brand -- in her wet food every day. Does the trick -- no constipation as long as she gets her probiotic and psyllium daily.

He's still not active like he normally is, but he's on so many meds and still treating liver/inflammation so I guess to be expected. Time will tell if he really does improve.

He did have a big soft poop again this morning! (sorry for details) He ate all his dry food overnight. He wasn't especially looking for his wet food as he used to, but we gave him a serving and he ate it all. We also had mixed 1/4 tsp miralax in the wet food. That was before the soft poop, so maybe we will skip that tomorrow? I don't love him being on dry food, but he has to eat to help his liver, so whatever he eats, he eats.

He slept with us all night and woke me up with bites and licking as per normal, so I pretended to be annoyed but secretly was so happy! ❤

Thanks again everyone!
 
He's still not active like he normally is, but he's on so many meds and still treating liver/inflammation so I guess to be expected. Time will tell if he really does improve.

He did have a big soft poop again this morning! (sorry for details) He ate all his dry food overnight. He wasn't especially looking for his wet food as he used to, but we gave him a serving and he ate it all. We also had mixed 1/4 tsp miralax in the wet food. That was before the soft poop, so maybe we will skip that tomorrow? I don't love him being on dry food, but he has to eat to help his liver, so whatever he eats, he eats.

He slept with us all night and woke me up with bites and licking as per normal, so I pretended to be annoyed but secretly was so happy! ❤

Thanks again everyone!
Miralax can be given daily as a preventative measure. A fountain waterer, if you don’t already have one, is a good way to encourage cats to drink more which will help with hydration and constipation. Happy to hear he’s doing so much better. :)
 
Miralax can be given daily as a preventative measure. A fountain waterer, if you don’t already have one, is a good way to encourage cats to drink more which will help with hydration and constipation. Happy to hear he’s doing so much better. :)


We switched to a fountain after my cat had surgery. All 3 are drinking much more and it's nice to have clean water constantly. They were dipping their paws into the big bowl we had. :sad2:
 
This is what we have. There is the water falling from the flower and some gathers on the top to drink from. Very pleased and very well used. And I like it because it's a cute light source at night! :)

Resized_20200208_161736.jpeg
 
I understand that. But we are dealing with life/death at the moment and it doesn't matter if he likes the vet or not, he has to go. Pancreatitis, liver inflammation, constipation and not eating. I don't have the luxury to see if things calm down as he calms down unfortunately.

Farro, I am so very happy to hear that Walnut has finally pooped.

-------

I was never ever suggesting keeping Walnut away from the vet.

Hope he keeps showing improvement.
 












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