Category Archives: Elderly Cat Care

Treating My Cat’s Severe IBD and Gastrointestinal Inflammation

In July 2017, my then 17-year-old cat Romeo started presenting with symptoms of vomiting, diarrhea, mild weight loss, and lethargy. Up to this point, Romeo had been a very healthy male cat with no medical issues other than a low-grade heart murmur, one eye infection, periodic dental cleanings, and routine annual checkups to maintain his health. But things were about to change for Romeo and his cat parents.

Concerned that Romeo’s diarrhea and vomiting had become more than just an isolated event, we scheduled an appointment at Four Corners Veterinary Hospital in Concord, our trusted vet who has been highly supportive and a critical partner in managing all of our cat’s health over the years. Romeo’s doctor did a full physical exam—palpating his abdomen—finding some thickening of his intestines. He took Romeo’s blood and ran a blood chemistry profile and urinalysis. Then recommended diagnostic tests—specifically an ultrasound that would rule out things like a GI tract obstruction or abdominal mass, but would provide a detailed examination of Romeo’s internal organs from all different angles, the sizes of the organs, as well as their functioning. An ultrasound evaluates the cat’s liver, spleen, kidneys, gallbladder, lymph nodes, small and large bowels, bladder and pancreas and is able to determine the size, shape and texture of each—revealing any abnormalities, enlargements, masses, fluids, stones, thickening, dilation or if any lesions are present. So we ponied up the $450 dollars (at the time) to get to the bottom of what was going on with Romeo’s gut. 

TREATING MY CAT’S SEVERE IBD AND GASTROINTESTINAL INFLAMMATION

The ultrasound findings were revealing – Romeo had developed immune mediated bowel disease or possible low-grade emergent round cell neoplasia (intestinal lymphoma). His findings also supported the diagnosis of generalized enteropathy, which just refers to any dysfunction of the intestines. With this finding, some damage or defects had occurred to the lining of Romeo’s intestines, allowing proteins and other particles from food to pass through to be absorbed by the bloodstream instead of the intestines. Thus, his extreme diarrhea.

Lymphoma is considered to be the most common cancer in cats, and Siamese cats (which Romeo is half Siamese) are at higher risk of developing lymphoma, and Siamese male cats are predominantly at more risk. Bingo, that was Romeo. So are Oriental pure bred cats. To definitively diagnose whether Romeo indeed had intestinal lymphoma, our vet recommended an intestinal biopsy for a more definitive diagnosis of his GI tract. But since that would require surgery and the ultrasound was already expensive, we accepted not knowing if Romeo had lymphoma at this stage. The results of Romeo’s ultrasound showed that all his organs were otherwise normal and healthy—all were a normal size, shape, and texture, but his bowel width was increased and showed thickening. Since Romeo goes outside (in our fenced-in backyard only), I had also wanted to rule out parasites as a cause of his symptoms. So I had gone ahead and dewormed him with the proper deworming protocol of Drontal (from our vet), then another Drontal 21 days later, to eliminate the most common worms – round, hook and tape worms, so we could rule this out as a cause of his symptoms.

Romeo’s treatment plan at the time included: 

  • The immunosuppressive corticosteroid Prednisolone, AM & PM, for four weeks–tapering down to once a day 
  • A diet of novel protein including duck, venison, or rabbit (dry and wet)—a hypoallergenic diet that contains a protein source that Romeo had never been exposed to before. Another option was a hydrolyzed diet where the protein has been hydrolyzed to make digestion easier
  • Daily probiotics for his wet food
  • Sub-Q fluid therapy to hydrate him – we do ourselves with lactated ringers
  • B12 shots every week for a month, then every other week for a month, then once a month (we do ourselves, it’s much cheaper and easy to learn)

Romeo did very well for one year and responded very well to his treatment, which was adequate to control his disease at the time. But since IBD is not curable, and symptoms can and do return—a year later Romeo’s symptoms came back. Now Romeo was 18 years old, and his symptoms had returned and started to become severe again. So we put Romeo back on the corticosteroid Prednisolone—twice a day, then slowly tapering down to once a day again. But weeks later, when we tried to reduce the Prednisolone to one time a day only, his diarrhea returned. So our vet recommended that Romeo stay on the Pred once a day long-term, which was successful in managing his symptoms again for another year. 

TREATING MY CAT’S SEVERE IBD AND GASTROINTESTINAL INFLAMMATION

Now it’s February 2019, and Romeo is 19 years old and his diarrhea has returned again with a vengeance—multiple times a day—and clearly the Prednisolone still given once a day is no longer enough. By this time, Romeo had also lost almost two pounds slowly over the past 1-2 years, and he was showing dramatic signs of becoming physically weaker, slower and more cautious. My once sprightly, energetic, active, vigorous, adventurous cat—was starting to show his old age and to slow down. Now, it was time to return to our veterinarian for another routine checkup and blood panel to see what had changed and where his disease was.

It turned out, this time, Romeo was mildly anemic, which was causing weakness and vomiting; and he had a suspected ulcer (some blood in his stool), a bacterial infection in his gut, and he had chronic low-grade inflammation. Wow, it was a lot to hear and I was feeling somewhat overwhelmed. Romeo was just one of many cats that I take care of every day.

Following this diagnosis, in March 2019. we started Romeo on Metronidazole—for the first time—an antibiotic-antibacterial medication for bacterial infections. He gave him a prescription of quarter tablet in the AM and one in the PM, for three weeks, then down to one ¼ pill only in the evenings. We bumped up Romeo’s B12 shots to every week again, and returned to giving him a novel protein diet in both his wet and dry food (rabbit, duck and venison), in addition to sub-Q fluid therapy to keep him hydrated. Plus to treat his gastric ulcer, our vet recommended Sucralfate, a medication that gets mixed with water into a slurry, and is drawn up in a syringe, then dripped into his mouth, morning and night, for two weeks. Again, Romeo’s symptoms subsided for a few months. 

Then five months later, in July 2019, Romeo started having a very bad flare-up again. So he is now back on the Metronidazole two times a day, and may need to stay on this drug twice-daily long-term, but our goal would be to reduce the drug back to one time a day. He is now less responsive to the Metronidazole than he first was, so his disease is clearly worsening. To calm his digestive tract, for the next couple of weeks, this will be Romeo’s treatment plan, and may continue long term, we will see:

Romeo’s treatment regimen is now the following:

  • Boiled white chicken and turkey breast (It is not an adequate diet for cats on its own, as all cooked muscle meats must be supplemented with Taurine and vitamins that cat’s need, so you can supplement the cooked meat with a nutritionally complete powder called EZComplete that can be added to your cooked meat. EZComplete is complete with all the necessary vitamins, minerals and taurine that cat’s need, see www.foodfurlife.com) Taurine is critical in a cat’s diet daily, here’s why. Here is more about how to add Taurine to your cat’s raw or home cooked meat diet.
  • Add this probiotic, S. Boulardii by Jarrow (on Amazon), to your cooked meat, one powdered capsule per meat serving. S. Boulardii is the best natural anti-diarrheal. Here’s why.
  • Add this probiotic with 25 beneficial bacteria strains – Nexabiotic Probiotic For Cats from Amazon (which has the S. Boulardii strain but not as much as the single full strain by Jarrow) to wet food every day. As an alternative you can use Dr. Mercola Complete Probiotics for Pets.
  • Every once in awhile, I use Gerber’s baby food, as an alternative to cooked turkey or chicken, again mixed with a nutritionally complete powder such as EZComplete – by www.foodfurlife.com – or another brand that has the nutritionally necessary vitamins cat’s need.
  • Give B12 shot every two weeks (we administer ourselves, learned from our vet how to administer sub-Q injections)
  • Give Metronidazole (1/4 of a 250 mg tablet) – AM and PM now until the diarrhea stops, which it has, so Romeo is now getting this 1x per day.
  • Prednisolone steroid – 1 pill every PM
  • Fluid therapy given 1-2 times per week (lactated ringers 1000 ml) to maintain adequate hydration. But there is ample hydration in his wet food every day as well.
  • The Assisi Loop for healing and pain management, see the video https://youtu.be/6oHkLHPb-_I
  • Digestive enzymes are recommended, but we are still researching to find the best brand for cats only
  • You can mix cooked meat (chicken or turkey) with Bone Broth (no sodium, no salt) and diluted with some water – but not necessary if you are using EZComplete by Food Fur Life, that has all the necessary vitamins and minerals that cat’s need mixed in with their cooked meat.

A week later, Romeo’s stools are starting to firm up, his diarrhea is gradually dissipating, but it has taken longer this time for his diarrhea to stop. Earlier, he was so sensitive and responsive to the Metronidazole, but not any longer. The change to boiled chicken/turkey 1-2 times per day is really helping—Romeo loves it, he is lapping it up with fury—and is eating more food as a result. But best of all, the addition of the S. Boulardii probiotic by Jarrow and Nexabiotic probiotic has made a huge difference. And importantly, going forward, I have added the necessary essential vitamins and minerals with the EZComplete powder for cats by FoodFurLife, so that his homemade cooked meats are a complete and balanced diet based on the prey model. Plus it contains no fillers, no additives, no thickeners, no flow agents, and no preservatives, that would set off his gut again, and ensures he gets enough Taurine. This is an easily digestible diet, and I can alternate with his novel protein cat food for variation. The diet therapy part of treating IBD is so critical and cannot be underestimated in controlling and managing this disease, because otherwise, we are only putting a bandaid on the problem with anti-inflammatory and immunosuppressive medications, that aren’t healing the disease.

TREATING MY CAT’S SEVERE IBD AND GASTROINTESTINAL INFLAMMATION

Our last and final treatment plan down the road for Romeo’s Inflammatory Bowel Disease will be to try the Immunosuppressive chemotherapy drug – Chlorambucil (Leukeran®) next, if necessary. This will come when Romeo is no longer responding to his current treatment plan of Prednisolone and Metronidazole. Chlorambucil is usually used in conjunction with corticosteroids for cats with severe IBD and the side effects are minimal, except for causing severe bone marrow suppression. So Romeo would have to be closely monitored at that point by our vet. But at his age, and at his stage of the disease, what choice is there? At least he could continue to live longer, be relatively symptom free, and enjoy more of his life and the things he loves—until the day when maybe none of this will be enough for his tired body. But I don’t have to think about that now. I’m focused on today. One day at a time they say.

Since IBD cannot be cured, the goal is to manage it by minimizing symptoms, managing the discomfort, and addressing the recurrences as they arise, quickly, and giving Romeo a simple, bland diet that will not trigger his gut. To all those who have IBD cats, I hope by sharing this with you, it helps you.

Here’s to a long, happy, healthy life for all the cats with IBD or other gastrointestinal diseases—and to the cat parents who are dealing with this disease and treating them. I wish you the very best.

TREATING MY CAT’S SEVERE IBD AND GASTROINTESTINAL INFLAMMATION

The Diagnosis of Malignant Melanoma In My Cat 

My 15+ year old rescue cat Marcello was always the picture of perfect health. He passed his annual routine checkups with flying colors every year and only needed two dentals in the 12 years he lived with us. No sniffles, no sneezing, no coughing, no viruses, no infections. He could not have been an easier cat to care for. Until he started peeing outside the litter box. That’s when things started to change. That was a year and a half ago. 

Marcello lived with three other rescue cats upstairs on our second floor. He would have been very happy as an only-cat, but unfortunately that was not his destiny as I was in cat rescue, and was actively trapping abandoned cats in our community, bringing them home to foster, medically treat, and socialize, before putting them up for adoption with my cat rescue organization. One by one, there was always a new rescue cat that Marcello had to put up with. He hated the competition for attention and would even punish and bully each cat for stealing affection away from him. He was a one-woman cat and that had to be understood by any new resident cat who came to share his home–those were Marcello’s ground rules and he strictly enforced them.

A Tribute to My Beloved, Beautiful Cat Marcello

Marcello himself had been abandoned. Someone who owned him in his early years had left him behind and moved away, leaving him to fend for himself outdoors. Marcello survived, but he had been in his share of cat fights and had the scars and torn ears to prove it. But his real wounds were all on the inside—his trust in people had been deeply injured and his confidence in people shaken to the core. During the first two months of Marcello’s healing with us, he feared being abandoned again. Every time I came to visit him in his room, he completely let his guard down and would wrap, twist and curl his body all around me, then head-butt me over and over again, all with a big orange tail flared out like a bottle brush. But when I would get up to leave, Marcello would attack me like a police dog—and bite my ankles with a vengeance and leave me a bloody mess. That fear of abandonment slowly dissipated over time as he came to trust and realize that he was safe with us. In short order, Marcello became one of the most affectionate, loving cats I have ever come to know. He was a cuddle bug who loved nothing more than being stroked, rubbed, petted, caressed and loved every minute I could give him. 

Continue reading The Diagnosis of Malignant Melanoma In My Cat 

How to Provide the Best Care for Your Senior Cat

Getting older is a normal, natural part of life for all of us. Today domestic cats are living longer than they ever did in the past—thanks to improved nutrition and better food, improved medical care, and more people keeping their cats indoors. But advancing age does not necessarily mean automatic degeneration. And aging does not necessarily mean inevitable disease. Many cats do grow old remaining relatively healthy into their geriatric years, while other cats in their senior years develop chronic or degenerative diseases. And know that even cats that do develop chronic diseases can live well into their late geriatric years—or 20+ years old—given excellent care and attention.

Never assume that changes in your older cat are simply due to “old age,” then write it off as normal aging for them. Most likely there is an underlying medical condition that is causing the changes you are observing in your cat’s behavior or physical appearance. That should always be the first consideration. The main thing is to give your cat the healthiest and best quality of life possible—by watching them closely, noticing any changes that take place, then getting them to a veterinarian to get the medical help they need.

How to Provide the Best Care for Your Senior Cat

Cats age much faster than humans, and they hide illness and pain very well, plus they aren’t able to tell us when and where something hurts, or if they feel sick, or when they want to see a doctor. So it’s up to us to pay attention, pick up on the early signs that something is wrong and is changing for them, and get them to a vet for help.

Continue reading How to Provide the Best Care for Your Senior Cat

The Importance of Annual Physical Exams for Cats

Maybe you adopted a new cat or have had your cat for years now—in either case annual physical exams are highly recommended for maintaining the optimal health of your cat. Your cat may be low-maintenance, but that’s no reason not to take them for a wellness exam every year. This article will highlight the reasons why annual physical exams for cats are so important, how annual checkups can prevent and detect disease as early as possible, reduce factors that may be health risks,  correct or delay the progression of disease, and help to give your cat the healthiest, highest quality of life possible for as long as possible.

Cats mask when they are sick or feel bad—they can hide suffering and pain very well, it’s an evolutionary trait—so you may not know they are suffering or are in pain. And just because your cat lives indoors doesn’t mean they can’t get sick or develop a congenital or chronic disease, or a bacterial or viral infection, or severe tooth decay and gum disease, or inflammation that causes health issues, or a possible stress-related illness. All of these are very possible health issues for indoor-only cats.

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Medicating and Pilling Cats – How to Make it Easier, Safer and Healthier for Your Cat 

If you have a cat at home chances are really good that sometime in your cat’s lifetime you will need to medicate them, especially as they transition into their senior years. Sometimes cats can be challenging to pill or medicate, but there are some techniques that will make medicating them easier, less stressful, more effective and healthier for them. Here are some important things to know and follow when medicating your cat.

Why Dry Pilling and Dry Swallowing is Bad For Cats

Have you ever taken a pill without water? Ouch, it’s not fun. Well the same goes for cats. Without chasing a pill down with water or liquid afterwards the pill can get lodged in the throat and irritate the lining of the esophagus. Dry swallowing can cause a pill to go down painfully and slowly, and can even damage the delicate tissues lining the esophagus. Dry pilling can cause choking, gagging, reflux, heartburn, esophagitis, esophageal injury and strictures, and even cause aspiration. There have been case studies where dry pilling certain medications (including Clindamycin and Doxycycline) have resulted in severe injury to cats and in some cases, even death when these cats were dry pilled. One study noted that “After five minutes 84 percent of capsules and 64 percent of tablets are still sitting in the esophagus,” when dry swallowed. (Journal of Feline Medicine and Surgery, Volume 8, Issue 6, Dec. 2006: 412-419) Another study that appeared in a veterinary journal found that following dry swallows, “No pills were in the stomach at 30 and 60 seconds, and only 6 percent of the pills were in the stomach at 90 seconds. At 5 minutes, only 36 percent of the pills were in the stomach. For wet swallows that were followed by 6 ccs of water, 90 percent of the pills were in the stomach.” (Journal of Western Internal Medicine, 2001, Sept-Oct: 15: 467-70)

Continue reading Medicating and Pilling Cats – How to Make it Easier, Safer and Healthier for Your Cat 

The Dreaded “H” Word – Treating Hyperthyroid Disease in Cats

Hyperthyroid disease in cats is very treatable and manageable, and though I had always feared being told one of my cats has “hyperthyroid disease,” I have found that it isn’t the dreaded word or disease that I thought it would be.

Hyperthyroidism in Cats
Beautiful, blind Godiva

Godiva was our first cat diagnosed with hyperthyroidism.  She’s a beautiful blind chocolate Persian who as a kitten, was taken to our local animal shelter where she was adopted by a volunteer. But at five years old she was given up again, and found her way to our rescue group where we became her foster parents. When Godiva was never adopted, we adopted her ourselves and have found her to be a courageous, determined blind girl that navigates our house beautifully, despite her blindness and many cat “obstacles.”

Continue reading The Dreaded “H” Word – Treating Hyperthyroid Disease in Cats

Cat Hospice Care Has Prolonged Our Cat’s Life

The decision to give cat hospice care to our cat Pumpkin has prolonged her life significantly. Now a year and half later after almost euthanizing her, she’s still alive and still enjoying life. Today she’s going to our vet for a checkup to see where her general health is and to understand if we need to make any adjustments to her medical regimen.

I wrote about Pumpkin over a year ago when our vet had recommended euthanizing her to relieve her obvious pain and suffering. She had declined quickly, had lost a significant amount of weight, and was diagnosed with possible lymphoma. But I wasn’t ready to make that decision to end her life and wanted to give Pumpkin another chance, so we worked with our vet to create a palliative care plan for her that would make her as comfortable as possible, address her symptoms, and possibly extend her life. Continue reading Cat Hospice Care Has Prolonged Our Cat’s Life

Cat Hospice Care Extends Senior Cat’s Quality of Life

Sometimes miracles do truly happen. Or maybe they are simply second chances. My cat Pumpkin definitely got her second chance with giving her daily hospice care, which is keeping her alive and comfortable. Here’s her story.

Cat Hospice Care Extends Senior Cat's Quality of Life
Pumpkin Lived 1.5 Years Longer with Hospice Care

 

When I last wrote about her in November 2012, she was literally on death’s doorstep. Although she is a 19-year-old cat, she had previously been very healthy up to last year. She rarely had anything but “annual” or “bi-annual” routine vet visits. But early last year, we noticed her mouth smelled and learned she had Stomatitis, which was followed by dental surgery to remove several teeth, and she was put on the steroid Prednisilone to treat the Stomatitis inflammation. Continue reading Cat Hospice Care Extends Senior Cat’s Quality of Life

Caring For Our Dying Cat in His Last Moments

Caring For Our Dying Cat in His Last Moments
Our Last Days With Red

Our sweet, darling Red passed away almost four months ago to this day, the day after Christmas. We cared for him up to his last moments, and honored his death with his cat friends and proper burial in our backyard.

I wanted to honor our beautiful Red by writing about him and sharing his story of survival, challenge, and incredible transformation. Red touched us everyday of his life with his beautiful soul, his profound courage, his hard earned trust, and his huge heart and unending love. I believe we were meant to find each other on that fateful day thirteen years ago, and I’m forever grateful for crossing paths with Red and having the honor of knowing him and sharing every day of his life since. Continue reading Caring For Our Dying Cat in His Last Moments

Making An End of Life Decision for Your Cat

For the first time, I’m faced with making an end of life decision for one of my cats. Though I knew this time would eventually come, I always felt it was far off in the future and I didn’t need to think about it. But suddenly that time has come with my cat Pumpkin and I’m forced to examine what the best, kindest, and most loving path is for my terminally sick but beautiful 18-year-old cat Pumpkin—to let her die a natural death at home with pain-killers or euthanize her.

Some backstory: About two years ago, my once sprightly, independent “Princess Pumpeedo” (my friend’s nickname for her) started showing signs of slowing down. She was my first rescue cat in 1998. She had been living outside of my apartment in the parking lot for almost a year, living under parked cars where she hid from the constant rain and weather. I fell in love with her the day I set eyes on her. Continue reading Making An End of Life Decision for Your Cat