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IBD and Slippery Elm

Discussion in 'Cat Health and Nutrition' started by DrummerCat, Nov 8, 2020.


  1. DrummerCat

    DrummerCat PetForums Newbie

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    I hope someone is able to help.

    Our cat (male 11) has had IBD for a while (longer than we probably realised). To give a history, he has been having B12 supplements for around 7 years, but recently (March) dropped a lot of weight and his vomiting increased.
    We had lots of tests and biopsies done. Other than cutting him open and testing for cancer in his intestines (something g we do does we didn’t want to put him through) we (and our vet) decided to treat him for IBD with an exclusion diet.
    He was given Purina One’s hydrolysed dry food. He didn’t like it. He dropped more weight so we put him on a novel protein wet food (kangaroo) which he loves and has been eating happily for several months. His vomiting was better, but he was still dropping weight so we decided to try him on prednisone which he had twice a day for two months. We then dropped the dose to 1 a day (5mg). As soon as we reduced his dosage he went rapidly downhill. Last week he had dreadful diarrhoea and was prescribed a probiotic which stopped that, but he is now so weak, he has trouble standing for any amount of time and today, I really almost called the emergency vet to have him put to sleep as I am worried he’s in pain. I must note here that his intestines are quite distended - as he is so thin his tummy sticks out a lot and I know that this can make it harder for him to lie down in a comfortable position. He’s still eating and drinking, but perhaps not as much as usual (sometimes a sign that he is getting ready to vomit).
    I then came here and read about slippery elm bark. I have got some from Holland and Barrett (the only option on a Sunday during lockdown) and would like to try it. The capsules are 370mg.
    Can someone please recommend how much we can feed to him? I am happy to feed at times around his medication too in order to not prevent the prednisone from working.
    If anyone can also offer advice or help, I would appreciate it so much. He’s a wonderful little cat and I want to do anything to help him. If we can get his weight up and strength back a bit, I know we can give him a fighting chance. Can we increase the dose of his prednisone again to see if we can just get him back in his feet that way?
    Thanks all. Sending love and hugs.
    Jx
     
  2. Douglas’ Dad

    Douglas’ Dad PetForums Senior

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    Awww I’m so sorry to hear about your poor boy. I’ve used slippery elm myself for when I’ve had tummy upsets. I can vouch for it 100%. It’s an amazing natural remedy which has been used safely for hundreds of years in humans. Please make sure the version you get has no fillers. Just 100% slippery elm. Ideally you are supposed to take it first thing in the morning and last thing at night (away from food) as then it can coat the gut lining unimpeded but I’m not sure you will manage to dose your cat like that as they are hard to medicate at the best of times.
     
  3. chillminx

    chillminx PetForums VIP

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    Hello @DrummerCat and welcome :)

    I am very sorry to hear your poor cat is unwell with IBD.

    I am alarmed to hear he is so weak now that he has trouble standing and really I would look at this as an emergency and contact the vet to have him admitted for IV fluids and treatment.

    A possible cause of his weakness is dehydration if he is not eating much, unless he is compensating by drinking large quantities of water.

    Or it could be that he is in a lot of pain. IBD flare-ups can be very painful. Has the vet prescribed pain relief for you to give him? If not then I would take him to the Out of Hours vet today for a pain relieving injection.

    It is good he liked the Kangaroo (was it the Catz Fine Food Purr one?) but maybe try and give him more variety in his diet. Eating just one type of food for more than a few weeks seems to set off flare-ups in my own cat who has IBD. He is better if he has at least 2 foods in his diet, which I rotate from day to day.

    Will your boy eat any home cooked meats? Or white fish? As he is prone to diarrhoea and underweight he needs some high protein foods.

    I also give my boy 5 mg of Famotidine a day when he is unwell. Has the vet prescribed this for your cat?

    You mentioned that biopsies have been done of his intestines - was anything abnormal found? Such as thickening of the intestines, or scarring? If a biopsy was done they would have checked for lymphoma, and if nothing was found and the scan found nothing either then it sounds as though he does not have cancer.

    If possible it would be good to get him off the prednisolone, because it causes insulin resistance and can trigger Diabetes Mellitus (DM) If he were to get DM it would mean he could never have prednisolone again.

    Could you tell me more about what diets you have tried for your boy? At only 11 yrs old he should have some good years of life left if we can sort out his diet for him. x

    Honestly I would try and get his condition more stable before you try the Slippery Elm Bark.
     
  4. Douglas’ Dad

    Douglas’ Dad PetForums Senior

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    I’m afraid I can’t recommend dosing for cats as I don’t know but as with any supplements you start low and check for adverse reaction. Have you considered psyllium husk? It can work well in cases of diarrhoea and improves gut flora.
     
  5. Douglas’ Dad

    Douglas’ Dad PetForums Senior

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    Yes I was thinking dehydration too. Bone broth would be excellent here as well as helping to heal the gut.
     
  6. chillminx

    chillminx PetForums VIP

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    I would be very cautious of using psyllium husk for managing IBD. But anyway not in the middle of a flare up when the gut needs calming down and soothing.
     
  7. DrummerCat

    DrummerCat PetForums Newbie

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    Thank you all for your advice.
    Sadly, although our vet has been great in the past, with lockdown and covid, we’ve found it much harder to get appointments for him.
    The only thing he’s been prescribed is the preds. He is eating and drinking. I don’t think he’s dehydrated. Unfortunately my husband and I are self-isolating too, my daughter has covid, so getting him the the emergency vet today could be difficult. I don’t have a car and my husband’s truck is at work because he came home on the train the day before we found out we have to self-isolate).
    We are allowed to go out from tomorrow though so I will book him an appointment for first thing in the morning and see what we can do to help him.
    He is still eating the prescribed dry biscuits and the kangaroo (he, it’s the Katz one) and this week I’ve been cooking him chicken breast (poached) - he has eaten three breasts on top of other food this weekend. We feed him little and often.
    I forgot to mention that he twisted his leg on weds (he got a claw tangled) and this hasn’t helped with his walking and standing.
    The biopsies that he had (liver etc) all came back clear for lymphoma, but the intestine biopsy was inconclusive as the cells they were able to get with a needle weren’t a great enough quantity to test. As mentioned, the vet said that they could operate to cut him open and. Obtain cells that way, but we didn’t want to put him through that.
    His intestines are very distended / you can feel them. They are thickened.
    I am happy to wait on the SEB until I’ve spoken to the vet tomorrow. I will also try calling the emergency vet and seeing if they can advise on the phone.
    Drummer also has acute kidney disease, I’m not sure if that affects the drugs he’s been offered.
    Thanks again.
    Jx
     
  8. DrummerCat

    DrummerCat PetForums Newbie

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    Duplicate
     
  9. Douglas’ Dad

    Douglas’ Dad PetForums Senior

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    Oh dear poor Drummer. His immune system must be taking a hammering.
    Agreed - psyllium husk may be too aggressive in a compromised cat. I don't think there is any harm in slippery elm as a form of symptom control though. As IBD is inflammatory, bringing down the inflammation is key and slippery elm is good at that. My cousin had stomach cancer, brought on by aggressive IBD, and the one thing which gave him relief during a very difficult time was slippery elm. It doesn't cure of course but it pacifies and allows other treatments to be more effective.

    @DrummerCat I am so sorry he twisted his paw - poor thing. He really has been through the wars. If it's any consolation, vets everywhere aren't being too responsive during lockdown. They seem to be struggling too. Try calling them first thing in the morning or last thing during the day - that's when they are usually not occupied with surgical treatments or interventions. Have you tried serrapeptase? It might be a better alternative to preds. There is a pet version but the human version is more or less the same thing.
     
    #9 Douglas’ Dad, Nov 8, 2020
    Last edited: Nov 8, 2020
  10. Douglas’ Dad

    Douglas’ Dad PetForums Senior

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  11. chillminx

    chillminx PetForums VIP

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    @DrummerCat - Drummer has acute kidney disease? What is the cause and what treatment is he having for it? Most kidney disease in older cats is chronic (CKD)

    Acute kidney. disease develops suddenly, over a matter of days or weeks. It can happen in a cat of any age and is usually caused by ---

    1/ Ingesting a poison such as lilies or antifreeze

    2/ Trauma, especially involving a broken pelvis or ruptured bladder

    3/ Shock from sudden loss of a lot of blood

    4/ Infection in the kidneys

    5/ Blockages

    6/ Heart failure with low blood pressure, [which reduces blood flow to the kidneys]

    EDIT - any kidney disease {acute or chronic} will mean he can't have Metacam for pain relief but there are other pain relieving drugs the vet can prescribe safely. If he has hurt his claw or leg he most likely needs some pain relief urgently. It may be the pain that is making him feel so rough. Cats are very good at hiding pain, so when it does show it must be pretty bad.
     
    #11 chillminx, Nov 8, 2020
    Last edited: Nov 8, 2020
  12. DrummerCat

    DrummerCat PetForums Newbie

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    Hi @chillminx.

    Apologies.its chronic kidney disease. We lost a cat in may to acute kidney disease, I was muddling the two. He has no medication for this.

    drummer’s diagnosis in July was:

    • Protein losing enteropathy (chronic enteropathy versus lymphoma)
    • Chronic kidney disease

    This is the problem list:

    • Chronic vomiting
    • Mild panhypoproteinemia
    • Previously documented hypocobalaminemia (normalised post supplementation)
    • Marked diffuse thickening of the small intestinal muscular layer
    • Mild jejunal lymphadenopathy
    • Minimal peritoneal effusion
    • Mild splenomegaly
    • Possible isosthenuria (urine SG 1.010) – needs to be re-checked
    • Equivocal proteinuria (UPC 0.28, ref: <0.2)
    • Bilateral renal infarcts and bilateral changes consistent with chronic kidney disease
    • Mild pyelectasia of the left renal pelvis.

    Drummer is also blind. He didn’t have a great start in life genetically - his parent are brother and sister. We took him on when he was 1 with his parents as rescue cats.

    We have fed him some turkey breast this afternoon and have also cooked some duck. He has eaten the turkey and has been drinking regularly.

    Our vet practice opens at 08:30. As we are allowed to leave the house tomorrow it will make it much easier to get him to the vet if we need to take him. If not, I am hoping the vet will prescribe some painkillers and other things that I can collect.

    Thank you all for your support, I really appreciate all the help.

    jx
     
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  13. chillminx

    chillminx PetForums VIP

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    Poor Drummer, he has a lot of things to contend with, bless him. I am so glad you were able to adopt him and give him the best possible life. x

    He sounds a little better as he has eaten some turkey. And I am glad he is drinking regularly.

    It will be good if the vet is willing to prescribe some pain relief for his injured leg. It may be that which is causing him to be wobbly on his feet.

    Please keep us updated. :)
     
    #13 chillminx, Nov 8, 2020
    Last edited: Nov 14, 2020
  14. DrummerCat

    DrummerCat PetForums Newbie

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    thank you so much - all of you, I will let you know how we get on over the next 24 hours. Please keep everything crossed for him. He’s a wonderful little critter.

    jx
     
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  15. Douglas’ Dad

    Douglas’ Dad PetForums Senior

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    Turkey has tryptophan which will for sure improve his mood. I definitely agree with pain relief. There are alternatives to Metacam. Pain, stress and inflammation form a horrible negative feedback loop which you want to break.
     
  16. lillytheunicorn

    lillytheunicorn PetForums VIP

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    Can he lift his head into the normal position? I only ask as Blue had hypokalemia after a nasty bout of campylobacter which caused chronic nasty diarrhoea. Which is low potassium, this was corrected by IV fluids with electrolytes.

    I would be worried with his severe diarrhoea that he is dehydrated, cats are rather good at this.
    If you feel his gums do they feel tacky and if you pinch his skin does it instantly retract? If is gums feel tacky or his skin does not instantly retract he is dehydrated, the emergency vet should still see you. They should have provisions in place to treat him even if you are isolating. If they won’t then make up some oral rehydration solution https://rehydrate.org/solutions/homemade.htm and ask them to calculate how much you should be giving him to correct his dehydration.
     
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  17. DrummerCat

    DrummerCat PetForums Newbie

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    Hi all.

    Thank you, again, for all the help you’ve offered.

    I spoke to the vet. As Drummer’s condition plummeted when we reduced the preds, we have decided to go back to 2 tablets a day. I have also collected some more probiotic paste and some tagmet syrup for him, all of which we managed to get into him yesterday.

    I have been cooking turkey breast and white fish for him and he is definitely picking up and enjoying the new foods with no side-effects so far. His stools are more solid again and he is spending more time up and around. He is using his litter tray, cleaning himself more and is a little less wobbly. He did have another incident yesterday when he caught his claw in my jeans as he tried to get off my knee and I think he twisted his leg again, but he’s not limping today so I’m hoping he’s starting to feel better.

    He is drinking as usual too. I’ll wait for a couple more days and then try the SEB to see if that boosts him and helps with pain and diarrhoea.

    As Drummer has been eating the Catz kangaroo for several months and @chillminx has suggested him with other proteins, can someone recommend some food we can try? I checked on Zooplus and they only have the kangaroo or chicken variety of the Catz Purrrrr and as drummer has eaten a lot of chicken in the past, I would prefer to avoid that flavour.

    Thank you again for everything. I feel like we have some hope again - having lost two cats this year (one to an RTA and another (Drummer’s Dad) to sudden kidney failure), the idea of losing Drummer too is just awful / he is so loved and I’ll do anything I can to help him.
    Drummer sends love and thanks too.
    Jx
     
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  18. lillytheunicorn

    lillytheunicorn PetForums VIP

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    Hopefully he will start to feel better on the Increased steroid dose soon.

    You can get Felini complete from zooplus to add to home cooked meat to make it complete.

    Our vet advised us to feed Complivit paste to give an energy boost to make them feel better and cover any nutritional deficiencies. It is full of b-vitamins and minerals.
     
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  19. TriTri

    TriTri Standing up for cats

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    Poor boy. I’d consider getting his claws trimmed a little at your next vet apt. I’d highly recommend Animonda Vom Feinsten for neutered cats, pure turkey, from Zooplus (cheaper than other suppliers). I’d also recommend a catnip mouse, as he’s blind ❤️.
     
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  20. chillminx

    chillminx PetForums VIP

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    @DrummerCat - I am very pleased Drummer is feeling a bit better and eating well compared to earlier. :)

    I agree with TriTri - Animonda Vom Feinsten Pure Turkey [trays] for neutered cats is gentle on the tummy and well liked by many cats. My boy with IBD has it as one of his main foods,

    https://www.zooplus.co.uk/shop/cats/canned_cat_food_pouches/animonda/trays/14008

    Another food that is gentle on the digestive system is Miamor Mild Meal trays, but all flavours contain chicken, (one of my previous cats used to love the chicken & ham flavour)

    https://www.zooplus.co.uk/shop/cats/canned_cat_food_pouches/miamor/miamor_trays/42061

    Or you could continue to feed plain homecooked meats and add a completer such as Felini Complete or Purrform Complete Supplement either of which is suitable for adding to cooked or raw meat.

    https://www.zooplus.co.uk/shop/cats/supplements_specialty_cat_food/vitamins/155860

    https://www.purrform.co.uk/product/purrform-complete-supplement-50g/

    Like lilytheunicorn I think trimming Drummer's claws a.s.a.p. is best to stop them catching in things. Do you have some cat claw clippers ? Just take the sharp tip - about a quarter of a centimetre - off the end of the claw.

    If he is not used to it you may need to do one claw a day. . Some cats hate having their paws touched so It is important not to force him, but to persuade and bribe. :) Maybe first get him used to having his paws touched for a day by holding each one and giving a high reward treat.

    https://www.amazon.co.uk/OneCut-Clippers-Version-Trimming-Professional/dp/B07V36BTS9/ref=sr_1_4?crid=3DOXHBEX3RDEQ&dchild=1&keywords=cat+claw+clipper&qid=1605017141&s=pet-supplies&sprefix=cat+claw+,aps,156&sr=1-4




    You could ask a vet nurse to trim his claws but I wonder if vets are offering routine procedures during the current lockdown (if you are in England i.e.)
     
    #20 chillminx, Nov 10, 2020
    Last edited: Nov 10, 2020
    TriTri likes this.
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