Hi there. I've emailed you in the past regarding my cat Sola.

Just to re-brief you, he is an indoor, male neutered 11 year old cat and has been totally healthy except he has had a history of IBD (never had a biopsy until now) but his problems seemed to be very sporatic. Diarrhea maybe once a month and periods of vomiting for every day or every other day for a week every few months. But has always acted normal through these bouts.

Last month he had a period where he had diarrhea almost every day for 3 weeks. We took him to the vet after this was going on for two weeks and he received a complete blood panel and urinalysis (as I usually do for him every 6 months) and everything seemed normal. We also did an x-ray, but nothing showed up. He acted totally normal and was bright-eyed, alert, everything he always was.

We finally took him to a specialist who did an ultrasound of his intestines and found some lymphnodes and thickening of his intestinal lining. The vet did an endocscopic biopsy, which apparently is the most non-invasive method to obtain a biopsy and found that he had moderate lymphocytic inflammatory bowel disease.

He was put on pepcid once a day, flagyl twice a day, sucralfrate three times a day, and metoclopramide three times a day. He did well for a week - no diarrhea, no vomiting.

As soon as he finished his flagyl he had liquid diarrhea and vomited 8 times (more gagging then vomiting really), and he wasn't acting himself so we took him to the ER on Saturday and they put him back on flagyl and now he seems to be doing better, no diarrhea since Saturday, a little vomiting, but he really doesn't like the metoclopramide and seems to gag, wheeze and sometimes vomit afterwards. Thank god he's done with that medication.

He just finished all his medications (they were only for 10 days) except for the flagyl that got re-prescribed. And he just got a steroid - budesonide - and has been taking thst once a day (just started it today) along with the flagyl twice a day. We've also switched him to IVD, which he was on years ago but I stopped because I wanted a more holistic diet and switched him to California Natural and he was fine for several years on this, until last month.

So, finally to my questions:

1. Why would his IBD flare up all of the sudden to the point where he got diarrhea for three straight weeks and now needs all of these meds?

2. Is it possible that he has intestinal lymphoma, but we don't know because he only got the endoscopic biopsy and not the full thickness biopsy? I just wanted to avoid the risks of anesthesia and he was put on a mild sedative for the ultrasound and stayed on that for the endoscopic biopsy rather then general anesthesia that was required for the other procedure. My other cat Luna was put totally under to remove a cyst that they thought was vaccine-induced sarcoma, it turned out to be negative, but she died several months later of a heart attack and I am still not convinced that it wasn't the surgery (and teeth cleaning) that put a strain on her heart.

3. Should we do a radiograph? I read several websites that recommended a radiograph to diagnose IBD, but I'm not really sure how a radiograph is different from an x-ray and an ultrasound, which he has already had.

4. I know there are side effects to prednisone and I've read that aside from the steroid affecting the liver and kidneys, it inhibits the ability to test for lymphoma for some reason. Instead of prednisone, Sola is budesonide.

Does budesonide have any side effects? I couldn't find any when I looked on the internet. The vet says that all his blood work and urinalysis came back clean. I personally like to see the results to see if he is even on the high or low side of the normal range, I don't like to just hear that he's "fine". But they don't like sending me the results because they say people freak out! But I'm still a little neurotic ever since I lost Sola's sister several months ago to a heart condition that we had no idea she had.

Sorry for all the questions. I'm just a little uneasy right now having just lost another cat to a disease where I knew nothing about and found out only after her death that she had an enlarged heart. I just struggle with the fact that even though I took them in every 6 months for a physical, bloodwork, urinalysis and blood pressure check, that the cardiomyopathy was never caught. Luna had very low blood pressure the month before she died but the vet didn't think that was a concern. I think, in hindesight, that that was a sign. So I'm making sure I do everything I can to help Sola!

Thanks in advance for you advice!

Lisa Acho

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