Anyone had full thickness intestinal biopsy done on their furbaby?

[Mollycat]

Hello and welcome to the forum.

We had the same question but for a 14 year old - age is important - and our wonderful vet was very honest with us about it. She said we could go through expensive and invasive tests but they had no guarantee of identifying the problem. I don't know if that included biopsy. In our case she didn't encourage us to go ahead with the tests because his condition was already under control with steroids and she said in either case (IBD or lymphoma) steroids would be the treatment of choice. In his case we were unable to reduce from a high dose steroid at all so he was already quite seriously ill with that and other things, and it's very possible he would not have survived the sedation needed for the biopsy anyway.

At 8 years old your dilemma is quite different but I would possibly get a second opinion and definitely have a full and frank discussion with your vet about the costs both financially and in terms of how your cat will handle a lot of tests and treatments and the potential benefit to her, quality of life as well as length of life. Opting for a maintenance treatment or a possible curative treatment has to depend on your means but also on what your cat will accept, and spending the most is not always in the cat's best interests. I would do a lot of research on both conditions so that you know as much as possible about progression, prognosis, management, treatment options and costs and have that conversation with the vet fully prepared with all the right questions.

This is just one guide to both problems https://www.vin.com/apputil/content/def ... id=3844071. Although the article pushes for biopsy and definitive diagnosis, it does at least give you some objective research facts to work with. Vitamin B injections are mentioned - my boy was well maintained with those in the early stages and we progressed to steroids when they stopped working for him. Your little lady might benefit from a diet review as well.

[Mollycat]

Of course it's difficult especially without even a ball-park idea of cost. It's so horrible and makes us feel so guilty to make decisions with cost factored in, makes us feel somehow disloyal or mean, that this is our precious animal and we should be able to fix them whatever the cost. That's why I always say keep your feet on the ground and the animal's best interests at heart. We spent £4000 on my other cat last year for radioactive iodine treatment and all the before and after tests - we did not have that kind of money but we managed to find it for her. She was 11 and I even asked what would happen if left untreated, she would not take pills, the operation has a high chance of needing to be done again, it was the only way for her. So how bad did I feel "giving up" on Boo a few months later and refusing even a biopsy? Luckily it wasn't a money decision, it was genuinely the best course of action for his welfare.

If you're a list kind of person it might help to literally write down all the options, pros and cons of each, what's involved for your cat and for you, care, money, % chances of success and life expectancy.

Going off food and losing weight could easily be the little ulcer. My dog has one at the moment. Inflamed bowel can be lots of things including food allergy, parasites, a simple infection easily treated with a course of antibiotics, or anything up to really serious things. Has she a history of diarrhoea? The thing with intestinal inflammation is they don't absorb nutrients from their food properly, and lack of vitamin B particularly causes more diarrhoea, that's why a vitamin B injection bypassing the gut altogether can be enough to fix a minor issue. There may be another reason these vets suspect something more serious but based purely on a relatively small weight loss and being off her food, especially with a mouth ulcer that could well explain this, it seems strange to jump straight into the IBD/lymphoma scenario. For scale, my boy lost 20% of his body weight in 8 days and that's what led to the steroids, I know that's enormous but even if your girl is 4kg 100g is barely 2.5% of her weight and based on what you describe alone I would have thought there could be other possibilities to look at before going for the high end stuff.

When all's said and done you are in charge of your girl's care and you need straight information from the professionals to help you make the best decisions. I can't advise but I have to say a low carb anti inflammatory diet, grass if she is an indoor cat, maybe a probiotic supplement if you feel it's right, vitamin B (you can buy Cobalaplex which is all the B vitamins but especially B12 cobalamin) or injections as needed, all might be worth a closer look. Cancers do have a better success rate if caught early though. But if you feel the risks of the full thickness biopsy are not for you and your girl, that's ok too. But I would ask why they are straight on to the IBD/lymphoma idea without looking at simpler possibilities first, there may be a simple answer, or not.

[Mollycat]

Apparently even a biopsy can sometimes be inconclusive, I remember our vet saying that, but here is a personal story that explains why this is so and how yet more tests can deal with that http://www.catmd.ca/tigger-1.html - parts 2 and 3 are linked at the bottom of the page.

Point remains, if you want to look at other less invasive ideas to see if they help, and it turns out to be lymphoma, you are inevitably losing some time, on the other hand if it isn't you can save a lot of stress for her by avoiding the biopsy, and the first thing to try for IBD is dietary change. It is a tough decision isn't it. I guess it's how much do you need answers before deciding on treatment, or how much do you want to try treatments and avoid unnecessary surgery to 'hopefully' get answers.

[Mollycat]

Sounds encouraging and more supportive. Hope this is able to give you an answer. Please update us when you have news!

[Mollycat]

Sounds positive, though IBD still needs managing.

There is an alternative to daily steroid pills once you get the dosage just right, which is as low as possible that works, and takes time to figure out. That is a steroid injection every 6 weeks. Downside - once it's given it can't be un-given hence dosage has to be worked out on pills first, and excludes certain other medications if they were needed, like Metacam for example, though there are alternatives.

For pills you could try the usual hiding it in something, vets sell some putty called Pill Pockets which cats find delicious, but that doesn't always fool them. My Molly loved the stuff but just one time she saw me put a pill in some for my other cat and after that she refused to touch it!

Lovely to get some positive updates though, thank you.

[booktigger]

My Molly had steroids for what the vet initially thought was lymphoma but turned out to be IBD, I hid hers in chicken. If they are thinking IBD, its unlikely they will go down the injection route as the aim is the lowest dose possible, as there are side effects to steroids. We managed to get down to two half tablets a week, but I didn't change her diet. With her age, I'd also do yearly bloods to make sure they aren't causing any side effects

[Mollycat]

My Molly had steroids for what the vet initially thought was lymphoma but turned out to be IBD, I hid hers in chicken. If they are thinking IBD, its unlikely they will go down the injection route as the aim is the lowest dose possible, as there are side effects to steroids. We managed to get down to two half tablets a week, but I didn't change her diet. With her age, I'd also do yearly bloods to make sure they aren't causing any side effects

Can't the 6 week injection be a lower dosage? I was under the impression it's slow release over 6 weeks but the dose can be set once the right level has been established on tablets? We were never able to drop the dose at all so not been there myself.

[booktigger]

Not as far as I know, although we stuck to tablets, vets prefer that for long term in case they develop anything else - my Molly needed a dental while on steroids and as you said, you can't use steroids and metacam together, so we had to stop steroids so she could have a dental, then wait for the metacam to leave her system before going back on steroids.