Disco T.

Disco NoFurNo Disco2Thorsteinson – Montclair, Virginia
Male, Sphynx
December 29, 2004 – November 8, 2020
Diagnosed with Toxoplasmosis October 2006, treated and cleared
Diagnosed with Giardia June 2008, treated and cleared
Diagnosed with Pancreatitis July 2012
Diagnosed with IBD August 2012
(lymphoplasmacytic mucosal enteritis/colitis/pancreas)

First Entry Feb. 6, 2014: Disco was born in cattery in Texas, MajikMoon and came to me when he was 7 months old. He was fed a raw diet of some form before I got him.

Here’s his story:
September 12, 2005: 1st exam with my vet. History of ‘sensitive stomach’. No vomiting but frequent smelly diarrhea. First fecal test was + for roundworms only. Dewormed with drontal 2 x, 2 wks apart. Started on metronidazole 30 mg BID x 10 days. Wt: 8.5#

September 26, 2005: No change, in-house fecal neg. Gave .7 ml depo medrol for inflammation.

October 4, 2005: No change, no vomiting, weight still 8.5#. abd: mild gas, squishy intestines, not thick. Direct fecal mostly rods, SIBO suspected. Rx carafate 1 gm 1/4 tab BID until stool firm and amoxitab 50 mg 1 BID x 30.

October 26, 2005: stool firm, odor gone, weight up 14 oz. Disco1

October 12, 2006: Routine testing for toxo in cattery, just by chance, included Disco in this testing. Disco tested Igg neg, Igm 1:64. Tx with clindamycin 75mg BID for 21 days. Note: he was the only positive in the house!

June 11, 2008: Fecal + for giardia antigen, began deworming cycle for all cats in house as I was breeding Cornish Rex at the time and suspected new cat brought it in and it recrudesced when she delivered kittens?

In July 2012, he began with loss of appetite and severe diarrhea. Metronidazole didn’t help at all. The regular CBC/Superchem was essentially normal. The Antech GI PCR Panel was all negative. Toxo neg/neg.

Antech GI panel (TLI PLI Cobalamin Folate). Cobalamin 339; Folate 20.4; TLI 101.7; PLI 15.7. Cobalamin low, TLI and PLI very high. Pancreatitis and infiltrative gut disease, probably IBD. He had pancreatitis, so in the beginning he was on antibiotics and gut medicines: metronidazole and marbofloxacin (antibiotics), sulfasalazine (for colitis) and buprenorphine for pain.

He also was tested for all the tick borne diseases as well (did them as he had a couple of vestibular episodes, could have been the metronidazole though) and they were all neg, as were the fecal PCR tests.

August 7, 2012: Soft stool again. Brief ultrasound should thickened intestine, bright muscle layer prominent. Start cobalamin at .5 ml 1st dose, then .25ml once a week for 5 wks and then monthly long term. Rx buprenorphine PO .24 ml x 4 doses; sulfasalazine 125 mg SID x 10 days; Hill’s z/d canned/dry; prednisolone 5 mg 1.5 tab BID x 30 days; metronidazole benzoate 62.5mg tabs 1 BID; marbofloxacin 25 mg SID x 14 days; Fortiflora 1/2 pkt x 14 days.

August 29, 2012: Abdominal exploratory and biopsies. Exposed pancreas, intestines, colon, spleen, visualized liver and bile ducts looked fine. Pancreas enlarged about 2 x as thick as normal, nodular and very firm; intestines grossly normal-small, colon dilated with gas, LN’s normal appearing, omentum normal.

IBD confirmed with some round cells seen which can be precursors to cancer, prednisolone (not prednisone!) and Leukeran 2 mg. His blood glucose readings went way up (361 on 1 test) on the prednisolone, so we switched to budesonide as it specifically targets the intestinal tract, and he’s fine on that. Stopped metronidazole. He started out on 2mg budesonide tiny tabs, once a day for 1 month, then lowered to 1mg once a day for a month and then 1mg every other day for a month and then lowered to every 3 days which he is still on.

The leukeran he started in a cycle of 3 days on and 18 days off, and is currently taking it twice a month now. It is used in lymphoma, too but at a different dose.

The supplements he takes are psyllium powder (I use Konsyl, human type) 1/4 teaspoon twice a day and he was on Fortiflora but a holistic vet didn’t care for the animal digest in it and I switched to the brand Rx Vitamins for Pets Nutrigest. He gets 1/4 teaspoon twice a day of that. He started out after diagnosis eating Hill’s z/d canned and dry, after 2 months went to Royal Canin Rabbit/Pea as the experts say that rabbit is the least protein reactive to IBD cats. All the cats are eating the same food with the supplements mixed in (they share) so I am not sure exactly how much Disco actually gets and I could stop both the psyllium and Nutrigest but heck, they are good for any gut so I will keep them on them. He currently is eating Natures Variety Rabbit, and Duck. Note: The CANNED dog variety of it has the proper amount of Taurine for a cat and is quite a savings, so I am feeding it now.

Here’s his biopsy report: Source / History

This is a 7-year-old neutered male Sphynx cat. History: Presented 7/30/12 for diarrhea for one week unresponsive to metronidazole. Labs: Negative. Presented each less than one with hives on rear thigh,growing, lung abdomen, and axillary area. Skin stripping negative. Diarrhea still present. Has URI symptoms. Samples of the pancreas,colon, ileum, jejunum, and pylorus are submitted for examination.

Microscopic Description
Jejunum: Mildly to moderately increased numbers of lymphocytes and plasma cells are noted in the lamina propria, accompanied by fibrosis. Mildly increased numbers of intraepithelial lymphocytes are also noted.

Ileum: The lamina propria is mildly expanded by fibrosis, with mildly increased numbers of lymphocytes and plasma cells also noted.

Pylorus: The samples from this site are not pyloric but rather small intestinal in origin. Mildly increased numbers of lymphocytes and plasma cells are again noted in the lamina propria.

Colon: A single full-thickness biopsy is examined, which is characterized by mildly increased numbers of lymphocytes and plasma cells in the lamina propria multifocally, accompanied by mild fibrosis and occasional neutrophils.

Pancreas: All components of the endocrine and exocrine pancreas are present in the normally expected position and proportion and appear unremarkable. Small numbers of lymphocytes and plasma cells are noted multifocally in the interlobular connective tissue.

Microscopic Interpretation (Biopsy)

Small intestine: Mild to moderate lymphoplasmacytic mucosal enteritis
Colon: Mild lymphoplasmacytic mucosal colitis with fibrosis
Pancreas: Mild multifocal lymphoplasmacytic interstitial inflammation

The histologic changes, in combination with the clinical signs, are suggestive of a clinical diagnosis of inflammatory bowel disease. Inflammatory bowel disease is a clinical syndrome for which it is difficult to develop a valid, objective histologic counterpart. In this case, histologic findings are compatible with a clinical diagnosis of this syndrome. The etiopathogenesis of idiopathic inflammatory bowel disease is not understood in any animal species.The nature of the inflammatory infiltrate suggests that intolerance to dietary antigens or antigens produced by the enteric microflora may be implicated. Histologic changes may be the side effects of T-cell mediated activity in the mucosa. An immunophenotypic investigation of inflammatory bowel disease in cats demonstrated outcomes consistent with dysregulation of immunoinflammatory events. Major histocompatibility complex class II expression by proprial round cells in affected sites was also more pronounced. Additionally, lymphoplasmacytic inflammatory bowel disease may progress to alimentary lymphoma in some cases.

The inflammation noted within the pancreatic interstitium is mild and may not be of clinical significance.

December 12, 2012: Labwork all great. Cobalamn 943, Folate 18.9, TLI 51.9, PLI 1.9
Weight–still overweight at 14.5#

January 1, 2014: Disco continues to do very well. Normal stool and appetite for over a year. Still obese at 14.5#. He eats 3 TBS of Nature’s Variety Duck a day and about 6 oz of Nature’s Variety Rabbit canned. He is overdue for lab work but he is symptom free. I am so glad I did the full-thickness biopsies rather than go with the pinch samples that endoscopies get, as we may have missed his diagnosis and I would think he was ‘cured’. While I know the doses of the meds he is currently on are very, very low and he may be able to be maintained on diet alone, I am fearful of lymphoma due to chronic inflammation and if what I am doing is keeping his guts calm, I will keep it up. If all the meds are doing is keeping me calm…well, that’s good too, hahameow!

January 22, 2014: Presenting complaint: Vomiting, diarrhea, may have been brought on from switching from rabbit to duck variety of Nature’s Variety food?

Wt: 14.18#; HR: Purring; RR: 30; BCS: 3/5/5
Abdomen soft and not painful
Current meds: Budesonide 1mg twice weekly; Leukeran 2mg, 1 tab on the 1st and 15th of the month; B12 injs 25u once a month.
Diet: Nature’s Variety Rabbit/Pea dry as a treat- 1 TBS two-4 x a day. Nature’s Variety Instinct Duck/Pea canned 6 oz twice a day, shared between 3 cats, with 1 tsp psyllium and 1 tsp Nutrigest once a day mixed in wet food.

Treatment plan: buprenex 0.2ml transmucosally 1-3 x a day as needed; Cerenia 1 tab once daily as needed for vomiting; B12 inns 25u once weekly; metronidazole 62/5mg tabs, 1 every 12 hours for 7-10 days, 150ml LRS sq, 1ml ondansetran; SA90 Senior Comprehensive lab work.

May 6, 2014: Senior wellness exam
wt: 14.5#; HR Purring; RR 30; BCS 4/5
Diet: Nature’s Variety Instinct Rabbit dry and canned, psyllium and Nutrigest 1 tsp daily mixed in with wet food.
Meds: same, with B12 twice a month maintenance, 25u
Oral: Moderate tartar, recommend dental
IBD well controlled
SA90 Senior labs w UA: WNL

8/18/14: Hx of urine spray marking, increasing again, start back on paroxetine 10mg tabs, 1/4 once daily or every other day.

September 2, 1014: Dental procedure, no extractions, recovery normal. Have been dieting with just 1 Tbs of dry food twice a day and 6 oz of wet food twice a day (that he shares with 2 other cats but he eats the most. He is finally just under 14#, with a goal weight of 13#.

May 10, 2015: He just had his 6 month exam and his labs were all good, but even though he seems symptom free, his PLI was elevated at 10.6, so some pancreatitis going on there. Vet said not surprising in association with IBD and obesity. He has been stuck at around 14# since diagnosis in 2012 in spite of getting very little dry food and his target weight is 11#. She said the Natures Variety Rabbit/Pea he’s been on still has too much plant material in it. She said he is at high risk for developing Diabetes Mellitus even though he is only on budesonide twice a week. She also said his urine is way too concentrated, 1.050 considering he is on canned food, and had some struvite crystals and blood (which may have been from the cystocentesis) and may partially be a reason for him urine marking.

She noted some pododermatitis (mushy paw pads) which is a non-specific indication of chronic inflammatory disease ddx bid, other. And he was slightly hypertensive (185) so he is now on amlodipine and will recheck urine and BP in 3 weeks. Because I am not quite ready to do raw, even a prepared formula, we are switching him to Weruva Paw Lickin Chicken and NO dry at all. If his gut situation remains in control for a few weeks, then we are going to start weaning the IBD meds (currently budesonide twice a week and leukeran every 2 weeks).

October 1, 2016: Disco is doing great. He’s completely weaned off all meds except B12 25u once a month, and currently is eating only Darwin’s Raw (chicken, turkey, duck) and Balanced Blend Raw (chicken) with the only treat being freezes dried bonita flakes. I began weaning him off meds in November 2015 (he had been on very low doses anyway, budesonide 1 mg twice a week and leukeran 2mg every 2 weeks and B12 .25ml twice a month). Currently he is just getting B12 25u once a month). He had been off all dry food since May 2015 (was feeding primarily Weruva Paw Lickin’ Chicken but he still was getting too many calories by cleaning up the other cats plates, so he still wasn’t losing weight! I began feeding raw around January 2016, still not losing weight, so now he eats alone and I don’t let him out of the bathroom til the others are finished! I finally have him down to 14lbs 8 oz again (he got up to 15lbs 8 oz at one point this year!).

His lab work results (he gets twice a year senior exam and labs) in Nov 2015 pertinent results were urine specific gravity 1.041 and the fPL was high at 13 (for some reason we didn’t do the cobalamin and folate!) and in May 2016 all was very good: urine specific gravity 1.023, fPL 7.4ug/L still high but improved over his last couple of readings, cobalamin 1,151 ng/L, folate 14.7 ug/L. I am glad he is doing so well off meds and on raw and now my goal is to get him down to 12lbs, so we’ll see what his next update shows!

October 5, 2018: Disco continues to do well, but had a couple of days of lethargy and poor appetite and so did labs and full exam as it was time for his 6 month senior exam/lab work anyway. We gave SC fluids and Cerenia. The pododermatitis noted in 2015/2016 has resolved.

He is on the same food as last update 2 years ago (Darwin’s Raw Chicken and Turkey) with dried bonita flakes daily as a treat, with occasional Fancy Feast as a treat. I do notice if he gets more frequent canned food, he will have soft stool and cramping on defecation, so I keep it to a minimum.

He was weaned off of budesonide about 2 years ago
He continues to get B12 25u SC every 2 weeks. We went back to twice a month as at once a month, he was a little lower than the 1000pg/ml the IMed specialists recommend.

His hypertension has resolved and he hasn’t been on amlodipine since 2016 and his blood pressure normal at 120-145mm/hg. His weight is good at 12# 4 oz and the vet has his target weight at 12# instead of 11# now (11# was his 1 year old, show cat weight).

He has been on clomipramine 2.5mg once daily for urine spray marking since 2016, and because of right hip dysplasia and mild bilateral elbow arthritis is on gabapentin 10mg once daily and Rx Vitamins for Pets Megaflex (glucosamine chondroitin/MSM powder) in food twice a day and is on Revolution once a month.

His lab results on 10/5/18 were:
BUN 20mg/dL
Creatinine 1.4mg/dL
SPEC fPL 9.7ug/L (elevated but he tends to run between 7.6 – 9.6 even when he has no symptoms of a flare)
Cobalamin 778ng/L
Folate 11.9ug/L
Urine SpG 1.020
ProBNP 114 (up from 64 6 months ago, so went to CVCA for evaluation/scan and more than likely age-related changes, nothing serious at this time).

I am going to retire next year, and will repeat his abdominal ultrasound at his next 6 month senior exam just to evaluate intestinal thickness as he hasn’t had one since the brief one prior to his exploratory and biopsies in 2012!

I am glad to report he is doing so well 6 years after his diagnosis with lymphocytic-plasmacytic IBD.

November 1, 2020: Hard to believe it’s been 2 years since I updated Disco’s Case Study! A lot has changed in our lives since then but all positive! I retired from my career of 47 years as a veterinary healthcare professional and moved back to Oregon to be with family in September 2019. My three cats (all with IBD) made the move easily and are happily settled in our new home. This is one of the very few times in my life where I have had to find a new vet and be a client instead of an employee, but I think I have found a good vet who is working with me well. Disco’s IBD is well-controlled on busedonide 1mg every other day, B12 @ .25ml every 2 weeks, and Darwin’s Raw Chicken and Turkey as his main food, with occasional Fancy Feast Classics mixed in. He is also on Miralax for constipation, 1/4 tsp twice a day in food. He also gets Adequan for elbow and hip arthritis, .20ml every 2 weeks. Pododermatitis (noted in 2015/2016) continues to be resolved and he continues not to be hypertensive.

Before I retired, I had all his senior vet care needs taken care of, including all labs with pancreatic profile (something I did every 6 months anyway), a repeat heart ultrasound and abdominal ultrasound to check on his IBD. His heart ultrasound showed slight changes with stable mild mitral regurgitation and mild left ventricular hypertrophy of the upper septum and posterior wall but no meds needed. His abdominal ultrasound showed high end of normal thickening of the small intestine and expected changes to the pancreas and lymph nodes were all WNL. We opted to maintain him with his current doses of budesonide and B12, as I was concerned about the level of vet care I would be able to maintain on a fixed income and hoped to ward off the development of intestinal lymphoma with the meds.

Unfortunately, right after we moved to Oregon, he was diagnosed with Diabetes, and just passed his 1 year anniversary with that disease and is doing pretty well, is an easy-to-treat patient and his numbers are improving finally and beginning to look like we can get him regulated, in spite of being on budesonide. I was afraid to stop that completely and have his IBD turn into lymphoma, so that does complicate regulation a bit. But he is doing well enough to have a much needed dental prophy (it has been almost 2 years since his last one) and we did a heart ultrasound to make sure he was ok for anesthesia etc and his age-related heart problems are a little worse, no meds needed but will need to be monitored closely during the procedure, regarding pre-anesthesia drugs and IV fluid administration, but his vet is following AAHA diabetic and heart patient protocols, so I am keeping my fingers crossed he will do fine!

11/5/2020: Disco did well with the dental, didn’t need any extractions and no problems under anesthesia.

11/7/2020: Disco vomited during the night and his appetite is off today, his respiration is increased also. His blood glucose was also high this morning but came down during the day. Watching him closely.

11/8/2020: When my alarm went off at 7am, Disco was vocalizing in distress, increased respiration over yesterday even and was now sounding congested. I rushed him to ER suspecting CHF, and due to COVID-19 protocols, had to wait outside but the vet said he was in DKA (diabetic ketoacidosis) with possible heart complications. My vet had already sent over his records thankfully. Four hours later, the vet called and he had gone into CHF because of the IV fluid treatment (which was needed to get the DKA under control). Continuing treatment was untenable, and I made the very difficult decision to euthanize him, but was able to go in and say goodbye and because of what therapy he had been given (massive doses of diuretic) and being in an oxygen cage) he was not stressed and was pretty comfortable and we loved on each other for a while before I had to let him go. He did well with his IBD, diagnosed in 2012, and I consider him a success story for that disease, doing well with minimal meds and diet.

I know with time, I will be able to think of him and look at his photos without crying, but it is going to take a long time to not be sad that he isn’t by my side still…

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