My cat, Bach, is scheduled for a cholecystectomy with biopsies tomorrow. To answer the above questions, he is a 14 year old, neutered DSH. He was a 16 lb kitty down to 10 something pounds now. Behavior is normal, energy is normal for him, appetite is good, mood seems pretty normal. He's been on a novel protein (mostly rabbit, venison) since March 2022. He was vaccinated as a teenager at the shelter when I rescued him and once more a few months later but not since. He developed allergies in early 2017 (environmental, based on testing) and has been on short courses of steroids and antibiotics since then. I noticed that he was losing weight (1 1/2 lbs) in August 2021 without having vomiting or diarrhea. I had tried Royal Canin Ultamino for a few months so thought maybe it was due to that. The regular vet wasn't available until December when he was down to 12.5 lbs. She wasn't that concerned but I was. I insisted that he needed a workup and, eventually, an ultrasound with their visiting internist was performed in March 2022 (presumed IBD). We started a novel protein and budesonide (5mg). Milk thistle and then Denamarin were added as the ALT was elevated (300s). Weight was fairly stable but never went higher than 13.5 lbs. I was not willing to do an endoscopic biopsy after a bad experience with a biopsy with another kitty. Followup ultrasounds in January 2023 showed cholelithiasis and choledocholithiasis (2 stones) Ursodiol was started. Another ultrasound in Sept 2023 showed the stones were unchanged. A 3 week course of Clavamox did not improve LFTs. We went to a different internist who increased the budesonide to 1mg but said not to worry about an obstruction. He prescribed prednisolone but agreed that we could hold it as Bach's weight went up a bit and was stable. I also tried 2 courses of fecal transplants from Animal Biome following a gut microbiome study (along with prebiotics and probiotics). Liver enzymes were fairly stable in January 2024, April 2024, August 2024. Weight was slowly dropping over the summer so we decided to start prednisolone in late September. LFTs a month later at exam were up (ALT in the 700s, AST, alk phos, total bilirubin also elevated). Repeat ultrasound showed the stones were unchanged (same size and number). We did another 3 week course of antibiotics (Clavamox and pradofloxacin). Repeat labs showed increase in ALT (900s), AST, alk phos, total bilirubin was about the same. So the internist recommended surgery, as medical management has not helped. Last Friday, we met with the surgeon, who feels like Bach is a good candidate. I spoke to the first internist and his regular vet and they agree. Also asked the surgeon a bunch of questions by phone yesterday. Nonetheless, I am going to be a nervous wreck. I am trying to remain as calm as possible between now and tomorrow morning, as Bach tends to pick up on my anxiety. Yesterday, I spoke to Dr. Jeff about best ways to support Bach as he has surgery and in the post-op period (being there for him, offering favorite foods, petting). I wondered if any other holistic veterinarians had suggestions. Thanks! @Dr. Christina @Dr. Jean Hofve @Dr. Jeff
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How to support presumed IBD cat with gallstones having surgery
- Thread starter ElissaB
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Hi Dr. Jeff, He was begging and wondering why he didn't get to eat and the other cats did. Surgery is supposed to be very soon (2pm Pacific). One of the stones is now in the papilla, according to the ultrasound this morning, so the surgeon said surgery is definitely indicated. I know of arnica. I will look into it. Thanks!
Hi Dr. Jeff, I sent you an update during Monday's Zoom talk but not sure if you saw it. The surgery went well. The CBD was very dilated, as the stone had migrated into the duodenal papilla but the gallbladder looked normal. Biopsies of the liver and duodenum were collected. Intra/ post- op was unremarkable, aside from some hypotension (probably anesthesia). I visited him on Sunday and he immediately jumped onto the chair and got on my lap. Bach was discharged on Monday morning after they felt comfortable with his I&Os. He was happy to be home. He doesn't appear to have any pain but I did order arnica from Chewy. Pretty much acting normal other than being a little extra finicky.
this morning
Monday after getting home
during hospital visit
this morning
Monday after getting home
during hospital visit
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Fantastic! Thanks for the great news Elissa.
BTW-The Arnica will help him heal optimallly.
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Unfortunately it is potentially harmful to her vital force's ability to regain healthy balance. As are all combination remedies like this.
Arnica 10M is best IMHO:
Arnica 10M is best IMHO:
Thank you, Dr. Jeff. I am familiar with Boiron, although I've never used their products. I ordered this morning from Amazon. Strange, I had looked for it there initially but that one did not come up. Thank you for the link!
Any advice on encouraging/supporting good appetite post-op? Bach has been finicky anyway but seems even more so. Probably normal after a GI surgery (certianly is with human patients) but he's definitely eating much less volume-wise. The novel protein has been off the table for the past few weeks, anyway. So he's been eating canned sardines, mackerel, tuna, and salmon, in addition to the canned Lotus venison and Primal frozen raw venison. He won't really do rabbit (canned or raw) this past week. Even gave some human chicken that he hasn't had in nearly 3 years. Also bonito flakes and Fussie Cat lickable treats, plus other freeze-dried treats. Eating, just not with as much enthusiasm. And he's been BAR since discharge. The surgeon says it may take a couple of weeks to return to baseline. Thanks!
Any advice on encouraging/supporting good appetite post-op? Bach has been finicky anyway but seems even more so. Probably normal after a GI surgery (certianly is with human patients) but he's definitely eating much less volume-wise. The novel protein has been off the table for the past few weeks, anyway. So he's been eating canned sardines, mackerel, tuna, and salmon, in addition to the canned Lotus venison and Primal frozen raw venison. He won't really do rabbit (canned or raw) this past week. Even gave some human chicken that he hasn't had in nearly 3 years. Also bonito flakes and Fussie Cat lickable treats, plus other freeze-dried treats. Eating, just not with as much enthusiasm. And he's been BAR since discharge. The surgeon says it may take a couple of weeks to return to baseline. Thanks!
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Yay!
Maybe offer him whatever he wants to eat. Human meat (chicken, turkey, lamb, etc.) baby food is a favorite.
With Arnica 10M dosing we typically see an even faster recovery.
Dr. Jeff. How many of the arnica tablets will I give daily?
Yes, I have been trying to give him human meat. But, for example, he attacked the chicken yesterday afternoon but was a lot less enthusiastic about it today. Same with the sardines and mackerel. He was attacking them the night before surgery but just sort of so-so about them since. He seems to be tired of them. I can try baby food. I usually reserve that for when they're really not eating anything.
The internist said to discontinue the Clavamox so maybe that will help.
Yes, I have been trying to give him human meat. But, for example, he attacked the chicken yesterday afternoon but was a lot less enthusiastic about it today. Same with the sardines and mackerel. He was attacking them the night before surgery but just sort of so-so about them since. He seems to be tired of them. I can try baby food. I usually reserve that for when they're really not eating anything.
The internist said to discontinue the Clavamox so maybe that will help.
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I typically add 1 pellet of 10M to 8 oz. of water. And dose 10/Q-tip from the original cup as often as needed, such as if BEAM drops, there's any isolating, apparent discomfort, etc.
10/Q-tip means 10 succussions (whacks/vigorous shakes) of the cup/jar. And a Q-tip dipped into the water and then touched to his gums.
10/Q-tip means 10 succussions (whacks/vigorous shakes) of the cup/jar. And a Q-tip dipped into the water and then touched to his gums.
