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  • Thickened small intestine

    One of my kitties recently had to have all her teeth pulled and when they examined her prior to the surgery my vet said her small intestine was thickened. They also found an elevated protein level when they did the blood work. Now I know those two things together can point to either IBD or lymphoma. This cat has never had any symptoms of IBD. The vet wants to recheck her blood work in a month or so and see if the blood protein level has gone back to normal since the inflammation in her mouth could also cause that to be elevated. What I'm interested to know is what other diseases or conditions could cause the thickened small intestine? Doing endoscopy and subsequent biopsy at $1600 isn't going to be possible. I want to do everything I can for this kitty but my pockets aren't deep. Is there any other way to diagnose lymphoma?
    Marci DeLisle
    Cats/Rescue, Feral and Stray
    Camp Counselor at Camp Happy Cat
    Owner of NW Critter Sitter - "Paws-itively Purr-fect Pet-sitting"
    Owner of Northwind Reiki ~Animal Reiki for the fur-persons in your life!
    www.nwcrittersitter.com

  • #2
    Well, you certainly have had a massive run of bad luck, and my heart goes out to you. They have been trying to develop a test for lymphoma, but nothing apparently yet. And, there is perhaps another complication in diagnosis as indicated in this link: http://www.vin.com/VINDBPub/SearchPB...00/PR00130.htm

    "The nodular form causes a segmental thickening of the bowel, most often in the ileocolic region, with resultant luminal narrowing and partial intestinal obstruction. Metastasis to regional lymph nodes is common with both forms of the disease. Gastric lymphoma in cats is rarely confined to the stomach and is best treated with adjuvant systemic chemotherapy. The prognosis for cats with gastric lymphoma is extremely variable with treated cats having survival times ranging from less than two months to more than one year. Adjuvant chemotherapy (Table 1) is also recommended following surgical excision of a solitary lymphomatous mass.

    Definitive diagnosis is usually made by intestinal biopsy via celiotomy or endoscopy. Caution must be exercised when diagnosing intestinal lymphoma via endoscopy. In some cats, the initial biopsy is interpreted as inflammatory bowel disease (lymphocytic-plasmacytic enteritis), and patients frequently show a favorable response to dietary modification and glucocorticoid therapy. These patients ultimately become refractory to therapy and necropsy reveals intestinal lymphoma. It is uncertain whether the initial lesion represented prelymphomatous change or whether it was erroneous because of sampling error."

    Unless someone else has more information, it appears that if it is a lymphoma, the prognosis is bleak. I don't know the treatments, but perhaps treat as if it is IBD, and if you are correct, it will save a lot of money. If not, perhaps there was little to be done in the long term.

    However, be awre that the link is from 2001, and there may have been many advances since then. But it appears that endoscopy and biopsy is the method of choice for a definitive diagnosis.
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    • #3
      Originally posted by calicokitty View Post
      Well, you certainly have had a massive run of bad luck, and my heart goes out to you. They have been trying to develop a test for lymphoma, but nothing apparently yet. And, there is perhaps another complication in diagnosis as indicated in this link: http://www.vin.com/VINDBPub/SearchPB...00/PR00130.htm

      "The nodular form causes a segmental thickening of the bowel, most often in the ileocolic region, with resultant luminal narrowing and partial intestinal obstruction. Metastasis to regional lymph nodes is common with both forms of the disease. Gastric lymphoma in cats is rarely confined to the stomach and is best treated with adjuvant systemic chemotherapy. The prognosis for cats with gastric lymphoma is extremely variable with treated cats having survival times ranging from less than two months to more than one year. Adjuvant chemotherapy (Table 1) is also recommended following surgical excision of a solitary lymphomatous mass.

      Definitive diagnosis is usually made by intestinal biopsy via celiotomy or endoscopy. Caution must be exercised when diagnosing intestinal lymphoma via endoscopy. In some cats, the initial biopsy is interpreted as inflammatory bowel disease (lymphocytic-plasmacytic enteritis), and patients frequently show a favorable response to dietary modification and glucocorticoid therapy. These patients ultimately become refractory to therapy and necropsy reveals intestinal lymphoma. It is uncertain whether the initial lesion represented prelymphomatous change or whether it was erroneous because of sampling error."

      Unless someone else has more information, it appears that if it is a lymphoma, the prognosis is bleak. I don't know the treatments, but perhaps treat as if it is IBD, and if you are correct, it will save a lot of money. If not, perhaps there was little to be done in the long term.

      However, be awre that the link is from 2001, and there may have been many advances since then. But it appears that endoscopy and biopsy is the method of choice for a definitive diagnosis.
      From what I gather in all my research it depends on what grade the lymphoma is as to the prognosis. However, since I don't have the $1600 to do the endoscopy it's rather a moot point. I guess we'll meet this head-on if and when she starts to have some problems. What's interesting to me is that she has no symptoms at this point of IBD or lymphoma (and the symtoms would be similar no matter which it was which is what makes it so frustrating).
      Marci DeLisle
      Cats/Rescue, Feral and Stray
      Camp Counselor at Camp Happy Cat
      Owner of NW Critter Sitter - "Paws-itively Purr-fect Pet-sitting"
      Owner of Northwind Reiki ~Animal Reiki for the fur-persons in your life!
      www.nwcrittersitter.com

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      • #4
        Originally posted by MarciD View Post
        However, since I don't have the $1600 to do the endoscopy it's rather a moot point. I guess we'll meet this head-on if and when she starts to have some problems.
        Sometimes, you just have to do what you can do, Marci, and hope and pray for the best. Hugs to you and the rugrat...and I'll light a candle that it's not too serious.

        Yazza
        Yasmine; Staff: Your First Cat.
        I love the smell of espresso in the morning.
        NYT, USA Today, and Publishers Weekly Bestselling urban fantasy author www.galenorn.com
        I miss all my Rainbow Bridge Gurlz...love to Meerclar, Luna , Keeter , Tara , Circe


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        • #5
          Originally posted by Yasmine View Post
          Sometimes, you just have to do what you can do, Marci, and hope and pray for the best. Hugs to you and the rugrat...and I'll light a candle that it's not too serious.

          Yazza
          If I had unlimited dollars to spend it would be one thing but I have to be realistic. This cat isn't a cuddler and would be so stressed to be on chemo at the vets office ... she doesn't deal well with having to go anywhere. I won't let her suffer if it does turn out to be lymphoma or even IBD. If there's anything I can do to make her life more comfortable I will be money is a factor in my life ... reality bites sometimes
          Marci DeLisle
          Cats/Rescue, Feral and Stray
          Camp Counselor at Camp Happy Cat
          Owner of NW Critter Sitter - "Paws-itively Purr-fect Pet-sitting"
          Owner of Northwind Reiki ~Animal Reiki for the fur-persons in your life!
          www.nwcrittersitter.com

          Comment


          • #6
            Originally posted by MarciD View Post
            If I had unlimited dollars to spend it would be one thing but I have to be realistic. This cat isn't a cuddler and would be so stressed to be on chemo at the vets office ... she doesn't deal well with having to go anywhere. I won't let her suffer if it does turn out to be lymphoma or even IBD. If there's anything I can do to make her life more comfortable I will be money is a factor in my life ... reality bites sometimes
            Dear Marci, Is this Shy Anne you're talking about? even if you had all the money in the world, some cats just aren't cut out for a lot of messing about and teatments. You know her best and I know you believe quality of life is more important than quantity. You'll do the best you can by her and not let her suffer, I know.

            A very dear friend of my lost her little kitty to an intesitnal lymphoma last year. They had the expnsive tests done, but there was nothing to do to save her, all they could do was keep her comfortable until she told them she wasn't, any more, then give her the gift of peace and rest. she didn't last very long, I'm afraid, about 2 months after her diagnosis.

            Has Shy Anne ever had any trouble with constipation? Maybe a long shot, but I wondered if megacolon had been considered. When Ootay's bowels are "full" her intestines feel thick. I'm not a vet of course, but I can tell when she's got to go just by feeling her. When she's "empty" I can't really find her intestines at all.

            Anyway my thoughts are with you as the blood test comes around, it's soon isn't it?

            Gail
            http://www.pawproject.org/

            http://catinfo.org/

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            • #7
              ps

              by the way Marci, actually I think my friend's cat was diagnosed by Ultrasound, not endoscopy.

              (in edit) she was being treated with prednisone and pepcid AC to help keep her more comfortable. She had a lot of trouble with diahrrea, too, but I don't think they were giving her anything for that, though I had suggested she try fortiflora or probios or even a finger full of yogurt every day.

              Gail
              http://www.pawproject.org/

              http://catinfo.org/

              Comment


              • #8
                Originally posted by GailS View Post
                Dear Marci, Is this Shy Anne you're talking about? even if you had all the money in the world, some cats just aren't cut out for a lot of messing about and teatments. You know her best and I know you believe quality of life is more important than quantity. You'll do the best you can by her and not let her suffer, I know.

                A very dear friend of my lost her little kitty to an intesitnal lymphoma last year. They had the expnsive tests done, but there was nothing to do to save her, all they could do was keep her comfortable until she told them she wasn't, any more, then give her the gift of peace and rest. she didn't last very long, I'm afraid, about 2 months after her diagnosis.

                Has Shy Anne ever had any trouble with constipation? Maybe a long shot, but I wondered if megacolon had been considered. When Ootay's bowels are "full" her intestines feel thick. I'm not a vet of course, but I can tell when she's got to go just by feeling her. When she's "empty" I can't really find her intestines at all.

                Anyway my thoughts are with you as the blood test comes around, it's soon isn't it?

                Gail
                Yup, it's Shy Anne. She's never been constipated nor has she had diarrhea. So this came as a total surprise to me when the vet was telling me about the small intestine being thickened. Shy Anne isn't the kind of kitty that would do well with lots of tests and procedures. It would be one thing to diagnose it easily then treat with chemo but that isn't to be. I'm just trying to figure out whether a thickened intestine could be caused by something other than IBD or lymphoma. We won't be doing the blood work for another month. In the meantime she's feeling very good after having all her teeth pulled.
                Marci DeLisle
                Cats/Rescue, Feral and Stray
                Camp Counselor at Camp Happy Cat
                Owner of NW Critter Sitter - "Paws-itively Purr-fect Pet-sitting"
                Owner of Northwind Reiki ~Animal Reiki for the fur-persons in your life!
                www.nwcrittersitter.com

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                • #9
                  Wish I could offer some helpful info, but since I can't I am sending giant Hugs, purrs and Prayers!

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                  • #10
                    Originally posted by Iluvkatz View Post
                    Wish I could offer some helpful info, but since I can't I am sending giant Hugs, purrs and Prayers!
                    Thanks ... the hugs, purrs and prayers are all very welcome
                    Marci DeLisle
                    Cats/Rescue, Feral and Stray
                    Camp Counselor at Camp Happy Cat
                    Owner of NW Critter Sitter - "Paws-itively Purr-fect Pet-sitting"
                    Owner of Northwind Reiki ~Animal Reiki for the fur-persons in your life!
                    www.nwcrittersitter.com

                    Comment


                    • #11
                      Originally posted by MarciD View Post
                      Yup, it's Shy Anne. She's never been constipated nor has she had diarrhea. So this came as a total surprise to me when the vet was telling me about the small intestine being thickened. Shy Anne isn't the kind of kitty that would do well with lots of tests and procedures. It would be one thing to diagnose it easily then treat with chemo but that isn't to be. I'm just trying to figure out whether a thickened intestine could be caused by something other than IBD or lymphoma. We won't be doing the blood work for another month. In the meantime she's feeling very good after having all her teeth pulled.
                      Even with an unlimited income the price for the tests is quite high and maybe not in Shy Anne's best interests -- or yours. All the money in the world isn't going to help the fact that she's not a good candidate for chemo because of her demeanor, and it's probably better to let her live her life happily until she shows symptoms -- then you'll have to make a decision on some sort of palliative treatment. Remember, SHE doesn't know there's anything wrong. The good news is that she's not having symptoms -- let's hope it stays that way for awhile.
                      Diane and Cicero - Sr. Manager:

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                      • #12
                        Originally posted by DianeP View Post
                        Even with an unlimited income the price for the tests is quite high and maybe not in Shy Anne's best interests -- or yours. All the money in the world isn't going to help the fact that she's not a good candidate for chemo because of her demeanor, and it's probably better to let her live her life happily until she shows symptoms -- then you'll have to make a decision on some sort of palliative treatment. Remember, SHE doesn't know there's anything wrong. The good news is that she's not having symptoms -- let's hope it stays that way for awhile.
                        Yup, that's kind of my take on the situation. Doesn't thrill me but may be the most reasonable thing given her attitude about the world. I just wish I could find out if the thickened intestine is ONLY present with IBD or lymphoma or whether there are other conditions that it might show up in that could be treated without robbing a bank.
                        Marci DeLisle
                        Cats/Rescue, Feral and Stray
                        Camp Counselor at Camp Happy Cat
                        Owner of NW Critter Sitter - "Paws-itively Purr-fect Pet-sitting"
                        Owner of Northwind Reiki ~Animal Reiki for the fur-persons in your life!
                        www.nwcrittersitter.com

                        Comment


                        • #13
                          Originally posted by MarciD View Post
                          Yup, that's kind of my take on the situation. Doesn't thrill me but may be the most reasonable thing given her attitude about the world. I just wish I could find out if the thickened intestine is ONLY present with IBD or lymphoma or whether there are other conditions that it might show up in that could be treated without robbing a bank.
                          Here's a link that explains various ultrasound findings. If you scroll down far enough you['ll find some causes of thickened intestinal wall: http://www.vet.gla.ac.uk/EVDI/fo-GI-ultra.pdf
                          Diane and Cicero - Sr. Manager:

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                          • #14
                            Originally posted by DianeP View Post
                            Here's a link that explains various ultrasound findings. If you scroll down far enough you['ll find some causes of thickened intestinal wall: http://www.vet.gla.ac.uk/EVDI/fo-GI-ultra.pdf
                            Thanks for the link ... I saved it and will be reading it and trying to digest all of the information. I guess the next thing is to ask my vet whether she thinks a ultrasound would show enough to diagnosis correctly. I'm not sure they even do ultrasound at our vet clinic and not sure if there's any vets close by that do. Then again it may still be out of my ability to afford it also (I have no idea what an ultrasound would cost). She has NO symptoms which is why when she said the small intestine was thickened it so surprised me. She doing much better since getting the teeth out and seems to be very happy at the moment. When I'm lying down in bed she comes up and wants to be petted and loved but is still shy about being touched if I'm standing over her.
                            Marci DeLisle
                            Cats/Rescue, Feral and Stray
                            Camp Counselor at Camp Happy Cat
                            Owner of NW Critter Sitter - "Paws-itively Purr-fect Pet-sitting"
                            Owner of Northwind Reiki ~Animal Reiki for the fur-persons in your life!
                            www.nwcrittersitter.com

                            Comment


                            • #15
                              >>>I have no idea what an ultrasound would cost<<<

                              Hi Marci,

                              Our 55-pound dog had an ultrasound of the pelvic area in April. It was about $300 which included $20 (I think) for their report to go to our vet. they shaved her stomach but didn't need to sedate her, and she didn't seem at all traumatized when I picked her up, but she's not shy. I wonder if it would cost less for a cat with much less area to cover. Anyway, I wish you the best outcome possible.

                              Carol

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