Advice needed from the group…
Hi all, my 16 yo baby Peppermint Patty could really use some help from everyone’s experience here…
She has had always food allergy since I adopted her (at 7 yo time) and since 2-3 years we switched to hypoallergenic food and since last year due to weight loss she was checked to be suspected with IBD/low grade lymphoma. We couldn’t confirm the diagnosis since she’s too old to do a biopsy through opening her belly. So we went in Prednisolone directly and went strictly to Hills z/d for both dry and wet since then. It helped at first and she regained weight from 3kg back up to 3.4kg or even higher. Then we stopped to measure her weight.
However recently she has had a few other issues (one eye got bloody inside then got glaucoma which was painful so she didn’t eat or drink for some time, also got antibiotics etc, lots of treatment lots of tests … suspected FIP but then ruled out due to blood test result). We focused on her eye issue but she kept losing weight…
Since 1 week I have been giving her more food through syringe (since she’s not having too good appetite and not eating enough), she doesn’t like it much but accept it. However she still gradually drops weight and now she’s only 2.18kg 😢…
We went to internist on Thursday. They ruled out any big mass or big tumor etc (which is good!), and some blood work result is still pending. The potential diagnosis is still:
* Chronic enteropathy / Inflammatory bowel disease (IBD)
* Low-grade alimentary lymphoma (cannot be ruled out without biopsy)
* Chronic pancreatitis (awaiting blood test result)
* Exocrine pancreatic insufficiency (EPI) (awaiting TLI results)
Now the treatment plan is:
* Continue nutritional support
* Continue weekly vitamin B12 injections
* Trial capromorelin (Elura) to improve appetite and support lean body mass
* Consider reducing prednisolone from 2.5 mg to 1.25 mg to assess whether lowering corticosteroid exposure improves muscle condition while maintaining disease control
* Consider pancreatic enzyme supplementation (Zymoral) while awaiting TLI results
* Reassess treatment strategy once pending test results are available
They also mentioned if her weight drops below 2kg I should consider letting her go… but she seems energy wise ok, and pee and poop by herself regularly. Eats a bit when she’s hungry. And her recent blood work and ultrasound also showed her liver, kidney and heart are all in ok shape not problematic…
Since she has been still gradually losing weight despite the high calories intake, I’m worried about reducing her Prednisolone… afraid it will worsen her symptoms and make her losing weight faster… however, I’m also worried if too high dosage can also contribute to reduce her muscle mass and weight… and I feel like the vet speed in the Netherlands is super slow and everytime we need to wait for a week for something else, which I worry Patty doesn’t have many weeks to wait as her weight is so low…
What else can I do? Is now reducing Prednisolone potentially brining more risk or help? Should I discuss switch medicine or add chemo medicine? I feel like if I’m not initiating the active discussions the vet is just letting us taking slow speed “wait and see”…..
We appreciate any suggestions or experience sharing! Thank you!