I'm getting desperate, and the specialist vet I got sent to seems annoying and unhelpful soooo who wants to help troubleshoot my cat's GI issues? Details under the cut, be warned, she has GI ISSUES.
My poor Lilycat has not had a solid shit in like six months. She has also been having a hairball about every other week during this time, while historically she very rarely had hairballs. She is not vomiting aside from the hairballs. Her guts make gurgly noises most of the time. This started about two months after she had a very nasty bout of acute pancreatitis that put her in the ER for a day. She required two rounds of steroids to get over the pancreatitis and she developed type "3c" diabetes as a result. The diabetes is still not really fully under control but it's getting there. She gets Lantus insulin twice a day and we're still adjusting the dosing with the help of continuous glucose monitors and blood testing. But still her blood sugar is typically a bit too high. But not crazy. She also has chronic kidney disease, diagnosed about a year and a half ago. She eats a special prescription diet for that (RC renal) and her kidney numbers have all been in normal range for over a year.
She keeps getting UTIs because of the high blood sugar and liquid diarrhea. They clear up pretty well with an antibiotic but I would really rather stop having to go through this, and it is so hard to keep things clean with her GI issues.
She is a good sport about her meds and is in good spirits and not lethargic (she's lazy, but she's fifteen, and she's only barely lazier than she was when I got her when she was seven, so I think it's warranted for her to be a little lazy) and she likes to cuddle and roll around in the sun and groom her baby brother so like, her GI issues are honestly more of a QOL issue for me than for her. She's a very happy kitty cat.
I was convinced she has exocrine pancreatitis insufficiency as a result of damage to the pancreas from her nasty bout of pancreatitis. It would make sense- she's not making enough digestive enzymes so she can't process fur and she's not processing her food well. It would make perfect sense in terms of timing and cause and symptoms. But, her TLI test came back on the low end of normal when she wasn't fasting. I wasn't convinced and had it redone fasting and it was in the middle of normal. I've read a study indicating that CKD kitties can have artificially higher TLI values but my vets seem convinced Lily does not have EPI and don't want to treat with enzymes. And I still think it makes the most sense in every way except for that the test says it's not that and I guess I will believe it.
Some other options are food insensitivity or allergy, GI lymphoma, and IBS. She had an ultrasound done which indicated her pancreas is a bit enlarged and misshapen but her PLI test was normal. Her pancreas has what the vet thinks are benign cysts. Her GI tract shows thickening but no masses. Her T4 is a bit high. Her B12 was low when they checked it a few months ago so I've been giving her weekly injections. She's got a fuck ton of labs so if anyone thinks something else might be relevant I can check and see if we've run that lab lately and tell you what it says.
None of the options I listed really seem to fully explain her symptoms and the timeline? Certainly not as well as EPI would have. I've tried several probiotics and fiber supplements and they seem to help a bit but they don't come close to getting her to normal.
Anyone have any ideas? Why are my girl's shits so wet? The vets seem stumped and want to try throwing a steroid at the problem even though that's probably not good for the diabetes. But idk it might be the best thing to try. I just don't know. If anyone can make sense of this constellation of symptoms any better than I can let me know. My carpets may thank you.