RE: Hypocalaemia and diarrhoea in a cat

Michael Woodhouse — Tue, 04 Feb 2025 00:14:49 GMT

My answer is vastly more simplistic - stick on steroids and see if the cat will eat raw liver. It's a great source of vitamin D.

RE: Hypocalaemia and diarrhoea in a cat

Mayank Seth — Mon, 03 Feb 2025 12:25:58 GMT

Catherine Gerrie

Hi Catherine

I read you case description thinking to myself "I have lots of ideas that could help". I then got to the end of your message and you ahd already covered most of them off!

-Firstly I would make REALLY sure that compliance is good and the cat is truly being seen to get the meds ytou think it is when it should be. After that, a "proper" hypoallergenic diet trial is absolutely the first thing that I would try. Advantages -rednuces medication related side effects and potentially costs, it sounds like ther is a reasonably diet responsive component of the GI signs and there's plenty of evidence to suggest that one failed diet trial can be followed by another successful one. Disadvantage - time/frustration if it doesn't work.

-I think its very reasonable to think about immunosuppression. There are the usual caveats/discussion points around obtaining GI biopsies to exclude infectious/neoplastic disease etc first but in cats witha very stable/chronic history I think there is a good couterarguement that can also be made to the necessity of these. If you want me to expand on this further I can, but its a long ramble/tirade so will spare you for now! I would agree that chlorambucil is a reasonable choice in this setting as pred for a "sort of stable" patient is not a great long term option, both in terms of calcium control and the rest of the side effect profile. There are obviously a load of diets that you can try. I've always beleived in Specific Allergen Management Plus in terms of palatability/results (mainly becuase its both wet and dry).

-I think that many would advise testing fPLI in the face of intermittent anorexia ina gI cat. You can, but other than putting a name to the problem I'm not sure what it would change! Could perhaps try buprenorphine if its a problem?

-I've never used budesonide in a cat, mainly because I've only ever used budesonide out of desparation and when you ahve chlorambucil available I've not ahd experience of getting that desparate!

-I wasn't sure if you are still using calcichew? With long term vit D supplementation you shouldn't need to so this may imply vit d underdosing and if you get that right, its at least 1 less med that you need to worry about for absorption/adminstration.

Hope that's some help!

Mayank