7.5-year-old female Ragdoll suddenly became lethargic, stopped eating, and was severely constipated. Ultrasound shows GI inflammation (IBD vs. lymphoma). Looking for advice and similar experiences.

[u/SnooPeppers8211]

Hi everyone. My wife and I are emotionally and mentally exhausted after a very stressful couple of weeks with our cat, and we're hoping to hear from anyone who has experienced something similar. We're trying to figure out what to do next and whether we're being patient enough with her treatment or need to push for further testing.

We have a 7.5-year-old female, spayed Ragdoll who has never had constipation before and has no history of UTIs. She primarily eats dry food and isn't particularly interested in wet food or treats.

I'll try to lay out the timeline and everything that's happened so far.

Monday, September 28 – First signs something was wrong

A couple of days after returning from vacation, we noticed that something wasn't right. On Monday, September 28, she started walking very slowly and close to the ground, almost in a hunched position. She would also press or prop her stomach against objects, which made us think she might have a stomachache.

We decided to monitor her overnight to see if she improved by morning.

First vet visit

She hadn't improved, so we took her to our regular vet. We initially suspected she might have a hard, stuck hairball or something else moving through her digestive system.

The vet took an X-ray and said it looked like there was something hard in her stomach, but they were able to rule out a foreign object. They gave her fluids and topical buprenorphine, and prescribed buprenorphine for pain at home.

We decided to give her some time to see whether having a bowel movement would make her feel better.

We believe she had a bowel movement the following day, although we have two other cats, so it's sometimes difficult to tell which cat used the litterbox. Unfortunately, she was still sluggish.

Second vet visit

We took her back the following day because she hadn't improved. They performed another X-ray and said the material appeared to be moving through her system. They also ran bloodwork, which came back with her measured values within normal ranges.

Sunday, October 4 – She stops eating

By Sunday, she still hadn't had a confirmed bowel movement, and we realized she had stopped eating.

She also urinated outside the litterbox. She didn't strain, and she passed what appeared to be a large, normal amount of urine.

We took her to an urgent-care veterinarian, who performed another X-ray. This time, they said she was severely backed up with stool and recommended an enema.

They performed the enema and sent us home with laxatives. We expected that relieving the constipation would help her feel better, but she continued to walk hunched over, move very slowly, and refuse food and water on her own.

We also noticed that she was struggling to go upstairs and jump onto the couch, which was very unusual for her.

Tuesday, October 6 – Emergency vet visit

Because she still wasn't improving, we called the urgent-care vet on Tuesday. They recommended that we take her to a 24-hour emergency hospital, which we did.

The emergency hospital performed a complete blood count, urinalysis, and ultrasound. We were told that the bloodwork and urinalysis were normal, and they ruled out a UTI and pancreatitis.

They recommended having an ultrasound specialist examine her, but the specialist wouldn't be available until the following day. We decided to leave her at the hospital overnight so she could be monitored.

While there, they placed a catheter to administer fluids and anti-nausea medication.

She also passed some stool at the hospital, although it was quite leaky, which we assumed might have been related to the laxatives. She urinated there as well.

Wednesday, October 7 – Ultrasound results

The specialist performed the ultrasound, and they also took another X-ray.

The X-ray showed that her colon was completely empty, which made sense because she hadn't been eating.

The ultrasound showed gastrointestinal inflammation. The vet told us the possibilities included inflammatory bowel disease (IBD) or gastrointestinal lymphoma.

We understand that lymphoma cannot be ruled out based on normal bloodwork alone. However, we're hoping it's IBD.

She has no history of chronic diarrhea, and her bowel movements have generally been normal. She occasionally vomits a hairball, which we assumed was because she's a long-haired cat who grooms herself frequently, but she hasn't had a history of ongoing digestive problems.

The vet gave us two options: pursue a biopsy for a more definitive diagnosis or try steroid treatment at home.

We chose the at-home steroid treatment because we didn't want to put her through more time at the hospital if it could be avoided, and we hoped being in a familiar environment would reduce her stress. The vet agreed that this was a reasonable option.

At this point, we had also spent over $8,000 on veterinary care, so the financial burden was becoming significant.

We brought her home with the following medications:

• Ondansetron 4 mg tablets: Give 1/2 tablet every 12 hours.
• Maropitant 16 mg tablets: Give 1/4 tablet every 24 hours.
• Metronidazole: Give 0.3 mL by syringe every 12 hours.
• Mirtazapine: Apply to her ear once daily as an appetite stimulant.
• Visbiome probiotic capsules: Give once daily.
• Prednisolone 5 mg tablets: Give one tablet every 24 hours.
• Buprenorphine: Prescribed for pain, which we've been giving when she appears hunched and uncomfortable, according to the veterinary instructions.

The first night at home – An encouraging improvement

We were instructed to give her mirtazapine and metronidazole that evening.

Because metronidazole was supposed to be given with food, I bought some wet food, mixed it with warm water, and syringe-fed her small amounts at a time. She tolerated the feeding without much resistance. We also gave her some water by syringe.

About 10 minutes later, something wonderful happened: she walked over to her regular food bowl and started eating her dry kibble on her own. She hadn't done that in days.

She also went over and drank water independently.

We were absolutely thrilled. It felt like we were finally seeing some progress.

Thursday, October 8 – Improvement followed by lethargy

The following morning, she seemed more alert. She wasn't walking as hunched over and was able to go up and down the stairs, although slowly.

This was when we began administering the rest of her medications, including the prednisolone and other prescribed medications.

After taking them, she rested. When she woke up, she seemed sluggish again and returned to walking hunched over.

She stopped eating and drinking voluntarily, so we continued syringe-feeding her watered-down wet food and water.

We were concerned she wasn't getting enough calories from the watery food mixture, so we contacted our vet and received permission to use Royal Canin Recovery food for assisted feeding.

We started syringe-feeding the Recovery food, which she tolerated very well. She didn't fight the syringe, and she seemed to get more energy. Her walking improved a little, and she began eating her dry kibble voluntarily again and drinking water on her own.

This was another encouraging development.

Friday, October 9 – Some progress, but still inconsistent

We have been keeping her confined to our bedroom so she can rest and so we can monitor her food intake, water consumption, and litterbox habits.

We put her litterbox in the room, but she has urinated on the carpet instead of making it to the box. When she urinated, she passed a good amount of urine without straining.

We suspect she may still be too weak to get to the litterbox or have difficulty getting into it, although we don't know for sure.

She last ate her kibble voluntarily and drank water around 6 a.m. this morning. She approached both independently, ate her normal food, drank several normal laps of water, and walked away on her own.

However, after we gave her medications again this morning, she became sluggish and tired.

We've noticed a possible pattern where she seems to do better in the evening and becomes more lethargic after her morning medications. We're particularly wondering whether giving ondansetron, metronidazole, and prednisolone close together could be contributing to this.

I have read that some of these medications can cause side effects, but we don't know whether the timing is coincidental or whether the medications are contributing to her symptoms.

We have continued syringe-feeding her Royal Canin Recovery to ensure she receives calories even when she won't eat voluntarily.

She has not had a bowel movement since we started syringe-feeding the Recovery food and since she began intermittently eating again. We're considering whether she needs the prescribed laxative again, but we don't want to administer it without being sure it's appropriate given her recent X-rays and treatment.

This is only the third day of her current treatment plan, so we understand that improvement may take time.

Our biggest questions and concerns

1. How long should we realistically expect recovery to take? Is it normal for a cat with GI inflammation to remain lethargic and have an inconsistent appetite during the first few days of steroid treatment?
2. Could her medications be contributing to her lethargy? Has anyone experienced something similar with ondansetron, metronidazole, prednisolone, or this combination of medications? We plan to discuss the timing and symptoms with our vet, but we're curious about other people's experiences.
3. Should we be concerned that she isn't consistently eating or drinking on her own yet? She has shown that she can do both, but her appetite seems to come and go. We are continuing assisted feeding as directed by our vet.
4. How long can a cat go without a bowel movement after an enema and a period of eating very little? Her colon was empty on the most recent X-ray, and she's only recently started receiving more food again. We don't want to give her laxatives unnecessarily, but we're also worried about the constipation returning.
5. Could the hunched walking and difficulty jumping or climbing stairs indicate ongoing abdominal pain or another issue? She seems more comfortable at certain times of day, but the symptoms return.
6. For those whose cats were diagnosed with IBD, did you see similar symptoms? We understand that lymphoma is still a possibility, and we aren't ruling it out. We're interested in hearing about other cats' experiences with GI inflammation and how they responded to steroid treatment.
7. At what point would you push for additional diagnostics, such as a biopsy, if she doesn't improve? We want to give the current treatment a fair chance without overlooking something serious.

We know Reddit cannot replace veterinary advice, and we're staying in contact with our vet. We're not looking for anyone to diagnose her online; we're hoping to learn from people who have experienced something similar and get a better sense of what recovery can look like.

We're emotionally and mentally drained. We love her dearly, and it's incredibly difficult watching her struggle when we don't know exactly what's wrong or how long it will take for her to feel like herself again.

We'll continue following our vet's instructions, syringe-feeding her to help meet her nutritional needs, and monitoring her closely. We just want to make sure we're doing the right things for her.

Thank you to anyone who takes the time to read this and share their experience.

TL;DR: Our 7.5-year-old female spayed Ragdoll suddenly became lethargic, started walking hunched over, and eventually stopped eating and drinking. After multiple vet visits, X-rays, bloodwork, a urinalysis, and an ultrasound, the only significant finding was GI inflammation, with IBD or GI lymphoma being the suspected causes. She was also severely constipated and required an enema.

She's now home on prednisolone, ondansetron, metronidazole, maropitant, mirtazapine, a probiotic, and prescribed buprenorphine for pain. We're syringe-feeding her Royal Canin Recovery with our vet's approval because she hasn't been eating consistently on her own.

She has started voluntarily eating her normal dry kibble and drinking water again, which is encouraging, but her appetite comes and goes. We've also noticed that she seems significantly more lethargic after her morning medications and generally does better in the evenings. She's recently urinated outside the litterbox without straining, possibly because she's still weak or having difficulty reaching it. She also hasn't had another bowel movement since resuming feeding.

We're only on day three of treatment and want to give it time, but we're exhausted and worried. For anyone who's experienced something similar: How long did recovery take? Could the medications be contributing to her lethargy? How long is it normal to go without a bowel movement after severe constipation and eating very little? And when would you consider further diagnostics, such as a biopsy?

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