Ozzy M.

Ozzy McElwee - Rochester, New York
Male, Domestic short hair
Born Approximately May, 1, 2005
Diagnosed with IBD in March of 2009

First Entry: May 1, 2009
March 2006: When Ozzy was almost one year old, he began vomiting after he ate his meals. It did not matter
whether it was soft or hard food. He would vomit about once a day. We went to the vet and had blood and urine
tests, x-rays, and an ultrasound. All came back normal, but the ultrasound showed that his pancreas might have
been slightly swollen. The vet recommended a diet change from Fancy Feast soft and hard food (all flavors) to
Royal Canin soft Duck or Lamb, and hard Royal Canin Duck or Lamb. For a period of time after, he also had Hill’
s T/D Dental Diet as a treat. This change to Royal Canin eliminated any vomiting due to food allergies.

2006, 2007, 2008: Ozzy was well, vomiting only occasionally (2 times a month) during this time period. Ozzy
loves food and has a tendency to eat quickly; inhaling his food, so the vomiting we thought might be attributed to
his devouring his food. Ozzy would eat Royal Canin soft food for breakfast and dinner. He ate Royal Canin hard
food for lunch and snacks. What worked well was feeding Ozzy smaller, more frequent meals. We purchased an
automatic, pop up feeder in which we put his hard food and set the timer. We could never leave hard food out for
Ozzy as he would devour all the food in one sitting and vomit afterward. The smaller, timed meals worked much
better. In September 2008, Ozzy was weighed at the vet and he was 10 lbs and 3 oz.

January 2009: Ozzy started to vomit very soon after he ate and it did not seem to matter whether he ate soft or
hard food. We took Ozzy to the vet due to the vomiting, increased thirst, and possible weight loss. He weighed 9
lbs and 8 oz when weighed at the vet. Blood tests, urine tests, and x-rays were normal. When we asked the vet
about a diet change, the vet did not want to change the diet at this point in time. The vet told us to see how he
does and that we could do further testing.

February 2009: Ozzy only vomited a few times the entire month and was doing well.

March 2009: On March 17th, Ozzy began vomiting every time he ate (soft and hard food). We immediately went
to the vet and in 3 days had numerous tests run. Blood tests, urine tests, and x-rays were normal. Another
specialized blood test was sent away to Texas to check for pancreatitis, low B12, and liver enzymes. That test
came back normal. An ultrasound was given and the results showed 2 enlarged lymph nodes in the stomach.
Ozzy weighed 8 pounds 11 ounces.

The vet thought Ozzy might have IBD or a motility problem with his stomach not emptying in a proper fashion.
We were told to try Natural Balance venison soft food and stop feeding him the Royal Canin soft and hard food.
Ozzy ate this food for 2 days and then refused to eat it. Even though Ozzy couldn’t keep food down, he was
constantly sitting by his food bowl wanting food, as he was still hungry. He continued to vomit each meal and
became dehydrated and needed an enema. Ozzy began taking metoclopramide to help with the vomiting. (It did
help with the vomiting, but he was very restless on the medicine.) Our vet suggested we receive a second
opinion from an internal medicine specialist. At the March 25th specialist appointment Ozzy weighed 8 pounds 8
ounces.

The specialist recommended a change to Hills prescription Z/D soft food. No hard food now. Both the vet and
the specialist believe Ozzy could have IBD (especially due to food allergies when he was so young) and that any
motility problem is being caused by IBD. Further testing could be conducted (endoscopic to get biopsies or more
invasive surgery), but since Ozzy was losing so much weight and vomiting each meal any surgeries were put on
hold, and medicine was prescribed. Ozzy weighed 8 pounds 4 ounces.

Ozzy began 5mg of prednisolone tab each day and 2.5 mg tab of Pepcid AC each day. He began suffering from
constipation, having bowel movements only every other day. He began Kristalose (a powder to put in his food for
constipation). With the diet change to Z/D soft food, with the prednisolone, Pepcid, and Kristalose, Ozzy is doing
better. He has not vomited and likes the food. He has only gained 4 ounces back, so we are concerned about
him gaining more weight. He just finished 30 days of the prednisolone and will be tapering to every other day. If
he doesn’t do well with the tapering of the prednisolone, I am not sure what will be the next step.

Update: July 24, 2009
May 2009 - We went to the vet after Ozzy tapered to 5 mg of prednisolone every other day for a month. The vet
said he was not doing well at all! He weighed 8 pounds 2 ounces, which was the lowest weight he had been
since he had been ill. He was also diagnosed for the first time with thickening of the intestines. The vet explained
that she didn’t think the dosage of the prednisolone had been aggressive enough at 5 mg. I was stressed about
this because 2 vets and 1 specialist had determined that 5 mg was the right dosage at the time.

So in June 2009 Ozzy immediately started 10 mg of prednisolone daily. We gave him a 5 mg pill in the morning
and a 5 mg pill in the evening. He was also given his 2.5 mg tab of Pepcid AC each day. The vet changed his
food from prescription soft Hills Z/D food to Royal Canin soft venison. We also began Royal Canin hard rabbit
food that we crush and put on top of his venison like sprinkles. After talking to Lisa (Alex's mom), I told the vet
that I wanted to give Ozzy vitamin B-12 injections. The vet thought this was a great idea on Lisa's part, even
though Ozzy’s previous test results showed he was fine for B-12. Oz received B-12 shots once a week for one
month and now we are going to try monthly shots. After 4 weeks on the 10 mg of prednisolone with the Pepcid
AC daily, Ozzy’s intestines did not feel thickened any longer and he had gained weight to 8 pounds 15 ounces.
(13 ounces in 4 weeks was the weight gain). He looked so much better. The vet kept him on the 10 mg dosage
for 4 weeks. I did notice with the 10 mg amount that he urinated more and sometimes seemed to breathe faster.

In July 2009 Ozzy’s prednisolone was tapered to 7.5 mg daily for 2 weeks. We gave him a 5 mg pill in the
morning and 2.5 mg in the evening. He still takes the Pepcid AC. The tapering is now at 5 mg daily for 2 weeks.
At this point in time, he has maintained his weight and not vomited at all.

Update: September 28, 2009
Oz tapered the prednisolone to every other day at 5 mg. He vomited a few times at the start of the every other
day tapering and our vet wanted him to go back on prednisolone every day at 5 mg.

At the beginning of August 2009, at times when Oz went into the litter box he began vocalizing as if in
distress/pain. Initially, we were not sure if his vocalization related to inability to urinate or defecate. After
vocalizing, he would then urinate so we surmised the distress was related to an inability to urinate. A urine
sample, urine culture, and x-ray showed appeared negative.

We were also concerned because Ozzy was breathing rapidly. When checked at the vet his heart rate was 130
when he was nervous, which is not fast. The rapid breathing is a serious concern. Our vet suggested an upper
chest x-ray be taken. The x-ray was done and our vet noted that Ozzy’s heart looked normal (not enlarged), an x-
ray would not show any thickening of the artery walls. She also did not note any issues in the lungs from what
she could see in the x-ray.

Separately from the issues above Oz began taking Entocort (budesonide) at 1.5 mg daily and stopped taking
prednisolone. This is a steroid that has fewer long-term side effects than prednisolone. The capsules were the
3mg size (too big for him to swallow), so we bought number 4 gel caps and took the beads from the 3 mg
capsule and put 1.5 mg in each gel cap. Please note he does not take the budesonide that has the powder in the
capsules, but takes Entocort, which is beaded. Oz began to have bowel movements a few times a day with some
diarrhea. He has never had diarrhea with IBD, but battled with constipation in the past. My vet did not know what
dosage Oz should take and was not aware of the difference between the powder and the beaded Entocort.

I contacted Dr. Louis J. Camuti Memorial Feline Consultation Service at Cornell University, to speak to a Cornell
Feline Health Center’s consulting veterinarian. The number is 1-800-548-8937. After discussing Oz’s specific
history, we changed the dosage to 3 mg of Entocort for 2 weeks to assess whether that would work. The
diarrhea went away and Oz was eating well. Our vet did not feel any thickening of the intestines at his visit and
he has had no vomiting issues.

The consultation service was contacted again after Oz had been on the Entocort for 2 weeks. Based on the
consultation with Cornell, we are reducing his dosage to 2 mg daily. The desire with this approach is to
determine the lowest dose for him that will control his disease. I also asked about the rapid breathing and
straining/pain when urinating or defecating. Since he has had constipation problems in the past, I was advised
to try Kristalose for the constipation, which we have used in the past. This way we can try to tell if the
straining/pain is due to urinating or defecating.

In regard to the rapid breathing, Cornell also recommended visiting a cardiologist to check his heart due to the
rapid breathing. We are in the process of scheduling this appointment.

Update: February 15, 2010
In October of 2009, Ozzy went to Cornell to have his heart checked out due to rapid breathing. Everything was
fine with his heart. We then went back to our regular vet and checked his blood and his white blood cell count
was extremely, extremely low. Our vet had us immediately change his Entocort dose of 3 mg to every other day
at 3mg with the plan to test his blood again in one month. The white blood cell count did improve some after one
month. Also, his breathing was less rapid with the Entocort change to every other day. Therefore, it appears that
the rapid breathing was due to steroids. Ozzy receives vitamin B-12 shots every 2 weeks and they really help
him.

Oz started to lose weight in the middle of December 2009 (I weighed him on the baby scale daily and he had lost
about 5 ounces) and was vomiting some, so we took him to the vet, because we recognize the signs of IBD
problems. The vet recommended that we do nothing and continue to watch him, since he appeared healthy.
Please note that I know my cat and I should have pushed for a medicine change.

Within three days of going to the vet, we had to rush Ozzy to an emergency animal hospital in the middle of the
night for severe vomiting, diarrhea and dehydration. They had to stabilize him and he was the most ill he has
ever been. Blood work indicated that his liver numbers were a touch high, but they attributed that to his
vomiting. We changed our regular vet. His weight at the hospital was 7 pounds 14 ounces, which is the lowest
he has ever weighed. The emergency animal hospital was excellent. They gave us anti-vomiting medication
(metoclopramide), anti-diarrhea medication (metronidazole) and a change from Entocort to prednisolone. The
dosage we are trying for the prednisolone is 5 mg in the morning and 2.5 mg at night. He stopped vomiting and
the diarrhea stopped within 2 days of changing to prednisolone.

He has had one bad episode within the last three weeks so we gave Oz a dose of the metoclopramide and the
metronidazole and he improved. The use of these two medicines is only on an as needed basis when he is
having a bad bout. We visit our vet again in a few weeks. An ultrasound was done at the emergency hospital and
an enlarged spleen was found. We have not had any further tests done on the spleen at this point in time. We
are also giving him L-lysine every other day for his immune system and B12 injections weekly instead of every
two weeks because of malabsorption.

Update: June 22, 2010
Ozzy started taking metronidazole (Flagyl) daily (1/4 of a 250 mg tablet) about a month ago due to some diarrhea
issues. He has had no diarrhea problems since taking it daily. He is still taking Prednisolone daily, but we are in
the process of tapering the dosage. Ozzy continues to get weekly B12 injections which really help him. Also, at
Lisa's suggestion we transitioned his food from soft Royal Canin venison to soft Royal Canin rabbit. Ozzy loves
the rabbit as he was getting tired of the venison and Lisa explained that it is important to change foods over time.
Ozzy has Eagle Pack probiotics sprinkled in his soft food once a day.

Ozzy has been doing well with the combination of meds, probiotics, food, and B12 injections in the above
paragraph. He has gained weight in the past 2 months from 8 pounds to 8 pounds 10 ounces! That is wonderful,
since 8 pounds was so thin and scary! I am hoping he can continue to gain weight even as we taper the
prednisolone. He will probably have to keep taking Prednisolone, but we need to determine what the lowest
dose will be that works for him. It is a constant battle every day to balance all of the items Ozzy needs to fight the
IBD.

Update: November 20, 2010
Ozzy has had his ups and downs the past months. He was doing well, so the prednisolone was reduced and the
Flagyl was stopped. About a month ago, he started hunching in pain and discomfort when he would be eating.
Also, he would jump/run away from the bowl during the time he was eating in pain and lift up his back right leg.
The vet recommended Flagyl for 2 weeks and we did see some improvement, but not totally. Since Ozzy has
also been troubled at times with constipation, we started Miralax 2 times a day in case the pain was related to
constipation. Then the vet started Ozzy on a higher dose of prednisolone of 10 mg a day (5mg pill in morning
and 5 mg pill at night). He has been on this dose for a week now and I rarely see the hunching and running away
in pain from the food bowl. The vet wants to continue this dosage for a short while to ensure we have treated the
flare up of IBD. The vet did not see any problems with Ozzy's gums or teeth or anything to note from a physical
exam.

He has a Pepcid pill at night and continues to receive .35 ml of vitamin B12 shots weekly. At times, Ozzy is given
probiotics and Symbiotics Colostrum Plus Powder for his immune system. I alternate what I give Ozzy since I
can't give him a ton of meds and supplements at one time. He is currently eating a new food for him called
Natural Balance venison and pea soft canned food and he loves it. It is huge news that Ozzy has gained weight
and is now at 9 pounds 3 ounces. The additional prednisolone is helping with weight gain the past week, but
Ozzy had been steadily gaining weight prior to this even though he was in pain. Since our vet did not detect
anything negative during the physical exam and since Ozzy had a good appetite/weight gain during the time the
hunching/pain started, she is figuring it is a flare up of the IBD. This is the most Ozzy has weighed in probably a
year! We are taking Ozzy for a blood test to check things out, since we need to be sure it a flare up of the IBD
and not anything else. Ozzy does his best to fight this terrible IBD that he has had from such a young age and he
is only 5 years old now.

Update: June 8, 2011
Ozzy had a blood test at the end of 2010 and everything was fine. He continues to take prednisolone daily for his
IBD. His dose is 5 mg one day and 7.5 mg the next day and back to 5 mg the next day. We have not been able to
reduce his dosage any further and at times he has battled diarrhea. When he has bouts of diarrhea, we give him
a quarter of a 250 mg Flagyl pill daily. Flagyl has worked well for him. Ozzy receives Pepcid each night. We
stopped the Pepcid to see if he really needs it and Ozzy sits under the dining room table looking uncomfortable
and does not eat as much and one time vomited without it. The Pepcid helps with the acid.

Ozzy continues to eat soft canned venison or rabbit. He receives B-12 injections weekly of .35 and I don't know
what he would do without them. They really help with his energy, digestion, weight, and IBD. I am happy to note
that he just weighed in at 10 pounds 2 ounces. He has gained approximately 1 pound in the past 6 months! This
is so important, since a bad IBD bout reduces his weight so quickly! The most Ozzy has ever weighed (prior to
this IBD nightmare) was 10 pounds 3 ounces, so his current weight is great for him.

I have not been giving Ozzy any probiotics or colostrum powder or L-lysine for the past 3 months. I need to start
giving him some of these things again as I know they help him. Ozzy has been doing well as long as he takes his
meds, B-12 shots, and eats the proper food. He just turned 6 years old and I love him so very much!

Update: February 6, 2012
Ozzy had his checkup and blood testing in October and everything was fine. His medications continue to be
prednisolone, Flagyl for diarrhea when needed, vitamin B-12 shots, and Pepcid. He is eating Natural Balance
venison and pea. I tried to transition his food to lamb in November, but he had terrible diarrhea, so went back to
venison.

At the start of December, Ozzy started licking and cleaning more than normal. My husband and I were extremely
stressed with working long hours and preparing for Christmas. I noticed the fur on Ozzy's left side was thinning
slightly from the over grooming. Relatives visited for Christmas. The day after Christmas, Ozzy's fur was gone on
a large area on his left side. It seemed to happen overnight! Our vet tested for mites, fleas, and fungal infections
by taking hair and skin scrapings and all came out negative. The vet believes the over grooming is due to stress
and can lead to self mutilation.

We focused on spending quality time with Ozzy including playing with him, distracting him when he would lick
obsessively, and purchased a calming collar for him to wear at times. The licking decreased some. However, the
vet said when a cat gets in this mode of over grooming, it is hard to stop even if the stress improves. Ozzy's
appetite was fine and his weight steady. We noticed that he needed Flagyl daily, since when the Flagyl was
stopped, he would have diarrhea. Usually, we give Flagyl for a week or two and it takes care of the diarrhea.
The vet thinks the over grooming is due to stress and with IBD any stress can result in flare ups and diarrhea.

Ozzy's fur started to thin on his right side from cleaning so much, so we started Prozac a week ago. After a few
days he was constipated. We stopped the Flagyl and increased the Probiotics. The dose of Prozac is 1/8 to 1/4
of a 10 mg pill (vet said to reduce the dose to 1/8 if constipation) daily. The Prozac makes him dopey, but I
already noticed the obsessive licking is better. The next steps are to see if the over grooming will stop, so we
can taper him off the Prozac and hopefully have no diarrhea to keep him off the Flagyl.

It has been frustrating and scary to watch my kitty obsessively lick fearing that it will lead to self mutilation. If you
notice that your kitty is licking and cleaning more, please get to the vet as soon as possible to address any
problem. Please remember that when we are stressed, our kitties absolutely sense this.

Update: February 20, 2012
On February 8 at 7am, I realized that Ozzy had not urinated the day before. I put Oz in front of the litter box to
see if he would urinate. He went into the box and nothing came out so he climbed out. Right away he went into
the litter box again and could not urinate, not even any drops, so I rushed him to the vet. I know that if a male
kitty can not urinate it is life threatening. The last times he urinated prior to this everything seemed fine. I had
been observing Ozzy each time in the box, as he was having diarrhea and I was tracking occurrences.

Ozzy's bladder was like a snow globe full of crystals and it was a medical emergency, as male kitties can quickly
die from blockages, toxins backing up, or kidney and organ damage. The vet anesthetized him to unblock a
lower urinary tract obstruction caused by calcium oxalate crystals and spasm of his urethral muscles. He had a
urine culture and blood test and was hooked up to an IV for fluids, a catheter, and had a cone around his head
when we visited him at the hospital. There was no infection after a urine culture.

They were going to keep him for 3 to 5 days/nights, but Ozzy was so stressed that they could not get near him
without him growling/screaming and trying to defend himself. I have never seen my kitty so upset. We took him
home after being in the hospital for one night since our vet thought Oz's recovery would be better at home.
Usually a kitty is supposed to continue getting IV fluids and pain meds, keep a catheter in to see if any more
blood and crystals result, and must be able to urinate on their own before being released.

prazosin was prescribed for 5 days, which relaxes the bladder to help him urinate and relieve discomfort. At first
he urinated frequently in small amounts. Then on Sunday (unblocked on Wed.) he began urinating with a greater
volume. Then a few days later, he seemed to be back to his normal urine volume. The blood test results showed
no kidney damage, since we rushed him to the vet so quickly.

I can not stress enough that if your male kitty can not urinate or is straining to urinate, you must rush him to your
vet or emergency hospital as this is life threatening. With Ozzy, there was no straining to urinate and he was
playing and eating normally. He just stopped being able to urinate! The only thing to note is that since December
he had been over grooming and you can read my last update about specifics. Whether this was due to painful
crystals we do not know as these can form within a few days, so not sure if timing is right. Calcium oxalate
crystals that form must be flushed or surgically removed, so it is critical that Ozzy has enough water to prevent
these from forming again. My vet does not recommend changing his Natural Balance venison canned food. I
spoke to a Cornell Feline Consultation vet and she agreed and explained that Prednisolone does not contribute
to calcium oxalate crystals based on what they know, but can contribute to infections (Ozzy was negative for
infections with urine culture). She told me that calcium oxalate crystals/blockage is not something they see often
in kitties with IBD.

October 10, 2012
Ozzy has been eating Natural Balance venison and pea soft food. He continues to need a 5 mg prednisolone pill
each morning and a 2.5 mg pill each night. Whenever we try to reduce the dosage he has issues. If he has any
bouts of diarrhea, we use Flagyl and that works well. I stopped giving Ozzy probiotics and his vitamin B12 shots
for a short while. He started to lose a few ounces and had diarrhea on and off, so have resumed them. I have
said it before that vitamin B12 shots help him a great deal, so need to be sure I am diligent in getting him these.
Sometimes Ozzy gets constipation and I use Miralax.

Since his urinary blockage and calcium oxalate crystals in his bladder last February, I keep a daily log of how
often he urinates in the litter boxes. I keep the log on the refrigerator and make a notation of the time of urination
when I clean the litter box. For example, if I know he urinated at 8 pm. I note that. If I am out of the house and
return and clean the litter box, I note a range of time as 1 pm to 5 pm for example. The reason for this log is to be
sure Ozzy is urinating 3 or 4 times per day. The vet would like him to be urinating about 3 or 4 times per day to
prevent urinary tract issues, so the log ensures I pay attention to this. One time we had a person putting in a new
bathroom floor for us and Ozzy went 6 times per day when he was here, due to stress. When Ozzy was
constipated, he only went 1 to 2 times per day, so I increased the water I put with his soft food. When I look at
the schedule for Ozzy, he has consistently gone 3 or 4 times per day most every day, so this has worked well.
Also, my husband and the two pet sitters make notations on the log, if they clean the litter boxes.

Ozzy does not like to drink water from his bowl or his fountain, so I put a little water with his soft food. This helps
to be sure he is getting enough water and urinating appropriately. This log may seem like an effort, but it is
valuable after his life threatening blockage and crystal scare, his lack of interest in drinking water, his IBD health
concerns, and four of us cleaning out the litter boxes. Ozzy is due for blood work in December. His IBD continues
to be a challenge and I work each day to try to give Ozzy the best quality of life I can.

Living With IBD - Ozzy M.