Feline Inflammatory Bowel Disease
Feline Inflammatory Bowel Disease (Feline IBD) is not a specific disease.
It is a group of chronic gastrointestinal disorders, typically indicated by chronic vomiting and diarrhea.
The vomiting and diarrhea cause the cat's body to lose water.
The resulting dehydration causes the body's systems to break down, and can ultimately become a life-threatening situation. Obviously, any cat showing signs of feline IBD should be examined by a veterinarian as soon as possible.
In some cats, there may be obvious symptoms of the disease, such as vomiting after each meal. In others, the signs of feline inflammatory bowel disease may be insignificant, such as vomiting once or twice per month.
Obvious symptoms or not, feline inflammatory bowel disease is the primary cause of gastrointestinal problems in the cat. Middle-aged or older cats are more susceptible to feline IBD, but it can afflict cats of any age.
This is a difficult disease to diagnose, and misdiagnosis is common. Vomiting and diarrhea can have many causes, and are common symptoms of other ailments and conditions. The resulting dehydration can bring on other symptoms as well. In addition, the best test for feline IBD requires an invasive procedure with anesthesia, and that can be dangerous.
Feline inflammatory bowel disease creates an infiltration of inflammatory cells into the lining (mucosa) of the digestive tract. From a clinical standpoint, the cause of feline inflammatory bowel disease is unknown. IBD can, however, be brought on by other factors.
In an article on feline IBD written by author and veterinary medicine pioneer, Dr. Wendell O. Belfield, DVM, he states, "IBD is precipitated by food allergies, intolerences[spelling unchanged], bacteria, and parasites." He goes on to say that "most pets are allergic to horsemeat, some to beef, turkey, chicken... " and that there are "other substances in pet foods that can initiate IBD... chemical preservatives and color enhancers."
Other sources seem to support the concept that reactions, especially to pet food, may be at least partially to blame. For example, the Cornell Feline Health Center tells us that examination of the changes to the tissues indicate that immunologic factors are involved in the root cause. This would imply that if you boost the immune system of your cat it might help. They also indicate, as does Dr. Belfield, that dietary changes are a key therapy.
In most cases feline IBD can be controlled by medication and dietary management, but the disease is rarely cured. In some cases, medications can be stopped after a time, and simply left on dietary therapy alone.
Feline Inflammatory Bowel Disease: What's in a name?
The names of the types of feline IBD are descriptive of both the types of cells involved, and the area of the digestive tract affected. The first part of the name refers to the types of inflammatory cells, and the last part to the location.
For example, the most common form of feline IBD is lymphocytic-plasmacytic enterocolitis.
In this form, lymphocytes (white blood cells) and plasma cells (cells that produce antibody) are the primary types of inflammatory cells present in the mucosa. Enterocolitis refers to fact that the inflammation in this form of IBD affects both the large and small intestine.
When inflammation occurs only in the small intestine, it is called enteritis; when only the large intestine is involved, it is called colitis; gastritis refers to inflammation of the stomach.
The Less common forms of feline inflammatory bowel disease are, depending upon the predominant inflammatory cell present, eosinophilic, neutrophilic, and granulomatous.
Feline Inflammatory Bowel Disease: Diagnosis
How do you know if your cat's problem is feline IBD? Well, you don't. Diagnosis of feline inflammatory bowel disease is done, in part, by exclusion: testing for other causes of cat gastrointestinal disorders in order to rule them out.
Typical diagnostic tests may include: a complete blood cell count; serum biochemistries; serum thyroxine level; tests for feline leukemia virus (FeLV) and feline immunodeficiency virus (FIV); urinalysis; fecal examinations for parasitic and bacterial agents; dietary trials; and abdominal radiographs and/or ultrasound.
A mucosal biopsy is the most definitive of the diagnostic tests. Small pieces of the intestinal lining are subject to microscopic evaluation. Tissue samples can be taken during abdominal surgery or during an endoscopic exam.
Both procedures require general anesthesia, which is always risky. Which procedure is used is dependent upon a number of factors, including the availability of equipment, and the area of the gastrointestinal tract suspected to be involved.
Feline Inflammatory Bowel Disease: Treatment
In most affected cats, a combination of dietary management and medical therapies will work to manage IBD. This may take some time, as your veterinarian may need to try several different combinations in order to determine what works best for your cat. There is no single best treatment for feline IBD.
Feline Inflammatory Bowel Disease: Dietary Therapy
As we've discussed, sensitivity to food antigens (and other pet food ingredients) can spawn or contribute to the inflammation. In these cases, a change in diet often provides symptomatic relief.
There is disagreement on whether commercial hypoallergenic diets are effective in relieving symptoms of IBD. The Cornell Feline Health Center tells us "Several balanced commercial diets have been advocated as effective in treating IBD."
Dr. Belfield seems to agree (sort of). In his article on IBD, he speaks of both dogs and cats. He first states that the current approach to treating IBD in pets is to use a combination of "expensive hypoallergenic diets" and drug therapy. He downplays the effectiveness of this course of treatment by stating that it is a "futile effort to control the disease."
Later in that same article, he says that treatment, prevention, and control of IBD "begins with an immune system friendly diet." He then goes on to tell us that he recommends California Natural (from Natura Pet Products), a "superior lamb and rice formula."
Since I can only find a lamb formula made for dogs by that company, I assume that this is an oversight on his part. The cat formulas contain either chicken, venison, or various forms of fish, such as salmon and herring. It should be noted that some have said that fish is allergenic in cats.
It should also be noted that Dr. Belfield has an affiliation with the company that manufactures California Natural. In fact, so the story goes, the company was started because Dr. Belfield accused a nearby feed supply store owner of causing diseases in animals.
Some pet owners have reported relief of IBD symptoms in their cats when switching to grain free cat food, raw food diets, or an ultra premium canned food.
For cats that refuse to eat a commercial diet, homemade diets are an alternative. Talk to your veterinarian about the correct recipe (see homemade cat food recipes for a discussion on this topic and some resources). Cats have specific nutritional needs, and the right combination of foods is essential to prevent nutritional deficiencies.
Do NOT try to invent your own recipe for your cat; you could end up making your cat's condition worse.
If possible, the diet should contain a single source of protein not normally in the cat's diet. For some cats, the addition of dietary fiber is helpful. Don't expect results right away - it may be weeks or months before your cat improves.
Remember that you need to remove all other food sources, such as table scraps, special treats, and flavored medications from the diet. Otherwise, you won't have any way of knowing the effectiveness of the diet change.
Feline Inflammatory Bowel Disease: Medical Therapy
Common drugs used to treat feline inflammatory bowel disease include corticosteroids. They are attractive for several reasons. First, corticosteroids have relatively few side effects in cats. Second, they are powerful, with excellent anti-inflammatory and immunosuppressive properties.
Third, corticosteroids may help to stimulate the appetite and enhance intestinal sodium and water absorption. This can help to relieve diarrhea.
Because of its short duration of action and availability in appropriate tablet sizes, oral prednisone is the corticosteroid used most frequently to treat feline IBD. For cats that are either too difficult to medicate or experience excessive vomiting, oral medications are not indicated. Injectable corticosteroid therapy can be used instead.
Unfortunately, if corticosteroid therapy works for your cat, she may need to remain on it for the rest of her life to prevent a relapse.
When combinations of dietary management and corticosteroid therapy have failed, certain antibiotics can be helpful. Side effects to antibiotic therapy may include loss of appetite and vomiting (just what your cat needs, more vomiting!).
If the aforementioned therapies do not produce results, it may be necessary to use more potent immunosuppressive drugs. These drugs will require closer monitoring by your veterinarian.
Feline Inflammatory Bowel Disease: Prognosis
In most cases feline inflammatory bowel disease can be controlled, but your cat may have to remain on various therapies for the rest of her life. Relapses have been known to occur if the treatment regimen is not followed closely.
One more note on Dr. Belfield. He has a liquid antioxidant formula for cats with inflammatory bowel disease. He claims that, in conjunction with an immune system friendly diet, his antioxidant formula can eliminate the "need for expensive special diets, costly drugs, and a fragile existence."
As always, your veterinarian should be your best source of information on your cat's health.
Suggested Reading: Feline Inflammatory Bowel Disease
My Feline IBD Symptoms Page for Cat Lovers Only Readers
Dr. Belfield's Feline IBD Page
Cornell Feline Health Center's IBD Online Brochure
Symptoms, Signs, and Treatment of Feline IBD
Vetinfo's IBD in Cats Page
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