By Jean Hofve, DVM
Inflammatory bowel disease (IBD) is a common feline problem. With the word “bowel” as part of the name, you might think that the main symptom would be diarrhea. However, vomiting is an even more common symptom and often the only symptom in cats.
Vomiting associated with IBD tends to be chronic, intermittent, and recurrent. It often occurs in spurts, where there will be a lot of vomiting for a week or two, then nothing for a month, then another bout. It is often misdiagnosed as “hairballs.” Giving a dose or two of Vaseline or other hairball remedy will help distinguish an irritated tummy from the more serious IBD.
What is IBD anyway? Really it’s just a general description of several chronic conditions of the stomach, intestines, and colon. The type of IBD varies by what types of immune/inflammatory cells are present. In IBD, so many inflammatory cells can accumulate that they cause thickening of the gut lining, interfering with absorption of nutrients, and sometimes causing significant weight loss.
Any cat that vomits more that occasionally should be checked by your veterinarian. The work-up will typically include a thorough physical exam, complete blood count and blood chemistry panel, a fecal analysis, and perhaps x-rays or ultrasound. There are many other causes of vomiting and diarrhea besides IBD that need to be ruled out before a tentative diagnosis can be reached.
IBD can be definitively diagnosed only by biopsy, either surgically or by endoscope. Both require general anesthesia and can be very costly. However, accurate diagnostics may be necessary in cases where more conservative treatment is not working.
Many veterinarians believe that most cases of feline IBD are caused by food allergies. When immune cells see foreign proteins from cat food in the blood, they may provoke the immune system into making antibodies to those proteins. Reactions between antibodies and food proteins cause inflammation, and the cycle is perpetuated.
Your veterinarian may suggest a food trial with a “hypoallergenic” diet, to see if a food allergy is contributing to the problem. The diet must be strictly followed (no treats or other cheating!) for several weeks, although an improvement may be seen in just a few days. Diet change is also a method of treatment, and many cats will experience a complete remission of symptoms with diet therapy alone.
Dry food is more commonly implicated in IBD than other diets. One case report described an IBD cat with an underlying food allergy where the dry trial diet had no effect, but the same food in a canned version resolved the problem completely.
Many times, trial drug therapy is used. The most commonly utilized drug is prednisolone, a form of prednisone. This anti-inflammatory steroid can provide a great deal of relief. However, prednisolone can have many unwanted side effects, such as weight gain (and the host of problems that come with obesity) and diabetes. Treatment with steroids is usually necessary for the life of the cat, so please think long and hard before condemning your cat to a life of drugs.
Holistic treatment options also start with diet, usually a homemade one. However, raw meat diets may be risky in IBD cats, because inflammation weakens the body’s defenses against foreign bacteria. A balanced diet based on lightly cooked meat may be a safer option; and still allows a transition to a raw diet as your cat’s health improves.
Antioxidants, Omega-3 fatty acids, digestive enzymes, and probiotics such as acidophilus, may be helpful supplements for animals with IBD.
Because IBD is prone to flare up under stress, anti-stress strategies including essences (such Spirit Essences) and regular interactive play sessions are important considerations for these cats.
Are there preventive strategies for IBD? Feeding a variety of foods, or at least changing diets at least every 3-4 months to a food with different protein sources, may prevent your cat from becoming allergic or intolerant to a single food in the first place. Remember to always make any diet switch gradually, to avoid rejection or tummy upset.
For an in-depth, comprehensive, recently updated report on IBD, including a review of holistic treatment options, see “Inflammatory Bowel Disease” in the Little Big Cat bookstore!