| Chronic cases of diarrhea in cats are a familiar | | | | IBD is a term used to describe the inflammation |
| headache for many veterinarians. Symptoms can | | | | of one of the layers in the intestinal wall. This |
| wax and wane over a period of time, which can | | | | swelling of the gut wall may occur with many |
| complicate the veterinarians assessment of the | | | | other intestinal diseases, but when no cause of |
| response to treatment in some cases. Many, | | | | the inflammation is found after doing thorough |
| though not all of these cats, will have | | | | testing as described above, the condition is |
| inflammatory bowel disease (IDB). This article will | | | | described as idiopathic IBD (essentially, IBD of |
| focus on how a veterinarian is able to diagnose | | | | unknown cause). IBD is thought to be an |
| IBD, and what the treatment options are. | | | | overreaction to bacteria or dietary ingredients |
| There are many possible underlying causes when | | | | within the gut. |
| a cat presents with vomiting, diarrhea or weight | | | | Are certain types of cats affected more than |
| loss: | | | | others? |
| 1. Parasites (worms) | | | | Any age of cat can be affected, and pedigree |
| 2. Viral disease (Coronavirus, Leukaemia virus) | | | | breeds may be more commonly affected than |
| 3. Bacteria (Salmonella, Campylobacter) | | | | domestic shorthair cats. |
| 4. Protozoa (Giardia, Tritrichomonas) | | | | What are the treatment options once IBD has |
| 5. Dietary (food intolerance, food allergy) | | | | been diagnosed? |
| 6. Cancer (lymphoma, adenocarcinoma) | | | | DIET |
| 7. Inflammatory bowel disease | | | | Many cats can be managed by diet alone in the |
| 8. Hormonal or metabolic (hyperthyroidism, kidney | | | | long term. Diets can be hypoallergenic, high fiber |
| failure) | | | | or low residue. Sometimes all three of these |
| 9. Drug or toxin induced | | | | types of food need to be trialed before the most |
| 10. Motility disorders | | | | effective one is selected. Cats are often resistant |
| The veterinarian should take a full history from | | | | to dietary trials, and this is the main reason why |
| the owner, to avoid spending time and money on | | | | many cats are given drugs to treat their IBD, the |
| unnecessary testing. Factors to be considered are | | | | cat will just not eat the specific diet. |
| age, diet, appetite, worming history, weight | | | | Hypoallergenic foods usually contain a new protein |
| change and the nature of the vomiting or diarrhea. | | | | source that the cat has not encountered before |
| It is important to differentiate vomiting from | | | | such as capelin & tapioca, duck, venison or |
| regurgitation, which is usually an esophageal | | | | hydrolyzed protein. Diets high in fiber are |
| problem, and to differentiate small intestinal | | | | recommended for colonic disease. |
| diarrhea from large intestinal diarrhea by the | | | | DRUGS |
| frequency and consistency of the feces. | | | | Drugs are a last resort, if the cat is still showing |
| The veterinarian will then carry out a full clinical | | | | symptoms despite various food trials or if the cat |
| examination, before embarking on a basic | | | | refuses to eat the prescription diet. |
| approach to the diagnosis as follows: | | | | Options are: |
| 1. Blood and urine tests to rule out disease | | | | 1. Anti inflammatory or immunosuppressive drugs |
| elsewhere in the body which has a knock on | | | | Prednisolone, a corticosteroid given at 2-4mg/kg, |
| effect on the gastrointestinal tract. | | | | is the most effective drug. |
| 2. Bacterial culture of the feces to rule out | | | | 2. Budesonide |
| Salmonella & Campylobacter | | | | This is also a steroid, with fewer side effects on |
| 3. Parasite check on the feces to rule out worms | | | | the rest of the body but it is unlicensed. |
| 4. Xrays to rule out an obstruction by a foreign | | | | 3. Chlorambucil |
| body or a tumor | | | | Sometimes given in addition to a steroid if the |
| 5. Ultrasound examination of the abdomen to | | | | steroid alone working. |
| measure gut wall thickness | | | | 4. Metronidazole |
| 6. Bland prescription diet for 4-6 weeks (e.g. Hills Z | | | | This reduces the number of bacteria in the gut, |
| D, Royal Canin Sensitivity Control) | | | | so theoretically will reduce the triggering factor for |
| 7. Intestinal biopsies via endoscopy or surgery. | | | | the inflammation. |
| IBD is a diagnosis of exclusion, so all of the | | | | 5. Cyclosporine |
| differentials previously mentioned must be ruled | | | | Normally used in dogs, this modifies the immune |
| out in order to make the diagnosis. | | | | system. It has only been tried in a small number |
| What is inflammatory bowel disease? | | | | of cats, with mixed results. |