The article: https://vcahospitals.com/know-your-pet/inflammatory-bowel-disease-in-cats
The sharing of all this information is so that we can look out for it as our cats (or dogs) age.
Here are some pertinent points from the article:
With inflammatory bowel disease, specific types of inflammatory cells, depending on the type of IBD, invade the wall of the stomach and/or intestines. As inflammatory cells invade, the lining of the gastrointestinal (GI) tract thickens. This thickening makes it harder for your cat to absorb nutrients and move food along the GI tract.
This is why Bunny kept losing protein (gradual but significant weight loss). It wasn’t due to his kidneys, it was IBD.
There are many causes of inflammatory bowel disease; however, the cause is often unknown or undetermined. Possible causes include bacterial infection, parasitic infection with worms or single-celled parasites, or an allergy or intolerance to a specific protein in the diet.
It is idiopathic. We might never know the cause. But changing the protein might just help. For Bunny, he already had protein rotation; all our cats do unless they simply refuse to eat it. Bunny had chicken, fish, turkey and rabbit. Previously, when he was on Cubgrub, he even had duck. Another website I saw recommended novel proteins such as venison and duck (those that are not common).
What are the clinical signs of IBD?
IBD can involve any part of the GI tract but most commonly affects the stomach and/or the intestines. If the stomach is involved, your cat will experience chronic vomiting. This is the most common clinical sign of IBD in cats. If the intestines are involved, chronic diarrhea will occur. In some cats, both parts of the digestive tract are involved so both vomiting and diarrhea occur.
Bunny had some vomiting but it wasn’t chronic, it was just occasional. His was a sudden change from chronic constipation to loose stools in October 2022. Maybe that was when it happened.
If the syndrome lasts for more than a few months, poor appetite and weight loss are common. In some cases, cats develop a ravenous appetite because they are unable to absorb the food they are eating, and this must be differentiated from hyperthyroidism.
Yes, Bunny had quite a ravenous appetite. He was always asking for food. I pandered to this as I knew he would only ask for food if he were hungry. Despite the amount that he ate, he was still losing weight. It was due to the poor absorption of the food. Bunny also became very choosy over his food. That is why I resorted to all kinds of foods, ranging for various raw diets, canned foods and kibble, just so that he would eat.
Vomiting hairballs more than once a month is not normal and represents your cat’s inability to pass the hair through his GI tract and may be a sign that he has IBD.
This gives me grave concern about Robin who vomits hairball very often as well as Indy who used to vomit his breakfast frequently. But Indy’s vomiting has stopped ever since I switched his breakfast to Cindy’s pureed food. But then again, Indy has had GI problems since he was very young.
Even now Indy has a loose stool problem very often. Giving him Bioflor helps a little; the stools would firm up. I’m giving him Slippery Elm Bark now, but it has not helped so far.
Now that Bunny is gone, I’m attempting to convert everyone back to raw food again, if that is possible. Because of Bunny, I had to reintroduce kibble to him. Giving it to him meant that the rest also had some as they also demanded for it. The biggest junkie is actually Tabs (more about this later).
Now, the most important part:
How is IBD treated?
The ideal way to treat IBD is to diagnose the underlying disease that is causing the reaction. If an exact cause cannot be found, the disease is called “idiopathic”. Many cases of IBD are considered idiopathic.
Deworming. Broad-spectrum deworming is recommended as fecal tests are not always representative of the parasites in the GI tract.
We did this. Three days in a row. It did not really help.
Diet. Some cats with IBD will respond to a change in diet. This can be accomplished in one of two ways. First, a commercial food that contains a protein source that is new to the cat (what is referred to as a novel protein) or a hydrolyzed protein (where it has been broken down to smaller parts, so the body does not recognize it as a specific protein) is chosen. If that is not effective, a high-fiber diet is tried. A true food trial requires that the test diet be fed exclusively for eight to twelve weeks. In some cases, your veterinarian will recommend that you feed a true elimination diet, in which a home-prepared diet containing only a single protein and a single carbohydrate is fed. In all food trials, no treats or other foods may be given at all.
“A true food trial requires that the test diet be fed exclusively for eight to twelve weeks.”
I gave Bunny various proteins, but I could not do the 8-12 week food trial as there was no way he would eat the same food for even two days in a row. He needed variety; otherwise he would just walk away. Diet elimination also could not be done.
Vitamin B12. Supplementation with Vitamin B12 can be considered as most cats with inflammatory bowel disease are unable to absorb this important vitamin. This is most often given by injection under the skin.
Bunny was on B-12 for a certain period too. Including folic acid.
Immunosuppressive Medications. If dietary therapy is not successful or is not possible to perform and no underlying cause can be found, medications are used to suppress the inflammatory reaction. Corticosteroids such as prednisolone (Delta-Cortef®, Prednis-Tab®), budesonide (Entocort®, Uceris®), or dexamethasone (Decadron®) are generally the most effective medications and are used initially. Other medications such as chlorambucil (Leukeran®) or azathioprine (Imuran®) are tried if corticosteroids are not successful on their own.
Steroids was only given towards the end. Long-term usage of steroids also causes other problems.
What is the prognosis?
If a positive response occurs to a diet change, your cat can be maintained on the new diet for the rest of his life, provided the diet is appropriately balanced. If your cat responds to medication for stomach bacteria, the long-term prognosis is good. If a response occurs to corticosteroids, the long-term prognosis is also good if the administration of the drug is feasible. However, if there is no response to diet or corticosteroids, the prognosis is more guarded. In these cases, further testing is suggested to see if an underlying disease can be identified. Some forms of inflammatory bowel disease may progress to intestinal cancer. Chronic inflammation has been hypothesized as a cause of GI lymphoma in cats.
Bunny’s case did progress to lymphoma and it went to the brain, which again, is stated in many websites. When the vet saw him twisting only to the right, she checked his ears first and it wasn’t an ear infection. The suspicion then was lumps (tumours) pressing on the right side of the brain (intracranial mass). She did say that this can happen with FIV+ cats too.
My plan now is to reintroduce the raw diet to the super seniors and Tabs, if that is possible. It’s going to be very challenging with Indy, though. He seems to want only cooked food. Then, I need to give them duck every now and then. Cubgrub has pure duck (which I have already bought) and Coco&Joe’s also has a Premium Combo which contains duck.
I already started my plan to replace kibble yesterday but giving them Primal Freeze-Dried when they asked for kibble. It may not be 100% successful, but I hope to reduce kibble in their diet. It is going to be very hard for Gerald and Creamy, though. Samantha actually ate Primal the other day.