Inflammatory bowel disease in cats is not a disease but a syndrome caused by specific reactions to irritation of the stomach or the intestines. Inflammation is a response of the body to a foreign substance, insult, or injuries. Inflammatory cells invade the walls of the intestines or the stomach causing thickening of the gastrointestinal tract making it impossible to absorb nutrients into the blood system, also the bowel movements are distracted making it difficult for food to move along the gastrointestinal tract. IBD is common with middle-aged and older cats.
Causes of IBD
While the cause of inflammatory bowel disease is unknown, there is evidence that it may be caused by the interaction between the immune system, bacterial population in the intestines, and the diet plus environmental factors. It is also believed that immune system genetic abnormalities contribute to IBD based on the similarities of IBD in people, dogs, and felines.
Symptoms of IBD
IBD may affect anywhere in the gastrointestinal tract but commonly the stomach and the intestines. If IBD involves the stomach, signs could be chronic vomiting, this is a common clinical sign of IBD for cats. Whereas if it involves intestines, chronic diarrhea will be imminent. If both parts of the gastrointestinal tract are involved, then both chronic diarrhea and vomiting will occur. If the syndrome persists for a month or more, weight loss and loss of appetite will be experienced. Another sign could be vomiting hairballs several times within a month. It means that cats GI is not able to pass hairballs through the tract and it should raise a concern, your cat might be having IBD.
How to diagnose IBD
Start by fecal examination, then a blood test and if nothing meaning comes up, go for imaging of the intestines and the stomach using ultrasound and/or x-ray. Ultrasound has proved to give better and conclusive results because it can measure the thickness of the stomach and intestinal lining, also evaluate the lymph node sizes around the intestines.
Depending on the region of the gastrointestinal tract and the types of inflammatory cells, there are different types of IBDs. If inflammation is found in the stomach, it is called gastritis, if inflammation occurs in the small intestine, the IBD syndrome is called enteritis, and the colon’s inflammation is colitis. The most common inflammation is lymphocytic plasmacytic enteritis involving plasma cells and lymphocytes invading the small intestines. Eosinophils are inflammatory white types of blood cells common in feline IBD. In Eosinophilic gastroenteritis, there may be a predominant cell type but part of a mixed population of inflammatory cells. A less common form of IBD is neutrophilic IBD involving neutrophils and the other one is granulomatous IBD involving macrophages. In some cases of IBD, inflammation may extend to other internal vital organs like the liver and pancreas.
Common signs include vomiting, loss of appetite, diarrhea, weight loss, lethargy, and stools with bloodstains. The signs may vary according to the severity and the frequency of inflammation but it all boils down the affected areas of GI. If on the stomach and the upper part of the small intestines, chronic vomiting may be predominant clinical sign while the colon and the lower parts of the small intestine will lead to severe diarrhea with or without blood in the stool.
Diagnosing feline IBD is not a small task because signs are common with many feline diseases. Blood tests, ultrasound, x-ray are some of the diagnostic procedures your vet may recommend establishing whether the cat is suffering from IBD or other diseases. Intestinal lymphoma (a type of cancer) for example may be difficult to distinguish from IBD in felines. IDB may hinder the absorption of certain vitamins so the veterinarian may measure the levels in the bloodstream to determine whether your cat has IBD or not. Hypoallergenic food trial may be done to rule out allergies related to food.
Definitive diagnosis requires gastric biopsy and tissue evaluation under a microscope. If a patient has IBD, there will be increased inflammatory cells along the intestinal wall. While the type of cells present determines the type of IBD present which goes along to guide the treatment given to the patient. The use of an endoscope camera inserted through the mouth or anus is another option for diagnosing IBD in felines. And if liver and pancreatic diseases are suspected, surgery may be a better option.
Treating IBD requires a combination of dietary and a variety of medications as the first step to treating IBD because there is no specific medication for IBD. As GI bacteria play a role in IBD development, prebiotics may be helpful, also probiotics which promote health GI bacterial strains may be used. The addition of soluble fiber to the diets of cats suffering from IBD is helpful and supplementation of B12 can help cats deficient in B vitamins.
Use hypoallergenic food trial initially in the diet that contains foods your cat has never eaten before. If the symptoms persist, use a diet with high fiber, low fat, and easy to digest. It may take weeks to monitor and see if changes occur after changing the diet. During this period, keep at bay flavored medications, table scraps, and treats.
Medical treatment of IBD
Use metronidazole or stronger prednisolone at first to control the inflammation and implement a dietary change while using metronidazole for long-term maintenance. Metronidazole has anti-inflammatory, anti-biotic, and antiprotozoal properties. If it fails, try corticosteroids a potent anti-inflammatory, and immune-suppressing agents.
If changing the diet gives a positive response in your cat, maintain that cat in the diet for the rest of her life if it is considered by the vet as a balanced diet. And if the cat responds to medications, then a long-term prognosis is recommended as long as medical administration is feasible on the side of the cat parent. If medication and change of diet yield blunt results, further testing is recommended to establish if there is an underlying disease. If IBD is not treated as required until the cat heals, it may progress to cancer called lymphoma.