Inflammatory Bowel Disease in Cats

Tabby & White cat crouched behind a food bowl and looking at the camera

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A common belief among well-meaning cat owners is that cleaning up cat vomit is normal. Frequent vomiting, however, should never be ignored and can be a sign of an underlying problem. If chronic vomiting is something your cat is struggling with, they may be suffering from inflammatory bowel disease.

What Is Inflammatory Bowel Disease in Cats?

Inflammatory Bowel Disease (IBD) is a gastrointestinal illness where the GI tract is chronically inflamed and irritated. An underlying cause of your cat's IBD may not ever be pinpointed, but inflammation, in general, is your cat's way of responding to some sort of internal injury or foreign substance.

As your cat's IBD progresses, and inflammatory cells continue to invade their GI tract, the walls will thicken. The thicker your cat's gastrointestinal lining gets, the more difficult it is for them to properly absorb the nutrients in their food.

There can be many causative agents for IBD in cats. Anything from a bacterial organism, such as E. coli, to intestinal parasites such as Giardia spp. and Tritrichomonas, to a food allergy. While there doesn't appear to be any breed predisposition to IBD, most cats that are diagnosed with it tend to be either middle-aged or older.

What are Signs of IBD in Cats?

As IBD is a gastrointestinal disease, the most common symptoms are general GI signs. This can be vomiting, diarrhea (with or without blood), a lack of appetite, weight loss, and/or lethargy.

If your cat has IBD, they may have any combination of these symptoms or they may only have one symptom. The symptoms your cat shows will also depend on what part of your cat's gastrointestinal tract is inflamed.

Vomiting would be indicative of a stomach or upper intestine issue while diarrhea is more common with your cat's lower gastrointestinal tract.

Since vomiting is a symptom of IBD and some cats may only exhibit one symptom, if your cat is struggling with routine vomiting it may be time for a check-up with your vet.

How is IBD in Cats Diagnosed?

Since the symptoms (or symptom) of IBD are also symptoms of other gastrointestinal illnesses, your vet may want to run a variety of tests to rule out other issues.

Baseline bloodwork will give insight to your cat's general organ function but sending a blood sample to an outside lab for more specialized testing may also be warranted if IBD is suspected. This test will check your cat's cobalamin and folate levels as well as changes that are indicative of pancreatitis in cats. Cats with IBD routinely have low levels of the B vitamins cobalamin and folate and they may also have concurrent pancreatitis.

When you call to make your appointment you may be asked to bring in a fresh stool sample. This is so that your vet can check for any intestinal parasites that can be making your cat sick. Try to collect your cat's stool the day of the appointment, as most commercial litters will desiccate the stool, so an older sample may be unreadable.

Finally, radiographs can rule out things like foreign bodies, which can upset your cat's GI tract, and an abdominal ultrasound will give insight into whether your cat's intestines are thickened or not.

All of these tests can help your vet pinpoint a diagnosis of IBD, but they don't provide a definitive diagnosis. Unfortunately, they can't differentiate IBD from another serious GI concern with cats; intestinal lymphoma.

For a definitive diagnosis of IBD, your vet will need to take samples of your cat's GI tract. These samples are then sent off for biopsy where a veterinary pathologist will look at the samples microscopically to detect inflammatory changes that are only present in IBD cases. Obtaining these biopsy samples can be invasive, though, and some vets and owners may opt to skip this diagnostic step and treat for IBD to see if symptoms resolve.

How is IBD in Cats Treated?

Since IBD can sometimes be caused by food allergies, your vet may recommend a special diet for your cat. This could be a commercially prepared, 'limited ingredient' diet or it could be a prescription, hydrolyzed diet.

If choosing a commercial diet, it is important to pick one that uses a 'novel' protein. This means selecting a protein source that your cat has never eaten before. Most commercial limited ingredient cat diets utilize rabbit, duck, or venison as their protein.

Prescription diets contain proteins that are hydrolyzed, meaning they are broken down into their individual amino acid components so that your cat's immune system will not recognize them as a potential allergen.

Whether you start your cat on a commercial diet or a prescription type, it is vitally important that you only feed the new diet for a period of 8 to 12 weeks. This means no other food, treats, etc. as these may cause a potential adverse reaction, making you believe the new diet isn't working.

Your vet may also start your cat on the antibiotic metronidazole to help treat any bacteria that may be causing the IBD symptoms. Corticosteroids such as prednisolone will work to suppress your cat's immune system so that they don't 'overreact' to an allergen or something potentially inflammatory. However, long term steroid use in cats comes with its own set of concerns, so your vet will instruct you on how to taper the dosage so that you are giving as minimal amount as possible while still providing relief.

If your cat does not recover with medical and nutritional management, your vet may reconsider your cat's diagnosis of IBD. Unfortunately, if this is the case, you and your vet will need to consider the possibility that your cat's symptoms are the result of intestinal lymphoma.

IBD in cats is a disease process that can't be fully cured, but with proper food and medications, your cat's symptoms can be well managed. If you have concerns about your cat's potential for having IBD, speak to your veterinarian.