Inflammatory Bowel Disease in Cats: What You Need to Know

Is your cat often troubled by vomiting, hairballs, or weight loss? If so, you might be dealing with more than the nuisance of cleaning up vomit or hairballs. Feline Inflammatory Bowel Disease (IBD) is a complex condition that results in chronic inflammation and irritation of your cat's gastrointestinal (GI) tract. Understanding IBD is important for cat owners, as it can significantly affect your cat's quality of life. In this comprehensive guide, we'll explore the symptoms, causes, and treatments for IBD in cats.

What is IBD in cats?

Inflammatory Bowel Disease, often abbreviated as IBD, is a syndrome that affects the gastrointestinal (GI) tract in cats. It is characterized by the presence of inflammatory cells that infiltrate the walls of the GI tract—specifically, the stomach, small intestine, and sometimes even the large intestine.

IBD can affect cats of all ages, although it tends to occur more frequently in cats that are middle-aged or older.

These inflammatory cells can vary in type, including lymphocytes, plasmacytes, and eosinophils, and their presence leads to an inability for the cat to properly digest and absorb food.

The GI tract is a complex system that plays an important role in your cat's overall health. It is responsible for digesting food, absorbing nutrients, and eliminating waste. When any part of the GI tract is compromised by IBD, it leads to malabsorption and maldigestion, contributing to symptoms and affecting your cat's quality of life.

The type of inflammatory cells involved can also indicate the specific type of IBD your cat may be suffering from. The two main common types are eosinophilic and lymphoplasmacytic IBD. The lymphoplasmacytic form is the most common in cats.

What causes inflammatory bowel disease in cats?

The exact cause of IBD in cats remains largely unknown, but there are several contributing factors that veterinarians and researchers believe may play a role.

Bacterial infection

Some cases of IBD are thought to be triggered by bacterial infections in the GI tract. An imbalance in the gut microbiota could lead to an inflammatory response, although this is not yet definitively proven.

Parasitic infection

Parasites like giardia can sometimes be implicated in cases of IBD. However, it is generally believed that parasitic infections are more likely to be a secondary issue rather than a primary cause of inflammatory bowel disease.

Diet and allergies

Dietary factors can also contribute to the development of IBD. Food allergies or intolerances to certain food sources may lead to an inflammatory response in the GI tract. A food trial may be recommended to identify specific allergens or dietary triggers.

Genetic predisposition

Although more research is needed, some breeds may be more susceptible to developing IBD. Additionally, genetic factors could play a role in how severe the condition becomes. Siamese cats have been found to have genetic predispositions to the development of IBD.

Symptoms of IBD in cats

One of the most challenging aspects of Inflammatory Bowel Disease (IBD) in cats lies in its wide range of symptoms, which can frequently be mistaken for other gastrointestinal disorders. However, there are some key symptoms of IBD in cats that every owner should be aware of.

The most common clinical signs of IBD in cats include:

• Vomiting: Frequent and sometimes severe, vomiting is a classic sign. You may also notice frequent hairballs if your cat has inflammatory bowel disease.
• Diarrhea: This symptom can be intermittent or persistent. Bloody stools are also a possibility.
• Weight Loss: Despite changes in appetite, weight loss is often a concern.
• Changes in Appetite: Your cat may eat more or less than usual.
• Flatulence: Excessive gas can be a less obvious but concerning sign.
• Poor Body Condition: Overall deterioration in physical condition is possible.
• Dehydration: Lack of sufficient water intake or excessive fluid loss can occur.
• Lethargy: Decreased energy levels may be observed.

The reason for the wide range of symptoms is that IBD can affect different parts of the gastrointestinal system. For example, if the disease predominantly affects the small intestine, you might notice symptoms like vomiting and diarrhea without blood in the stool. On the other hand, if the disease is localized in the colon, symptoms of inflammatory colitis such as bloody diarrhea may be more apparent.

Additionally, IBD symptoms in cats can fluctuate in severity, sometimes leading to what is known as an "IBD flare-up." During these periods, symptoms can intensify, causing additional stress and discomfort for your cat.

How IBD is diagnosed in cats

Diagnosing feline IBD is a multi-step process that involves a variety of tests and procedures. It's essential to consult with your veterinarian if you notice any symptoms of IBD in your cat, as early diagnosis can significantly improve treatment outcomes.

Physical examination

The first step in diagnosing IBD is usually a thorough physical examination. Your veterinarian will palpate the abdomen to check for any discomfort, distension, or masses. They may also examine your cat for signs of dehydration and poor body condition, which are common findings.

An experienced veterinarian may pick up on intestinal thickening and inflammation that would support a diagnosis of IBD.

Ultrasound and other imaging tests

An ultrasound is often recommended as it can provide valuable information about the condition of your cat's gastrointestinal tract. Ultrasound can show thickening of the intestinal walls, which is often seen in affected cats.

However, an ultrasound cannot definitively diagnose IBD and determine the extent of the disease; it can only suggest the presence of an issue that needs further investigation.

Tissue biopsies and endoscopic procedure

To definitively diagnose IBD, a biopsy of the affected tissues is often required. An endoscopic procedure may be performed to obtain these tissue samples. During the endoscopy, a small camera is inserted through a tiny incision, allowing the veterinarian to visualize the interior of the GI tract and take biopsy samples.

The benefit of endoscopy is that it is less invasive compared to traditional surgery.

Abdominal exploratory surgery

In some severe cases, a full abdominal exploratory surgery may be needed to obtain tissue samples. The benefit of this approach is that all abdominal structures can be visualized and assessed. Additionally, this approach allows for full-thickness biopsies which can improve the diagnostic rate.

Additional tests

Blood work will be performed to assess the white blood cell counts, blood proteins, as well as the status of the metabolic system and major organs.

Tests for B12 and folate levels are also commonly done, as deviations from normal levels often occur in cats with IBD.

A dietary elimination trial may also be performed to rule out food allergies as a contributing factor.

Empirical treatments

In some cases where biopsy is not attainable or not an option, ask your veterinarian about empirical therapy. If there is enough suspicion of IBD based on the case history, physical exam, and blood tests, your veterinarian may perform a 2-4 week trial of medication such as prednisolone and observe the response. A hypoallergenic diet may also be recommended at this time. The response to these treatments can support a diagnosis of inflammatory bowel disease.

What is the treatment for cats with IBD?

Managing IBD in cats requires a comprehensive approach that includes medication, dietary changes, and ongoing monitoring. Here's how veterinarians generally approach the treatment of IBD:

First, accurate diagnosis is the cornerstone of effective treatment. Your veterinarian will rule out other potential causes and tailor the treatment to your cat's specific needs.

Once the diagnosis has been established, your veterinarian may recommend immunosuppressants to help control the inflammation and manage symptoms.

• Corticosteroids: Prednisolone is often the first choice for reducing inflammation and can bring quick relief to symptoms. With direction and oversight by your vet, prednisolone can be tapered to a dose that is suitable for long-term use.
• Other Immunosuppressive Medications: If corticosteroids aren't fully effective, other immunosuppressive drugs like cyclosporine or azathioprine may be used.

Your veterinarian may also recommend empirical antimicrobial therapy. A broad-spectrum anti-parasitic medication such as fenbendazole is typically used. If diarrhea is present, an intestinal antibiotic (metronidazole or tylosin) is typically used.

Additionally, diet plays a pivotal role in managing IBD and its symptoms. Your veterinarian may therefore recommend a diet change such as:

• Novel Protein and High-Fiber Diets: Introducing a protein source your cat has never eaten can help rule out food allergies. High-fiber diets can also improve digestion and stool quality. Examples include venison or duck-based diets.
• Hypoallergenic Diet: These diets are designed to minimize the risk of allergic reactions and can be beneficial in managing IBD symptoms. Many veterinarians recommend hydrolyzed diets for their hypoallergenic properties.

As many cats with IBD are Vitamin B12 (Cobalamin) deficient, supplementing is extremely important. This is usually done via subcutaneous injection for 4-6 weeks, then monthly thereafter. This will improve energy levels, hair coat, and mental alertness.

What is the prognosis for cats with IBD?

The prognosis can differ and is influenced by the severity of the disease and the presence of other health conditions. Many cats with mild to moderate IBD can be managed by just making changes to their diet or using antimicrobial therapy.

Cats that are more severely affected or those who do not respond to dietary therapy usually need immunosuppressive treatment. In certain cases, immunosuppressive therapy can be discontinued after 8-12 weeks of remission, but many cats require ongoing treatment.

Is my cat at risk?

IBD can affect cats of any age, but there are some factors that may increase the likelihood of your cat developing this condition. Understanding these risk factors can help you take preventive measures.

While cats of any age can develop IBD, it is more commonly diagnosed in middle-aged and older cats. Siamese cats appear to be predisposed.

If your cat has frequent hairballs, they are at risk. Numerous studies have revealed that cats with frequent hairballs have concurrent gastrointestinal disease.

Cats that have food allergies or intolerances may be at a higher risk of developing IBD. Feeding a hypoallergenic diet can help prevent or manage symptoms.

When IBD turns ugly

While managing IBD can be challenging, it's important to understand that chronic, untreated inflammatory bowel disease can have more severe implications. One of the most concerning is the potential progression from IBD to intestinal lymphoma, a form of cancer that affects the gastrointestinal tract.

The exact mechanisms behind the progression from IBD to lymphoma are not fully understood. However, it's believed that prolonged inflammation in the GI tract may create a favorable environment for the development of cancerous cells.

So it's important that cats with IBD are accurately diagnosed and receive appropriate treatment as soon as possible to prevent the disease from progressing. Additionally, regular follow-up visits with your veterinarian are strongly recommended so that any changes or developments can be monitored and treated quickly if necessary.

FAQs

Inflammatory Bowel Disease (IBD) in cats is a common gastrointestinal disorder where the walls of the intestines become inflamed and thickened. This leads to symptoms such as frequent vomiting, changes in appetite, weight loss, and diarrhea. Diagnosis of IBD in cats typically requires a combination of blood tests, imaging, and biopsies to rule out other possible causes. Treatment for IBD may include immunosuppressant drugs, antibiotics, or dietary therapy, as well as vitamin B12 supplementations. With early diagnosis and proper treatment, cats with IBD can have good long-term prognoses. In some cases, chronic IBD can develop into intestinal lymphoma, so it's important to monitor cats closely and seek veterinary care if necessary.

Please contact your veterinarian if you have any questions or are concerned about IBD affecting your cat.