About IBD

By Lisa Provost

When Alex died in 2008, I never would have believed it could get so much worse; but it has. I used to think we were making progress on treatments, diets, medications, etc. But now it’s time to get serious because there isn’t enough research and it’s not happening fast enough. These cats are being poisoned by so many things; just like we humans. But their systems are nothing like ours, they are quite fragile beings. And we’re losing them. There are so many more facets to IBD now it’s dizzying sometimes.

The truth is there is no easy answer because IBD is a trickster, a shape shifter, an ever-changing face like Jeckyll and Hyde. How do you go into battle with something like that? And make no mistake about it; it IS a battle…a constant roller coaster of ups and downs. The stress from this disease can take its toll on both you and your pet. Some days you feel like they’re finally turning the corner and you’re able to exhale. Then without warning, things change and you’re trying to figure out what happened and how to fix it. Its frustrating, exhausting and can leave pet parents feeling helpless and hopeless. I hope this website serves you well with information, a better way handle this disease and maybe a little relief knowing you aren’t alone in this.

I’m often asked if there are any statistics, if it’s known how long an IBD kitty can live. The absolute truth is there are no statistics at all and every single cat reacts very differently to each treatment. It may sound like an cop out or exaggeration to say this, but it’s far from it. Which is why it’s so hard to develop any kind of protocol with this disease. One thing will work for one cat, and not at all for the other. It’s pretty much a gamble and one you have to take in order for them to recover. It’s daunting, but you have to keep trying. Know there is support and you are definitely not alone.

What is IBD:
Feline Inflammatory Bowel Disease (IBD) is a group of disorders that cause inflammation in the lining of the stomach and/or intestinal tracts, basically changing how these organs perform their normal bodily functions. IBD is an uncontrolled inflammatory response, causing the inflow of inflammatory cells into various parts of the gastrointestinal tract.

IBS, or irritable bowel syndrome is not the same thing as IBD (inflammatory bowel disease). IBS is occasional GI and intestinal inflammation or distress that’s more easily controlled with diet change and probiotics, and it’s rare in cats. IBD is chronic, and in some cases severe inflammation, that can spread to other areas of the GI tract and involve other organs, particularly the liver, pancreas and even kidneys. Due to the spread of inflammation, other problems may arise such as malabsorption of nutrients, poor digestion and scar-like fibrous tissue, SIBO (small bacterial overgrowth), EPI (exocrine pancreatic insufficiency), pancreatitis and liver disease.
See SIBO: http://ibdkitties.net/sibo/
See EPI: http://ibdkitties.net/pancreatitis/epi/

There is no cure for IBD and no definitive cause. In humans, although the underlying causes are not yet known, IBD has been definitively linked to “gut dysbiosis.” This means an imbalance between “unhealthy” and “healthy” bacteria, and the few studies so far in cats point to the same basic problem.
See Probiotics: http://ibdkitties.net/probiotics/

Management includes diet change, medications, traditional and holistic treatments (always under the care of a holistic vet). Symptoms can be varied and include vomiting, bad breath (halitosis), diarrhea, constipation, increased thirst from dehydration, gas, rumbling and gurgling in the stomach, abdominal pain, anorexia, moderate to severe weight loss, litter box refusal, dark/tarry stools, lethargy and depression, weakness and fatigue, vitamin deficiencies and anemia. Although many cats suffer from diarrhea as the main symptom, not all cats have to have diarrhea to be diagnosed with IBD. My Alex never had diarrhea with her disease.
See Alex’s case study: http://ibdkitties.net/case-studies-4/alex-p/

Inflammation can lead to other complications either from the disease or medication induced side effects. Unfortunately, there are occasions when there’s no way around that and the only choice is to treat the IBD or risk the disease progressing quickly, further complicating the recovery process. This is why it’s so important if you notice signs of ill health of any kind, such as those mentioned above, don’t procrastinate or hesitate. Get them seen by a vet well versed in IBD. When suspecting IBD or any gastrointestinal disease, it does not pay to wait. Early detection and treatment is paramount to stabilizing your pet and giving them a healthy, happy and long life. The sooner you get the inflammation under control, the better.

The GI tract acts as a second brain with a rich network of nerves and ganglia, communicating directly with the brain and the heart. Your digestive system also affects your moods through the hundreds of chemicals and hormones it produces, which is why some cats also suffer depression with this disease. There are literally trillions of microbes inside of all of us, human and animal. Altering the healthy bacteria that normally inhabit the GI tract can affect conditions ranging from IBD to asthma and allergies. The GI tract also has the largest amount of lymphatic tissue in the body with the lymphatic tissue being the main part of the immune system; which is why some cases of IBD can affect the lymph nodes and further stress the immune system itself.

Some Possible Causes:
Bacterial Overgrowth – Bacterial overgrowth as a result of overuse of antibiotics which in turn kills off all the healthy bacteria in the gut that’s meant to fight inflammation, parasites, etc.

Dental disease – This one is on me. There is no current information as to whether dental disease can contribute to IBD but I don’t see why not. Dental disease can cause major health issues like heart and kidney disease. As with humans, anytime there is inflammation in the gums that worsens and gets infected, it easily go into the blood stream. Inflammation spreads, there is no doubting that. If the inflammation begins in the mouth, it can easily spread to the GI tract, then to the intestines. Dental disease is not to be taken lightly in cats and can be extremely painful and take years off of their lives.

Environmental toxins – pesticides, mycotoxins, alfatoxins. Located in the outdoor environment, food and even cat litter.

Food allergies or intolerance – (protein allergies and/or grain allergies). Their immune system is overly sensitive to certain everyday substances and begins to identify them as dangerous.

Gut flora/bacteria – An inappropriate immune response to the natural flora in the intestines, or the result of a certain bacteria. The overuse of antibiotics are stripping their gut bare of good bacteria.

Gums/thickeners – Carrageenan is the big one. Scientific studies have shown that carrageenan can induce inflammatory bowel disease (IBD) in both humans and animals.
See Toxic/Unsafe Foods: http://ibdkitties.net/toxicunsafe-foods/

Infection – The intestinal tract harbors good bacteria and bad bacteria. If infection is chronic, the bad bacteria can take over and if this happens gradually enough, you may see a lymphocytic response to the resulting inflammation.

Over vaccination – Over-vaccinations can wreck havoc on their immune system and immune response and in turn cause the body to develop allergy responses.

Parasites – Parasites that cause the cat to produce antibodies which attacks its own digestive tract.

Poor Diet – Adding ingredients like grains, soy, starches, sugars, etc. Cats are obligate carnivores; always were, always will be. Adding a plethora of ingredients because it sounds good, does them NO good.

Stress – Stress can cause many changes in a person’s natural immune response and flora and it can do the same in a pet’s system. You’ll notice since they’ve developed IBD or inestinal issues, they get very easily stressed.

Testing and diagnosis:
There can be considerable costs between testing, diagnostics, food, treatments, medications and at times hospitalizations. But without intervention your cat cannot start to improve until it may be too late to stop the progression of the disease. Your cat is a valued family member and these treatments would be expensive even for a human. Proper tests consist of a blood panel, a biochemical profile, a complete T4 to check for hyperthyroidism, a urinalysis and fecal exam. Ultrasound can help identify IBD and is useful to rule out other medical conditions such as cancer. The most accurate way to diagnose IBD is through an open biopsy of the intestinal tract, where increased numbers of white cells called lymphocytes, eosinophils, and neutrophils may be seen in the intestinal wall. The types of cells present will provide a complete diagnosis of which type of IBD the cat has. An open biopsy is also the only sure way to differentiate between IBD and lymphoma (See IBD or cancer: http://ibdkitties.net/ibd-or-cancer/.

A biopsy can also be performed through an endoscope or via a needle guided by ultrasound, but since it is not full thickness it may miss a diagnosis of lymphoma and occasionally even IBD as IBD is an ever-changing condition. And biopsy itself is not always conclusive, which is what makes IBD so challenging to diagnose. It should first be discussed with your vet as to whether your pet’s condition warrants an immediate biopsy or if there could be complications from the operation. Occasionally there are underlying conditions that may affect your pet’s ability to undergo surgery, and other factors such as age.

Folate and B12 levels should always be checked. Low folate and/or B12 can indicate several things including SIBO (small bacterial overgrowth) and malabsorption syndrome. Additional tests may be warranted for secondary organ failure such as pancreatitis, liver enzymes and kidney levels. Please see the links on this site for information on those specific organs.

Treatments:
The first step is usually an elimination diet. Limiting their diet to one protein in order to find out if they have a food allergy/intolerance that is not IBD or is contributing to IBD. This can be a long process and if your kitty is very sick medications such as steroids, anti-nausea/anti-emetics, appetite stimulants, immunosupressants, antibiotics, fluids and B12 may be prescribed. It’s very important to understand that there is a time for trying holistic treatments and there is a time to go straight to the medications. If your kitty is in the beginning stages of IBD or over the hump of a bad flare, then seeing a holistic vet is a good idea and may in fact do the trick in terms of treatment. But if your kitty suddenly becomes very ill or continues to go downhill, it’s time to hit the medications. No one likes giving their pets meds but in times of crisis, you need to do what you need to do not only for their lives but their level of comfort. IBD can be painful and imagine if you threw up several times every day, or had explosive diarrhea several times a day, and you couldn’t stop it. Pain is pain and they experience it just as much as we do. The goal is to lesson their pain and give them quality of life over everything.

I am a big believer that both Western and Eastern medicine has a place in recovery from all diseases and health conditions. There can be side effects to using both as well as a lot of benefits. Feline IBD is not something to play around with and needs to be treated immediately. If your pet’s condition is deteriorating quickly and your vet feels that Western medications are warranted or things will continue to go downhill, I believe it’s necessary to do what you have to do in order to save your pet’s life. I’ve seen benefits from people who’ve brought their cats to two vets – one being a traditional vet and the other a holistic vet that works with their primary vet. When treating with all-natural remedies, be aware that natural doesn’t necessarily mean safe. Many natural remedies can be dangerous and even toxic to your pet. Try not to overload your pet with treatments as well. Your pet’s liver has to filter everything and too many treatments at once may unintentionally over-stress the liver. Never give your pet multivitamins without first asking your vet. Your pet’s food already has the proper and sufficient amount of vitamins and minerals.

Don’t buy into any miracle cures you may see on the web, or hear from other people (and there are many). IBD is manageable but NOT yet curable. IBD is a chronic disease; there are no magic pills, no magic diet or food, and no magic alternative treatments. That being said, feeding our cats as the obligate carnivores they are often helps by removing ingredients that contribute to GI stress and inflammation. And there are in fact many safe and effective treatments that stabilize your pet’s condition and greatly help in their recovery. Many all-natural products that are safe for human consumption may be too strong or not safe at all in high doses for pets. Your pet may have several health conditions where using certain treatments could worsen recovery. Always obtain all-natural products from a reputable source. Even if it may be cheaper to buy the human version, they could contain additives that are potentially harmful or damaging to your pet’s recovery. An exception to this is probiotic supplementation. In many studies human probiotic supplements administered to cats in the proper doses, have generally proven to be safer and higher quality in terms of meeting label claims of active strains. Make sure to always discuss alternative and all-natural therapies with your vet. And do the research yourself, look up the ingredients and make sure you KNOW it’s safe. Many pet product companies will state they are perfectly safe and that’s just not always true. We are seeing plenty of lawsuits these days in this regard and unfortuantely it means a pet has suffered dearly or even died. So please don’t chance it.

Look for a vet that’s open to knowledge and understands that experience from other pet owners is invaluable to treating these conditions. If you have a cats-only veterinarian in your area, it’s best to take your cat there. Their main focus in vet medicine is on cats and the diseases that affect them differently than other animals. In a dog, the bile duct and the pancreatic duct empty at separate locations in the GI tract. In the cat, they join and empty at the same place, making it more likely for inflammation to affect the various organs. An internist may also offer better treatment options if there’s one available in your area. Just remember in any case, to be as proactive as you can and learn as much about Feline IBD as possible.

References:
http://www.vcahospitals.com/main/pet-health-information/article/animal-health/endoscopy-gastrointestinal-in-cats/117
http://www.vcaspecialtyvets.com/arboretum-view/our-services/internal-medicine/colonoscopy
www.drhoffman.com
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3845678/
http://healthypets.mercola.com/sites/healthypets/archive/2012/06/01/feline-ibd-symptoms.aspx
www.manhattancats.com/Articles/IBD
www.marvistavet.com/html/inflammatory_bowel_disease
www.peteducation.com/article
www.merckvetmanual.com/mvm
www.maxshouse.com/inflammatory_bowel_disease.htm

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