Important Facts

By Lisa Provost

  • 1) First and foremost as I’ve stated on many occasions, IBS and IBD are NOT the same thing. These terms should not be used interchangeably.

IBS is “irritable” bowel syndrome. No thickening of the intestines, no inflammation or disease is present; the lining is only irritated. It’s easily managed with diet change and usually minor to no medications are needed. It may progress eventually to IBD if not addressed properly but not always. IBS is not as common in cats as IBD.

IBD is “inflammatory” bowel disease. Thickening of the intestines is present along with inflammation. It can be extremely difficult to manage, painful, chronic and incurable. Sometimes it can be managed with diet but it’s already in the diseased stage which can then lead to other inflammatory conditions like pancreatitis, liver disease and lymphoma.

Also as of yet, there is no cure for IBD.

  • 2) Steroids take time to work. I know you’re in a rush for your baby to feel better. But remember, this didn’t happen overnight, it’s not going to heal overnight. A few days, a few weeks may not be enough. Pred usually works faster than budesonide. Bud can take up to a month to really notice a difference. But both meds depend on how bad your cat’s inflammation is and how long it’s been going on.  
  • 3) Appetite stimulants won’t work alone if the kitty is nauseous. If your kitty still isn’t eating with that alone, add in Cerenia, Zofran or slippery elm bark for nausea.
  • 4) Pancreatitis is painful and nauseating. There should be a standard set of meds to have on hand at home for this condition; Anti nausea medication, appetite stimulant, pain medication (buprenex is usually more effective for this type of pain), and sub q fluids to do at home if you’re able to.
  • 5) Pancreatic enzymes should not be given without a definitive diagnose of EPI. They are way too strong and can burn the esophagus and GI tract. Digestive enzymes are fine. GET THE TEST DONE!
  • 6) Empty veggie gelcaps can be used for bitter medications or combining meds.
  • 7) Pepcid, Prilosec or any antacids are NOT for nausea unless it’s caused by acid reflux. It simply will not work well at all and you should not be giving antacids for long periods of time. It changes the gut lining and interferes with medication absorption. The body becomes dependant and it’s difficult to get off these. If you’ve given them long term, you need to wean your kitty off them very slowly, otherwise it can cause severe acid backlash. Also they are not anti-emetics and will not prevent vomiting. Not to be used when pancreatitis is present. That should be Cerenia or Zofran.
  • https://www.ibdkitties.net/pepcid-and-other-antacids/.
  • 8) Do NOT dry pill. It can cause esophageal strictures, scarring and lesions. Water chasers in a syringe should be given even with liquid medications as they can burn. Always go slow inside the cheek, not the back of the throat as this can cause aspiration.
  • https://www.ibdkitties.net/esophageal-stricture/
  • 9) Pet insurance can save your cat’s life. Most will not do pre-existing conditions so if you have other pets that are healthy right now, get it for them ASAP. Make sure to shop around as there are plenty out there.
  • 11) Many medications can be compounded. If your kitty won’t eat it, think about liquids you can administer orally or transdermal you can apply to the ears. Transdermals don’t always absorb well and the ear skin can become damaged so they are not always effective. The best base to use for transdermal medication absorption is Lipoderm. You can request the vet specify base to the compounding pharmacy. You can also have medications compounded into treats.
  • 12) For kitties that have uncontrolled vomiting, please get them tested for pancreatitis which is very, very painful and nauseating. Sometimes all they need in addition to everything is pain medication. Pain CAN cause vomiting and nausea. Also if you can do sub q fluids at home, this stops dehydration, keeps their organs flushed from toxins and hydrated which means they don’t have to work as hard. Another avenue to consider is home cooking. It’s very easy and once YOU control what goes into your cat’s food, sometimes that works wonders. No fillers, gums, etc. Your kitties may have an intolerance/allergy to a filler or gum in commercial foods. Just something to consider. Anytime you feed regular human food, home cook or home prepare raw, you need to add a balanced supplement package. Kitties shouldn’t go more than two weeks on these foods without properly balancing them.
  • https://www.ibdkitties.net/homecook
  • 13) Zofran (ondansetron) is more bioavailable via injections in cats than pills. If your cat’s nausea and vomiting is still bad, consider asking your vet for injections instead of pills for the bad days and flares. Be careful what medications you give your kitty with Zofran. Some like Mirtazapine or Mirataz can cause serotonin syndrome. If you’re giving zofran, maybe try Elura instead or give it as far apart from those other meds as possible. Be aware that these particular injections can sting. I usually put the needles in the freezer for better insertion. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4059788/
  • 14) If your kitty is on a low dose of steroids and your vet says it’s okay to just stop it, we suggest you still wean them off. It could be as short as a week. But most kitties are too sensitive to just stop them and end up suffering withdrawals. Remember, your kitty’s system is in chaos so be careful with abrupt changes unless your kitty is experiencing serious side effects. Sometimes you need to stop quickly.
  • 15) When giving slippery elm bark, take a tablespoon of hot water and mix it with about 1/2 capsule of SEB powder. As it starts to cool, it will thicken. Sometimes you can add more powder and sometimes more water to get it to a thin enough consistency that you can fill a syringe. The easiest syringe to use is a 3ml, and fill completely. Then insert the syringe in the side corner of your cat’s cheek and let them drink it down. Just be sure to make it as thick as possible as it helps coat the lining of the GI tract, similar to Pepto Bismol. (NEVER use Pepto Bismol or Kaopectate). You can mix about 1/4 teaspoon of slippery elm bark powder with hot water for every 10 pounds of body weight. Mix well and let cool. They call it a “liquid band aid”. Slippery elm should be given at least two hours away from any other medications or supplements. 30 minutes isn’t long enough for the mucilagenous coating in the digestive tract to dilute enough to let absorption take place, mostly in the intestines. When given with a meal, it can inhibit the absorption of nutrients from the food. The slurry is best for nausea and vomiting. You can use the powder for diarrhea in food. But be careful of doing that too often as it can absorb nutrients in the food. Here is the SEB that I use: Celebration Herbals Slippery Elm Bark Powder Bulk Tea Caffeine Free. For more information on SEB:
  • https://littlebigcat.com/slippery-elm/
  • 16) Over the counter baby gas drops or simithicone all contain citric acid which is toxic to cats. Possibly not in a once in awhile small dose but when given consistently we don’t know if it will cause issues or building up in the liver. They also contain sugars and sweeteners like sorbitol, which causes diarrhea among other issues, especially bad for diabetic cats. Compounding pharmacies are able to compound simithicone (the main ingredient in gas x or baby gas drops), without any of the harmful ingredients like citric acid, sorbitol, sweeteners, dyes etc. When your vet calls them to put the order in, make sure they specify not to include any of those ingredients just to be on the safe side. As a side note, it can constipate or make constipation worse.
  • 17) Many times if a kitty isn’t eating it can be due to seasonal allergies, herpes virus sinusitis or rhinitis. They can’t smell their food. Many kitties cannot take antihistamines due to kidney or heart disease. Instead, ask your vet for Cerenia nasal drops.  They can convert Cerenia into a diluted, clear liquid. It must be kept in the fridge. The drop is so small it doesn’t affect them. I use a syringe and go to the first line only. One drop per day for 5 days, then either two days off and start again (just like with oral), or wait until they need it again.
  • 18) Chicken is NOT the enemy. A cat can have problems with any protein, not just chicken or beef. My cat can’t eat anything fatty like lamb, duck, beef or venison. He can only eat chicken, quail, turkey, rabbit or seafood. Every kitty is different, same as with people with IBD. It’s truly individual. Sometimes it’s the antibiotics etc in the chicken itself. Sometimes going organic can make all the difference and if you home cook it instead. And yes sometimes they are truly allergic or have intolerance.

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