By Lisa Provost
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. It’s also very hard to treat something if you don’t have an idea of what exactly is happening and why. Your cat is a valued family member and these treatments would be expensive even for a human.
Allergy testing – Food elimination and diet trials are the most accurate and reliable testing for allergies. While many want the simplicity of hair, saliva and other forms of testing, unfortunately studies have proven them unreliable in dogs and cats.
https://www.veterinarypracticenews.com/the-pros-and-cons-of-food-allergy-testing/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5577833
PCR – If your cat suffers from diarrhea, please give a fecal sample and request they send it to an outside lab for a PCR. VERY IMPORTANT as in-house cannot test for all the pathogens an outside lab can. We have seen this play out over and over again where valuable time is lost with treatment because something was missed. This website explains what they test for (at any outside lab) and what it entails. Your vet will take the sample and send it out to the proper lab.
https://www.idexx.com/en/veterinary/reference-laboratories/idexx-realpcr-tests
If that PCR comes back negative then move onto the next phase which is a complete blood work panel (CBC including T4 for thyroid), a GI-1 and GI-2 panel which can also test for pancreatitis. Request testing for low or deficient B12, folate and/or EPI (exocrine pancreatic insufficiency) in that GI2 panel. Those require 12 hour fasting, otherwise it’s not accurate. You must request those two in addition to any blood work, they are not normally included. These tests are not just for diarrhea but for everything. Other health conditions may be happening such as hyperthyroidism so a T4 should also be done. B12 levels should be tested before supplementation and should not be supplemented unless your kitty tested low. Doctors don’t give B12 injections to people without a valid reason. If B12 is naturally high, it may indicate other potentially serious health issues. Although water soluble, supplementing can mask the true levels and you will not be able to distinguish the difference. If it’s not low, nothing is being absorbed and it’s a waste of money.
https://cat-world.com/biochemical-profile-in-cats
https://www.ibdkitties.net/epi
https://tvmdl.tamu.edu/tests/?species=feline&viewall=1&orderby=title&order=ASC
https://ivcjournal.com/feline-gastrointestinal-disease-diagnosis
Ultrasound can help identify thickening and inflammation and can rule out other medical conditions. Many don’t believe ultrasound is useful but you cannot see the pancreas on X-ray, it’s hidden behind the stomach. Ultrasound also gives you a better picture of other organs such as kidneys, spleen, liver and gallbladder. 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. We recommend getting an ultrasound done once a year, sometimes every 6 months depending on your kitty’s situation.
https://www.petplace.com/article/cats/pet-health/abdominal-ultrasound-in-cats
https://vcahospitals.com/know-your-pet/ultrasound-examination-in-cats
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. Unfortunately 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 or anesthesia. Occasionally there are underlying conditions that may affect your pet’s ability to undergo surgery, and factors such as age and other conditions like heart disease or asthma; which make it risky to go under anesthesia.
https://www.ibdkitties.net/ibd-or-cancer/
PARR– PCR for Antigen Receptor Rearrangement (PARR or Clonality PCR) aids in diagnosing lymphoma in difficult cases, helping diagnose it earlier and with less invasive sampling. PARR testing is useful when the results of biopsy or cytology are inconclusive or are suggestive of lymphoma. This page does an excellent job of explaining the testing and process.
https://vdxpathology.com/PARR.htm
https://pubmed.ncbi.nlm.nih.gov/31478220
Always asks for copies of everything from your vets; office visits, tests run, results, ultrasounds, echocardiograms, everything. This helps you have the information at hand and you don’t have to keep asking the vet for the information.