A couple of years in the past, I owned an exquisite and distinctive polydactyl cat named Mittens. She had many distinguishing character traits and quirky traits along with her big entrance toes. But Mittens was a vomiter.
If I got here dwelling and there was a puddle of cat vomit someplace within the house, there was little doubt as to which of my cats was the offender. Mittens was thoughtful sufficient to make just a few weird vocalizations earlier than she vomited, which was her approach of claiming to me, “You have 20 seconds to run and get some paper towels,” and more often than not I slid these towels in entrance of her simply within the nick of time, sparing the sofa or the rug.
Initially, the episodes have been rare (possibly as soon as a month), however as time went on, the frequency elevated, and it turned obvious that this wasn’t only a “sensitive stomach.” As a cat veterinarian, I had my suspicions, and after quite a lot of assessments, they have been confirmed. Mittens had inflammatory bowel illness.
What is IBD?
Inflammatory bowel illness (IBD) is a situation wherein an extreme quantity of inflammatory cells infiltrate the gastrointestinal (GI) tract, inflicting it to develop into chronically irritated and infected. All ages, genders and breeds might be affected, however it’s commonest in middle-aged and older cats.
The exuberant inflammatory response can have an effect on completely different areas of the GI tract: abdomen, small gut or colon (giant gut).
- If the abdomen is the first web site, we name the situation gastritis.
- If it’s the small gut, it’s termed enteritis.
- Inflammation of the big gut is named colitis.
These all fall underneath the umbrella of inflammatory bowel illness.
Zeroing in on IBD
The scientific indicators of IBD can mimic these of different issues, making prognosis difficult and necessitating a reasonably in depth workup. For instance, vomiting and weight reduction are generally seen in cats with kidney illness and/or hyperthyroidism, and these issues must be dominated out. Intestinal parasites, viral infections (like feline leukemia and feline immunodeficiency virus), meals allergy and gastrointestinal most cancers should even be thought of when evaluating cats with the above scientific indicators.
In circumstances of IBD, routine laboratory assessments are sometimes regular. On a biochemistry panel, a rise within the liver enzymes is usually seen, as some cats with IBD may have concurrent cholangiohepatitis — irritation of the liver and bile ducts.
Abdominal X-rays would possibly assist rule out circumstances resembling a GI obstruction or an stomach tumor, however they’re ineffective for diagnosing IBD. Ultrasound gives extra info, resembling whether or not the intestinal partitions are thicker than regular, if the pancreas is concurrently infected and if the lymph nodes related to the GI tract are enlarged, findings that assist (however nonetheless don’t affirm) a prognosis of IBD.
To definitively diagnose feline IBD, biopsy specimens from the GI tract have to be obtained in one in every of two methods:
1. Endoscopy is a process wherein a protracted, versatile snake-like probe (the endoscope) enters the GI tract by the cat’s mouth (“upper GI endoscopy”) or anus (“lower GI endoscopy”), so as to visualize the interior lining of the GI tract and acquire biopsy specimens. Endoscopy provides benefits over surgical procedure in that it’s a lot much less invasive; cats normally can go dwelling the identical day.
A big limitation of endoscopy is that the endoscope can solely attain the abdomen and the primary a part of the small gut (the duodenum). The sections additional alongside the gut (the jejunum and ileum) can’t be accessed with an endoscope. Another limitation of endoscopy is that the biopsy specimens obtained by this technique consist solely of the intestinal lining fairly than a full-thickness biopsy of the intestinal tract. This can sometimes lead to a misdiagnosis.
2. Exploratory surgical procedure is extra invasive, however permits higher high quality intestinal biopsy specimens to be taken. During surgical procedure, the liver, pancreas and stomach lymph nodes may also be inspected and biopsied if warranted. Your veterinarian will talk about with you, intimately, the professionals and cons of every process and which might be most acceptable to your cat. Both procedures — endoscopy and stomach exploratory surgical procedure — require basic anesthesia.
Treating IBD
Treatment includes suppression of the inflammatory response within the GI tract, normally by the usage of prescription diets and immunosuppressive medication.
Because dietary allergens have been implicated in some circumstances, a hypoallergenic food regimen might produce important enchancment. A hypoallergenic food regimen accommodates a protein supply that the cat has by no means been uncovered to earlier than. There are quite a few commercially manufactured hypoallergenic diets with novel protein sources, resembling rabbit, venison and duck. There are additionally prescription diets wherein the protein has been hydrolyzed into fragments which are too small to be detected by the immune system, stopping it from overreacting. These diets alone are insufficient at inducing long-lasting remission in cats with IBD.
Corticosteroids are probably the most generally prescribed immunosuppressive medication for IBD. Typically, oral prednisolone is given for at the least two to 4 weeks. If scientific indicators resolve, the dosage is slowly tapered till the bottom efficient dose is reached. In circumstances of extreme irritation wherein a dietary change and prednisolone are ineffective, different immunosuppressive medication might be added to the protocol.
Although IBD isn’t curable, most cats reply effectively to remedy and dwell good high quality, comfy lives. After her prognosis (at age 6), my Mittens responded effectively to remedy and lived comparatively symptom-free for one more eight years.
