IBD kitty

[caesarsmom]

My little man Caesar was recently diagnosed with IBD, or at least, they assume it is. Can't confirm the diagnosis without abiopsy and won't administer meds without confirmation, so I decided I'm was going to try to treat this with a change in diet, slippery elm bark and probiotics. For the last two weeks it has been going fantastic, his energy levels are up, he's hungry, and his symptoms, which were vomiting and weight loss had started to go away. Today he vomited 3 times, so I took him to the vet who thought I should do the biopsy, but from what I've researched, vets don't appear to have all the knowledge when it comes to IBD. She wanted him on a hills I/d dry food diet, which I tried but I realized that was the root of his problem. When I put him on an all wet food diet, Ziwipeak, he got better over night. Before that he had been weak, couldn't jump onto the couch and lethargic but now he's running and jumping all over the place.
Aside from the vomiting today, nothing has changed, he's hungry, active, alert and cuddly, so I decided to put the biopsy on hold again. I just hope I'm making the right decision... He received subcutaneous IV at the vets, and I have been feeding him a teaspoon of food every hour, and so far no vomiting, just a little tired, probably because he is underfed at the moment. I gave him some slippery elm too, which he's been getting for the last two weeks as well. Any other suggestions/pep talks?

Maddie

 

[vball91]

Whoa, I'm surprised the vet wouldn't prescribe any meds without a biopsy. While a biopsy is the only way to confirm IBD, it's not generally done unless surgery is needed anyway. Most vets do treat the symptoms even without a biopsy. I would also not feed an IBD kitty dry food. Honestly, I think you need a second opinion.

I think you're on the right path with feeding an all wet meat based diet and using probiotics and SEB as an anti-inflamatory. I would consider raw feeding. There have been some amazing turnarounds for cats fed a raw diet. Raw is the most easily digestible source which is great for IBD kitties.

However, it would be great to have a vet work with you on all of this and be able to prescribe any meds as needed.

 

[jcat]

I would consider raw feeding. There have been some amazing turnarounds for cats fed a raw diet. Raw is the most easily digestible source which is great for IBD kitties.

Sorry, but that's too general a statement, as it really depends on the cause of the IBD, if it's ever determined. Raw food is high in fat content, and that's contraindicated for some cats and dogs who need a low-fat diet to keep it under control. What helps some cats may really aggravate the disorder in others, so any switch should be discussed with one's vet and a certified nutritionist.

 

[vball91]

Yes, which is why I said it would be great if the OP could find a vet to work with her on this. Right now it sounds like she's going at it alone without much support from her vet.

I'm offering suggestions to look into per her request.

 

[ldg]

Sorry, but that's too general a statement, as it really depends on the cause of the IBD, if it's ever determined. Raw food is high in fat content, and that's contraindicated for some cats and dogs who need a low-fat diet to keep it under control. What helps some cats may really aggravate the disorder in others, so any switch should be discussed with one's vet and a certified nutritionist.

Though this is also not necessarily correct. A homemade raw diet can be totally tailored.

The guaranteed analysis of the Ziwipeak venison, for instance, indicates a macronutrient content (on a dry matter basis) of

Protein 45% min
Fat 31.8% min
Fiber 9% max
Carbs implied: 4.5%

Whereas the raw diet I feed my cats is

Protein 72%
Fat 19%
Carbs 0.8%

A typical PMR (prey model raw) diet using half chicken with skin and half beef (though typically 3 - 5 proteins are recommended) is

Protein 56%
Fat 42%
Carbs 0.2%

The homemade ground food recipe recommended by Dr. Pierson on her site would be similar to the Ziwipeak - perhaps a little less fat - as she recommends removing half the skin and some of the fat from the chicken in the recipe.

Nature's Variety Instinct cans are around 32% fat; EVO cans are around 45% fat.

...and we don't know that fat is a problem for Caesar.

And while of course it's best to discuss diet changes in an IBD kitty with a vet or nutritionist, nutrionists like Dr. Pierson are incredibly expensive, and most vets that recommend prescription I/D really aren't familiar enough with treating IBD via diet to have helpful information, IMO. In fact, most vets know very little about nutrition. I have the Small Animal Clinical Nutrition book used in vet courses, and it doesn't address nutrition from any perspective other than needs of various nutrient levels - not at all how they are delivered, which is the information most vets are lacking and the information so critical to IBD kitties.

This is why so many kitty parents with cats that have IBD turn for advice to places like TCS where they can get advice - based on other's experiences - on how to best manage it.

And the fact of the matter is that over the past year+ that I've been feeding raw to my cats, I've seen a lot of cats with IBD switch to raw, and I'm aware of only one for whom it didn't help - and that was because the kitty couldn't tolerate it. We don't know whether it was fat, or bone more likely - or just because the cat was 17 years old - and switching to raw does cause a cat to go through a lot of digestive adjustments. Oh - there is another kitty that still has a few issues on raw, so her mom and vet decided to keep her on a low dose of pred. But on raw, she's done the best of all the diets they'd tried. I'm sure Lisa (Finnlacey on TCS, the person responsible for IBDkitties.net) is familiar with plenty more cases of IBD kitties that don't do well on raw... but the question remains - was it introduced slowly enough? Is the problem the fat? Or the bone? Because going boneless is an option, and it does appear that some IBD cats have a problem with the bone in raw food.

But there are the cats like Carolina's Bugsy, who was down to the option of exploratory surgery after having tried everything BUT raw - and on his first day on 100% raw food (she took several weeks to transition him TO that), Bugsy had the first normal poop he'd had in 14 months. (Carolina opted for homemade raw that is boneless, but used a commercial food with bonemeal, not ground bone, to transition to raw).

So while raw is no guarantee to help a kitty with IBD, it has a very high chance of helping, not hurting. And it can easily be tailored, if homemade, to be high or low fat. In fact, it can easily be tailored to be low phosphorus, for CRF kitties, or low phos/magnesium, for FLUTD kitties (if that's even necessary, because the diet itself naturally targets a urine pH of 6.5).

There are two sites I think you will find very helpful. The first one is dedicated to IBD kitties and their needs, not raw food: http://www.ibdkitties.net

The other one is dedicated to various conditions, but particularly just helping people become familiar with the concept of species-appropriate. It is geared toward helping people either find an appropriate canned food, or to making their own homemade raw (or partially cooked) food. http://www.catinfo.org

But being that raw IS species-appropriate, and so many kitties with IBD do have their condition improve almost overnight once fully transitioned to raw food, if you're interested in learning more about it, the raw resources thread in the TCS raw forum may be helpful to you. Or you may want to just start a thread there, asking any questions you have. The IBD parents feeding raw will surely chime in. http://www.thecatsite.com/f/65/raw-feeding-for-cats

 

[ldg]

BTW, if you're in the U.S., you can search to see if there is a holistic vet in your area: they tend to be far more focused on diet in cat health, and some know enough to help you with a homemade diet, though all can likely help with diet choices. http://www.ahvma.org

 

[jcat]

Yes, which is why I said it would be great if the OP could find a vet to work with her on this. Right now it sounds like she's going at it alone without much support from her vet.

I'm offering suggestions to look into per her request.

Yeah, just putting him on an intestinal dry food isn't enough - that's what Mogli was on at the shelter I got him from in early March, and it was a disaster. Right now I'm working with a vet and a nutritionist (MSc in Animal Science [Nutrition]), and aside from tests for intestinal parasites, the first step was keeping a food/excrement diary and starting an exclusion diet based on it. He's doing okay at the moment on a very low-fat diet, but the cause of his months-long diarrhea hasn't been determined yet. It may be food intolerance (we already know he can't eat grains, poultry, raw or rare meat) or pancreatic insufficiency, but the symptoms are being treated with diet, veterinary prebiotics and probiotics without a definitive diagnosis.

I don't mean to go off topic, but to suggest that this is something best done under the supervision of professionals, and if one isn't satisfied, to get a second or third opinion.

ETA: Laurie, even 19% fat is way too much for Mogli; he's been put on

 

[ldg]

Commercial raw foods, macronutrient content on a dry matter basis, according to Dr. Lisa Pierson (who contacted the companies for the nutritional analysis, this is NOT based on the guaranteed analysis):

Rad Cat (chicken)

Protein 66%
Fat 27%
Carbs 0%


Nature's Variety (chicken). (not really appropriate for IBD kitties, given the 5% of the food that is veggies and fruits)

Protein 39%
Fat 48%
Carbs 1%


Primal (Turkey)

Protein 56%
Fat 33%
Carbs 0%


Bravo Balanced Blend (chicken)

Protein 49%
Fat 36%
Carbs 2%


Feline's Pride (chicken)

Protein 55%
Fat 37%
Carbs 2%


Etc. FYI, chicken & duck are higher fat than turkey and rabbit options.

Here is a link to Dr. Pierson's analysis of commercial foods: http://www.catinfo.org/docs/FoodChartPublic9-22-12.pdf

And her discussion of canned foods: http://www.catinfo.org/?link=cannedfoods#Commercial_Foods






Stella & Chewy's (chicken)

Protein 47%
Fat 26%
Fiber 1%

 

[ldg]

Yeah, just putting him on an intestinal dry food isn't enough - that's what Mogli was on at the shelter I got him from in early March, and it was a disaster. Right now I'm working with a vet and a nutritionist (MSc in Animal Science [Nutrition]), and aside from tests for intestinal parasites, the first step was keeping a food/excrement diary and starting an exclusion diet based on it. He's doing okay at the moment on a very low-fat diet, but the cause of his months-long diarrhea hasn't been determined yet. It may be food intolerance (we already know he can't eat grains, poultry, raw or rare meat) or pancreatic insufficiency, but the symptoms are being treated with diet, veterinary prebiotics and probiotics without a definitive diagnosis.

I don't mean to go off topic, but to suggest that this is something best left to professionals, and if one isn't satisfied, to get a second or third opinion.

ETA: Laurie, even 19% fat is way too much for Mogli; he's been put on

 

[ldg]

Oh - and my only point is that since Cesaer seems to (overall) do well on Ziwipeak, it would seem that fat content in and of itself isn't the problem - at least not at that level.

And, of course, to reply to your comment that raw foods are "high" in fat. They're not - not "by definition," anyway.

 

[caesarsmom]

Unfortunately I'm not in the states at the moment, I'm stuck in Sweden where they seem to care more about running tests to make money than to actually help him. I've contacted a few holistic vets nearby, and hopefully they can help and direct me to a nutritionist so I can help him. I believe his problem is caused by diet, I just need to figure out what it is. It might be fat, he's been eating lamb for a few days, I've now switched to venison, hopefully that will make a difference since its a novel protein for him. IBD is a learning curve I just have to be patient and take it one step at a time, and find people who can help me! I genuinely think the vet is going in the wrong direction seeing as he has improved since his diet change, so now it's just a matter of finding the right diet! Keep throwing suggestions my way, I appreciate any advice I can get.
I gotten a 2nd opinion, but I don't think vets are really able to deal IBD, since she basically agreed with the first vet, but was a little more supportive of diet change at least.
Madeleine

 

[vball91]

I think the novel protein diet is a good idea. Given that you're not getting much vet support, I think working with a nutritionist on his diet is the best thing you can do. I think it probably is a good step to try and see if it can be managed by diet before going to meds like prednisolone.

I've also read that Omega 3s are good for IBD kitties. Maybe you also want to look into a high quality salmon or krill oil to add to his diet?

Another thing I just thought of, has a specFPL test been done to rule out pancreatitis? The symptoms you describe could also apply to pancreatitis, and pancreatitis and IBD sometimes go hand in hand. It's an easy blood test that needs to be sent out to a special lab. I would suggest not doing the snapFPLI test if offered. The results are not as accurate and would need to be confirmed anyway, so I would just do the full test once.

 

[ldg]

I think the novel protein diet is a good idea. Given that you're not getting much vet support, I think working with a nutritionist on his diet is the best thing you can do. I think it probably is a good step to try and see if it can be managed by diet before going to meds like prednisolone.

I've also read that Omega 3s are good for IBD kitties. Maybe you also want to look into a high quality salmon or krill oil to add to his diet?

Another thing I just thought of, has a specFPL test been done to rule out pancreatitis? The symptoms you describe could also apply to pancreatitis, and pancreatitis and IBD sometimes go hand in hand. It's an easy blood test that needs to be sent out to a special lab. I would suggest not doing the snapFPLI test if offered. The results are not as accurate and would need to be confirmed anyway, so I would just do the full test once.

Great suggestions. :nod:

Also, just to make sure it didn't get overlooked in my overly long post ( :anon: ), there is information on pancreatitis as well, at http://www.ibdkitties.net

 

[caesarsmom]

Tbh, the vets here have been useless, but they did run a bunch of tests on him to which I have the results. I don't understand them at all, but I have a cousin who is a doctor who said she'd help me decipher them. Grain is definitely a problem, that much I've figured out by now, but I'm sure there are other things out there that he's sensitive to, at least at the moment. Trial by error is what is happening now, but I like I wrote I have contacted a few holistic vets, so hopefully that will help...
It's a strange feeling knowing that you know more about your cats health than a vet..and the only way I can get him meds like prednisolone is to give him a biopsy. I feel money plays more of a factor here than my cats health.

 

[ldg]

I'm really sad to hear that. At least the vets here will treat to see if it helps, rather than forcing something like a biopsy. Of course... the flip side to that is that often they'll just "throw" medicines at the problem, without knowing what it is. So that knife cuts both ways.

And, sadly, at least in the U.S. (and it seems, internationally as well), most vets receive very little in the way of nutritional training - especially when it comes to the concept of "species-appropriate" feeding. It was really an eye opener for me, learning about what's in cat food - and thinking about what a cat would naturally eat. Quite the difference! Interestingly, it's a University in the Netherlands that's done the most useful (IMO) work on species-appropriate feeding.

It seems like keeping a journal of what goes in and what comes out will be really helpful to you.

 

[caesarsmom]

It is fairly upsetting, but at least I'm learning what's good and what's not. If the vet can't help him, I will. I've been telling my story in several chat rooms and I'm amazed at how many similar stories are out there, and how important it is to educate ourselves. I am weighing him almost obsessively, as weight gain definitely indicates a step in the right direction. I do want to get him on a raw food diet, but Ziwipeak is working at the moment and I'd rather wait until he's a little more stable before switching his diet again. All the food switching probably contributed to his vomiting today anyway.
A journal seems like a good idea, thanks for the suggestion!

 

[denice]

I have a cat that has been diagnosed with probable IBD.  I never did figure out what triggers it, he would be on the same food for months and then have a flareup.  He is on a permanent small daily dose of a steroid.  He didn't have the biopsy to find out for sure.  At one point he had two forms of hepatitis one of them being fatty liver and was on a feeding tube for awhile.  The vet ruled out everything else except lymphoma.  There is often a fine line between lymphoma and IBD.  She started treating him for the IBD and that has been over two years ago.  I doubt that a small dose of steroid would've kept lymphoma in check this long.  From what I have read and heard it is normal to rule out everything else and then treat for IBD.  Hopefully you can find the food that works so it can be controlled that way.

 

[imbri]

I have a cat that has been diagnosed with probable IBD.  I never did figure out what triggers it, he would be on the same food for months and then have a flareup.  He is on a permanent small daily dose of a steroid.  He didn't have the biopsy to find out for sure.  At one point he had two forms of hepatitis one of them being fatty liver and was on a feeding tube for awhile.  The vet ruled out everything else except lymphoma.  There is often a fine line between lymphoma and IBD.  She started treating him for the IBD and that has been over two years ago.  I doubt that a small dose of steroid would've kept lymphoma in check this long.  From what I have read and heard it is normal to rule out everything else and then treat for IBD.  Hopefully you can find the food that works so it can be controlled that way.

Not only is there a fine line between lymphoma and IBD, current research suggests that IBD, especially unchecked, can become lymphoma.  Anecdotally I can attest to that, as my lovely Artemis had IBD when I adopted her (well, more like when she was dumped on me)  Since I am a paranoid person I went ahead with a biopsy, confirmed IBD.  4 years later her symptoms were raging out of control and on x-ray we saw what looked like a few irregular lymph nodes, did another biopsy and behold, lymphoma.  I really wish I knew back then what I know now regarding nutritional therapy, perhaps then she might have gotten a few more happy years to make up for all the trauma she suffered before she came to live with me.

 

[caesarsmom]

I have been told that it can lead to cancer in the future, which is why I'm anxious to try to get it in check now. For all I know I waited to long and cancer is inevitable, but it doesn't hurt to try. Ive also heard testimonials from people who have said changing the diet helps the cancer too, so here's hoping for the best. We do what we can with the information we have at the time, and I have to say, nutritional therapy is well kept secret unless you ask the right people because vets don't know anything about it. Artemis was lucky to have you. Hopefully I'm doing the right thing for Caesar, if. I hadn't seen an improvement, I would have scheduled a biopsy, no doubt, which is why I think I may be on the right track.

 

[violet]

I have no illusions about IBD and lymphoma. Been through the indescribable heartache of losing one of my babies to lymphoma after doing everything anyone could think of at the time trying to treat IBD.

My IBD kitty was diagnosed by endoscopy. This procedure should be available to you in your country as well, so please check with your vet. If it isn't, please let us know.

I'm including two pieces of information. Hopefully they will be helpful to you.

http://vetconfidential.typepad.com/vetconfidential/2009/10/inflammatory-bowel-disease-in-cats-ibd-1.html

http://auld-louie.net/?p=63f

If you can't find any holistic help, please let us know. (In some Europian countries holistic medicine is very important and it can offer an incredible amount of help for humans and cats and dogs. )