Colitis/Colonoscopy

Has anyone's cat ever had a colonoscopy? Mine is likely to have one next week, and I was wondering what to expect and what's involved. Is the cat anesthetized? Did you have to withhold food for 12 hours beforehand?

This is to try to figure out what caused his colitis, which started suddenly three months ago and won't stop. It hasn't responded to antibiotics, pro-biotics, worming, or an allergy diet, and blood tests and bacterial tests haven't shown anything. The colonoscopy (and possibly an ultrasound) are the last steps. If they show nothing, then I can rest assured that he doesn't have polyps or some kind of malformation or ingested foreign body, and that nothing too serious is wrong. After that a high-fiber diet is the only thing left; I didn't want to try that until everything was checked out, since I had tried adding some canned pumpkin for fiber but saw no change.

I doubt it is stress, since the cat has never seemed more mellow, and he's been very stressed at times in the past and never showed these symptoms.

Any experience with colitis would be helpful. Thanks.

Thanks. Mine isn't scheduled to be there overnight. He'll be dropped off early in the morning and picked up in the evening... but maybe they will want to keep him overnight. If he has an ultrasound it will probably be the same day.

I guess I (and the vets, possibly) are confused by the sudden onset. He's a reasonably young cat and had been normal and regular, and then suddenly within a week he wasn't. Of course, right at that time he'd gotten worms and a respiratory infection (both of which are gone now), and he does have a mild heart condition. Possibly (unless they find something else next week) the colitis just was triggered somehow, and once triggered it can't be un-triggered. I'm hoping that's not the case.

Is there no difference between colitis and IBD? Did your cats develop it suddenly?

I can talk about it in humans at least, as half the four members of my family have IBD.

IBS is just irritable bowel syndrome, whereas IBD is inflammatory bowel disease. Crohn's and ulcerative colitis are both IBD. The major difference is that Crohn's is recurring and can be anywhere in your GI, while colitis *generally* does not recur and starts in the colon.

High fiber diets are helpful in that they help move stuff through and make you regular.

I imagine your vet will answer the other questions regarding exactly what procedure he is doing, withholding food, etc. They will be unconscious and have the probe either in one end or the other.

Your kitties are in my thoughts.

From what I've gathered, with my cat it seems to be in the large intestine rather than the small. Fortunately, he doesn't have diarrhea or constipation... just blood and mucus, which seems to fall more under colitis. But I guess I'll see.

Thanks for the links... I've read a fair amount about it, but I hadn't seen those. The vet is a specialist in internal medicine, and the whole thing will be supervised by his cardiology specialist, so I trust that he'll get good care. His regular vet is also good but tends to take a more conservative, wait-and-see approach... I thought it'd be better to rule out something serious before trying yet another diet change.

The result of the colonoscopy was that it's a kind of ulcerative colitis that's rare in cats. The vet said a bunch of things were going on in the biopsy report, but that's the gist. She said that it could be genetic, and may be influenced by stress. There are no signs that it was a food allergy. Apparently in some young cats that get this, it goes away on its own, but that doesn't often happen when the symptoms are as bad as my cat's have been. Though he has been doing better for a few weeks, for no reason I can figure out. According to the vet, the enemas done before the colonoscopy sometimes have a healing effect.

I guess I have some questions to ask the vet. We're looking at a variety of drugs and/or diet for solutions. The first being Flagyl again (argh). Prednisone is out because the cat has a heart condition.

The ultrasound found a small mass in the abdomen... this sounds similar to what one of you described. The guess is that it may be a secondary effect of the inflammation in the colon... it was too hard to get to so it wasn't biopsied.

Actually, what you're describing sounds very much like my Gabby's symptoms. Gabby has IBD and was diagnosed 7 years ago. Like your kitty, she had a colonoscopy & it was just a day procedure--she was home that night, albeit a bit groggy.

There are several different types of IBD, depending on the types of infiltrative cells found in the biopsies. Some are due to food allergies, others aren't, and don't have a known cause. Bloody diarrhea & mucous are both symptoms of colitis--colitis is different from IBD. Colitis simply means inflammation of the colon (large intestine)--whatever the cause may be. Colitis-like symptoms of IBD simply mean that the inflammation is taking place in the colon. If the inflammation were in the small intestine, you'd notice diarrhea as well, but it would be different--huge volumes of it, like undigested food...... also the coloring might be different. You might also notice vomiting and weight loss. Inflammation in the small bowel means the intestines are not able to absorb the nutrients in the food like they should, hence the weight loss, and rapid transit of food. IBD can be present in one or both places. Gabby's started out exactly like your kitty with only colitis symptoms, and alot of pain.......but over the years it has worked its way into her small bowel, too. We're able to maintain pretty decent control of it most of the time.

Sadly, when I call my vet regarding IBD relapses in Gabby, our conversation usually consists of me telling her whether I'm seeing large or small bowel diarrhea, because it makes a difference in how we treat it. In 7 years, I've learned to tell the difference (the things we learn from our cats, huh!? ).

Flagyl is an excellent drug for IBD. The side effects aren't much fun (give it when your kitty' stomach is full!!), but it does an amazing job at getting it under control. It works really well with the Pred, but it sounds like your vet may take a different approach due to a pre-existing heart condition.

Best of luck to you and your kitty.

The ultrasound was a one-day procedure, but for the colonoscopy he ended up being there two whole nights... for observation.

What are the side effects of Flagyl? The only problem I've had is on the giving end... where they drool and won't take it. This time I'm trying a fish-flavored compounded liquid. If it doesn't work or is too much hassle, we're going to try one of the other drugs. Apparently there are some brand new ones.

Have you ever tried fiber additives? Petromalt makes one in capsules that seems similar to Metamucil. My vet said diet may be a place to tackle, but that it's necessary to find the right balance since too much fiber would be as bad as too little. I'm thinking adding some powder to the cat's food would be much less difficult in the long term. Or maybe some of the drugs that are tiny and given every other day.

I guess I should have been clearer... there is almost positive proof that it isn't a food allergy. There's a slight chance that he's allergic to something but not to what he was eating when the biopsy was taken. But it's looking like that's not it, fortunately.

Well, you've already hit on one of the major drawbacks of Flagyl........the taste! It is very, very bitter and if you don't get it down the cat's throat clean the first time out & they get the slightest taste of it, they will drool, & foam terribly. Also, it is notorious for causing nausea & vomiting. It can put a cat off his food due to the nausea. I've been able to get around that problem for the most part by giving it on a very full stomach--I feed her & immediately after give her the pill. Some cats might be more sensitive to it than others, but this trick has worked with all of mine that have been on it at one time or another. The flavored liquid might help getting it down, but I'd still recommend giving it on a full stomach. A couple of other side effects that I'm aware of, though rare, are neurological (I think this is with extended use or very high doses) and elevated liver enzymes.

Not sure about the fiber capsules.......Gabby's was not a food allergy, either, but we had to switch her diet. After many, many unsuccessful food trials, Hill's w/d was the one that her IBD responded to. It's a low fat/high fiber diet. In the last several years, we've tried to switch her to some of the newer foods created for these types of conditions, but always end up back at w/d. Just to cut back on her getting so many carbs, though, I feed her the w/d canned food, in addition to the kibble.

There are newer drugs out now to treat IBD......Budesonide is one that comes to mind--I have no experience with it but supposedly it is a steroid that is metabolized by the body differently, making it a better option for cats who aren't good candidates for Pred. I believe there may be a few more that are used in kitties that shouldn't be on Pred--but I'm just not sure what they are.

I think Budesonide is one of the ones my vet mentioned. She wasn't sure whether it would have enough impact on the large intestine, though.

What newer high-fiber foods did you try? Thanks for all the advice.

I just tried giving the fish-flavored liquid Flagyl, and it was so much better than the pill form. With the pill there was the foaming and spitting. This went down in a second and the cat happily licked his lips and wandered away... he wasn't too happy about me getting him into liquid-giving position, but other than that it was fine. It's still a little messy, though... did not enjoy getting stinky fish liquid on my clothes.

Alot of the other foods that we tried were not necessarily high-fiber, but various other foods out there that may be beneficial to her condition. Some of the ones we tried (& either she refused to eat or they aggravated the problem) were Eukanuba Low Residue, the Waltham hypo-allergenic diets (alternate protein sources like rabbit, duck, etc.), Hill's z/d, Purina DM, Hill's i/d, and some of the Eukanuba hypo-allergenic. We also tried some of the IVD alternate protein source foods but I believe they've since merged with Royal Canin (??). I lose track....... Anyway......there may be a few more that we've tried that I'm skipping but these all come to mind now.

It's really anybody's guess what the condition will respond to with any given cat. The Hill's z/d I believe is made specifically for cases like IBD, but it caused one of the worst relapses she's ever had with this disease. My thought on that is that Gabby's is primarily located in her large intestine so foods that treat colitis work better for her (like the w/d). Just a guess on my part, but my vet & I have decided to leave well enough alone after 7 years--it's under control so we try not to rock the boat any more than we have to.

I'm glad the fish-flavored liquid went down easier, though I can imagine it was not much fun at all to wear.

Have any of you used sulfa drugs for your cats' colitis? They were one of the other options my vet initially said we could try, but now she's resisting giving it. She insists on only the Flagyl... but even in liquid form my cat is hating it and I hate giving it. Plus it's making him constipated. The effectiveness was pretty good, though there's still a bit of mucus.

I tried it for a month and now would like to try something else, to see if it can knock the symptoms out completely. But she insists that any other drug would have side effects given long term (which is not what I've read about the sulfa class of drugs), and besides Flagyl has its own side effects. I don't want to have to pin my cat down and force-medicate him. I'm already giving heart medications in treats twice a day, and so a third is just too much burden... I'm lucky to have a cat that will take tasteless pills in food, so it seems like a pill option for the colitis would be better for all concerned.

They did finally give me a different prescription, I think for sulfasalazine (I haven't picked it up yet). I guess I'll have to see how it goes... I asked for it in pill form, and apparently it also has a bad taste (though not as bad as Flagyl), so I don't know how successful I'll be at getting the cat to take it in food.

So constipation is a symptom? He was already having that from the Flagyl, so it might not be any worse.

I'm trying to avoid using a pill shooter or liquid syringe... because the process is stressing both him and me out. The vet had said that stress can make the colitis worse, which accords with what I've observed.

In the last few days since the Flagyl ran out, he has been unmedicated. And though it's definitely not as good, it's not as bad as it used to be. I'm going to try just adding fiber powder to his food for a few days to see if it might be at a point where I could control the symptoms with diet alone... of course that'd be the ideal.

Yes, it's tricky to change the food. How long does the food trial still have to go?

I still don't know whether my cat's one of those who'll always have this condition, or whether he'll be one of the lucky ones where it goes away. After six months, I don't know. It did start to improve (pre-medication) in the fourth month, but it's still there.

When you give Metamucil, curious, how much do you give? I bought a pet fiber that seems to have essentially the same ingredient. For his weight, the package instructions say 1-2 500 mg capsules 3 or 4 days a week. I think I'll start small, with half a capsule a day, to see how that works, and increase if he tolerates it well. The vet said that it's important to find the right balance, since too much fiber can be as bad as too little.