Food and small intestine trouble

One of the cats I share my life with has developed a stomach/digestive system problem.  She has been under veterinary care for the last two months or so, she has had every blood test imaginable and she has had an ultra sound which has ruled out the presence of masses or tumours.  The vets have ruled out thyroid issues and pancreatic problems.  We have been told to put her on a hypoallergenic diet, which we have done, as well as a daily steroid dose to try and ease the inflammation in her gut (the issue seems to be her small intestine) and stimulate her appetite and a weekly vitamin B(12 I think) jab.  Her bowel movements are extremely runny, but not greasy.

But we still don't know what is wrong with her and she is painfully thin (but not dehydrated) and doesn't seem interested in her food.

I was wondering if anyone had any thoughts they would be willing to share?  Is there anything we can do to urge her to get some fuel on board that she desperately needs.  We have been told to not chop and change her food, to focus on the prescription food because it is almost as if she has an out of control food allergy.  We have tried warming it.  We have tried chilling it a little (it smells pretty strong to us and we wondered if she was overwhelmed when it was warm and energetic). 

She is about 11 years old.  Exact age unknown.  And she is a rescue.  We believe her to be developmentally backward - her history was that she was obtained as a kitten/juvenile, and when she developed a serious gum infection/disorder, her original owner simply shut her in a shed rather than call the RSPCA or take her to a vet, and she was starving when she was finally found.  She has been with us for 8 years now and she has always been very much kitten-like, as if her body was so desperate to keep her alive when she was young that there was no energy left to let her grow up properly.  So she is a little...well...odd.  But we love her.  Because of her problems, she is strictly an indoor cat.

She is showing no particular signs of distress as I would understand it in a cat, she hasn't gone to ground and she responds to the people around her.  But she's all skin and bone and she doesn't seem to want to eat (the day we got the HA food, she was willing to have some, so she can eat it).  Everything the vets are trying is coming back negative and I suppose this is one of those difficult times where you long desperately to be able to communicate with them.

Oh gosh, what a tough situation to be in. What is the prescription food that she's on? Have you ever tried a novel protein raw diet?

I had a cat with inflammatory bowel disease, and the only thing that helped firm up his stool was slippery elm bark powder. It's soothing to the lining of the intestinal tract and helps to keep moisture levels in the gut balanced. There is no risk in trying it. You can find it at most health food stores. Here is some info for you on dosage: http://www.felinecrf.org/holistic_treatments.htm#SEB1

Thanks for taking the time to answer.  She's on Hill's Prescription (we wanted her to have wet food, she hasn't got any teeth and dry can be a problem sometimes)

Will look in to your suggestion

What a love you are for rescuing this baby! :heart3: I'm so sorry she's facing such a confusing problem. Yes, if only they could talk!

Some questions for you first, okay? IBD can be definitively diagonsed by endoscopic biopsy. Has this been done?

If not, it's something to consider. There are members here with kitties with IBD, and they are experiencing great success with a probiotic clincally proven to help IBD in people, and we're now finding that it works for cats, though there are no studies specifically in cats. I don't know if it is available in the UK, but it is called ALIGN, and it is manufactured by Johnson & Johnson. :nod: If it is IBD, one capsule a day sprinkled onto food will help immensely.

Now, how much does she eat a day? Or how long has it been since she's eaten? Does she nibble here and there? Can you quantify how much she's eaten daily recently? Which prescription food is she on? Are you feeding her wet food or dry food? How much of each do you try to give her, how much does she eat, and (though I already asked), specifically what kind of food?

Has she had antibiotics recently? Because another member's kitty with IBD was given antibiotics, and it made his system insanely crazy for... 7-8 months until she figured out how to get it back under control.

Lastly, and you may think I'm nuts, but can you search a little or ask your vet - are there any vets trained in alternatives (especially chinese medicine/acupuncture) anywhere you can get to? I ask this, because one of our kitties is FIV+. This meant he had all kinds of immune-related problems - allergies, sensitivities, chronic diarrhea - and nothing our conventional vets (and we have several FABULOUS ones) did helped. We were lucky to find a VET trained in alternatives. Within two weeks of her suggested treatment (chinese herbal formulations), it was clear we were on the right track. Within a couple of months, he was as healthy as any of our other kitties. We have to keep giving him the herbals, but he is doing just amazing. In my experience, when there are immune-related problems, western medicine struggles to treat them and often not very successfully, but chinese medicine does a very good job of it. :nod:

:heart3:

Thanks for taking the time and trouble to answer.  I'm not the one who rescued her, her bipeds are a couple who have a long history of rescues and took her in with two other troubled cats a number of years ago.  But she is a treasure and I live with her (and them) and she's an important part of life.

She is eating Hills Prescription z/d as instructed by the veterinarian.  She has eaten a very small amount today, probably no more than 70-100g or so (3-4oz?) although it is hard to tell (she weighs 2kg or so, a weight range she has been at for 3-4 weeks by my memory and what she weighed when she was discharged 8 days ago).  She will have a nibble and then wander off.  She needs encouragement to eat.  She is drinking water, but no more than I would expect.  

She had antibiotics for a problem about a year ago, but not since then.  The problem was never diagnosed, they ran bloods but were never able to pin down what had happened (she ran a high temp and became limp and unresponsive, she was rushed in, given fluids and an anti-biotic shot and recovered).  We are a number of months in on trying to fix this current digestive system problem and are only succeeding in ruling out problems.

She hasn't had endoscopy of any sort, but then she is very frail at the moment so I guess it's possible that the vets don't want to give her a general anaesthetic (she is insured, so cost is no problem, but the vets haven't wanted to do it).  They did shave off a big patch of belly fur and have done an ultrasound and do localise it to the small intestine, telling us that food could be seen racing through there at some speed.  And we know that she is capable of getting quite gassy (she will growl and grumble at people near her until she has gone to her litter box because she isn't sure what her body is doing and wants to be in the right place, just in case) although not in the last 48 hours or so.

The only medication she  is on is a dose of 2 x 5mg of a steroid called Prednizone (sp?).  The vets told us that improvement might take a number of weeks, but when she is not eating much, that's a frightening concept.  But I see from reading up on IBD that corticosteroids seem to be the primary drug treatment, as well as the provision of a special diet.  It looks as if the vets are carrying out an IBD sort of regimen for her.  (admittedly, an assumption based only on my reading of:  http://www.cat-world.com.au/inflammatory-bowel-disease-ibd-in-cats ).  If they can see that the problem is in her small intestine, and have ruled out all the other possible factors, is it worth the risk of a general anaesthetic to get a definitive diagnosis?

I believe that she had a higher than normal white blood count, which I think is consistent with IBD .  FIV was ruled out.  And we took a stool sample in which was all clear.  Pancreas is all clear.  Salmonella ruled out.  Thyroid all clear.

The product that you mentioned does not seem to be for sale in the UK and I'm not sure what, if any, rules there are on importing it - the rules on food additives, natural remedies, over the counter products  etc changed  this year.  Problem is, of course, that adding something to her food is a problem when she really isn't eating a lot.  We were expressly told not to chop and change her diet and not keep exposing her to different products - she started the Z/D  4 days ago.  The very first day she was offered it, she ate a good sized portion (within the anticipated range for a cat her size) so we don't think she is refusing because she hates the stuff.  

I suppose it is possible that she is still acclimatising to it and her gut might be a bit upset - except she can't tell us what is happening.  And she hasn't gone to ground or done anything that I associate with "ill cat" behaviour, her eyes are bright and clear and she will track a waved hand, and her coat is very plushy and she is responsive enough to give an annoyed "tail twitch" when guided towards her food bowl.  She does seem dopey, but if she's not eating much I'm not surprised that she doesn't have much energy.

I'm so sorry. :anon: You didn't mention if she's being given the z/d wet or the z/d dry.

It's important if she's got food sensitivities, because brewer's rice is sometimes a trigger (not always). Our FIV+ boy, Chumley, was on z/d for three months to see if the hypoallergenic diet would help. It did not. We were letting him free feed kibble (measured) and giving him three wet meals of food/day. As it turned out, he was allergic to brewer's rice, which is an ingredient in the dry z/d, but not the wet z/d.

I just remembered, there is another kitty on TCS, Lucas (momto4kitties is his mom) that is allergic to the WET z/d, but not the dry! There is corn starch in the wet, and apparently he's allergic to the corn starch, but not the brewer's rice!

So whatever z/d you give, I'd give either only wet, or only dry for a month or so. If it doesn't, I'd switch to whichever one you weren't giving her.

Of course... if she's not eating enough, you may have to syringe feed her. The z/d wet is a good consistency to get into a syringe for feeding, so you may want to consider starting with that, because you can supplement what she eats with the syringe feeding.

But 4 oz. is not bad for a 2kg cat. According to the feeding requirements of the a/d (the critical care formula, nutritionally dense food) (here: http://www.hillspet.com/products/pd-feline-ad-caninefeline-critical-care-canned.html, her daily nutritional requirement is about one can of a/d per day to maintain her weight. Obviously more to get her to gain weight).

Here is the feeding guide for the z/d wet: http://www.hillspet.com/products/pd-feline-zd-feline-ultra-allergen-free-canned.html
and the z/d dry: http://www.hillspet.com/products/pd-feline-zd-feline-low-allergen-dry.html

I'm so sorry all of you are going through this difficulty with this sweet kitty.

A website I believe is very informative, helpful and supportive for IBD kitties and their owners is IBDKitties.net. The site maintains case studies and a forum, provides food recommendations - including raw food, which, as has been mentioned, is often extraordinarily effective in addressing IBD - and much more. Connections through the site sometimes also allow participation in various clinical studies.

I wish you and this little old lady the very best!

AC

Thanks to folks for answering.

She is eating Z/D wet, when she eats.  She had a little this morning and there has been a minor improvement in the firmness of her stools.  Not great, but a step in the right direction.

The syringe feeding is an interesting idea.  But I've never done that before so will need to do some reading.  She is quite easy to pill and quite handle-able.  But due to her oddness, she has a poor sense of her own wellbeing and safety that I worry that she will thrash and hurt herself.  Will look in to that.  Right now we are just desperate to get some food on board.