Suspected colitis

Hi everyone,

I have a cat, Miss, who is 4 years old. The vet suspects she has colitis, as she's had soft stools and occasional blood in her stool off and on her whole life.

She recently had a bout where she stopped eating large amounts of food, and vomited clear. She also seemed to try and vomit but ended up just drooling. That went on for about 5 minutes.

I took her to the vet a few times over the course of three days and he suspects colitis. He gave her a few medicines, hydrated her and took a bunch of blood levels/stool sample. She has a normal temperature

Before this for about 8 months or so, she seemed to eat through about three bags of food, stop eating, get the clear vomiting, and when I'd switch her food, she'd be ok.

I  try to feed her a simple digestable diet. Before this happened recently, she had been through 3 bags of Green pea and Duck.

She HATES canned, and despite my efforts to give her Wellness, and other high quality brands, she licks the juice and that's it. I've sampled, many, many wet foods. I always give her the option each day, but her diet is mostly dry food.

I switched her to a hypoallergenic diet shortly after this started, also duck based, and she didn't like it.

So now that her appetite is better, I've decided to try her on the I/D dry food. I'm not really happy with the quality of ingredients, but at this point, I want her to feel better, and she seems to go crazy over it. I've also got her eating a bit of the wet I/D. She doesn't eat a lot, but I want her to have some canned. 

He prescribed metrodinazole... But after a few days of rough pilling, (she doesn't bite or hiss, just doesn't open her mouth or let us move her head back) he said lets give her a break since she started eating again, watch her stool, and if it's still soft, we can try it again in a week or so and see if we can come up with an easier way to give it to her.

Right now she is on famatodine only. Which is still hard to pill. She spat most of a dissolved pill out today. 

After all this rambling, I want to know if I/D has helped any of your colitis cats with improved stool. I was going to ask him about a probiotic, but I don't want to be starting too many new things after her 3 stressful vet visits.

I'm thrilled she's eating, but scared this process is going to start up again without the metrodinazole. I've been trying not to give her large amounts of food, either. She is a HUGE eater...wanting to eat every 5 hours or so. She doesn't seem to have quite the same huge appetite, but it's coming back, and I'm relieved, but still, I'm so anxious. She's such a sweet cat, and I just want her to feel better. She seems like she is on the rebound, but I want to make sure she stays that way.

A www Miss . Just a couple of ideas/suggestions. First off Metronidazole is very, very bitter and would be impossible to pill the nicest cat once they get a taste of that. Ask the vet to have it made into a liquid, chicken flavor, most cat's will accept that readily. You have to keep it in the fridge and shake it up each dosing. If you use the pill form, I wrap the pill in a small section of a pill pocket to coat it and then put it in the back of my cat's mouth. They usually swallow it right down then.

I/D is fine and don't worry about the ingredients right now as long as this gets her stools back to normal. You can also give her W/D :nod:. But that is lower in fat, if she is a bit over weight then tha would be a good overall gastrointestinal diet too. Ask your vet about W/D.

If you can, add some chicken broth to one ot two of her dry meals a day just to get more moisture into her system. Make it a small amount of dry mixed with the broth so she will eat it all in one feeding as you cannot leave it sit out for more than twenty minutes or so. it would spoil if you don't take it up. Also, the jars of baby food, the pure meat ones would be good to water down and mix in with the dry. Just try it and see if she likes it. That will help to firm up her stools too.

You can also add Acidophilus (probiotic) the people one from the pharmacy. Capsule form, sprinkle 1/2 capsul to start on her food. She won't taste it, and it is not bitter. You can then go to a whole capsule once daily.

Does the vet think she has ulcers ?? Famatodine is Pepcid to treat ulcers. Poor baby, so much going on but I think you can find some great suggestions here on TCS. I want your kitty to feel better too , she sounds like a sweetie and you love her so :heart3:

Thank you so much for your kind reply and suggestions! 

I like the idea about the chicken broth. I will see if there are any without onion and garlic.

I have started to use a pill crusher to crush some of the dry i/d and sprinkle it on the wet. Seems to work to trick her into eating more wet at the moment.

Does the chicken flavor really hide the bitter taste of the flagyl? I wasn't sure. She is hard to pill, but I don't want her to aspirate anything squirting down her throat, as I'm new to all this medicine giving.

I don't think he suspects ulcers, but he said it helps with acid build up, which can be a side effect of her flare up. Sounds like her whole digestive tract was a mess so he's trying to cover all bases.

Thank you again,

Jen

Oh good about no ulcer's and agreed that the pepcid would help her digestive troubles as well. The I/D is not for long-term use - just to get her stool's back to normal and then I would mix that with the food you plan on feeding her. Canned is best :nod:. The broth is only for the dry food to get her excited about eating and will add some moisture and you can even add a little to the wet food to entice her, if she likes the broth. Plain organic broth - no salt and no garlic :nod: - is best to use for this. The vet would give you the Metronidazole compounded into a chicken flavored liquid and give you a small dosing syringe to dispense. Don't worry, you won't hurt her by squirting a little in her mouth - and no, it is not bitter like the pill's. I have used the liquid before too. If you can't get the liquid, see if you can use a pill plunger and surround the pill "lightly" by using a part of a soft pill pocket. That is what I do, then I just place it behind their tongue's. No bitter taste that way and no bad experience on their part then. They just can't figure out why I shoving a treat in the back of their throat hno:......

Good idea about crushing the dry food and lace the wet food with it :bigthumb:!!!!! If you can - see if she will like the W/D wet food. That can be used long term and will help keep her stools completely normal too. Ask the vet. Works very well. Ultimately - a grain free wet food and even a commercial raw cat food will help her stool's to stay normal too. I have found that to be true for my Pipsqueak - who a few years back has serious issues with runny poop's. Keep up posted :nod:

famotidine is for heart burn. don't even bother if its stressful for her to take it. It has no effect on colitis, which doesnt seem to be the problem here. She has had soft stools with occasional blood her whole life... so if the cat isnt anemic or have electrolyte abnormalities in the blood, let her have her colitis... 

the more acute issue here is the vomiting after gorging a lot of food it likes. Is the cat overweight from its heavy appetite? If so, have you tried just letting it eat the food it likes but cutting down the amount it can eat by a significant amount? That could be all it needs. On the otherhand, if the cat is overweight I would worry about diabetes, and if that were the case I would give it wet food, and if it doesn't eat it then let it starve for a few days. It would probably be good for the cat (w/ water being available of course) and the cat will have to give up and start eating it, despite in smaller amounts, leading to weight loss and resolution of the diabetes.

But that's still unlikely and more likely is simple overeating or a reaction to that food. If there is a fever than infection is likely

Originally Posted by mediCATe  
... On the otherhand, if the cat is overweight I would worry about diabetes, and if that were the case I would give it wet food, and if it doesn't eat it then let it starve for a few days. It would probably be good for the cat (w/ water being available of course) and the cat will have to give up and start eating it, despite in smaller amounts, leading to weight loss and resolution of the diabetes.

...

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Heavens no! An owner should never let their cat "starve for a few days" - twelve hours is the max! - and this applies double to cats that are overweight. It's very dangerous and can cause hepatitis lipidosis (fatty liver disease).

There are members of this board who have had to manage a cat with hepatitis lipidosis, and they can tell you it's not something to be taken lightly.

Best regards!

AC

Auntie Crazy said:

Heavens no! An owner should never let their cat "starve for a few days" - twelve hours is the max! - and this applies double to cats that are overweight. It's very dangerous and can cause hepatitis lipidosis (fatty liver disease).

There are members of this board who have had to manage a cat with hepatitis lipidosis, and they can tell you it's not something to be taken lightly.

Best regards!

AC

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Perhaps I did word that too strongly! haha. I meant leave the food for the cat and let it starve itself if doesn't want to eat. Eventually it will develop an appetite and eat something. If it doesn't eat for over a day then consider a trip to a vet. Fatty liver disease doesn't happen from fasting. It happens from severe chronic malnutrition. It's what happens to kids in Africa with the big bellies. If fatty liver happened form a 12h fast, half the cats in the world would be walking around with oversized livers!

House cats though, unlike dogs, will starve themselves rather than eat what is available if they do not deem it edible for whatever reasons.

A perfect example of this is a cat with a severe URI, unable to smell its food.

No, a twelve hour fast will not harm a house cat, but more than 24 hours puts a cat at serious risk of fatty liver disease.

And the longer a house cat goes without eating, the less likely it is to get its appetite back without force feeding.

Fasting a cat for more than 24 hours becomes a very slippery slope.

Keep in mind here that house cats, unlike wild cats, came to be as they are because they had food available at all times (generally speaking).

Because of mankind, there always seems to be something around.

Large wild cats are made to gorge and fast, while house cats are not.

You cannot compare a house cat to a malnourished child, as humans are designed to absorb fat cells when food is scarce, a cat's physiology is quite different, they do not use up fat stores.

Birds are actually much the same in this respect.

That's not true. Although we are different from cats and have variation in disease, our physiology is basically the same. Our DNA is probably around 95% the same as a cats and the same goes for our metabolism. Cats do in fact use fat as energy stores the same way we do and the disease process of fatty liver in cats is also the same. Look up feline hepatic lipidosis on wikipedia and see for yourself. Even though cats are more prone to develop the disease than humans, it still takes days to weeks to develop the disease. 
 

Use wikipedia for medical information. It's the best source for the public to use.

mediCATe said:

That's not true. Although we are different from cats and have variation in disease, our physiology is basically the same. Our DNA is probably around 95% the same as a cats and the same goes for our metabolism. Cats do in fact use fat as energy stores the same way we do and the disease process of fatty liver in cats is also the same.

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You might want to brush up on feline physiology. Cat and human metabolism has some key differences and they don't, in fact, use fat stores the same way we do. Maybe read these links instead of relying completely on Wikipedia for all your info:

http://www.walthamusa.com/articles/f-liver.pdf 

• The cat has a number of anatomic and metabolic peculiarities predisposing this
species to some specific liver diseases and posing particular challenges to their dietary
management.

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The liver performs many vital functions with respect to nutrient digestion and metabolism,
detoxification and excretion, hematology and coagulation, and hormonal balance. Cats have,
however, some very specific metabolic features, which are important for the understanding of feline
liver disease:
• Cats show a relative deficiency of glucuronyl transferase that affects the liver's ability to
metabolize drugs and chemicals.
• The feline species is unable to synthesize arginine (an important part of the hepatic urea cycle),
which predisposes cats to the development of hyperammonemia during inadequate food intake
or anorexia.

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Lipid Metabolism
The liver performs a key role in the fat metabolism of the cat including synthesis of fatty acids,
cholesterol and triglycerides, and the excretion of cholesterol and bile acids. The implications of an
abnormal lipid metabolism are still largely unknown. However, it is known that the feline liver is
unable to handle the rapid mobilization of fat stores during states of caloric restriction or prolonged
periods of starvation, and may result in the pathologic deposition of excess lipids within hepatocytes
(hepatic lipidosis). Total serum cholesterol may be increased by extrahepatic bile duct obstruction,
while it may be decreased in severe hepatocellular failure or portosystemic shunts.
Protein Metabolism
Being an obligate carnivore, protein is one of the key nutrients in the cat’s diet. The cat requires a
minimum overall protein intake, as well as the supply of certain essential amino acids.
The cat’s hepatic protein metabolism shows some peculiarities when compared with other species,
such as the dog:
• The cat's inability to synthesize arginine predisposes the cat to hyperammonemia, as arginine
plays an important part in the urea cycle.
• The cat's inability to down-regulate hepatic enzyme activity means that the cat will break
down its own body protein tissue when not supplied with adequate levels of exogenous protein.

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http://www.merckvetmanual.com/mvm/index.jsp?cfile=htm/bc/23616.htm

Feline idiopathic hepatic lipidosis is the most common cause of feline hepatopathy. The etiology is undetermined but is associated with a period of anorexia (few days to several weeks), especially in obese cats. Factors that may trigger anorexia include a change of diet to initiate weight loss or other stressful events (eg, moving, boarding, death of other pets or owners).

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Miss is plump, but not obese. She is 14 lbs. The vet wants her to stay at that weight or lower. He  was very vocal about making sure Miss was eating. When I told him she was, but not at full appetite, he recommended sub q'ing her to kickstart her eating since he said he doesnt want her to get that fatty liver problem. She is eating well. However, I am still going to try and get her to eat more wet food. I just dont believe she will ever be off dry. She despises wet. Id have to try raw before other canned varients. She likes canned rabbit best.

I am happy to report that Miss's stools are fully formed-for the first time ever! Is this the result of the i/d? She stopped the flagyl on Monday. I am worried she will get sensitive to it and the process will start over....

Kyle, thanks for the insight! What type of diet is Franklin on?

Sugarcatmom said:

You might want to brush up on feline physiology. Cat and human metabolism has some key differences and they don't, in fact, use fat stores the same way we do. Maybe read these links instead of relying completely on Wikipedia for all your info:

http://www.walthamusa.com/articles/f-liver.pdf 

http://www.merckvetmanual.com/mvm/index.jsp?cfile=htm/bc/23616.htm

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Yeah those things you wrote are similar to people except that cats are more susceptible to fatty liver because they rely on protein more than us due to their carnivore nature. But all those descriptions are basically the same thing that happens to humans. As you noted it takes days to weeks of starvation to develop it. Just like I said.

jen it sounds like it was an infection since the abx worked. good for Miss!

mediCATe said:

That's not true. Although we are different from cats and have variation in disease, our physiology is basically the same. Our DNA is probably around 95% the same as a cats and the same goes for our metabolism. Cats do in fact use fat as energy stores the same way we do and the disease process of fatty liver in cats is also the same. Look up feline hepatic lipidosis on wikipedia and see for yourself. Even though cats are more prone to develop the disease than humans, it still takes days to weeks to develop the disease. 

 
Use wikipedia for medical information. It's the best source for the public to use.

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Well referenced wikipedia articles can point you to good sources, but to advise people to use Wikipedia for medical information in lieu of vet advice is simply irresponsible.

I would also recommend you pay better attention when you read. Even the Wikipedia article you cite points out "The cat liver however is poor at metabolizing fat, causing a build-up of fat in the cells of the liver, leading to fatty liver."

If you want to disagree with Arlyn's point that cats do not use fat stores for energy, fine. But the FACT is that cats are not nearly as efficient at doing this as people are because because their physiology IS different. Cats are PRONE to fatty liver disease because their livers are particularly slow to break down the fat. Wikipedia may not emphasize this, but cats, just like people, are individual in their metabolism and proclivities, and in many cats, just a day or two of not eating can start the cycle.

It is also irresponsible to provide advice without reading the information provided in people's posts.

In fact, the OP wrote

JenL said:

She recently had a bout where she stopped eating large amounts of food, and vomited clear.

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and you replied, "

mediCATe said:

famotidine is for heart burn. don't even bother if its stressful for her to take it. It has no effect on colitis, which doesnt seem to be the problem here. She has had soft stools with occasional blood her whole life... so if the cat isnt anemic or have electrolyte abnormalities in the blood, let her have her colitis...

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The cat was vomiting when she STOPPED eating the large amounts of food she normally eats. The cat was not gorging and vomiting. The cat was NOT EATING AS MUCH and started vomiting.

Further, you advise

mediCATe said:

famotidine is for heart burn. don't even bother if its stressful for her to take it. It has no effect on colitis

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You're right, famotidine CAN be used for heart burn. But it's a histamine H2-receptor agonist. Antacids neutralize stomach acid: pepcid (famotidine) inhibits their production, and used in combination with antacids, increases their effectiveness. Famotidine is used to treat and prevent gastric and duodenal ulcers, and if the overproduction of acid is contributing to the inflammation of the intestines/colon, it may help improve the condition. And apparently, according to the OP's VET,

JenL said:

he said it helps with acid build up, which can be a side effect of her flare up.

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If you want to disagree with the vet, it would be helpful to the OP to address the point, not just dismiss offhand the vet's recommendation and reasoning.

JenL said:

Miss is plump, but not obese. She is 14 lbs. The vet wants her to stay at that weight or lower. He  was very vocal about making sure Miss was eating. When I told him she was, but not at full appetite, he recommended sub q'ing her to kickstart her eating since he said he doesnt want her to get that fatty liver problem. She is eating well. However, I am still going to try and get her to eat more wet food. I just dont believe she will ever be off dry. She despises wet. Id have to try raw before other canned varients. She likes canned rabbit best.

I am happy to report that Miss's stools are fully formed-for the first time ever! Is this the result of the i/d? She stopped the flagyl on Monday. I am worried she will get sensitive to it and the process will start over....
Kyle, thanks for the insight! What type of diet is Franklin on?

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Jen, I'm so glad she's got formed stools! It may be the i/d - or a combo of the use of i/d and the flagyl. Given the flagyl finished Monday, and it took almost a week for the stools to form up, I'd lean toward the i/d. I know you worry about her developing the sensitivity.... but were you going to use the i/d long term?

FYI, we have a kitty that can't go too long without food in his tummy or he gets sick. The pepcid a/c helps him make it through the night, but we need to feed him every 4-5 hours. :nod:

We also have a kitty that was diagnosed with colitis. Fortunately he never went off his food, but switching to all wet really improved his condition. I know the problem in that, and it can be REALLY hard to do. But a probiotic daily REALLY helped him (and that's MUCH easier to give if just sprinkled on wet!) He was the same way - he only liked the gravy. So we turn all his food into "gravy" with a little blender. :nod: If I use a little warm water (if she likes the chicken broth, you can use warm chicken broth instead) and put the food in the blender, it becomes "gravy" and he eats it. Might want to give it a try.... Don't know if you feed her any treats, but we cut out all treats, and that helped a LOT.

The other problem is that dry foods are kind of like kids eating junk food. It's got all those yummy things that aren't so good for them in it. Switching to higher quality wet foods is like trying to get kids to eat whole grains and healthy foods without the sugar and other additives. IF you can get her eating the i/d wet, you can then pick other limited ingredient wet foods to try mixing in slowly?

@LDG Yeah the cat ate large amounts of food, stopped eating (probably from nausea), and then vomited. Sounds like its from eating a lot of food to me, but it can be taken as she stopped eating and THEN vomited. From the little info she wrote, it sounds like the stopping of eating is because of eating a lot but it can be taken both ways.

as for famotidine, just writing the mechanism of action does not make you right. I wouldnt say stop taking the vet prescribed med if I had no idea how it works or what it is for. The cat had blood in the stool... thats not from intestinal ulcers, perhaps a colitis, but not from ulcers from acid which are far closer to the stomach than the colon. If the blood was from an ulcer due to acid production it would have been digested in the feces and it would look black and tarry. If that's not the case, then the famotidine is not gonna stop lower GI bleeding. 

What happened was Miss stopped eating her usual amount of food and started leaving lots of food behind in her dish for a few days. So she was nibbling on stuff for a few days and didn't have her usual voracious appetite. When she started rejecting food totally on the third day, and vomiting up the clear stuff, that's when I took her to the vet.

She didn't eat large amounts of food, then throw up.

She is still on the last amount of famotidine, 1 quarter pill left. I cut it in half so I have a bit for tomorrow.

@LDG -I LOVE your avatar. That kitty face is the sweetest!

You had some really great ideas-I like the idea about making all of her wet food gravy. That actually might work. I was happy today because she actually ate a huge chunk of Fancy Feast wet food. She never really does. I am trying to add more wet and less dry, but it is a huge challenge. My other two happily eat wet. 

I really don't know about being on the i/d long term. Right now, I just want her to stabilize and then I can see how to procede. I've been sprinkling crushed up i/d dry on the wet food, and that gets her to eat more than normal. I also have been bringing her water dish to her. I figure while she's on the i/d I want to keep her hydrated as best I can. 

Her appetite is really good, but not the voracious level it was before. It was almost ridiculous before- like she wasn't full. Maybe the grain satisfies her. 

I mentioned in another post that she has been on Now! Grain Free, gluten, beef, corn and soy free dry, and got sensitive, Evo ancestral and got sensitive, and NB Green Pea and Duck and also got sensiive. Those three common ingredients were pea. All were grain free. Her wet foods were also grain free. 

I think for now, my goal is to get her more active, and maybe introduce some bland food processed chicken with plain broth as one of her wet meals. I will continue with the I/D. Honestly, if she does well on it, I will be tempted to keep her on it for a while for her digestive health. I think for now the best thing I can do is feed her a mix of the wet and dry and keep tempting her with more wet food. 

I will be looking into a probiotic as well.

I feel totally overwhelmed-it's been a rollercoaster of a week. I got all panicked today because I notice she should have had a early stool this morning but hasn't. But maybe she doesn't need to go as often with this food as she did with the other. 

Thanks for all of your tips. I appreciate them!

Jen

mediCATe said:

@LDG Yeah the cat ate large amounts of food, stopped eating (probably from nausea), and then vomited. Sounds like its from eating a lot of food to me, but it can be taken as she stopped eating and THEN vomited. From the little info she wrote, it sounds like the stopping of eating is because of eating a lot but it can be taken both ways.

as for famotidine, just writing the mechanism of action does not make you right. I wouldnt say stop taking the vet prescribed med if I had no idea how it works or what it is for. The cat had blood in the stool... thats not from intestinal ulcers, perhaps a colitis, but not from ulcers from acid which are far closer to the stomach than the colon. If the blood was from an ulcer due to acid production it would have been digested in the feces and it would look black and tarry. If that's not the case, then the famotidine is not gonna stop lower GI bleeding. 

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Reading the OP's post, it's quite clear the pepcid was prescribed to address the stomach upset that the vet felt was a result of the colitis flare-up. Your response to stop the pepcid indicated pepcid won't help the colitis, so stop giving it. Yet that's not why the pepcid was prescribed in the first place. It was prescribed, apparently, to reduce the production of acid, which was my point. That's what it does.

JenL said:

@LDG -I LOVE your avatar. That kitty face is the sweetest!

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Aw, thanks! :heart3: He's our most recent rescue, Chumley. An FIV+ 3-4 year old feral kitty - that's why his cheeks are so big LOL. That amazing smile is because of his big ole Tom Cat cheeks. :lol3:

JenL said:

I really don't know about being on the i/d long term. Right now, I just want her to stabilize and then I can see how to procede.

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:nod: Definitely the best idea! :lol3:

You might want to PM TCS user Carolina about the probiotic - she did a lot of work on the subject. I know your kitty hasn't been diagnosed with IBD, but it might be worth looking into the ALIGN probiotic. We use an acidophilus-bifidus combo (from the health food store, you have to store them in the fridge). :nod:

Sending more vibes to you and Miss!