Possible food intolerance, on rx diet?

southpaw · Feb 10, 2012

Okay, this might end up being super long but I'm going to try to just jump into the situation...

Jinx is a 10 year old neutered male. For the first 6 or so years of his life, he ate Iams. He would vomit, on average, about once a day while on this, but was healthy and normal otherwise so we just accepted that the vomiting was just his "norm" and something we'd have to put up with.

I then learned more about nutrition and wanted to get him off the Iams ASAP. Decided to switch him to California Natural and, while the vomiting did not cease completely, it decreased in frequency and I would guess was "only" happening on about a weekly basis. Figured the diet change must have helped but, again, assumed that the vomiting was just "his thing" and not something that we'd ever get to go away.

So, July 2010 he goes through a urethral blockage. He had been on the Cali Natural for ~2 years at this point. 8 years old and this was the only time he had ever had any urinary problems. Much to my disappointment, he was of course put on Hills C/D, and as much as I don't like the food I was willing to do what it took to hopefully prevent this from recurring. He's been on it ever since (we feed the dry formula), no urinary problems and his most recent urinalysis done in November came back "perfect." So, something somewhere has obviously been working for him.

The problem is that ever since he's been on the C/D, his vomiting has gotten sooo bad again. He'll go through good spurts where he might go a week or two without vomiting, but then it's also not uncommon for him to vomit multiple times a day, for days in a row. I'm really inclined to believe it's an intolerance to the food, as we've experienced in the past that changing brands changes the frequency of the vomiting.... but obviously it's a little more worrisome to switch him off an Rx diet, and it requires a bit more planning. Bloodwork and such has never indicated any issues. In all other aspects, he's a perfectly healthy cat.

I work at a specialty pet food store so the other day, I got fed up with all the vomiting and decided to grab some Wysong Uretic kibble and Weruva cans, just because I can... my thought process here is that they were the only things I could find that most closely mimic the C/D, in terms of both being low in magnesium and phosphorous, and the Wysong contains an acidifier. Ideally I'd really like to see if a grain-free diet might help the issue, but I feel like that's too risky of a move.

He's been on the new food for 2 full days now and the vomiting has dropped to once a day, instead of 10 times a day... but it's definitely too early for me to make any real calls on whether or not the diet change is affecting him in any way.

Any thoughts or other input on this? I know it's a mess.

I feel like I'm stuck between a rock and a hard place though; obviously I don't want to risk having crystals form because he's not on the Rx diet, but on the other hand it can't be good for him to be vomiting up everything he eats.

I just don't want to make the wrong decision.

carolina · Feb 10, 2012

Has your vet ever spoken to you about the possibility of your cat having IBD? Have you done any tests to try to rule that out? or rule anything else that could be causing the vomiting?
This constant vomiting is not normal.... sounds like it could be..... You said you work in a specialty pet food store right? Any chance you carry commercial raw? (frozen foods)?

p3 and the king · Feb 11, 2012

Iams is not a good food to begin with. Have you thought about Royal Canin? It's a holistic/natural food that vets often prescribe for cats with sensitive stomachs and IBD. You might talk to your vet about it. It is kind of expensive but it's worth it and less waste to clean up, too. It's good for Persians and any other cat prone to crystals.

just mike · Feb 11, 2012

Hmmm... sorry you and the kitty are going through all of this. Just from what you have posted it does not sound like a bad brand (IAMS) intolerance to me as much as a possible ingredient in the food that your cat may be having a reaction to. What has the vet said about the constant vomiting? Sending vibes

violet · Feb 11, 2012

Two IBD cats and struggling with food intolerance issues for 19 years (one developing very serious symptoms only hours after trying a prescription food), Southpaw, I can safely say, depending on a cat's particular needs, there is no such thing as even a safe prescription food.

A grain-free, vegetable-free canned diet (because it's completely balanced) is perfectly safe for cats with urinary issues as long as it doesn't contain inflammation inducing protein ingredients such as fish. Some cats develop very serious issues with inflammation when they have certain fish-based foods. (One type of fish can be safe for them while another sends them to the hospital because of severe pain and symptoms that look exactly like the symptoms of a blockage. Only a vet can determine at that time whether the cat is really blocked or not.)

As far as urinary tract health is concerned, the most important thing the right diet for a particular cat must accomplish is to cause a slightly acidic urine - without any added acidifying ingredients - within a certain range that prevents crystal and stone formation.

(The urine pH should not go higher than 7.0 and it should not go lower than 6.0)

Animal protein causes an acidic pH which is just right for cats. That's what their body chemistry requires. Any other ingredients (grains, vegetables, fruits) added to the animal protein in manufactured formulas can cause the pH to go into an undesired direction (higher or lower) and cause health problems.

And I'd just like to add that the right diet for cats does not have to mimic the C/D. Please, read these two articles because they help clear up the misunderstandings about phosphorus and magnesium in the cat's diet.

http://rawmeatcatfood.com/2010/08/16/magnesium-in-the-feline-diet-and-its-association-with-fus/

http://rawmeatcatfood.com/2010/08/16/dry-cat-food-crisis/

Also, please read this extremely important information as well

http://www.holisticat.com/vaccinations.html

p3 and the king · Feb 11, 2012

With anything, it is best to follow your trusted veterinarians advice. Just don't rely on the internet. A lot of sites can be confusing because they want to push their agenda. (Not always but a lot of the times this is the unfortunate truth... We have information overload. Some good and a lot bad!) If you trust your vet, then he/she will not steer you wrong.

Prescription Cat Food

Obviously, prescription products fall under the vet recommended cat food category. There are prescription cat food products for diabetic cats, urinary tract health, overweight cats, and other conditions.

Certain cat food lines, such as the Royal Canin Veterinary Diet products for example, are sold only through veterinarians. As Royal Canin state on their website:

"Innovative diets can’t do it alone. You need the expert advice of your veterinarian before making any food changes or diagnosis. That’s why all ROYAL CANIN Veterinary Diets are sold only by veterinarians."

This is not always the case, however, with the Internet being what it is. In fact, you can buy some of these so called prescription or veterinary only diets through Amazon.com.

Some people wonder whether or not this exclusivity of being sold through vets only is strictly a marketing strategy. Are they really any better? Some experts say no, and question the quality of these formulations.

However, you can also get Royal Canin (in the US anyway) at Pet Specialty stores such as Petco & PetSmart.

Here's the link to the Royal Canin website so you can read through it and decide if it's something you even want to ask your vet about...

http://www.royalcanin.us/cats/Veterinary_Diets.aspx

carolina · Feb 11, 2012

IMHO Prescription foods have their agendas too. IMHO they are the ones with the strongest agendas.... I have fed Royal Canin (HP, Prescription) for my IBD cat Bugsy for almost a year - it did nothing for him. nothing. I fed Z/D for even longer. What made him Better? A raw diet. Some things did make him a tiny little better before - but nothing, nothing came even close to a raw diet.... That turned his life around - that solved his problem right away. No.... It is not a a cure for IBD.... but it is a wonderful thing for most cats with it. No, it does not replace treatment for all - but it does for many many. Kitty still needs to see the vet about this vomiting..... Yes, talk to your vet about IBD - discuss it with him..... Meanwhile, take a look at the links Violet gave you....
Take a look at this website too: www.ibdkitties.net

There are vets who recommends raw diets - mine does. Mine says that this is what Bugsy should be eating (or any cat, for that matter). My vet says that what was pushing Bugsy's IBD was all the additives in commercial foods - including prescriptions - and there was no way, absolutely no way to get out of that unless being on raw. He is 100% behind the diet, and agrees that this is the best path for Bugsy's IBD. He said to leave him on raw, and that this diet is the diet for Bugsy. It is not because a diet is not prescription, that is not going to be recommended..... Bugsy for the last 6 months or so was treated with herbs and different probiotics - yes, with a vet - instead of with drugs. The same way that now he is on a raw diet, and it is recommended by his vet. Prescription, just because it is prescription, is not always the best way to go - Bugsy is living proof of that :nod:

p3 and the king · Feb 11, 2012

Carolina said:
IMHO Prescription foods have their agendas too. IMHO they are the ones with the strongest agendas.... I have fed Royal Canin (HP, Prescription) for my IBD cat Bugsy for almost a year - it did nothing for him. nothing. I fed Z/D for even longer. What made him Better? A raw diet. Some things did make him a tiny little better before - but nothing, nothing came even close to a raw diet.... That turned his life around - that solved his problem right away. No.... It is not a a cure for IBD.... but it is a wonderful thing for most cats with it. No, it does not replace treatment for all - but it does for many many. Kitty still needs to see the vet about this vomiting..... Yes, talk to your vet about IBD - discuss it with him..... Meanwhile, take a look at the links Violet gave you....
Take a look at this website too: www.ibdkitties.net
There are vets who recommends raw diets - mine does. Mine says that this is what Bugsy should be eating (or any cat, for that matter). My vet says that what was pushing Bugsy's IBD was all the additives in commercial foods - including prescriptions - and there was no way, absolutely no way to get out of that unless being on raw. He is 100% behind the diet, and agrees that this is the best path for Bugsy's IBD. He said to leave him on raw, and that this diet is the diet for Bugsy. It is not because a diet is not prescription, that is not going to be recommended..... Bugsy for the last 6 months or so was treated with herbs and different probiotics - yes, with a vet - instead of with drugs. The same way that now he is on a raw diet, and it is recommended by his vet. Prescription, just because it is prescription, is not always the best way to go - Bugsy is living proof of that

I have nothing against raw. But, it is not for everyone. I am not saying that Royal Canin works for everyone, either. I have spoken to a lot of people, cat people, mostly with Persians, who swear by it. That is why I recommended it. When my Piper was sick, my vet gave me a canned version to get her to eat again. She didn't really like it either. But, that doesn't mean it won't help the posters cat.

A lot of sites out there will because they are not based on much but someone pushing their own agenda. I happen to believe that fact is what you make it. If you believe in something then it is true for you.... But it may not be for everyone else. I am just trying to give her other options besides the one that seems to be popping up here. It is not the only option and not for everyone.

Also I would like to point out that going raw requires research and dedication. "Garnishments" that a lot of people put in their raw recipies are often toxic to cats. So, go to an expert again... One that you know and trusts if you decide this is your best option.

Here are two good webpages I found...This is NOT against a raw diet entirely... It is just warning of the dangers and bad advice out there is all.

http://www.caberfeidh.com/NaturalDiet.htm

http://www.christinedemerchant.com/rawmeatdiet.html

violet · Feb 11, 2012

Just some thoughts on prescription diets if I may.

My problem is that, for the life of me, I can't understand why companies making these prescription foods are doing what they are doing, why prescription foods contain the ingredients they do. Most importantly, because in some cats those ingredients are exactly the ones that have been associated with IBD and digestive problems in general and just avoiding them makes a huge big difference for sensitive cats.

I imagine that cats with a perfectly sound, healthy digestive system can tolerate those ingredients but in my experience, struggling with IBD for 19 years (starting when one of my little ones was only seven weeks old) I can't think of anything worse than those grain-based ingredients. (Not that the protein ingredients are so great either.)

I remember looking for foods many years ago that this little one and the other cat with IBD could safely eat and learning from reading labels that, because of the grain ingredients, I had to avoid all regular Royal Canin foods. Maybe the situation is different these days and there are other, better choices. I haven't looked in a very long time.

Anyway......I could write the same thing about many prescription foods. The one that made one of my IBD kitties sick in no time at all was Eukanuba. Not Royal Canin. In my mind the problem is that, basically, they all have the same ingredients and the brand name makes little or no difference.

Managing my babies' IBD issues for all these years has not been an easy task. One baby has done well - in spite of a few, sometimes scary, ups and downs. The other eventually developed lymphoma.

Grains, including ingredients in prescription diets have been the worst, absolute worst for both of them from day one, which is the reason I can't help wondering about prescription diets. There is no doubt in my mind that they can work just fine for many cats but the fact is, they don't work for every cat and I feel that the makers of these diets don't consider the particular, individual needs of every cat that might try these diets. I imagine they don't because doing so would simply be impossible. I guess I can understand that.

goingpostal · Feb 11, 2012

Did you try the canned c/d? It's still junky, but better than the dry by quite a bit. It sounds like your cat is puking because he can't handle the grains/veggies in those foods, my cat was much the same way, she threw up a lot and we just thought that was her, because the vet kept recommending SD this or that while my cat was constantly sick and in pain, so I cannot agree that putting blind faith in your vet just because you trust them is a good idea, we did and my cat suffered for it. Same as you I did some research when I moved out with her and changed to a better kibble, puking dropped hugely but ultimately moving to canned and then raw completely solved the issue, she only pukes now if she eats something she shouldn't, or the occasional stomach upset, she's like a whole new cat. I don't know much about crystals or anything but wet is better for sure, you can always try grain free canned or go with a better urinary formula, you really just need to balance his issues here, there's no point in stopping crystals with food he can't keep down and I know many people have success without using "rx" diets.

southpaw · Feb 11, 2012

Carolina - yes, we carry Stella & Chewys, Natures Variety, and Primal premade raw. I have contemplated on and off over the past couple years if I should give it a try with him. I'll have to look into those brands a little more

Overall though I do believe raw is the best way to go, for both dogs and cats, so I'm definitely open to it.... in the past it's just never really been feasible for me to feed that way, but I think I could now.

Violet - Thanks for the articles. The only reason I was looking for foods with similar properties to the C/D is because, that food at least hasn't exacerbated any urinary issues. It might not be the actual reason why he hasn't had a recurrence, but it's at least not making that problem any worse, you know? It just felt "safe" to go with something relatively similar, instead of making the change too drastic.

What has me curious is the information about fish-based diets. The blockage occurred when he was on the Cali Natural herring & sweet potato formula. He had been on it for about 2 years, likely a little less than that. I don't know how long they'd have to be on a fish food for it to have that sort of negative effect, but could that possibly have contributed or is it just coincidence? The animal protein in the Iams he was on and in the C/D is chicken.

I don't like the quality of prescription diets and I don't believe that they are the ONLY diets out there that can be good for animals with specific health problems - HOWEVER at the end of the day I want to do right by my pets, and if the prescription diet is the only thing that works for them, so be it. I don't like the ingredients in the C/D and I don't like what it has done to Jinx's coat and energy level, but I would have continued feeding it if it weren't for the vomiting issue. I can agree that in this case it's not really a "good food vs bad food" situation... I know that it's likely some ingredient(s) that he's not tolerating. I just also don't feel that switching to another brand of Rx diet is going to get rid of whatever that ingredient(s) is.

Forgot to add - since he's been on the C/D we have not talked to the vet about the vomiting. Admittedly it's probably been a looong time since we mentioned it.

Thanks for all the advice so far.

ldg · Feb 11, 2012

P3 and The King said:
Iams is not a good food to begin with. Have you thought about Royal Canin? It's a holistic/natural food that vets often prescribe for cats with sensitive stomachs and IBD. You might talk to your vet about it. It is kind of expensive but it's worth it and less waste to clean up, too. It's good for Persians and any other cat prone to crystals.

I'm curious - why do you say Royal Canin is a holistic/natural food?

The prescription urinary formula (dry) ingredients are:

Chicken meal, brewers rice, gluten meal, corn, chicken fat, natural flavors, soy protein isolate, powdered celluose, salt, dried egg product, brewers dried yeast (and then the list of supplements) - and for preservatives it has both rosemary extract AND mixed tocopherols and citric acid.

To claim this is in any way holistic or natural is... confusing.

P3 and The King said:
With anything, it is best to follow your trusted veterinarians advice. Just don't rely on the internet. A lot of sites can be confusing because they want to push their agenda. (Not always but a lot of the times this is the unfortunate truth... We have information overload. Some good and a lot bad!) If you trust your vet, then he/she will not steer you wrong.

Regarding the above statement, to the OP, I suggest that whatever you do, you do in consult with your vet and with the knowledge of your vet. THAT SAID, however, vets are NOT the end-all-be-all of knowledge when it comes to cat NUTRITION and dietary needs, especially as they relate to "prescription" health problems. Vets that are NOT trained in holistic treatments and/OR nutrition, tend to know very little about the impact of diet on health-related problems other than they training they get FROM the prescription food companies.

When our Chumley was having problems with food allergies, we put him on the prescription diet Hill's z/d. He was eating both wet and dry. Well, the problem didn't go away. And you know what? Yes, the wet food is hypoallergenic. But the dry food is "low allergan." The second ingredient in that dry food list? Brewer's Rice. Brewer's rice is often a trigger for cats with allergies. Chumley was one of them. It wasn't until we went to an ACTUAL holistic vet (yes, also trained as a D.V.M.) that she explained why the z/d probably didn't work for him. As an additionally trained nutritionist, she explained the disconnect bet ween most vets and their understanding of diet and its relationship to various health problems.

So yes, working with your vet is important. But believing that your vet is an expert at nutrition and how it relates to your cat's particular issues can be a big mistake. If they want to work with you to learn, help you research - GREAT. If they don't? You have to do your own, or find a vet who will.

You can search for a holistic vet here: http://www.ahvma.org

carolina · Feb 13, 2012

Violet said:
Just some thoughts on prescription diets if I may.

My problem is that, for the life of me, I can't understand why companies making these prescription foods are doing what they are doing, why prescription foods contain the ingredients they do. Most importantly, because in some cats those ingredients are exactly the ones that have been associated with IBD and digestive problems in general and just avoiding them makes a huge big difference for sensitive cats.

I imagine that cats with a perfectly sound, healthy digestive system can tolerate those ingredients but in my experience, struggling with IBD for 19 years (starting when one of my little ones was only seven weeks old) I can't think of anything worse than those grain-based ingredients. (Not that the protein ingredients are so great either.)

I remember looking for foods many years ago that this little one and the other cat with IBD could safely eat and learning from reading labels that, because of the grain ingredients, I had to avoid all regular Royal Canin foods. Maybe the situation is different these days and there are other, better choices. I haven't looked in a very long time.

Things have not Changed Violet.... Here is the food I was feeding Bugsy for his IBD...... Royal Canin HP 23 (Hypoallergenic), very often used for kitties with IBD.
Look at these ingredients:
Brewers rice, hydrolyzed soy protein, chicken fat, natural flavors, powdered cellulose, vegetable oil, dried beet pulp, monocalcium phosphate, fish oil, potassium chloride, calcium sulfate, calcium carbonate, fructooligosaccharides, sodium silico aluminate, salt, taurine, vitamins [DL-alpha tocopherol acetate (source of vitamin E), inositol, niacin supplement, L-ascorbyl-2-polyphosphate (source of vitamin C), D-calcium pantothenate, biotin, pyridoxine hydrochloride (vitamin B6), riboflavin supplement (vitamin B2), thiamine mononitrate (vitamin B1), vitamin A acetate, folic acid, vitamin B12 supplement, vitamin D3 supplement], choline chloride, DL-methionine, marigold extract (Tagetes erecta L.), trace minerals [zinc proteinate, zinc oxide, ferrous sulfate, manganese proteinate, copper proteinate, copper sulfate, manganous oxide, calcium iodate, sodium selenite], rosemary extract, preserved with natural mixed tocopherols and citric acid.

Not only there is only grains...... But there is only grains...... Bugsy would be vegetarian if I were to feed him that 100%. This food's protein comes from Soy. The first ingredient is Brewers Rice. There is nothing there that I would call appropriate for a cat's digestion.

He was being fed this and Z/D 50/50 as dry..... And for canned for a long time, Z/D wet.

In the end, I started giving him ZiwiPeak, as I wanted to give him some real meat..... ZiwiPeak is a very high end canned from New Zealand - all meat and organs, doesn't mix proteins, but unfortunately it does have Carrageenan, which might be an irritant for IBD kitties as well......
These diets were the ones he did best, but still VERY sub-par - meaning daily diarrhea, but "only" once a day - and that is with a lot of supplements to keep him going.....

He only turned around when he was out of all these diets - kibbles and canned all together.

southpaw · Feb 13, 2012

I am pretty confident that the vet would tell me to keep him on C/D.

I went to school to be a vet tech and we were basically taught, that in a situation like this, taking a cat off this prescription diet would be a guarantee that they would form crystals and block again. That the ONLY way to prevent it from happening again was to stick with the Rx diet. Owners are foolish for thinking they can try "regular" food again.

Maybe I am foolish....

Then again, our nutrition education was a course provided by Purina, sooo... hard to believe there was no bias there.

Good news: major improvement with the vomiting. The first 2 days he was on the new food, he vomited once each day (which was still a decrease). And now the past 3 days, he hasn't vomited at all. Of course, I can't do a victory dance yet because there's always the possibility that it's just a coincidence! So, we'll have to give it some time before we can know for sure if it's helping him in that area. Monitoring his litter box habits closely, fingers tightly crossed we don't run into any issues!

carolina · Feb 13, 2012

Southpaw said:
I am pretty confident that the vet would tell me to keep him on C/D.
I went to school to be a vet tech and we were basically taught, that in a situation like this, taking a cat off this prescription diet would be a guarantee that they would form crystals and block again. That the ONLY way to prevent it from happening again was to stick with the Rx diet. Owners are foolish for thinking they can try "regular" food again.
Maybe I am foolish....
Then again, our nutrition education was a course provided by Purina, sooo... hard to believe there was no bias there. Well.... That's just it..... That seems to be where the majority of the nutritional education comes from.... The RX foods manufacturers themselves

Good news: major improvement with the vomiting. The first 2 days he was on the new food, he vomited once each day (which was still a decrease). And now the past 3 days, he hasn't vomited at all. Of course, I can't do a victory dance yet because there's always the possibility that it's just a coincidence! So, we'll have to give it some time before we can know for sure if it's helping him in that area. Monitoring his litter box habits closely, fingers tightly crossed we don't run into any issues! :cross:

brandy rowe · Feb 13, 2012

Sending good vibes your way! My Mario was on all kinds of food - Purina Pro Plan, Iams Digestive care, Indoor forumula, Science diet z/d h/p HO, you name it she was on it! None of those would help her vomiting. Right now she's on Natural Balance Duck and Pea and her vomiting has dropped to about once every two weeks and I was able to reduce her Prednisolone to half the dosage she was on when she was on the prescription diets. So good luck!!

violet · Feb 13, 2012

Originally posted by Southpaw

What has me curious is the information about fish-based diets. The blockage occurred when he was on the Cali Natural herring & sweet potato formula. He had been on it for about 2 years, likely a little less than that. I don't know how long they'd have to be on a fish food for it to have that sort of negative effect, but could that possibly have contributed or is it just coincidence? The animal protein in the Iams he was on and in the C/D is chicken.

My thoughts on this. We had some horrific experiences with inflammation caused by fish with one of our cats. Several emergency trips to the vet because he was in so much pain that he couldn't pass urine. Incredibly, tests always came back showing perfect pH, the same pH he normally had.

Years before that, our first cat had life-threatening problems with an unusual type of bladder stone in cats. Long story short, hard as we tried, we couldn't pin his problems on the fish in his diet. (At our vet's advice he didn't have any fish for an entire year. And it made no difference.)

I'm thinking, the problem your baby had was more likely caused by the sweet potato because vegetables have an alkalinizing effect and do affect (raise) the pH, which creates an ideal environment for struvites.

I really believe the problems our babies have from fish is caused by inflammation and not a change in pH. On his web site Dr. Mike Richards explained once that fish-based foods are higher in histamine levels, which causes inflammation and they are also among the more common causes of food allergies. (From what I've observed over the years is that, because of the inflammation it can cause, fish can be very bad for kitties with IBD and urinary problems.)

I'm so glad you're seeing major improvement with the vomiting. This is wonderful news. I'm so happy for you.

Possible food intolerance, on rx diet?

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