Sick cat -- Potential IBD and respiratory distress?

I just joined this site to see if I can get useful information/advice in addition to the veterinary assistance I've acquired.

I have two girls (sisters) that are JUST about 2 years old.   A couple months ago, one of my girls lost complete interest in eating dry food.  Her appetite from the morning to her appetite that night was like, well, night and day!  A one month struggle commenced of day to day feeding requiring immense encouragement.  It only started to get REALLY bad when she started refusing her wet food as well, however.  At that point things happened pretty quickly.

She was being brought to our family vet and the emergency vet every 3, 4, 5 days to be rehydrated and have further testing done every time she crashed and burned again.  The blood work was the first test and came back fine.  X-Ray came back mostly fine, very mild inflammation of the intestinal walls.  She was then started on prednisolone.  When she got sick yet again and had an ultrasound done, the ultrasound results were "unremarkable", and the veterinarian even said that there wasn't really any indication of intestinal inflammation.

So we played around with food and drugs for another month (in addition to prednisolone: cerenium, zantac, and mirtazapine) and that brings us to today.

She is currently once again only on prednisolone.  She started with a dose of 0.8ml every 24 hours and she's currently been worked down to 0.4ml/24h.  She is by all means doing much better.  She has puked about once a week since all the emerg. fiasco, but the days in between all that she gradually works herself up to being as close as can be expected to being her usual self (until she pukes again).

I just can't help but feel like there is something missing.  She has only puked about 4 times, so nothing chronic considering this has been an issue since mid-February.  Half of those instances were accompanied by diarrhea.  So again, nothing chronic.  I just feel weird about an IBD diagnosis because everything just seems so grey right now.  There are no definitives brought about by any testing to date.

I personally wonder if she is having some sort of oral/esophageal/respiratory upset.  The dry food avoidance is one thing.  She also tends to avoid drinking water (which I'm sure brought about her dehydration spells).  She was looking for water in the taps and shower for a time.  I wonder if the only reason she drinks on occasion now is because of the prednisolone.  (She also is known to do a lot of splashing.  And yes, I've bought her a fountain.)

When she eats, she sometimes ***** her head around awkwardly.  If I were to picture myself needing to make this head motion while eating, I would assume it's because I have the food stuck in my throat or its going down awkwardly.  I do NOT notice any gagging or coughing while eating.  She sits up completely to take a break from eating throughout the course of her meal time.  When she was still eating dry food, she would throw it from her mouth and this head jerking while swallowing was much more frequent.

Yet, her teeth and gums seem in good repair.  The teeth are a little yellow since I started her strictly on wet food, but I've started brushing them now.  I don't notice any worrisome redness and she does not seem to be in pain when I brush her teeth or handle her mouth, and she still grooms frequently.  Her breath has been a lot more offensive than her sisters for months now though.  I remember noticing before she even got sick and thinking to myself that her breath smells like B.O.

And lastly, when she is content and laying around and lets out a sigh, it is always very shaky and comes out sounding like a quiver.  I do not notice any other signs of respiratory distress however.  And I cannot recall if she has always done this or if it is a new development.

I keep thinking:  Food Allergies, Esophageal Obstruction, Aspiration Pneumonia, GI Lymphoma, Cancer in general, or maybe it is IBD.  I just have no idea.  Everything just seems so inconclusive.

Any thoughts?  Advice?  Similar past experiences?

I love my vet clinic, and I don't want to leave them, but sometimes I feel like they try and push exams more than I'm presently comfortable with.  I have a need for knowledge, and I just want someone to offer explanations and knowledge and reasoning behind these types of things before I surrender my poor girl to another test.

(One more random thing I've noticed.  Since I brought her home ~two years ago, one of her toes has the hair chopped down super short.  Like, always.  I don't know if it's natural or if she's barbering that one little toe, but it never appears red or irritated.  Also, the little knobby joints on the back side of her hind legs are both bald.  They look mildly red, but not really.  I was looking through older pictures and she's at least had it since last summer, unbeknownst to me until yesterday.  I truthfully have no idea what to think of this, as she can't really reach such a spot with her mouth.)

Crap, I should also add that twice (and only twice) during all of this, she has become off-balance and drooled a lot.  The first time the vet gave her an anti-nausea injection and prescribed cerenium and zantac, and the second time (weeks later and after those meds ran out), it just kinda went away on it's own the next day.

And lastly, in the past week or so I'll occasionally see her with her mouth open.  Seldom I see this though.

Having a lot of diagnostics with possible IBD is not uncommon.  IBD is usually a diagnosis of elimination so yes there is a lot of testing to rule out everything else.  The only way to possibly get a clear cut diagnosis is with a biopsy and sometimes that doesn't give a clear cut diagnoses.  Kitties will do a lot of what you mentioned as a sign of nausea.  Going to the bowl, acting interested and then not eating is a very common one.  When my kitty was still having flares he would even go so far as chewing on some food and spitting it out.

It's better if she eats all wet food, it's a myth that dry food helps with keeping teeth clean.  Kitties swallow a lot of kibble whole and what is chewed is broken at the points of the teeth and there is no abrasive effect close to the gum line.

You could try a LTD ingredient wet food in a protein that she hasn't had before.  Nature's Variety, EVO, and Hounds and Gatos all make simple foods in novel proteins.  You could also add a probiotic.  Many people have gotten good results with controlling IBD using a probiotic.

http://ibdkitties.net/  is a good resource with info on IBD.

Thank you for your reply!

The biggest reason I'm struggling with IBD right now is because for the past few weeks, apart from vomiting once a week and sometimes diarrhea, she is basically a healthy cat.

Pre-sickness, she was on Science Diet Indoor twice a day every day, with the exception of Science Diet Wet once every other day.  Post-sickness, she is exclusively on wet food, and it is Medi-cal Hypoallergenic.

She eats it with reasonable vigor.  Unless she is in the day before/day after phase of vomiting, she eats on her own volition and licks the bowl clean.  And licks her sister's clean too!!  A couple days ago the two of them were even ripping around the apartment together playing and chasing.

It's all just so confusing.