Major setback with IBD kitty!

I reported in one of my posts a couple of weeks ago that my cat had seemed to be doing well on the predisone and had not had any (or maybe just one--can't remember) vomiting incidents for about 3 weeks. Well that all changed starting last week. Starting last Wednesday, she has vomited 5 times. I think Saturday was the only vomit-free day. I do have medicine that the vet gave me a while back for vomiting (Metaclopramide) but she does not always seem to tolerate it well, and it in fact seems to induce vomiting! I gave it to her today and she spent about 10 minutes gagging and wheezing until she spit it back up.

I have a scheduled vet appointment (I have one every two weeks) for this Wednesday, and I suspect that the vet will either increase her prednisone, try to talk me into a prescription hydrolyzed protein diet, or both. I really don't want to give her the prescription food because the ingredients are terrible. I would rather try a novel protein diet. Any suggestions?

By the way, I am not sure, to be perfectly honest, if she actually has Inflammatory Bowel Disease at all. I think the vet "diagnosed" her based on process of elimination. No biopsy was ever done, and I fear it could be something worse, like cancer. She is only five years old.

Despite the vomiting, she still seems to have a good appetite and is acting normally. She was chasing a toy all over the room like a maniac a few minutes ago. So, I am not sure what to think.

The vomiting has been an issue since she was about a year old (I think) and every new "solution" (diet change, now medicine) has always just been a temporary fix.

This is all very frustrating.

It really sounds to me that you and this vet are not seeing eye to eye, and believe me I've been there!  Is there another vet is your area that you could try?  I know myself when I had issues with Sydney back a few years ago I had to go to 3 vets before finally finding a feline only vet. 

Tabbysia said:

I reported in one of my posts a couple of weeks ago that my cat had seemed to be doing well on the predisone and had not had any (or maybe just one--can't remember) vomiting incidents for about 3 weeks. Well that all changed starting last week. Starting last Wednesday, she has vomited 5 times. I think Saturday was the only vomit-free day. I do have medicine that the vet gave me a while back for vomiting (Metaclopramide) but she does not always seem to tolerate it well, and it in fact seems to induce vomiting! I gave it to her today and she spent about 10 minutes gagging and wheezing until she spit it back up.

I have a scheduled vet appointment (I have one every two weeks) for this Wednesday, and I suspect that the vet will either increase her prednisone, try to talk me into a prescription hydrolyzed protein diet, or both. I really don't want to give her the prescription food because the ingredients are terrible. I would rather try a novel protein diet. Any suggestions?

By the way, I am not sure, to be perfectly honest, if she actually has Inflammatory Bowel Disease at all. I think the vet "diagnosed" her based on process of elimination. No biopsy was ever done, and I fear it could be something worse, like cancer. She is only five years old.

Despite the vomiting, she still seems to have a good appetite and is acting normally. She was chasing a toy all over the room like a maniac a few minutes ago. So, I am not sure what to think.

The vomiting has been an issue since she was about a year old (I think) and every new "solution" (diet change, now medicine) has always just been a temporary fix.

This is all very frustrating.

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If your cat was losing weight and kidney and pancreatic disease was ruled out then it is reasonable to make a diagnosis of IBD without a biopsy.  If the cat doesn't gain weight on a reasonable dose of Pred (note that prednisilone is preferable to prednisone) then one could suspect small cell lymphoma as an alternate diagnosis especially if there was diarrhea.

Instead of using Metaclopramide (Reglan) to reduce nausea I would speak with your vet about using Cerenia, which technically is off label use (its a dog medicine) but vets are using it with great success with cats (including mine!).  It's a neural block for nausea and when used properly is basically without side effects.  The normal protocol is 4 days on, 1 day off (to give the brain a rest) but at lose doses can even be given 7 days a week.

As to diet, novel protein versus hydrolyzed protein here are some thoughts:

- As to "quality" of ingredients, my POV is use what works.  We can afford to talk about ingredients when we're basically dealing with healthy cats, fresh, raw, organic, grain free, pretty labels, but when we have a sick cat, we have to talk about food in medicinal terms - ie, treating a disease.  An IBD cat doesn't care what the label looks like, or if the food has by-products. If the intestines are allergic to a protein then that has to be addressed first before anything else.

- At least one study has shown that IBD cats can be significantly helped by a raw diet, but i know of only one small study. It may be worth trying.

- Non-prescription novel protein diets are made in the same vats as regular food and DNA testing has shown non-novel proteins leaching into these foods.  Only prescription novel protein diets have been shown by DNA testing to be 100% novel protein, so at least according to my vet, you are fooling yourself and not actually treating your cat if you go with an OTC novel protein food.

- Some cats don't respond to novel protein diets but will respond to hydrolyzed protein diets.  Go with whatever works.  Nothing succeeds like success as they say.

Thanks for the advice. She actually has gained six ounces since being on the prednisone--not a big amount but better than constantly losing weight, I guess. Maybe this means it is not something more serious like lymphoma?

I will see what the vet has to say about the food tomorrow. Since she is SO picky, there is a chance that she will not even eat the prescription food, if that is even what the vet recommends. I would have to find a way to keep my healthy non-IBD cat out of the food. That could be an issue.

There has been no vomit today so far. Hopefully, I will not find any when I get home.

Weight gain is great, and it shows the pred is having an effect.  Keep us updated ok !

I went to the vet yesterday, and she has only lost one ounce. She managed to keep on the other five ounces that she gained back, despite the vomiting. The vet did not recommend a prescription diet. She was going to increase the prednisone, but decided instead to just eliminate the salmon and feed her ONLY duck. She has been eating Blue Basics dry duck and Wellness Sliced Salmon, which as I have mentioned before, is the only canned food that she will eat.

Now, I have been told to feed her only DRY duck food, which is a little confusing, since I thought that only dry food was supposed to be bad.

She did not say that I could not feed any canned, but the only limited ingredient duck foods that I can find are either pâté (which she hates), or they have other proteins in them--like chicken, turkey, or fish. The closest that I have found is Canidae Pure grain-free duck. It is sliced, like she prefers, but it does have chicken FAT in it. Would this be the same thing as chicken MEAT, or would it be okay for a cat on a single protein diet?

Unfortunately most of the limited ingredient type foods are pate.  Dry food is harder to digest but for now I would go with the dry food until you can get this under control and she has been doing well for awhile.  Many vets think there is no difference between dry and wet, I think your vet was thinking in terms of the one protein rather than dry over wet.   Many IBD kitties can't tolerate fish or red meat so the salmon could well be an issue.