Underweight cat with IBD

My cat was recently diagnosed with IBD. Her one and only symptom was vomiting. She has also lost a lot of weight over the last year as a result of all the dietary changes we've tried. Since her diagnosis, she was on Prednisone for two months which successfully stopped her vomiting and the vet put her on a dry food for sensitive stomachs. She wasn't a fan and lost even more weight. She should be 9 lbs and probably weighs barely 6 at this point so it's pretty serious and distressing.  I have done a lot of research on the best diets for cats with IBD and am giving her both raw food and high quality canned food. She is only eating sporadically (sometimes she'll inhale a meal, sometimes she'll barely touch it).  I've tried everything from goat's milk to fish broth, different brands of raw and canned, different types of meat. She seems to have an appetite (she gets excited at mealtime) but just isn't interested in any of the food I'm giving her.  She had a teeth cleaning less than a year ago, so I don't think she has any dental issues making eating uncomfortable.  I'm considering a high calorie, nutritional supplement to give her for a short time in order to get her weight and metabolism up, but the ones I've found so far (Tomlyn and GNC) have corn syrup and vegetable or soil bean oil so I'm not overly enthused.  I don't want to risk infamming her IBD and having her start vomiting again - I don't think she can handle at her current weight. I just don't know what else to do to get my girl to put on weight. Any advice??

Have you tried supplementing with baby food?  Sometimes when my IBD kitties wouldn't eat anything else, they would eat the baby food.  It should be the kind with only meat and broth, like this:  http://www.diapers.com/p/beech-nut-...-sg-to-mobile&utm_term=organic baby food meat

I feel for you--it's so scary to see them losing weight like that.  

Was she still loosing weight when she was on the steroid?  If she was that is very unusual.  I have an IBD kitty and the steroid also not only stopped the weight loss but he put weight on.  He actually got up to a healthy weight for the first time in his life.  His flares started when he was only 18 months old so he hadn't really fully gotten out of the thin lanky build of an older kitten, young adult when it started for him.

I think IBD kitties are thought of as picky because they avoid foods that has made them feel  bad in the past.  Over time there are fewer and fewer foods that they will  eat.  He may still be having nausea issues of and on even though he isn't vomiting.

Insightful about her being nauseas even though she isn't throwing up...  She could be hungry, but not want to eat because she's nauseas off and on.  Thank you for that!

I'm not sure if she lost weight while on the steroid, but she certainly didn't seem to gain any.  At first, she had a major spike in appetite, but it waned quickly.  She didn't seem to eat more than normal after the first few days or so.

I haven't tried baby food, but that is now on my shopping list!  Thank you!

I also just ordered this: http://www.amazon.com/gp/product/B00061MRU4?psc=1&redirect=true&ref_=oh_aui_detailpage_o01_s00.   I don't know how high calorie it is, but the ingredients looked decent and if I sprinkle it on her food and it gets her to eat it, I'll take it as a win.

One of our members, @LTS3  posted some helpful photos of the baby foods that are safe for cats.  See post #88 in this thread:
[thread="225595"]Anyone Else Have An Only Gravy Licker  [/thread]

My kitty has had IBD for 8 years, and I have had to constantly battle with her nausea. Even though the vomiting subsides, they can still feel nauseous, which causes them to stop eating.

I have had success with rotating foods, Cerenia (anti-nausea drug) & Mirtazapine (appetite stimulant & anti-nausea drug). These things, combined with Prednisolone, got her weight back up and kept it stable!

My cat, Tabby also has IBD, and her symptom was mainly vomiting. Have you tried nature's variety instinct limited ingredient canned foods?

http://www.instinctpetfood.com/instinct-limited-canned-natural-healthy-foods-pets

My cat lost a lot of weight, and she refused to eat SO MANY foods that my vet recommended her. But once I introduced NV LID canned foods, she loves them so much! Tabby has continued to gain weight.

Also, I heard that Prednisolone is better than Prednisone. If she still lose weight even though she is on Prednisone, you may ask your vet to try Prednisolone? 

It was actually Prednisolone that she was on (I said Prednisone in error) and is going back on as of tonight.  I'll check out the Nature's Variety Instinct limited ingredient canned food for sure.  My plan now is to put her back on the steriod for probably two months while giving her high quality food so that she's eating consistently and gets her weight back up.  Once we're in a good place, I'm going to wean her again and hope that she continues on that path.  My vet thinks she's going to need to be on the steroid for the rest of her life, but perhaps the anti-nausea med is something to consider...  I really appreciate everyone's thoughts and advice!  It's comforting to know people have had success with their IBD kitties without having to keep them on meds.  I'm hoping for the same!

TiggerMarie said:

My kitty has had IBD for 8 years, and I have had to constantly battle with her nausea. Even though the vomiting subsides, they can still feel nauseous, which causes them to stop eating.

I have had success with rotating foods, Cerenia (anti-nausea drug) & Mirtazapine (appetite stimulant & anti-nausea drug). These things, combined with Prednisolone, got her weight back up and kept it stable!

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Hi TiggerMarie, 
Sorry to interrupt this thread, but may I ask what foods you are feeding your kitty? I was really glad you have had success with rotating foods and drugs for 8 years! My cat diagnosed with IBD back in April. She’s been doing well, but sometimes she has loose stools. (Her main IBD symptom was vomiting.) Thank you!

Yes - TiggerMarie, if you could share a more detailed description of your routine and food regimen, that would be very helpful!

I have used many different (always canned) foods over the years. My vet advised me to stick with chicken & turkey, and to avoid seafood, beef and pork. My cat doesn't like turkey, so I always buy chicken. I stick with the more natural, higher end foods, and I check ingredients very closely to make sure chicken is the only protein in the food.

I just give her one type of food until she stops liking it, then I switch. Sometimes she lets me go back to a previous food, but a lot of times I have to introduce a novel food.

One trick I've also learned with my cat is that she gets nauseous when she has an empty stomach, so I always have food available for her, and I leave it out at night with an ice pack underneath.

As far as medications, she has always been on daily Prednisolone, but has recently switched to Budesonide. Cerenia every other day has also been a staple, and works wonders for vomiting and nausea. In the last two years I have also added Mirtazapine, which helps her maintain her weight better as a senior kitty, and also does a great job of eliminating any nausea. It can be used as needed, which is nice.

Please let me know if you have other questions. I'm happy to help, as I've dealt with this a long time

TiggerMarie said:

I have used many different (always canned) foods over the years. My vet advised me to stick with chicken & turkey, and to avoid seafood, beef and pork. My cat doesn't like turkey, so I always buy chicken. I stick with the more natural, higher end foods, and I check ingredients very closely to make sure chicken is the only protein in the food.

I just give her one type of food until she stops liking it, then I switch. Sometimes she lets me go back to a previous food, but a lot of times I have to introduce a novel food.

One trick I've also learned with my cat is that she gets nauseous when she has an empty stomach, so I always have food available for her, and I leave it out at night with an ice pack underneath.

As far as medications, she has always been on daily Prednisolone, but has recently switched to Budesonide. Cerenia every other day has also been a staple, and works wonders for vomiting and nausea. In the last two years I have also added Mirtazapine, which helps her maintain her weight better as a senior kitty, and also does a great job of eliminating any nausea. It can be used as needed, which is nice.

Please let me know if you have other questions. I'm happy to help, as I've dealt with this a long time

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Thanks SO much! That was really so helpful! Ironically though my vet said chicken was the one protein we should avoid! Reese doesn't seem to like it anyways.

Skinny Peanut said:

Thanks SO much! That was really so helpful! Ironically though my vet said chicken was the one protein we should avoid! Reese doesn't seem to like it anyways.

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Chicken is a common trigger for IBD so that may be why your vet suggested not feeding it, though IBD seems to be manifest itself in very individual ways, making it difficult to pin down the source(s) of problem. Do you have any sense of what ingredient(s) your cat is sensitive to so you can eliminate it/them from Reese's diet? I realize that's a somewhat secondary concern right now, since the main goal is to get her to eat and regain some weight! I agree with the others that nausea is probably the issue: we saw the same thing with our previous cat, who would hover over the dish but have difficulty actually getting herself to eat. Keeping a food and litter box diary for Brooksie helped a lot.

Good luck!

TiggerMarie said:

My vet advised me to stick with chicken & turkey, and to avoid seafood, beef and pork. 

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Thank you SO much, TiggerMarie! 

Do you know why your vet told you to avoid beef and pork? 

My cat’s vet assumes Tabby is allergic to chicken, and she recommended to avoid poultry. Tabby has been transitioned to lamb from rabbit. Because NV’s LID rabbit is giving her loose stools. If lamb is not good for her, I’m thinking to try pork. 

Thank you so much again! 

With IBD, there is a lot of trial and error to see what works best. A common approach is to first try a diet with a single protein source never previously eaten. We tried duck & rabbit, and my cat would not eat either of them. We later tried Z/D, which is a hydrolyzed protein diet. Since that did not help with the vomiting, and she needed medication to control her symptoms, I began giving her regular food again.

As far as my vet's recommendation as to which proteins to avoid, this was due to her showing other food allergy symptoms related to her skin & ears. I was going from memory as to what my vet said, but I was able to find a source that states "Several studies have shown that some ingredients are more likely to cause food allergies than others. In cats, the most common offenders are beef, lamb, seafood, corn, soy, dairy products and wheat gluten."(http://www.peteducation.com/article.cfm?c=1+2141&aid=142)

I agree with LisaHE that the most important thing is that your cat is eating & weight is stable, so finding something they like is a primary goal.

Hi TiggerMarie, Thank you very much for your detailed explanation. It really helped me a lot. 

TiggerMarie said:

With IBD, there is a lot of trial and error to see what works best. A common approach is to first try a diet with a single protein source never previously eaten. We tried duck & rabbit, and my cat would not eat either of them. We later tried Z/D, which is a hydrolyzed protein diet. Since that did not help with the vomiting, and she needed medication to control her symptoms, I began giving her regular food again.

As far as my vet's recommendation as to which proteins to avoid, this was due to her showing other food allergy symptoms related to her skin & ears. I was going from memory as to what my vet said, but I was able to find a source that states "Several studies have shown that some ingredients are more likely to cause food allergies than others. In cats, the most common offenders are beef, lamb, seafood, corn, soy, dairy products and wheat gluten."(http://www.peteducation.com/article.cfm?c=1+2141&aid=142)

I agree with LisaHE that the most important thing is that your cat is eating & weight is stable, so finding something they like is a primary goal.

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This is such a good summary! Trial and error is key, which is why a food/box diary can help so much: you never know what conclusions you might stumble upon even without trying a novel protein. With our previous cat, the combination of food diary and looking for things she'd eat helped show that fish and grains had likely been her problem foods. Despite her overall frail health (she had multiple serious illnesses and, for many reasons, was not a candidate for serious diagnostics or aggressive treatments) her IBD symptoms lessened some in her last months, after we changed her diet.

Hi everyone, I'm brand new here.  

I have an eight-year-old calico that has what I would call "tongue to tush" IBD.  Primarily her concern is constant diarrhea (never a firm stool), but she also exhibits vomiting and nausea, plus lethargy, behavioral issues and discomfort.  I took her in almost two years ago and her health has been a constant..."work in progress".  I'll list what protocols she's been on at the end of this post so you don't have to dig long to get to my point, ok?  

I found that changing her diet to commercial raw frozen or freeze-dried improved all of her IBD symptoms to the point where she is symptom-free, with the help of 1mg Medrol / every 2nd day, which my vet thinks she might not need if she maintains her improved condition.   In the six weeks she's been on this diet, her weight  increased from 5.17 lbs to 6.50 lbs and she has firm stools, energy, increased sociability, and she has discontinued defecating in inappropriate areas of the house.

I do not have a clear answer to why her diet has caused these improvements.  There are not enough peer-reviewed studies (that I could find) that substantiate the positive effects of a raw diet with IBD cats, but the main point I want to make is I don't know if "raw" is the reason for my cat's changes.  When I look at pet food labels, every ingredient that is added holds the possibility that it will have either a neutral, beneficial or irritating potential response.  

[The following is only a theory I have and if valid, would only apply to subset of IBD cats, as there are many different reasons why cats suffer from this condition, as there are different solutions that provide relief.]

One type of ingredient category that doesn't get much attention is vitamin supplementation.  It is almost universal in commercial pet foods, including hypoallergenic diets, prescription diets, LID foods, dry foods, canned foods, etc.  The one place vitamins are not always showing up are in the newer commercial frozen raw diets, where supplemented vitamins are either minimal or not included altogether.  And vitamin supplements don't show up in stage 1 baby foods such as Beech Nut Turkey or Chicken( with broth).  In humans, nausea is one of the common side effects of vitamin supplementation, especially with niacin (B3).  If certain people cannot tolerate vitamin pills, it's my opinion that *some* cats may not tolerate vitamin supplementation, either.  

Here are ingredient examples of two commercial raw diets my cat tolerates:

Nature's Variety Instinct Raw - Chicken Formula

Chicken (including Ground Chicken Bone), Turkey Heart, Turkey Liver, Turkey Bone, Yeast Culture, Pumpkinseeds, Montmorillonite Clay, Apples, Broccoli, Butternut Squash, Salt, Cod Liver Oil, Dried Kelp, Carrots, Spinach, Taurine, Dried Chicory Root, Blueberries

Primal Pet Foods - Frozen Raw - Turkey Formula

Turkey, Turkey Necks, Turkey Hearts, Turkey Livers, Organic Collard Greens, Organic Squash, Organic Celery, Cranberries, Blueberries, Organic Pumpkin Seeds, Organic Sunflower Seeds, Montmorillonite Clay, Organic Apple Cider Vinegar, Sardine Oil, Taurine, Organic Quinoa Sprout Powder, Dried Organic Kelp, Organic Cilantro, Organic Coconut Oil, Cod Liver Oil, Organic Ginger, Vitamin E Supplement.

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The above two raw food companies use the same base ingredients in their raw varieties and exchange out different proteins.  She just can't have the varieties that contain Salmon.  She has eaten and can tolerate chicken, turkey, rabbit, venison, pheasant and duck proteins.  I haven't tested her on plain beef or lamb.  The only meat protein I've confirmed she cannot tolerate is fish.  I gave her a piece of clean fish to eat and diarrhea resumed for a few days.  (Fish oils are different as they are filtered and don't contain fish proteins).   For example, my cat can eat the Primal Turkey as well as Rabbit, Duck, and Venison or Pheasant because the extra ingredients are all the same.  

Traditional hypoallergenic or LID recipes she didn't tolerate at all:

Hill's Prescription Diet z/d, Skin and Food Sensitivities

Hydrolyzed Chicken Liver, Water, Corn Starch, Soybean Oil, Powdered Cellulose, Calcium Carbonate, DL-Methionine, Potassium Chloride, Dicalcium Phosphate, Choline Chloride, vitamins (Vitamin E Supplement, Thiamine Mononitrate, Ascorbic Acid (source of vitamin C), Niacin Supplement, Pyridoxine Hydrochloride, Calcium Pantothenate, Vitamin B12 Supplement, Riboflavin Supplement, Biotin, Vitamin D3 Supplement , Folic Acid), Iodized Salt, Taurine, Calcium Sulfate, minerals (Zinc Oxide, Ferrous Sulfate, Manganous Oxide, Copper Sulfate, Calcium Iodate, Sodium Selenite), Beta-Carotene

Nature's Variety Instinct LID Canned Turkey (she didn't tolerate this or any other NV LID meat varieties)

Turkey, Turkey Broth, Turkey Liver, Peas, Montmorillonite Clay, Flaxseed Oil, Potassium Chloride, Minerals (Zinc Proteinate, Iron Proteinate, Manganese Proteinate, Copper Proteinate, Cobalt Proteinate, Sodium Selenite, Potassium Iodide), Salt, Vitamins (Vitamin E Supplement, Thiamine Mononitrate, Niacin Supplement, d-Calcium Pantothenate, Pyridoxine Hydrochloride, Riboflavin Supplement, Vitamin A Supplement, Biotin, Vitamin D3 Supplement, Vitamin B12 Supplement, Folic Acid), Choline Chloride, L-Ascorbyl-2-Polyphosphate, Taurine

(raw freeze-dried) Stella & Chewy's Chick, Chick, Chicken Dinner:

Chicken (Ground with Bone), Chicken Liver, Chicken Gizzard, Pumpkin Seed, Potassium Chloride, Sodium Phosphate Monobasic, Choline Chloride, Dried Pediococcus Acidilactici Fermentation Product, Dried Lactobacillus Acidophilus Fermentation Product, Dried Bifidobacterium Longum Fermentation Product, Dried Enterococcus Faecium Fermentation Product, Taurine, Tocopherols (Preservative), Zinc Proteinate, Zinc Sulfate, Iron Sulfate, Iron Proteinate, Vitamin E Supplement, Niacin, Copper Sulfate, Copper Proteinate, Manganese Sulfate, Sodium Selenite, Manganese Proteinate, Thiamine Mononitrate, Pyridoxine Hydrochloride, Vitamin D3 Supplement, Calcium Iodate, Vitamin B12 Supplement.

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There are dozens more commercial food options she has tried and with which she failed to improve.  In truth, all other foods have failed her.  

I want to stress that I do not think there is ONE source or cause of feline IBD.  All I want to do is present to anyone caring for an IBD cat another possible treatment option.    As anyone who cares for an IBD cat knows, it's all about trial and error and figuring out what triggers your cat's IBD symptoms.  I hope this helps!

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List of treatments that failed to work:

2 mg oral Medrol/day for a 5-lb cat.  That is very high!  (she was doing this for over a year w/out success)

Injectable steroid shots

Atopica / cyclosporine to suppress her immune system

LID diet (all NV canned LID failed for her)

Hill's Rx Z/D canned

Stella & Chewy raw diet, chicken and turkey varieties

B12 Injections weekly for 8 weeks 

Tylan powder (gave her seizures!)

Probiotics - several brands

Prebiotics - several brands

Home made raw chicken diet (included b-complex, vitamin e) 

Valium

Pheromone collars