What is it?
Chronic thickening of the intestines with inflammatory cells that prevents absorption of nutrients and slows peristalsis (intestinal movement).
The cause is poorly understood but it is likely that the bowel has become hypersensitive to normal food and bacterial allergens. It is more common in older cats. Some cats have concurrent pancreas and liver inflammation with a condition called “triaditis”.
Chronic vomiting and diarrhoea, weight loss, anorexia. May be more severe and sudden with“triaditis”.
How is it diagnosed?
Ultrasound is a non-invasive method to identify small bowel thickening. Further tests may berequired to rule out diseases that can cause similar symptoms such as full blood test, thyroid test, faecal tests for parasites, faecal culture for bacterial food poisoning, virus tests (FIV, FeLV, FIP / coronavirus) and x rays and barium study if an obstruction is suspected. Your vet will advise you further on the need for these tests. IBD can only be confirmed with biopsies sampled via abdominal surgery under general anaesthesia. Intestinal biopsies may also be important to rule out intestinal lymphoma (a type of bowel cancer).
How is it treated?
The goal of treatment is to control the inflammation. The following treatments may be suggested:
- Allergy free diet such as Hills Prescription Z/D
- Highly digestible novel protein diet(ie a protein source that your cat has never been on before)
- Prednisolone is an anti-inflammatory, immunosuppressant corticosteroid and is the mainstay of treatment.Side effects include: thirst, weight gain, diabetes and infections. Some cats may be managed with prednisolone alone although combination therapy will allow dose reduction and alternate day therapy.
- Metronidazole is an narrow spectrum antibiotic which may also modulate the immune system
- Chlorambucil is a chemotherapy drug and a good choice for cats who do poorly on prednisolone.Monitoring blood counts with a blood test is usually necessary. Side effects include: vomiting, diarrhoea, anorexia, anaemia and bleeding problems.
- Vitamin supplementation
- Prebiotics and Probiotics
Prognosis and monitoring
Most cats can be well controlled with a combination of medication and a special diet.Thin cats, cats with triaditis or other pre-existing conditions may be harder to control. Some research suggests that a small number of cats with IBD may progress to intestinal lymphoma which is very difficult to control. Successful treatment means no vomiting or diarrhoea with a return to normal weight. Ultrasound can check that the intestines are no longer thickened and guide ongoing treatment options. Ultrasound monitoring is especially important if biopsies haven’t been taken.