Feline Inflammatory Bowel Disease

My cat, a 14-year-old female, is suspected to have Feline Irritable Bowel. She has a loss of appetite and a little vomiting, usually just a small puddle of fluid and no food. She also does not have diarrhea. She has had feline hyperthyroid radioactive treatment and her blood work is normal. An ultrasound showed a little thickness in bowels. The first time she was given prednisone and it worked for 5 months. Then she had a second bout and had same injection but it only worked for 3 weeks. Does this seem like the right diagnosis for my cat and what would be the next step?

Inflammatory bowel disease in cats (often interchangeably called irritable bowel) is frequently a diagnosis obtained by elimination of other possible feline illnesses that could be causing your cat’s symptoms.
Without further information, it is a bit difficult to provide verification of your cat’s diagnosis. Your veterinarian is the most familiar with your cat’s particular case, symptoms and treatments, and the timeline that testing and treatments have occurred over.

Has your cat’s bloodwork been rechecked to include a T4 level since her initial radioactive iodine treatment? In cases such as these, it is important to rule out whether feline hyperthyroidism is still contributing to her symptoms. Although she received radioactive iodine treatment for her hyperthyroidism, it is possible that a second treatment may be needed to achieve a cure. Uncontrolled feline hyperthyroidism could certainly be causing the symptoms that appear to be feline inflammatory bowel.

Aside from feline hyperthyroidism or inflammatory bowel disease, the other condition that should be ruled out by your veterinarian is feline intestinal cancer. While it is possible that the ultrasound your kitty received would have ruled out this condition, I would recommend discussing this directly with your veterinarian. When feline inflammatory bowel causes a diffuse thickening of the bowel wall, it may not be distinguishable from feline intestinal cancer. The only test that can give you a definitive diagnosis is an intestinal biopsy.

Irritable bowel should, in general, be viewed as a condition that needs to be maintained and controlled, rather than cured. Generally, cats with IBD are treated with a daily medication regimen of prednisolone and metronidazole to control their symptoms. I would definitely recommend that daily tablets be given to start and that metronidazole be given at the same time. It is often the case that the addition of metronidazole can enable you to treat your kitty with less prednisolone.

Other options that may help include testing for food allergy and perhaps a change in diet. In addition, if the inflammatory bowel condition is severe enough and is not responding to all of the above mentioned treatments, stronger medications may be suggested including some in the chemotherapy category.

If you are still concerned, I would suggest bringing your cat to another veterinarian for an examination and testing. Obtaining a second opinion for a cat with a chronic problem is always wise, just as it is with us humans!

Thank you for writing in with concern for your kitty.

Best wishes,
Dr. Neely

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