If you’ve read my article about Feline FIP, you probably remember my kitten Noodles who was diagnosed with FIP when he was just a few months old. He was one of the few to survive FIP and he lived 15 more years until he had to be euthanized finally from the debilitating effects of Feline Inflammatory Bowel Disease.
In veterinary medicine, the term feline irritable bowel syndrome is often wrongly used to refer to what is actually feline inflammatory bowel disease.
I have heard this happen in human medicine as well. The terms are often used interchangeably, when, in fact, the two conditions are very different.
When cat owners talk about feline irritable bowel syndrome, they are referring to their kitty’s diarrhea, weight loss, and vomiting. There may or may not be obvious mucus or blood in the stool and you may see your cat straining in the litter bowel. These symptoms are actually those of feline inflammatory bowel disease, not feline irritable bowel syndrome. Here’s the difference:
Feline Irritable Bowel Syndrome
We can probably best understand it by looking at human medicine first. You have probably known friends or family members who had episodes of irritable bowel or even experienced it yourself. You may have felt pain in the lower half your abdomen, had gas, and produced looser (or sometimes harder) bowels movements than are normal for you. This doesn’t happen to you daily or even regularly. It usually happens when you are under excessive stress or have eaten something that didn’t agree with you or are taking a new medication that may be irritating your GI tract.
When this happens, it is actually your colon, the lower half of your intestines, that is the problem. The muscle contractions of the colon are excessive at those times and it hurts and it causes changes in your stool. Again, this is irritable bowel syndrome (IBS), not inflammatory bowel disease (IBD).
You may have seen the same thing happen to your cat. Has your cat ever defecated in the carrier on the way to the vet or at other times when he is very anxious? It happens fairly often and if we use the right terminology, we would refer to that as feline irritable bowel syndrome, not feline inflammatory bowel disease. Most of the time your cat is fine; it is just under stressful circumstances that he vomits or has diarrhea.
Feline Inflammatory Bowel Disease
On the other hand, chronic diarrhea and/or vomiting accompanied by weight loss can indicate feline inflammatory bowel disease. This is a condition where there is actual inflammation of the intestinal tract and it can become very debilitating and even lead to death. The lining of the intestines can become very thickened. The cat may have a normal or increased appetite initially, but as the intestinal lining becomes thickened, important nutrients cannot be absorbed. The kitty then becomes thinner and thinner in spite of taking in adequate food.
Most often inflammatory bowel disease in cats causes no abnormalities in the cat’s blood work, at least initially. In fact, when a cat comes in to see me with the symptoms of chronic vomiting, diarrhea, and weight loss and a fecal analysis is normal and the blood work is normal (including FeLV, FIV, and Thyroid testing), feline inflammatory bowel disease moves to the top of my list of possible diseases along with intestinal cancer.
Diagnosis of Feline Inflammatory Bowel Disease vs Feline Irritable Bowel Syndrome vs Intestinal Cancer
Definitive diagnosis can only be made with an intestinal biopsy. My clients often prefer a trial of medication for feline inflammatory bowel disease before choosing the intestinal biopsy. The biggest problem with this is that intestinal cancer may also show improvement on these same medications temporarily and therefore complicate a diagnosis and delay a diagnosis of cancer if it is present
The flip side of that is that many clients do not want to treat their cats with chemotherapy if they do have intestinal cancer, in which case it really doesn’t matter. The main reason for performing an intestinal biopsy is to determine if the disease is feline inflammatory bowel disease or a type of intestinal cancer. If you wouldn’t treat your cat for cancer even if you knew it was cancer, then I generally agree that putting your cat through a biopsy is probably pointless and just increases the suffering of the kitty.
Treatment for Inflammatory Bowel Disease in Cats
The primary medications used to treat inflammatory bowel disease in cats (or feline irritable bowel disease as it is also inaccurately referred to by many) are Prednisolone and Metronidazole. (Make sure your vet puts your cat on Prednisolone, not Prednisone.)
A dietary change is also recommended. Over the last few years, there have been several prescription diets formulated by various pet food companies directed toward helping treat feline inflammatory bowel disease. They tend to be formulated to be low in fat or based on a protein that your cat has never eaten before such as venison, lamb, rabbit, or duck.
For more information on selecting a diet as part of the treatment for inflammatory bowel disease in cats, see my page about The Role of Diet in Feline Inflammatory Bowel Disease. Also, please see CatInfo.org which offers, in my opinion, the finest diet information in general for cats.
When my cat, Noodles, was diagnosed with IBD, I started him on Prednisolone and Metronidazole. I also changed his diet and added some pancreatic enzymes and other medications and supplements because he also had liver and pancreas involvement (there are some excellent veterinarians that believe all cats with inflammatory bowel disease have liver and pancreas involvement). He had extreme weight loss and diarrhea, but with treatment he lived another 3 years. Considering his age and his battle with FIP in the first year of his life, I felt we were given quite an extension on life even though I never wanted to say good-bye to him.
Also, Noodles’ battle with IBD was several years ago and there have since been some advancements in treatment, particularly in the area of diet. Today, a younger cat without Noodles’ early history, could hope to keep the disease in check for an even longer period, and possibly even achieve a cure.
As with any other disease, the early the diagnosis and treatment, the better the prognosis. Feline Inflammatory Bowel Disease is no different. Left untreated, the inflammation of the intestinal wall just gets worse and it becomes harder to achieve a remission of the disease.
In summary, if your cat has occasional vomiting or diarrhea during stressful situations, but is not losing weight and appears otherwise healthy, the kitty probably has episodes of Feline Irritable Bowel Syndrome. Talk to your veterinarian about treatment for the anxiety, possible dietary changes, or the usage of anti-diarrhea medications at times of flare-ups.
On the other hand, if your cat has chronic vomiting or diarrhea, please have it checked out by your veterinarian sooner rather than later. The longer you wait, the worse the inflammation of the intestines will become, and the less treatable it will be.
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