Major G.

Major Garrity - London, UK
Male, Domestic Shorthair
Born February 1999
Diagnosed with feline diabetes in February 2008
Diagnosed with gastroenteritis in Oct 2008
Diagnosed with mild neutrophilic inflammation of the large bowel in
December 2008
Diagnosed with suspected IBD in December 2008

In Nov 2007, Major had rabies vaccinations for the first time since 2001 due to our pending move to Bahrain. In
mid-Dec, Major had a mini-check up at his 30-day follow up blood test for his rabies booster. The check up
revealed that everything was fine with Major. At the end of Dec 2007, we noticed that Major’ appetite was off (he
normally LOVES his food) for a few days but he bounced back. In Jan 2008, we noticed that he was more
lethargic and drank more water but other than that, he seemed fine.

In Feb, we took him back to the vet for his annual vaccination and another check up before moving to Bahrain.
This was when we noticed that he had lost 0.7kg in two months. Later the blood test (both blood glucose test
and frutosamine test) confirmed that Major had feline diabetes. He was immediately put on Insuvet Lente
insulin.

Major was on Hill’s Diet and Hill’s Prescription Diet (R/D) for his entire life till this point. Upon doing some
research, I realised that dry food is full of carbohydrate, and most commercial food is made of poor quality
ingredients. I immediately switched him to wet food with low carbohydrate content (less than 7%) with the
intention of transitioning him to raw diet in the coming months.

Thanks to Feline Diabetes Message Board (FDMB) – www.felinediabetes.com, I received wonderful support and
help from the members of this forum to get us through a very rocky start of keeping Major's blood glucose under
control.

I relied a lot on the valuable information provided by the Janet and Binky’s List. It is a very good start for anyone
who is interested in finding the appropriate diet for diabetic kitties. Janet and Binky’s List:
www.felinediabetes.com/diabetic-cat-diets.

Major was on Insulvet Lente for 4 weeks without much improvement. His blood glucose level was consistently
high at pre-shots (in mid 20’s mmol/L). By the end of March, I decided to change to Insuvet PZI insulin and
followed Dr. Elizabeth Hodgkins’ protocol (www.yourdiabeticcat.com/forums). Within two weeks of following this
protocol, Major came off insulin. He is currently in remission. For any cat lovers who care for their kitty’s health
and dietary requirement, I highly recommend Dr. Elizabeth Hodgkin’s book – Your Cat.

I started transitioning Major from commercial food to raw diet (with bones) in March, by the end of May, Major
was on 100% raw meat diet. He was thriving on raw meat diet, his coat was shining, and he seemed to have
much more energy. However, Major started having occasional vomiting episodes after eating. After many trials
and experiments, I believe vitamin B complex – one of the supplements in his raw meat diet was making him sick.
It did make sense to me as I know many people (including myself) also feel sick after taking vitamin B complex.
Therefore, instead of adding what’s required by the recipe, I only added about 1/5 the required amount of vitamin
B in his diet. It seemed to have solved the problem.

Major was doing very well on this new diet and was maintaining a normal blood glucose level. In July, I decided
to introduce a new kind of meat to Major’s diet – turkey. Up to this point, Major was on 100% raw rabbit diet and
cooked turkey and chicken as snacks daily. As a start, I only added about 15% of raw minced turkey to his
normal rabbit meat diet. Major seemed fine but did vomit once.

I didn’t give him any more raw turkey meat until Oct when I added 50% raw minced turkey meat to his normal
rabbit meat diet. Within hours of eating this new turkey and rabbit meat diet, Major started having diarrhea –
frequent with small volume. Other than having diarrhea, Major was still eating well with good appetite. I took him
to the vet, and the vet believed it was the contaminated meat (possibly turkey) that caused the diarrhea.

Major was prescribed Zantac and a five-day course of antibiotics (Clavaseptin). Major’s diarrhea stopped
immediately and was back to his normal self. For a week after the start of his diarrhea, I gave him cooked
chicken and commercial food.

Then I made a crucial mistake, I decided to give Major raw minced chicken right after he recovered from
gastroenteritis. This brought on the second bout of diarrhea and vomiting. The emergency vet prescribed
another five-day course of antibiotics (Synulox) and Zantac. This time, Major didn’t response to the antibiotic
treatment immediately, and the diarrhea lingered for a few more days before it finally stopped.

Almost as soon as Major completed the second course of antibiotics, the diarrhea returned. At this time, both our
regular vet and the emergency vet strongly objected that I continued to feed Major raw meat diet. Our regular vet
also suspected that Major was allergic or had food intolerance to chicken and turkey. So this really limited what I
was able to feed Major as I also had to consider Major’s special dietary requirement for his diabetes. Major
doesn’t eat beef and throws up after eating lamb and fish. Now, he may be allergic to chicken and turkey as well.
That didn’t leave me with too many choices so I decided to home cook his food.

Following the raw recipe with cooked meat, I steamed rabbit meat or duck breasts then pureed the meat for
Major. This diet lasted only for a few days then Major refused to eat. I kept trying different ways of cooking,
adding/omitting certain supplements. None seemed to make him interested in his food. Out of desperation, I took
out a bag of raw minced rabbit meat to thaw. Major jumped on the kitchen counter and started licking the bag
and wanted to eat.

This was a turning point for us. I decided to ignore what the vets told me and started feeding Major raw rabbit
meat again supplemented with some commercial food. The only problem was that as soon as I added those
supplements, Major would refuse to eat the raw rabbit meat. So I found a way for him to eat but this diet was not
balanced. Within two days after Major started eating raw rabbit meat supplemented with some commercial food,
his diarrhea stopped. Over the next couple of weeks, he showed that he preferred to eat the commercial food
instead of the raw rabbit meat. So we put Major back on commercial food only. While his diarrhea seemed to be
under control, we also noticed that he seems nauseated at times. To control his nausea, Major started taking
Zofran, 4mg (1mg or 1/4 tablet twice a day).

It is not confirmed that Major has IBD but in the last two months, we have had the following tests done (listed in
chronological order):

· Four sets of blood tests (14 Oct, 28 Oct, 13 Nov & 28 Nov)
· Cobalamin and Folate test at TAMU (13 Nov)
· fPTLI and TLI test at TAMU (13 Nov)
· Two sets of fecal analysis tests (14 Oct, 11 Nov)
· CTDS food panel test (13 Nov)
· Full thyroid panel test at Hemopet by Dr. Dodds (13 Nov)
· Abdominal ultra sound at Royal Veterinary Collage, UK (24 Nov)
· Two sets of rectal cytology tests done by two separate labs with samples taken at the same time (28 Nov)
· Urine analysis (15 Dec)

All the tests came back normal EXCEPT for his full thyroid panel, folate test and rectal cytology test.

Both the folate and full thyroid tests only indicated that something was not right with Major but they
couldn’t pinpoint what exactly was wrong with Major.

One of the feline specialists we consulted suggested that we get a rectal cytology test done.

Finally, the rectal cytology test (both tests by two separate labs) showed that Major has mild neutrophilic
inflammation of large bowel. It also showed presence of organisms that looked like clostridial spores and
presence of many yeast-like organisms that may be associated with one the three scenarios:
1. rabbit feces
2. probiotic therapy
3. antibiotic therapy resulting in an imbalance of normal intestinal microorganisms

Since Major was on rabbit meat diet, had been taking probitoic, had three courses of antibiotic therapies
(including Antirobe for redness/inflammation of his gum prior to taking two courses of antibiotics for two bouts of
diarrhea), all three scenarios may be possible. I also noticed a couple of times that if I added just a tiny bit more
probitics into Major’s food, his would get terrible diarrhea. I have now stopped giving Major any probiotics.

Following the rectal cytology test, the feline specialist recommended clostridial enterotoxin assay (ELISA) to
check if the organisms that look like clostridial spores are producing toxin or are merely present and benign.

Here’s some information on clostridial perfringens enterotoxemia:

According to Antech Diagnostics lab, clostridium perfringens is a normal enteric bacterium found predominantly
in a vegetative, non-enterotoxin producing form. Under certain conditions, the organism undergoes enteric
sporulation at which stage the enterotoxin is released. The organisms tend to colonize the distal small intestine
and upper colon. Nutritional changes, alternation of bacterial microflora, decreased local IgA immunity and
intestinal epithelial injury may all play a role in initiating the spores forming change in the strains of clostridium
that produce this disease.

Most acute case responds well to fluids and oral antibiotic therapy directed against clostridium perfringens.
ampicillin, amoxicillin, tylosin, clindamycin or high dose metronidazole therapy are recommended.

Chronic cases require long-term antibiotic use and/or diet manipulation using high fibre content diets. Fibre has
been shown to alter colonic bacterial microflora and maintain a more acidic pH. These changes inhibit clostridial
spore formation. Soluble fibre supplements such as psyllium can also be used.

Update: December 23, 2008
Major still has some good days and bad days – reduced appetite and nausea. He is not 100% his old self –
playful, energetic, great appetite…….but he is still as sweet and affectionate as before.

Major’s next test after the Christmas holiday will be a clostridial enterotoxin assay (ELISA).

Major’s diarrhea is currently under control. Nausea is more of a problem now. He is currently taking Zofran, 4mg
(1/4 table twice a day) to keep his nausea at bay and folic Acid 200mcg a day for his folate deficiency. Major
also gets vitamin 12 (cyanocobalmin) injection once a week.

Update, May 1, 2009:
Major's IBD is controlled with raw rabbit mixed with Instinct Rabbit canned food. He takes Plant Enzyme and
Probiotics by Animal Essentials with each meal. He is fed fives times a day. Three main meals + two snacks.

He also takes Australian Bush Flower Essence ABFE. The essence is customised for Major's needs. I purchased
the complete set (69 essences) to make up the dosing bottle myself. I also bought the book: Animal Healing by
Marie Matthews as my guide to use the essences. There's a yahoo forum for using ABFE to treat animals. In
short, Major seems to be doing better (touch wood) after we stopped feeding him chicken. So chicken and turkey
seem to be the trigger that started the whole nightmare.

Update: September 28, 2009
There hasn't been any change with Major. He is not taking any medication except 1/8 tablet Zantac before
bedtime.

His is on a combination of Instinct rabbit and raw rabbit. Every once awhile my father in law will give him a
teaspoonful of pumpkin to keep him regulated. Since we figured out that Major is allergic to chicken and turkey,
Major has been on strictly rabbit diet, and this seems to work well with him.

Update: February 7, 2010
Major's diet and daily care routine are still the same and nothing has changed with his health or IBD. He's still
stable and doing well. We are keeping his weight at 6.5kg (14.5 lb).

Update: June 10, 2010
Everything is the same except that Major is not on a raw diet now. He only eats NV Instinct Rabbit canned food.
He doesn't like farmed rabbit meat and because he's living in Canada, this is the only one available.

When I was at my wits end dealing with Major's re-occurring diarrhea, vomiting and poor appetite, I contacted Dr.
Deva Khalsa whom I found out about through a Yahoo Group I belonged to:
http://pets.groups.yahoo.com/group/WholeCatHealth/.

Dr. Deva Khalsa helped Major with his sever food allergies which was mis-diagnosed as IBD because the
symptoms are somewhat similar - diarrhea, vomiting, poor appetite. In Major's case, he was allergic to many
types of protein (chicken, turkey, beef, eggs), supplements like vitamin B - you name it.

In Major's case, Dr. Deva Khalsa used NAET technique and conducted fur testing to see which food, type of
food, supplement and elements were causing Major's allergic reactions. All I can say is that I am absolutely
amazed by her work and the results.

Once Dr. Khalsa received Major's fur testing result, she prescribed a very unconventional treatment plan. Her
treatment for Major consisted of some homoeopathic remedies, several vials of liquid (not for consuming) and
tapping certain meridian points along the spine. I know it sounds strange, and crazy in a way, but it worked.
NAET technique has been used to treat allergies for humans for a long time but now many vets are using the
same technique to treat animals.

She is based in New Zealand and Florida (splitting her time) and does phone and email consultation.
Her website is: www.doctordeva.com/

Update: June 8, 2011
In Feb of this year, we brought Sudbina and Major to Saudi Arabia from Canada where they were cared by my in-
laws. Major had a tooth extraction and dental cleaning last Nov. He had a post surgery reaction to the
anaesthetics which caused GI upset (not due to antibiotics) and diarrhoea. The diarrhea did clear up after the
vet prescribed metronidazole but I noticed that Major was slowing losing weight and his bowel movement was
not quite normal.

At around the same time, I noticed Major started having large volume and pale color poops up to three times a
day, and he was eating a lot more to barely maintain his normal weight. After doing some research, I suspected
that Major had pancreatic insufficiency. The vet in Canada agreed to put Major on pancreatic enzyme. A friend of
mine recommended that we use human grade, time released (coated) pancreatic enzyme because the enzyme
will break down the protein over time in the stomach. We put Major on Creon 5 (in the US, it's been replaced by
Creon 600). The result was dramatic. Major's poops became normal and he is able to maintain weight with his
usual/normal food intake.

As of March of this year, Major is back on half raw rabbit and half canned pork diet (Almos Nature). I am able to
source raw rabbit meat here in our neighboring country, Bahrain. He is doing fine on this diet.

Major had a fur testing for allergy tests by Dr. Deva Khalsa again earlier this year as a re-check. I credit Dr.
Khalsa for correctly determining the cause of Major's GI upset and diarrhea problems two and half years ago.
Major was allergic to turkey, beef, chicken, lamb.

Update: June 3, 2012
Major is doing well. I have not changed his diet. He is still on raw rabbit diet (100g per day split into 4 meals) and
Nature Variety's Instinct rabbit canned food (60g per day split into 4 meals). His weight is maintained at 6.5kg.
He has Vitamin B12 injection once a week and takes pancreatic enzyme with breakfast and dinner.

Important note: even though this particular case turned out not to be IBD, I feel it's important to illustrate how
the symptoms may overlap with other differential diagnoses and that people need to be aware of work-ups and
testing needed with their kitties to be sure it's not one of these other diseases. I'm inclined to believe there's a
food allergy/IBD overlap in many cases and that more commonly IBD is misdiagnosed as something else
rather than that condition being misdiagnosed as IBD.

Living With IBD - Major G.