By Lisa Provost
IBS and IBD are not the same thing.
IBS is “irritable” bowel syndrome. No thickening of the intestines, no inflammation or disease is present; the lining is only irritated. It’s easily managed with diet change and usually minor to no medications are needed. It may progress eventually to IBD if not addressed properly but not always. IBS is not as common in cats as IBD.
IBD is “inflammatory” bowel disease. Thickening of the intestines is present along with inflammation. It can be extremely difficult to manage, painful, chronic and incurable. Sometimes it can be managed with diet but it’s already in the diseased stage which can then lead to other inflammatory conditions like pancreatitis, liver disease and lymphoma.
Many vets are now diagnosing cats with IBD that have no thickening or inflammation present on ultrasound. The problem here is that “inflammatory and thickening” are the very definition of IBD. If there is no thickening or inflammation present anywhere on ultrasound, then most likely your cat does not have IBD, something else may be going on. Or it’s in the very beginning stages and not yet visible. But that’s hard to define and jumping right to steroids is tricky and shouldn’t be the first choice when IBD is not visible. Please always make sure to have a licensed and experienced ultrasonographer perform and read the ultrasound.
IBD is a trickster, a shape shifter, an ever-changing face like Jekyll and Hyde. It’s a constant roller coaster of ups and downs. The stress from this disease can take its toll on both you and your pet. Some days you feel like they’re finally turning the corner and you’re able to exhale. Then without warning, things change and you’re trying to figure out what happened and how to fix it. It’s frustrating, exhausting and can leave pet parents feeling helpless and hopeless. I wish I had answers on how to make this easier. But many people do find ways to stabilize their kitties with interchanging treatments; diet change, medications, acupuncture and other holistic treatments. Some are even put on antidepressants or anti-anxiety medication to better stop flares caused by stress. That’s not common but it is a choice if you have a kitty that is prone to severe stress, agitation, behavioral issues, etc.
I’m often asked about lifespan. There’s no way to know, because every single cat reacts very differently to each treatment. It’s why there’s no way to develop any kind of protocol with this disease. One thing will work for one cat, and not at all for the other. It’s pretty much a gamble, lots of trial and error. (And btw, it’s the exact same for people with IBD). I can tell you from both pet experience and my own health experience that IBD makes no sense whatsoever when it comes to what works and what “should” work. You would automatically think a better diet would be the ultimate answer. And yes, that’s obviously the goal, always. We encourage you to absolutely try! But many times unfortunately (and to our frustration with this disease), it doesn’t work and things you wouldn’t normally feed, do work. Which is why we say do whatever works for your cat. What’s important is not what WE want for them, but what’s actually working for them and bringing them comfort and quality of life. Again, there’s no rhyme or reason, no formula or protocol. If there was one, I’d be the first to shout it from the rooftops.
What is IBD
Feline Inflammatory Bowel Disease (IBD) is a group of disorders that cause inflammation in the lining of the stomach and/or intestinal tracts, basically changing how these organs perform their normal bodily functions. IBD is an uncontrolled inflammatory response, causing the inflow of inflammatory cells into various parts of the gastrointestinal tract. IBD is chronic, and in some cases severe inflammation, that can spread to other areas of the GI tract. This can involve other organs, particularly the liver, pancreas and even kidneys. Due to the spread of inflammation, other problems may arise such as malabsorption of nutrients, poor digestion and scar-like fibrous tissue, SIBO (small bacterial overgrowth), EPI (exocrine pancreatic insufficiency), pancreatitis and liver disease.
The GI tract acts as a second brain with a rich network of nerves and ganglia, communicating directly with the brain and the heart. Your digestive system also affects your moods through the hundreds of chemicals and hormones it produces, which is why some cats also suffer depression with this disease. There are trillions of microbes inside of all of us, human and animal. Altering the healthy bacteria that normally inhabit the GI tract can affect conditions ranging from IBD to asthma and allergies. The GI tract also has the largest amount of lymphatic tissue in the body with that tissue being the main part of the immune system; which is why some cases of IBD can affect the lymph nodes and further stress the immune system itself.
Management includes diet change, medications, traditional and/or holistic treatments (always under the care of a licensed holistic veterinarian). Symptoms can be varied and include vomiting, bad breath (halitosis), diarrhea, constipation, increased thirst from dehydration, gas, rumbling and gurgling in the stomach, abdominal pain, anorexia, moderate to severe weight loss, litter box refusal, dark/tarry stools, lethargy and depression, weakness and fatigue, vitamin deficiencies and anemia. Although many cats suffer from diarrhea as the main symptom, many also suffer from chronic constipation or mega colon.
Inflammation can spread quickly, further complicating the recovery process. This is why it’s so important if you notice signs of ill health of any kind, such as those mentioned above, don’t procrastinate or hesitate. Get them seen by a vet well versed in IBD. When suspecting IBD or any gastrointestinal disease, it does not pay to wait. Early detection and treatment is paramount to stabilizing your pet and giving them a healthy, happy and long life. The sooner you get the inflammation under control, the better.
Medications are often used such as steroids, anti-nausea/anti-emetics, appetite stimulants, antibiotics, pain medication, sub q fluids and B12 injections. No one likes giving their pets medications but in times of crisis, it’s important to think about their level of comfort. IBD can be painful and imagine if you threw up several times every day, or had explosive diarrhea several times a day, and you couldn’t stop it. Pain is pain and they experience it just as much as we do. The goal is to lessen their pain and give them quality of life over everything.
There is no cure for IBD and no definitive cause. Although we are starting to see that environmental contaminants and carcinogens are playing the biggest role in this disease. In humans IBD has been linked to “gut dysbiosis.” This means an imbalance between “unhealthy” and “healthy” bacteria, and the few studies so far in cats point to the same basic problem. Studies are also coming out in droves showing microplastics in our water, soil and food are just about everywhere on this earth. These contaminants are in the guts of humans, wildlife and pets, and to the farthest reaches of this planet. These are foreign objects in our bodies. Not only are they causing inflammation and disease, your body is in a war trying to get rid of the infiltrators. There’s nothing natural about plastics and forever chemicals like PFAS. And in fact, they may be the biggest threat to all of our bodies we’ve seen in our lifetime.
Just remember you’re not alone in this. Unfortunately feline IBD is rampant. We know of no way to prevent this disease and its adjoining conditions. We’ve got better treatments than we did 20 years ago, but not good enough. We need a lot more research specifically on cats. Some universities are starting to do that so check their websites for trials and studies.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7152115/
https://medicalxpress.com/news/2023-11-body-years-inflammatory-bowel-disease.html
https://pubmed.ncbi.nlm.nih.gov/31525038/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9367336/