What is IBD in cats? Signs, diagnosis and treatment

Many cat owners think vomiting is just something cats do. It's common, yes, but regular vomiting isn't normal, and it's worth finding out why. One possible cause is inflammatory bowel disease, or IBD. Watch the short film above, then read on.

What is IBD?

Inflammatory bowel disease is a long-term condition in which the lining of the stomach and/or intestines is invaded by inflammatory cells. The inflamed gut can't digest food and absorb nutrients properly, which leads to vomiting, diarrhoea and weight loss. The exact cause isn't fully understood; it probably involves the immune system reacting to things like food proteins or gut bacteria.

IBD is not the same as irritable bowel syndrome (IBS) in people, and it isn't contagious.

Signs of IBD

Signs often come and go, and depend on which part of the gut is affected:

• vomiting that keeps coming back (stomach or upper intestine)
• diarrhoea or soft stools, sometimes with mucus or blood (lower intestine)
• weight loss, sometimes even though your cat is eating
• appetite changes: eating less, or being unusually hungry
• frequent hairballs: bringing up hairballs more than about once a month isn't normal, and can be a sign of gut problems
• lethargy, or a dull, unkempt coat

If your cat has vomiting or diarrhoea that lasts more than a couple of weeks, or keeps coming back, see your vet. If there is blood, repeated vomiting in one day, weakness, or your cat stops eating, go sooner.

How IBD is diagnosed

There is no single test for IBD. Your vet will first rule out other causes of similar signs, such as:

• intestinal parasites
• an overactive thyroid (hyperthyroidism)
• kidney or liver disease, pancreatitis or diabetes
• food intolerance or allergy
• infections

This usually involves blood tests (including vitamin B12 levels, which are often low in gut disease), stool tests and an ultrasound of the abdomen. Often a diet trial comes next (see below).

The only way to confirm IBD is a biopsy: small samples of the gut lining, taken with an endoscope or during surgery. A biopsy also tells IBD apart from intestinal lymphoma, a type of cancer that can cause the same signs and look very similar on scans. Sometimes, depending on the cat, vets start treatment based on the other tests and consider a biopsy if the cat doesn't respond.

Treatment

IBD usually can't be cured, but it can be managed well, and many cats live long, happy lives. Treatment is tailored to each cat and often includes:

• A special diet. Many cats improve on a hydrolysed-protein or novel-protein diet (a protein the cat hasn't eaten before). A diet trial must be strict: no other food or treats for several weeks, or the results won't be clear. Some cats need only the diet.
• Anti-inflammatory or immune-modulating medicine, most often a corticosteroid such as prednisolone, gradually reduced to the lowest dose that works.
• Vitamin B12 (cobalamin) supplements, usually by injection, because cats with gut disease often can't absorb it properly.
• Other support as needed, such as anti-sickness medicine, fibre or probiotics, as advised by your vet.

Relapses can happen, so keep regular check-ups, watch the weight, and tell your vet if signs come back.

Living with an IBD cat

• Stick exactly to the diet your vet recommends, including treats.
• Keep a simple diary: vomiting, stools, appetite, weight. It helps your vet adjust the treatment.
• Weigh your cat regularly. Weight loss is often the first sign that something needs adjusting.
• Keep stress low: routine helps many sensitive cats.

His Majesty finds his new diet boring. The carpet is thrilled.