What is inflammatory bowel disease?
Inflammatory Bowel Disease (IBD) is a chronic disease of the intestinal
tract. Occasionally, the stomach is involved. Most affected cats have a
history of recurrent or chronic vomiting and/or diarrhea or smelly, soft
stool. During periods of vomiting or diarrhea, the cat may lose weight but
is generally normal in other ways. As a rule, most affected cats eat well
(or even have an increased appetite) and appear normal.
What causes this disease?
The cause of IBD is poorly understood. In fact, it appears that there may be
several causes. Whatever the causes, the end result is that the lining of
the intestine is invaded by inflammatory cells. An allergic-type response is
then set in place within the bowel lining. This interferes with the ability
of the cat to digest and absorb nutrients.
In most instances, an underlying cause cannot be identified: dietary
components may play a role initiating the disease; bacterial proteins may be
involved in other cases.
How is IBD diagnosed?
There are two ways to diagnose IBD. The first method is a biopsy of the
affected part of the stomach or intestine. The preferred technique is to use a flexible endoscope
that allows access to the lining of the stomach, small intestine, and
colon. If the site of inflammation involves any of these locations, a
confirmed diagnosis is achieved. Sometimes, the small intestine may be
difficult to enter because of the cat's small size; in these cases, a
surgical biopsy may be needed. Fortunately, this is rarely necessary.
The second method of diagnosis is a therapeutic trial involving
administration of particular drugs, along with certain dietary changes.
Since not all cats respond to the same drugs, the trial may involve a series
of drugs and may take several weeks. Also, different diets may be tried,
depending on which part of the bowel appears most involved. These diets
include hypoallergenic, low residue, or high fiber foods.
The cat is monitored during the therapeutic trial for a decrease in clinical
signs and, in some cases, weight gain.
Is IBD treatable?
When a diagnosis of IBD is made, the cat is placed on a hypoallergenic, low
residue, or high fiber diet for 8 weeks or more. This helps to identify the
contribution of dietary components to the problem. Although diet is not a
common cause of the disease, it is an inexpensive and effective way to treat IBD if an acceptable food is found.
If the dietary trial does not offer any improvement, medication is used to
control (not cure) the problem. Since not all cats respond to the same
medication, a series of drug trials may be necessary.
What is the prognosis?
Once the appropriate drugs or diet are determined, many cats are maintained
on these for life, although dosages of the drugs may have to be changed.
Occasionally, a cat will be able to stop drug therapy at some point.
Most cats do well for many years; others require alterations in therapy
every few months. Unfortunately, a few cats will ultimately become totally
resistant to treatment.
Note: Many people confuse Inflammatory Bowel Disease with Irritable
Bowel Syndrome (IBS), a stress-related diarrhea problem. Treatment for IBS
is aimed at stress; it is a completely different condition from IBD.
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