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There are few things more frustrating
than having a cat that is suffering chronic bouts of vomiting and
diarrhea. Vomiting and diarrhea cause dehydration, and if left
untreated, can become a life-threatening situation. Therefore,
any cat displaying those signs should be examined by a
veterinarian. There are many possible causes of vomiting and
diarrhea, but inflammatory bowel disease (IBD) is a common cause
of gastrointestinal problems in the cat. Although cats of any age
can be affected, middle-aged or older cats are more susceptible
to IBD.
IBD describes a group of chronic
gastrointestinal disorders. Microscopically the disease is
characterized by the infiltration of inflammatory cells into the
lining (mucosa) of the digestive tract. The cause of IBD is
unknown, but the microscopic changes in the tissues
(histopathology) imply that immunologic factors play an important
role.
The scientific names given to the different
forms of the disease are tongue-twisters, but they actually
describe the features of the disease. For example, the most
common form of IBD in cats is called lymphocytic-plasmacytic
enterocolitis. Translated this means that lymphocytes (a type of
white blood cell) and plasma cells (cells that produce antibody)
are the primary types of inflammatory cells present in the
mucosa. Less common forms are called eosinophilic, neutrophilic,
and granulomatous, depending upon the predominant inflammatory
cell present. Enterocolitis refers to the inflammation of the
large and small intestines that occurs in this form of IBD. In
cases where inflammation occurs only in the small intestines, it
is called enteritis; in cases of only large intestine
inflammation, it is called colitis; and gastritis in those cases
where inflammation of the stomach predominates.
Diagnosis
To rule out other causes of gastrointestinal disease, your
veterinarian will perform diagnostic tests that may include a
complete blood cell count, serum biochemistries, serum thyroxine
level, tests for feline leukemia virus (FeLV) and feline
immunodeficiency virus (FIV), urinalysis, fecal examinations for
parasitic and bacterial agents, dietary trials, and abdominal
radiographs and/or ultrasound.
The most definitive of the diagnostic tests is
the microscopic examination of small pieces of the intestinal
lining (mucosal biopsy). Tissue samples can be obtained during
abdominal surgery (e.g. laparotomy) or during endoscopic
examination. Although both procedures require general anesthesia,
the choice of methods depends upon a number of factors, including
the availability of equipment and the part of the
gastrointestinal tract suspected to be involved.
Treatment
A combination of dietary management and medical therapy will
successfully manage IBD in most cats. Because there is no single
best treatment, your veterinarian may need to try several
different combinations in order to determine the best therapy for
your cat.
DIETARY
MANAGEMENT
Sensitivity to food antigens contributes to the
gastrointestinal inflammation in some cats, so a change in diet
often provides symptomatic relief. Several balanced commercial
diets have been advocated as effective in treating IBD.
Homemade diets are an alternative for cats
that refuse to eat a commercial diet. Your veterinarian can
provide you with an appropriate recipe. Ideally, the diet
should contain a single source of protein not normally consumed
by the cat. The addition of dietary fiber is beneficial to some
cats. It may take several weeks or longer for cats to improve
after a diet change, and during this trial feeding period, all
other food sources (like table food, and flavored medications
and treats) must be eliminated from the diet.
MEDICAL
THERAPY
Corticosteroids are commonly used to treat cats with IBD. These
drugs have potent anti-inflammatory and immunosuppressive
properties with relatively few side effects in cats.
Additionally, corticosteroids may stimulate the appetite and
enhance intestinal sodium and water absorption. Oral prednisone
is the corticosteroid used most frequently because of its short
duration of action and availability in appropriate tablet
sizes. If necessary, injectable corticosteroid therapy can be
used in cats that are too difficult to medicate orally or if
vomiting and malabsorption is severe.
Antibiotics, such as metronidazole or tylosin,
can be helpful when combinations of dietary management and
corticosteroid therapy have failed to adequately control the
disease. Side effects to metronidazole therapy are uncommon at
low dosages, but loss of appetite and vomiting may occur.
Excessive salivation is a common reaction of cats after
receiving the pill. This is probably a response to the
unpleasant taste of the medication. Sulfasalazine is a
medication that is often used if large bowel inflammation
(colitis) is the predominate problem.
If none of these medications successfully
control the signs, more potent immunosuppressive drugs may be
necessary, but they necessitate closer monitoring by your
veterinarian.
Prognosis
It is rarely possible to cure inflammatory bowel disease, but
most cases can be satisfactorily controlled by medication and
dietary management. Relapses can occur if the treatment regimen
is not followed completely.
Prepared by the Cornell Feline Health
Center, Cornell University, College of Veterinary Medicine,
Ithaca, New York 14853-6401. The ultimate purpose of the Feline
Health Center is to improve the health of cats by developing
methods to prevent or cure feline diseases and by providing
continuing education to veterinarians and cat owners. Much of
that work is made possible by the financial support of friends.
©1995 by Cornell University. All rights reserved. Cornell
University is an equal opportunity, affirmative action educator
and employer.
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