Poorly cat with ibd

[Catfan5]

My dear old cat, who is nearly 15yo, has had chronic diarrhoea since before he came to live with us in 2009. Courses of antibiotics, probiotics and different foods including hydrolysed protein ones haven’t helped over the years. This year his weight started to drop and his appetite increased until he seemed desperate for food. A full senior blood test showed malabsorption in the small bowel, deficiency of vitamin b and a problem with the pancreas. Other results were normal. An ultrasound scan showed generalised thickening of the bowel wall, enlarged lymph nodes and enlarged pancreas. He’s had a course of vitamin b injections which didn’t help. The vet wants to do surgical full thickness biopsies to see if it’s ibd or lymphoma. I’ve said no to this and any invasive treatments as I don’t want the poor boy going through any more trauma at his age. I just want him to be comfortable.
What I would like is to find a good quality single protein wet cat food. The vet suggested single protein venison, duck or turkey for a change from the usual proteins. I’ve looked online but can’t tell what’s good or rubbish food, a lot I’ve never heard of. So if anyone has experience of this and can advise I would be grateful.

[booktigger]

I agree with you not wanting to put him through anything more. Has the vet suggested steroids, as they are used for both IBD and lymphoma.

[fjm]

You may find home cooking easier than finding a single protein commercial food. Most of the big raw food suppliers have suitable meats - I use Durham Animal Feeds, and they have complete duck, goose and game amongst others. You will need to consider whether other supplements are needed, of course.

[Catfan5]

Hi, yes the vet has talked about steroids if he doesn’t improve with the diet change. When I see him on Friday I’ll talk to him about starting

[Catfan5]

Ah yes I’ll have a look into buying meat for home cooking. He’s very fussy but it’s worth looking at.Is there a website to go to for info into how to go about it and using the correct supplements?

[fjm]

I don't know of a good site for cats, unfortunately - someone else may. The basic principle for a healthy cat is to include some bone or other calcium source to keep the phosphorus/calcium balance correct, use rather fatty meat, and always include a little offal, especially a very small amount of liver. The average mouse contains 70-80% water, 14% protein and 10% fat, which is a good ball park to aim for. The fur (or feathers from birds) provide magnesium and other trace elements that are often low in meat itself - I use wholemeal flour in treat recipes to fill that gap for my animals if they are not hunting. A very little fish oil can also be helpful. There are powdered supplement mixes that you can buy to add to raw or cooked meat which may simplify getting started. Well used muscles - thighs, heart, etc - are naturally high in taurine, but if you are feeding breast meat it might be worth supplementing with taurine to be safe.

If he is fussy I would start with supermarket meats that you can eat yourself - saves a lot of waste! You can supplement calcium by adding finely ground eggshell at the rate of 1 teaspoonful per kilo of meat - a pinch per meal. Ask your vet first, of course, but perhaps start with lowish fat muscle meat - skinned duck thigh might be ideal - and gradually introduce the richer offal and fat when you see how he tolerates it.

Has your vet discussed hypoallergenic diets? Or hydrolysed protein?

[Mollycat]

Is that correct 2009? You've been struggling with this all these years?

Also can I just clarify, when you say you want him to be comfortable, is that comfortable with the hope/aim to make his bowel better, or comfortable for the time he has left in palliative care?

I lost my Boo 3 years ago to whichever it was, IBD or lymphoma, and like you I was not prepared to put him through invasive and distressing tests just to make no difference to the recommended treatment plan. We began with vitamin B injections, progressed to steroids, were unable to reduce the dose and he lost a lot of weight quickly at the end. No regrets at all.

My Molly has muscle meat raw or cooked with Felini which is a complete supplement to give all the nutrients missing from pure muscle meat. It's expensive but a small pot lasts a long time as you only need a tiny tiny bit.

As an aside, my Boo got so much worse so quickly when we put him on a probiotic at the vet's suggestion that he only had one dose and I threw it in the bin. The reason for injections of vitamin B is that absorption is especially badly affected whenever the cat has diarrhoea or is given antibiotics, and lack of vitamin B aggravates the diarrhoea, so it's a vicious circle.

[Catfan5]

Hi fjm, thank you for your reply and all the info re homemade meals, sounds complicated but I’m sure it’ll be healthier than Felix..I tried him with KatKin (steamed raw- if that makes sense)a while ago but he didn’t take to it unfortunately.
Yes the vet recommended a hydrolysed diet. I bought Purina ha which didn’t make a difference. At the moment he’s eating RC anallergenic dry which he likes but because he’s so hungry all the time it’s not enough and he ends up eating wet food too which isn’t hydrolysed.

[Catfan5]

Hi Mollycat, yes he has always had a bowel problem. He was a stray before he moved in with us in 2009, no owners found. He used to leave ‘cow pats’ on our back grass before then, bless him!
I’m really not sure what I mean when I say I want make him comfortable but with his weight loss due to malabsorption, as well as the changes shown on his scan I don’t know if I’m looking at palliative care for cancer, or hoping a diet change might reverse ibd if that’s what it is. Hard to know how to help him. The vet seems keen to try the diet change first before progressing onto steroids, but in my heart I feel it’s unlikely to help him. Like your Boo things like prokolin probiotics makes BC much worse, antibiotics didn’t work, he loved a little homemade chicken bone broth but it goes straight through. He’s recently finished a course of vitamin b injections. He seemed a little perkier in himself but has made no difference to the diarrhoea and his weight is down again.

[Mollycat]

Ok so anything is possible from a congenital issue upward. I'm not certain on this but would he have got this far if it was lymphoma? IBD is manageable up to a point, but only up to a point sadly. From what my vet told me at the time I got the impression the two diseases are almost identical in both symptoms and management options.

One other thought on diet, and I do not know if this applies to cats at all, but many human chronic diseases including many of the digestive issue ones from Crohns to IBS and beyond have a contributory factor in common and that is histamine, or the body having more histamine than it can process. One of the categories of foods to avoid with HI (Histamine Intolerance, though really it's overload not an intolerance) is processed and preserved, ie canned foods. Home cooking fresh ingredients in batches and freezing might well help by reducing histamine, if nothing else. Might be easier than an entirely hydrolysed protein diet, too, and cheaper.

[booktigger]

I missed the year on the original post and was just thinking the exact same thing Molly - I'm sure when I looked into it, the mean average for not treating intestinal lymphoma was months, so I'd be very surprised it is with the length of time, unless it has recently progressed. From my reading, they are very similar, the only way to tell as far as I know is a biopsy, and even they are hit and miss, it depends if they biopsy the right part of the thickened bowel, and as steroids are used for both, I opted to just treat with steroids rather than know for definite.

[Catfan5]

Over the years it’s been treated as an overgrowth of good bacteria hence the antibiotics, which was rather controversial as it wasn’t an infection. Didn’t work anyway. Faecal checks were done and repeated, always negative. Food intolerances were suspected so we tried a hydrolysed diet for a while and to find out what could be causing the diarrhoea. Currently trying the hydrolysed food again and looking into homemade meals.
The bowel changes could be due to years of ibd or it has progressed to cancer. Without biopsies we won’t know as you say. We’ve had two old boys years ago who had cancer, one was ibd related one wasn’t. It took only a few months before they passed away.
Anyway whatever it is I want him to feel better in himself as he has been quite subdued for a while.

[fjm]

Was the antibiotic metronidazole? It acts to soothe the bowel as well as to reduce bacteria levels - Poppy, my toy poodle, has probable SIBO as a result of chronic liver failure and I have found a small dose every 2.5 days just keeps her digestion in reasonable balance. It doesn't work for all animals, though.

If he is eating a complete and balanced food then adding a little home cooked becomes a lot less complicated. I would try something bland and easily digested - eggs would be ideal if he likes them, chicken breast if you have not established chicken as a trigger, poached white fish, etc. Remember that sometimes it takes a while for the bowel to reject a new food, so don't put it on your OK'd list till he has been eating it for a few weeks. Once you know which proteins he can tolerate you can either continue to supplement the commercial or look at moving towards a balanced home cooked diet. If he is on steroids they will increase his appetite, as you know, which does make introducing novel foods easier in some ways.

[Catfan5]

yes that was the antibiotic given. It slowed down the diarrhoea to start with but subsequent courses had little effect. BC’s symptoms seem very like SIBO with the malabsorption in the small bowel and gassiness. In his case it seems the pancreas is involved. But his appetite has increased, constantly hungry but losing weight. He’s having a check up today and will discuss his next step. He loves cooked white fish, usually cod. A couple of days eating this seems to rest his bowel and slow down the diarrhoea. Apart from that he eats complete cat food, hydrolysed at the moment.