Need advise on managing IBD. Any success stories?

Sillycat41

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My 15 yr old Bengal was diagnosed with IBD although that diagnosis may not be accurate since I didn't want to put him thru the biopsy procedure at this age. He has had regular blood tests, a special blood tests, x-rays, etc. The vet suggested B12 injections since it was low... other results were okay. The vet suggested we try Prednisolone for the inflammation causes by suspected IBD. I've tried to switch him to a novel protein diet but he has always been a fussy eater and that didn't work. And tried probiotics on his food but he's a very smart cat and can tell when something different is added to his food. As for the typical symptoms of IBD, he has never had diarrhea in his 15 yrs... his stools are normal to slightly hard. He rarely ever vomits up food... just clear foam occasionally with a pink tinge if the irritation is bad. Those are the only symptoms he has really... not sure if food allergies fit because he has beautiful fur and no itchy skin or anything, but I suppose there could be internal symptoms of allergies like IBD causes. I'm also concerned about long term use of Prednisonlone since I've read that it weakens the immune system. I'm so stressed worrying about losing my baby... I'd like to hear from others who successfully treated their beloved cats. Thanks in advance.
 

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daftcat75 daftcat75 will have tons of info.

In the meantime, take a look at these web sites:


When does your cat vomit? Clear vomit before meals usually indicates stomach acid because the tummy is going to long without food.

Some people opt to to an ultrasound instead of a biopsy. Ask your vet about that. My vet diagnosed my cat with IBD by simply palpating the intestines through the abdomen and taking the symptoms into consideration. We did do a biopsy to confirm.

Long term use of pred can result in diabetes. Many cats only need an occasional short course of pred as needed based on symptoms. Diabetes-like symptoms are common while on a high dose of pred but as the dose is tapered off, the symptoms go away.

My IBD is currently being managed with a novel protein diet (a commercial raw brand), pred, and B12. He can't eat chicken and I just found out that he can't eat turkey either. So he only gets rabbit and other novel proteins.
 
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tarasgirl06

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Hello S Sillycat41 and sweet Bengal boy and welcome to TCS! I have not had experience with this and am posting only to give encouragement, *PRAYERS* and best wishes, and to generate interest with others who will hopefully have more helpful information for you. Your boy may have a glossy coat and healthy skin and still need perhaps a change in his diet. Experts often recommend switching foods gradually by decreasing the amount of his regular food while increasing the new food until he is eating this exclusively. I hope you will receive more information very soon!
 

daftcat75

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How did the vet arrive at the IBD diagnosis? Was an ultrasound performed? Without an ultrasound, IBD is just a guess. And frankly, not a very good one given the symptoms you describe. Clear or foamy vomit without food sounds like excess stomach acid. I'm guessing that happens early morning or late afternoon when the length of time between meals is longest. Your easiest fix for now is simply increase feeding frequency. Smaller meals, more often. If he eats twice a day, I would add in a daytime and an overnight meal for him. You can use timed feeders to set out meals that you may not be around or awake to prepare and serve.

My favorite kind of timed feeders are the clamshell design. The wheel design isn't very flexible in feeding schedule and it will rotate uneaten food back inside. The clamshells are also cheap enough to deploy in pairs which is what I recommend. They don't fail to open often (maybe a few times in over 1000 uses in my experience.) But if the cost of failure is an acid barf, redundancy is a very affordable price to pay.

https://www.amazon.com/dp/B07FT93YM2/?tag=thecatsite

My only other pieces of advice in the absence of any symptoms to monitor your progress:

1. Monitor his weight. Buy a baby scale and weigh him no more than once a week, preferably the same time and place each week. If you have the space, leave the scale out for him so it's not something foreign that keeps showing up every Monday morning (or whenever the weekly weigh-in happens.) Then it might be as simple as putting a treat on the scale and herding his butt onto the platform (because you know he'll just try to eat it without getting on it.) As long as he can maintain or gain weight, it is most likely not lymphoma. A biopsy is not needed at this time as long as you keep an eye on his weight.

2. If he's eating dry food, try to cut that out. Dry food is irritating and inflammatory and eliminating it will be the first step in any sane IBD or lymphoma treatment. As a bonus, a few other health conditions that can affect older cats are improved by the elimination of dry food. Kidney disease, dental disease, and diabetes are all greatly improved by the increase in moisture in a diet that comes from eliminating dry food (very dehydrating!) Even the most avid drinkers can't and won't make up the moisture difference at the water bowl that an all wet food diet provides.

B12 sounds good. I'm not convinced steroids or a novel protein are needed without some kind of way to assess progress and measure improvement. In other words, if he's not vomiting and his stools aren't abnormal, how do you know if the food or the steroids are doing anything for him?
 
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Sillycat41

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daftcat75 daftcat75 will have tons of info.

In the meantime, take a look at these web sites:


When does your cat vomit? Clear vomit before meals usually indicates stomach acid because the tummy is going to long without food.

Some people opt to to an ultrasound instead of a biopsy. Ask your vet about that. My vet diagnosed my cat with IBD by simply palpating the intestines through the abdomen and taking the symptoms into consideration. We did do a biopsy to confirm.

Long term use of pred can result in diabetes. Many cats only need an occasional short course of pred as needed based on symptoms. Diabetes-like symptoms are common while on a high dose of pred but as the dose is tapered off, the symptoms go away.

My IBD is currently being managed with a novel protein diet (a commercial raw brand), pred, and B12. He can't eat chicken and I just found out that he can't eat turkey either. So he only gets rabbit and other novel proteins.
Thanks for the replies and links. I should have included more info in my post, but it was getting kind of long. Jengo usually vomits during the night, but also during the day if he goes for a long time without eating. I try to feed him every 4 hours which seems to help. I'm retired so that usually works and I get up 3 times during the night to feed him. However if I have to be gone for 6 hours during the day I leave food for him in a timed feeder. Unfortunately he usually doesn't eat when I'm not here to coax him so I often find foamy vomit somewhere when I come home.

My vet agrees that a biospy would not be good for him at his age. I don't recall if he had an ultrasound though... going thru my records the other two cats had ultrasounds. I'll have to check with the vet. He was on 2.5 mg Prednisolone twice a day for at least a month and then weaned down to a 2.5 mg. twice a week. He still vomited occasionally while on the higher dose. He was on B12 shots twice a week for a couple of months and the vet said 1 shot a month is okay now.

He's a high strung, nervous cat and only weighs 9 lbs... his younger weight was 11 lbs... and has always been a fussy eater. Getting him to eat is a huge problem... I'm so afraid of him losing weight. I have been buying premium brands of rabbit and duck for novel protein... he'll eat a couple of meals and then he turns his nose up at them. He doesn't like dry food... only eats pates. Having a hard time getting him to eat at all... only eats a TB of food and quits.. hence feeding his many times during the day with a lot of coaxing. I even tried feeding raw... that didn't work either.

It's so stressful dealing with his health problems... I'm so afraid I'm losing him because I can't find a solution that works. I lost a beautiful 10 year old in May to intestinal lymphoma... didn't see that coming. Hopefully I can learn from other people's experiences. Thanks again.



 

daftcat75

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How is his teeth? Cats can hide dental pain. But it could be a reason why he isn’t eating much. Another possibility is pancreatitis which can happen with frequent vomiting. It isn’t a standard blood test. It is frequently overlooked. If his kidneys are okay and his thyroid checks out (these are easy enough to test and your vet has probably already have cleared him of these), then it could just be old age. Your vet can prescribe anti nausea and appetite stimulant drugs to help out here. There’s a transdermal appetite stimulant called Mirtaz. Easy as giving him a medicated wet willy in the ear. 😹 Regardless of what might be ailing him, keeping him eating and maintaining his weight will be the single best health step you can take for him. Conversely if he starts losing weight despite eating enough, that’s a dead giveaway of a developing disease process.

So Im still inclined to reject the theory that this is IBD especially in the absence of butt or gut symptoms. I still believe this is too much stomach acid. And since you are feeding multiple times a day already, then I would look into why he is not eating enough. Get him eating healthy amounts again and he likely won’t have that excess stomach acid anymore.
 
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Sillycat41

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How did the vet arrive at the IBD diagnosis? Was an ultrasound performed? Without an ultrasound, IBD is just a guess. And frankly, not a very good one given the symptoms you describe. Clear or foamy vomit without food sounds like excess stomach acid. I'm guessing that happens early morning or late afternoon when the length of time between meals is longest. Your easiest fix for now is simply increase feeding frequency. Smaller meals, more often. If he eats twice a day, I would add in a daytime and an overnight meal for him. You can use timed feeders to set out meals that you may not be around or awake to prepare and serve.

My favorite kind of timed feeders are the clamshell design. The wheel design isn't very flexible in feeding schedule and it will rotate uneaten food back inside. The clamshells are also cheap enough to deploy in pairs which is what I recommend. They don't fail to open often (maybe a few times in over 1000 uses in my experience.) But if the cost of failure is an acid barf, redundancy is a very affordable price to pay.

https://www.amazon.com/dp/B07FT93YM2/?tag=thecatsite

My only other pieces of advice in the absence of any symptoms to monitor your progress:

1. Monitor his weight. Buy a baby scale and weigh him no more than once a week, preferably the same time and place each week. If you have the space, leave the scale out for him so it's not something foreign that keeps showing up every Monday morning (or whenever the weekly weigh-in happens.) Then it might be as simple as putting a treat on the scale and herding his butt onto the platform (because you know he'll just try to eat it without getting on it.) As long as he can maintain or gain weight, it is most likely not lymphoma. A biopsy is not needed at this time as long as you keep an eye on his weight.

2. If he's eating dry food, try to cut that out. Dry food is irritating and inflammatory and eliminating it will be the first step in any sane IBD or lymphoma treatment. As a bonus, a few other health conditions that can affect older cats are improved by the elimination of dry food. Kidney disease, dental disease, and diabetes are all greatly improved by the increase in moisture in a diet that comes from eliminating dry food (very dehydrating!) Even the most avid drinkers can't and won't make up the moisture difference at the water bowl that an all wet food diet provides.

B12 sounds good. I'm not convinced steroids or a novel protein are needed without some kind of way to assess progress and measure improvement. In other words, if he's not vomiting and his stools aren't abnormal, how do you know if the food or the steroids are doing anything for him?
How did the vet arrive at the IBD diagnosis? Was an ultrasound performed? Without an ultrasound, IBD is just a guess. And frankly, not a very good one given the symptoms you describe. Clear or foamy vomit without food sounds like excess stomach acid. I'm guessing that happens early morning or late afternoon when the length of time between meals is longest. Your easiest fix for now is simply increase feeding frequency. Smaller meals, more often. If he eats twice a day, I would add in a daytime and an overnight meal for him. You can use timed feeders to set out meals that you may not be around or awake to prepare and serve.

My favorite kind of timed feeders are the clamshell design. The wheel design isn't very flexible in feeding schedule and it will rotate uneaten food back inside. The clamshells are also cheap enough to deploy in pairs which is what I recommend. They don't fail to open often (maybe a few times in over 1000 uses in my experience.) But if the cost of failure is an acid barf, redundancy is a very affordable price to pay.

https://www.amazon.com/dp/B07FT93YM2/?tag=thecatsite

My only other pieces of advice in the absence of any symptoms to monitor your progress:

1. Monitor his weight. Buy a baby scale and weigh him no more than once a week, preferably the same time and place each week. If you have the space, leave the scale out for him so it's not something foreign that keeps showing up every Monday morning (or whenever the weekly weigh-in happens.) Then it might be as simple as putting a treat on the scale and herding his butt onto the platform (because you know he'll just try to eat it without getting on it.) As long as he can maintain or gain weight, it is most likely not lymphoma. A biopsy is not needed at this time as long as you keep an eye on his weight.

2. If he's eating dry food, try to cut that out. Dry food is irritating and inflammatory and eliminating it will be the first step in any sane IBD or lymphoma treatment. As a bonus, a few other health conditions that can affect older cats are improved by the elimination of dry food. Kidney disease, dental disease, and diabetes are all greatly improved by the increase in moisture in a diet that comes from eliminating dry food (very dehydrating!) Even the most avid drinkers can't and won't make up the moisture difference at the water bowl that an all wet food diet provides.

B12 sounds good. I'm not convinced steroids or a novel protein are needed without some kind of way to assess progress and measure improvement. In other words, if he's not vomiting and his stools aren't abnormal, how do you know if the food or the steroids are doing anything for him?
As I mentioned to LTS3, I don't recall if he had an ultrasound because the other two cats did. I'll have to check with the vet clinic. The vet did do x-rays though and is basically treating him for IBD because of the symptoms and special blood test that was send to a vet school in Texas... results were low B12. I also thought that vomiting clear foam sounds more like a stomach acid problem. Yes, it happens usually very early in the morning... 5 ot 6 am. I fed him every 4 hours hoping to calm his stomach. I get up 3 times during the night to fee d him even though he only eats a TB at a time.

I do have a couple of timed feeders that I use when I am away for the day. I'm retired so most of the time I'm here to feed him. I do monitor his weight as I know that is very important. I should get baby scale for more accuracy though.
He has never liked dry food and only like pate. I mix water with it since he is not an avid drinker in spite of liking the fountain.

I give him 1/2 Cerenia occasionally for vomiting, but it can't be used regularly. I'm always nervous about giving my cats medications. My vet wants to put him back on the high dose of Prednisolone. Thanks for sharing your opinions.
 
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Sillycat41

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How is his teeth? Cats can hide dental pain. But it could be a reason why he isn’t eating much. Another possibility is pancreatitis which can happen with frequent vomiting. It isn’t a standard blood test. It is frequently overlooked. If his kidneys are okay and his thyroid checks out (these are easy enough to test and your vet has probably already have cleared him of these), then it could just be old age. Your vet can prescribe anti nausea and appetite stimulant drugs to help out here. There’s a transdermal appetite stimulant called Mirtaz. Easy as giving him a medicated wet willy in the ear. 😹 Regardless of what might be ailing him, keeping him eating and maintaining his weight will be the single best health step you can take for him. Conversely if he starts losing weight despite eating enough, that’s a dead giveaway of a developing disease process.

So Im still inclined to reject the theory that this is IBD especially in the absence of butt or gut symptoms. I still believe this is too much stomach acid. And since you are feeding multiple times a day already, then I would look into why he is not eating enough. Get him eating healthy amounts again and he likely won’t have that excess stomach acid anymore.
Sorry, I should have mentioned that he did have his teeth checked, cleaned and had one pulled. He has always had regular dental cleaning. Didn't know there was a special blood test for pancreatitis... will ask my vet. I have a script for Cerenia and give him 1/2 a pill occasionally when he vomited but it's not something the vet recommended for regular use. I'll ask the vet about the Mirtaz... definitely advantage to transdermal since he is very hard to pill. Have you ever heard of giving cats the original Pepcid for stomach acid? I read that somewhere. However my vet rejected that idea. :(

He's pretty active for his age... 15 yrs. He is very smart but high-strung and nervous. He walks on a cat wheel for an hour or two a day.
:runningcat:My vet said he's the most muscular cat he's ever seen. He's my soul mate and I'd do anything to help him as my vet bills for the last year would show. :ohwell:
 

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daftcat75

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Sorry, I should have mentioned that he did have his teeth checked, cleaned and had one pulled. He has always had regular dental cleaning. Didn't know there was a special blood test for pancreatitis... will ask my vet. I have a script for Cerenia and give him 1/2 a pill occasionally when he vomited but it's not something the vet recommended for regular use. I'll ask the vet about the Mirtaz... definitely advantage to transdermal since he is very hard to pill. Have you ever heard of giving cats the original Pepcid for stomach acid? I read that somewhere. However my vet rejected that idea. :(

He's pretty active for his age... 15 yrs. He is very smart but high-strung and nervous. He walks on a cat wheel for an hour or two a day.
:runningcat:My vet said he's the most muscular cat he's ever seen. He's my soul mate and I'd do anything to help him as my vet bills for the last year would show. :ohwell:
The only thing Pepcid did for my Krista was classically condition her (Pavlov) to respond to the microwave timer like it was a dinner bell. I had to give it to her 30 minutes before meals. I would set the timer on the microwave. And although she would only take this for a couple of weeks, the remainder of her life I would have to stop the microwave before the beep if I didn’t want her running into the kitchen and pestering me for a meal no matter what time it was or when I last fed her. 🤦🏼‍♂️🐷

Because his acid barfs are before meals and not after them, Pepcid won’t do what you think it will. Stomach acid production before a meal is normal and expected. That’s not the problem. The problem is that the meal doesn’t come in time. Cats aren’t nocturnal but diurnal. That means they are most active at dawn and dusk. The early bird gets the worm. The early cat gets the bird. Their bodies will also produce the most stomach acid just before these times in anticipation of the meals they will be having soon. So either you shift his first breakfast and first dinner to these times or just set out timed feeders. Because often cats jump the gun and want to be fed before dawn and before dusk. I would set out two feeders for Krista and have them open about two hours apart so that however fast her clock might be running, there’d likely be a feeder of food waiting for her. Towards the end, it was like keeping a bus schedule and it seemed like I was always picking up a plate or a feeder and putting down another in its place. She had lymphoma and was on steroids though. Always hungry and pooping it all out. 😿😔

But yeah. In the absence of any other symptoms, I would just work with your vet on his appetite and keep putting out overnight feeders. Make sure one is popping open at 3:30 or 4 am.

If the Cerenia and Mirtaz don’t help and he’s cleared for pancreatitis, then you may have to do another dental check. Some extractions go better than others. Some vets are more skilled than others. It wasn’t uncommon for Krista to go back two or three times to look for any root fragments missed from the last extraction. She had resorption though. Her body was eating her teeth from the roots up. Nasty business. If that’s why your guy’s tooth was removed, he may very well need another dental already. And perhaps a consultation with a dentist for a long-term proactive maintenance or monitoring plan. Krista ended up needing all her remaining teeth removed because she was miserable having them go one by one. My only regret is that I didn’t do that sooner for her.

But I’m digressing and getting ahead of things. The next time he goes into the vet, you could ask about the pancreatitis blood test. And if you still can’t figure out his appetite even with Cerenia and Mirtaz, you may want to see about another dental.
 
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Sillycat41

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The only thing Pepcid did for my Krista was classically condition her (Pavlov) to respond to the microwave timer like it was a dinner bell. I had to give it to her 30 minutes before meals. I would set the timer on the microwave. And although she would only take this for a couple of weeks, the remainder of her life I would have to stop the microwave before the beep if I didn’t want her running into the kitchen and pestering me for a meal no matter what time it was or when I last fed her. 🤦🏼‍♂️🐷

Because his acid barfs are before meals and not after them, Pepcid won’t do what you think it will. Stomach acid production before a meal is normal and expected. That’s not the problem. The problem is that the meal doesn’t come in time. Cats aren’t nocturnal but diurnal. That means they are most active at dawn and dusk. The early bird gets the worm. The early cat gets the bird. Their bodies will also produce the most stomach acid just before these times in anticipation of the meals they will be having soon. So either you shift his first breakfast and first dinner to these times or just set out timed feeders. Because often cats jump the gun and want to be fed before dawn and before dusk. I would set out two feeders for Krista and have them open about two hours apart so that however fast her clock might be running, there’d likely be a feeder of food waiting for her. Towards the end, it was like keeping a bus schedule and it seemed like I was always picking up a plate or a feeder and putting down another in its place. She had lymphoma and was on steroids though. Always hungry and pooping it all out. 😿😔

But yeah. In the absence of any other symptoms, I would just work with your vet on his appetite and keep putting out overnight feeders. Make sure one is popping open at 3:30 or 4 am.

If the Cerenia and Mirtaz don’t help and he’s cleared for pancreatitis, then you may have to do another dental check. Some extractions go better than others. Some vets are more skilled than others. It wasn’t uncommon for Krista to go back two or three times to look for any root fragments missed from the last extraction. She had resorption though. Her body was eating her teeth from the roots up. Nasty business. If that’s why your guy’s tooth was removed, he may very well need another dental already. And perhaps a consultation with a dentist for a long-term proactive maintenance or monitoring plan. Krista ended up needing all her remaining teeth removed because she was miserable having them go one by one. My only regret is that I didn’t do that sooner for her.

But I’m digressing and getting ahead of things. The next time he goes into the vet, you could ask about the pancreatitis blood test. And if you still can’t figure out his appetite even with Cerenia and Mirtaz, you may want to see about another dental.
I see your point about Pepcid. Plus he needs the stomach acid to digest meals as I read that he may not be getting all the nutrients out of his food because of IBD... if that's what he has. I bought some expensive pre & probiotics that the vet clinic sells. Stupid idea... should have known better. Whenever the instructions say "sprinkle it over their food" that means they can smell it and it turns them off. Cats aren't stupid... you can't fool them! He wouldn't touch his favorite food with that stuff on it!!

Anyway, I realized that frequent meals meant less vomiting so I started feeding him small meals about every 4 hours... yes during the night too. I don't get much sleep any more. :-( That seemed to help but occasionally he would still throw up... last night about 2:30 AM... even though he ate something around 12:45. You're right about the dawn and dusk feeding though... seems like the time he usually vomits is around 5 or 6 AM so I try to feed him before that. He is also more interested in food during the night. During the day I have to sit with him and coax him to eat.

As for timed feeders.... he doesn't eat much when I use them if I'm gone for part of the day... most of the food it still there when I get home. :-(

He has had a check-up since the tooth extraction and the vet said everything looked good. He's a really good vet and I trust his judgement. I doubt that is the problem because I could tell when his mouth was sore and it seems fine now.

Thanks for the tips.
 
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