Should my IBD cat be on steroids?

Wendy0910

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My 10 year old kitty was diagnosed with IBD after an ultrasound. She started throwing up hairballs about every other day and so I took her in for a check-up.

Initially the vet prescribed Temaril-P (combo antihistamine and prednisolone) because I was suspecting flea allergies (she gets supervised outside time). Also she has always been a bit of an excessive groomer and it is shedding season. (Her bloodwork was normal at this visit.) About a week after the vet visit I called the vet because my cat started having convulsions. She was still throwing up hairballs and so the vet wanted to get her in for an ultrasound right away. She got an ultrasound that week and was diagnosed with IBD.

About a week after the ultrasound she stopped throwing up hairballs and she has not had one since. When I got the diagnosis, the vet told me to finish the pills and that was it for medication. I told the vet that I had been researching IBD and the limited ingredient diet and she said we were on the same page in terms of treatment. She gave me a prescription for Science Diet cans and that was it.

Most of the pills did not end up in my cat and instead were lost to the tuna juice (or whatever other trick I was trying to get her to take the pills). In all honesty I gave up on medication and focused more on grooming her as much as possible to avoid the hairballs. (This was before I knew about the IBD.) I also got her on a prescription flea treatment because the over the counter stuff was no longer working. The Bravecto seemed to do the trick.

After the IBD diagnosis I switched her to a novel protein diet and have been trying all kinds of canned food, but she loves her Sheba. She is very very picky when it comes to canned food. She also loves her kibble. I have also tried freeze-dried raw (without success) and the goal is to transition her completely to raw. I feel that I have had some success getting her off the Purina One onto Farmina N&D lamb, but other than that there has been no progress.

I have been super stressed because I do not want the inflammation to get worse and I do not feel like I am doing enough. I have read that steroids are really best for symptom flare-ups only but then it seems like some IBD cats are on steroids long-term. My cat is a very high-strung anxious cat and so it is especially hard getting medicine in her. I was wondering about a steroid shot but maybe that is too drastic at this stage.

Anyway, the last couple of weeks she has been eating grass and then throwing up white foam with grass in it. This happens about every second or third day. She has done this off and on in the past but now that I know about her diagnosis any vomiting raises a red flag for me.

I am not too crazy about the current vet and so my plan was to take my cat back to the old vet to get a second opinion about medication. I left the other vet practice last year because of some very major and very legitimate concerns. I really liked the vet personally but there were some issues with the owner of the practice and the way it was being run. The vet that gave me the IBD diagnosis seems clinically knowledgeable but I think she is more of a dog person. I also feel there is a lack of information and very poor follow-up.

I was hoping to avoid any vet visit at this point and just work on her diet. But given the white foam with the grass, should I get her in for a steroid prescription? She has no other symptoms and so I do not know if I should save the steroids for later.

Sorry for the long post. Thanks everybody!
 

fionasmom

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Inflammatory Bowel Disease In Cats – TheCatSite Articles
Inflammatory Bowel Disease in Cats
Inflammatory Bowel Disease

Welcome to The Cat Site! The articles above may give you a little more insight into IBD. A number of your concerns are addressed between the three. I understand your concern about beginning steroid use if it can be avoided currently, the vomiting, and the diet. The use of steroids' is a frequent solution, but you have some issues regarding that which you want to discuss with your vet.

Feline IBD
IBDKitties – Helping Save Lives…One Paw at a Time

The above may help as well.

daftcat75 daftcat75 ?
 

Meowmee

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Usually for ibd you do us then treat and see if it responds, then do a look see etc.- have you tried not letting her ear grass? I managed to get Merlin’s ibd runs controlled with a home cooked diet and only one canned food. A grain free diet. He was on steroids for a while then I weaned him off and as we switched to hc completely. He also had numerous other treatments for possible parasites and c diff as well.
There are a few supplements which may help but they made him worse so I stopped them. Sacchamoryces boulardi and various probiotics etc.
 
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Wendy0910

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Thanks for the responses. I did a lot of reading on this site when I got the diagnosis but I need to go through the info again. There was so much to take in at one time!

Meowmee, thank you for what you said about the grass. I have cut it as low as possible and I try to keep her away but I need to take more drastic action. I imagine the vomiting is very irritating. There are other areas of grass she likes but this one area is her favorite and if I can eliminate that completely then I can solve some of the problem.

I am sorry to hear the supplements did not work for your cat. I have some on order so I will see what happens.
 

Orcachic

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Hi. I have an IBD kitty 5 yrs old. He doesn't vomit as mich as yours but he has constant bowel pain..he is always squatting everywhere and crying in pain..and has explosive liquid bowels. The steroids helped a lot..and he was placed on a hydrolyzed protein diet..it is very expensive. But it helps when he doesn't get into ANY other food..such as the foos for my other 6 cats. He likes their food much more than the diet food...and he actively seeks it..opens cabinets..looks for any morsel he can find..plus he steals human food. I can't blame him as he always feels hungry. I've been worried about long term steroids but we have to..because it is all that helps his pain. It's a kibble food...Royal Canin hydrolyzed protein..but my vet was very clear..he will die of his IBD before he ever dies of urinary stones. So basically..if your cat reallyneeds the steroids...its a pros versus cons situation. For mine..the pros outweight the cons.
 

daftcat75

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“The food you eat can be either the safest and most powerful form of medicine or the slowest form of poison.”

The best treatment for IBD is dietary. No amount of medicine can solve IBD without eliminating the dietary sources of inflammation. My biggest regret with Krista's treatment was what I called, "our devil's bargain." I wrapped her nightly steroid pill in a fish flake. I knew it was a trigger for her. But I figured getting her to take her medicine daily was more important and it was such a small amount each night. And her vet couldn't tell me one way or another why her remission was incomplete. It wasn't until a severe middle ear infection (probably brought on by months of eating a trigger on a nightly basis 🤦‍♂️) required a surgery, activity restriction, and forced my hand to change the way I medicated her. I finally got her on transdermal prednislione (a nightly wet willy in the ear) and her remission was immediate. Sadly, she had been on steroids for so long and she had lost so much weight to GI lymphoma (what IBD can progress to if it is not managed properly) that a bladder infection would prove too much for her a couple months post-remission. 😿🌈

Keep a detailed food journal of what you feed, when you feed, and whether she has a butt or gut reaction, including hairballs. Hairballs are basically a signal that her gut is inflamed and/or not working as well as it should. Cats should be able to pass ingested hair in their stool.

Dry food and IBD are pretty much incompatible. There's just too many inappropriate (plant protein, grains, starches), nonsense (fruits, vegetables, flaxseeds), and possible allergens (chicken and fish ingredients) and irritants (gums, oils, and seeds) in dry food to conduct any kind of meaningful food trials/trigger investigations.

A limited ingredient diet is best. But only if it truly is limited ingredient and not some marketing gimmick on the label. For example, one "limited ingredient diet" brand includes both clay and cranberries in the recipe. Neither of these are essential. They fit somewhere between the nonsense and possible irritants. What is truly limited ingredient? Meat, moisture, organs, and supplements. Organs are sometimes called byproducts. It's an unfortunate name but it's not as bad as it sounds. It means that when a processor sells the primary product, the meat, what is left over that they are still allowed to sell (hint: it's not lips and buttholes!), that's called byproducts. It is the byproduct of the meat industry. AAFCO has strict definitions for what is allowed to be included and called byproducts. That's basically a mixed bag of organs. For a cat, that's perfect. They eat whole prey. There is no byproducts as far as the cat is concerned. The only drawback of byproducts (that I would concern myself with) is that their source is often too generic: "poultry byproducts" or "meat byproducts". And while these are also regulated definitions, poultry can include chicken (a potential allergen) or it could include turkey or duck which can be novel proteins. One other potential source of irritants is the gums and thickeners in wet food. Carrageenan and agar agar should be avoided. Not every cat is sensitive to these. But they are known irritants to many cats. Xanthan gum makes smooth foods smooth. It can also make poops smooth. Mousse in, mousse out. Guar gum is mostly harmless. Some are sensitive to this one, but a lot fewer than the others. Krista and I are/were undecided on locust bean gum and cassia gum. They often appeared with other gums making it difficult to say which one might have been irritating. And now you see why you need limited ingredient recipes to sort these details out.

Coming back to novel proteins, they only have to be novel to your cat; not all cats. For many cats, a switch to turkey or duck is novel enough if they have been eating chicken and fish their whole life (as long as there aren't other chicken or fish ingredients further down the list.) For others, rabbit is a better protein. But it's harder to source and find in a good recipe. Rawz is basically the gold standard for IBD cats because their pates are truly limited ingredient and they come in a number of single proteins and novel proteins. They will send you samples if you write them. There are some online retailers who will also sell their food by the can rather than the case.
Where to Buy | RAWZ

Many guardians of IBD kitties find that ultimately homemade (raw or cooked) is the best way to manage their cat's IBD. That's because they have the most control over the ingredients and often it is the closest to what nature intended. If you decide to start with commercial raw, I recommend a boneless recipe. Bone tends to be difficult for IBD cats to pass. It can be constipating too. Darwin's Lamb flavor is a boneless recipe. Their other flavors have bone. Stella and Chewy's has boneless frozen medallions. They also have recipes with ground bone. Commercial raw doesn't always tell you if it has bone in it. This isn't fool-proof, but if you see a calcium supplement in the ingredients, it is more probably boneless. But then Tiki Cat's raw has both ground bone and a calcium supplement. So now you can understand why homemade is where we ultimately end up.

There's so much good stuff on this site about IBD, raw feeding, homemade, and other feline nutrition and health articles.
StackPath

If you do need to use steroids (or any of many other medicines), I highly recommend getting them compounded into forms that are either highly appealing (flavored liquids or treats) or easy to administer (oral paste or transdermal.) Steroids should probably be compounded to transdermal to ensure compliance. Steroids can be difficult on the body if they are given erratically rather than a consistent schedule. Wedgewood is my favorite compounding pharmacy. Your vet will need to call or fax the prescription in. But then you can choose the form the medicine is compounded into. Their support is excellent and you can often speak directly with one of their pharmacists if you have a question their support can't answer.
Veterinary Pharmacy

Lastly, if you have access to an internal medicine specialist, I would definitely choose to work with a specialist over a general vet. Many general vets have one or two treatment modes: prescription food and/or pred. You want someone who is knowledgeable, experienced, and focused on your case, rather than a jack of all trades, master of none.
 
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daftcat75

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Cut out the grass. Some cats can eat grass without ill effects. But for many, grass is eaten specifically to help them vomit. It's not a useful instinct when house cats aren't eating as much inedible matter (fur, feathers, and bones) as their wild counterparts who ate grass to purge those bits from their stomach. The other trouble with grass is that the grass barfs could contribute to the inflammation in IBD and it would make identifying other dietary triggers that much harder.

Another tip is smaller, more frequent meals are easier for IBD cats than two daily gut bombs. Krista did a whole lot better on two breakfasts, two dinners, and daytime and overnight meals in timed feeders. Only wet food for her.
 

LTS3

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Pilling tips:

Pilling Cats: Must-know Tips For Hiding Pills – Cat Articles
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Pill Pockets are sold at any pet stores so go buy a bag and see if that helps to get pills into the cat. One thing to note: all the varieties of Pill Pockets contain chicken, even the salmon one, and many IBD cats have an intolerance to chicken. I personally use a bacon flavored pill dough for my IBD cat's pred pills. My IBD cat doesn't need steroids all the time. We do a short course every couple of months depending on symptoms

The steroids will help with IBD flare ups so, yes, your cat needs to be on it until the IBD is under control. If pills are really a problem even with trying all of the tips above, have the steroid compounded into another form like a transdermal gel or a flavored chew treat.

When does your cat eat the grass? My IBD cat will throw up grass if he eats some too soon before a meal. I guess grass just irritates his hungry tummy.
 
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