What can we do about our cat’s chronic bowel problem?

Dear Most Esteemed and Knowledgeable Kitties:

We’re having a pretty urgent problem with our Barnie. He is a two-year-old male cat, neutered, and rescued here in Spain. He apparently has a smooth muscle colon problem which is causing him serious pain. He has been x-rayed twice, which showed pockets of gas; this was treated by vet for two weeks initially with an enema and then Flatoril and Purina paste. We have been giving him bran with food. He does his business, which is medium firm, but almost immediately seems to have worse bouts of pain. I take him on little walks when he does a few cat things like scratching his paws and sniffing around where other animals have been, then takes himself off to lie in the long grass. His nose now lacks color, and his posture at times reflects pain. We are worried he does not drink enough and we wonder about electrolyte replacement. We have mentioned ranatadine and cisapride, which are mentioned a lot in the literature, and the vet gives short shrift to this when I mention it. It’s not easy to talk about complicated medical issues in a foreign language. We think he wants to operate, but he says there are risks to this and we sense he wants Barnie put down. We’re probably going to a second vet on Monday for another opinion. But has anyone any experience of managing this kind of problem?

~Susan

Siouxsie: Awww, the poor little guy. It’s no fun to have bowel pain.

Thomas: Although we’re not vets, Susan, we may be able to provide some advice for you and some things to discuss with your vet as well.

Dahlia: From what we’ve read, it sounds like Barnie may be suffering from a form of inflammatory bowel disease (IBD). Typically, IBD is characterized by irregularities in defecation, usually diarrhea; occasional vomiting; and malabsorption of nutrients. In long-standing cases, IBD can result in weight loss, anemia, and malnutrition.

Siouxsie: Colitis, an inflammatory disease of the large bowel or colon, usually occurs as a manifestation of IBD. Signs of colitis include urgent straining, painful defecation, prolonged squatting, gas, and passing many small stools mixed with blood and/or mucus. Defecation is so painful that cats may try to stop pooping, thus causing constipation.

Thomas: Cats showing these symptoms are typically given a round of diagnostic tests including a CBC (complete blood count) to show how many red and white blood cells are circulating. The number of each type of cells can help your vet determine if your cat is anemic (too few red blood cells), has an infection (too many white blood cells), or has an immune system-suppressing disease (too few white blood cells).

Dahlia: Blood tests can also check your cat’s kidney, thyroid, and liver function. In cases of severe chronic diarrhea, for example, the kidneys and liver can be effected. Your vet may test your cat for feline leukemia (FeLV) or feline immunodeficiency virus (FIV), because these diseases suppress your cat’s immune system and can have an impact on your cat’s intestinal bacteria growth.

Siouxsie: The next diagnostic test a vet generally does is to check your cat’s stools for giardia, which can cause a cat to have pale, greasy-looking and rancid-smelling diarrhea. A simple fecal examination, as is done for worms, will not detect giardia. This article from peteducation.com describes giardia symptoms and the methods used to detect the parasite.

Thomas: Once other diseases and parasitic infections are ruled out, the next step in diagnosis is to take a biopsy of the bowel. This is generally done via endoscopy, a minimally invasive exploratory surgery. If your vet doesn’t have the equipment to do endoscopy, however, he may need to do a full abdominal surgery with a relatively large incision.

Dahlia: There are four types of IBD, each of which is a result of a different type of inflammatory cell.  The biopsy will reveal whether or not Barnie has IBD, and if so, which type of cell is responsible. Some types of IBD are treated with antibiotics (typically metronidazole), but all forms of IBD and colitis involve diet changes.

Siouxsie: Because food intolerances can cause or aggravate IBD, vets recommend feeding these cats hypoallergenic diets. Most food allergies are caused by beef, wheat, milk, cheese, eggs, nuts, fruits, tomatoes, carrots, yeast, and various spices and additives. However, other foods commonly found in cat foods should be eliminated as well; this would include tuna, corn (used as the grain in dry cat food), and mackerel.

Thomas: Dr. Richard Pitcairn, in his book Natural Health Care for Dogs and Cats, recommends homemade diets with meats like lamb, chicken or turkey, and grains like rice or millet, since these foods are not typically found in cat foods.

Dahlia: Be careful if you make your own foods, though, because you need to make sure Barnie gets all the vitamins and minerals he needs in order to stay healthy.

Siouxsie: Some people recommend feeding raw meat to cats as part of a homemade diet, but we think you should avoid raw foods right now since Barnie’s intestines probably won’t be able to tolerate such things. We’d recommend that you boil the meat lightly and serve it to him at about rodent body temperature (just over 100 degrees F) instead.

Thomas: Don’t give Barnie cow’s milk. Cow milk tends to cause diarrhea in cats. You can try feeding him plain, unsweetened yogurt, maybe a tablespoon or so a day. The beneficial bacteria in yogurt could help regulate his intestines some. Goat milk might be OK as an occasional treat because it doesn’t have as much fat as cow milk.

Dahlia: I like fresh goat milk, straight from the goat. It’s yummy!

Siouxsie: Mama says she’s been to Spain before and she’s seen lots of butcher stalls and such where you can get fresh meat. In the US, fresh, locally grown meat is not as easily available as it is in Europe and the UK.

Thomas: Another option is to feed Barnie turkey or chicken baby food, warmed up to body temperature. You should get Stage 1 (earliest) baby food and make sure it doesn’t contain any garlic.

Dahlia: Of course, there are a number of pre-made foods for kitties with allergies, such as prescription diets from Hill’s or Purina, or any one of a number of premium, organic hypoallergenic cat foods. We don’t know how easily available such products are in Spain, which is why we started with the homemade diet recommendations.

Siouxsie: If you do try Barnie on a homemade diet, we’d strongly recommend that you talk to a veterinary nutritionist. He or she will be able to help you create a diet that will relieve Barnie’s symptoms and give him the vitamins and minerals he needs.

Thomas: A homemade diet, or a diet featuring hypoallergenic canned cat food, can help you get more liquids into Barnie, too. Canned cat food has a much higher moisture content than dry food, and if you give Barnie home-cooked meat, provide it to him with some “gravy” (the water you boiled it in).

Dahlia: Some forms of IBD are treated with imunosuppressive drugs and corticosteroids. The steroids reduce the inflammation, and the imunosuppressive drugs will turn down the overactive immune-system response causing the swelling. However, long-term use of steroids has its risks, and imunosuppressive drugs lower cats’ resistance to diseases they may encounter in their environment.

Siouxsie: A good vet will be your best guide through treating Barnie’s illness. We hope you can find one who’s willing to work with you, understands why you want to treat his disease rather than putting him down, and is fluent enough in English to help you understand why he or she is recommending certain treatments and tests.

Thomas: A high-fiber diet is usually used to treat cats with colitis. However, if your cat’s problem is IBD, your vet may recommend a low-fiber, low-carbohydrate, high-protein diet instead.

Dahlia: Early on in our Paws and Effect writing days, a reader told us about her success story with treating her cat’s IBD.

Siouxsie: Good luck, Susan. Please let us know how things turn out for you and Barnie.