Help me troubleshoot: IBD in kitty

[MommaMare]

Miss Daisy Kitty has never been quite “right” digestively since we got her from the shelter two and a half years ago. She had the runs more often than not, and would have vomiting episodes. We had bloodwork done, and an ultrasound and barium x-ray after a particularly bad vomiting episode. Tried Pepcid, tried probiotics at vet’s suggestion - no help. We switched to a grain-free, no-chicken food and that seemed to help, a little.

Then the poo turned bloody and jelly-like and we went in again and the rule-out diagnosis was IBD. A definitive diagnosis requires endoscopy and a biopsy done under general anaesthesia, which is not financially in the cards right now. She went on metronidazole and switched to a more limited ingredient, novel protein food and WOW - for the first time ever she had normal poo and wasn’t vomiting.

But as we started to taper down the metronidazole it all came back, and she started to poop just outside the litterbox, too. Vet says well, she just may need to stay on the metronidazole forever and at a higher dose, which is fine - so we’ve bumped her back up - but this time we’re not seeing much improvement.

I don’t think this is an allergy issue. We try our best, but have four very young kids and a dog and so her diet is not limited to just her cat food - if a kid drops something on the floor (spaghetti noodle, chicken nugget), she’s over there as quick as a flash to clean it up, and since the metronidazole, eating weird stuff doesn’t seem to trigger any vomiting episodes. We can pursue allergy testing, but that just doesn’t sound like the problem to me.

Vet says we can always try pred, but I’d rather exhaust our other options first. So: do we just need to give the metronidazole longer to work? She’s been on the highest dose (which helped before) for five days now, and we’re not seeing any improvement. And what’s up with the pooping everywhere? I’m guessing it hurts to go and she’s associating that with her litterbox, since she still uses it to pee. She poops just outside the box, usually, so it’s not like she gets the urge and can’t hold it. I set up a new litterbox with different litter last night to see if that helped. I left the old one up, too, and she chose the old one to pee - I didn’t get a chance to check the state of things this morning.

Are there other things we should be doing or trying? The poor kitty has got to be really uncomfortable, and we want to find a long-term, sustainable solution if we can. I’m aware that these cats often just need a lot of mixing up the treatments as symptoms come and go, but how much mixing up can be done? Are there options besides metronidazole and pred? TIA!

[x-halt-salute]

Hey JJI! I am so sorry you and your kitty are dealing with this. I’ve been through the very same ringer with my cat and it can be so incredibly frustrating – especially when you can’t figure out how to make a sick pet more comfortable. My cat’s story/symptoms are very similar to yours’. The poop just outside the box, the bloody jelly-like stool, the vomiting – all the story of my cat’s life.

Just FYI, here’s a rundown of what we’ve tried with my cat and the results. IBD diagnoses seem to cover a pretty broad range of GI disease, esp. without biopsies. So ymmv, but in case it is of interest to you we tried:

1. Switch from “regular” Royal Canin kibble to grain-free Taste of the Wild kibble: produced some semi-formed stool, but no real change. Tried various other formulas with similar results.
2. Switch from grain-free kibble to prescription allergy-safe kibble diet: No real change.
3. Switch from kibble to all canned food: Reduced vomiting dramatically. Stool still soft-to-liquid. Some “flavors” are better tolerated than others, but overall we found Fancy Feast Classic caused less GI upset than most of the fancy brands (Blue Basics, Natural Balance LID, Nature’s Variety Instinct). My vet was not onboard with this change (citing dental health), but it did lead to improvement.
4. Metronidazole: produced semi-solid stool for a matter of days. No long-term improvement
5. Prednisalone: Glory, hallelujah! This created solid, non-bloody stool for the first time in years. Truly miraculous for my cat. However, we’re on a cycle where we give it in response to GI upset, then taper it off. Eventually (usually a matter of months after we withdraw the prednisalone) the diarrhea and sometimes vomit return and we start prednisalone all over again. But this has so far been the most effective tool for managing her pain/digestion.
6. Raw diet. A lot of vets advise against this, esp. for cats with compromised immune systems or GI tracts, but things got so bad during my cat’s last episode that I figured the cat and I had nothing to lose by trying it. So far this has made my cat’s digestion so much more normal! Perfectly formed stool and no vomit! I’m still transitioning my cat to a fully raw diet so it’s too early to report on long-term outcomes, but so far it has created a happier, healthier, less stinky cat. I’ve got my fingers crossed that it will reduce our dependence on prednisolone…

Best of luck to you and your cat!

[SquishTheBunny]

Prednisone (or Prednisilone - NOT the same but do work fairly similar).

It will help settle the IBD gut, then when symptoms have resolved, you slowly taper down to a low dose, or wean down to nothing.

Diet is very important too…stay on a novel protein diet as well.

Im not sure why so many are hesitant to do a prednisone trial, in cats there are very few side effects especially at the low doses which are used for IBD. Our IBD cat wason 5mg per day (tapered down to 2.5 now), and he does VERY well on it. He eats well, no major increase in thirst or urination (dogs will often have this side effect more frequently than cats).

Its a great drug in the essence that you can taper down once the GI system has responded. So its not necessarily something you have to keep your cat on forever…especially if the gut responds well to a novel protein food.

My old cat was on 25 mg per day (GI lymphoma) and tolerated it well…so 5mg most cats handle like its nothing

Worth a try in my opinion.

You can also try raw, but as another poster indicated - there are concerns with this when there is already a compromised GI tract. It may be safer to home cook tat first if you want to go that route until the diarrhea resolves (then switch over to raw).

[oliverreed]

My IBD cat has been on pred (low dose, every other day) for YEARS and he is mostly fine. Sometimes has runny poop which is NOT fun on a white persian (YUK), but he is usually just fine.

[witherbee]

I have an old kitty with diarrhea too, and we have tried a few of the things mentioned. I have noticed an issue with my other cats lately too, and the chihuahuas who sometimes get into the cat food. I am planning to change the cat’s food and wondered what “novel protein” is - is that a brand?

I hate changing food because they are so darn picky. They hated all of the “good” wet cat food and it is too expensive to waste. They also aren’t great about the “good” dry food, but I think the crap I am feeding them now (which they love) may be the culprit.

[ChocoMare]

I have and IBD kitty too. Did do a course of steroids and it helped for a while until…

While it’s not totally firmed her up, giving Petals a Tablespoon of pureed pumpkin two to three times a day has helped. At least they’re patties and are in the box! She even “asks” for it by stomping the bowl & howling at me. :winkgrin: