By Dr. Becker
Inflammatory bowel disease or IBD is actually a group of diseases involving uncontrolled intestinal inflammation.
IBD in kitties (and other susceptible animals) is thought to be caused by a combination of factors including diet, gut bacteria, environment, and an abnormal immune system response.
What Feline IBD Looks Like
The food your kitty eats is digested en route to the intestines, and is absorbed into the bloodstream from the small intestine.
The walls of the small intestine have tiny finger-like protrusions called villi.
In between the villi are deep crevices lined with cells called enterocytes.
(Visualize the fingers of your hand as villi and the spaces in between each finger as deep crevices, with cells lining the insides of each finger, down into the crevices.)
The job of enterocytes is to absorb nutrients from digested food and pass them into the bloodstream as nourishment for your cat's body.
Enterocytes are extremely important cells.
They are produced at the base of the villi in the deep crevices, and work their way to the top of the villi where they are shed.
Enterocyte cells are constantly replenished so there are always enough available to do the very hard work of nutrient absorption.
In cats with IBD, the normal architecture of the villi is changed.
The villi lose their individual finger-like shape and become flat, shortened, and fused together.
This change dramatically reduces the amount of enterocyte cells available for nutrient absorption.
In addition, inflammatory material fills in the crevices between villi and flattens the gut walls. The intestinal mucosal lining becomes injured and weakened through this process, increasing its permeability and allowing toxins (partially digested proteins and allergens) from the gut to leak into the bloodstream. This is a condition known as dysbiosis, or leaky gut.
How IBD Destroys Your Cat's Health
Symptoms of IBD in kitties as a result of this damage include chronic vomiting, diarrhea and malabsorption of nutrients from food. IBD is the number one cause of GI disturbances in felines.
Toxins circulating in the bloodstream will ultimately trigger a powerful systemic immune response. The result for your kitty can be allergies and/or any number of autoimmune diseases.
Lack of healthy digestion is a common cause of secondary infections in cats as well. Since over half your kitty's immune function is located in his GI tract, compromised intestines lead to a compromised immune system.
Secondary organ failure is common in IBD patients, especially the kidneys and liver. And nutritional deficiencies are a given because chronic GI inflammation greatly interferes with your kitty's ability to process and absorb nutrients from his diet.
With cats there's also a correlation between lymphoma of the GI tract and chronic IBD. Lymphoma is the most common type of feline cancer and accounts for about a third of all cancers in cats. The chronic diarrhea and/or vomiting symptomatic of IBD result in additional inflammation and scar tissue in the lining of the intestines. These changes can then evolve to cancerous cells and progress to lymphoma of the GI tract.
When I suspect a kitty patient has IBD, I like to order functional GI testing using blood samples.
These tests give me information on how well the cat is absorbing both folate (a water-soluble B vitamin) and cobalamin, another B vitamin which binds to protein.
A low folate level indicates one of two things – either the kitty's ability to absorb nutrients is compromised, or there is disease of the small intestine. If the folate level is too high, it can indicate another problem known as SIBO – Small Intestinal Bacterial Overgrowth.
If the cobalamin level is low, it's another indicator that all is not well with the small intestine. Cobalamin levels are a measure of digestion.
I also run two more functional tests – TLI and PLI – which assess pancreatic function. Secondary pancreatitis is a very common condition in IBD cats.
There is another test known as the "confirming" test for IBD, which involves a biopsy to look for changes in the architecture of the GI tract characteristic of the condition. This isn't my first choice because it's invasive, expensive, and involves anesthesia.
Helping Your IBD Kitty
If your cat is diagnosed with IBD, I recommend you work with a holistic/integrative vet to create a comprehensive protocol to address dietary issues and appropriate supplements, including a high quality pet probiotic to heal and reseed the gut with healthy bacteria.
The entire length of your pet's digestive tract, when healthy, is coated with a good balance of bacteria that protects against foreign invaders, undigested food particles, toxins and parasites. Friendly gut bacteria serves as a natural antibiotic and also contains anti-fungal and anti-viral properties. It also promotes appropriate immune response to invaders.
When gut bacteria is out of whack, the intestine walls are essentially unprotected and undernourished. A healthy balance of bacteria provides a rich source of energy and nourishment for the lining of the GI tract.
Depending on your cat's symptoms, your vet may recommend a bland diet, which in my practice means a grain-free menu of cooked ground turkey and canned pumpkin (pure pumpkin, not the filling used in pies) or cooked sweet potato. I don't like the traditional bland diet of beef and rice, because high-fat beef and the tendency of rice to ferment in the intestines can exacerbate problems in the GI tract and pancreas.
When it's safe for your cat to transition from the bland diet, again, I suggest you work with your holistic vet to create a novel protein diet. This will give the GI tract and your pet's immune system a good rest.
After a period of time on the novel protein regimen (I recommend three months), under the guidance of your holistic vet, you should be able to gradually transition your kitty to a balanced, species-appropriate diet, preferably raw.
Other environmental and lifestyle factors you should discuss with your vet are future vaccinations, the use of drug therapy, and any potential toxins in your pet's environment or lifestyle that could be contributing to unaddressed inflammation.