By Dr. Becker
The term irritable bowel syndrome (IBS) is often used interchangeably with inflammatory bowel disease (IBD), but they are actually somewhat different conditions. However, left untreated, I believe IBS can progress to full-blown IBD in cats. In IBD, there is chronic inflammation of the bowels. However, kitties with IBS usually have what I call “consistently intermittent” inflammation, meaning it comes and goes, but does so dependably.
Irritable bowel syndrome, also often called “sensitive stomach,” is actually less common in cats than IBD and other GI diseases, but it may not seem so, because when a kitty’s digestive issues aren’t accurately or thoroughly diagnosed, they are often lumped into the category of IBS.
Potential Causes and Symptoms of IBS in Cats
There are a handful of suspected causes of “true” IBS, including:
- Abnormal colonic myoelectrical activity and motility
- Changes in neural or neurochemical regulation of colonic function
- Dietary intolerances
- Lack of dietary fiber
The most common symptoms of irritable bowel syndrome in kitties involve intermittent-but-consistent bouts of diarrhea, frequent trips to the litterbox to pass small amounts of poop and mucus and constipation. Some cats also suffer from abdominal pain, bloating, nausea and vomiting.
Diagnosing Irritable Bowel Syndrome
IBS is a diagnosis of exclusion, meaning it’s the diagnosis we arrive at after every other condition with similar symptoms is ruled out. Most gastrointestinal (GI) disorders share a long list of symptoms, so there’s a lot to rule out before deciding on a diagnosis of feline IBS. Some of the conditions that may need to be ruled out include:
- Intestinal worms (e.g., whipworms) or parasites (e.g., giardia, coccidia)
- Inflammatory colitis
- A bacterial, fungal or other type of infection (e.g., pythiosis)
- Tumors of the colon
- Abnormal turning of the intestine (cecal inversion)
Since inflammatory bowel disease is the No. 1 cause of GI issues in kitties, and since diarrhea is a symptom of both IBS and IBD, I almost always check for IBD in cats with GI issues. Lack of healthy digestion is a common cause of secondary infections. 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.
Nutritional deficiencies are also a significant risk because 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. To check for IBD, functional GI testing is required, at a minimum. These blood tests provide information on how well the cat is absorbing folate (a water-soluble B vitamin) and cobalamin, another B vitamin that 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 — that assess pancreatic function.
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, but it’s the only option to differentiate lymphoma from IBD.
Dietary Recommendations for Cats With IBS
If your cat is diagnosed with irritable bowel syndrome, I recommend you work with an 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 serve as a natural antibiotic and also contain antifungal and antiviral properties. It also promotes appropriate immune response to invaders.
When gut bacteria (your cat’s microbiome) are 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. Microbiome restorative therapy can also be an inexpensive and profoundly effective tool at rebalancing your cat’s internal terrain.
Depending on your kitty’s symptoms, your veterinarian may recommend a bland diet. The bland diet I prefer is a grain-free menu of cooked ground turkey and canned pumpkin (pure pumpkin, not the filling used in pies) or cooked sweet potato. Make sure to eliminate all grocery store treats at the same time.
When it's safe for your cat to transition away from the bland diet, I recommend working with your integrative vet to create a novel protein diet. This will give kitty’s GI tract and immune system a good rest.
Novel protein diets are made with foods your cat hasn’t consumed before. I also recommend giving IBS cats a break from all sources of food contaminants, including high heat processing that creates AGEs, foods that have been genetically modified, added colors and flavors and synthetic vitamins.
After three months on a novel protein diet, you should be able to gradually transition your cat to a balanced, species-appropriate, fresh food diet, including healthy treats.
You and your veterinarian should also discuss appropriate supplements in addition to a high-quality pet probiotic, for example, digestive enzymes. There are also numerous homeopathics and nutraceuticals that can be very beneficial in helping to reduce GI inflammation and IBS symptoms.
I absolutely do not recommend that IBS cats stay on steroids as the only treatment plan, which is currently how most cats are managed. Also provide kitty with filtered water, free from fluoride and chorine. Eliminate chemical-based household cleaning supplies and discontinue use of room sprays, plug-ins and fabric deodorizers.
Adding Fiber to Kitty’s Diet
Irritable bowel syndrome can cause either diarrhea or constipation, and fiber supplementation can address both symptoms. If your cat lived in the wild, her natural prey would provide ample fiber in the form of fur, feathers and predigested gut contents. Since housecats don’t get prey animal fiber in their meals, it can be beneficial to add fiber to an IBS kitty’s diet to help keep things moving smoothly through the digestive tract — not too fast, and not too slow. Good options include:
Psyllium husk powder: 1/2 teaspoon per 10 pounds of body weight one to two times daily on food
Ground dark green leafy veggies: 1 teaspoon per 10 pounds of body weight one to two times daily with food
Coconut oil: 1/2 teaspoon per 10 pounds of body weight one to two times daily
Canned 100 percent pumpkin: 1 teaspoon per 10 pounds of body weight one to two times daily on food
Organic apple cider vinegar (ACV), raw and unfiltered: 1/8 teaspoon per 10 pounds of body weight added to food one to two times daily (not all cats will consume this)
Aloe juice (not the topical gel): 1/4 teaspoon per 10 pounds of body weight one to two times daily on food
Acacia fiber: 1/8 teaspoon per 10 pounds of body weight one to two times daily as prebiotic fiber
It’s also very important that cats with IBS stay well hydrated. As I mentioned above, make sure your kitty has access to clean, fresh, filtered drinking water at all times. Place a few bowls around the house in areas where she hangs out. You might also want to consider a pet water fountain, since many kitties will drink more from a moving water source. Also consider adding bone broth to her food.
Managing Stress in Cats With Irritable Bowel Syndrome
Since stress plays a role in many feline disorders and is a particular problem for kitties with IBS, one of the best ways to help a cat with irritable bowel syndrome is to make sure her environment and lifestyle are as stress free as possible. Enriching your cat’s environment means improving or enhancing his living situation to optimize his health and quality of life. The more comfortable your cat feels in your home, the lower his stress level will be.
Enriching your cat's surroundings means creating minimally stressful living quarters, and reducing or eliminating changes in his life that cause anxiety. Any variation to a kitty's routine is experienced as stressful. Cats need to feel they're in control of their living situation. Enrichment may also mean adding or changing things in your pet's environment that encourage him to enjoy natural feline activities like climbing to a high spot or hunting prey in the form of a cat toy.
Because change is unnerving for cats, nothing should be forced on them. If you decide to purchase a cat tree, for example, place it in an area of your home where kitty spends a lot of time, and let him discover it on his own terms. Also consider the electrical stress in your cat’s environment. We tend to underestimate the effect of household radiation and EMFs on sensitive animals. Pets need to be outside touching the earth in order to ground themselves, and many cats never get this opportunity.
Enriching Kitty’s Indoor Environment
There are several components to a cat's indoor environment, and when it comes to enrichment, each should be considered from the perspective of your kitty. These include:
• Food, water and litterbox locations. Cats feel most vulnerable while eating, drinking or eliminating. This vulnerability is what causes a fearful response when a cat's food dish or litterbox is in a noisy or high-traffic area.
The essentials of your kitty's life — food, water and his bathroom, should be located in a safe, secure location away from any area that is noisy enough to startle him or make him feel trapped and unable to escape. They should also remain in one spot and not be moved from place to place.
• Places for climbing, scratching, resting and hiding. Cats are natural climbers and scratchers, and your cat also needs her own resting place and a hiding spot. Jackson Galaxy has written several books on creating feline environmental enrichment around the house that I highly recommend. He also has a line of flower essences that can be beneficial for IBS cats.
• Consistency in interactions with humans. Your kitty feels most comfortable when his daily routine is predictable. Cats prefer to interact with other creatures (including humans) on their terms, and according to their schedule. Always remember: well-balanced indoor kitties are given the opportunity to feel in control of their environment.
• Sensory stimulation. Visual stimulation: Some cats can gaze out the window for hours. Others are captivated by fish in an aquarium. Some even enjoy kitty videos.
Auditory stimulation: When you're away from home, provide background noise for kitty that is similar to the ambient sounds she hears when you're home, for example, music or the TV at low volume.
Olfactory stimulation: You can stimulate your cat's keen sense of smell with cat-safe herbs or synthetic feline pheromones.
• Same-species friends. This can be a sensitive area. The way cats interact with each other is very different from most other animals. Trying to predict how two or more cats, especially kitties who haven’t grown up together, will get on living under the same roof is nearly impossible.
Problems with intercat aggression can arise when a new cat is brought home, when two cat owners blend their feline families, and even among cats that have lived peacefully together for years. Because of the complex nature of feline social structures, if you have a multi-cat household and there are problems, or you're hoping to add a new cat to the family, I recommend you talk with your veterinarian or an animal behavior specialist.
Does Your Cat Get Outside in Good Weather?
Another way to relieve your cat’s stress and enrich his lifestyle is make sure he gets to spend some time outdoors in nice weather in controlled situations such as on a leash walk, or inside a protective enclosure like a “catio” (a cat patio). The idea is allow him safe access to the outdoors, as well as the chance to ground himself.
Safe access is key. Allowing your cat to run around loose outside is never a good idea. It presents much more risk to his health and longevity than keeping him indoors.