The first time you see your cat throw up a hairball, you may think, “Well, that’s normal.” The next time you might say, “Well, I guess they just finished grooming.” But did you know cats shouldn’t really be throwing up hairballs more than once a month? When it feels like your cat might just be having an off-day, ignoring symptoms like these could mean you’re missing a bigger problem, like inflammatory bowel disease, aka IBD.
Like an iceberg peeking above the surface with its true mass lurking beneath, IBD has plenty of signs that can seem inconsequential when looked at individually. After all, who hasn’t had a day or two of the runs and shrugged it off? But a cat’s body is a finely tuned machine, so any bodily disturbances, no matter how minor they may seem—and especially if they’re recurring—can be a red flag pertaining to your cat’s health. On top of it all, cats have evolved to hide their pain and discomfort, so it’s up to you to take action when you notice something amiss. With that in mind, let’s look at some of the causes, symptoms, and treatment options for cats with inflammatory bowel disease.
IBD is not curable, but your cat can live a long, happy life with proper treatment and management
IBD causes inflammation and thickening of the stomach and/or intestines and can block nutrient absorption
It can be caused by a myriad of different things, though it’s often related to gut health, food intolerances, and allergies
Frequent vomiting, hairballs (more than 1x a month), chronic diarrhea, lack of or decreased appetite, rapid weight loss, and abdominal pain can all be symptoms of IBD
Your vet may have to do multiple tests, some requiring anesthesia and intestinal biopsies, to confirm a diagnosis of IBD
A strict elimination or novel protein diet might be the most efficient method of managing IBD
What Is Inflammatory Bowel Disease?
IBD isn’t an easy thing to pin down. It refers to a specific reaction that causes chronic inflammation to the stomach and/or intestines. Over time, your cat’s gastrointestinal tract lining can thicken to the point where absorbing the necessary nutrients becomes difficult.
This reaction can be triggered by so many different things, and that’s part of the challenge of diagnosing it! Bacterial infections (such as E. coli or Salmonella), parasitic infections (either from worms or single-cell parasites like Giardia), chronic and unaddressed food allergies or intolerances, even genetic factors can all be precipitating causes of IBD.
In some cases, this thickening of the gastrointestinal tract can become so severe that it blocks digestive flow and can even progress into intestinal lymphoma cancer. So while no one likes visiting the vet—your cat least of all—it’s important to make a trip to the vet even if you’re not sure if those infrequent or benign symptoms could be attributed to IBD. And speaking of symptoms…
What Does IBD Symptoms Look Like in Cats?
As we mentioned earlier, some symptoms of IBD can first appear as mild or as a one-off case of a bad day. But IBD is known for inconsistent symptoms, which can vary in frequency and intensity. Even if it doesn’t end up being IBD, these are all symptoms that would warrant a vet visit.
Chronic vomiting or hairballs. Again, cats should only be getting hairballs around 1x a month, at most. Any more frequently, and it means the hair—or anything else they’re throwing up— can’t pass through the GI tract. In cases of IBD, vomiting means the disease could be affecting the stomach.
Chronic diarrhea and/or bloody poops. These symptoms may be difficult to notice if your cat is still making it to the litterbox in time and covering up their deposits. The presence of diarrhea in response to IBD means the disease is affecting the intestines. This diagnosis can be split into two categories: enteritis, meaning IBD is occurring in the small intestine, or colitis, in the large intestine.
In the cases of enteritis or colitis, you may also see rapid weight loss. This can be accompanied by either a diminished appetite or, conversely, a ravenous appetite (but still losing weight). In either circumstance, it’s happening because your cat is no longer absorbing nutrients through the inflamed, thickened lining of their GI tract.
Excessive gas (kitty farts) or gurgling stomach sounds.
A tender abdomen—pay attention to uncharacteristic protests when you pick them up.
A dull or distressed coat.
Remember that while IBD is most common in middle age to older cats (approximately 5–12 years) it can still crop up at any age, so keep an eye out for irregular behaviour at any time in their life.
How to Diagnose IBD in Your Cat
IBD is a true chameleon of a disease, so don’t expect an immediate diagnosis; instead, your vet will be doing some detective work to narrow down what may be causing the symptoms. Initial tests could include blood or fecal samples, which are used to rule out some internal parasites, cancers, and other disorders. The next step might involve x-rays and/or ultrasounds to measure the thickness of the stomach and intestinal lining, which is particularly useful as it will also show the size of the lymph nodes around the intestines—enlargement could be an indication of a cancer known as intestinal lymphoma.
While all of these tests have their purpose, the only conclusive way to diagnose IBD is by performing a tissue biopsy from the affected area(s). Unfortunately, this is a surgical procedure performed under anesthesia; often, samples can be taken by a veterinarian or specialist skilled in endoscopic biopsies. However, if an endoscope is not accessible or isn’t a feasible option for other reasons, then a full abdominal surgery would be needed in order to get intestinal samples.
While getting a confirmed diagnosis of IBD can be a comfort to start, it’s not the end of the mystery; knowing your cat has IBD isn’t the same as knowing what’s causing their IBD, and more importantly, how to effectively treat it.
Treatment Options for Cats with IBD
As you enter the treatment and management phase, the first thing to remember is that while IBD is a life-long battle, the outlook for cats is generally very good, provided that the symptoms haven't been ignored for too long. There are a lot of treatment options available, and while they might not all be necessary, expect to work with your vet through a few treatments as you figure out what will work best for your cat. Many of the treatments are intended to cover your bases and give your cat their best chance to get back to their normal, comfortable life as soon as possible.
Thorough deworming: some parasitic worms won’t show up in fecal samples, so this is a gastrointestinal irritant that can be quick and easy to tick off your list of possible causes. Keep in mind that some deworming medications target a broader spectrum than others, killing a wider variety of parasites in a wider range of lifecycles. So just because you’ve dewormed your cat in the past that you’re in the clear—you might still need different medications or multiple treatments.
Pre and probiotics: a regimen of pre and probiotics can repopulate the gut with healthy bacteria, especially if your cat has recently been on antibiotics. Because some antibiotics use a “scorched-earth method” when it comes to healthy gut flora, they can destroy “good” bacteria in the gut that controls anti-inflammatory functions and nutrient absorption.
Gut health supplements: Gut health supplements: there are a wide variety of supplements with ingredients that help coat and soothe the gastrointestinal tract that can be helpful for some cats.
Omega Fatty Acids (EFAs): these are powerful anti-inflammatories and may work very well in some cats but cause diarrhea in others. Start with small amounts and gradually build up to a full dose.
Acupuncture: while this treatment will likely not be enough on its own, it’s particularly good at reducing inflammation using the body’s natural processes and could be a welcome addition to your kitty’s IBD management plan.
B12 supplement injections: vitamin B12 is crucial to your cat’s health. It supports both their immune system and their digestive system, so you can understand how it’s an essential vitamin for cats battling IBD. Unfortunately, cats can’t absorb this vitamin in sufficient amounts with their thickened GI tract and can become deficient, hence the need to inject the supplement under the skin.
Elimination/Novel Protein Diet: This treatment has the highest rates of long-term success for cats; however, it is one of the more complicated methods—it requires strict discipline and steadfast resistance to begging kitties. Elimination diets require putting your kitty on a diet with a protein they’ve never tried before—usually something exotic, like kangaroo, boar, or buffalo and absolutely nothing else to hopefully reduce the inflammation caused by food allergies or intolerances. Most cats see the best results if this diet is also low fat, high fibre, and easily digestible. Of course, every cat is different, so some experimentation and veterinary guidance may be required to find what works for your particular kitty. Additionally, some cats with IBD do well on their new protein diet for a long time before they suddenly stop tolerating it, so further changes, modifications, or medications may be needed.
Medications: In some more severe cases, an elimination diet might not be enough on its own. Your vet may prescribe medications with antibiotic, anti-inflammatory and antiprotozoal properties to get your kitty’s symptoms under control, often in addition to a new diet and nutritional management plan
Remember that symptoms can wax and wane; just because you’ve managed to get it under control doesn’t mean it’s gone forever. But there’s a light at the end of the IBD tunnel: if you find a diet or medical treatment that’s working, you just need to stick with it, tackle any flare-ups as they come, and your cat can live a normal, happy, and full life for years to come.
Because the symptoms of IBD can be mild or show up inconsistently, it might be tempting to see if you can wait it out and hope it passes. But in almost every case, you’d be better off hauling out the cat carrier and getting your feline companion to a vet just to be sure. Knowing what’s normal for your cat and paying attention to changes might mean catching IBD early, which can save you from a mountain of hardships further down the road!