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Norwich Bulletin - 6/20/2010

IBD What Is It, Really?

Five years ago we brought home a beautiful silver spotted Egyptian Mau kitten who looked like Silver Christmas Tinsel. She had beautiful type and a wonderful pedigree. At three months old she had the necessary gooseberry green eyes that you could get lost in. She also had IBD, Inflammatory Bowel Disease. This disease was a long expensive process to diagnose and after years of different treatments, we sadly realized that we would never be able to manage her so that we could allow her to live a real pet’s life. Tinsel spent her life relegated to the downstairs kitty area and the outside courtyard.

We allowed her to live as normal a life as possible without ruining our home with her constant and uncontrollable diarrhea. But she never got to sleep on a lap or share our bed – she never knew what it was like to hang around the kitchen and steal food off of the table. And five years took an awful toll on her little body. It became apparent that she was constantly uncomfortable and she no longer had any type of quality of life. Last month my husband took this poor sick baby to our vet and sadly told her goodbye.

IBD – people have it all of their lives. So do cats and dogs. It is a condition that results when cells involved in inflammation and immune response are called into the lining of the GI tract. This infiltration thickens the bowel lining and interferes with absorption and the ability of the bowel to contract and move food. With this abnormal ability or lack of ability, the bowel’s normal function is disrupted. A watery diarrhea with weight loss results if the infiltration is in the lower small intestine. The entire tract from top to bottom may be involved. IBD is often confused with Irritable Bowel Syndrome, which is a stress-related diarrhea problem. Although the symptoms appear to be the same, it is a completely different condition and when you take away the stress, you take away the IBS. It’s not so easy with IBD.

The first thing we did when we realized that Tinsel had a serious problem, was a basic blood panel and urinalysis to rule out biochemically widespread problems such as liver or kidney disease. Since IBD is localized to the GI tract, the basic blood panel will usually result in a normal finding. We then did an ultrasound to rule out growths in the abdomen or tumors that could be responsible for the re-occurring problems. Of course, we did an extensive testing for parasites because she had come from a cattery type environment. We needed to rule our Giardia, Cryptosporidium and Tritrichomonas. She was treated with metronidazole to see if there could be any symptomatic relief. Test after test failed and left us less and less hopeful of a good outcome.

The next thing we tried was a long search for a dietary management. We tried hypoallergenic diets; low residue diets; high fiber diets, adding different types of fibers to her already restricted diet. Nothing worked – in fact, it didn’t even make a dent in her condition.

Tinsel went through the definitive test for IBD at the same time she was spayed. Tissue samples were taken from several areas of her GI tract and they were harvested. The tissue samples were processed by a special laboratory and analyzed (more expense), and then when IBD was definitive, it was graded. The choices were mild, moderate or severe and the type of cells involved in the inflammation were identified.

Unfortunately for Tinsel, her IBD was graded as severe. The most serious causes of chronic gastrointestinal complaints might include intestinal cancer, fungal infection infiltrating the GI lining or a lymphatic condition called lymphangiectasia. This last condition is not exactly a form of IBD, although the clinical signs are pretty much the same (with none of the treatments working). It is an obstructive disorder and the underlying cause is rarely found. The prognosis is very poor. No matter what you do for treatments, there is no relief for the animal. Eventually there is such a breakdown in the animal’s body, and the disease is so debilitating, that the animal needs to be given relief in the only possible way – euthanasia.

When the diagnosis is not severe, the cornerstone of treatment for IBD is suppression of the inflammation. You can use prednisone or prednisolone – and sometimes you need even stronger immune suppression. Long term use of any of these drugs must be monitored as they have their own dangers to small companion animals.

Unfortunately, the causes of IBD are not well understood and the cause is usually not found. The basic theory is that “something” is causing a chronic stimulus of infection. It could be caused by anything. Genetics can play a part, allergies to food proteins, the continuing presence of a parasite, inflammatory products produced by the normal bacteria living in the intestine or there may just be an underlying problem with the immune system in affected individuals. There are so many unknowns, but there is one thing that is known. If you cannot relieve the symptoms, your pet cannot live a healthy life.

This disease exists and it continues to be a common cause of chronic intestinal distress in both humans and animals. Research for less invasive tests and for newer treatments are on going. However, it is too late for a sweet little spotted cat that was dealt a bad hand. Dear Tinsel, we really did try to do the best we could for you. I hope you are now at peace.

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