Inflammatory bowel disease
Inflammatory bowel disease (IBD) currently is recognized as a common and important medical problem in cats. Three general
types of clinical presentations have been identified in cats with idiopathic IBD: (1) a clinical course characterized primarily
by vomiting, (2) a clinical course characterized primarily by diarrhea, and (3) a clinical course that includes both vomiting
and diarrhea as primary signs. Associated clinical signs can include change in appetite (anorexia, inappetence, or ravenousness),
weight loss, and lethargy. In some cats, the clinical signs are cyclic; they seem to flare up and then abate in a predictable
Vomiting, one of the most frequent clinical signsof IBD in cats, is most often recognized as an intermittent occurrence for
weeks, months, or years. Affected cats are frequently misdiagnosed as having hairballs as the primary problem. As the disorder
progresses, an increased frequency of vomiting often leads the owner to seek veterinary attention. In addition to vomiting,
diarrhea is a common sign observed in feline IBD and most likely is due to derangement of normal mechanisms of absorption
and motility caused by mucosal inflammation. In most cases, diarrhea is intermittent early in the course of the disorder,
and there may be a transient response (weeks to several months) to dietary manipulation or any of a variety of medications.
Later, the diarrhea becomes persistent and usually responds only to specific treatment, which is determined after a definitive
diagnosis is made. Signs of small bowel diarrhea predominate, but signs of large bowel diarrhea may be evident as well if
there is generalized intestinal tract involvement.
Appetite changes in cats with idiopathic IBD vary from decreased appetite to complete anorexia to ravenousness. Inappetence
seems to occur more commonly in cats that have vomiting as the primary clinical sign and usually occurs during exacerbation
of clinical signs, and vomiting or diarrhea is not observed until later or not at all. The three leading differential diagnoses
for a cat with a ravenous appetite, diarrhea, and weight loss are IBD, hyperthyroidism, and exocrine pancreatic insufficiency
A definitive diagnosis of IBD can be made based only on intestinal biopsy. Further tests are run to evaluate the overall
health status of the patient and to rule out other disorders. Recommended baseline tests include a complete blood count,
biochemical profile, urinalysis, fecal exams for parasites, serum thyroxine test, and a feline leukemia virus test. Testing
for feline immunodeficiency virus should be considered in cats with chronic wasting disease.