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Feeding Tube and IBD
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Feeding Tube and IBD

Hi there,

My cat developed a fatty liver disease after we moved into our new home. He was very stressed and stopped eating. Also, he is an IBD cat. He was diagnosed with Chronic Colitis at 6 months of age...but nothing ever worked. He was on Hill's (you name the letters he's been on those) plus steroids and antibiotics. I got tired of my cat not getting better and switched him to raw diet. His IBD went away. Then these past few weeks he has been hospitalized due to stress from the move. They were feeding him Hill's a/d and then l/d for his liver.

Now I got two problems. His IBD is bad even though they gave me prednizolone. He is still on Hill's l/d. But this isn't my main concern. My main concern is he is EXTREMELY sensitive where the tube meets the skin. His tube goes directly into his tomach. I'm feeding him four times daily, 20cc, and I'm supposed to keep that area clean and dry. But he cries every time I touch him there. They know this, but don't seem to react to my cat's crying. Is this normal?

Moreover, PLEASE, is there something better than Hill's for both liver and IBD?  This vet wants me to keep my cat on Hill's l/d and then switch him to a/d and steroids for the rest of his life. I'm tired of telling him that a/d has never, ever worked for my cat. Is there a better food that I could perhaps talk to this vet about for my cat? It's really sad to see him pooping blood. Is Wellness a good food?
Type of Animal
:  
Feline
Age of Animal
:  
2
Sex of Animal
:  
Male
Breed of Animal
:  
Domestic Long Hair
Last date your pet was examined by a vet?
:  
December 09, 2009
City
:  
Jupiter
State/Province
:  
Florida
X-Ray Results
:  
Liver values high - Billirubin 26 but dropped to 10 on the day of discharge.
Other pertinent test results
:  
ACTH normal
Biopsy Results: Hepatic Lipidosis, Mild IBD
Related Discussions
931217_tn?1283484935
Hi,

If your cat indeed has a gastrostomy tube (direct into the stomach) your doctor may want to consider an esophagostomy (into the esophagus, on left side of neck) instead. They are well tolerated and can stay in for long periods without ill effect (I've got one out there now approaching 8 months). They usually create much less dermatitis and have no leakage etc. Its true that their smaller diameter means a liquid to semiliquid diet is required, but almost any food can be blenderized to work.

As far as type of food to manage IBD, and assuming the IBD has been worked up with biopsies for the specific type, then trials with reduced antigen diets MAY  be helpful, as in z/d. A/d is convenient for tube feedings as it comes in pate style. Still food alone, will not manage most such cases. Just ask people with IBS, the human terminology for these diseases. The point is the food brand, variety or type is not the relevent factor. It is the antigen or antigens (immune stimulating protein in the food that affects your one cat adversely) of the given food that does.

Also, appropriate medication can be adminsitered via the same tube as well. I think you know my feelings about raw diets, but that is your decision to make. Typically the IBD family of diseases cannot be managed with dietary changes alone. usually corticosteroids, particular antibiotics or drugs which dampen abnormally hyperactive immune responses (cyslosporine for example) are required to keep vomiting and diarrhea under control.

Good luck getyting your kitty some relief.

Sincerely,

Arnold L. Goldman DVM, mS
Medhelp
5 Comments
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541150_tn?1306037443
ugh....nevermind about Wellness. I tried that one too and it didn't work.
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541150_tn?1306037443
Thanks!
We have already tried Hill's z/d. This particular one makes it 10 times worse. I do not want to keep my cat on meds for a long time. Hill's a/d....we just tried that one about a month ago and his IBD didn't get better. He is now on l/d and still nothing. He is getting better from his hepatic lipidosis, but not from his IBD and he is taking steroids and antibiotics.

He has taken predisone and is now taking prednisolone. None of that is making it better, or has ever made it better. It is nothing but short term solution....the IBD always comes back very aggressively.

My boy has been through two biopsies already, all indicating IBD. This last Biopsy showed mild IBD while the first one showed chronic colitis. The mild IBD started when we fed him Hill's a/d. He did not have IBD symptoms while on the raw diet. I know how you feel about the raw diet.  But it was my ONLY solution after spending thousand on trying o manage his IBD with meds and foods that never ever worked. He had been doing very well on it. I have been keeping track of his health by taking him to the vet for blood and stool tests, etc. I am aware of the risks, but I'd rather take those risks than living with a cat that's pooping blood every 35 minutes. But that's not the point.

I am kind of getting desperate about this food issue, because it'd be easier if he wasn't sick with a liver disease. His IBD would be easier to manage.
The doctors are puzzled as to why none of the recommended foods work. He is a young cat!

Arnold, if you have any other suggestions as to what food could be good for his liver and IBD, I'd highly appreciate it.

Thank You!
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931217_tn?1283484935
Clearly you have pursued every opportunity to manage your cat's problems. From this distance, it is hard to weigh in further than I have. Your own doctors know the cat's case best and I defer to what they are doing, have done. I assume you have already had consultation with an internal medicine specialist, who may bring a deeper persepctive to this particular situation. If not, please consider it.

Typically foods used therapeutically for GI disease are rationally chosen based on a characteristic such as: "high fiber", "low residue", "low or no antigen" etc. There are a few companies making disease targeted products including Hills and Royal Canin. If no rational criteria exist with which to choose a particular set of diet characteristics for a case of IBD, then its trial and error thereafter. Those trials may then include a set of dietary characteristics, a change in company producing (each may have slightly different ingredients ostensibly producing similar characteristics) or other factors.

At this point your own doctor(s), in consultation with you and perhaps the specialist I mentioned are better suited to pursue the next steps. No question a complex case with frustrating characteristics. If raw diet alone makes your cat well, then I say use it. Generalizations aside, if your cats health requires it, using it makes sense, even if it may not for many others. I would caution only to take care to avoid cross contamination of surfaces, utensils and hands. And good luck! I do hope you achieve relief for your cat....
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541150_tn?1306037443
Arnold, Thank you very much. I appreciate your recommendations.  I will definitely follow them. I have not tried Royal Canin you know. I might take that step first, then consult with a specialist. I spoke with a dietitian/nutritionist about a year ago. She gave me tons of information about the raw food. That’s what she feeds her cats. But I will take Abby to someone else if I have to.

Thanks for the tips. Since I started feeding the kitties raw diet, I wear gloves when cleaning the box , preparing their meals, and cleaning the surface with Clorox. I wash my hands thoroughly, never touch the raw meat and always keep it frozen. I make sure I know where the meat comes from and what the conditions of the animals were. I try as much as possible to be sure I’m getting good stuff for them. I go to wholesale markets and get my kitties organic chicken, duck, or rabbit. They’ve had no nutrient deficiencies until we moved and Abby stopped eating, and Dillan started eating more. Go figure.

I will try the Royal Canin and will let you know how that goes. Thank You! You’ve been a great help! My boy means a lot to me.
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