It's been a busy week at the North American Veterinary Conference and it's only Monday. I had dinner with Tom and Yvonne last night and we got together this morning at the Feline Health Symposium sponsored by Purina. I attended two really interesting presentations on Feline Inflammatory Bowel Disease (IBD) and Managing Obesity in Cats.
The IBD presentation was given by Dr Debra Zoran an internal medicine specialist from the College of Veterinary Medicine atTexas A&M. IBD is a common yet somewhat poorly understood disease. It is often diagnosed by elimination, meaning we rule out diseases that are more easily identified until we arrive at a presumptive diagnosis of Inflammatory Bowel Disease.
Most cats with IBD present with typical gastro-intestinal sign like vomiting, anorexia, diarrhea and weight loss. Most of these cats are middle aged and they may have had signs and symptoms for quite some time. The disease can be frustrating for both cat lovers and veterinarians. Intestinal biopsy is helpful in diagnosis and usually reveals the presence of inflammatory cells like lymphocytes, neutrophils, plasma cells and eosinophils infiltrating the lining of the intestine. In severe cases the normal cellular structure of the lining of the intestine is changed dramatically. The latter is important because the more damage that is done to the structural anatomy of the gut the more difficult the treatment.
The revelation in Dr Zoran's talk concerned the importance of the bacterial population that resides in the intestine and the role these bugs play in intestinal health. Many of you will be surprised to know that there are more bacteria in your intestines than there are cells in your body. Researchers are beginning to think of this normal gut flora as another organ in the body that has a huge impact on normal metabolism and normal health. A healthy intestinal tract is dependent on a balance of so called protective bacteria (good bugs) and not so healthy species of bacteria. When things are in balance a state of "eubiosis" is said to exist and when things are out of whack, when the bad, reactive or pathogenic bacteria predominate, a state of "dysbiosis" exists.
In fact, in a state of dysbiosis, the immune system in the intestine can over react leading to the presence of the cells we see in inflammatory bowel disease. The bad bacteria like e-coli and clostridium set up the conditions that trigger a reaction from the cat's own immune system that lead to the gut inflammation seen in IBD.
The other news is that diet can have a big impact on the balance of good VS bad bacteria and diet alone has a huge role in treatment and management of IBD. Diets that are high in protein, especially if the protein is high quality and highly digestible, result in lower total numbers of bacteria and more different kinds of bacteria. That's good because it favors eubiosis or balance. Diets that are higher in carbohydrates and of lower digestibility result in more bacteria and fewer species which favors dysbiosis.
While corticosteroids and certain antibiotics are usually prescribed in IBD, Dr Zoran believes that in most cases these drugs are less important than diet in the long term health of the patient. You need the drugs to calm things down in the acute case, but diet is the real long term answer.
Probiotics, or supplemental "good" bacteria are also helpful. Adding good bacteria to an inflamed gut helps reestablish eubiosis and the balance that calms inflammation. According to Dr Zoran, a diet like PVD EN and probiotics like Forti Flora are a good place to start in the long term management of IBD in cats. And, of course, a PurinaCare Pet Health Insurance Policy is a good way to help you with the financial burden of managing the medications and diagnostic procedures needed to control IBD in a cat.