Inflammatory Bowel Disease or IBD is typically something that a cat will have for the rest of its life. It can be variable as to how effectively we can control it and how well your cat will do. You can not diagnose IBD with an ultrasound. The ultrasound can look like IBD but the only true diagnosis is by obtaining biopsies with endoscopy or exploratory surgery.
Even a diagnosis of Inflammatory Bowel Disease does not let you know if there is an underlying cause. IBD can be a reaction to a food allergy, parasites, bacterial infections or low vitamin b levels. It can also be related to pancreas and liver disease. You didn't say if your veterinarian did any blood tests. I assume all the abdominal organs were examined during the ultrasound to see if there was involvement of anything besides the intestinal tract. I am also assuming that the main symptom is diarrhea from what you said.
Because getting biopsies can be quite expensive ($1000-3000), I will usually begin with the other less expensive tests and food trials. Fecal samples can look for parasites. Even if they are negative, I usually give a dewormer for the common parasites such as roundworms, hookworms, and tapeworms. A fasted (12 hour) blood sample can be tested for pancreas, vitamin b12, and folate levels. This can be very helpful. Some cats have very good improvement with vitamin b12 injections. A general blood panel to look at liver enzymes, white blood cell counts, electrolytes,etc should also be done as well as Feline Leukemia Virus and Feline Immunodeficiency Virus testing if your cat has not had this done.
A diet trial with a hypoallergenic diet can help determine if food allergy is a contributing factor. There are also prescription diets made for intestinal problems (Purina EN, Royal Canin HE, Hills i/d) that I have had good success with in some cats.
Once all possible causes have been ruled out, biopsies are the only way to know for sure that your cat has IBD.
You rarely have a quick fix with chronic diarrhea or vomiting problems but there are many tests and treatment trials that may help. It will take some time and some testing but many cats can do well. Probiotics such as Fortiflora often help as well.
Metronidazole can help some cats but usually only short-term unless it resolves an underlying cause such as Giardia. Prednisolone, a steroid medication, can often help long term. There are potential side effects so it is best to use when you have a definite diagnosis with the biopsies or when your veterinarian has ruled out most other possible causes. You should never use prednisolone at the same time as Metacam.
I have thrown alot of things at you here but hopefully have helped some. This can be a very frustrating problem for the cat, the owner, and the veterinarian. Get as many tests done as you can afford even if you need to space them out, so your veterinarian can have as much information as possible. Always keep the litter box very clean and try to make your cat's life as stress free as possible.
Good luck and write again with further questions and updates.
Judy Karnia, DVM
Scottsdale Cat Clinic
Well, his blood work came back all within normal ranges, the ultrasound showed his intestines all thickened. Right now, its his little bum that is inflamed and no doubt painful...he DID manage to move bowel during the night, (soft semi formed, not diarrhea). He also urinated, very well this morning. He took his meds, ate, and is now playing a bit with his favorite toy, a long string tied to my chair! So he is doing a little better...
I have contacted an internist, to get some more insight, into this thing, and what I should do, as the vet hospital I normally go to DID NOT do an endoscopy, or biopsy of any kind. Just said the ultrasound showed thickened intestines, and pronounced it IBD, and gave the Metronidazol, and Metacam.
I will keep you posted. He is a Purina One kitty, and likes Friskies canned for his wet food. He is on a diet as well, as he is about 6 lbs. overweight right now.
I agree with all that the experts have mentioned above. As a traditionally trained holistic veterinarian, I have has success using holistic, natural therapies for cats with IBD.
We use a home made diet(1/3 lean protein such as a chicken breast, or lamb, salmon, veal, turkey, duck; 1/3 long acting carbohydrates like sweet potatoes,or any kind of potato, rice, pasta or oatmeal; 1/3 veggies like broccoli, cauliflower, green beans, peas etc. Cook it up and mix together, add a little (1/2 teaspoon) extra virgin olive oil. The olive oil enhances the smell and taste and is a great source of omega-3 fatty acids. Then flavor it so its tasty; many cats like barbecue sauce, pasta sauce or tamari sauce which is the brown sauce many Chinese carry out meals come with. You can buy low sodium tamari at most grocery stores. We add natural, plant based digestive enzymes, and probiotics (friendly bacteria) to each meal along with a balanced vitamin-mineral supplement. Meals should be small so they are easier to digest. Three to four small meals daily works well for many cats like yours. We have successfully been able to avoid using prescription medications and prednisone with this regime for many cats with IBD.
I am glad to discuss this with you in detail
Dr Carol Osborne, DVM