Feline Vomiting and Diarrhea – IBD

Inflammatory Bowel Disease (IBD)

Comments from specialists:

• We do not believe it is ‘normal’ for cats to vomit hairballs, but feel it is symptomatic of gastrointestinal disease, especially IBD and its various presentations.
• Cats are built to eat a lot of hair from self-grooming, grooming other cat friends and eating small, furry rodents.
• I might accept vomiting one or two hair balls a year as possibly normal. However, it is more likely the cat is vomiting for some other reason and the owners only see the hair as the problem.
• I don’t rely on laxative-type products in vomiting cats since vomiting is not a “grease” deficiency, just as grease is not a treatment for vomiting people.  I don’t believe that nature created a vomiting species.  Vomiting hair is frequently the result of a motility disorder due to inflammation of the intestines = IBD.

Vomiting and Diarrhea can be acute or chronic. Acute cases have a greater probability of being less serious but some acute causes such as foreign body obstruction and exposure to a toxin can require immediate attention for a good outcome. Chronic disease can be slowly progressing or intermittent or may take weeks or even years before owners are certain that there is a problem.

Owners and veterinarians always hope that vomiting or diarrhea “is nothing”. For example, in cats, vomiting is sometimes dismissed with the comment, “I thought it was just hairballs.” The following list shows how varied and complex the causes can be. Some possible broad categories of causes of vomiting and diarrhea include: viral, bacterial, fungal, protozoal, parasites, obstruction, inflammatory, immune mediated, metabolic, hormonal, systemic disease, cancer, anatomic abnormalities, drug-induced, toxins and an array of adverse reactions to food.

Diagnosing a cause of vomiting or diarrhea requires a series of questions (a good history) and a good physical with abdominal palpation. Treatment can range from supervised observation, to a trial of symptomatic medication, to a diet trial, to tests, which might include, fecal parasites, blood, X-ray, barium, endoscopy with stomach/intestine biopsy and/or ultrasound. Tests are only recommended when warranted because simple approaches have failed.

The purpose of this discussion is to broaden our thoughts beyond “hairball” whenever our cat vomits, even if the vomit is hair.  An examination and a good history with your veterinarian will allow a better understanding of possible causes and a diagnostic and/or treatment plan can be developed.

FELINE HEART MURMUR: SUSPECT CARDIOMYOPATHY

Mistoffelees has cardiomyopathy and also an arrhythmia (an abnormal heartbeat).

Years ago, a veterinarian might detect a heart murmur during your pet’s annual examination, and you might have heard the comment, “We’ll watch this.”  Not too long ago, veterinary medicine was limited in what could be done diagnostically, and effective heart medications had not been developed.  Now, with new diagnostic capabilities, new knowledge and new medications, many pets with heart disease are living longer and more comfortably than was possible previously.

There are many causes of heart murmurs, and it is impossible to know the cause, the severity or the treatability just by listening with a stethoscope. Causes of heart murmurs in cats include birth defects, valve infection (valvular endocarditis) and the list goes on, but the most common cause is Hypertrophic Cardiomyopathy (hypertrophic = thick, cardio = heart, myo = muscle and pathy = disease).  The heart muscle thickens to the point that there is very little space in the heart for blood to accumulate to be pumped.

A special ultrasound termed an echocardiogram gives us the ability to painlessly see inside the heart while it is beating and evaluate the valves and  heart muscle.  It is the best method available to determine the severity of cat heart disease.  Ultrasound is greatly preferred over x-ray for this disease because x-rays can appear normal until this condition is very advanced.  Having an ultrasound does not require anesthesia, but an occasional pet does need a calming medication.

Dr. Earley performing an echocardiogram on a feline patient.

Echocardiograms are not commonly available in veterinary hospitals.  Animal Hospital of North Asheville is proud to be the first animal hospital in Western North Carolina to have untrasound with color flow and continuous wave doppler for advanced imaging of the heart.  Additionally, Dr. Jim Earley has taken extensive special training and has years of experience in performing echocardiograms for our patients and for referral patients from other veterinary hospitals.

It is important to detect Cardiomyopathy  before the pet develops problems. Many cats can live comfortable, happy lives for many years with medication and monitoring.  Without treatment cats can develop congestive heart failure, or fatal complications such as a “saddle” thrombus, a clot that blocks blood flow to the rear legs and is horribly painful.

Breeds more likley to develop this condition are Ragdolls, Maine Coons, Persians and American and Oriental shorthairs, but the most commonly diagnosed breed is the common domestic shorthair cat.  This condition is more common in young to middle aged cats over a year of age, but can affect any age cat.

ACTUAL CASE: Mistoffelees, (see his picture above), is one of the most striking cats that we have ever seen.  He is a 5 year old Maine Coon who weighs 18 pounds and is not overweight.  His personality is absolutely delightful.

During his Annual Comprehensive Examination, a mild heart murmur was detected.  Dr. Earley recommended an echocardiogram because this was a new murmur and because Maine Coon cats are at higher risk for Hypertrophic Cardiomyopathy.

Unfortunately, the test shows that Mistoffelees does have cardiomyopathy and also has an arrhythmia (an abnormal beat).  Because the arrhythmia is unusual, Dr. Earley recommended a consultation with a cardiologist.  Utilizing our telemedicine capabilities, his data was sent to three cardiologists who have reviewed his case and have made recommendations.  We generally receive a written report from our specialists within 1 hour.  Mistoffelees’ cardiomyopathy has been caught early which gives a better prognosis, and the arrhythmia will be monitored closely to determine if it is stable or unstable.

We all hope that Mistoffelees will continue to feel as wonderful as he does now. Medications will be initiated to treat symptoms should it become necessary.

Animal Wellness Exams

An annual wellness exam is one of the most important things you can do for your pet to maintain their good health. Even if your pet has had several veterinary visits due to illness or other problems, they should not skip their annual visit.

An annual exam is a much more thorough physical and dental examination than can be done during illness visits. Your pet’s overall health will be assessed and recommendations will be outlined for keeping your pet healthy. Among other things, the doctor will decide which vaccinations your pet should receive based on his or her history, age and lifestyle. Important parasite preventatives and other medications will be discussed and renewed, and you will also be given the latest information for preventing health problems in your pet.

Click on the link below to watch a video from the American Animal Hospital Association (AAHA) to learn more about animal wellness exams.

Animal Wellness Exams

Please call us at 253-3393 today to make this very important appointment.

Did you know? Animal Hospital of North Asheville was the first veterinarian office in Asheville to receive accreditation from AAHA.