Food

Black with shades of calico

As I mentioned earlier, the suggestion for an IBD cat is to change food once in a while. Where most cats aren't at all thrilled by having their food changed, Basti responds very well to it. To the point where she will change an entire brand in less than a day. Not that I advise people to change catfood in a day; she does that all by herself. With the change in food, other weird but good things have happened.

Where before she would only eat teaspoons at a time and I'd feed her 10 to 12 times a day, she now manages to eat half an ounce or more in one meal. The number of feeding times has been cut in half. Where before she would eat somewhere between half an hour and an hour after the regular feeding times of my other cats, she has started surfacing at their evening meal times and requesting wet food. Most of the time that still means 'junk food' like Hill's and Whiskas which are high in carbohydrates but it's wet food. As the B12 is starting to wear off, the amount of wet food she consumes also goes down. Before, even the intake of kibble went down but we don't see that happening now. I'm hoping it's the food she's currently on, Cat Lovers Gold. The most uncommon phenomenon is the fact that as of lately, she has started crawling on my lap at regular intervals.

Besides that, her fur has gotten this beautiful shine and it's gotten thicker. It reminds me a lot of the 4 British Shorthairs of a friend of mine. The thickness may simply be because it's getting colder outside but it's a lot softer than it used to be!

A revised box

Basti playing

After months of trying to coax her into her box and failing miserably, I figured something had to give. In this case, my thought was that the box made Basti feel claustrophobic and so I searched the internet for an alternative. The only option left was to change the top of the box into something transparent which meant two possible options; plexiglass or acrylic glass. The former turned out to be too soft and would probably sag so I went with the latter. I ordered 1 cm (.4 inch) thick acrylic glass, precut.

After replacing the wood with the plastic, Basti wouldn't step on the plastic when the lid was closed because she presumably thought there was nothing there. Then again, she wasn't interested in eating in her box anyway as her interest in food in general was lagging.

Finally, one night, my husband managed to place the food in her box and she jumped in. He then closed the lid and happily reported that she continued to eat as if there was no change in the situation. With the wooden lid, she normally would stop eating as soon as the lid closed and scurry out of the box a few seconds after that. It went horribly wrong because after finishing her food, Basti thought she could jump out of the box through the lid and bumped into the clear plastic. Basti was startled, my husband panicked and opened the lid and she got out. The next few days we couldn't even get her close to the box.

Box with clear plastic lid

It's now back to basics; she needed to be reassured that we wouldn't close the lid before she got in. Closing the lid and putting a piece of cloth on top will make her understand that she can't jump out through the top but causes the same problems; as soon as she realizes she's closed in, she'll stop eating and will want to get out. And I've been reading a book on cat behavior; it may simply be that she doesn't like getting out through the cat flap because she can't see if there is another cat ready to pounce on her (as Blinky will sometimes do). I may have to create peep holes...

Another glitch may be the fact that we put a small carpet underneath the box to prevent it from scratching the floor and Blinky has been using his claws on it. This potentially means that if Basti wants to exit her box, the only thing she'll smell is the marks that Blinky left. Territorially speaking, I may have made a huge mistake!

That being said, yesterday she weighed in at 3.45 kg...so she is gaining weight!

B12 shots and wet food

OMG, Amen and Happy Days!! So much good has happened in the last few days that I couldn't be more thrilled!

The first positive event was that I managed to give Basti her first B12 shot without the vet present. The night before, I really felt the jitters of injecting her so to be on the safe side, I had emailed my vet (Malou) with  the last few questions. Malou is such an angel! She was so sure that everything would work out, that I felt confident enough to actually do it. Although things didn't exactly go as planned (halfway through the injection Basti started squirming and for a split second I had my doubts) I got the full amount of 1 ml into her body without too much of a fight and no broken needles. For the next hour or so, she avoided me but after that, she responded normally again.

Yesterday afternoon, while visiting the vet clinic to pick up some more Prednoral for Basti, Malou told me she had been telling other customers about the box I built for Basti. That really meant the world to me. In addition, the people at ibdkitties.net had been responding to my messages on Facebook and due to those conversations, last night I decided to try and feed Basti wet food. And she ate a whopping 56 grams (2 oz)! Plus, there seem to be no adverse effects (read: no diarrhea).

This morning she weighed 3470 grams...20 grams more than the last time, Hallelujah!  I'm crossing my fingers that this will continue and another possible relapse will be many months away...

In the mean time, I'm really disappointed in the homeopathic vet! Ten days after sending an email, I finally got a response at which point I figured that if he didn't care, neither did I. I also have been reading a Dutch article on the effects of kibble and high carbohydrate content in cat food. The article didn't just describe what happened, but also how it happened. The short version of the story is that unlike humans, a cat's liver cannot produce a particular enzyme called glucokinase to process large quantities of carbohydrates after a meal. This because carbs are not in their natural diet. They use a different enzyme to process smaller amounts during the day. This means that cats on kibble get fluctuating blood sugar levels when eating larges amounts of carbs. The suggestion that Basti would do well on diet kibble even higher in carbs than regular kibble, is nonsense. Basti has already proven that by starting to eat wet food.

My advise to all of the 'owners' of an IBD cat; read up on the disease and be aware that whatever your vet tells you to do, it's not always the right thing for your cat!

B12 shots

Today, my own vet came to the house to administer another round of cobalamin or B12 vitamin for Basti. She also left a vial for the next round, 3 weeks from now so I'm happy to say she kept her word; I can do it myself!

I mentioned the dietary changes I had made to Basti's food and she mentioned that Hill's Science Plan (the food she's currently on) also has a diet version. I checked: the amount of fiber doesn't come close to what Vet Concept has. The only good thing is that Hill's food doesn't contain potatoes, nor does it contain yeast. I recently read  that feeding potatoes to an IBD cat isn't such a good idea anyway; the complex sugars of potatoes feed the 'bad bacteria' (whatever they may be) in the gut of the cat. Then again, the probiotics I'm feeding the cat on advice of the holistic vet contains dextrose. How do I explain to my vets I really don't want sugars?!?

Not in the box, but on top of the box...

I must admit however, that she's 3,4 kg at this point (the vet weighed her today) which means she gained a whopping 150 grams in the last few weeks! Whether that's due to any dietary changes however, remains the question. Her coat is softer and she's been very cuddly the last few weeks...She's never been a lapcat but she's been asking to sit in my lap!

The last few days I've seen a gradual decline in eating but the vet confirmed my belief: after 3 weeks, the B12 shots wear off and you see the results immediately...her food intake also goes down. Let's see if the amount of food she consumes per day goes up again after the shot; if it does, than that's how we can keep her at a decent weight. If it doesn't, it's back to messing with food.

Second opinion revised

I got the package that the vet had sent with the Vet Concept food, the probiotics and the homeopathic pills. Basti was in a good mood, she was eating and when I mixed the new food in with her old food, she literally fished the new food out of her bowl and left her old food. I was ecstatic! Took out the old food, gave her a full bowl of new food and she ate that too. Of course, at this point, I went overboard and gave her the probiotics sprinkled over her new food. She ate it but wasn't happy with it.

Basti is being pensive...

The next day, I gave her the new food and she refused. I kept trying until the middle of the afternoon and then I had to cave; I put her back on her old food which she happily ate again. 

In the days that followed, I managed to hand-feed her the Vet Concept at about 10 grams a day and only fed her the probiotics on her old kibble. Additionally, I would wait until she had eaten at least 50 grams before putting the probiotics on her food; if she decided not to eat, at least it wouldn't hurt her as far as calories were concerned. 

In the mean time, I spoke to the vet tech a second time and mentioned what had happened. She said she'd discuss it with the vet and called me back afterwards. Not happy with the response: keep trying to feed her the new food. There have been mails back and forth since then but without seeing me or my cat, I get the feeling it's all very 'passive'...like they don't really care. I prefer my own vet.

Second opinion

On September 4, in my everlasting internet search for answers on Basti's condition, I stumbled upon a petfood site (http://www.prinspetfoods.nl/pages/prinspetfoods-careteam.php) where I could leave a message. Figuring that it couldn't hurt, I left the story of Basti's problems and promptly forget I'd sent it. I did however get an answer the same day, something that is rare in this country.

As it is a pet food company, naturally I received advice on how to change to their own pet food. However, she sent me another suggestion which may turn out to be a lifesaver for my cat. She suggested contacting a vet on the other side of the country who does both regular medicine as well as homeopathic remedies for pets. The clinic is called Klaver4Dieren and the vet's name Atjo Westerhuis. So I emailed him as well with the short version of Basti's problems. Him it took 5 days to respond to my email, the 'normal' response time. He suggested emailing him the pertinent information on Basti's problems and then call the clinic for an telephone appointment.

Cat's in the bag?

 

Conversation with the vet

Yesterday, I talked to Mr. Westerhuis and it went really well. The first time I talked to a vet in a long time where I didn't feel like I had to explain myself. He didn't talk down to me and he took my concerns seriously.
Some of the things I suspected, were confirmed. He too was of the opinion that Basti has IBD, not food allergies (unlike the vet who did the endoscopy one-and-a-half years ago). He mentioned that Basti's problems are most likely located in the lower end of her GI tract (her intestines) which explains why she has diarrhea and doesn't vomit. He also explained that things go upwards; problems with her colon work their way up to her duodenum and stomach which causes her to stop eating. He basically said what I had read in many other articles online; she needs fiber. He explained that hypoallergenic food was, in this case, not going to help and suggested another counterintuitive solution: diet food! His logic was that that type of food is always high in fiber and low in fat which is exactly what she needs. He also said she needs probiotics to get the bacteria in her gut back on track.
In addition, because I had asked if homeopathics could work, he is going to give me hyoscyamus niger 30D for her nervousness. If she eats the new kibble, and I can feed her the probiotics without her ignoring her food, it will be 2 out of 3 and I'll be very happy!

Yearly vet visit

Friday the 5th, Basti was due for her yearly vaccinations. Her sister and 'step-brother' are due as well, but it's almost impossible to safely take 3 cats to the vet in my tiny car. So, being the specialty cat in my house, she went first.  The good thing about all those past trips to the vet is that she is the easiest of the three to transport. She was talkative this time which is unusual. I sometimes think that she keeps quiet in the car to the vet when she feels really unwell but when she feels reasonably well, she doesn't understand why she should be going to a doctor and therefore complaints.

Basti saying she wants food..sitting on top of her box.

One thing that seemed to work last April when she had one of her anorexic episodes, was cobalamin and folate injections. As she's gradually been eating less and less again, I was hoping that giving her the vitamin shots now, would at least help her in going back to her old amounts. Here comes the weird part; I didn't see any improvement over the weekend but we were out a lot. Come Monday however, and I'm home most of the time, she ate an amazing 62 grams! Compared to the 40 or so grams she has been eating, I was ecstatic.Then a thought occurred to me: Could it be that she eats less because she doesn't like being alone or even doesn't like eating alone?

In the mean time, we're still trying to get her in her box. Our vet had 'open house' on Sunday, and the cat behaviorist was present as well. I mentioned to her that we had problems getting Basti into her box. She asked if Basti was responsive to catnip and when we said 'yes', she suggested using dried Valerian. Boy, that stuff smells!

Well, she reacted to it like we would..she squinted her eyes, pulled a face and walked away. Not the response I had expected. Still no other solutions besides perhaps dried catnip leaves. I've already tried spraying the inside of the box with catnip spray but that has no effect. If my guess about her not wanting to eat alone is correct, I'll never get her to go inside on her own.

A new meaning

BUNDLE OF JOY

Of course, Basti isn't this tiny ball of fluff anymore. She's now a little over 3 years old and a little wacky at times. In many ways, she reminds me a little bit of my previous cat Topaz, a sand colored Birmese. They say that IBD is often a disease that pedigree cats have and it wouldn't surprise me if she has Siamese blood in her veins.

Basti wrapped herself in my shirt

What does surprise me is that the average age by which time a cat is diagnosed with IBD is 6 years! How on earth is it possible that it takes a human 6 years to find out that the constant diarrhea and frequent bouts of anorexia (with or without vomiting) mean more than just finicky eating habits?

Of course, this makes me wonder if what she has really is IBD. I may be in denial  but the fact that she was diagnosed with IBD at age 2 in stead of 6 gives me pause to think.

I'm assuming that without the prednisolone I'm giving her, she's in a fair amount of pain. At a quarter pill every 3 days (the current amount she's on), she's supposedly not in any danger of becoming diabetic as well. I hate giving it to her but she is my bundle of joy and I don't want to see her all stressed out or in pain. Sometimes, however,  she gives that term a whole new meaning!

Her own box

No, I wasn't talking about a litter box...there are 4 of those in my house and a large one outside called my yard. It's a 'feeding box'. For those of you who don't own a pet, you're probably are going to think I'm insane.

SPOILED CAT

When Basti started her anorexic episodes, I became frantic. If there's one thing I don't like, it's a cat not eating because it usually means something's wrong. So for a year or so, I carried the food to her. The other 2 cats get fed 4 times a day but she got food whenever, wherever she wanted. And also when she didn't want it. She got fed on the floor, on a cabinet, on the table, on a cat tree at any given time during the day. Now, in itself that's not a bad thing. Cats supposedly eat for 3 minutes at a time all through the day if left to their own devices. One big problem though: I couldn't leave the house for long periods of time because leaving food out creates a different set of problems:

My red monster Blinky

Blinky, my red-haired tomcat is a cookie monster.He eats wet food, kibble, peas, broccoli, cauliflower and his favorite; croutons! If I leave any food out, there's a 99% chance he'll be the one to eat it. And he's the one who's on a permanent diet. This 7 kilo (15.5 lbs) cat does not need food from either of my other cats.

SOLUTION

I needed a space that only Basti could go into that wasn't any room the others would want to sleep in (bedrooms) or were noisy (laundry room). This meant I couldn't do it in any specific room in the house. So I built a wooden box with a cat flap that responded only to her chip and put it in the living room where I could keep an eye out. The box is 45 cm wide, 78 cm long and 68 cm high ( 18x31x27 inches). It is made from really sturdy wood and has a lid that's too heavy to be opened by even my red monster. The only disadvantage is that it's completely closed off except for the cat flap so it's pretty dark inside. So I came up with another solution; a light running on batteries.

Now the only solution I have to find is how to get the cat in the box :-). That is, without first putting her in front of the cat flap, with the flap duct-taped open...

Introduction to my IBD cat

BASTI

Basti at the shelter

Basti (or Bas for short) was born on April 11, 2011 in a rural area in Heijningen, the Netherlands. I don't think she was born feral but I don't think she was very used to people either. She most likely belonged to one of the farms situated there because she´s an excellent hunter. Although she´s not your typical lapcat, I love her to pieces but she's got some 'issues'..

In January of 2013 Basti was diagnosed with Inflammatory Bowel Disease (IBD). She was almost 2 years of age. At this point I'm still having problems trying to figure what works for her and what doesn't. But maybe, one of these days, someone with the same problems as I'm having with Basti, will see this blog and fill in the blanks. Or maybe just one blank. Or maybe, by searching, I will eventually figure it out myself and thereby help someone else. Anyway, I'll try anything to figure out what makes this sweet little ball of fluff tick. Below a little history of what happened until now...

We'd been having diarrhea problems pretty much from the moment we got her in July 2011 when she was 13 weeks old. The vets kept thinking that it was giardia because she came from a shelter. I should have known that that couldn't be the issue because her sister Niké (pronounced: Knee-cay) had no problems at all. Basti was at this point, however, still eating her food and happily came in when feeding time came around.



In May of 2012, we unintentionally added a stressor by adopting a 5-year old fixed male cat named Blinky. It never came to full-blown fights but Blinky was defensive and territorial at first and had the tendency to attack Basti. Even now, he still jumps her from time to time but as far as I can see, he stops as quickly as he starts. It's more play than aggression. Then again, Blinky has had his fair share of warnings from me because he is more than twice her weight.
By the time Blinky came around, we'd already gone through several rounds of metronidazole (antibiotics). When she stopped eating the summer of 2012, we took a few trips to the vet without avail. In October of that year we decided to see a specialist. The specialist vet suggested an elimination diet to see if she had any food allergies. That went well for 2 months and then she stopped eating again. In January 2013 we went for an endoscopy. She had gone from almost 3.7 kilograms (8,1 lbs) to a little over 3.1 kilograms (6.8 lbs). This time, the vet diagnosed her with lymphocytic gastroenteritis; the lining of her stomach and duodenum were inflamed and 'flaky'. He put her on prednisolone and the (human) proton pump inhibitor omeprazole.

FOOD

Shortly after the trouble began, I assumed that adding a third cat to the mix was most likely the stressor that made her stop eating. There was however something else I had changed exactly around that same time: I went from part kibble, part canned food to no kibble at all and only grain free wet food. 
After her initial diagnosis, it took me another 4 months to realize that grain free wet food wasn't going to do it for Basti. The frustrating part is that no vet here has any clue as to what the dietary needs for an IBD cat are. I had to scour the internet for the information.  It turned out she needed more fiber, not less. With all the reading I had done over what a cat should and should not eat, kibble wasn't what I wanted but Basti was extremely happy with her dry food. She started eating again and around autumn of last year, she weighed a whopping 3.8 kg; I was ecstatic!  
Unfortunately, it didn't last. This spring we were back at the 3.1 kg, she was barely eating and we put her back of the prednisolone.  She now weighs 3.3 kg and although she's eating a decent amount of food, she doesn't really gain weight.