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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Cat
Satisfied Customers: 32856
Experience:  University of California at Davis graduate veterinarian with 45 years of experience.
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My 16 year old male Birman seems to have what's best described

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My 16 year old male Birman seems to have what's best described in layman's terms as IBS.
He normally has a very good appetite but every week or so he has a day or so where he's asking for food but has little real appetite this usually ends with a bout of diarrhoea & as he uses a litter tray I can observe that this appears to contain a somewhat jelly like mucus & some blood flecks.
Within 24 hours he's back to normal with varying sized firm stools & a very good appetite.
This cycle has repeated for some years now although his weight has been constant for that period.
He only ever eats wet food & whilst clean water is always available I've never seen him drink other than returning from a short cattery stay a year or so ago.
He did have a blood test a couple of years ago, that was normal with the exception of slightly raised liver enzymes.
We were given Laxapet in case constipation was causing this cycle but we've only ever used it very sparingly.
When he's in the low appetite part of the cycle he'll nibble at grass in the garden.
He pees freely & very seldom vomits. He's predominately a house cat in the winter hence the litter tray. He's generally of a very friendly disposition but is a tad depressed in his off periods. Would be interested in your thoughts especially as it's been in the background for some years now.
Thanks Chris...
Chris, I believe that you're on the right track but instead of IBS (irritable bowel syndrome, functional bowel syndrome, "nervous colitis"), IBD (inflammatory bowel disease) is my primary consideration. IBD is an idiopathic (unknown cause) disorder of cats which can behave as you've described. A significant concern, however, is that it can transmute into small cell lymphoma and so should Maxwell not remiss as regularly as he has done previously, that cancer needs to be considered. Conservative therapy for IBD involves the use of a glucocorticoid such as prednisolone, the antiinflammatory antibiotic metronidazole, or both. A food intolerance, gastrointestinal infection, pancreatitis, or hepatitis isn't expected to wax and wane over so many years as you've described.Please respond with further questions or concerns if you wish.
Customer: replied 2 years ago.
Firstly thanks very much for your expert & entirely plausible response / diagnosis.
Wednesday morning Maxwell was a little lethargic but that didn't stop him from asking for food although he had little interest once it was offered. By late afternoon he was again asking & actually was eating a few mouthfuls. I've been out for two or three hours in the evening & on return he's pleading for more & has polished off quite a hearty bowl full, very happy & lively as a lad half his age!
My question is should I consult my vet with the information you've presented? Is the course of treatment you've mentioned intravenous or oral? Is it regular or as required?
My concerns are entirely related to his well being & not financially constrained.
Thanks again for your encouraging but realistic response to my initial enquiry.
You're quite welcome, Chris. I'm pleased to hear that Maxwell continues to remiss so quickly and thoroughly. Please feel free to share our conversation with Maxwell's vet. Therapy would be oral and the smallest dose and least frequent dosing of either or both of those drugs is the correct dose. Please continue our conversation if you wish.
Customer: replied 2 years ago.
This morning, 24 hrs after the bout of diarrhoea yesterday morning, Maxwell still has a healthy appetite & passed quite a firm stool as well as peeing freely in the litter tray.
I think I will consult my vet next week based on our earlier conversations.
Thanks for your thoughts & advice thus far.
That sounds good to me! I can't set a follow-up in this venue so please return to our conversation - even after rating - with an update at your convenience.
Dr. Michael Salkin and other Cat Specialists are ready to help you
Thank you for your kind accept. I appreciate it.
Customer: replied 2 years ago.
No problem Michael, just to say Maxwell was very lively yesterday evening even asked to go into the garden which is quite rare in this weather! He came in really lively about 10 mins later to the point where he was running from room to room & up the hall way a couple of times......I've heard it said that can been an indication of Thyroid issues but not worried as he seems to enjoy it before settling down for a few more hour sleep! Today he's been quieter, eaten a bit but has struggled in the litter tray only passing a very small stool that was hard as concrete. How things can swing from liquid diarrhoea to almost hard as stone in 48 hrs is amazing, I'll see what the vet has to say next week
Curiously, that kind of change in stool quality is more consistent with IBS than IBD but there may be overlap between the two disorders in cats. Hyperthyroidism is relatively common at Maxwell's age and is evidenced by polyphagia (inreased hunger) yet weight loss, polydipsia (increased thirst/in just 35 % of hyperthyroid cats), and more vomiting than we would expect in a cat. Keep me posted, please. No need to reply at this time.
Customer: replied 2 years ago.
Hi Michael, took Maxwell to the vet & mentioned our conversations. He had a good grope around his abdomen & thankfully came to the conclusion there was nothing sinister in there & his weight was exactly the same as his previous visit a few months before He tended to agree in the IBS/ IBD theory but was of the opinion that if we're able to manage the episodes he'd rather not medicate unless things worsen, he was of the opinion some of the anti inflammatory drugs are not ideal for cats. Would you be able to comment on that? Maxwell is currently in one of his better periods eating reasonably, fairly active & alert although nothing in the litter tray at all today, we'll see what tomorrow brings!
Thank you for the good update. The nonsteroidal antiinflammatory drugs (NSAID) are problematic in cats and so we usually prescribe either the antiinflammatory antibiotic metronidazole or an antiinflammatory glucocorticoid such as prednisolone...which I'd prefer to avoid at Maxwell's age. I would just as soon not medicate or, perhaps, medicate only at the onset of one of his cycles.