Canberra Cat Vet Blog

RIP Spunky

Spunky was a big boy and aptly named. He ruled the house and his carers' day centred on his every need - because he wouldn't let them forget his standards and requirements.

He often brought up a furball, so often that his carers just thought it was normal for him to bring one up every week or so. Six months ago it became more frequent and he started bringing up food as well. He seemed as bright, happy and demanding as ever so at first they thought nothing was wrong. After talking to us they tried out a few different foods, including a hypoallergenic diet, thinking that maybe something was interfering with his delicate digestion.

He vomited all the more and started to lose weight despite appearing normal. We tested him for all the usual causes of vomiting in cats - kidney disease, liver disease, pancreatitis, hyperthyroidism - but everything came back normal. Something nasty was going on.

Dr John recommended biopsies of his stomach and intestines. His carers were reluctant to go so far and played with his diet a bit more. Eventually they decided that something must be done and he came in to hospital for an anaesthetic and investigation. Samples were sent to the pathologist.

The result was a diagnosis of low grade lymphoma of the intestines. This is the end result of chronic inflammation of the stomach and bowel.

The good news is that it can be controlled with low grade medication if caught early. Spunky lived another healthy 5 months, but the lymphoma spread to his stomach at the end. Many cats live much longer than 5 months. Some, especially if the lymphoma is advanced on diagnosis, have a more limited time to live.

If we diagnose the inflammatory bowel disease in the early stages we can prevent it from developing into lymphoma all together. Spunky's carers urge everyone to take notice of any 'furballs' or vomiting early on. Furballs are simply a sign that the stomach or intestine is inflamed - they are usually not because of the fur. If you see them more than once a fortnight, discuss it with your vet.

Stomach and intestinal disease is so common in cats that many people think vomiting and ‘furballs’ in an otherwise healthy cat are normal.

Vomiting more than once a week, particularly if your cat is losing weight is NOT normal. Furballs are a sign of stomach or intestinal inflammation and should be investigated.

There are many causes of vomiting. The easiest to diagnose and treat is an intolerance to a particular food, usually a protein like fish, lamb or beef. If the vomiting stops when your cat is switched to a hypoallergenic diet then a dietary intolerance is the most likely cause. Once the offending protein has been identified you just have to avoid feeding it to your cat.

Cats that eat grass or other hard- to-digest plants frequently vomit. Preventing access to the grass may solve the problem but often they are driven to eat grass by an irritated stomach.

If a hypoallergenic diet does not eliminate the vomiting we suspect a more serious disease like Inflammatory Bowel Disease (IBD) or a gut cancer. IBD and low grade gastrointestinal lymphoma are quite responsive to treatment. Occasionally more serious cancers are found.

An ultrasound may show increased thickness of the stomach or small intestinal wall indicating IBD or lymphoma. Occasionally another problem like a partial blockage or a solid cancer is found.

Unfortunately ultrasound does not distinguish between inflammatory bowel disease (IBD) and lymphoma. Biopsy samples of the stomach, small intestinal wall, abdominal lymph nodes, liver and pancreas obtained during abdominal surgery are the most accurate way of distinguishing them.

A veterinary pathologist looks at the biopsy sample under the microscope and determines if IBD or lymphoma is present and then classifies them. This information helps us make a treatment plan and predict the response to treatment.

Inflammatory bowel disease is caused by a chronically irritated stomach and intestinal lining. The inflammation is sometimes caused by an irritant in the food. Often the cat’s immune system overreacts to components of a normal diet. It is usually very difficult to identify the specific cause. The inflammation interferes with digestion of food and absorption of nutrients. Therefore cats with advanced disease lose weight and try to compensate with an increase in appetite. Treatment includes immunosuppressive drugs such as prednisolone, special diets and vitamin B12 injections. Often, cats get an initial short course of antiparasitic drugs and antibiotics to rule out other irritants of the intestine.

IBD is not a curable disease but proper treatment controls it and stops or slows the vomiting and weight loss. Overall, the prognosis is very good.

Low grade lymphoma is treated similarly but a low dose chemotherapy drug is added in. Many cats live for years with proper treatment.

If dietary intolerance, IBD or low grade lymphoma are left untreated higher grade bowel cancers may develop.