Category Archives: Medical & Health Care

Treating My Cat’s Severe IBD and Gastrointestinal Inflammation

In July 2017, my then 17-year-old cat Romeo started presenting with symptoms of vomiting, diarrhea, mild weight loss, and lethargy. Up to this point, Romeo had been a very healthy male cat with no medical issues other than a low-grade heart murmur, one eye infection, periodic dental cleanings, and routine annual checkups to maintain his health. But things were about to change for Romeo and his cat parents.

Concerned that Romeo’s diarrhea and vomiting had become more than just an isolated event, we scheduled an appointment at Four Corners Veterinary Hospital in Concord, our trusted vet who has been highly supportive and a critical partner in managing all of our cat’s health over the years. Romeo’s doctor did a full physical exam—palpating his abdomen—finding some thickening of his intestines. He took Romeo’s blood and ran a blood chemistry profile and urinalysis. Then recommended diagnostic tests—specifically an ultrasound that would rule out things like a GI tract obstruction or abdominal mass, but would provide a detailed examination of Romeo’s internal organs from all different angles, the sizes of the organs, as well as their functioning. An ultrasound evaluates the cat’s liver, spleen, kidneys, gallbladder, lymph nodes, small and large bowels, bladder and pancreas and is able to determine the size, shape and texture of each—revealing any abnormalities, enlargements, masses, fluids, stones, thickening, dilation or if any lesions are present. So we ponied up the $450 dollars (at the time) to get to the bottom of what was going on with Romeo’s gut. 


The ultrasound findings were revealing – Romeo had developed immune mediated bowel disease or possible low-grade emergent round cell neoplasia (intestinal lymphoma). His findings also supported the diagnosis of generalized enteropathy, which just refers to any dysfunction of the intestines. With this finding, some damage or defects had occurred to the lining of Romeo’s intestines, allowing proteins and other particles from food to pass through to be absorbed by the bloodstream instead of the intestines. Thus, his extreme diarrhea.

Lymphoma is considered to be the most common cancer in cats, and Siamese cats (which Romeo is half Siamese) are at higher risk of developing lymphoma, and Siamese male cats are predominantly at more risk. Bingo, that was Romeo. So are Oriental pure bred cats. To definitively diagnose whether Romeo indeed had intestinal lymphoma, our vet recommended an intestinal biopsy for a more definitive diagnosis of his GI tract. But since that would require surgery and the ultrasound was already expensive, we accepted not knowing if Romeo had lymphoma at this stage. The results of Romeo’s ultrasound showed that all his organs were otherwise normal and healthy—all were a normal size, shape, and texture, but his bowel width was increased and showed thickening. Since Romeo goes outside (in our fenced-in backyard only), I had also wanted to rule out parasites as a cause of his symptoms. So I had gone ahead and dewormed him with the proper deworming protocol of Drontal (from our vet), then another Drontal 21 days later, to eliminate the most common worms – round, hook and tape worms, so we could rule this out as a cause of his symptoms.

Romeo’s treatment plan at the time included: 

  • The immunosuppressive corticosteroid Prednisolone, AM & PM, for four weeks–tapering down to once a day 
  • A diet of novel protein including duck, venison, or rabbit (dry and wet)—a hypoallergenic diet that contains a protein source that Romeo had never been exposed to before. Another option was a hydrolyzed diet where the protein has been hydrolyzed to make digestion easier
  • Daily probiotics for his wet food
  • Sub-Q fluid therapy to hydrate him – we do ourselves with lactated ringers
  • B12 shots every week for a month, then every other week for a month, then once a month (we do ourselves, it’s much cheaper and easy to learn)

Romeo did very well for one year and responded very well to his treatment, which was adequate to control his disease at the time. But since IBD is not curable, and symptoms can and do return—a year later Romeo’s symptoms came back. Now Romeo was 18 years old, and his symptoms had returned and started to become severe again. So we put Romeo back on the corticosteroid Prednisolone—twice a day, then slowly tapering down to once a day again. But weeks later, when we tried to reduce the Prednisolone to one time a day only, his diarrhea returned. So our vet recommended that Romeo stay on the Pred once a day long-term, which was successful in managing his symptoms again for another year. 


Now it’s February 2019, and Romeo is 19 years old and his diarrhea has returned again with a vengeance—multiple times a day—and clearly the Prednisolone still given once a day is no longer enough. By this time, Romeo had also lost almost two pounds slowly over the past 1-2 years, and he was showing dramatic signs of becoming physically weaker, slower and more cautious. My once sprightly, energetic, active, vigorous, adventurous cat—was starting to show his old age and to slow down. Now, it was time to return to our veterinarian for another routine checkup and blood panel to see what had changed and where his disease was.

It turned out, this time, Romeo was mildly anemic, which was causing weakness and vomiting; and he had a suspected ulcer (some blood in his stool), a bacterial infection in his gut, and he had chronic low-grade inflammation. Wow, it was a lot to hear and I was feeling somewhat overwhelmed. Romeo was just one of many cats that I take care of every day.

Following this diagnosis, in March 2019. we started Romeo on Metronidazole—for the first time—an antibiotic-antibacterial medication for bacterial infections. He gave him a prescription of quarter tablet in the AM and one in the PM, for three weeks, then down to one ¼ pill only in the evenings. We bumped up Romeo’s B12 shots to every week again, and returned to giving him a novel protein diet in both his wet and dry food (rabbit, duck and venison), in addition to sub-Q fluid therapy to keep him hydrated. Plus to treat his gastric ulcer, our vet recommended Sucralfate, a medication that gets mixed with water into a slurry, and is drawn up in a syringe, then dripped into his mouth, morning and night, for two weeks. Again, Romeo’s symptoms subsided for a few months. 

Then five months later, in July 2019, Romeo started having a very bad flare-up again. So he is now back on the Metronidazole two times a day, and may need to stay on this drug twice-daily long-term, but our goal would be to reduce the drug back to one time a day. He is now less responsive to the Metronidazole than he first was, so his disease is clearly worsening. To calm his digestive tract, for the next couple of weeks, this will be Romeo’s treatment plan, and may continue long term, we will see:

Romeo’s treatment regimen is now the following:

  • Boiled white chicken and turkey breast (It is not an adequate diet for cats on its own, as all cooked muscle meats must be supplemented with Taurine and vitamins that cat’s need, so you can supplement the cooked meat with a nutritionally complete powder called EZComplete that can be added to your cooked meat. EZComplete is complete with all the necessary vitamins, minerals and taurine that cat’s need, see Taurine is critical in a cat’s diet daily, here’s why. Here is more about how to add Taurine to your cat’s raw or home cooked meat diet.
  • Add this probiotic, S. Boulardii by Jarrow (on Amazon), to your cooked meat, one powdered capsule per meat serving. S. Boulardii is the best natural anti-diarrheal. Here’s why.
  • Add this probiotic with 25 beneficial bacteria strains – Nexabiotic Probiotic For Cats from Amazon (which has the S. Boulardii strain but not as much as the single full strain by Jarrow) to wet food every day. As an alternative you can use Dr. Mercola Complete Probiotics for Pets.
  • Every once in awhile, I use Gerber’s baby food, as an alternative to cooked turkey or chicken, again mixed with a nutritionally complete powder such as EZComplete – by – or another brand that has the nutritionally necessary vitamins cat’s need.
  • Give B12 shot every two weeks (we administer ourselves, learned from our vet how to administer sub-Q injections)
  • Give Metronidazole (1/4 of a 250 mg tablet) – AM and PM now until the diarrhea stops, which it has, so Romeo is now getting this 1x per day.
  • Prednisolone steroid – 1 pill every PM
  • Fluid therapy given 1-2 times per week (lactated ringers 1000 ml) to maintain adequate hydration. But there is ample hydration in his wet food every day as well.
  • The Assisi Loop for healing and pain management, see the video
  • Digestive enzymes are recommended, but we are still researching to find the best brand for cats only
  • You can mix cooked meat (chicken or turkey) with Bone Broth (no sodium, no salt) and diluted with some water – but not necessary if you are using EZComplete by Food Fur Life, that has all the necessary vitamins and minerals that cat’s need mixed in with their cooked meat.

A week later, Romeo’s stools are starting to firm up, his diarrhea is gradually dissipating, but it has taken longer this time for his diarrhea to stop. Earlier, he was so sensitive and responsive to the Metronidazole, but not any longer. The change to boiled chicken/turkey 1-2 times per day is really helping—Romeo loves it, he is lapping it up with fury—and is eating more food as a result. But best of all, the addition of the S. Boulardii probiotic by Jarrow and Nexabiotic probiotic has made a huge difference. And importantly, going forward, I have added the necessary essential vitamins and minerals with the EZComplete powder for cats by FoodFurLife, so that his homemade cooked meats are a complete and balanced diet based on the prey model. Plus it contains no fillers, no additives, no thickeners, no flow agents, and no preservatives, that would set off his gut again, and ensures he gets enough Taurine. This is an easily digestible diet, and I can alternate with his novel protein cat food for variation. The diet therapy part of treating IBD is so critical and cannot be underestimated in controlling and managing this disease, because otherwise, we are only putting a bandaid on the problem with anti-inflammatory and immunosuppressive medications, that aren’t healing the disease.


Our last and final treatment plan down the road for Romeo’s Inflammatory Bowel Disease will be to try the Immunosuppressive chemotherapy drug – Chlorambucil (Leukeran®) next, if necessary. This will come when Romeo is no longer responding to his current treatment plan of Prednisolone and Metronidazole. Chlorambucil is usually used in conjunction with corticosteroids for cats with severe IBD and the side effects are minimal, except for causing severe bone marrow suppression. So Romeo would have to be closely monitored at that point by our vet. But at his age, and at his stage of the disease, what choice is there? At least he could continue to live longer, be relatively symptom free, and enjoy more of his life and the things he loves—until the day when maybe none of this will be enough for his tired body. But I don’t have to think about that now. I’m focused on today. One day at a time they say.

Since IBD cannot be cured, the goal is to manage it by minimizing symptoms, managing the discomfort, and addressing the recurrences as they arise, quickly, and giving Romeo a simple, bland diet that will not trigger his gut. To all those who have IBD cats, I hope by sharing this with you, it helps you.

Here’s to a long, happy, healthy life for all the cats with IBD or other gastrointestinal diseases—and to the cat parents who are dealing with this disease and treating them. I wish you the very best.


Treating and Preventing Feline Herpes Virus Infections

In our household of multiple cats, you could say we learned the hard way about feline herpes virus infections, how they are triggered and how to prevent them. We came home from a week vacation to a serious herpes virus infection that worsened for months before improving. This is our experience treating a stubborn herpes eye infection and how to avoid an outbreak in your cat in the future.

Feline Herpes Virus is extremely common in cats, with kittens often born with the virus from their mothers. Adult cats can carry the virus for years without showing any symptoms. Feline herpes virus can lie dormant until the immune system is weakened, or the cat experiences a stressful event, or even a particular medication can trigger the infection. In our case, it was our vacation that triggered the “stressful event” that brought on a raging eye infection and stubborn corneal eye ulcer that took five months to treat, heal and overcome.

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Second-Hand Cigarette Smoke Causes Cancer in Cats

Was your New Year’s resolution this year to quit smoking? If it wasn’t and you’re a smoker, it may be time to quit smoking for your pets’ sake. An increasing number of research studies show that animals face significant health risks exposed to the toxins and carcinogens in second and third-hand smoke. And numerous research studies have revealed that cats exposed to second-hand cigarette smoke causes cancer in cats.

Toxic Chemicals in Cigarette Smoke

Cigarette smoke contains 4,000 chemicals including hydrogen cyanide, formaldehyde, arsenic, ammonia and urea among them. Second-hand smoke is considered the smoke that is exhaled or comes from the cigarette itself and can be inhaled by non-smokers including our pets. Third-hand smoke is the residue from smoke and smoke particles that can be found on clothing, furniture, bed linens, skin, and fur even after the air is clear of smoke. Cats get into problems with third-hand smoke when they lick smoke and particles from smoke off their fur.

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Safety and Protection Checklist for Cats

Cats are curious animals, and because of it, they can get themselves into trouble at times. This list of dos and don’ts will help you be a more responsible guardian of your cat, and help to keep your cat safe from harm; free from unnecessary injury and accidents; free from unnecessary disease and suffering; and keep your cat as healthy and happy as possible!

Some Don’ts

DON’T leave your cat unattended in your car. NEVER leave a cat inside a car on a warm or hot day, not even for one minute.

DON’T let your cat roam free in the neighborhood.

DON’T re-home or give your cat away. Always try to keep your cat even when life requires making unexpected changes or facing unexpected challenges. If you must re-home your cat, be sure to screen and interview the potential adopters in person for their experience and history with cats; learn everything about them and meet all family members that live in the home; check their work/landlord/school/personal references; and visit their home in advance to make sure the cat will have a safe and loving environment to live. Here is a list of tips for preparing to adopt a cat.

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Signs of Dehydration in Cats

Your cat’s body is made up of 70-80% water or three-quarters of your cat’s body weight is water, so it’s critical that your cat gets enough fluids daily to maintain good health and prevent dehydration. Water is essential for cat’s urinary and kidney health, circulation, digestion, and waste removal. With hot summer days now upon us, it’s even more important that your cat has access to and drinks enough water, as dehydration can lead to a number of serious medical problems and even death. Here are the signs of dehydration in cats and why it’s so important to treat dehydration immediately.

Why Hydration is So Important

Dehydration happens when your cat loses body fluids faster than he can replace them, and it can happen when your cat is either not drinking enough water or is losing too many fluids. Fluids lost through daily urination, elimination and respiration all need to be replaced to normal levels everyday. But if your cat hasn’t been drinking enough water; has been vomiting or has diarrhea; or has been ill or had a fever; or your cat is old, then rehydration is even more critical as all of these can leave your cat severely dehydrated.

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Preventing and Treating Fleas in Cats – The Good, The Bad and The Ugly

Summer is a favorite season for picnics in the park, enjoying the seashore, and dining al fresco—but with warm summer temperatures also come the fleas! Fleas can wreak havoc on cats causing discomfort, severe skin conditions, allergic reactions, parasites (tape worms), anemia and even death in the worst cases, if left untreated. So it’s important to protect your cat from fleas, but it’s also important to know the dangers of some flea control products on the market today. In this article, you’ll become knowledgeable about the different flea treatment options, some of the health consequences associated with them, and you’ll learn ways to provide your cat with the safest possible flea treatments and precautions available. Here’s the good, the bad and the ugly on preventing and treating fleas in cats.

Does Your Cat Have Fleas?

To check whether your cat has fleas, you can run a flea comb through your cat’s fur pressing along the skin to check for adult fleas or flea feces and eggs. These will look like little specks of salt and pepper or tiny black and white grains in the fur. The white grains are flea eggs, and the black grains are flea feces. If you have found and removed some grains on your flea comb, rub the grains onto a piece of white paper and if the grains turn a reddish-brown color, you know you have a flea problem.

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The Diagnosis of Malignant Melanoma In My Cat 

My 15+ year old rescue cat Marcello was always the picture of perfect health. He passed his annual routine checkups with flying colors every year and only needed two dentals in the 12 years he lived with us. No sniffles, no sneezing, no coughing, no viruses, no infections. He could not have been an easier cat to care for. Until he started peeing outside the litter box. That’s when things started to change. That was a year and a half ago. 

Marcello lived with three other rescue cats upstairs on our second floor. He would have been very happy as an only-cat, but unfortunately that was not his destiny as I was in cat rescue, and was actively trapping abandoned cats in our community, bringing them home to foster, medically treat, and socialize, before putting them up for adoption with my cat rescue organization. One by one, there was always a new rescue cat that Marcello had to put up with. He hated the competition for attention and would even punish and bully each cat for stealing affection away from him. He was a one-woman cat and that had to be understood by any new resident cat who came to share his home–those were Marcello’s ground rules and he strictly enforced them.

A Tribute to My Beloved, Beautiful Cat Marcello

Marcello himself had been abandoned. Someone who owned him in his early years had left him behind and moved away, leaving him to fend for himself outdoors. Marcello survived, but he had been in his share of cat fights and had the scars and torn ears to prove it. But his real wounds were all on the inside—his trust in people had been deeply injured and his confidence in people shaken to the core. During the first two months of Marcello’s healing with us, he feared being abandoned again. Every time I came to visit him in his room, he completely let his guard down and would wrap, twist and curl his body all around me, then head-butt me over and over again, all with a big orange tail flared out like a bottle brush. But when I would get up to leave, Marcello would attack me like a police dog—and bite my ankles with a vengeance and leave me a bloody mess. That fear of abandonment slowly dissipated over time as he came to trust and realize that he was safe with us. In short order, Marcello became one of the most affectionate, loving cats I have ever come to know. He was a cuddle bug who loved nothing more than being stroked, rubbed, petted, caressed and loved every minute I could give him. 

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Don’t Ignore the Signs of Dental Disease in Cats

Cats Need Dental CareFebruary is Dental Awareness Month, so it’s a perfect time to start the year off right by providing good dental care for your cat. Dental or periodontal disease can lead to many serious health and medical issues if left untreated. And untreated dental disease can be very painful for your cat and can even cause them to stop eating. The key to good dental care and managing dental disease is prevention.

Dental disease and oral tumors can start in cats as young as 1-2 years old so it’s important to have your cat’s mouth, gums and teeth evaluated starting when they are young. Gum disease is an infection that results from a build-up of dental plaque or bacteria on the surfaces of the teeth around the gum line. If plaque is allowed to accumulate it can lead to infection in the bone surrounding the teeth. The gums will then become inflamed causing bleeding and oral pain. Inflammation can progress affecting both soft and bony tissues causing gum disease, bone loss, and periodontal damage. When severe periodontal disease is present bacteria from the mouth can enter the bloodstream and damage the kidneys, heart and liver.

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Why Your Cat Needs Good Dental Care

February is dental month! Dental disease has become the number one health concern in adult cats. Your cat needs good dental care just like you do. Without it, cats are more prone to problems associated with poor dental hygiene and can get serious and painful dental diseases. Without good dental care cats can suffer from having a painful mouth and as a result, can even stop eating. Good dental hygiene is as important to cats as it is to humans and contributes to your cat’s overall well being, comfort and happiness. The good news is most periodontal disease in cats is completely preventable with good dental care and annual wellness checks.

Roughly 4 out of 5 cats develop periodontal disease. Why? Partly because dental care in cats is often overlooked and left untreated. Cats hide their pain very well though they may be silently suffering, and many cat owners don’t take their cat for regular annual wellness exams each year. Untreated gingivitis (inflammation of the gums) often progresses into gum infection, chronic disease and can even impact vital organs.

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What Are the Warning Signs Your Cat is Sick?

Don’t miss the warning signs your cat is sick and may be in pain. Research shows that cats feel pain just like we do. But they tend to hide their pain—so just because they don’t show you obvious signs of pain, doesn’t mean they aren’t suffering or in distress. It’s up to you to know the signs that something is wrong and advocate for them by getting them the help they need.

When cats aren’t feeling well they give us clues. The clues may be physical or behavioral, or both. Some signs require immediate veterinary attention like respiratory problems or changes in breathing; straining to urinate, defecate or crying in the litter box; dilated pupils, or having any dramatic changes in behavior from normal. Some signs may increase over time with illness and won’t go away until your cat is diagnosed and treated by your veterinarian.

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