Feline IBD: The Alternative Protocol for Treatment
To download and print, please click here: Raw Feeding for IBD Cats Facebook Group ALTERNATIVE PROTOCOL for Treatment
Disclaimer: We are not vets. While this approach has been supervised by vets in plenty of IBD cats, this protocol is more readily embraced by holistic vets than most traditional vets. We recommend you discuss changes with your vet, but many have had to forge ahead on their own due to lack of support (other than from groups like this).
Also please note, all cats react differently to food and supplements. There is no “one size fits all” especially when it comes to IBD. All we have is anecdotal evidence that this works for MOST cats.
We DO recommend that if your cat has not had recent blood work (within the last three to six months) including the full GI panel, please do it. If your cat has been losing weight, additionally check thyroid function (including the Free T4); also check serum fructosamine (in addition to glucose which is normally checked), to rule diabetes in or out. The GI panel is a test that requires a 12 hour fast and should include (and ensure it does) the
fPLI (for pancreatitis, though a negative does not mean your cat doesn’t have pancreatitis. The test is very specific, but not very sensitive. Please see Feline Pancreatitis and fPLI for more information)
B12 (cobalamin)
Folate
fTLI (for pancreatic function, checks for exocrine pancreatic insufficiency (“EPI”). In some labs, this test for exocrine pancreatic insufficiency must be requested. ESPECIALLY if your cat has been losing weight, make sure it is. EPI is far more prevalent than most vets seem to think.
Note:
The basis of this treatment approach:
In humans, IBD has been definitively linked to gut dysbiosis. Probiotics are a central cornerstone in ongoing management and treatment. Please see our file “What is IBD” for more information. We also recommend you read the important information on healing gut dysbiosis, the root of IBD in our file Prebiotics & Probiotics for Cats: A Cornerstone of Health & Healing in Feline IBD
There is one basic approach that works most of the time. (There is no always, especially not with IBD!).
Traditional vet protocol for IBD is flagyl (metronadizole), steroids, and a prescription or limited ingredient diet. That may stop the symptoms, and the metro may help with an unhealthy bacterial overgrowth (dysbiosis), but it doesn't address the root problem from an ongoing management perspective. (And Tylosin is a better antibiotic choice than metro/flagyl. Too many vets put cats on metro for long lengths of time. It is meant for short-term use only. Please see our file Flagyl - Metronadizole - is Genotoxic, Potentially Cancerous, and Neurotoxic). Steroids can be an important tool when there is severe and rampant inflammation, but the goal would be to use them for a short sharp taper (several weeks to several months) while giving your kitty food and supplements that help their guts heal, hopefully to the point they successfully wean off the steroids. This has been the case for many cats in the group. Those that use raw feeding as the first step in treatment often find they don’t need the drugs at all. This is because “IBD” is a diagnosis of exclusion. Many cats are diagnosed as having IBD without ultrasound or biopsy. The only definitive diagnosis, in fact, is via biopsy.
It turns out that many, many cats are sensitive to *something* in commercial food. For some it is the gums and thickeners, for others, turns out something like the peas in the LID diets are the culprit. Also bear in mind that many pet foods identified as having a certain protein also have others not listed on the label. Pet food testing often reveals significant labeling problems. Many never know what the problem ingredient was. But ditching the commercial food often is all that's needed. And that includes the prescription stuff. Almost NONE of the prescription options are species-appropriate, particularly healthy, or anything that can be considered high quality. I haven’t reviewed them recently, but in 2010, there wasn’t a single Rx food that had no thickeners, which are implicated in human IBD. The LEAST appropriate is the RC hydrolyzed food. The only animal-based ingredient in it is fat. As cats are metabolically inflexible obligate hypercarnivores, not vegetarians or vegans, feeding them inappropriately is, in our opinion, a major contributing factor to the primary diseases cats suffer – including the disruption to their gut flora that is at the heart of IBD. …Let alone that soy is likely a culprit in hyperthyroidism, according to the world's leading expert in feline hyper-T, Dr. Mark Peterson.
Yes, this document is blunt. But we see people go insane trying to find the "right" food to buy. Many spend months or years ripping their hair out to find a food their cat will eat that doesn't set them off. Picky cats are usually picky because they don't feel well. Then everyone says "feed your cat whatever it will eat" to avoid hepatic lipidosis (fatty liver). Well, all those foods make the cat feel nauseous, many contribute to the inflammation causing the problem, and it is a seemingly never-ending cycle. Get off the merry-go-round and feed your cat a meat-based diet. FRESH meat and organ. Human Grade. Ingredients YOU control. Or high-quality commercial raw with limited fruits and veggies (5% or less) that is already nutritionally balanced. Fine. If you are concerned about your homemade food and bacteria, cook it. Though if making cooked food:
Whether raw or cooked, the point remains the same: give your cat's guts real food. Also, some cats accept cooked food more readily, cooking (if using eggshell – again, do NOT feed cooked bone!!!!) can help the transition, and cooking it less and less to the point of feeding it raw is a transition tool that works for some.
No, there is no cure for IBD. But it is possible to reduce the inflammation via diet and probiotics, and guts do heal. Or can. If you want to know what works most often, this is it. This is advice you'd likely get from a holistic vet, not (usually) a traditional vet.
This is for ALL IBD cats, but *especially* if your kitty is in crisis, stop ALL food you are currently feeding and do this:
1) Put kitty on a bland diet of poached turkey leg or pork (any boneless) cut for a week or two. If you suspect food sensitivity, go with the pork, your cat has likely been least exposed to it. If you prefer, use baby food: Beechnut (stage 1, meat-only) baby food or Gerber (stage 2, meat-only: we note Gerber contains corn starch, but this does not seem to bother most cats and many prefer Gerber to Beechnut). Also note “Broth” in Beechnut is NOT spices or flavoring, it is the water the meat and bone was cooked in with the bone removed). No, this diet is not balanced. It will not hurt your kitten for a few days or your adult for a few weeks. There is information to help you balance the food in the Raw Feeding section of this website, and we can help in the Raw Feeding for IBD Cats Facebook group with any questions.
2) Make and feed bone broth. If a chicken allergy or sensitivity is suspected, use other meat and bones. The two-stage method is still recommended. For cats, obviously nothing but meat and bones go in the broth. Bone broth not only provides quick nourishment and hydration, the collagen in the bones is 11% L-glutamine, which literally helps repair the intestinal mucosa. Please see our file on Bone Broth.
3) Start human grade, not pet, probiotics. A detailed discussion on the importance of appropriate prebiotics, probiotics – particularly Jarrow S boulardii with MOS (or in Europe, a plain S boulardii and the product Entero Chronic, available on amazon UK) and doses is in our article Prebiotics & Probiotics for Cats: A Cornerstone of Health & Healing in Feline IBD. The information in this article is critical for helping your kitty.
Repopulating healthy bacteria is the absolute key in the long term management of IBD that traditional vets tend to not recognize. The growing body of published research (in humans and our pets) has found that the composition, format, and processing of food has a direct impact on gut microbiota. Thus species-appropriate raw feeding is more critical than we could ever have imagined when it comes to the health of our cats. There is no such thing (yet) as "animal specific strains" of probiotics outside of the of AnimalBiome Gut Restoration pills (discussed in the article on prebiotics and probiotics) as science has only touched the very tip of the iceberg when it comes to knowledge of what populates the human gut, let alone the feline gut. And while probiotics have an important role in feline IBD (as gut bacteria perform many important functions in nutrition metabolism), repairing the intestines and addressing inflammation is also important in enabling colonies of needed, healthy bacteria to flourish.
Please note we recommend human grade probiotics for many reasons, and this is supported by researchers studying the microbiome of our pets and disease (again, please reference the article on prebiotics & probiotics). Importantly, Fortiflora, provided by many vets, is a poor probiotic. It is mostly animal digest and with just ONE type of probiotic in it - E faceium – and just 100 million CFU. It is very limited in its ability to help an IBD cat. If “probiotics aren’t working,” it is because your vet didn’t give you a probiotic with the correct strains for your cat, it wasn’t given long enough (inflammation took time – often years – to develop, we should not expect it to resolve overnight), or you didn’t give your kitty enough colony forming units. Doses are guidelines, not rules, and what each cat needs can vary substantially. This is an emerging science, and use of probiotics in our cats can take trial-and-error – just as it does in human medicine currently. For diarrhea, Jarrow S boulardii with MOS is the most effective probiotic. How to use it is in the Prebiotics & Probiotics article.
Note: L-acidophilus has proven benefit in cats. See supporting links, below. It is also important to note that acidophilus plays an important role in amino acid uptake. This was seen in research on gastric by-pass surgeries in humans administered an L acidophilus probiotic post-surgery. Where supplementation with L acidophilus helped those patients lose weight, in cats with IBD, L acidophilus actually helps them gain weight when there is malabsorption from IBD - especially when combined with (plant-based) digestive enzymes (pancreatic enzymes are only needed when a cat has exocrine pancreatic insufficiency, “EPI”).
Info on S boulardii and a collection of research as to why it is beneficial: The Science of S Boulardii
Information on Mannan oligosaccharides (MOS) and a collection of research as to why it is beneficial: The Science of Mannan oligosaccharides
4) Transition to balanced home-cooked, or a balanced homemade or commercial raw. It is very easy to make your own balanced and complete food. You can either follow Dr. Pierson's recipe with a grinder, or substitute 1/2 teaspoon of finely ground eggshell powder per pound of food if you don't want to invest in a grinder that can handle bone: http://www.catinfo.org/?link=makingcatfood (and bake or don't), or follow this recipe: “Balanced Recipe for Use with Raw or Cooked Homemade Cat Food” OR this one: “Balanced Recipe with Analysis (more flexible, works with chunked).” A Raw Feeding for IBD Cats group member, Tracy Stillman, wrote an excellent blog post with step-by-step instructions, links to supplements, and pictures based on this recipe (with healthy adaptations included). That blog post is here: http://pawesomecats.com/2015/08/24/balanced-raw-recipe-for-cats-supplements/ . Of course we’ve updated this file to note that the co-founders of Raw Feeding for IBD Cats Facebook group also co-founded the company Food Fur Life, LLC, with the meat-completer supplement, EZcomplete fur Cats. This supplement requires just boneless meat, water, and the supplement (and can be used with raw or cooked boneless meat). It contains two organs, digestive enzymes and full daily requirement of omega 3. It IS very complete. It is also very easy, and many cats – IBD cats included – are thriving on food made with EZcomplete. There is also Alnutrin, made by www.knowwhatyoufeed.com is another quality supplement for a base for making food – you need to add meat and liver (and we recommend an omega 3). In Europe, Felini Complete is available on Zooplus, and is a meat-completer, though again, we recommend adding an omega 3.
Important: slowly introduce ANY new food, and treat new proteins as new foods – introduce them one at a time. And ultimately have AT LEAST THREE PROTEINS in rotation. Whether you rotate every meal, every day, every week, or every month is up to you and your cats. But it is imperative not to use just one protein in order to prevent a sensitivity/allergy from developing and to prevent your cat from getting bored and rejecting the food.
For nausea and vomiting, using slippery elm bark powder syrup half an hour or so before a meal helps. Some will lap it up, some do better with slippery elm mixed with a bit of water or George’s Aloe Vera Juice and sprinkled with some kind of freeze dried powdered treat like chicken, chicken liver, turkey, turkey liver, etc. Some need it syringed (add water as needed to get it through the syringe you have. We recommend Four Paws Easy Feeder food syringe. Make sure you know the signs of nausea - any or all of these: Wanting food but not eating, sitting near the water dish but not drinking, lip smacking, drooling while eating (can also be tooth related), and meatloafing. Please see our files Nausea in Cats – Incl Slippery Elm Bark Powder Syrup Instructions, How to Manage Nausea – the Role of Food, and How to Manage Nausea – Supplements and Medicines.
Once or twice a day, it helps to add one-half teaspoon of George's Aloe Vera Juice to the syrup IF you're in the U.S. It’s likely not worth having it shipped if you're not, but it has to be George's, it is distilled, so contains no latex (aloe latex is toxic to cats). You can use Lily of the Desert organic, unflavored juice (not gel), but it is organic and a bit bitter. George's has no taste. The three (SEB syrup, George's Aloe Vera Juice, and probiotics) work synergistically. Aloe and SEB syrup help heal and soothe, probiotics help restore normal function and reduce inflammation. Aloe and SEB also work as prebiotics, increasing the efficacy of probiotics.
If this approach does not work to relieve the symptoms your cat is exhibiting, let us know. We have been able to help kitties with other approaches, other supplements not discussed here, and combinations of traditional and alternative meds. Please make sure to ask ANY questions and/or post for support. That’s why we created the Facebook group.
For a short summary, please see: My Cat Has Diarrhea – What Do I Do?
Supporting Links:
On slippery elm bark powder: http://www.littlebigcat.com/health/slippery-elm/
L-acidophilus in cats: http://www.ncbi.nlm.nih.gov/pubmed/16740094
and http://www.winnfelinefoundation.org/education/cat-health-news-blog/details/cat-health-news-from-the-winn-feline-foundation/2009/04/02/probiotics-for-cats
On the low B12 and diarrhea:
Article: Kook 2012. Cobalamin in Gastrointestinal Disease. http://www.zora.uzh.ch/72883/1/Kook_2013_NAVC_Cobalamin_in_GI_disease.pdf
Study: Kook et al. 2012. [Evaluation of serum cobalamin concentration in cats with clinical signs of gastrointestinal disease]. Schweiz Arch Tierheilkd. 2012 Nov;154(11):479-86. http://www.ncbi.nlm.nih.gov/pubmed/23117990
On L acidophilus and its role in B12 / Folate uptake:
Mohammad et al. 2006. Plasma cobalamin and folate and their metabolic markers methylmalonic acid and total homocysteine among Egyptian children before and after nutritional supplementation with the probiotic bacteria Lactobacillus acidophilus in yoghurt matrix. Int J Food Sci Nutr. 2006 Nov-Dec;57(7-8):470-80. http://www.ncbi.nlm.nih.gov/pubmed/17162326
Article: Woodward et al. 2009, Stanford Medicine News. Probiotics help gastric-bypass patients lose weight more quickly, Stanford study shows. http://med.stanford.edu/news/all-news/2009/07/probiotics-help-gastric-bypass-patients-lose-weight-more-quickly-stanford-study-shows.html
Study: Woodward et al. 2009. Probiotics improve outcomes after Roux-en-Y gastric bypass surgery: a prospective randomized trial. J Gastrointest Surg. 2009 Jul;13(7):1198-204. http://www.ncbi.nlm.nih.gov/pubmed/19381735
Also please note, all cats react differently to food and supplements. There is no “one size fits all” especially when it comes to IBD. All we have is anecdotal evidence that this works for MOST cats.
We DO recommend that if your cat has not had recent blood work (within the last three to six months) including the full GI panel, please do it. If your cat has been losing weight, additionally check thyroid function (including the Free T4); also check serum fructosamine (in addition to glucose which is normally checked), to rule diabetes in or out. The GI panel is a test that requires a 12 hour fast and should include (and ensure it does) the
fPLI (for pancreatitis, though a negative does not mean your cat doesn’t have pancreatitis. The test is very specific, but not very sensitive. Please see Feline Pancreatitis and fPLI for more information)
B12 (cobalamin)
Folate
fTLI (for pancreatic function, checks for exocrine pancreatic insufficiency (“EPI”). In some labs, this test for exocrine pancreatic insufficiency must be requested. ESPECIALLY if your cat has been losing weight, make sure it is. EPI is far more prevalent than most vets seem to think.
Note:
- Low B12 with high Folate points to small bowel intestinal overgrowth.
- When diarrhea is present, if there is low B12, nothing will resolve the diarrhea until B12 is at normal blood serum levels
- If your cat has Exocrine Pancreatic Insufficiency (EPI), nothing will help until your cat is on pancreatic enzymes (NOT “digestive” enzymes, which are usually plant-based).
The basis of this treatment approach:
In humans, IBD has been definitively linked to gut dysbiosis. Probiotics are a central cornerstone in ongoing management and treatment. Please see our file “What is IBD” for more information. We also recommend you read the important information on healing gut dysbiosis, the root of IBD in our file Prebiotics & Probiotics for Cats: A Cornerstone of Health & Healing in Feline IBD
There is one basic approach that works most of the time. (There is no always, especially not with IBD!).
Traditional vet protocol for IBD is flagyl (metronadizole), steroids, and a prescription or limited ingredient diet. That may stop the symptoms, and the metro may help with an unhealthy bacterial overgrowth (dysbiosis), but it doesn't address the root problem from an ongoing management perspective. (And Tylosin is a better antibiotic choice than metro/flagyl. Too many vets put cats on metro for long lengths of time. It is meant for short-term use only. Please see our file Flagyl - Metronadizole - is Genotoxic, Potentially Cancerous, and Neurotoxic). Steroids can be an important tool when there is severe and rampant inflammation, but the goal would be to use them for a short sharp taper (several weeks to several months) while giving your kitty food and supplements that help their guts heal, hopefully to the point they successfully wean off the steroids. This has been the case for many cats in the group. Those that use raw feeding as the first step in treatment often find they don’t need the drugs at all. This is because “IBD” is a diagnosis of exclusion. Many cats are diagnosed as having IBD without ultrasound or biopsy. The only definitive diagnosis, in fact, is via biopsy.
It turns out that many, many cats are sensitive to *something* in commercial food. For some it is the gums and thickeners, for others, turns out something like the peas in the LID diets are the culprit. Also bear in mind that many pet foods identified as having a certain protein also have others not listed on the label. Pet food testing often reveals significant labeling problems. Many never know what the problem ingredient was. But ditching the commercial food often is all that's needed. And that includes the prescription stuff. Almost NONE of the prescription options are species-appropriate, particularly healthy, or anything that can be considered high quality. I haven’t reviewed them recently, but in 2010, there wasn’t a single Rx food that had no thickeners, which are implicated in human IBD. The LEAST appropriate is the RC hydrolyzed food. The only animal-based ingredient in it is fat. As cats are metabolically inflexible obligate hypercarnivores, not vegetarians or vegans, feeding them inappropriately is, in our opinion, a major contributing factor to the primary diseases cats suffer – including the disruption to their gut flora that is at the heart of IBD. …Let alone that soy is likely a culprit in hyperthyroidism, according to the world's leading expert in feline hyper-T, Dr. Mark Peterson.
Yes, this document is blunt. But we see people go insane trying to find the "right" food to buy. Many spend months or years ripping their hair out to find a food their cat will eat that doesn't set them off. Picky cats are usually picky because they don't feel well. Then everyone says "feed your cat whatever it will eat" to avoid hepatic lipidosis (fatty liver). Well, all those foods make the cat feel nauseous, many contribute to the inflammation causing the problem, and it is a seemingly never-ending cycle. Get off the merry-go-round and feed your cat a meat-based diet. FRESH meat and organ. Human Grade. Ingredients YOU control. Or high-quality commercial raw with limited fruits and veggies (5% or less) that is already nutritionally balanced. Fine. If you are concerned about your homemade food and bacteria, cook it. Though if making cooked food:
- Make a wise choice as to cooking method, because cooking creates compounds that cause inflammation and stresses the organs by killing the naturally occurring enzymes.
- You can only use an alternative to bones. Cooked bones must NOT be fed to cats, they are very dangerous. Although we note many IBD cats are too damaged to do well with bone at first, and we recommend bone alternative for sources of calcium and trace minerals in IBD cats, at least when starting the new diet.
Whether raw or cooked, the point remains the same: give your cat's guts real food. Also, some cats accept cooked food more readily, cooking (if using eggshell – again, do NOT feed cooked bone!!!!) can help the transition, and cooking it less and less to the point of feeding it raw is a transition tool that works for some.
No, there is no cure for IBD. But it is possible to reduce the inflammation via diet and probiotics, and guts do heal. Or can. If you want to know what works most often, this is it. This is advice you'd likely get from a holistic vet, not (usually) a traditional vet.
This is for ALL IBD cats, but *especially* if your kitty is in crisis, stop ALL food you are currently feeding and do this:
1) Put kitty on a bland diet of poached turkey leg or pork (any boneless) cut for a week or two. If you suspect food sensitivity, go with the pork, your cat has likely been least exposed to it. If you prefer, use baby food: Beechnut (stage 1, meat-only) baby food or Gerber (stage 2, meat-only: we note Gerber contains corn starch, but this does not seem to bother most cats and many prefer Gerber to Beechnut). Also note “Broth” in Beechnut is NOT spices or flavoring, it is the water the meat and bone was cooked in with the bone removed). No, this diet is not balanced. It will not hurt your kitten for a few days or your adult for a few weeks. There is information to help you balance the food in the Raw Feeding section of this website, and we can help in the Raw Feeding for IBD Cats Facebook group with any questions.
2) Make and feed bone broth. If a chicken allergy or sensitivity is suspected, use other meat and bones. The two-stage method is still recommended. For cats, obviously nothing but meat and bones go in the broth. Bone broth not only provides quick nourishment and hydration, the collagen in the bones is 11% L-glutamine, which literally helps repair the intestinal mucosa. Please see our file on Bone Broth.
3) Start human grade, not pet, probiotics. A detailed discussion on the importance of appropriate prebiotics, probiotics – particularly Jarrow S boulardii with MOS (or in Europe, a plain S boulardii and the product Entero Chronic, available on amazon UK) and doses is in our article Prebiotics & Probiotics for Cats: A Cornerstone of Health & Healing in Feline IBD. The information in this article is critical for helping your kitty.
Repopulating healthy bacteria is the absolute key in the long term management of IBD that traditional vets tend to not recognize. The growing body of published research (in humans and our pets) has found that the composition, format, and processing of food has a direct impact on gut microbiota. Thus species-appropriate raw feeding is more critical than we could ever have imagined when it comes to the health of our cats. There is no such thing (yet) as "animal specific strains" of probiotics outside of the of AnimalBiome Gut Restoration pills (discussed in the article on prebiotics and probiotics) as science has only touched the very tip of the iceberg when it comes to knowledge of what populates the human gut, let alone the feline gut. And while probiotics have an important role in feline IBD (as gut bacteria perform many important functions in nutrition metabolism), repairing the intestines and addressing inflammation is also important in enabling colonies of needed, healthy bacteria to flourish.
Please note we recommend human grade probiotics for many reasons, and this is supported by researchers studying the microbiome of our pets and disease (again, please reference the article on prebiotics & probiotics). Importantly, Fortiflora, provided by many vets, is a poor probiotic. It is mostly animal digest and with just ONE type of probiotic in it - E faceium – and just 100 million CFU. It is very limited in its ability to help an IBD cat. If “probiotics aren’t working,” it is because your vet didn’t give you a probiotic with the correct strains for your cat, it wasn’t given long enough (inflammation took time – often years – to develop, we should not expect it to resolve overnight), or you didn’t give your kitty enough colony forming units. Doses are guidelines, not rules, and what each cat needs can vary substantially. This is an emerging science, and use of probiotics in our cats can take trial-and-error – just as it does in human medicine currently. For diarrhea, Jarrow S boulardii with MOS is the most effective probiotic. How to use it is in the Prebiotics & Probiotics article.
Note: L-acidophilus has proven benefit in cats. See supporting links, below. It is also important to note that acidophilus plays an important role in amino acid uptake. This was seen in research on gastric by-pass surgeries in humans administered an L acidophilus probiotic post-surgery. Where supplementation with L acidophilus helped those patients lose weight, in cats with IBD, L acidophilus actually helps them gain weight when there is malabsorption from IBD - especially when combined with (plant-based) digestive enzymes (pancreatic enzymes are only needed when a cat has exocrine pancreatic insufficiency, “EPI”).
Info on S boulardii and a collection of research as to why it is beneficial: The Science of S Boulardii
Information on Mannan oligosaccharides (MOS) and a collection of research as to why it is beneficial: The Science of Mannan oligosaccharides
4) Transition to balanced home-cooked, or a balanced homemade or commercial raw. It is very easy to make your own balanced and complete food. You can either follow Dr. Pierson's recipe with a grinder, or substitute 1/2 teaspoon of finely ground eggshell powder per pound of food if you don't want to invest in a grinder that can handle bone: http://www.catinfo.org/?link=makingcatfood (and bake or don't), or follow this recipe: “Balanced Recipe for Use with Raw or Cooked Homemade Cat Food” OR this one: “Balanced Recipe with Analysis (more flexible, works with chunked).” A Raw Feeding for IBD Cats group member, Tracy Stillman, wrote an excellent blog post with step-by-step instructions, links to supplements, and pictures based on this recipe (with healthy adaptations included). That blog post is here: http://pawesomecats.com/2015/08/24/balanced-raw-recipe-for-cats-supplements/ . Of course we’ve updated this file to note that the co-founders of Raw Feeding for IBD Cats Facebook group also co-founded the company Food Fur Life, LLC, with the meat-completer supplement, EZcomplete fur Cats. This supplement requires just boneless meat, water, and the supplement (and can be used with raw or cooked boneless meat). It contains two organs, digestive enzymes and full daily requirement of omega 3. It IS very complete. It is also very easy, and many cats – IBD cats included – are thriving on food made with EZcomplete. There is also Alnutrin, made by www.knowwhatyoufeed.com is another quality supplement for a base for making food – you need to add meat and liver (and we recommend an omega 3). In Europe, Felini Complete is available on Zooplus, and is a meat-completer, though again, we recommend adding an omega 3.
Important: slowly introduce ANY new food, and treat new proteins as new foods – introduce them one at a time. And ultimately have AT LEAST THREE PROTEINS in rotation. Whether you rotate every meal, every day, every week, or every month is up to you and your cats. But it is imperative not to use just one protein in order to prevent a sensitivity/allergy from developing and to prevent your cat from getting bored and rejecting the food.
For nausea and vomiting, using slippery elm bark powder syrup half an hour or so before a meal helps. Some will lap it up, some do better with slippery elm mixed with a bit of water or George’s Aloe Vera Juice and sprinkled with some kind of freeze dried powdered treat like chicken, chicken liver, turkey, turkey liver, etc. Some need it syringed (add water as needed to get it through the syringe you have. We recommend Four Paws Easy Feeder food syringe. Make sure you know the signs of nausea - any or all of these: Wanting food but not eating, sitting near the water dish but not drinking, lip smacking, drooling while eating (can also be tooth related), and meatloafing. Please see our files Nausea in Cats – Incl Slippery Elm Bark Powder Syrup Instructions, How to Manage Nausea – the Role of Food, and How to Manage Nausea – Supplements and Medicines.
Once or twice a day, it helps to add one-half teaspoon of George's Aloe Vera Juice to the syrup IF you're in the U.S. It’s likely not worth having it shipped if you're not, but it has to be George's, it is distilled, so contains no latex (aloe latex is toxic to cats). You can use Lily of the Desert organic, unflavored juice (not gel), but it is organic and a bit bitter. George's has no taste. The three (SEB syrup, George's Aloe Vera Juice, and probiotics) work synergistically. Aloe and SEB syrup help heal and soothe, probiotics help restore normal function and reduce inflammation. Aloe and SEB also work as prebiotics, increasing the efficacy of probiotics.
If this approach does not work to relieve the symptoms your cat is exhibiting, let us know. We have been able to help kitties with other approaches, other supplements not discussed here, and combinations of traditional and alternative meds. Please make sure to ask ANY questions and/or post for support. That’s why we created the Facebook group.
For a short summary, please see: My Cat Has Diarrhea – What Do I Do?
Supporting Links:
On slippery elm bark powder: http://www.littlebigcat.com/health/slippery-elm/
L-acidophilus in cats: http://www.ncbi.nlm.nih.gov/pubmed/16740094
and http://www.winnfelinefoundation.org/education/cat-health-news-blog/details/cat-health-news-from-the-winn-feline-foundation/2009/04/02/probiotics-for-cats
On the low B12 and diarrhea:
Article: Kook 2012. Cobalamin in Gastrointestinal Disease. http://www.zora.uzh.ch/72883/1/Kook_2013_NAVC_Cobalamin_in_GI_disease.pdf
Study: Kook et al. 2012. [Evaluation of serum cobalamin concentration in cats with clinical signs of gastrointestinal disease]. Schweiz Arch Tierheilkd. 2012 Nov;154(11):479-86. http://www.ncbi.nlm.nih.gov/pubmed/23117990
On L acidophilus and its role in B12 / Folate uptake:
Mohammad et al. 2006. Plasma cobalamin and folate and their metabolic markers methylmalonic acid and total homocysteine among Egyptian children before and after nutritional supplementation with the probiotic bacteria Lactobacillus acidophilus in yoghurt matrix. Int J Food Sci Nutr. 2006 Nov-Dec;57(7-8):470-80. http://www.ncbi.nlm.nih.gov/pubmed/17162326
Article: Woodward et al. 2009, Stanford Medicine News. Probiotics help gastric-bypass patients lose weight more quickly, Stanford study shows. http://med.stanford.edu/news/all-news/2009/07/probiotics-help-gastric-bypass-patients-lose-weight-more-quickly-stanford-study-shows.html
Study: Woodward et al. 2009. Probiotics improve outcomes after Roux-en-Y gastric bypass surgery: a prospective randomized trial. J Gastrointest Surg. 2009 Jul;13(7):1198-204. http://www.ncbi.nlm.nih.gov/pubmed/19381735