Chronic inflammatory bowel disease (IBD) in cats is of unknown cause and has an ill-defined pathogenesis. Diagnostic testing consists of excluding many other diseases. It is essential that clinical signs be correlated with appropriate diagnostic testing, because systemic diseases, chronic parasitism, dietary sensitivity, infectious diseases, and alimentary lymphosarcoma are the major differential diagnoses for IBD. Staging can be difficult because uniform criteria for evaluating biopsy specimens have not been established, but preliminary guidelines do exist. Treatment and/or maintenance therapy consists of nutritional and dietary manipulation and use of prebiotics and probiotics to modify intestinal bacterial populations, in conjunction with pharmacologic therapies (corticosteroids, metronidazole, azathioprine, miscellaneous immunomodulating drugs, etc.). Combination drug therapy for dogs and cats may be beneficial, especially for severe disease or multiorgan involvement and to reduce the systemic effects of corticosteroids.

COMMENTARY: The waxing and waning course of IBD makes diagnosis and assessment of treatment difficult. Although one study suggested that up to 30% of cats with idiopathic gastrointestinal problems may have food sensitivities, we need to search for other causes and treatment options.

Feline inflammatory bowel disease - current perspectives on etiopathogenesis and therapy. Jergens AE: J Feline Med Surg 4:175-178, 2002.