Inflammatory bowel disease (IBD) causes chronic inflammation and irritation of the digestive tract. This condition is one of the most common chronic intestinal disorders in cats. IBD in cats is similar to Crohn disease in humans.
 
Cause
In IBD, inflammatory cells accumulate within the walls of the digestive tract. The small intestine is the most common location in cats; the large intestine and stomach can also be affected. The intestinal walls become thickened and can’t absorb nutrients normally. Some cats with IBD also have inflammation of the pancreas and liver, a combination called triaditis.
 
The cause of IBD isn’t known. The disease is probably caused by abnormal immune system function related to intestinal bacteria (which are necessary for normal digestion and immune function), diet, genetics, or other factors. IBD usually affects middle-aged or older cats, although cats of any age can develop the disease.
 
Signs
The signs are similar to those of many other digestive system disorders:

• Vomiting
• Weight loss
• Diarrhea or soft stool
• Decreased appetite (maybe)
• Decreased energy (maybe)

 
Diagnosis
Because so many conditions cause the same signs as IBD, cats with chronic digestive tract problems need a thorough workup. Diagnostic tests are performed to rule out a long list of other possibilities, including intestinal lymphoma (a cancer that is clinically very similar to IBD), parasites, intestinal foreign bodies, bacterial and viral infections, food allergies, other types of cancer, and diseases like hyperthyroidism that cause general illness.
 
Baseline tests include fecal parasite tests, bloodwork, and urinalysis. Additional blood tests are used to assess the function of the pancreas and check for evidence that the small intestine is not absorbing nutrients properly. Imaging (radiography and ultrasonography) is used to evaluate the digestive tract, liver, pancreas, and other organs.
 
The only way to definitely diagnose IBD and distinguish it from intestinal lymphoma is to obtain biopsy samples from the intestine and submit them to a diagnostic laboratory for analysis. Biopsy is performed either with endoscopy (tube inserted through the mouth or anus) or abdominal surgery. Both of these procedures require general anesthesia.
 
Treatment
IBD is managed, not cured. Treatment is tailored to the individual cat, depending on what works best for that cat. Most cats receive a dewormer to eliminate parasites as a possible cause. Some cats’ signs improve with a hypoallergenic diet, so treatment can include several weeks of a food trial with a prescription diet. Antibiotics are sometimes used carefully (they can disrupt the normal intestinal bacteria). Probiotics and prebiotics, which contain beneficial bacteria or nutrients for existing intestinal bacteria, might be included in the treatment plan. Drugs that suppress the immune response, such as the corticosteroid prednisolone, are necessary for some cats.
 
Prognosis
Cats whose disease responds well to treatment can have a good quality of life, although their IBD signs will probably still flare up occasionally. The treatment type and medication doses often need to be adjusted over time.
 
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Home dental care is a crucial part of keeping dogs’ and cats’ mouths healthy. But many pet owners are reluctant to brush their pets' teeth (and brushing is not safe with animals that might bite), so the market is full of products that claim to clean teeth or freshen breath without brushing.
 
Some home dental care products work pretty well, some don’t work at all, and a few pose safety risks for pets. Here’s how to choose dental products for your pet.
 
The Point of Home Dental Care
The goal of cleaning your pet’s teeth at home is to remove plaque. Plaque, a sticky biofilm that contains millions of bacteria, attaches to tooth surfaces. Dental disease in dogs and cats is caused by plaque under and at the edges of the gums, not by tartar (hardened plaque) that you can see on tooth surfaces.
 
Like humans, pets need a combination of professional dental cleanings and home dental care. Home dental products can’t remove tartar or treat dental conditions like periodontal disease. Some products make gum inflammation worse. Tartar and dental diseases require a dental procedure with general anesthesia at a veterinary clinic.
 
When to Use Dental Products
If your pet has smelly breath, visible tartar, bleeding gums, loose teeth, missing teeth, or signs of mouth pain, this is not the time to go shopping for dental products. This is the time to take your pet to the veterinarian and then schedule a dental procedure if your veterinarian recommends it.
 
The time to start home dental care is when it will be effective and not painful for your pet, which means before your pet develops dental disease or after dental disease has been treated. It’s ideal to train puppies and kittens to have their teeth brushed while they’re young so they will build positive associations with dental care. If your pet has dental disease, talk to your veterinarian about the timing of home care; it’s usually best to start about a week after a dental procedure to give the gums time to heal.
 
Active vs Passive Plaque Removal (How Much Work You Have to Do)
Home plaque removal products fall into 2 categories: active and passive. With active plaque removal, the pet owner cleans the teeth with toothbrushes, toothpaste, or dental wipes. Passive plaque removal relies on chewing and doesn’t directly involve the pet owner; these are products like dental diets, treats, and chews.
 
Many of us would love to use only passive dental care because tossing a treat to a dog is easier than brushing the dog’s teeth. (This is why the dental care aisle of the pet store has about 3 hooks for toothbrushes and 20 linear feet of toys and chews.) But passive dental care alone isn’t enough to keep a pet’s mouth healthy. Passive dental care products are best used along with professional cleanings when tooth brushing isn’t appropriate.
 
Active plaque removal products have been shown to be most effective on the front teeth (the teeth the owner can easily reach). Passive plaque removal is generally most effective on the back teeth (the teeth used for chewing). Therefore, your veterinarian might recommend that you use more than one dental care product.
 
Look for Veterinary Oral Health Council Seal
Products that have the Veterinary Oral Health Council (VOHC) seal of acceptance have been shown to be effective for plaque or tartar control. The VOHC doesn’t test products; they review data submitted by product manufacturers. Some products that work, like most toothbrushes, haven’t been submitted to the VOHC, so lack of a seal doesn’t necessarily mean that a product is useless. However, looking for the VOHC seal is a good place to start. You can find lists of accepted products on the VOHC website: https://vohc.org/.
 
Product Types
Toothbrushes and toothpaste:

• Toothbrushes are better than wipes for removing plaque below the gumline.
• Toothbrushes marketed either for animal use or for human use are fine as long as the size is appropriate for the animal’s mouth.
• Bristles should be soft nylon.
• The toothpaste is less important than the brushing action, but animal toothpaste tastes good (to them) and helps animals accept brushing.
• Don’t use human toothpaste; it contains ingredients that animals shouldn’t swallow.
• If your pet has dental disease or might bite, talk to your veterinarian before considering tooth brushing.

 
Dental rinses:

• Many of these don’t really work. Choose rinses with VOHC acceptance.
• Look for chlorhexidine in the active ingredient list. Chlorhexidine is an antiseptic that reduces bacterial growth, and therefore plaque buildup, inside the mouth.
• Rinses containing zinc salts might also be effective.

 
Dental chews, toys, diets, and treats:

• Some can reduce plaque on back teeth (premolars and molars).
• To remove plaque, these products need to touch the sides of the teeth where plaque accumulates. Products that break apart at the biting surface are less effective.
• These products generally do not prevent periodontal disease.
• Dental chews can be a choking hazard and can cause intestinal blockage.
• Products that are chewed and swallowed can cause vomiting and diarrhea.
• Hard chews and toys can cause tooth fractures.
• “Natural” and raw diets haven’t been shown to reduce the risk of periodontal disease and can be contaminated with harmful bacteria.
• Look for products with VOHC acceptance.
• Be sure a chew or toy is soft enough for you to indent with a fingernail.
• Don’t leave your pet alone with a dental chew.

 
Water additives:

• Most of these don’t work. As with other products, look for VOHC acceptance.
• Some contain xylitol, which in high enough concentrations is dangerous for dogs.

 
Sources          

• Bellows J, Berg ML, Dennis S, et al. 2019 AAHA dental care guidelines for dogs and cats. J Am Anim Hosp Assoc. 2019;55(2):49-69. doi:10.5326/JAAHA-MS-6933
• Niemiec B, Gawor J, Nemec A, et al. World Small Animal Veterinary Association global dental guidelines. J Small Anim Pract. 2020;61(7):E36-E161. doi:10.1111/jsap.13132

Image source: https://www.pexels.com/photo/person-using-a-toothbrush-on-dog-with-shower-cap-4588018/