Question

After repeated bouts of sickness and treatment including antibiotics and special food, our cat was given tests to determine possible cause. The histopathology report shows a diagnosis of:

1.) Eosinophilic gastritis and surface spiral bactaria

2.) Mild lymphoplasmacytic and eosinophilic enteritis

Also Peyer's patch hyperplasia indicating chronic antigenic stimulation. Some of the lymphoplasmacytic inflammation may be secondary to the Peyer's patch hyperplasia. This could be idiopathic inflammatory bowel disease but other potential causes, such as infectious agents, endoparasites and food allergy should be ruled out as far as possible. The latter favoured are favoured, given the increased numbers of eosinophils.

Can you explain what all this means?

Answer

Inflammatory bowel disease (IBD) is a common cause of intestinal problems in cats. This diagnosis is made on the basis of biopsy results (ie, taking a sample of tissue and then looking at it under the microscope). Different types of IBD are described according to what the predominant cell types are. Most commonly lymphocytes and plasma cells (two types of white blood cells) are involved so it is termed lymphocytc/plasmacytic IBD. The signs seen in cats with IBD include appetite changes (poor appetite or voracious appetite), vomiting, diarrhoea and weight loss. In some cases, a cause of the IBD can be found - for example an infection with a parasite such as giardia or a food intolerance. In these cases, treatment of the primary problem is often successful at resolving the cat's clinical signs. In those cats where no cause of the IBD is found, this is termed idiopathic IBD.

These cases often respond well with symptomatic therapy (treating the symptoms) which usually includes a change of diet (to a high quality, highly digestible diet) and anti-inflammatory drugs. Prednisolone (a glucocorticoid steroid drug) is most commonly used as an anti-inflammatory and the majority of cats do very well on this regime. Many cats can be weaned off treatment after a period of weeks to months although in some cases, long-term or intermittent treatment is required to keep the problem under control. In your cat's case, the histology report which you quoted stated that a lot of eosinophils were present which is a less common type of IBD. Eosinophils are a type of white blood cell which are often associated with allergic conditions and fighting parasite infections (eg, worms). Spiral bacteria are often found in stomach biopsies of cats, including healthy cats, so the significance of this infection is often doubted. Without the benefit of knowing your cat, it is difficult for me to comment specifically on the management of the IBD. I would suggest that you discuss this with your own vet who is in the best position to advise you. Options which may be discussed with you would include treatment of any parasite infections, another dietary trial and use of anti-inflammatory agents. If your vet feels that it would be useful to discuss your cat with an expert then he or she can also consider calling someone at a specialist centre for advice. The main thing is that you are now a step closer to knowing what the cause of your cat's problems are and the biopsies have ruled out cancer as a cause which is more good news.