Suspected IBS

Hello, my 13 year old cat has always had mushy poop. As she has aged, she has lost weight and it seems like she is having trouble pooping.  She wanders a lot and hunches like she wants to go, usually she does get some out but other times nothing comes out.  I can tell she is uncomfortable and she growls as she wanders around.  I have taken her to the vet for this a few times.  She had a blood test, urine test and a fecal test.  All came back great. The vet suggested she may have IBS and gave her an anti-inflammatory pill which helped her for maybe 2 days.  I took her back to the vet when her symptoms came back and this time they gave her an anti-inflammatory shot.  The same thing happened, she was good for about 2 days and the symptoms keep coming back.  I feel bad for my cat because I don't know what I can do to help her, the vet told me that she has lost muscle and I can feel her spine now. I am taking her back to her vet soon but I wanted to ask for another opinion.  Thank you so much for any help.

Hello - I always explain at this point, that mine never constitutes a second opinion; that I know much less about this case than the vet who has already taken a full history, run some tests and examined the patient.  If a better opinion is to be sought, we would reccommend a specialist or another in-person vet.   However, this is not necessarily needed in the case you describe; it sounds as though your vet would have started with a mental list of things that could be causing this diarrhoea, done tests to rule certain ones out (have they ruled out hyperthyroidism for example?) and arrived at IBS.  Regarding the diagnosis, good questions for them are:  how sure are you that my cat has IBS?  Could it be anything else?  (hyperthyroidism, intestinal lymphoma etc) and 'Are there any tests you could do / refer us for to tell the difference between these things and what difference would it make?  Would you do more tests if this was your cat?'  These questions may help towards understanding the diagnosis.

Regarding the treatment, from what you say, whatever is currently being done does not appear to be controlling the symptoms.  Good questions are:  Why might this be? (Is the patient definitely getting the drug?)  Is it possible that this is not IBS?  Is it possible that different treatment could be better?  Could continual low-level use of some drug be more helpful? Could a specialist help?  It seems important to have this conversation with your own or a different vet as soon as possible.