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You may need a blood test for vitamin B12, B vitamins, and other nutrients

This points out that vitamin D downregulates the mast cell activation increased in allergic sensitization

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Early signs that get missed Vomiting 1-2x per week not hairballs, often clear/yellow, often unrelated to eating Intermittent diarrhea or soft stool Slow weight loss over months pet parents often don't notice until clothes fit differently or the cat feels bony Eats normally but isn't gaining or maintaining weight Just 'not quite right' slower, less interactive, sleeping more Red flags that escalate the workup Rapid weight loss (more than 10% in a month) Black tarry stool GI bleeding Refusing food entirely (cats develop hepatic lipidosis after ~48 hours of fasting) Painful belly on palpation Vomiting blood Yellow gums or eyes (jaundice) Diagnosis the workup pyramid IBD is a diagnosis of exclusion

Flanagan, J