DIARRHEA

How is diarrhea recognized?

Most cats defecate outside, and since they usually bury their feces, diarrhea readily passes unnoticed by the owner. It may only be if the cat has an accident in the house or soils the fur around the anus (particularly in a long-haired cat) that the diarrhea becomes apparent. If the cat uses a litter tray the owner may have much more information about variations in the feces Some variation in the appearance and the feces is quite normal, particularly in some individual cats and may be related to minor factors such as variations in diet. Persistently liquid or semi-liquid feces, however, should be reported to your veterinary surgeon.

If a litter tray is used in a household with more than one cat it is helpful to establish if it is just the one cat that has diarrhea or whether more than one cat in the household is affected. If an infectious agent or some dietary factor is involved all the cats in the household are likely to have been exposed to the same problem. It may be necessary to confine one cat to a specific area of the house at a time to determine which cats have diarrhea

What causes diarrhea?

Diarrhea is not a disease in itself but a sign which may reflect many different problems, some of which involve specific diseases, whilst others may be related more to management factors, such as diet. If chronic diarrhea has been present for some time, this is most often, but not necessarily, related to some intestinal disorder.

Initial approach to diarrhea

Many cases of diarrhea will respond quite readily to simple treatment, frequently without the initial cause ever being established. Generally acute diarrhea which has been present for only up to a few days will resolve quickly. Chronic diarrhea which has been present for some time, often over 2-3 weeks, may prove more difficult to treat effectively. It will help your veterinary surgeon to decide on the most appropriate approach to dealing with the case if it can be established whether the diarrhea is acute or chronic. Therefore any information you can provide on how long the diarrhea has been present will be very helpful. Information about any other signs your cat has shown will also be helpful in deciding whether symptomatic treatment or further investigations are appropriate.

Particularly important signs to recognize are:-

1. Does your cat seem ill - lethargic, etc.?

2. Any marked weight loss?

3. Any vomiting?

4. Any change of appetite?

It is also helpful, particularly in cases of chronic diarrhea to establish whether the diarrhea is related to a problem high up in the intestines (affecting the small intestine) or lower down in the colon (large intestine).

The pattern and nature of the diarrhea may provide clues to help differentiate between these two:-

• any weight loss
• the frequency of defecation
• whether increased quantities of feces are produced
• the appearance of the feces - very fatty/greasy and smelly
• any fresh blood
• any "changed" blood (very dark feces)
• any mucus or slime
• any straining or pain on defecation

Another important area which can be of help is in reporting any change in management recently, particularly relating to feeding:-

• what is the cat's normal diet
• has the diet changed recently
• does the cat have milk
• does the cat have scraps or tidbits
• has the cat stolen any food recently
• does the cat hunt and eat its prey
• does the cat take food from anywhere else - neighbor etc.

If the diarrhea is mild

If the diarrhea is so severe that it is causing other problems to develop such as dehydration and weakness, or the veterinary surgeon decides that either other worrying signs are present or that a serious underlying problem is involved, he or she may recommend certain investigations. However most cases are relatively mild and in this situation, symptomatic treatment is usually tried initially without any further investigations. Most such cases will resolve even though the underlying cause is never clear. Frequently it may be a relatively minor unknown factor such as stealing some food from a neighbor's bird table, or breaking in to the dustbin bag for the remains of last week's roast.

Symptomatic treatment

Symptomatic treatment is usually tried initially in mild cases of diarrhea It may involve a number of measures:

1. Withholding food for up to 24 hours. This may help the function of the intestine to return to normal

2. Provision of a simple diet.

Feeding a readily digestible diet may help. You may be provided with a special "prescription" diet for this purpose or your veterinary surgeon may suggest a homemade diet. Boiled chicken, rabbit or sometimes fish with rice or sometimes pasta are often used.

It is very important that the cat does not receive any other foods during this period. This includes milk - the cat should receive only water to drink unless specifically instructed by your veterinary surgeon. It also includes mice or any other prey, tit-bits and next door cat's food! The only effective way of ensuring this may be to confine your cat indoors for a period. This is particularly important if a dietary trial is being undertaken to test whether the cat is allergic to foods in its diet. A single dietary "indiscretion" may ruin the test! If you do not think it is practical to prevent your cat from having access to foods outside: you should mention this to your veterinary surgeon who may suggest hospitalizing the cat for a dietary trial.

3. Drugs

There are some drugs which are occasionally used to help improve diarrhea - by slowing down the passage of food in the intestine, coating the lining of the intestine etc. Antibiotics are sometimes used but are generally reserved for cases in which a specific, severe infection has been diagnosed. Otherwise they may upset the balance of the bacteria in the intestines which may further contribute to the diarrhea It is a common misconception that infections are a common cause of diarrhea Specific infections are relatively rare causes of diarrhea in cats.

Do not use human proprietary antidiarrheals sold by pharmacists - some of these are very dangerous to cats.

If further investigation is required

If your veterinary surgeon suspects a serious underlying cause to the diarrhea or complications are developing such as dehydration and severe weakness, further investigations may be required at an early stage and other treatment may be necessary. In particular it will be important to avoid dehydration. If your cat is mildly dehydrated you may be given a special solution to administer to your cat. You may be provided with a syringe to help do this. You must be patient but if your cat is becoming unduly distressed by this, report back to your veterinary surgeon. If the dehydration is severe your cat may have to be hospitalized for a "drip".

Since there are many possible causes of diarrhea, there are many potential tests required to establish the underlying cause. Some of the more commonly used tests are:-

• Blood tests - to check for serious viral infections and provide clues of other problems
• Fecal tests - to hunt for infections, parasites etc. A fresh fecal sample is required for this and is preferable to a rectal swab.
• X-rays - to check for thickenings, blockages, tumors, foreign bodies etc.
• Intestinal biopsy - in some cases a diagnosis will only be achieved by microscopic examination of a small biopsy of the intestine. This may necessitate "opening up" the abdomen, which is a major operation, but at specialist clinics it is now possible to obtain biopsies using an endoscope (a flexible viewing tube) passed through the mouth.

These further investigations can be expensive and do not always provide a diagnosis. Chronic diarrhea can be a very difficult condition to diagnose. In some selected cases your veterinary surgeon may decide to use a series of trial treatments. It is most important that you follow these very carefully if this approach is to be used effectively. Such a trial usually start with a dietary trial (as described above). If you anticipate or encounter any problems in sticking to the trial, it is important that you discuss this with your veterinary surgeon.

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