How many times have you been presented with a cat with diarrhoea? For anyone who’s ever owned a cat, you’ll appreciate this problem is certainly one you want resolving as soon as possible. It’s unpleasant for everyone and especially for the patient.
Posted: 29 May 2019
Colitis, or inflammation of the colon, results in a reduction in the amount of water and electrolytes which are absorbed, as well as suppressing the normal mixing contractions. The end result is that the intestinal contents are voluminous and are passed out without control. Look for;
Inflammation of the colon may be acute or chronic, and for many patients, the original cause is unknown. When looking for a cause, think of bacterial, parasitic, fungal, dietary, stress induced or allergic triggers.
Initially, you need to determine if the problem is primary or secondary in origin. Perhaps it’s associated with a gastrointestinal complaint or perhaps a systemic or metabolic disease? You also need to find out if the diarrhoea is from the large or small intestine, the clues of which will often be found in the history.
The standard investigation of feline diarrhoea would be;
In early cases, with few signs and no obvious debilitation, patients are often treated symptomatically, using electrolytes, dietary management (low fat and highly digestible food) and perhaps some drugs to help control gut motility. However, if after the initial treatment the patient is still not responding, additional tests may be required, which might include;
In many situations, a cat with diarrhoea can be helped by a simple change of diet. As many as half of all non-specific causes of feline diarrhoea will respond to diet alone. Some of the typical food-responsive diarrhoea cases include;
The choice of diet is important. In the ideal world, avoid home-made and over the counter diets as these are inconsistent and confuse the diagnosis. If you think that the colitis is caused by diet, it’s best to suggest prescription diets as the formula and recipes are stable.
Lactobacillus, Enterococcus, Streptococcus and Bifidobacterium are used to provide a beneficial effect on the gut microflora and are worth considering. Whilst the mechanism remains poorly understood, some probiotic strains are thought to be able improve the immune system. Read or article on Probiotics >
3. Antibiotics and anthelmintics
If the patient fails to improve, then you may consider a short trial therapy using an anthelmintic, food trial or perhaps antibiotics.
Cats presenting with chronic colitis are frequently treated with a combination of dietary management, metronidazole and glucocorticoids. Fortunately cats usually tolerate glucocorticoids very well.
Inflammatory changes in the colon are usually lymphocytic-plasmacytic, though other forms occur such as eosinophilic, neutrophilic, and granulomatous enteritis. The inflammation can be confined to the colon (colitis), though if it also involves the small intestine, it’s usually referred to as inflammatory bowel disease.
Immunosuppressive drugs tend to be used in combination with glucocorticoids when the response to steroids alone is not completely effective. The most commonly used drugs are;
In the short-term, the prognosis for chronic feline colitis is usually good, though many cats will have relapses. Long term treatment is often required, but fortunately this can often be achieved with diet alone.