Diarrhea in a cat what to do. The cat has black diarrhea. Treatment of loose stools in cats, what to do, how to treat diarrhea

03.08.2019

often leads the owner to confusion: should I go to the veterinarian or treat the animal at home, what methods of treating the animal should I choose? Depending on the frequency of bowel movements and the color (as well as consistency, smell) of the stool, the cat owner needs to decide whether to self-medicate. Like the people cats have diarrhea can occur due to many reasons and stop absolutely painlessly, or lead to serious consequences.

Causes of diarrhea in cats

Poisoning with toxic substances. Eating toxic substances and poisoning them. Often cats can eat indoor flowers and plants, household chemicals, various flammable liquids, expired and low-quality medicines. With such poisoning cat, cat or kitten diarrhea often associated with convulsions. At the same time, the owner should wash the stomach of the cat as soon as possible and give adsorbents (for example, activated charcoal) to drink.
Poisoning with poor-quality or unusual food for the animal. Often, for the sake of a joke, the owner can treat his pet with alcoholic drinks, sweets, dishes that are too flavored with seasonings and spices. In this case, the animal may experience indigestion, bloating, gases. Diarrhea in a cat or kitten in this case, it is most often single and does not cause significant harm to the animal. The owner should remember that cats are not people, and such food is harmful to them!
Abrupt transition of the animal to a new food. When transitioning to a new food, you should carefully read the recommendations of the feed manufacturer. As a rule, a new product should be introduced gradually, starting with small portions. With such a reason diarrhea in a kitten, cat or cat is of short duration.
Allergic reactions in an animal. Regardless of age and breed, an animal may have a reaction to a particular allergen (cigarette smoke, plant pollen, perfumes). Often a side effect of an allergy can be diarrhea in an animal. If, in addition to indigestion, the cat has watery eyes, itching, vomiting, sneezing and coughing, then most likely it is an allergy.
Hairballs in the stomach of a cat. Cats often lick themselves and absorb large amounts of their own fur. This is especially true for furry individuals. In addition to diarrhea in this case, the cat may have vomiting with hair clots. The owner should thoroughly comb the pet, if necessary, give the animal special preparations that prevent the formation of hairballs.
bacterial infection. Such cause of diarrhea in cats is very dangerous, while the stool is fetid, with mucus, sometimes bloody clots can occur. The animal is lethargic, looks unhealthy, there is no appetite. The cat may have a fever and vomit. The presence of blood in the stool is the reason for an immediate visit to a specialist.
Viral infection. Viral infections in cats are often accompanied by vomiting, discharge from the nose, eyes. The stool of the animal is liquid, the temperature of the cat may rise or fall, and the appearance may indicate illness. In cases of infection with viruses, medical intervention is required.
Diseases of the small or large intestine. The cat has repeated bowel movements, and mucus and blood clots are common. Sometimes the stool turns dark (brown or black), in which case the animal could have intestinal bleeding.
Intestinal obstruction. The chair with intestinal obstruction in cats is frequent, liquid, associated with vomiting. Touching the stomach causes pain in the cat.
Diseases of the pancreas. The cat's stool has a yellow-green tint. With weight loss, a good appetite of the animal is observed. Flatulence is often observed in an animal. With such diseases (chronic or acute pancreatitis), the destruction of the pancreas begins, the animal may even die. The cause of such diseases can be overweight or underweight, congenital pathologies in the animal, infection, inflammation, poisoning. It is necessary to consult a doctor as soon as possible, to pass the necessary tests. If the cat is lethargic, it has difficulty breathing, the smell of liquid feces is sour, the temperature is elevated - this is a reason to suspect violations in the pancreas.
Stress. Often, a non-standard or unusual life situation, a surge of emotions, fear or mental discomfort (for example, participation in an exhibition, a change of home) can cause a short-term upset stomach in a cat. In this case, the owner should show maximum attention to his pet.
Benign and malignant tumors (cancer) in cats. Such diseases cause not only diarrhea, but also vomiting, weight loss, appetite, interest in life, discharge or an unpleasant odor from the nose, mouth, eyes. Females and older animals are especially susceptible to cancerous tumors. You should not miss precious time and consult a doctor as soon as possible to take a biopsy and take tests for the upcoming treatment.
Kidney diseases. Often diseases of these internal organs are accompanied by diarrhea in a cat, lack of appetite, frequent urination, vomiting, difficulty urinating. With such diseases, it is recommended to consult a specialist, a change in the animal's diet is desirable. Overheating of the cat or being in a draft is undesirable.
Diseases of the liver. These diseases are not only stool disorder but also staining of urine in a dark color. The belly of the cat is swollen. Cats are advised not to eat for a day, then switch to cereal. It is necessary to take tests and consult a doctor.
Intolerance to cow's milk in kittens. In addition to the above causes of diarrhea in kittens, they may also have such problems when switching to cow's milk.

Cat diarrhea treatment

Depending on the frequency of bowel movements, the smell and color of feces, it is worth deciding whether to contact a specialist or self-help the animal. If pet diarrhea lasts no more than a day (and infrequently), then only clean water should be offered during the day to prevent dehydration. Can you also let your cat take activated charcoal? 2-3 times a day, dissolving the tablet in water. Instead of activated charcoal, many experienced owners advise giving the cat a diluted "Smekta" (or other adsorbent remedy for diarrhea, bloating) to drink. Despite the fact that both activated charcoal and Smecta are drugs for people, their action also has a beneficial effect on cats. As a natural anti-inflammatory agent, you can use a decoction of chamomile, and to fix it, give the animal a decoction of oak bark to drink (it is worth remembering that the decoction should not be too strong, otherwise it will be bitter).

In cases where cat diarrhea frequent, and the animal behaves restlessly at the same time, you can give your pet half a No-shpa tablet (Drotaverine) to relieve pain and spasms. For 7 days, it is worth keeping the animal on a special diet, excluding milk and sour cream, fatty foods. You can give the cat boiled meat, poultry and fish, low-fat broth, boiled eggs, low-fat cottage cheese, cereals, but all this in small quantities 3-4 times a day. All of the above remedies can only help with mild ailments of the animal, if the diarrhea lasts no more than one or two days, and if there is no mucus, blood in the stool, and the color is not too dark or yellowish-green. In addition, the too early age of the animal also does not provide for domestic treatment of diarrhea in a cat, cat or kitten.

In cases where the animal is seriously suffering, it is clear from its appearance that the disease is caused by an infection or diseases of the internal organs, if loose stools are accompanied by vomiting, discharge from the eyes, nose and other signs characteristic of serious conditions - treat diarrhea in a cat, cat or kitten at home Absolutely forbidden! Because self-treatment can be harmful, and the owner and the cat will lose precious time, which could correct the situation during treatment under the supervision of a specialist.

Pet owners often turn to veterinarians to find out why a cat has an upset stomach, how to treat it and what to do. At the same time, when people talk about an upset stomach, they usually mean a complex of unpleasant phenomena associated with a violation of the function of this organ.

Most consider diarrhea to be the main manifestation of the disorder. This is partly true: since the stomach plays a major role in the digestion of incoming food, changes in its activity affect the entire process of digestion as a whole, and the stool most often becomes liquid.

But this is not the only symptom of the disease. Let us consider in more detail the causes of the problem, the main symptoms and methods of treatment.

What is indigestion in a cat

From a medical point of view, the term "indigestion" means not only diarrhea. An upset or indigestion of the stomach, it is also dyspepsia, is a violation of its main functions, namely:

moving food through the gastrointestinal tract;
secretion of gastric juice and enzymes;
normal digestion of food.

At the same time, under the influence of unfavorable factors (high or low temperature, toxins, general intoxication, consumption of salty and spicy foods, etc.), the production of gastric juice and enzymes by the secretory glands decreases.

Food ceases to be digested normally and stagnates in the stomach. Fermentation processes occur, leading to bloating of the stomach, overflowing with gases. All this is accompanied by a decrease in the motility of the organ, which is sometimes accompanied by pylorospasm, which greatly complicates the movement of food through the gastrointestinal tract, causing pain, nausea and vomiting.

If the poorly processed food mass enters the small intestine, then fermentation processes also occur there. This leads to bloating, increased peristalsis and diarrhea.

In case of an upset stomach in a cat, treatment should be prescribed as soon as possible, because this problem affects the work of the whole organism and can lead to sad consequences.

Causes of indigestion

No matter how diverse the factors that disrupt the normal functioning of the stomach, I would like to separately note that a properly and regularly fed animal, vaccinated and dewormed on time, living with loving owners, has minimal chances of getting dyspepsia.

Indigestion in a cat can be affected by the following factors:

Symptoms of dyspepsia may vary somewhat depending on the development of the process. The main features should include:

Rapid saturation with food. The cat begins to eat little, up to the complete refusal of food.
Vomit. In case of indigestion, regurgitation is observed within half an hour after eating.
Diarrhea is quite common in dyspepsia, with stools that become frequent, thin, may contain mucus, or have a greenish tint.
Constipation is less common if intestinal motility is impaired.
Abdominal distention can be detected by palpation, while the animal is restless.
Lethargy. When feeling unwell, the cat will not be as energetic as usual.

Kitten upset stomach

The kitten's digestive tract is not yet fully formed, which is why it is especially susceptible to damaging factors.

Most often, indigestion in kittens occurs in the following cases:

With artificial feeding, if the milk mixture is poorly selected.
With a sharp transition from mother's milk to an adult diet.
When changing the diet after separation from the mother (when the kitten ends up with other owners).

If the baby is not able to suckle the mother's breast milk, he should receive a specialized mixture for cats. Feeding cow's milk, goat's milk, or infant formula can cause severe indigestion in a kitten. Cats produce less lactose than other animals, so excess milk sugar cannot be absorbed by the body, causing fermentation in the gastrointestinal tract.

In rare cases, dyspepsia develops in newborn kittens with abnormal enzyme production. In this case, only feeding with a special lactose-free mixture for kittens helps.

The transition to an adult diet should be gradual. With a sharp weaning from the mother, if the kitten has not yet completely switched to adult food, part of the diet should be replaced with a specialized milk mixture.

It is also important to ensure that after the change of owners, the kitten receives the same food for the first time. The transition to other types of food should be smooth, with a gradual replacement with a new food within 1-2 weeks.

Treatment of indigestion in cats

A condition that is symptomatic of indigestion can occur with a variety of other life-threatening conditions. Repeated vomiting, lethargy of the animal, constipation or diarrhea - this is a reason for an early visit to the clinic.

If the indigestion is caused by a general condition, treatment will be directed at the underlying cause. If tests and examinations do not show pathologies of other organs or infections, then symptomatic therapy is carried out, which includes the following main points with various variations:

starvation diet during the day;
injections of antiemetic drugs;
oral administration of sorbents;
with dehydration - infusion therapy.

After stabilization of the condition, the doctor usually prescribes a therapeutic diet, fractional meals, probiotics, and also explains to the owner the basics of proper feeding.

Quick help and the right treatment for indigestion in cats can help avoid many health problems. The main prevention of this unpleasant phenomenon will be only proper nutrition of the pet.

How to treat indigestion in cats at home

Of course, the best solution is a visit to the clinic, but there are situations when the owner does not have such an opportunity. What to do if an upset stomach of a cat or a grown kitten caught you, for example, in the country? How can you help your pet at home?

Diet and drink

Do not try to tempt your cat with delicious food in the hope that he will eat. Only a bowl of clean drinking water should be left.

If repeated vomiting and diarrhea are observed, dehydration of the body should be feared. It is best in this case to drink special solutions, such as Regidron, which are sold in a regular pharmacy.

The contents of 1 sachet should be diluted in 1 liter of water and fed to the animal as often as possible from a 5–10 ml syringe without a needle.

Sorbents

Sorbents, which can most often be found in a home medicine cabinet, will help to reduce fermentation processes, soothe the irritated gastric mucosa, neutralize toxins and normalize stools.

It is best to use Smecta. 1 sachet is diluted with 100 ml of water and drunk during the day in small portions: 5-10 ml for an adult cat, 1-2 ml for a kitten 4-5 times a day. You can also take "Enterosgel", after diluting it with water to a liquid consistency.

Probiotics

When the animal becomes better, you should start giving him food in small portions, but not earlier than a day after the onset of symptoms. It is useful to drink probiotics, such as the veterinary drug Vetom 1.1 (the dose for an adult cat is 1/10 of a sachet) or another probiotic for animals.

If no veterinary drugs are available, human drugs can be used. The easiest way to dose liquid probiotics, for example, the dose of "Hilak Forte" for an adult cat will be 3-5 drops 3 times a day.

These measures can also be used as first aid in case of illness, even when a further visit to the clinic is planned.

When to contact the clinic

If during the day the animal does not get better, and in addition to the described signs, any other symptoms appear (outflow from the eyes and nose, staining of vomit and feces black, vomiting of bile, yellowness of the mucous membranes), then you still cannot do without medical help .

The lack of timely diagnosis can lead to the development of other dangerous diseases, often the root cause of dyspepsia. If the symptoms quickly subside and the pet returns to its former activity, then most likely the problem was minor, but repeated vomiting and diarrhea quickly lead to dehydration, threatening the life of the animal.

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Etiology
Table 1 presents the possibilities of differential diagnosis of chronic diarrhea (diarrhea) in cats. More details on this issue can be found in the works listed in the list of references (1-3).

Food hypersensitivity has been reported in one study (4) to be the cause in approximately 30% of cases. This cause is very difficult to differentiate from IBD because most affected cats have histologic changes consistent with chronic inflammatory bowel disease (4) and because definitive diagnosis requires initial diet testing, which owners often refuse to perform. Unlike most cases of IBD, the severity of clinical signs in this disease decreases within 2-3 days after changing the composition of the diet in feed-sensitive cats (4).

Table 1. Differential diagnosis of chronic diarrhea in cats:

History and clinical examination
Chronology of deworming, characterization of the type of diarrhea (small or large intestine, see Table 2), and a complete feeding history are key items in the history. Prior therapy should be documented, especially the use of antibiotics, as it may be associated with bacterial disturbance and secondary chronic diarrhoea. If there was vomiting, then this fact should also be noted. The clinical examination should be complete, including palpation of the abdomen and careful examination of the ventral surface of the neck, in particular the thyroid gland.

Table 2. Characteristics of diarrhea of the small and large intestines:

		Small intestine	Colon
Feces	Quantity	Upgraded	Decreased or normal
	Slime	Absent (except for ileitis)	Often observed
	Intestinal bleeding	May be	Is always
	Blood in stool	Missing	Often observed
	Steatorrhea	Present, manifested by disturbances in digestion or absorption of nutrients	Missing
defecation	Frequency	Usually rises slightly - up to 4 times a day	Increases (frequent small bowel movements)
	Difficulty defecation	Missing	Usually present
	Urgency	Missing	Usually present (sometimes - defecation outside the litter box)
Other signs	gassing, bloating	May be observed	May be observed
	weight loss	May be observed	Rarely
	Vomit	May be observed	May be observed

Basic laboratory tests include a complete blood count and biochemistry, including a test for total thyroxine, especially in older cats. The goal is to rule out metabolic disorders and identify any possible sequelae of primary intestinal disease such as hypoalbuminemia, hypocholesterolemia, or any electrolyte disturbances. Moderate increases in alanine aminotransferase and alkaline phosphatase levels are often seen in hyperthyroidism and chronic intestinal inflammation.

The next step in case of indeterminate results from previous tests should be to identify pancreatic diseases, including exocrine insufficiency and chronic pancreatitis, respectively, with the measurement of fTLI (feline trypsin immunoreactivity) or fPLI (feline pancreatic lipase immunoreactivity) in the blood. Serum folate and cobalamin concentrations should also be measured to diagnose possible malabsorption of these vitamins and initiate replacement in case of cobalamin deficiency. Ultrasound is used to look for internal changes, especially in the liver, pancreas, intestinal wall, and abdominal lymph nodes. Puncture of observed abnormalities with a fine needle may help in making a diagnosis of cancer or pancreatitis. If liver failure is suspected, a determination of bile acids before and after feeding is recommended. Deviation of the results from the norm is an indicator for a liver biopsy.

After this stage, if a definitive diagnosis is still not made, intestinal biopsy helps to differentiate between chronic inflammation and neoplasia. If abdominal ultrasonography reveals any focal (focal) lesion, full thickness biopsy and mass extirpation are recommended.

Because cholangitis (cholangiohepatitis), pancreatitis, and inflammatory bowel disease (IBD) are often associated in cats, liver and pancreas biopsies should be performed simultaneously (5). All three segments of the small intestine are recommended for biopsy. If ultrasonography shows no focal lesions, an endoscopic biopsy may be performed. In this case, it is likely to be more efficient to sample the stomach and duodenum by upper endoscopy, but also the colon and ileum by colonoscopy, in particular because intestinal inflammation and neoplastic lesions may be unevenly distributed.

Three clinical cases are presented below to illustrate treatments for chronic feline diarrhea.

Case 1 - giardiasis
An 8-month-old domestic ovariectomized Shorthair cat presented with chronic diarrhea lasting 4 months.
The cat was treated with: deworming (including praziquantel/pyrantel and milbemycin), dietary changes (including easy-to-digest food and a diet with previously untapped protein sources), and one month of metronidazole (10 mg/kg twice daily) . These measures proved to be ineffective. The history of diarrhea seemed to be of a mixed type (small and large intestine), with increased stool volume, sometimes with severe diarrhea and mucus.
The owner did not notice any change in the cat's behavior, no vomiting was observed, but polyphagia has been noticed in the last few weeks.
The animal was mostly in the house and walked in the courtyard, always under the control of the owner. On clinical examination, the cat was alive, alert and sensitive, the weight was below normal, with a body index of 2-3/9, and was 2.5 kg. Abdominal palpation showed that gas/liquid filled the bowel loops without pain or significant dilatation. Further examination revealed no abnormalities.

Figure 1. Giardia trophozoites in a fresh faecal smear.

Relapse after the first treatment could probably be explained by contamination of the environment and the other cat with cysts. The persistence of cysts has also been explained by their transfer to the fur of cats (2). But this relapse could also be due to resistance to metronidazole. The study of feces at the end of the course of treatment was not carried out, but, nevertheless, it was decided to cancel the drug used and to prescribe fenbendazole. Even though fenbendazole proved to be effective in this case, the treatment of choice for feline giardiasis is metronidazole, which has recently been reported to be very effective in stopping spore formation in a group of chronically infected cats (10). Fenbendazole is not approved for use in cats and stopped the spread of cysts in only 4 of 8 cats co-infected with Giardia and Cryptosporidium (11).

In healthy adult cats, doses up to 5 times the recommended dose of fenbendazole can be safely administered in one study (12), but a severe hypersensitivity reaction (idiosyncrasy) has recently been described in a cat (13). Giardia are sensitive to humidity levels and die in a dry environment. But the main problem is the persistence of cysts in the places where the animal is kept. Cysts die at temperatures above 55°C. The best are disinfectants containing tetravalent ammonium compounds. Chlorine-containing products are also effective (2).

At this stage, for this cat with chronic diarrhea and a concomitant increase in liver enzyme levels, the following hypotheses have been put forward:

chronic liver disease,
chronic pancreatitis,
IBD or intestinal neoplasia and hyperthyroidism.

The presence of hypertension without any symptoms of renal insufficiency made it possible to take the main version of hyperthyroidism as the main version. The total plasma thyroxine was at the level of 75 nmol/l (normal values: 15-52 nmol/l), and after that the diagnosis of hyperthyroidism was made. Urine was cultured on culture media as urinary tract infections are known to be common in cats with hyperthyroidism (14). The results were negative. The cat was prescribed Mercazolil 2.5 mg twice a day and at the same time amlodipine 0.625 mg once a day to relieve hypertension, because the blood pressure was high enough and there was a threat of organ damage. A week later, systolic blood pressure was 166 mm Hg. Art., the stool improved, but was still soft. Echocardiography showed no signs of hypertrophy. 3 weeks after the start of treatment, the level of total plasma thyroxine was 30 nmol/l, so the initial dosage of Mercazolil was maintained. An increase in the levels of creatinine and urea was not observed, the parameters of biochemistry, alkaline phosphatase, alanine aminotransferase were normal. The chair returned to normal. Systolic pressure - 156 mm Hg. Art., and the animal was supported on amlodipine.

This case shows that metabolic disorders should never be excluded from the list of possible diagnoses in feline chronic diarrhea and that hyperthyroidism should be ruled out first and then differential diagnosis should continue, especially in underweight cats older than 7 years of age.

Case 3 - Inflammatory Bowel Disease (IBD)
An eight-year-old ovariectomized domestic shorthair cat was admitted with a complaint of recurring diarrhea for 8 months, with concomitant weight loss. Appetite was inconsistent, vomiting was sometimes observed, but not more than three times a week. Occasionally the stool contained fresh blood and mucus. There were no attempts and sudden diarrhea, on average there were 2-3 stools per day, occasionally with some difficulty. Tests for FIV (Feline Immunodeficiency Virus) and FLV (Feline Leukemia Virus) were negative. The cat, on the recommendation of a veterinarian, was dewormed twice a month with praziquantel and pyrantel pamoate without any changes. A monthly course of metronidazole did not improve the cat's clinical condition, nor did dietary changes.
Clinical examination revealed no pathology, dehydration was absent. Abdominal palpation revealed a slight thickening of the intestinal loops.

A complete blood count revealed no changes, except for mild non-regenerative anemia, which was considered a symptom of a chronic illness. A coagulation test performed due to a report of fresh blood in the stool was normal. Triple flotation and reaction to Giardia antigen were negative. With the exception of reduced plasma albumin (20 g/l, norm - 25-38 g/l) with normal globulin and a slight increase in alkaline phosphatase (110 u/l, norm - 12-85 u/l), blood biochemistry, including total thyroxine , was normal.

Urinalysis showed no proteinuria, specific gravity - 1.038. Thus, in this cat, diarrhea was accompanied by hypoalbuminemia. Therefore, the main possible causes could be: liver disease, possibly associated with chronic pancreatitis, loss of protein through the gastrointestinal tract (due to chronic inflammation or primary intestinal neoplasia), and exocrine pancreatic insufficiency. The determination of bile acids before and after feeding made it possible to exclude liver failure. Abdominal ultrasound showed no changes in the liver or pancreas, but the small intestinal mucosa was abnormal (Figure 2), and the mesenteric lymph nodes were enlarged.

Figure 2. Abdominal ultrasonography of case #3. Loop image of the middle of the jejunum showing wall thickening (3.1 mm). There is a thickening in the outer muscular layer, the entire outer serous membrane has an irregular structure.

Serum trypsin immunoreactivity did not go out of the normal range, which made it possible to exclude exocrine pancreatic insufficiency, but serum cobalamin was significantly reduced (190 ng/l, normal - 290-1499 ng/l). Serum folate concentration without abnormalities. Due to the severity of the clinical picture and the presence of mixed diarrhea, gastroduodeno- and colonoscopy was performed. Abnormal, due to increased heterogeneity and friability, only the duodenal mucosa was recognized (Figure 3).

Figure 3. Endoscopy view of the duodenum in Case #3. Note the altered, grainy texture of the mucosa.

Biopsies were taken from the stomach, descending duodenum, colon, and, blindly, from the ileum. The cat was placed on a soy protein hydrolysate elimination diet and metronidazole 10 mg/kg twice daily for 4 weeks was administered. Due to the reduced serum cobalamin concentration, therapy was supplemented with injections of vitamin B 12 (250 µg/kg once a week subcutaneously for 6 weeks).

The histopathologist's report indicated severe lymphoplastic inflammation of the small intestine with very severe infiltration and architectural changes, but the biopsy was considered unreliable. The pathologist reported that he could not rule out the possibility of lymphoma due to the very superficial manner in which the biopsy was performed. Immunohistochemical staining of biopsies (15) also failed to distinguish between the two possibilities. The stomach and colonic mucosa were considered normal. Considering the possibility of lymphoma, it was decided to perform full-thickness biopsies of the intestinal wall before starting immunosuppressive therapy. Three segments of the small intestine, tissues of the enlarged lymph node, pancreas and liver were examined. The liver and pancreas were considered healthy, and the version of severe chronic inflammation of the small intestine was confirmed (Figure 4).

Figure 4. Histopathological picture of a full thickness jejunal biopsy (case #3). The architecture of the villi is destroyed, there is blunting and, in some places, fusion of the tips of the villi, a moderate expansion of the central papilla and protruding smooth muscle fibers. The assimilation layer is diffuse and saturated with increased numbers of mature lymphocytes and plasma cells, which blur the crypts in 7-9 cells of the thick layer. There is also an increase in the number of intraepithelial lymphocytes. The epithelium of the mucous membrane is slightly thinned, with cuboidal enterocytes, which often reduces the clear brush border of the epithelial tissue.

After these procedures, lymphoma was ruled out. The cat was definitively diagnosed with inflammatory bowel disease (IBD).

Treatment consisted of administering prednisolone as follows: 2 mg/kg twice daily for 5 days, 1.5 mg/kg twice daily for the next week, and 1 mg/kg twice daily for the second week. After 3 weeks, the animal was presented for re-examination. The stool was semi-formed, but still moist, and there was no evidence of blood or mucus. During this time, weight gain was 0.4 kg. After 6 weeks, the serum cobalamin concentration returned to normal. Therefore, the cat was given 250 micrograms of cobalamin subcutaneously every 4-6 weeks. The dosage of prednisolone was progressively reduced and after 3 months the animal was clinically healthy. Thereafter, steroid administration (1 mg/kg every other day) and an elimination diet were continued for another 6 weeks. Minor annual relapses are treated with a course of metronidazole or prednisolone and cobalamin. Therapeutic diet is applied on an ongoing basis.

It can also develop due to a decrease in the tolerance of the intestinal immune system to the following factors:

In IBD, dietary changes are usually recommended, such as the use of an elimination diet, a diet based on a previously unused protein, or a diet with increased digestibility. The therapeutic diet itself, as a rule, is ineffective, and therefore it is recommended, at least in the early stages, to supplement it with antibiotic therapy. A recent study in cats demonstrated a relationship between the number of bacteria attached to the mucosa and the severity of tissue lesions in IBD (17). Moreover, the number of attached Enterobacteriaceae, E. Coli and Clostridium spp. correlated with the severity of clinical signs and the level of cytokine mRNA production (17). These results increase the likelihood of bacterial involvement in the pathogenesis of feline IBD and justify the use of antibiotics in such cases.

With the ineffectiveness of the above measures, immunosuppressants are used. It is recommended to start with steroids and then add or apply another drug if they do not work well (Table 3).

Table 3 Drugs used to treat IBD in cats:

Therapeutic diet	A diet based on previously unused or hydrolyzed proteins. Highly digestible diet
	A drug	Dosage
Antibiotics	Metronidazole	7-10 mg/kg po twice a day
	Oxytetracycline
	Doxycycline	5 mg/kg po twice a day
Immunosuppressants	Prednisolone	1-2 mg/kg p/o twice a day for 4-7 days, then gradually reduce the dosage in accordance with the clinical picture (at least 2-3 months course)
	Cyclosporine	1-4 mg/kg twice daily (watch for falling levels)
	Chlorambucil	1-2 mg / m2 p / o every other day with a gradual decrease
Other	cobalamin	250 mcg per week sc for 6 weeks, then 250 mcg per month for a year
Other	Sulfasalazine	10-20 mg/kg po twice a day

Cobalamin deficiency is common in cats with gastrointestinal disease in the US, especially in IBD and alimentary lymphoma (18,19). However, the prevalence of hypocobalaminemia may be lower in other countries such as the UK (20).
Since it indicates a serious metabolic disorder, cobalamin levels should be monitored and adjusted to normalize metabolism and improve the clinical picture (18).

This case of IBD is unusual due to the possibility of a diagnosis of lymphoma based on endoscopic biopsies - and therefore the need for a full-thickness biopsy for further investigation. There are reports that it is not possible to reliably differentiate between IBD and lymphoma based on endoscopic biopsies of the small intestine (21). In this case, the lymphoma needed to be ruled out before steroids could be used because of the risk of possible secondary resistance to chemotherapy.

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Olivier Dossen,
Department of Internal Medicine, University of Illinois, USA

Diarrhea in cats is characterized by frequent liquid stools. A change in diet, as well as various infections and diseases, can lead to the disorder. If diarrhea lasts for several days and other unpleasant symptoms are observed, then the cat must be urgently treated.

Normally, cat stool should be slightly moist, soft, structured and dark brown. healthy animal defecate 1-2 times a day. If the feces have lost their shape or become watery, then this indicates diarrhea.

In most cases, diarrhea is caused by a malfunction of the digestive system. It can be caused by eating spoiled foods or food waste. Also, the cause of diarrhea in cats is a change in food. In some cases, the disorder is observed after motion sickness in transport or as a result of severe stress, which can occur when contacting another animal or after visiting a veterinarian. Such causes are easily eliminated, which means that it will be easy to cure a cat of diarrhea.

Sometimes diarrhea happens caused by more serious reasons:

worms;
various viral infections;
fungus;
bacterial infections, namely salmonella and clostridia;
various diseases of the liver and kidneys;
diabetes;
intestinal obstruction.

Despite such an impressive list, you should not panic, because in most cases it is indigestion that leads to diarrhea.

To determine the cause, pay attention to the cat's feces:

Diagnostics

The most important thing in the treatment of diarrhea is to determine its exact cause. To help the doctor make the correct diagnosis, it is necessary to describe all the subtleties of the behavior, feeding and condition of the cat. within the last 2-3 days. In addition to a thorough examination, the doctor will measure the temperature of the cat, probe its organs, and also determine the degree of dehydration. In some cases, an additional study of feces, urine, and blood will be required. To make sure that there is no intestinal obstruction and other diseases, an x-ray should be taken.

How to treat diarrhea in a cat?

If you notice that your cat has diarrhea, you need to start analyze animal nutrition and only then treat it. If during the last 2 days the pet's menu has had raw seafood or liver, milk, too fatty meat, then most likely they caused the disorder. In this case, it is enough to exclude the mentioned products from the diet and keep the cat on a half-starved diet for some time. With abundant liquid diarrhea, reduce portions and feed the animal less frequently.

When a kitten has diarrhea when switching to another food enough to give small portions. In fact, this is quite normal, that is, you should only worry if the diarrhea does not go away for a long time or occurs after you have stopped giving a new food. In this case, you need to treat the worms and show the kitten to the veterinarian.

If the animal shows no other symptoms other than diarrhea, including fever, treatment should be initiated. A kitten is not fed for 12 hours, and an adult cat for a day. During this period, activated charcoal is given at the rate of a 1 tablet per 10 kg. The required amount of the drug is dissolved in warm boiled water, and then the solution is drawn into a syringe without a needle, with which the liquid is poured into the cat's mouth. Many veterinarians, in addition to activated charcoal, recommend giving your pet a decoction of St. John's wort or chamomile.

After a daily fast, you can start feeding the cat. Easily digestible foods are suitable for this purpose. This applies to foods such as boiled chicken, boiled eggs and rice. You can also give medicated food created specifically for cats. When choosing it, you need to pay attention to the fact that the package contains a note about the treatment of digestive disorders, including diarrhea. It is worth noting that the first few days after diarrhea, the animal is given half the usual portion.

To avoid developing diarrhea in a cat, it is necessary follow simple guidelines:

If the cat has diarrhea for several days or there are impurities of mucus and blood in the feces, it is necessary to visit a veterinarian. This also applies to cases where presence of other symptoms, including plaintive meowing, fever, weakness, lethargy, and vomiting. In the absence of such signs, therapeutic fasting and a review of the diet will help improve the cat's condition.