Accepted Answer

Hi kkaren,
I am so sorry to hear that your kitty is so uncomfortable.


There are many things that can cause chronic diarrhea in a cat. The list includes (but is not limited to):

Inflammatory bowel disease (IBD)
Neoplasia (cancer)
Obstruction of the gastrointestinal tract (due to neoplasia, foreign body, IBD, intussusception, or stricture)
Parasites
Metabolic disorders--hyperthyroidism, kidney disease, liver disease, diabetes, toxins
Viral- Feline leukemia, Feline AIDS (FIV), and FIP
Fungal diseases
Noninflammatory malabsorption--lymphangiectasia, small intestinal bacterial overgrowth (SIBO), villous atrophy, duodenal ulcers
Dietary---dietary sensitivity, deitary indiscretion (cat age something that he shouldn't have), and diet changes

As you can see, the list just goes on and on. It is good that your vet has ruled out any parasitic diseases, as this can be the most common cause of this problem.

It sounds like your vet has already done some baseline bloodwork to look for any obvious abnormalities that might point in the direction of why your cat is having this problem. Many of the problems on the list can be ruled out by this bloodwork being normal. For example, diabetes and kidney disease would have been obvious.
If the initial bloodwork did not include tests for hyperthyroidism (a T4, free T4), feline leukemia (FeLV) and FIV, then these should absolutely be done now. All of these tests can definitively diagnose these problems..so that could be your answer right there. And...hyperthyroidism is a very treatable disease.

SIBO is a condition in which there is an overgrowth of certain bacteria that normally live in the gut. This can result in chronic diarrhea, and altered malabsorption and maldigestion and gut motility. It is diagnosed with a serum blood test called folate and cobalamine. Treatment involves lifelong administration of metronidazole or Tylan powder to help control the overgrowth. Most animals do well once they are being appropriately treated.
Inflammatory bowel disease is diagnosed with biopsies of the inside of the intestinal tract, usually obtained using an endoscope. The treatment is specific to the type of IBD the cat has, but often involves a change to a special prescription diet and a low-dose of corticosteroids to control the inflammation. In cats with inflammatory bowel disease, sometimes several different diets have to be tried before this can be controlled. Not all cats with this condition will fespond to the same type of diet. If this has not been tried with your cat yet, I do recommend trying Hill's z/d diet. This is a hydrolyzed protein diet and works very well for many cats with this type of problem.
I am attaching a client information handout that I use in my practice concerning chronic diarrhea. I hope that you find it useful.

Click Here

If this problem is being caused by cancer, this can usually be detected with either an endoscopic exam of the gut, or with abdominal ultrasound. If no discreet mass is seen, then biopsies of the inside of the gut are taken to look for any signs of cancer. Some types of cancers are more treatable than others, and your cat's prognosis and treatment are really going to depend on the underlying cause.

Since this has been going on for so long, and your vet does not seem to know what is causing it, I strongly recommend that you ask for a referral to a specialist in veterinary internal medicine in your area. Most specialists are located at referral centers or colleges of veterinary medicine. The benefit of seeing a specialist, is that you are more likely to get a quick and accurate diagnosis of your animal's problem, and thus a faster resolution of the symptoms. It is also more likely that a specialist has seen this problem before and treated it successfully.

I hope that this information is of help to you, and I wish you the best of luck with your kitty. Please let me know if I can be of further assistance.

Dr. K

Expert:	Dr. K
Pos. Feedback:	99.5 %
Accepts:	1123
Answered:	8/25/2008

Veterinarian

9 years experience as Veterinarian