Accepted Answer

Thanks for the information. Chronic diarrhea can definitely be a difficult problem to find a cause for. Luckily, there are still some tests that can be ran for a diagnosis. My biggest concern is the blackish color in the stool and the red-jelly like substance. Usually, blackish color in the stool is digested blood. The reddish color may be fresher blood. I have a suspicion that something in his stomach or intestinal tract is causing bleeding. Possibilities include gastrointestinal ulcer, intestinal parasites (roundworms, hookworms, Giardia, Cryptosporidium, abherrant heartworms), chronic pancreatitis, bacterial infection (Salmonella, Campylobacter, Yersinia, Clostridium), fungal infection (Histoplasmosis, mycobacteriosis, phycomycosis), cancer and an immune mediated problem (inflammatory bowel disease). Routine bloodwork may or may not pick up bleeding in the gastrointestinal tract (usually the BUN is elevated, but not always). I know multiple fecal exams were negative, but I never let any of these guys leave the hospital without trying a therapeutic round of Panacur. Some parasites are more difficult to pick up on a fecal exam than others. Panacur is probably the most all inclusive dewormer. I definitely use metronidazole for the anti-inflammatory effects. I would probably add Clavamox to the regimen for more antibacterial control. An H2 blocker like Pepcid may help to protect the intestinal tract better if dealing with an ulceration. Sucralfate would be a good medication to use to protect and heal the stomach lining. These are all medications I would consider for empiric therapy. As far as getting a diagnosis, I would start with a fecal occult blood test to check for the presence of blood, stained fecal cytology (you would have to ask your vet if this was included in the fecal exams), Giardia SNAP test, a fecal bacterial culture, test for feline leukemia and feline FIV (if not already done), Feline PLI (pancreatitis) and an ultrasound of the abdomen. Endoscopy of the stomach and intestinal tract may be your best bet for getting a diagnosis. From here, a biopsy of the intestinal tract can be taken without major abdominal surgery. Please let me know if you have any other questions. Hope this helps.

Expert:	Texas Veterinarian
Pos. Feedback:	100.0 %
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Answered:	10/29/2009

Cat Veterinarian

7 years of clinical veterinary medicine and 17 years experience caring for household pets.