Hello, my name is***** and I have over 20 years of experience as a veterinarian. I'm sorry to hear about Aileen's chronic loose stools.
It will be important to describe what sort of loose stools she has to try and localize the problem. Loose stools with mucous or bright red blood and small amounts frequently point more towards large bowel diarrhea
or colitis, whereas just watery stools with no mucous point more toward small bowel disease.
Chronic diarrhea does cause changes in motility of the gut and can lead to reflux and vomiting. It can also lead to bacterial overgrowth in the gut. Probiotics such as Fortiflora or Benebac can help replace appropriate bacteria. I understand that you may have tried one probiotic but perhaps a different one will work better.
I assume that she has had stool samples checked to make sure that parasites aren't part of her problem. Sometimes we need to submit these to the laboratory rather than checking them in the clinic to look for more unusual parasites.
Have any other diagnostic tests been checked?
Has she had a fecal culture to check for abnormal bacteria such as clostridia?
In a young cat parasites, abnormal bacteria and food
sensitivities account for most loose stools.
Is she losing weight?
If she truly doesn't have parasites or abnormal bacteria it is quite possible that she has a food allergy/sensitivity or inflammatory bowel disease and that she needs a low residue, easy to digest food or a hypoallergenic food to be able to properly digest and absorb her food and not have loose stools. I highly recommend a trial of either Hills i/d or Purina Veterinary Diets EN. No treats, table food or flavored medications while she is on her food trial. If he does well she can eat these foods for life as they are balanced.
Cats with food allergies can benefit from Hills z/d or Purina Veterinary Diets HA.
Cats with inflammatory bowel disease will worsen with stressful situations. There may be times when she will need medications too, such as metronidazole or even steroids too if that is her problem, but I have found that a consistent, easy to digest diet is very helpful for long term control.
We can diagnose inflammatory bowel disease via biopsies, but checking blood levels of folate and cobamalin may point toward primary intestinal disease and what part specifically may be affected.
There are other possibilities too.
Addison's disease, which is a poorly functioning adrenal gland, can lead to chronic diarrhea and vomiting. These kitties cannot handle stress at all because their adrenal gland doesn't produce cortisone when stressed and their electrolytes can be off too if their adrenal gland isn't controlling that normally either. We see vomiting, diarrhea and sometimes physical collapse in severely affected cats. This is more common in dogs than cats. Testing is an ACTH response test to check adrenal gland function and checking electrolyte levels. Treatment is steroid replacement therapy and electrolyte replacement.
Pancreatic insufficiency is another possibility. These cats have a pancreas that produces a decreased amount of digestive enzymes, and the amount produced can wax and wane in some cases, especially early in the disease process. Testing is by running a blood test called a TLI which checks for digestive enzymes. Treatment is replacement of digestive enzymes at each meal. An easier to digest food would be expected to create less problems with digestion and as such less diarrhea.Kidney
and liver disease can cause diarrhea too, but I would expect her to be sicker in general.
In short since this has been a long term problem for Aileen then more diagnostics need to be done. They can be as simple as fecal checks and cultures, as well as a complete blood count and biochemistry profile to assess general health. Or they can be more invasive such as biopsies of her gastrointestinal tract to look for inflammatory bowel disease or infiltrative cancers such as lymphoma.
In the meantime it may help to food fast her for 12 hours to stop gut spasms then offer a bland diet mix of 2/3 boiled, minced, white, skinless chicken and 1/3 boiled, plain, white rice mixed with some low salt chicken broth to make it easy to lap up and swallow as well as increase her fluid intake. Probiotics such as Fortiflora, Proviable, or Benebac can help replace appropriate bacteria. You can add those to the bland diet mix.
Please let me know if you have any further questions.