The Cat Clinic of Stillwater

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Gastroenteritis, and the resulting clinical sign of diarrhea, is second only to feline respiratory disease as the most common disease seen in cats. For a kitten, diarrhea can be a mild problem or a life-threatening one. When there are signs of systemic disease, intensive therapy may be needed.

Diarrhea in cats has many causes. Among these are:

Changes in diet or dietary indiscretion
Intestinal worms, such as Toxocara (roundworms) and Ancylostoma (hookworms)
Protozoan parasites such as Coccidia, Giardia, Cryptosporidium, Tritrichomonas, and Toxoplasma
Bacterial infections such as Salmonella, Clostridium, and Campylobacter
Viral infections such as Panleukopenia or feline enteric corona virus
Diarrhea can also be induced by prescription medications.

Diagnosis
The first steps to reach a diagnosis are: a complete medical history (including diet), a physical examination, and a fecal sample. If a diagnosis is not reached, or if the patient does not respond to therapy, additional testing may be necessary. The additional testing will include: a complete blood count, blood chemistry analysis, urinalysis, FeLV/FIV testing and specialized fecal testing.

Management
All kittens with diarrhea should receive small meals of bland, low fat diets. We recommend high protein, low carbohydrate diets such as canned kitten food or special diets developed for cats with intestinal disease. For short periods of time (5-10 days), cooked chicken or baby food may be used. Milk and dry food should be avoided.

Some kittens with diarrhea will require fluid therapy given subcutaneously or intravenously.

All kittens should be treated for common intestinal worms with pyrantel + praziquantel and receive a second dose of pyrantel in three weeks. All litter boxes and other surfaces exposed to fecal material should be disinfected using bleach diluted in water with a ratio of 1:20.

Many kittens will receive metronidazole. This medication alters the intestinal microflora, dampens cell mediated immunity, and kills some specific pathogens (such as Giardia). Some will receive probiotics to help the intestinal flora. Motility modifying drugs are generally not recommended.

Some of the infectious organisms that can cause diarrhea in kittens can also cause problems for humans. These include Salmonella, Campylobacter, Cryptosporidium, Giardia and Toxocara. Studies have shown that 30-40% of shelter kittens test positive for one of these infections. It is important to always wash your hands after handling a kitten with diarrhea.

Sometimes the underlying cause of diarrhea cannot be identified. Some young cats simply grow out of the problem. Kittens that do not respond to initial symptomatic therapy will require additional testing and will receive treatment specific to their condition. The keys to successful resolution of the problem are performing appropriate tests, utilizing appropriate food trials, and providing supportive care.