Chronic Diarrhea

Maggie, my sweet Ragdoll cat, is almost 2 years old. She was rescued in December, and since I’ve had her, she hasn’t had a single, solid BM. She has chronic diarrhea, and we have tried the following: 3 rounds of antidirrhea meds, Panacur twice for possible giardia as well as another antibiotic for coccydidia (sp?) Hills SD GI food, RC Novel Protein P&D. We have also tried an assortment of other RC sensitive digest foods as well as grain free foods. Today, I ordered litter attractant and Feliway diffusers in case she has anxiety? We’ve seen 2 vets, and I’m not sure what to feed her at this point. She does better on wet food compared to dry, but anything I give her upsets her stomach. We have tried cutting out chicken in case of food allergies. Please help!

Hello!  Chronic diarrhoea is not uncommon in certain pedigree cats and can have a multitude of causes, including parasites (worms, giardia), bacteria, allergy, pancreatitis, liver disease, cancer, and various inflammatory diseases of the bowel often linked to allergies.  You list a lot of remedies and diets that you have tried and in some cases, trying remedies can prove effective;  you might hit on exactly the right thing, or else the problem might pass on its own accord.  However, trying one thing after another can have its drawbacks:  1)  each 'thing' needs to be tried consistently for a substantial amount of time before it can be said not to be working. 2) there are a lot of different possible bugs, parasites, immune conditions and organ conditions that may be causing the problem.  The chances of you hitting on the 'right' treatment by trial and error are quite slim - that is, after the basics (ie an appropriate diet and complete, consistent parasite regime) are in place.  Chicken, for example, may be an allergen for some cats (although it's not a common one in my experience), but so might beef, mouse, lamb, pork, grain, certain soya proteins and so on and so on.  It would take a long time to trial test for every allergen in this manner and it doesn't sound as though time is on your side.

Switching vets can also complicate things;. The first has just ruled most of the basic stuff out and is gearing up for the more complex vets when... The client gets fed up and tries a different vet, who starts from the beginning with their own work-up.  I have seen this time and time again, in both directions.

So: that's a lot about what not to do, but what can be done?  I would stick to one vet and go to see them - let them know in advance that you're not after a 'treat the symptoms' type consult, but want to discuss the overall Plan for diagnosing and treating your cat.  Usually your vet will have a running list in their head of possible causes, and should gradually be trying to rule different ones out.  Instigating a low-allergy diet and worming regime is usually a starting point, and -particularly if the weight is changing - vets will also try to exclude systemic diseases such as pancreatitis, thyroid and liver disease pretty early too.  They will generally have in their heads a way to balance treating the existing symptoms while finding out the underlying cause, and a long conversation about the bigger picture as to how they want to approach this is useful to prevent frustration on everyone's part. Failing that, referral to a specialist may be necessary to get a handle on where to go next.  Meanwhile, for further reading, there are articles that might interest you in the blog.

Wow!  I've written a giant essay there.....   I guess the main thing is that a decision might have to be made between trying different treatments in the hope of hitting one that works, and trying to find the diagnosis.  In the UK, some vets prefer one or the other and you may need to talk it through with your vets to find a plan that suits you.  Best of luck and please do let us know how Maggie gets on!

How is Maggie doing now? Do you have any updates?