## The issue shared by all cat owners

Do you find the litter box "disturbed"? Soft or liquid stools. Sometimes outside the litter box. It is **diarrhea**.

In 70% of cases, it is self-limiting within 24-48 hours. In **30% it is pathological** and requires veterinary care.

Knowing the home protocol + warning signs is essential.

## What is feline diarrhea

**Diarrhea**: increased frequency, volume, or liquidity of stools.

**Types**:

**Acute** (<2 weeks):
- Most common.
- Various causes (dietary, viral, parasitic).

**Chronic** (>2 weeks):
- More serious.
- Causes: IBD, food allergies, tumors, chronic parasites.

## The most common causes

### 1. Sudden food change

Abrupt change of brand/type = intestinal stress.

**Solution**: gradual changes over 7-10 days.

### 2. Dietary indiscretion

The cat has eaten something "inappropriate":
- Table scraps.
- Inappropriate snacks.
- Caught mice/lizards.
- Plants.

### 3. Intestinal parasites

**Common**:
- **Giardia**: protozoan, watery chronic diarrhea.
- **Coccidia**: especially in puppies.
- **Worms** (roundworms, hookworms).

Diagnosis: fecal examination.

### 4. Stress

Cats are sensitive to changes:
- Moving.
- New animals.
- Home renovations.

### 5. Food allergy/intolerance

Common, often undiagnosed.

Most common ingredients:
- Chicken.
- Fish.
- Beef.

Solution: elimination diet with "novel" proteins (rabbit, duck).

### 6. Viral infections

- **Panleukopenia**: very serious, unvaccinated kittens.
- **Feline coronavirus**: often self-limiting, but can progress to **FIP** (feline infectious peritonitis, very serious).

### 7. Bacterial infections

- Salmonella.
- Campylobacter.
- Clostridium.

### 8. IBD (Inflammatory Bowel Disease)

Chronic inflammatory bowel disease.
Common in adult cats.

### 9. Intestinal tumors

In older cats: intestinal lymphoma is common.

### 10. Toxins

- Plants (lilies, pothos).
- Cleaning agents.
- Antifreeze.

## The home protocol for simple diarrhea

### Step 1: short fasting

**Important**: cats **do not fast** like dogs.

- **Maximum 12 hours** of fasting.
- Water always available.
- Never more than 24 hours (risk of lipidosis).

### Step 2: bland diet

**Classic recipe for cats**:
- **Boiled chicken** without skin, without salt.
- **Boiled white rice** (little, cats do not digest it much).
- **Boiled potato** (alternative to rice).

**Proportions**:
- 70% chicken + 30% rice/potato.
- Cooked without seasonings.

**Quantity**:
- Average cat (4-5 kg): 80-120 g total, 3-4 meals.

**Specific gastrointestinal wet food**:
- Royal Canin Gastrointestinal.
- Hill's i/d.
- Purina EN.

Practical, balanced, enjoyable.

### Step 3: hydration

**Crucial**:
- Fresh water changed often.
- Possible chicken broth (without salt).
- Water fountain.

**Dehydration**: increased risk. Recognize it:
- Skin of the scruff returns slowly.
- Dry gums.
- Sunken eyes.
- Lethargy.

### Step 4: probiotics

**Specific for cats**:
- Fortiflora (Purina).
- Florentero.
- Diaroal.

**Effect**: restores intestinal flora.

**Cost**: 10-20 € per packet.

### Step 5: clay (optional)

**Smecta** (diosmectite):
- Absorbs toxins.
- Away from medications/food.
- Pediatric dose.

### Step 6: gradual return

After 48 hours of bland diet with normal stools:

**Day 3**: 50% bland diet + 50% regular food.
**Day 4**: 25% + 75%.
**Day 5**: 100% regular food.

Never abrupt change.

## When to run to the veterinarian

Go immediately if:

- ❌ **Kitten under 6 months** (rapid dehydration).
- ❌ **Senior cat** or with health issues.
- ❌ **Overweight cat** (risk of lipidosis if fasting).
- ❌ **Blood in stools** (bright red or black/tarry).
- ❌ **Repeated vomiting** associated.
- ❌ **Profound lethargy**.
- ❌ **Visible dehydration**.
- ❌ **Diarrhea > 48 hours** despite bland diet.
- ❌ **Diarrhea > 1 month** (chronic).
- ❌ **Fever**.

## What the veterinarian does

**Initial visit**:
- Physical examination.
- History.

**Diagnostic tests**:
- Fecal examination (parasites).
- Blood tests.
- Possible ultrasound.
- FIV/FeLV test (if suspected).

**Specific treatment** based on diagnosis.

## Chronic diarrhea: the other story

**If duration >2 weeks**:

**Most common causes**:
- IBD.
- Chronic food allergy.
- Chronic parasites (Giardia, Tritrichomonas).
- Intestinal lymphoma.

**More complex diagnosis**:
- Complete blood tests.
- Multiple parasitological tests.
- Abdominal ultrasound.
- Possibly intestinal biopsy.

**Personalized treatment**.

## Long-term strategies

For cats with recurring intestinal problems:

**1. Specific gastrointestinal food**:
- Long-term.
- Royal Canin, Hill's, Purina.

**2. Daily probiotics**:
- Fortiflora or equivalents.

**3. Fiber**:
- Psyllium (little).
- Cooked pumpkin (1 teaspoon).

**4. Stress reduction**:
- Stable routine.
- Feliway.

**5. Regular deworming**.

**6. "Limited ingredient" food**:
- For cats with allergies.

## Myths to debunk

**Myth 1**: "Giving yogurt helps".
**Partially true**: contains probiotics, but many cats are lactose intolerant.

**Myth 2**: "Milk helps".
**False**: worsens diarrhea (lactose).

**Myth 3**: "Diarrhea = worms".
**Partially true**: only one of the causes.

**Myth 4**: "Human anti-diarrheals are fine".
**Dangerous**: some are toxic to cats.

**Myth 5**: "Wait for it to pass".
**Truth**: 48 hours is okay, longer = problem.

## The "special" causes

### Tritrichomonas foetus

Little-known parasite, chronic diarrhea in young cats.

Specific diagnosis.

Difficult treatment (ronidazole, not always available).

### Low-grade intestinal lymphoma

Common tumor in senior cats.

Symptoms: chronic diarrhea, weight loss.

Treatment: chemotherapy (surprisingly well tolerated by cats).

Prognosis: 1-3 years of quality life.

### FIP (Feline Infectious Peritonitis)

The "dry" form can cause chronic diarrhea.

Very serious.

New treatment (GS-441524) has revolutionized prognosis.

## The truth

Feline diarrhea is **common but manageable**.

**Approach**:

1. **Acute diarrhea + healthy cat**: home protocol, 24-48 hours of observation.

2. **Severe or associated symptoms**: veterinarian immediately.

3. **Chronic diarrhea**: thorough investigations.

**Hydration always a priority**.

**Never underestimate**: in cats, complications arise quickly.

With the right approach, **70% of episodes** resolve at home. For the remaining 30%, early diagnosis saves (literally) lives.

Know your cat. Recognize the signs. Act promptly.