has had diarrhea on and off for the last three months.
She has been treated several times with various
medications at least some of which, according to Anne,
were antibiotics. The medications have had varying
degrees of success in lessening the diarrhea, none have
completely eliminated it. Turtle is a 10-year-old tabby
reports that Turtle seems to eat well though none of the
various diets she has tried have helped with the
diarrhea. Anne is frustrated and a bit worried at this
point and suspects that Turtle is less than thrilled
with the situation as well. She seems to be spending
much more time in the litter box though, thankfully from
Anneís perspective, Turtle always makes it to the
litter box in time ó so far.
Turtleís diarrhea is not a straightforward and simple
case. The first step is to return to Turtleís
veterinarian. Turtle will need some diagnostic testing,
which should include blood work and radiology to examine
her digestive tract.
on my list of possible causes for Turtleís diarrhea is
a disease called inflammatory bowel disease, IBD. This
is caused by the immune system reacting against
"something" in the digestive tract, causing an
inflammatory response within the wall of the digestive
system. This most commonly occurs in the stomach and/or
the small intestine. This inflammation then decreases
the ability of the digestive tract to do its job,
therefore causing less than thorough digestion of food
leading to diarrhea. Affected cats can sometimes vomit
as well because of stomach involvement in the process.
Turtle was not reported to be vomiting.
bowel disease can show on a radiograph as thickening of
the small intestinal wall. This thickening of the wall
is not, however, definitively diagnostic for IBD. There
are other diseases that can cause this radiographic sign
one of which is a type of cancer within the bowel wall
called intestinal lymphosarcoma. There is no way to
distinguish these two diseases by radiography.
Turtleís radiographs do demonstrate small bowel wall
thickening and I think they will, it likely will be
necessary to biopsy her bowel. This can sometimes be
accomplished with an endoscopic technique under
anesthesia. A special flexible scope with camera and
channels for special instruments is introduced down the
catís esophagus through the stomach and into the
earliest section of small bowel.
with cats, it is difficult to advance the scope much
farther. It is for that reason that, in cats, I usually
recommend using a laparotomy technique to obtain biopsy
samples. This is a surgical technique similar to a spay
surgery in its approach and allows the surgeon to
visualize the catís entire digestive system from the
outside in, so to speak. It also allows visualization of
the lymph nodes in the abdomen associated with the small
intestine. Biopsy samples can be obtained from theses
nodes along with sample of the small bowl wall allowing
for the best chance to obtain that definitive diagnosis
with the answer to the underlying cause for Turtleís
chronic diarrhea, we can hopefully formulate a treatment
plan to bring her back to normal digestive function.