How should we deal with cats with chronic diarrhoea in our practice?

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: Chronic diarrhoea in cats can be a thoroughly frustrating affliction for patients, owners and vets alike. What are the common underlying aetiologies? Do these change according to the age of the cat? Or the breed? Which extra-digestive causes should be considered? Can faecal analysis ever be useful? How can you get the most out of such samples? Does abdominal imaging provide any helpful clues? If you’re going to collect gastrointestinal biopsies, does it matter which parts of the gastrointestinal tract you sample? Is endoscopy as good as surgical biopsy? Do therapeutic trials have a role to play in the diagnostic algorithm? This lecture delves into some of the common (and not so common) causes of chronic diarrhoea in cats and try to answer at least a few of the questions listed above.

: Inflammatory bowel disease (IBD) has a complex aetiology in which dietary antigens play a role but are not the sole cause. Dietary management alone can be effective in resolving around 50% of cases of feline IBD, but in order to optimise response to this line of treatment, it is essential to have obtained a good dietary history. Three types of diets are available for dietary trials – highly digestible; restricted ingredient; hydrolysed. The dietary history should enable the clinician to identify a novel protein source to which the patient has not previously been exposed, as well as food preferences of the patient (e.g. wet vs dry; fish vs meat flavours). There are a huge number of commercial diets to choose from and many diets advertised as hypoallergenic contain multiple ingredients. Highly digestible diets are not the same as restricted ingredient diets, hence some diet trials can fail due to selection of an inappropriate diet. It is therefore important to understand the rationale behind performing a diet trial for IBD and be able to advise clients on what are appropriate diets to use.

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