Page 738 - Problem-Based Feline Medicine

730 PART 9 CAT WITH SIGNS OF GASTROINTESTINAL TRACT DISEASE

Hematology is non-specific: inflammatory leukogram, Diagnosis
stress leukogram or sequestration of neutrophils.
The diagnosis is presumptive if surgical resection is
the cause.
SHORT BOWEL SYNDROME
Cats are often hypoproteinemic, may be hypocholes-
terolemic, and have other non-specific hemogram or
Classical signs
chemistry abnormalities.
● Severe, and in some cases intractable,
Imaging studies can be used to confirm the diagnosis.
small bowel diarrhea.
● Peracute onset of vomiting, depression and
anorexia if associated with ischemic Differential diagnosis
intestinal disease. Other diseases that may cause similar signs include
severe infectious enteropathies, inflammatory bowel
disease or alimentary neoplasia.
Pathogenesis
Treatment
Short bowel syndrome is classically due to surgical
resection of a large segment (75–90%) of the small If the disease is spontaneous in the adult cat, stabi-
intestine that results in fluid overload to the colon and lization and prompt surgery is required.
resultant diarrhea.
Tincture of thyme will allow the bowel to adapt when
Other causes include ischemic intestinal diseases the syndrome is iatrogenic in origin.
such as intussusception, bowel strangulation and
Broad-spectrum antibiotics may be needed.
intestinal volvulus, which are very rare in the cat.
Low-fat, highly digestible diets are necessary to max-
Intestinal adaptation occurs in the large bowel,
imize absorption of nutrients.
which ultimately results in a return to a soft or semi-
formed fecal specimen. Fat-soluble vitamins should be administered as
needed. Cobalamin 125–250 μg SQ once per week
If greater than 85% of the small intestine has been
until serum concentrations are normalized, then every
removed the chance for adaptation is poor.
1–2 months to maintain levels. Folate 0.5 mg PO daily
Congenital forms of short bowel syndrome are also until serum levels normalized then as required.
rare, and will be seen in kittens with intractable diar- Vitamin E supplementation may also be needed.
rhea.
Parenteral nutrition may be required in some cats in
the early stages to support them until bowel function
Clinical signs returns.
Diarrhea, dehydration and weight loss all occur as Prognosis
a result of short bowel syndrome.
Guarded; in cats where diarrhea persists for longer
Other signs are related to intestinal malabsorption: than 2 months after the resection, the prognosis for
deficiency of proteins, vitamins or clotting factors. a return to function is poor.

Small intestinal bacterial overgrowth may also occur
resulting in vomiting or anorexia as well.
EXOCRINE PANCREATIC INSUFFICIENCY
If associated with ischemic intestinal diseases, evi-
dence of endotoxemia and shock may be present. Classical signs
Depression, anorexia and vomiting are the most ● Weight loss despite a vigorous appetite,
common signs. The acuteness and severity of the which may include pica and coprophagy.
signs depend on the extent of the bowel compromise.