Page 745 - Problem-Based Feline Medicine

33 – THE CAT WITH SIGNS OF CHRONIC SMALL BOWEL DIARRHEA 737

Bacterial:
● Clostridium perfringens enterocolitis/clostridial enterocolitis (p 748)
Diarrhea occurs due to sporulation of clostridial organisms and release of enterotoxin resulting in a
secretory diarrhea that is usually small bowel in character, but may also have a large bowel compo-
nent.
● Campylobacteriosis (p 750)
Campylobacter infection may cause mucoid, bloody diarrhea, weight loss, anorexia and fever in
affected kittens or young cats. Most affected cats are from shelters or catteries that have crowded
conditions and poor hygiene.
Protozoal:
● Giardiasis* (p 744)
Acute or chronic small bowel diarrhea is the most common clinical presentation. However, in
some cats large bowel diarrhea also may occur.
Fungal:
● Histoplasmosis (p 755)
Diarrhea associated with intestinal histoplasmosis is uncommon in cats compared to dogs. The
most common clinical signs in cats are associated with respiratory infection, or anorexia, fever and
weight loss associated with systemic illness.
Parasitic:
● Coccidiosis (isosporosis, cryptosporidiosis, toxoplasmosis)** (p 741)
Infections that result in mild to moderate diarrhea are most common in neonates and immunosup-
pressed adults. Most adults have asymptomatic infestations. The species of coccidia most com-
monly associated with disease in cats are Cystoisospora spp., Cryptosporidium parvum, and
occasionally Toxoplasma gondii. Toxoplasmosis has recently been observed in association with IBD.

Idiopathic:
● Idiopathic juvenile diarrhea (p 753)
This condition is associated with small bowel diarrhea and occurs in kittens or young cats less than
a year of age. There is no known cause for the diarrhea and when the cat reaches adulthood, the
diarrhea resolves.
● Protein-losing enteropathy (p 760)
This condition is much less common in cats than in dogs, but may result in chronic diarrhea, mal-
absorption, weight loss and hypoproteinemia. Primary lymphangiectasia is rare, but secondary
causes of lymphatic obstruction, such as inflammation or neoplasia, are relatively more common
and must be considered.
● Hypereosinophilic syndrome (p 758)
This rare disorder is associated with eosinophilic IBD and systemic eosinophilia (increased circu-
lating eosinophils and eosinophilic infiltrate in the lymph nodes, etc). It is usually associated with
chronic vomiting, diarrhea, and weight loss, and is poorly responsive to treatment.