Page 769 - Problem-Based Feline Medicine

33 – THE CAT WITH SIGNS OF CHRONIC SMALL BOWEL DIARRHEA 761

If greater than 85% of the small intestine has been Treatment
removed the chance for adaptation is poor.
Tincture of time will allow the bowel to adapt.
Clinical signs Broad-spectrum antibiotics may be needed.
Low-fat, highly digestible diets are necessary to max-
Diarrhea, dehydration and weight loss all occur as
imize absorption of nutrients.
a result of short bowel syndrome.
Administration of vitamins and minerals is usually
Other signs are related to intestinal malabsorption,
needed. Monitoring prothrombin time and serum
such as deficiencies of essential amino acids, vitamins
cobalamin levels will help determine whether supple-
or clotting factors.
mentation is needed. (Vitamin K 5 mg/kg once, then
1
Small intestinal bacterial overgrowth may also 2.5 mg/kg q 12–24 h, cobalamin or multi-B complex
occur, resulting in vomiting or anorexia as well. injection weekly).
Parenteral nutrition may be required in some cats in
Diagnosis the early stages to support them until bowel function
returns.
The diagnosis is presumptive if surgical resection is
the cause.
Prognosis
Cats are often hypoproteinemic, may be hypocholes-
terolemic, and have other non-specific hemogram or The prognosis is guarded in cats in which diarrhea per-
chemistry abnormalities. sists for longer than 2 months after the resection, as by
that time, the chances of a return to normal function are
Imaging studies can be used to confirm the diagnosis.
poor.
Differential diagnosis
Other diseases that may cause similar signs include
severe intestinal strangulation, intussusception and
intestinal volvulus, which is rare in cats.

RECOMMENDED READING
August JR. Consultations in Feline Internal Medicine, 2001, WB Saunders, Philadelphia, PA.
Guilford W, Jones B, Markwell P, Arthur D, Collett M, Harte J. Food sensitivity in cats with chronic idiopathic gastro-
intestinal problems. J Vet Intern Med 2001; 15: 7–13.
Guilford WG, Center SA, Strombeck DR, Williams DA, (eds). Strombeck’s Small Animal Gastroenterology,
1996,WB Saunders, Philadelphia, PA.
Marks SL, Kather EJ. Bacterial-associated diarrhea in the dog: a critical appraisal. Vet Clin North Am Small Anim
Pract 2003; 33: 1029–1060.
Simpson KW. Vet Clin North Am 1999; 29(2).