Page 779 - Problem-Based Feline Medicine

34 – THE CAT WITH SIGNS OF LARGE BOWEL DIARRHEA 771

(regardless of spore numbers) in the context of clin- Dietary management should include feeding a high-
ical signs consistent with C. perfringens is strongly fiber diet, unless the signs also involve the small
supportive of clostridial-associated diarrhea. In intestine. In those cases, a low-residue diet is recom-
dogs, the RPLA test does not differentiate dogs mended.
with clostridial diarrhea from normal dogs and 25%
Most cases in adults are self-limiting, but respond
of normal dogs have positive test results. In both
rapidly to antibiotics and dietary intervention. In
cats and dogs, there appears to be poor correlation
neonates or debilitated cats, additional supportive
between the presence of fecal endospores and the
care (e.g. fluid therapy) may be required in severe
presence of enterotoxin.
cases.
Campylobacter is also a normal inhabitant of the
feline colon and thus, a pure culture along with detec-
tion of the presence of enterotoxin is recommended Prognosis
for diagnosis.
Good to excellent, especially with appropriate antibi-
Pathogenic and nonpathogenic strains of E. coli can otic therapy.
be cultured from feces and thus before a diagnosis can
be based upon the culture results and clinical pres-
entation, the results should be confirmed by PCR Prevention
testing for specific pathogenic strains.
In kittens or colonies of cats that have recurrent prob-
Once the diagnosis has been made, affected cats should lems with infectious colitis, minimizing stress,
be tested for FIV/FeLV, in case the condition is sec- improving sanitation, and maximizing nutrition will
ondary to immunocompromise by viral disease. all help to reduce the occurrence of these stress-related
diseases.
Differential diagnosis All cats should be tested to be sure that they are
FeLV/FIV negative.
Dietary indiscretion.
Parasitic enterocolitis (e.g. protozoal agents such as
Giardia, Tritrichomonas, etc.), and mechanical diseases HYPERTHYROIDISM*
of the large bowel (e.g. intussusception, cecal inver-
sion, foreign bodies) should all be considered when for- Classical signs
mulating a differential diagnosis.
● Weight loss despite a good appetite.
● GI signs (vomiting or diarrhea).
Treatment
● Unkempt hair coat and increased dander
Clostridial enterocolitis: ampicillin (22–33 mg/kg PO are common.
q 8 h), amoxicillin (10–22 mg/kg PO q 12 h), metroni- ● Tachycardia secondary to thyrotoxic heart
dazole (5–15 mg/kg PO q 12 h), tylosin 5–20 mg/kg PO disease.
q 12–24 h), clindamycin (5–10 mg/kg q 12 h). ● Hyperactivity or restlessness.
Campylobacteriosis: tetracycline (20 mg/kg q 8 h PO)
See main reference on page 304 for details.
tylosin (20 mg/kg PO q 12 h) or fluorinated quinolones
(e.g. enrofloxacin).
E. colibacillosis: trimethoprim-sulfonamide (15 mg/kg Clinical signs
PO q 12 h), cephalosporins (10–30 mg/kg PO q 12 h),
This disease is most commonly observed in middle-
doxycycline (5–10 mg/kg PO q 12–24 h), or fluorinated
aged to old cats (> 8 years).
quinolones (e.g. enrofloxacin, orbifloxacin, ciprofloxacin,
etc.). Weight loss is a very common feature of the disease.