Vet Blog
09/28/09
 Stress is a bad thing. My poor pal Buster found this out the hard way two weeks ago. We moved.
Our new place is great. It even has off-street parking, which is a very big deal in San Francisco. But I hate moving. And apparently so does Buster.
Buster developed diarrhea two days before the move. It lasted until three days after, when I finally gave up on a mild protocol of easily digestible food and resorted to antidiarrheal medications.
During the move Buster also developed severe itching. He constantly scratched his abdomen. He engaged in excessive licking of areas that only dogs (and cats) can reach. At first I suspected that the itching was related to switching from Advantage to Frontline (which happened shortly before the move), or from an allergy to some chemical, contaminant, plant or mold in the new house. But now that we’re settled in, Buster is no longer itchy.
I suspect that both of these problems were caused by stress. Although Buster didn’t show any obvious outward signs of stress during the move, rehousing is famously and predictably stressful in dogs, cats, and humans.
Stress is a well known cause of diarrhea in all three species mentioned above. Stress is also known for causing skin issues in cats and humans. I now believe that it contributes to skin problems in dogs as well.
Stress also weakens the immune system, predisposing animals of all species to disease. In humans it has been linked to heart disease, diabetes, and cancer. In cats there is a well documented link between stress and severe gum disease as well as certain potentially life-threatening urinary conditions.
Moving, unfortunately, is a fact of life. But if you have to move, try to settle in quickly. And once you’re in your new home, take time to pet the cat and walk the dog.
Photo: Buster settles in to his new digs.
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09/18/09
 Many thanks to Mrs. Kitty, who offered several good feline questions when I asked cat lovers to help me give the “second species” of veterinary medicine its due.
Mrs. Kitty works in feline rescue. This means she may have more cats in her house than the average reader.
Let’s answer one of her questions.
What do you do with a cat with chronic diarrhea who has been on repeated courses of Albon and has a clear stool sample?
Chronic diarrhea is a common complaint in multi-cat households. Especially in rescue situations, a new bogeyman has emerged as a leading cause of the problem.
A relatively-new-to-the-scene (in cats) parasite called Tritrichomonas appears to be a common cause of refractory, chronic diarrhea in households in which multiple cats reside.
The parasite is not detected by standard fecal tests. Specific Tritrichomonas cultures or PCR assays (DNA testing) on feces is required to diagnose the poorly understood parasite. Many cats in rescue situations who suffer from chronic diarrhea will respond to treatment for Tritrichomonas regardless of test outcome. I recommend that you talk to your vet about this.
Although treatment for Tritrichomonas may solve the problem, you should remember that there also are plenty of old bogeymen out there causing chronic diarrhea in cats. Infiltrative (also known as inflammatory) bowel disease is a common cause of feline diarrhea. Food intolerance, chronic pancreatitis, and a number of viral and bacterial infections also may cause the problem.
Albon treats a different parasite, coccidia, that is ubiquitous and causes diarrhea in young animals. If your cat already has received several courses of this medicine, I wouldn’t repeat it. Also, you should know that Albon isn’t terribly effective. A newer medication, ponazuril, is believed to be much better.
Finally, in a rescue situation one must consider stress-based diarrhea. Cats are exquisitely sensitive to overcrowding. Diarrhea may be the only outward manifestation of this stress.
Photo: Dude is a rescue cat with no known history of diarrhea.
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09/05/09
My 12-year-old male cat was diagnosed with a urinary tract infection and prescribed Clavamox. He has had two days of meds plus his pain med. I was told he did not have crystals in his urine, just blood, he is now trying to urinate in odd places and his bowel movements are runny and he is using his litter box for those. Shouldn’t he be better by now and urinating in his box?
Julie
Knoxville, TN
Urinary tract infections, or bladder infections, commonly cause bloody urine and house soiling in cats. But other problems can cause these symptoms as well.
Bladder infections generally show marked improvement during the first 24 to 48 hours of treatment. Clavamox is effective against most bladder infections. If your cat’s condition hasn’t improved after two days on the medicine, I am worried that something other than a bladder infection might be going on.
Bladder stones, bladder tumors, and chronic irritation of the bladder can cause bloody urine and house soiling in cats. Blood clotting problems, infections with resistant strains of bacteria, and trauma are less frequent causes of these symptoms.
I recommend that you visit the vet again for more tests such as X-rays and abdominal ultrasound. These are the next steps in solving your cat’s urinary problems.
Your cat’s diarrhea probably is a side effect of the Clavamox. All antibiotics can cause upset stomach or diarrhea. This problem is likely to get worse if you keep administering the Clavamox.
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02/28/09
 Diarrhea… I am in rescue and the past two years
myself as well as co-rescuers have come up against
diarrhea in cats and kittens that we cannot stop.
Fecals have been done and they are negative. We
have treated with Albon, Flagyl, Panacur, Strongid
(to name a few). Nothing works. These cats are
not related and are in different households.
Without being able to solve this problem we cannot
adopt these cats out and it takes away from each
of us saving others that currently sit on Death
Row. PLEASE help us.
Kitten Lady
New York
Diarrhea has many potential causes in cats. Rescue cats are especially prone to diarrhea caused by parasites. The most common diarrhea-causing parasites in cats are intestinal worms and microscopic organisms called coccidia. Another microscopic parasite, Giardia, also may cause diarrhea especially in stressed cats.
Panacur and Strongid treat intestinal worms. Albon treats coccidia. Panacur and Flagyl treat Giardia. Stool tests that often detect these parasites have repeatedly been negative. It is therefore unlikely that these parasites are playing a role in your problem.
Other common causes of diarrhea include stress (which is common in cats that are in the rescue process), food intolerance, and inflammatory bowel disease. I would not, however, expect any of these conditions to cause an epidemic such as you describe.
There are several other infectious causes of diarrhea, and one of them in particular sounds like it may be the culprit in your cats. A microscopic organism called Tritrichomonas foetus has recently been identified as a cause of diarrhea in cats. In my experience, it is most common in cats from shelters or rescue environments. It causes symptoms exactly like the ones you describe. T. foetus infection is treatable.
There are two major veterinary diagnostic laboratories in the United States. One of them, Idexx Laboratories, has a new test called the RealPCR Feline Diarrhea Panel. The test, which is run on feces, checks for T. foetus and several other infectious causes of diarrhea in cats. I recommend that you find a veterinarian who uses Idexx Laboratories and request this test. I have a hunch that it will help solve your problem.
Photo: Calli Girl has no known history of diarrhea. She is available for adoption.
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02/01/09
 our cat whiskers has all the symptoms of IBD and
we have 5 other cats and 2 dogs the vet we went to
didn’t tell us of and exploitory surgry untill
she was to week to do anything and we want to know
if any other animal could get it?
audra
La Porte, IN
I don’t understand your question perfectly, but I think you are asking whether IBD (short for inflammatory or infiltrative bowel disease) can spread from one pet to another. The answer is no.
IBD is a syndrome in which the intestines become chronically inflamed. Its symptoms can include vomiting, diarrhea, loss of appetite and weight loss. It can affect cats and dogs.
IBD occurs when the immune system becomes hyperactive in the intestines. A hereditary (genetic) cause is suspected, although some experts have posited that certain bacterial or viral infections may contribute to the syndrome. In my experience, IBD is not contagious.
Several other conditions can cause symptoms that are similar to IBD, and some of these conditions are contagious. Comprehensive testing involving bloodwork, urine tests, X-rays, and ultrasound is frequently necessary to diagnose IBD and rule out other similar conditions. Definitive diagnosis of IBD requires biopsies of the intestines. Exploratory surgery generally is needed for intestinal biopsies.
IBD can be treated in some cases with dietary modification. Severe cases may require medications, such as prednisone, that modulate the function of the immune system.
If you have not already done so, I recommend that you seek further tests for Whiskers. An ultrasound exam performed by a specialist may be particularly useful.
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01/05/09
 My five-month-old cat has been throwing up and having
diarrhea for the last four days. It is not all of
the time, but it is 85% of the time. He plays
normally, eats normally and acts the same. If you
have any ideas what could be wrong with him please
let me know. Thank you!
Tessa
Kinderhook, Il.
Many things can cause otherwise healthy young cats to vomit or produce diarrhea. Intestinal parasites are high on the list.
Young animals are especially prone to infestation with intestinal worms and microscopic parasites called coccidia. These parasites are common causes of diarrhea in kittens and puppies. Severe infestations may cause vomiting as well. Some intestinal worms are potentially contagious to humans.
Adverse reactions to rapid diet changes also may cause the sort of gastrointestinal upset that you describe. Foreign objects lodged in the intestines, infection with a number of viruses or bacteria, and inflammatory disorders of the intestines are on the list of causes but are less common.
Your cat needs to see a vet. Be sure to take a stool sample so that he or she can test for parasites. After evaluating your pet and looking at his deworming and vaccination history, the veterinarian will be able to offer an educated assessment of the situation.
Photo credit: click here.
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11/26/08
 The end of human dinner time tomorrow marks the start of a very dangerous period for the dogs of America.
People, exhausted and bloated, will retire to sofas and armchairs across the country. Dogs will devour unattended turkey carcasses, ransack garbage cans (compost bins in northern California), gobble up giblets, stuff themselves with stuffing, lap up gravy, pilfer pumpkin pie and help themselves to whatever leftovers they can get their paws on.
Dogs that engage in these sorts of activities aren’t bad dogs. They are simply doing what dogs do.
However, many dogs will pay a price for their dietary indiscretion. Some will suffer from transient diarrhea or vomiting as their systems react to rich Thanksgiving food. Others may suffer more serious consequences. Some dogs will develop pancreatitis, a life-threatening inflammation of the pancreas. Others may consume turkey bones and develop intestinal obstructions–these dogs will require major abdominal surgery to survive.
Happy Thanksgiving, everyone! Enjoy your day. But don’t leave your leftovers unattended, and don’t let your dog have access to the garbage. This will help to ensure a happy and safe turkey day for all members of the family!
Photo credit: Stu Spivak. Photo license: CC.
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08/03/08
Hello,
My dog had diarrhea from giving her table food.
What do you suggest if that ever
happens again? She is back to “normal” now.
Vita
Hilton Head, SC
Diarrhea is incredibly common in dogs. The majority of cases that I treat are caused by dietary indiscretion. Dietary indiscretion occurs when a dog eats something that causes gastrointestinal upset.
 Some cases of dietary indiscretion are the result of table scrap feeding by people living with the dog. Many other cases are self-inflicted. Dogs that eat trash or break into a cabinet may pay for their actions with diarrhea a few hours later.
The treatment for dietary indiscretion is intestinal rest. Dietary indiscretion leads to irritated intestines. Feeding normal meals to a pet with irritated intestines may lead to more diarrhea and further irritation. This can create a nasty cycle.
So, when my pal Buster gets into the trash (this can happen even when people are diligent), he skips his next meal. This allows his intestines to rest and recover. It also makes sense–he ate tasty garbage, so he does not need more food. He is always allowed free and unrestricted access to water.
If mild diarrhea persists for more than 12 hours, the next step is to feed easily digestible food that will not promote intestinal irritation (vets refer to such foods as bland diets). Steamed white rice, lowfat cottage cheese, boiled boneless skinless chicken breast or any combination of the three fits the bill. When stools return to normal, gradually wean the dog back onto his normal diet.
The advice in this post applies only to healthy adult dogs that suffer mild diarrhea after dietary indiscretion. Puppies with diarrhea, any dog that is lethargic or looks sick, or any dog that suffers vomiting as well as diarrhea should see a vet.
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05/05/08
My dog (approximately 12 years old) keeps having
bouts of diarrhea. This has gone on (off and on)
for about two years. My vet has given him several
rounds of medicine (one for tummy upset and one
for loose stools). Additionally, he has given him
some powder to try to balance the “flora” in his
digestive tract. Also, he recommended I feed him
Purina EN (dry and canned) to help with his
stomach. Nothing seems to help. He likes to eat
grass, which seems to be the only thing he gets
into when he is out in the yard. We give him
Meaty bone biscuit treats. I generally mix in
rice with his food when his stools are very runny.
And now he is starting to lose weight.
Liz
Margate, South Florida
I am a bit troubled by your final comment–that your dog is starting to lose weight.
A number of syndromes can cause intermittent diarrhea, and some animals have irregular bowel movements throughout their lives. For instance, a syndrome called infiltrative (or inflammatory) bowel disease (also known as IBD) is a common cause of chronic, intermittent diarrhea. This disease is frustrating, but treatable.
However, when an older dog develops diarrhea in combination with weight loss, something more serious may be going on. For instance, disorders of the liver, pancreas, kidneys, and intestines can cause this combination of symptoms.
It sounds like your vet has treated your pet for some causes of chronic intermittent diarrhea with special diets and dietary flora supplements. But you don’t mention whether he has run any tests to determine what is causing the problem.
For your dog, I would recommend stool, blood, and urine tests. This combination may lead to an answer. If not, you may need to follow up with X-rays and ultrasound.
Unless you know what is causing the problem, you will face an uphill battle to eliminate your pet’s symptoms.
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03/04/08
Summed up… Miko is 4 months old. We got her at 8
weeks old. One day after we got her she got Parvo
and Coccidia, which of course gave her horrible
diarrhea. She luckily lived through that. She has
since been to the vet several times, had blood
work and fecal tests, and they have come back
clean. She has also had all of her shots now as
well. She still has really watery diarrhea.
Could her stomach or intestines be damaged from
the Parvo, and if so, how long till she starts
having regular bowel movements?
Miko acts perfectly fine, but I can’t imagine
her poor bum feals good. Can you help!!!
ALSO!!! One vet told me that since she had Parvo,
she couldn’t get it again, and another vet told
me that wasn’t true. Can she still get it again
if she’s already had it?
Lindsey
Costa Mesa, CA
Wow. It sounds like Miko’s life got off to a rough start. You have asked several questions, and I’ll try to address them one by one.
First, let’s talk about Parvo. Parvovirus (aka Parvo) is an extremely contagious disease of dogs. It occurs mainly in puppies, or in dogs that have not been vaccinated. The bad news: many dogs that contract Parvovirus die. The good news: dogs that do not die (such as Milo) almost always make complete recoveries. They usually do not suffer long-term health consequences. The intestines should heal quite rapidly.
Also, there are no 100% guarantees about anything in this world, but I can tell you that it is extremely unlikely that Miko could contract parvo again. Most dogs that live through parvo develop permanent immunity.
Now, let’s talk about Coccidia. Coccidia are ubiquitous microscopic intestinal parasites that infect huge numbers of puppies and kittens. They rarely cause serious health problems, but they can lead to long-term, frustrating watery diarrhea. They are hard to treat, and sometimes several rounds of medication are necessary to eliminate the problem.
Based on your description, I am suspicious that Coccidia may be playing a role in Miko’s ongoing diarrhea. You may want to consider treating for the parasite again, or doing a special fecal test (zinc sulfate centrifugation) that is more sensitive than standard fecal tests.
Of course, other parasites (such as worms, which also can be missed by some fecal tests), reactions to foods, inflammatory bowel disease, or (and this is unlikely) lingering damage from Parvovirus infection could be playing a role in Miko’s problems. But my hunch is that the Coccidia are the culprits. I recommend that you and your vet go after them first. If that doesn’t work, it will be time to do an extensive investigation into the problem with comprehensive diagnostic tests.
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Stress is a bad thing. My poor pal Buster found this out the hard way two weeks ago. We moved.
You have questions. 