Stomach Upset in Cats

Brulee went back to the vet yesterday for an upset tummy. She appears to be okay, but she is on the "watch list" with Mom Paula for a few days. What causes an upset stomach? How can you treat your cat when it happens?

Brulee inside her Sleepypod® at the veterinary hospital

Having a cat who begins vomiting or having diarrhea can be a cause for concern since cats are vulnerable to a wide variety of different causes of an upset stomach. The problem for many cat parents is the concern for why it is happening and what to do. Do you rush your feline to the vet or do you let it pass? 

Brulee waiting under the chairs for the vet to come into the examination room

Causes of Upset Stomach

Possible causes for your cat’s upset stomach, which may include vomiting and/or diarrhea, can include overeating, eating something that she can’t digest, a change in her diet, infection, and larger health issues. Many times, a cat parent may be able to trace the cause of her cat’s diarrhea or vomiting, but others can be more perplexing. Cannapet® identifies possible causes of vomiting & diarrhea in cats: 

• Allergies to food
• Intolerance to dairy products, wheat, corn, beer, or other ingredients in food
• Switching too quickly to a new food
• Eating something toxic
• Gastritis or Enteritis
• Intestinal Parasites
• Bacteria, fungi, and infections
• Heat Stroke

Brulee calmly waiting under the table

Diarrhea

Diarrhea is not uncommon with cats and there are many possible reasons your cat may have it. Diarrhea can sometimes occur quickly and disappear just as quickly while other time it can last for days, weeks, or months. "Diarrhea that lasts for 24 to 48 hours probably won’t cause a problem, but if it lasts longer, your cat can get dehydrated, which can be dangerous (WebMD)." Most cats will have a bowel movement at least once a day and it should be deep brown in color, not too hard or soft, and not smell too foul. If your cat has diarrhea that lasts more than a day or two, you should take your cat to the veterinarian to figure out the cause. Call your vet immediately if the diarrhea is black or bloody, or if it happens along with fever, vomiting, sluggishness, or a loss of appetite.

Did you know there were two ways to classify diarrhea (Pet Health Network, February 5, 2016)?  Diarrhea can be classified as either small or large bowel diarrhea.

"With small bowel diarrhea you are more likely to see large volumes or watery diarrhea which can quickly lead to significant dehydration and an electrolyte imbalance.

On the other hand, large bowel diarrheas involve the lower bowel or colon so that you more typically see a cat straining and uncomfortable, but passing only small amounts of soft/mucoid/sometimes bloody stool."

Dr. Strom (Cherokee Trail Veterinary Hospital) with Brulee

Treatment

The treatment for your cat depends on the cause. If the diarrhea goes away within 48 hours, she should be fine. Dr. Mike Paul, DVM (Pet Health Network, February 5, 2016) recommends if cat owners are concerned about their cats, they shouldn't hesitate to contact their veterinarian. Dr. Paul states if your cat has one somewhat soft stool but is still happy, playful and eating normally, you are probably safe to see what the next bowel movement looks like before taking major steps for treatment. Some "red flags" that should make you more concerned are:

• Loss of appetite
• Lethargy/depression
• Pain/discomfort
• Blood in the stool (either dark, blackish stool or visible, frank, red blood)
• Associated vomiting
• Or if your cat is more likely to be quickly compromised by ongoing diarrhea (i.e. very young, very old, or already battling some other medical problem)

Treatment at Home

In minor cases of diarrhea, your cat will often get better with simple home care. You can help your cat with some minor fasting and fluids. Sometimes cats just need to get whatever it was that caused the issue out of their system and they return to normal. Make sure you do not to overfeed your cat, as her stomach is still sensitive and may have diarrhea again. You can feed her short doses of bland food every few hours as she tolerates it. You may continue this process for a couple days as your cat improves before gradually returning her to her regular diet (Canna-Pet®, March 16, 2017). 

Dr. Jennifer Coates, DVM (PetMD.com) recommends the following possible options for home treatment of diarrhea in felines:

• Change Your Cat's Food. Do not withhold food. Simplify your cat's diet. Eliminate treats or table scraps. Focus on the core, nutritionally complete cats food offered each day.
• Fiber. Consider a low-fiber (highly digestible) diet. Look for foods that are advertised as highly digestible or good for cats with "sensitive stomachs." Some diarrhea responds to fiber supplements - unflavored psyllium and canned pumpkin.
• Encourage Water and Electrolyte Intake. Water helps prevent dehydration. Keep water bowls filled with fresh and clean water. You can mix an extra tablespoon or two of warm water into canned food.
• Probiotics. Probiotic supplements can help return your cat's intestinal bacterial population to normal. Choose a probiotic that is labeled for use in cats and made by a reputable company.
• Anti-Diarrheal Medications. Only use anti-diarrheal medications under supervision of a veterinarian.

Treatment by Veterinarian

Most times, with the help of home treatment, your cat will feel better within a couple of days. However, if your cat experiences the following, you should get her to the vet immediately:

• Your cat is very young, very old, or has an underlying health problem that could make him vulnerable to the effects of dehydration.
• Your cat is vomiting, lethargic, depressed, in pain, or has any other worrisome symptoms.
• The diarrhea is profuse, watery, explosive, or very frequent.
• The diarrhea contains blood or is dark and tarry (Pet Health Network, February 5, 2016).

When you arrive in the examination room, the veterinarian or veterinary tech/assistant will perform in initial examination which may include obtaining a complete history of your pet, taking her temperature, and checking for dehydration. The history may include details about the frequency, urgency, and appearance of the diarrhea. Other useful information would include whether your cat has eaten anything unusual such as house plants or table scraps, or whether the pet is showing other signs of illness such as weight loss, poor appetite, or vomiting (Dr. Kristiina Ruotsalo, DVM, VCA Hospitals, 2018). 

Your vet will perform a physical examination that will involve looking at all parts of the body and includes listening to the heart and lungs with a stethoscope and palpating the abdomen. Sometimes, a veterinarian can make a diagnosis based on the history and physical examination. Many times, a veterinarian may want to perform additional diagnostic tests, such as complete blood count (CBC), serum biochemistry profile, urinalysis, and fecal parasite tests. In middle aged to older cats, a serum thyroxine (total T4) concentration is also recommended. If your cat is bright and alert and the physical examination is normal, the vet may not recommend screening tests immediately. 

Your vet may prescribe medication to treat a possible bacterial infection in the digestive tract, such as Metronidazole. Metronidazole (also known as Flagyl) is used primarily as an anti-diarrheal medication for cats. It is effective against certain protozoal infections including Giardia, Trichomonas, and Balantidium coli as well as anaerobic bacterial pathogens. Metronidazole may also be prescribed to relieve inflammation of the intestinal tract (PetMD). 

You should follow the instructions for administering the medication and let your vet know if there are any problems.

Brulee resting comfortably in her Sleepypod® while waiting for the vet

Brulee's Results

Brulee had an upset stomach with loose stools that contained some mucus that smelled terrible and had occurred three times within a 24 hour period. Normally, I wouldn't be overly concerned about a little diarrhea, but Brulee's health can quickly turn into something more severe which requires a trip to the emergency animal hospital, so I wanted to get her to the vet to make sure this wasn't the beginning of something worse.

I called the vet after her third instance and they had no available appointments until later that evening or the next morning. I asked if I could bring Brulee to the hospital and sit and let them work us in, because I had some medical appointments myself I had to deal with. I put a towel in her Sleepypod® Mobile Pet Bed and off we went to the vet. After about 30 minutes, we were taken into an examination room (not the cat room) and the veterinary technician looked at Brulee's bottom to see the color and consistency of her diarrhea that was still on her. She noted there was no blood and wasn't too concerned. She did take Brulee to the back to clean her up and came back with some litter and water for Brulee. Brulee's temperature was normal and there was no evidence of dehydration. Brulee was very relaxed and strutted around the examination room and eventually rested under the chairs, table, and in her Sleepypod. 

Dr. Strom came in about 30 minutes later for Brulee's physical examination. He said everything looked and sounded normal. He said Brulee wasn't acting sick and he felt she just ate something that didn't agree with her or she could be a little stressed (which is a possibility since I'm having some health issues and am stressed). He recommended some probiotics and a prescription for Metronidazole. He also suggested Brulee have a bland diet for a couple of day, such as a prescription diet. I told him that Brulee was a very finicky eater and wouldn't touch the prescription food in the past and would barely eat canned food at home. We decided to feed her the canned and kibble she normally eats. I was advised to watch her and call him if she got worse.

Brulee at Home

Update on Brulee

Brulee arrived home and began getting re-acclimated. I put her pill in the Tomlyn Pill Masker and she immediately took it. However, once the bitter taste of the pill got in her mouth, she began foaming and didn't want to swallow it. She did eventually get it down. I gave her some of her favorite Wellness food and she didn't really want it (I guess the taste of the pill was still in her mouth.) I did pull out some of the Purely Fancy Feast Natural Chicken Treats and she ate that. She did drink water and was resting comfortably. This morning, there was no evidence of diarrhea except for a little trail of some fecal matter on the end of her long tail, but nothing in the anal region like yesterday. She was drinking water and ate some of her treats. I fed her this morning and she did eat some of her canned food. I then gave her another pill and I thought she'd eaten it because I saw no foaming, but when I looked on the floor, I saw some remnants of the pill in the Pill Masker on the floor. She isn't hiding and is acting fine. I called Dr. Strom to see if I could discontinue the Metronidazole. He called back and said I could discontinue it, but to continue giving her the probiotic. If she won't eat the prescription probiotic he sent home, I have some other brands to try. Fingers and paws crossed Brulee will be back to herself soon.

Resources:

Canna-Pet®.com, Causes of Vomiting & Diarrhea in Cat, March 26, 2017, https://canna-pet.com/causes-vomiting-diarrhea-cats/.

WebMD.com, The Scoop on Cat Poop, January 24, 2017, https://pets.webmd.com/cats/the-scoop-on-cat-poop#1

Mike Paul, DVM. Pet Health Network®.com, Cat Diarrhea: When is it serious and how do I stop it? January 5, 2016, https://www.pethealthnetwork.com/cat-health/cat-diseases-conditions-a-z/cat-diarrhea-when-it-serious-and-how-do-i-stop-it

Jennifer Coates, DVM. PetMD.com, Cat Diarrhea: 5 Treatment Options You Should Try. https://www.petmd.com/cat/care/cat-diarrhea-5-treatment-options-you-should-try.