Diarrhea in dogs and cats (Proceedings)


Diarrhea in dogs and cats (Proceedings)

May 01, 2011

Table 1: Common Causes of Acute Diarrhea in Dogs and Cats
Giardia, Clostridium perfringens enterotoxin, and Cryptosporidium are important causes of diarrhea in dogs and cats. Tritrichomonas foetus is an important problem in cats. These disorders should be investigated early in the course of diarrhea, whether it is persistent or intermittent, along with evaluation for dietary causes of GI signs, nematode parasites, bacterial and viral causes, and acute idiopathic colitis. This group of disorders constitutes a thorough differential list for animals with acute and intermittent diarrhea (Table 1).

The challenge to veterinarians is in making an accurate diagnosis, so that the best therapy can be instituted as early as possible. This will then lead to the best opportunity for successful control of the medical disorder. It is also important to recognize that some animals may have several disorders at the same time, so a thorough diagnostic approach is recommended. This is why it is often best to run tests for these disorders at the same time, through use of a "fecal diagnostics panel" that is now available at many commercial laboratories. A single fecal sample is submitted to the lab, and tests for each of these disorders is done at the same time. This provides a prompt and thorough analysis for important clinical disorders of the GI tract. The clinician then has more clear direction on how to proceed with treatment, or other diagnostic tests in the event that none of these disorders is identified.

Giardia is an important cause of diarrhea, and for some patients other GI signs as well. It is an important pathogen in dogs and cats, as well as humans and other species. Historically, accurate diagnosis of Giardia has posed a significant challenge to veterinary practitioners, but there are now much more sensitive tests readily available for veterinarians to use on a routine basis. Because of the impact that this organism can have on animals, and also humans because of its zoonotic potential, it is important that veterinarians perform accurate diagnostic testing on animals to determine whether or not an animal is infected with Giardia. These notes will emphasize steps for accurate diagnosis, and also management of giardiasis.

Clostridium perfringens enterotoxicosis is a common cause of intermittent diarrhea in dogs and cats. Veterinary practitioners should test for the enterotoxin whenever faced with a patient that has unexplained diarrhea.

Early Diagnostic Screening in Animals with Diarrhea
Cryptosporidiosis is now recognized to be a more common disorder in dogs and cats than was previously thought. It can cause significant abnormalities, and it has zoonotic potential. Cryptosporidiosis can be fatal in people that also are immunosuppressed (e.g., on chemotherapy or corticosteroids, carriers of HIV). Therefore, it is incumbent on veterinarians to test for this disorder, as there are important implications to both the patient as well as to humans who may come in contact with an infected animal.

Options for Therapy of Nonspecific Diarrhea (GI parasites already ruled out via appropriate testing)

  • Change food (trial 2-3 weeks), may need to try several different foods
  • Colitis signs?

     o Metronidazole or sulfasalazine (Azulfidine)
  • Metronidazole (antibacterial/anti-inflammatory effect)
  • Probiotics
  • Tylosin
  • Or, some combination if mono therapy doesn't work (**but don't wait too long on further diagnostics if the response is inadequate)