Watery diarrhea.

Dr. Marie replied:

I'm sorry to hear that Weasie is having these problems. Chronic diarrhea in cats can be a VERY frustrating thing to deal with.

It's interesting that she responded to coccidia treatment. It is uncommon for a cat of this age to pick up coccidia. I'm wondering if the treatment was an antibiotic like S-125. It's possible that she has something called SIBO (small intestinal bacterial overgrowth) and that the antibiotic helped temporarily.

SIBO is sometimes a component of IBD (inflammatory bowel disease). IBD is really common in cats, especially as they get older. It sounds like your vet was thinking of IBD if they were treating with B12.

I have found that most of my patients with IBD will need steroids of some sort, either by pill form or sometimes in injection every 4-6 weeks. (I prefer to use pills though.) You could ask your vet if this is an option. Cats handle steroids really well. For most of my patients I am able to get them down to a miniscule dose every other day.

Giardia is unlikely unless for some reason it is rampant in your area. I often will put diarrhea patients on a course of metronidazole which is a medication that treats giardia but also helps with intestinal inflammation as well.

The other thing that I worry about when an older cat has diarrhea is intestinal lymphoma which is a cancer of the intestines. Unfortunately the only way to tell the difference between lymphoma and IBD is to have biopsies done which is expensive and invasive.

I hope this helps. I would definitely suggest asking your vet about using steroids.

Dr. Marie.

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