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    Diarrhoea in cats: most common causes and solutions

    Gastrointestinal disorders in cats are mainly caused by chronic enteropathies, above all inflammatory bowel disease. What are the other causes? What effect does hypocobalaminaemia have?

    Gastrointestinal problems are among the main causes of morbidity in cats and are also among the leading causes of veterinary visits. There are numerous disorders that course with vomiting and diarrhoea in cats, ranging from pancreatitis to food intolerance or even hairballs. They are summarised in the attached table.

    Why do they become chronic?

    Vomiting and diarrhoea in cats often go unnoticed by owners due to the very nature of cats, as their behaviour is typically more private and independent than that of other pets. Some owners may even interpret this as a normal situation for their cat, especially if any episodes of vomiting are intermittent, which worsens the situation further and can lead to the patient developing a chronic gastrointestinal disorder. In such cases, animals are taken to the clinic when the pathological process is already very advanced and solutions are more complicated.

    Inflammatory bowel disease (IBD) as a diagnosis of diarrhoea in cats

    IBD is one of the most frequent causes of gastroenteritis in cats. It includes the nonspecific signs of diarrhoea, vomiting, abdominal pain and weight loss, which may occur alone or in combination. It is characterised by chronic inflammation of the small intestine, which causes lymphoplasmacytic inflammation. Its diagnosis is established once lymphoma and other causes of chronic enteropathies have been ruled out.

    Unlike lymphoma, which usually affects cats aged 8 years or older, IBD can affect cats of any age. The exact aetiology of feline IBD is unknown, but studies suggest that a complex interaction of several factors alter the mucosal immune system and cause chronic inflammation of the small intestine in genetically predisposed cats. Environmental factors such as diet, foreign substances, exposure to pathogens or the administration of NSAIDs or antibiotics may trigger the onset or recurrence of the inflammatory process.

    Treatment options for IBD

    The therapeutic options available are aimed at reducing antigen stimulation and controlling the intestinal immune response.

    They include treatment with drugs, dietary solutions and the use of prebiotics and probiotics.

    As dietary factors are thought to be one of the causes of IBD, a nutritional strategy should be the first to follow once IBD has been diagnosed.

    Nutritional interventions are based on either hypoallergenic diets containing novel proteins or diets with hydrolysed proteins. They are intended to reduce the hypersensitivity threshold and avert allergic reactions. The nutritional strategy should also consider the addition of specific nutrients that will counteract any nutrient malabsorption secondary to the underlying pathological process, for example, by supplementing the diet with cobalamin (vitamin B12).

    Dietary interventions usually yield very good results, as most cats respond favourably within just a few days.

    The role of vitamin B12 (cobalamin) in diarrhoea in cats

    Cats with gastrointestinal disorders often have a cobalamin deficiency, which in turn will lead to more significant metabolic disorders. Cobalamin is a water soluble vitamin essential for many biochemical and enzymatic reactions, including DNA and methionine synthesis, and it participates as a cofactor in the citric acid cycle. 

    Cobalamin absorption is particularly complex in cats and depends on pancreas and small intestine function.

    The cobalamin half-life in cats with a gastrointestinal disorder drops from 13 days to 5 days, which is a very rapid turnover when compared to other species.

    Recent research by Affinity Petcare has shown that cobalamin administered orally for 1 week to cats with vomiting and diarrhoea is enough to restore cobalamin serum levels