Vomiting … Not Normal
Diarrhea … Not Normal
Unexplained Weight Loss … Not Normal
As obvious as the above might sound, you might be surprised at how often owners seem to write off those very symptoms in cats. I suspect this occurs for several reasons:
- Cats are very good at hiding just how bad they feel. A cat with vomiting, diarrhea, and/or weight loss may appear to be perfectly normal otherwise.
- Hairballs are typically blamed when a cat occasionally vomits, and hairballs are normal, right? (Wrong!)
- As long as a cat’s diarrhea is not severe and the cat is making it to the litter box every time, it’s not that inconvenient for owners.
- Owners assume nothing can be done to make their cat’s symptoms go away or that the diagnostic process will be too invasive.
A new study published in the Journal of the American Veterinary Medical Association demonstrates how easy it is to confirm the presence of intestinal disease using a noninvasive test (abdominal ultrasound) and how pervasive it is in cats with the aforementioned symptoms. One hundred cats were included in the study. Seventy were losing weight, 61 vomited at least twice a month, 11 had diarrhea (many had some combination symptoms), and all had thickened areas of small intestinal wall on an abdominal ultrasound. They then underwent surgery to obtain multiple biopsy samples to determine what, if any, disease was present that could explain the cat’s symptoms and the abnormal findings on ultrasonography.
The two most common diseases identified were intestinal inflammation in 49 cats (most likely due to inflammatory bowel disease but other possible causes weren’t eliminated) and intestinal lymphoma (a type of cancer) in 46 cats. Inflammation was the most likely diagnosis in cats under eight years of age, while those eight years of age or older had either inflammation or lymphoma. Of the 100 cats included in the study, only one had normal biopsy samples.
Interestingly, two cats had hairballs surgically removed from their stomachs at the time of surgery but both also had underlying bowel disease, which emphasizes the point that hairball formation is often a symptom of underlying gastrointestinal disease and is not normal. The authors conclude their paper with the following statement:
Chronic small bowel disease [CSBD] is a common condition in cats. One of the main clinical signs of CSBD, recurrent vomiting, is often dismissed as a clinically unimportant or normal event by cat owners and veterinarians. The use of ultrasonography permits clinicians to select cats from which multiple biopsy specimens of the small bowel should be collected and examined so that CSBD can be confirmed and chronic enteritis and neoplasia can be definitively diagnosed and treated appropriately.
If your cat has chronic vomiting, diarrhea, or weight loss, abdominal ultrasonography is a safe, effective (99% is pretty good!), and relatively inexpensive way to determine whether or not he or she has a disease that would best be diagnosed through biopsies.
Dr. Jennifer Coates
Diagnosis of chronic small bowel disease in cats: 100 cases (2008-2012). Norsworthy GD, Scot Estep J, Kiupel M, Olson JC, Gassler LN. J Am Vet Med Assoc. 2013 Nov 15;243(10):1455-61.