Most cases of diarrhoea in dogs and cats will be short-lived and not require any medicines such as antibiotics to resolve. However, gut upsets can occasionally cause discomfort and more serious, so it’s important to know what to look out for and when a visit to the vets is needed.
Some causes of acute diarrhoea include:
Dietary indiscretion – bin raiding, table scraps, scavenging, basically eating things they shouldn’t do
Infections. Just like us, dogs and cats can catch stomach bugs from each other, pick up infections from contaminated foods and suffer from a variety of parasites.
Parvovirus. Also an infection, however it’s extremely serious and relatively common in unvaccinated animals, so I’ve given it its own point.
Rapid diet changes
Stress
Toxins
Side effects of medications, for example antibiotics and some pain relief
A sign of a more serious condition happening elsewhere in the body. Animals that are ill for another reason can sometimes develop diarrhoea.
Allergic reactions and dietary intolerances
Unknown. In some cases, extensive investigation may not reveal a cause. Often it is not necessary to establish one due to the self-limiting nature of most cases.
Toxicity can cause diarrhoea
When should I worry?
First of all, it’s easier to describe when you need not worry. If your pet remains active, bright, is behaving like its usual self and eating normally, there’s no need to worry unless the diarrhoea isn’t improving after 3 days. However, you should call your veterinary team for advice if:
Your pet is lethargic
Not eating
There is blood in the faeces. Small streaks of fresh blood are common, and probably nothing to worry about, but it’s best to get in contact with your veterinary team for advice
Persistent vomiting
Other signs of illness such as vulval discharge
Your pet is taking medication
Known toxin ingestion
Vulnerable animals e.g. diabetics, puppies and kittens
Swollen abdomen
Signs of pain, for example the prayer position, restlessness, whining, hiding, reluctance to let you pick up or move him/her
If you are concerned or something doesn’t seem right
Dog in the 'prayer position' will be very different in comparison to a 'play bow', they are sore, uncomfortable, can show facial features of pain like a furrowed brow, and are trying to relieve their discomfort by getting into the position.
What should I do?
If you’re not concerned, or you’ve contacted the vets and they don’t think your pet needs to be seen, there are some things you can do at home to help.
Keep your pet hydrated. Provide multiple bowls of fresh, clean water. There are other techniques that can be used, especially for tricky cats. Help, I need my cat to drink more! (vetvoices.co.uk)
Feed a veterinary diet designed for dogs and cats with compromised gastrointestinal tracts. Such diets are highly digestible and contain added nutrients to support the gut as it recovers. Feed little and often following the manufacturer’s feeding guide.
Give a high quality, evidence-based probiotic such as FortiFlora. Probiotics can support the immune system, help restore the intestinal microflora balance and maintain good faecal quality. Probiotics may be suitable for your pet, even if you are not able to change their usual diet.
Your vets will probably be able to supply you with gastrointestinal food and probiotics, even if you don’t need an appointment. A top tip is to stock up in advance, so you’re never caught out on a bank holiday!
Don’t starve the pet. The cells of the gut rely on nutrients from food to recover. Cats can sometimes develop other complications such as liver problems if they are starved.
Dietary management of acute diarrhoea
Gastrointestinal problems are the most common reason for a dog to visit the vets in the UK. Nutritional modifications are a cornerstone of management for patients with acute gastrointestinal diseases. The optimal diet for patients with acute diarrhoea will be influenced by the underlying cause and any comorbidities. This article will focus purely on general principles of nutritional management in acute diarrhoea. Pet owners should always contact their veterinary practice for advice on a case-by-case basis, if needed. Discussion of other elements of supportive therapy and treatment are beyond the scope of this article.
Should I starve patients with diarrhoea?
Although starving the patient may reduce the volume of diarrhoea produced, early enteral feeding is highly advised. Enterocytes and colonocytes derive much of their nutrition from the lumen of the gut e.g. glutamine and butyrate, respectively. Early enteral nutrition helps with gut cell repair and turnover. In acute gastrointestinal diseases, studies have shown that early nutrition can result in a shortened recovery time and reduced mortality (puppies with parvovirus, dogs with septic peritonitis and acute pancreatitis). There is also a risk of hepatic lipidosis when cats are starved, especially if they were already in a state of negative energy balance. In general, it’s a good idea to “feed through the diarrhoea”, rather than starving.
What features should the diet have?
Highly digestible / low residue – helps to maximise nutrient availability and reduce complications associated with undigested food. Reduces the antigenic load within the gut.
Limited antigen diet – may reduce the risk of developing new allergies when the epithelial barrier is compromised.
Highly palatable – inappetence may be seen in animals with acute diarrhoea. High palatability helps to ensure the food is consumed and the pet meets its energy needs, an important factor influencing recovery. Food aversion may develop in cats – food that is highly palatable may help to overcome this.
Appropriate fat content - the “ideal” fat content depends on the case and the species. For dogs, a low-moderate fat diet is sensible*, whereas cats are less fat sensitive and may benefit from a moderate fat content diet with higher energy density and improved palatability.
Prebiotics – soluble fibres that selectively promote the growth of beneficial bacteria. For example, inulin from chicory. The fermentation of soluble fibres produces short chain fatty acids, vital for normal colonic structure and function and maintaining a healthy colonic environment and microbial population.
Adapted fibre levels – usually low fibre. A lower fibre content increases digestibility. However, an appropriate level of mixed fibres supports normal gastrointestinal motility, absorption, and they act as prebiotics. In some cases (e.g. large bowel diarrhoea in dogs), an increased fibre content may be recommended.
Omega 3 fatty acids – maximise natural anti-inflammatory processes.
Reasons for low-moderate fat diets in dogs
Fat malabsorption is often seen in canine acute small intestinal diarrhoea. A lower fat diet helps to limit the fats passing through to the colon where they can be fermented to hydroxylated fatty acids, which may exacerbate diarrhoea.
Long chain triglycerides (LCTs) are the main source of fat in pet foods. Digestion of LCTs is a complex, multi-step process requiring bile acids and pancreatic enzymes. The area of highest absorption is via the epithelial cells at the tips of the villi, which are also the cells most susceptible to mucosal injury.
Fat delays gastric emptying so a lower fat diet may be useful for nauseous or vomiting patients
Helps minimise fat malassimilation, bile acid malabsorption and consequential deconjugation of unabsorbed bile acids, and minimises increased mucosal permeability
Some long chain triglycerides are replaced with medium chain triglycerides (MCTs) in some commercial gastrointestinal diets. MCTs are an easily digestible fat source compared to LCTs. Digestion of MCTs involves two steps (vs eight for LCTs) and does not depend on the presence of pancreatic lipase and bile acids.
Why not just feed chicken and rice?
Commercially available diets that are complete and balanced and have most, if not all, of the features above are readily available in both wet and dry formats. They are specifically designed to meet the needs of animals with a compromised gastrointestinal tract and compensate for maldigestion. Chicken and rice:
Not complete or balanced.
Inconvenient and inconsistent nutrition
Pet’s energy requirements and nutritional needs not met
Does not contain added functional ingredients (as listed above).
Once the diarrhoea has resolved, the transition back to the pet’s regular food should be gradual over ~7 days.
Encouraging food intake
Any nausea should be controlled as much as possible before introducing food. Feed small meals, little and often, considering the patient’s dietary preferences. Taking a diet history will help guide you to an appropriate product and format, for example if the pet has always eaten wet food, a dry diet is not as likely to be accepted. Leave food down for a maximum of 30 minutes and feed wet food at room temperature (or gently heat some to body temperature) to improve aroma. Avoid administering medications in food when possible, especially in cats as this may lead to refusal. Finally, consider adding a palatability enhancer such as Pro Plan FortiFlora (a highly palatable probiotic supplement).
Other considerations
Consider probiotics as part of a multimodal approach for gastrointestinal disturbances to support intestinal health and the restoration of microflora balance. Take care to select a high-quality, reputable product with evidence for use of the particular strain and preparation in dogs and cats.
It can be useful to use resources to aid communication with pet owners and other members of the veterinary team such as faecal scoring charts and nutritional assessment templates. It can also be useful to have a practice gastrointestinal protocol which all members of staff are familiar with to ensure consistent communication and an optimal dietary approach to acute diarrhoea cases.
Thank you to the support of © Nestle Purina Petcare 2024 for this article
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