How to Treat Diarrhea in Kittens

What You Need to Know

When a kitten has diarrhea, he or she should see a veterinarian as soon as possible. Kittens can quickly become dehydrated, suffer from sepsis (harmful bacteria), gastrointestinal hemorrhage  and become hypoglycemic (sugar deficiency). Kittens are known to look fine one moment and then ill the next.

Most cases that are limited to one incident do not require intervention by any therapies. 

Warning signs of an immediate problem include vomiting, bloody stool and lethargic behavior.

 A veterinarian will do a physical examination and check the stool for bacteria or parasites.  There are also tests for problematic viruses such as feline leukemia and FIV (feline immunodeficiency virus).  If the cause is not identified, the vet will do a blood test, urine test and possibly an abdominal ultrasound or x-ray.  The veterinarian will also consider problems such as a food intolerance and consider factors such as toxic exposure and infection.

Issues seen in adult cats such as cancer, inflammatory bowel disease and immune-medicated diseases are rarely seen in kittens.

The best approach for managing diarrhea in kittens is to:

  1. Determine the cause
  2. If food, determine which food is causing the intolerance or food sensitivity
  3. Treat with conventional medications if needed or natural approaches such as probiotics, high protein, low carbohydrate diets.
Normal Color Stool For a Kitten That Is On Kitten Formulat

Chronic vs. Acute Diarrhea

Chronic diarrhea refers to cases where the condition relapses or is persistent over 3 to 4 weeks. Acute diarrhea refers to a case that is self-limiting and that doesn't require a full medical work up.

Chronic cases are solved using a step-by-step approach to reach a definitive diagnosis and then a treatment plan.

Video: How to Treat Kitten Diarrhea

Video providing advice for treating kitten diarrhea.

Causes of Diarrhea in Kittens

There are many potential causes of diarrhea in kittens. These include:

  • Parasites
    - Giardia
    - Trichomonosis
    - Cryptosporidiosis
    - Worms (hookworms, tapeworms, strongyloides)
  • Viral Diseases
    - Feline Panleukopenia
    - Hemorrhagic Calcivirus
    - Rotavirus
    - Astrovirus
    - Enteric Coronavirus
    - Feline infectious Peritonitis (FIP)
  • Bacterial Infection
  • Ingesting foreign substances
  • Nutrition
  • Inflammatory Bowel Disease (IBD)
  • Reactions to Food
  • Neoplasia

Diagnosis

The veterinarian will work to categorize the diarrhea as occurring in the small bowel or large bowel as a point of origin.  The vet will also take a history to determine if the underlying causes is a factor such as diet, environment, parasite exposure, medications or a toxin.  

The veterinarian will ask about:

  • duration and daily frequency of the diarrhea
  • consistency of the feces (blood, mucus, color)
  • deworming history
  • any aggravating factors
  • urgency of defecation

Treatment Based on Symptoms

Diarrhea with No Other Symptoms

If the kitten is well (normal eating and drinking) the veterinarian will do a physical exam, monitor the kitten and provide oral fluids. The condition will be treated with the medication Fenbendazole.

If the diarrhea does not resolve in 5 to 7 days, then the veterinarian will test the feces for parasites (ELISA, PCR tests).  If the tests come back positive, treatment will be as described in the next section.  If this does not stop the diarrhea, then the veterinarian will look at factors such as diet and conduct additional tests (blood, for viruses, B12 levels, TLI level and an ultrasound to look for any mechanical issues).

Diarrhea, Lethargic, Appetite Loss and Dehydrated Kittens 

If the kitten is suffering from diarrhea, acting lethargic and is dehydrated, the veterinarian will test for parasites (ELISA, PCR on a fecal culture.). If a diagnosis is confirmed, that the diarrhea will be treated as described below for parasites.

If the tests come back negative, the veterinarian will consider diet, viruses (FeLV/FIV), vitamin B12 levels, TLI levels (enzyme test) and will conduct an ultrasound to detect an foreign objects or mechanical problems.

Vomiting, Pain with Bleeding and Diarrhea

In the case where the kitten is suffering from pain along with bleeding, imaging tests are needed to determine the cause. If the images do not reveal the problem, then the feces is tested for parasites.  If this comes up negative then diet, viruses (FIV, FeLV), vitamin levels (B12 and a TLI test (enzymes) are reviewed.

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Treatment

Parasites and Infections

Giardia in Kittens

The leading cause of diarrhea in kittens is giardia with the disease found in 1% to 12% of all cats. In kittens, diarrhea caused by giardia will smell, appear pale in color and contain mucous.  The diarrhea occurs right after being infected.

Diagnosis:

Diagnosis of giardia in kittens is done by examining a stool sample using a DIF test (Direct immunoflourescense), SNAP or ELISA test. Tests are up to 90% accurate.  Giardia needs to be differentiated from causes that produce similar symptoms such as the ingestion of grass or pollen.

direct immunoflourescence assay of kitten diarrhea causing giardia in fecesA DirectImmunoflourescense Assay Test (DIF) can detect the presence in feces of kitten diarrhea causing giardia (green flourescent shapes)

Treatment:

Treatment includes antiprotozoal therapy plus cleaning the kitten's environment. Medications used include Metronidazole (some concern with the possible side effect neurotoxicosis which is toxicity in the nervous system) and Fenbendazole (primary treatment ) . Fenbendazole side effects are rare.

Be sure to thoroughly clean the kitten's floor area, cage, litter pan). When cleaning floors use a mix of bleach and water.

Caution:

Giardia can spread from kittens to humans so proper handling is required.

Trichomonosis (T foetus or Tritrichomonas feotus)

Tichonomosis is a protozoal organism that infects the large intestine. It is caught from contact with other animals.  It is often misdiagnosed and mistaken for giardia.  Is is possible that cats are infected with both Tritrichomonas feotus and giardia)

Most cases occur in kittens that are 9 months old that live in crowded conditions such as a shelter, but it can happen at any age. 

Symptoms:

It causes chronic large bowel diarrhea which contains mucus, frequent bouts of diarrhea, blood streaks (hematochezia) and straining when making a bowel movement or when urinating.  Diarrhea is foul-smelling.

Diagnosis:

 Tichonomosis in kittens is diagnosed by examining the feces using some type of smear test (PCR testing)

Beyond the diarrhea, most kittens will appear active and alert.

Treatment:

There are no approved medications for trichomonosis. Antibiotics and Metronidazole are used experimentally. Ronidazole has been shown to clear the infection, but there are side effects such as liver toxicity.  It should only be used when there is a definitive diagnosis.

Some infected cats will go into remission at 2 years of age with no treatment. 

Caution:

The condition can spread from cat to cat.

Cryptosporidiosis

Cryptosporidiosis parvum is a parasite that infects the outer layer of the small intestines. Diarrhea can be mild or severe, short-term or long-term.  It can also be life-threatening in some kittens. 

Diagnosis:

Cryptosporidiosis is sometimes not diagnosed since symptoms are similar to Irritable Bowel Disease (IBD). The organisms are small, making them easy to miss in testing.  The ELISA or immunofluorescence tests can detect the parasite.

Treatment:

Kitten diarrhea treatment for Cryptosporidiosis Parvum is challenging. There are human medications that can be tried in cats (azithromycin), but there is no medication that is specifically effective.

Worms

Fecal flotation tests can easily show if worms are the cause.

Most of the parasitic causes of diarrhea in kittens are typical (e.g., hookworms, roundworms, and strongyloides) and can be easily found on fecal flotation. However, therapeutic deworming should still be done in kittens that have diarrhea, even if the results of fecal testing is negative.

Treatment:

Kittens with diarrhea should receive treatment for deworming, even if tests come back negative for parasites.

Viral Diseases

There are several viruses that can cause kitten diarrhea. These are:

  • feline panleukopenia
  • hemorrhagic calcivirus
  • rotavirus
  • astrovirus
  • enteric coronaviruss
  • feline infectious peritonitis

If kitten symptoms include vomiting and diarrhea, FeLV, RIV or FIP viruses are the probable cause. 

Of all the intestinal viruses, feline panleukopenia is of the greatest concern.

Feline Panleukopenia

Symptoms:

  • diarrhea
  • fever
  • depression
  • anorexia (loss of appetite)
  • vomiting

Diagnosis:

A veterinarian will diagnose feline panleukopenia based on a physical exam and the kitten's medical history. There is also an antigen test that can be used for a definitive diagnosis (canine parvovirus antigen test).  Cats that have reduced levels of neutrophils (neutropenia) are tested for panleukopenia virus.

Virus Treatment

Treatment for all viruses involves addressing the symptoms and related problems such as hypoglycemia (low blood sugar)  via nutrition support and dehydration using fluid therapy.  There is virus specific cure for diarrhea.

Bacterial Causes of Kitten Diarrhea

Bacterial causes of diarrhea in kittens includes:

  • Salmonellosis
  • Campylobacteriosis
  • Clostridial infection
  • Yersiniosis
  • Tyzzer's disease (Bacillus piliformis)
  • Colibacillosis

Diagnosis:

It is difficult to diagnose a bacterial infection as the cause of kitten diarrhea, because it is a challenge to find the bacteria in the cat's feces during testing . The veterinarian can collect 2 to 3 grams of fresh feces for lab testing.  Specimens need to be examined within 2 hours after collection. 

Fungal Diseases

Fungal diseases (histoplasma) are more likely to be found in adults and are not frequently seen in kittens.

Mechanical Causes and Foreign Objects

There are several mechanical causes of diarrhea:

  • developmental problems (short bowel syndrome)
  •  inversion of one portion of the intestine on another (intussusception) 
  • obstruction
  • foreign body (string, ribbon, plants, hair, bones)

Kittens are naturally curious and will ingest substances that can cause harm to their digestive tract. These substances can cause diarrhea and vomiting.  Most foreign objects cause vomiting alone, but if objects travel further into the gastrointestinal tract, diarrhea becomes the dominant symptom.

Vomiting is the usual sign of an obstruction or foreign body as opposed to diarrhea.

Diagnosis:

An X-ray is needed to see what is causing any obstruction or some hint of the cause, such as the end of a string still visible in the mouth or detectable via palpitation.

Treatment:

Surgery is frequently needed to remove any object or to correct any physical abnormalities.    Most treatments have a good prognosis with the exception of problems related to developmental abnormalities.

ultrasonographic study of cat jejunum with IBD or small-cell lymphomaAn Ultrasonic Image of Lymphoma in a cat with Chronic Diarrhea

Nutrition and Diet

Diet is a leading cause of diarrhea in kittens. Determining the best diet for your kitten can be complex. If you believe diet is the cause, then start by feeding your kitten a diet that is highly digestible. This means the diet  has :

  • low to moderate fat 
  • moderate protein
  • moderate carbohydrates
  • less to no artificial colors and flavors
  • fewer preservatives
  • low components such as lactose and gluten that may contribute to a food intolerance

Diets that are highly digestible contain ingredients that contribute to intestinal health such as:

  • soluble fiber
  • omega 3 fatty acids
  • prebiotics or probiotics
  • antioxidants

Probiotics help to restore the microflora in the gastrointestinal system and can be utilized to eliminate intestinal parasites.

Also note that not all kitten foods that are labeled highly digestible are the same. If one doesn't help stop the kitten diarrhea, another choice may work.

Feed your kitten the new diet for 2 weeks before determining if it is effective.  You can also try alternative dietary formulations such as:

  • hydrolyzed (for elimination diets down to fewer ingredients such as 1 protein)
  • high-protein/low carbohydrates
  • novel antigen

Carbohydrate Intolerance and Gastrointestinal Bacterial Change

Kittens can suffer from carbohydrate intolerance or a change in the bacterial or microflora in the gastrointestinal tract. The Microflora can be effected when there is a change, such as from canned to dry kitten food.

To correct these types of problems, see if the microflora can be corrected by changing to a low carbohydrate canned kitten food or adding probiotics as a supplement (similar to humans eating Activa Yogurt to correct the microflora).

Supportive Therapy When a Kitten Has Diarrhea

There are several supportive therapies when a kitten has diarrhea:

  • Fluids: kitten quickly become dehydrated.  Fluids are administered subcutaneous (under the skin) or intravenous (into a a vein).
  • Gastrointestinal Protectants: prescription medications such as sucralfate or famotidine. 
  • Anti-vomiting agents if needed (maropitant, metoclopramide)
  • Antimicrobal therapy: if bacterial infection is suspected
  • Moist foods: to overcome dehydration, additional liquid such as chicken stock is added to food.  Highly digestable foods such as cooked turkey or chicken to 5 to 10 days can help
  • Deworming: the medication fenbendazole is tolerated well in kittens

Free Brochure on Kitten Diarrhea

Management of kitten diarrhea.
Available in a free Ebook

Tips for when a kitten has diarrhea.
Available in a free Ebook

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Where To Next?

Identifying and Caring for a Sick Kitten

References

Diarrhea in Cats

Diarrhea in Kittens and Cats
D.L. Zoran
College of Veterinary Medicine, Texas A&M University

Marks SL, Willard MD. Diarrhea in Kittens: In August JR (ed) Consultations in Feline Internal Medicine, vol 5 St. Louis, MO