The digestive system probably has more separate parts or segments than any other system in the body. From mouth to anus, this system is responsible for breaking down foodstuffs, separating out the essential nutrients, absorbing the nutrients into the blood stream and preparing the waste products for excretion.

Diseases of the digestive system are one of the top problems veterinarians deal with in pet cats. Diseases of other systems also commonly affect the digestive tract. After all, a decreased appetite is a common symptom in hundreds of different illnesses. This section will attempt to cover conditions one subsection at a time, i.e., mouth, stomach and so forth.

Stomatitis is inflammation of the oral membranes; Glossitis is inflammation of the tongue; Gingivitis is inflammation of the gums. Notwithstanding the exact area affected, most oral lesions are due to some other specific problem which ultimately affects the mouth. Because the mouth is full of bacteria, yeast and other organisms, internal diseases can allow these to attack and cause infection. Most commonly, these infections occur as resistance is altered due to the following:

Systemic Fungal Disease

Diabetes Mellitus

Chronic Renal Failure

Burns

Electrical Injury

Foreign Objects Like Foxtails

Toxins and Poisons

Systemic Lupus Erythematosus

Pemphigus

Dental Disease

Drug Reactions

Food Allergy

Contact Dermatitis

Immunodeficiency

Chronic Feline Gingivitis-Stomatitis

Plasma-Cell Gingivitis-Stomatitis

Bacterial Infections

Feline Calicivirus

Feline Herpesvirus

Feline Leukemia Virus

Feline Immunodeficiency Virus

The clinical signs include decreased or poor appetite, reluctance to eat, foul oral odors, trouble swallowing, rubbing the face, pawing the mouth, unusual chewing-like motions, salivation and vomiting. Diagnosis is based on these clinical signs, physical examination of the mouth which may reveal redness, odor and ulceration, complete blood counts, serum chemical analysis, urinalysis, thyroid testing, cytology, cultures, serology for specific diseases and biopsy of the affected tissues.

Some cats can suffer from a chronic form of oral disease with all the aforementioned symptoms. The gums and throat will be continually inflamed, teeth become lost to resorptive lesions, oral ulcers are noted on various surfaces and most cats have moderate to severe pain when opening or touching the mouth. Most cats have a decreased appetite, fever, lethargy and moderate weight loss. If all other initiating causes are ruled out, then this diagnosis should be considered. A specific cause, however, may never be determined. ((Stomatitis)) ((Tongue Ulcers))

Specific conditions require their own treatment. Selected antibiotics, anti-fungal medications, oral antiseptic washes and anti-inflammatory medications will all be useful depending on cause. Dental cleaning may be warranted and usually will improve oral health under all circumstances. Feeding soft or pureed foods or giving a liquid diet will help keep the cat's strength and resistance up while healing. Antibiotics should not be overused as they can lead to a worsening of certain infections.

Cats with chronic gingivitis-stomatitis generally need antibiotics to control secondary infections, consistent doses of cortisone-type medications to control inflammation, oral rinses to cleanse the mouth, and in some cases, pulling all the teeth except the incisors and canine teeth. While this may sound extreme, this treatment has brought a cure to many cats where nothing else worked. ((Full Mouth Extraction))

This condition is an inflammatory disorder of the gums, back of the mouth (fauces), base of the tongue and other areas in the mouth. Upon biopsy of gum tissue, cells called lymphocytes and plasmacytes (both are types of white blood cells) are found in high numbers. It is thought that this may be a hypersensitivity disorder but the exact cause of this condition remains unknown. Unfortunately many cases are chronic and poorly responsive to current therapy.

Clinical signs include extreme redness to the above described areas, oral pain, trouble chewing and swallowing, foul oral odors and bleeding from the mouth. Some cats become so severe as to stop eating completely until some relief is rendered. Diagnosis is based on history, physical examination, biopsy of gum tissue and excluding all other causes of glossitis/stomatitis. Blood counts and oral cultures may be useful in directing treatment. ((Lymphoplasmacytic Stomatitis))

Most if not all cats will require ongoing treatment for this disorder. The use of cortisone-type drugs, azathioprine, chlorambucil and aurothioglucose all seem to offer some relief. The use of antibiotics and oral rinses may help control odor and secondary infections. In cats that are poorly or otherwise nonresponsive, pulling all teeth behind the canine teeth can result in a cessation of symptoms. It is possible to put cats into remission but a cure is unlikely in most cases.

The pharynx is the back part of the mouth, after the teeth but before the esophagus. The tonsils lie on either side of the pharynx in small pockets called crypts. Inflammation of either of these structures (one would rarely occur without the other) results in pharyngitis and tonsillitis. This problem can also be concurrent to other oral conditions. (see stomatitis) Respiratory diseases, vomiting problems and nasal or sinus conditions all can cause inflammation at the back of the throat. Young cats may have tonsillitis only, but this usually needs little or no treatment as it resolves with age and maturity.

Clinical signs seem more common in young cats, often where there has been some recent troubles with coughing, vomiting, nasal discharge, or so forth. Fever, loss of appetite, increased salivation, trouble swallowing, rubbing the throat, gagging, and shaking the head may be present. Diagnosis is based on history, physical examination of the head and throat, X-rays, and cytology. A throat culture as is commonly performed in people is usually worthless.

Most cats respond well to antibiotic and anti-inflammatory medications. Soft diets may help until soreness of the throat passes. Tonsillectomy is rarely performed and then only if there is a chronic failure of treatment or in an attempt to better diagnose the problem.

DENTAL DISEASE

As a broad or more general classification, dental disease encompasses many problems of the teeth and gums. It is calculated that 95% of cats will have dental disease in their lifetime, making this the most common disease of pet cats. To be more specific, it is periodontal disease, infection along the borders of teeth and gums (the periodontium) that is most commonly observed. One might also know this disease simply as "Bad Teeth"!

Dental disease begins as the cat eats and food particles accumulate along tooth surfaces. Bacteria in the mouth digest the food to form plaque, which is the yellow sticky film found on the teeth. As this infection spreads, dental disease develops.

When enough plaque builds up, an infection of the gums known as gingivitis can occur. This is often seen as a red line along the teeth on the gums. As time passes, the plaque calcifies and hardens to form tartar which, in a way, holds the infection against the teeth and pushes it still further under the gums, leading to the formation of "pockets". Periodontal Disease is this deeper infection of the gums along the tooth margins and tooth roots, which will, if left unchecked, lead to tooth loss as the root decays.

All cats seem to be affected, probably because the teeth are closer together, because cats are often given soft foods, and because they are not good about chewing rawhide bones and so forth to help keep teeth clean as dogs will do. It has been observed that soft moist, canned or table foods greatly increase the rate at which plaque and tartar build on the teeth so hard foods are highly advised. 

While dental disease does cause teeth to look and smell bad, it is the damage that isn't seen that is far worse. The gum tissues have an extensive blood supply, and all the bacteria involved in periodontal infections easily enter the blood stream leading to valvular heart disease, kidney disease, hepatitis and joint disease, not to mention that constant pain from tooth loss is also occurring.

Clinical signs include bad breath, rubbing the face and mouth, increased salivation, bleeding gums, pus around the teeth and the obvious build up of plaque and tartar on the teeth. Many cats will be less active, have poor appetite, and loose weight. Diagnosis is based on oral examination, X-rays and measuring the pockets around teeth with a special probe. ((Dental Disease))

As for humans, plaque and tartar must be removed from the teeth with scrapers and mechanical devices, and then teeth need to be polished smooth again. As animals will not "hold still and open wide", anesthesia will be needed. Once cleaned, fluoride treatments and antibiotics can be used to cure existing infection.

While not 100% preventable, there are many things that can be done to preserve oral health. Feeding only hard dry chow is the best place to start. Some special diets are also now available that clean the teeth more effectively than most regular dry diets. Brushing the teeth on a regular basis with disinfectant medications or enzymatic pastes is also possible depending upon how cooperative the patient is. Your veterinarian can show you how to do this and recommend appropriate products. Lastly, remember that plaque will still form and some degree of professional care will be needed from time to time. Note: avoid human toothpaste; it is high in detergents that should not be consumed by your cat.

A cavity is erosion in the surface of the tooth surface (enamel). As plaque-forming bacteria produce acids which sometimes dissolve the calcium matrix and thusly the tooth surface. Cavities are uncommon in cats with cervical neck lesions being seen more frequently. Clinical signs include mouth pain, trouble chewing, salivation and pawing at the mouth. Diagnosis is based on oral examination and X-rays.

In some cases teeth are so badly decayed as to require extraction. If caught early, a filling may be put into a tooth and its soundness restored. Many veterinarians are now capable of doing this type of restoration work.

Dental fractures are common in cats. Many cats chew and bite objects with such a force as to fracture the crowns of the teeth. Canine teeth (fangs) are most commonly damaged. Clinical signs include the obvious fracture, oral pain, difficulty chewing and bleeding from the mouth. Diagnosis is based on physical examination and X-rays. 

Badly fractured teeth may need to be extracted. Vital pulpotomy, which is like a filling with a partial root canal, can be performed in some cases. Root canals will be needed if infection and decay have begun. Some cats can also receive a crown to preserve the "bite" of the tooth. Antibiotics for infection are indicated.

Periodontal disease which becomes so bad as to extend to the deep root areas known as the "apex" is not uncommon. Bacteria causing infection form pockets between the tooth root and supporting bone structures and ultimately loosen the root hold. The canine teeth and the large upper premolars are most commonly involved but this process easily affects any tooth in the mouth. 

Clinical signs include foul oral odors, rubbing the face and mouth, open and draining sores on the face often just in front of the eye, nasal discharges, salivation, facial swellings, and open sores on the gums away from the dental crowns. Loose teeth most commonly have apical abscesses. Diagnosis is based on physical examination and X-rays.

Some teeth, particularly those that are loose, may only be treated by extraction. Sometimes the communication between root and face or nose must be opened and flushed. Antibiotic therapy is always indicated. Once the infection is addressed, facial swelling and open sores will generally heal quickly.

Deciduous teeth are the "baby" or temporary teeth. These are generally pushed out as the permanent teeth cut in between 3 1/2 and 6 months of age. If the alignment needed to push the baby teeth out as the new tooth emerges is not perfect, this will not occur and two teeth are then present where one should be. The baby teeth are generally smaller, thinner and sharper than their adult counterparts.

Symptoms/diagnosis of the condition is readily obvious upon physical examination. Unfortunately, left untreated, the retained teeth alter position of the adult teeth resulting in abnormal tooth wear, dental fractures and faster decay processes. Sometimes sores may be cut on the gums from tooth malposition. Cats rarely have retained teeth as compared to dogs. ((Retained Tooth))

All retained teeth should be extracted. This is all baby teeth not out by 6-6 1/2 months of age. We often advise this being done when cats are spayed or neutered at about this age. If not, extraction should nevertheless be undertaken by itself. If it becomes evident during routine examination of young kittens that the deciduous teeth are or will cause misplacement of the adult teeth, extraction can and should be done at an earlier age.

Feline neck lesions are erosions or cavities on the teeth but no decay or infection is present as with caries. The resorption occurs as tooth enamel is literally eaten away by specialized cells on the tooth surface. This erosion is progressive with various degrees of damage occurring depending on the time since the process began. Why this occurs in cats still baffles researchers as the lesions are not found in cats from bygone eras.

Clinical signs include small to large pits in the premolar and molar teeth, sometimes with raw pulp being exposed; some teeth being so badly resorbed as to only have their roots, or parts thereof present upon examination. Gum tissue may grow in the pits or completely cover badly damaged teeth. Inflammation of the gums, oral pain and salivation may also be present. Diagnosis is based on physical examination and oral X-rays. ((Neck Lesions))

Treatment will depend upon how badly teeth have been damaged. Early lesions may be treated with cleaning and polishing the teeth followed by the application of a fluoridated sealer. Some slightly deeper areas have been treated with surface restoration but many times these restorations do not last the life of the cat. More extensive lesions will necessitate removal of the tooth as the size of canine teeth makes complete restoration nearly impossible. Most cats benefit from regular use of fluoride gels, dental cleanings and specialized diets.

A salivary mucocele is an accumulation of saliva in a pocket, under the skin but outside of the salivary gland(s) and ducts. While diseases of the salivary glands are uncommon, this is the most common salivary disease of cats. While it is usually impossible to exactly determine what causes a leak in the system, trauma to the head, foreign objects penetrating the salivary glands or ducts, tumors or other swelling near the duct which causes obstruction may all lead to a mucocele.

The usual swelling occurs near or under the angle of the jaw. Rarely, cats will have a large swelling under the tongue that is called a Ranula. As saliva leaks under the skin, a pocket, which is an encapsulation of the saliva inside connective and inflammatory tissues, forms. This may cause the fluid mass to feel solid like some sort of tumor.

The clinical signs will vary with which salivary gland and/or duct has the leak. A ranula will cause trouble chewing, swallowing, and the tongue will often deviate out one side of the mouth. Large cervical mucoceles will rarely cause any noticeable problems. Trouble swallowing and obstruction to breathing can occur with pharyngeal mucoceles. Diagnosis is based on physical examination, X-rays, aspiration, cytology of the masses, culture and biopsy. ((Salivary Glands))

While drainage can be tried, it will rarely cure this condition. The best treatment will be the surgical removal of the affected glands along with surgical drainage of the mucocele. A ranula can be treated with surgery also. The surgery is delicate and using an experienced surgeon is highly advisable.

Salivary adenitis describes an uncommon inflammatory disease of the salivary glands, most often a bacterial infection secondary to foreign objects, bite wounds, oral infections or dental infections which spread to the salivary glands, salivary mucocele, trauma, and sometimes viral infections. One or more glands may be affected at any one time, but rarely would all glands be involved. ((Salivary Glands))

Clinical signs include salivation, including an abnormal thickening and color changes to the saliva, swelling of involved glands, which may also be warm and painful, trouble chewing or swallowing, and, in some cases, open, draining sores on the side of the face. Physical examination, aspiration, cytology of fluids and cultures will usually establish the diagnosis.

Any draining abscesses should be flushed and cleaned under anesthesia. Exploration for foreign objects should also be considered in these cases. Oral infections should be treated, and abscessed teeth may require removal. After these or any other initiating cause is dealt with, antibiotics, prednisolone and oral rinses should help to resolve the condition.

A sialolith is a stone that forms in some part of the salivary system. They are very rare, and the cause for their formation is poorly understood. If present, they will more likely be secondary to salivary adenitis or a salivary mucocele. Salivary stones, if present, can block the flow of saliva and result in failure of the associated gland. Clinical signs are similar to salivary gland inflammation and include localized swelling, heat and pain. Diagnosis is based on physical examination, X-rays and ultrasound. Aspirates and cytology may be useful to differentiate this from similar problems. ((Salivary Glands))

When present, surgery is the treatment of choice and should be performed promptly. Once the stone is removed and assuming there are no complications, function of the gland and duct involved should quickly return to normal.

Traditionally, megaesophagus was used to describe an abnormal dilatation of the esophagus. More correctly, while dilatation will exist, there are generally problems with the motility of the esophagus that goes along with the abnormal dilation. Esophageal motility is very important; special contractions are what moves food from the mouth towards the stomach as food does not just "fall" in that direction. Without this normal motility, food and liquids do not move in the proper direction.

Two main types of megaesophagus are commonly seen; a primary form and a secondary form. The primary form is a congenital defect that affects young kittens and for which the cause is unknown. Otherwise, megaesophagus will arise secondary to cases of esophageal foreign body obstruction, persistent right aortic arch, polymyositis, polyneuritis, myasthenia gravis, esophagitis, certain poisons, tumors which block the esophagus, and other uncommon neurologic diseases. Thusly, when megaesophagus is diagnosed, a primary cause should be sought. With this said, feline megaesophagus is very rare in the United States, more commonly seen in Europe for some unknown reason.

Clinical signs include regurgitation, which most people will describe as vomiting when in reality, forceful vomiting is not occurring. Young cats will often regurgitate milk through the nose and look poorly developed. Weight loss, salivation, gurgling sounds, weakness, paralysis, trouble swallowing, and bad oral odors can all be present. Because the regurgitation is uncontrolled, unlike vomiting, cats may inhale fluids and food particles and severe aspiration pneumonia will then occur.

Diagnosis will be based on historical information, X-rays including dye studies, neurological examination, endoscopy, blood counts, serum chemistries, thyroid testing, urinalysis, and special neurological testing. It is important to understand that while the actual diagnosis of a megaesophagus may be relatively easy; the determination of the cause will be more involved. ((Esophogram)) ((Megaesophagus))

Foreign objects should be removed and any other strictures should be approached and dealt with. Persistent right aortic arch will require surgical treatment. All cats should be fed a gruel-like diet that the veterinarian determines as best for the patient. Some cats may require feeding through a stomach tube for a time if the regurgitation has become too severe. Surgery is rarely useful to "reshape" the esophagus, and few drugs are available to help. Treatment of any primary disease as mentioned above will offer the best hope of control or reversal of this problem. Most cats that die do so because of aspiration pneumonia or from poor home administration of dietary recommendations.

Esophagitis, which is inflammation of the esophagus, can include ulceration of the esophagus in more severe instances. The causes of this can include chronic vomiting problems, swallowing acid, alkali, and other poisons, thermal burns, and traumatic injury including swallowing some type of foreign objects such as a bone, stick or fishhook.

Clinical symptoms include poor appetite, salivation, trouble swallowing, regurgitation which may be confused as vomiting, blood may be present in any regurgitated materials; fever, shock and aspiration pneumonia can occur in some extreme cases. Oral inflammations may also be present. Diagnosis will be made with historical information, physical examination, endoscopy, X-rays including dye studies, and blood counts.

If the cat has ingested a poison, then treatment for such should be undertaken first. Do not, in these cases, induce vomiting. General care for an inflamed esophagus will include antibiotics to control infection, the use of cimetidine to curb acid formation, feeding a diet that is watery and mushy like baby food, fluid therapy to prevent dehydration, and in some cases, using cortisone to relieve inflammation.

In some cases, as the esophagus heals, a scar that reduces the size of the esophagus will form. This is known as a stricture. Minor strictures may respond well to simple dietary changes. Major strictures may require manual stretching under anesthesia, or even surgical reconstruction by a surgical specialist.

Every veterinarian will probably have their own story of items they have removed from a cat's esophagus. Bones, fishhooks, balls, pantyhose and so forth all get swallowed and stuck. Sometimes objects will only abrade the inside lining of the esophagus and pass on to other parts of the digestive tract. However, this may predispose the patient to esophagitis. More often, the object will become lodged, and in a worse case scenario, will puncture the esophagus and allow leakage of fluids and food into the neck or chest cavity, possibly causing a pyothorax. ((Esophageal FB))

Symptoms may include trouble swallowing, pain, salivation, blood in regurgitated fluids, loss of appetite, depression and an inability to get into a comfortable position. Trouble breathing or swelling to the neck may be indicators of an actual perforation and subsequent infection. Diagnosis is based on history, although many owners may fail to be aware that the pet has swallowed anything, physical examination, X-rays including dye studies, endoscopy, ultrasound and analysis of fluids either from the mouth or aspirated from the chest cavity.

Because the esophagus is encased mostly within the chest cavity and surrounded by vital structures, removal of lodged objects can be extremely difficult. The best results can be obtained if an object can be removed with the aid of an endoscope. This will usually result in minimal trauma and damage. In some cases, objects can be gently "pushed' into the stomach and removed from there.

Other times, surgery will be the only hope. However, this may mean that the cat will have to have an open-chest procedure performed that can be more expensive and moderately risky. Only a surgeon will all the proper equipment and training should routinely attempt such a surgery. Reconstruction of part of the esophagus may be required and possible complications include infection, failure of the surgery to hold and death.

Acute gastritis involves a sudden inflammation of the stomach with some damage to the lining of the stomach usually being present. Clinical signs of gastritis include a sudden onset of vomiting, and if the vomiting persists, abdominal pain, dehydration, and lethargy. Many cases of gastritis will be associated with cases of enteritis, colitis or the mixed forms called gastroenteritis or enterocolitis.

There are many causes of gastritis, but probably the most common cause is the cat eating either a different food than it is used to, including changing cat foods or after providing new treats, eat grass or houseplants, giving some type of "human" or "table" food, or the pet getting into the garbage. Rancid or spoiled foods, non-food items including toys, wood, bones and weeds or grass, feces, chemicals, drugs, viruses, certain bacteria and internal parasites can all cause gastritis. If we remember that vomiting is the body's way of removing material that is causing an insult, we then best understand this disease process.

There are, however, quite a few diseases that will ultimately cause vomiting, but in any case of sudden vomiting in an otherwise healthy cat, acute gastritis and its associated causes should be highly suspect. Diagnosis is based on history, including what the pet has eaten and when, fecal analysis, X-rays and blood counts in some cases.

In many cases, the offending substance will remain unknown or only supposed. Nevertheless, with proper historical and physical findings, good symptomatic treatment can and should be undertaken. Anti-vomiting medications and sometimes antibiotics are used to settle the stomach. Fluids are given if the pet has become dehydrated. Otherwise, symptomatic therapy of vomiting is done as follows:

No food or water is given for a period of time determined by the veterinarian. Assuming that no vomiting occurs during this time, the pet will be given relatively small amounts of water or mild electrolyte solutions every 30-60 minutes. If these small amounts are held down and no vomiting occurs, the amount of fluids given at each interval is gradually increased until the pet is drinking normally. Food is withheld until the cat is drinking and not vomiting, then as with the water, small quantities of a bland, low fat and easily digestible food is given every 3-4 hours, and gradually increased until the pet is also eating normally. Some veterinarians will use mixtures of rice and boiled chicken, but we prefer special prescription pre-made foods. Cats that continue to vomit and do not respond well to this simple treatment generally have more serious problems and will often require IV fluids and further diagnostic tests to obtain a proper diagnosis and allow correct treatment.

Chronic gastritis occurs when a cat has repeat bouts of gastritis (vomiting) that is either nonresponsive to therapy or due to some type of chronic inflammatory process of the stomach. In many cases, a cause is never determined. Other times, a diagnosis may be obtained by gastric biopsy, a procedure easily performed with an endoscope. A biopsy will usually show some specific type of inflammatory process, an abnormal thickening of the stomach lining, ulcerative disease, an abnormal thinning of the stomach lining, or evidence of an allergic-type reaction.

The clinical signs of chronic gastritis are basically vomiting that occurs relatively frequently or at a regular interval. Vomitus may be mucoid, thick and may contain blood. Cats can have poor appetite, dark stools, mild abdominal pain and drink more than usual. Diagnosis is based on history, physical examination, blood counts, serum chemical analysis, fecal analysis, X-rays, endoscopy and gastric biopsy.

There is not one exact treatment for all cases of chronic gastritis. If there is an exact cause or disease found that should be directly addressed. Various prescription diets are available including highly specific foods that would be unlikely to cause dietary allergies. Some foods may be used because they are low in fat and highly digestible. Feeding smaller but more frequent meals is also often employed.

Tagamet or Zantac are used in some cases to reduce gastric acidity. Cortisone- like drugs work well in cases of allergic or inflammatory disease. Drugs which control vomiting and improve gastric emptying, such as metoclopramide, have been used in some cases with good response. In other cases, simple protectants such as Pepto Bismol can be used to soothe the stomach. No matter which treatment ultimately does the best job, most cats will require lifetime therapy, if at least being on a special diet.

The pylorus is the portion of the stomach leading into the small intestine that controls or regulates the emptying of the stomach. Hypertophy denotes a thickening or enlargement. Thus, if the pylorus becomes thickened, the ability of material to flow from the stomach to the intestines is diminished. This condition may be seen in very young cats and is therefore congenital. More often, but still uncommon, older cats develop this hypertrophy secondary to cases of chronic gastritis, inflammatory bowel disease or neoplastic thickening of the stomach and intestines. ((Pyloric Stenosis))

Most cats with this condition are the smaller and short-nosed breeds. Clinical signs will include a chronic recurrent vomiting which is often related to feeding schedule. Weight loss, general loss of condition and dehydration will also be noted. Diagnosis is based on history, physical examination, blood counts and serum chemistries, X-rays including dye studies, ultrasound and endoscopy. Doing an upper GI study often elucidates the failure of food to pass the pylorus.

If a chronic gastritis is involved, treatment of that may resolve the situation by decreasing the swelling at the pylorus. In other cases, surgical alteration of the pylorus will be the only option to (partially) restore a normal flow. Most cats respond fairly well with this type of procedure and can live a normal life.

There is no evidence that this disease occurs in cats, but as some cats with chronic vomiting problems respond to motility modifiers, the condition does hypothetically exist. This is not simply one disease, but rather, a number of disease entities that alter the function of the stomach and then inhibit the flow of food from the stomach into the intestines. Normally, food in the stomach should enter the intestines within 6-8 hours. If food is retained longer than 8 hours, then impairment to motility is said to be occurring.

Causes of gastric motility disorder can include trauma, pain, stress, surgery, chronic gastritis, diabetes, hyperthyroidism, hepatic disease, chronic renal disease, other metabolic conditions, gastrointestinal foreign objects and certain drugs; there may be no obvious cause. Food retained in the stomach will cause vomiting, usually 6-8 hours after the meal. Other symptoms include bloating of the abdomen, weight loss, loss of appetite and salivation due to nausea. Diagnosis is based on the history, physical examination, X-rays including dye studies such as an upper GI, blood counts, and serum chemistries.

Most cats will need to be fed small, frequent meals of a bland, highly digestible food and even then the food may need to be blended with water. The use of metoclopramide, which can be used long term if needed, often improves gastric activity and outflow. Few other drugs benefit these cats.

Cats do not love to chew and swallow rocks, balls, toys, sticks, socks, pantyhose and a million other household items the way dogs do, making the presence of internal foreign objects relatively uncommon in this species. The two major exceptions occur if one considers Hairballs a foreign object, and that cats do seem somewhat prone to swallowing string, often with needles attached. Unfortunately, any foreign object can become stuck and grossly interfere with the normal function of the digestive system. Kittens, in their exuberance, seem more prone to this condition but a few mature adults fail to learn the lessons of careful eating. ((GI Foreign Body))

One gross error and myth that we would like to dispel here is that every time a cat vomits, it does not mean that they have a hairball! In most cases when a furball is present, the vomit will contain a large clump of familiar looking fur. If not, and especially if the vomiting is repeated or recurring, there is some other cause that needs to be investigated. In rare cases will large masses of hair clump and form a hard ball to actually block the stomach or intestine of a cat. To summarize, if a cat has hairballs they will usually vomit them up.

The symptoms of an obstruction will depend on where in the digestive tract the blockage is located, and whether or not the bowel or stomach has been damaged in the process. Obstructions of the stomach and upper part of the intestines will cause repeated vomiting, dehydration, weakness and moderate abdominal pain. Obstruction farther down the intestine may not cause any vomiting but will lead to diarrhea that may become bloody, loss of appetite, abdominal pain, bloating and abnormal posture as if the cat is unable to become comfortable.

Some cats may have partial or "floating" obstructions where some material is still passing, this making establishment of a final diagnosis even more difficult. One of the most dangerous types of foreign object is what is called a linear foreign body, where a string or pantyhose is inside a long portion of the intestine. This tends to pleat up a large portion of intestine and also cut through the intestine wall leading to the very serious condition of peritonitis.

Diagnosis is based on history, especially if the pet was observed eating an item, physical examination, X-rays including dye studies, blood counts and serum chemical analysis, endoscopy, and ultrasound studies. Early diagnosis and rapid treatment will usually allow the veterinarian to save the cat. ((GI Foreign Objects))

Most cats will need to be hospitalized and given IV fluids to correct dehydration and electrolyte disturbances. Once stable, surgical removal of the object(s) will be required. Direct removal of the object, removal of part of the intestine, or repair of any holes in the intestines will all be needed, depending upon the damage done by a given foreign body. Only at surgery can the exact best course be determined. ((Gastrotomy))

Post operative hospital care including fluids, antibiotics, withholding of food and water for several days, followed by a slow and gradual return to a normal consumption will be needed. It may be best to feed cats a bland and highly digestible food for up to 2 weeks post surgery. Once past the crisis, 100% recovery is possible for most cats.

Fortunately, stomach ulcers are uncommon in the cat. Ulcers are described as erosions, superficial or deep, in the lining of the stomach. Ulcers are not a primary condition, but may be caused by acute gastritis, chronic gastritis, foreign objects, drugs, stress, poisons and toxins, cancers or tumors, altered blood flow to the stomach, and (possibly) infections by Heliobacter, a newly identified cause of gastric ulcers. Kidney disease, liver disease and hypoadrenocorticism can also lead to irritation and ulceration of the stomach as well. ((Gastric Ulceration))

Cats with gastric ulceration may have symptoms related to some primary condition, but symptoms of the ulcers can include vomiting, which may contain blood, dark black stools, abdominal pain, poor appetite, loss of weight, fever, pale gums, weakness and collapse. Any cat having some type of chronic gastritis would be suspect for ulceration.

Diagnosis is based on history, physical examination, blood counts, serum chemistries, X-rays including dye studies, and endoscopy including gastric biopsy.

Besides treating any primary condition, some cats will respond well to feeding bland, easy to digest foods, and giving antacids or Tagamet. The drug sucrafate has been used with good results to coat and seal ulcerated tissues. Debilitated cats may need fluid therapy and even liquid nutritional support. Extreme cases may call for removal of damaged portions of the stomach, but this is rarely performed. Cats with Heliobacter infection may heal quickly and completely with simple antibiotic therapy.

Gastroenteritis and enterocolitis are mentioned here, not because they are different diseases, but because they are commonly diagnosed mixtures of other basic conditions. Because the digestive tract is connected from mouth to rectum, it is common for inflammation to be occurring in more than one area at a time. Hence, gastritis often occurs along with enteritis, and enteritis often occurs along with colitis. Because these conditions are most commonly associated with eating "people", "table" foods or garbage, veterinarians often use the name garbage-can toxicosis.

The common clinical signs of gastroenteritis include vomiting and diarrhea. These symptoms may be strong and frequent. If they continue, dehydration and abdominal tenderness will then occur. Besides the ingestion of foodstuffs not intended for the cat, bones, toys, sticks, grass and houseplants, internal parasites, and poisons and toxins can all produce this condition. Nevertheless, the most common cause of this condition is the owner giving the cat "just a little bit of..." or the cat helping his or herself to something left within reach. 

The cause of gastroenteritis or enterocolitis may never be exactly determined unless the owner admits to the offending feeding or knows of a specific toxic ingestion. Otherwise, diagnosis is based on history available, physical examination, fecal analysis, X-rays and blood counts.

In many cases, the offending substance will remain unknown or only supposed. Nevertheless, with proper historical and physical findings, good symptomatic treatment can and should be undertaken. Anti-vomiting medications and sometimes antibiotics are used to settle the stomach. Other medications are used to control diarrhea. Fluids are given if the pet has become dehydrated. Otherwise, symptomatic therapy is done as follows:

No food or water is given for a period of time determined by the veterinarian. Assuming that no vomiting occurs during this time, the pet will be given relatively small amounts of water or mild electrolyte solutions every 30-60 minutes. If these small amounts are held down and no vomiting occurs, the amount of fluids given at each interval is gradually increased until the pet is drinking normally.

Food is withheld until the cat is drinking and not vomiting, then as with the water, small quantities of a bland, low fat and highly digestible food is given every 3-4 hours and gradually increased until the pet is also eating normally. Some veterinarians will use mixtures of rice and boiled chicken, but we prefer special pre-made prescription foods. Cats that continue to vomit and do not respond well to this simple treatment generally have more serious problems and will often require IV fluids and further diagnostic tests to obtain a proper diagnosis and allow correct treatment.

Enteritis is inflammation of the small intestines. While foods or foreign objects can cause enteritis, more common an infection will lead to this condition. This includes many different types of bacterial infections including salmonella and camphylobacter, feline distemper, poisons and toxins, intestinal parasites of all kinds, histoplasmosis, stress and drugs. Intestinal lymphosarcoma can also produce acute or chronic intestinal disease. The severity of the disease and thusly the clinical signs produced varies greatly, depending on the agent causing the primary insult; thusly, specific individual diseases should be studied as to their role in causing enteritis.

Clinical signs in general include vomiting, diarrhea which can include blood in some cases, weight loss, loss of appetite, fever, increased amounts of stool volume, very watery stools, weakness, and collapse. Diagnosis is based on history, physical examination, stool analysis, blood counts and serum chemistries, specific tests for specific agents, X-rays including dye studies and endoscopy including biopsy. 

Methods of treatment will vary depending on which primary cause is present. In general, fluid and electrolyte therapy will be used to combat dehydration. Antibiotics will be used to control infection and sepsis. Anti-vomiting and anti-diarrhea medications will be used depending on the nature and severity of the symptoms. Medications to kill parasites may also be needed. If the illness is severe, then the cat will require hospitalization. Less severe cases may respond to outpatient therapy as follows:

No food or water is given for a period of time determined by the veterinarian. Assuming that no vomiting occurs during this time, the pet will be given relatively small amounts of water or mild electrolyte solutions every 30-60 minutes. If these small amounts are held down and no vomiting occurs, the amount of fluids given at each interval is gradually increased until the pet is drinking normally.

Food is withheld until the cat is drinking and not vomiting, then as with the water, small quantities of a bland, low fat and easily digestible food is given every 3-4 hours, and gradually increased until the pet is also eating normally. Some veterinarians will use mixtures of rice and boiled chicken, but we prefer pre-made prescription foods. Cats that continue to vomit or have severe diarrhea and do not respond well to this simple treatment generally have more serious problems and will often require IV fluids and further diagnostic tests to obtain a proper diagnosis and allow correct treatment. This will, again, generally require hospital care.

Lymphocytic/plasmacytic enteritis occurs when millions of lymphocytes and plasmacytes (these are types of white blood cells) infiltrate and line the small intestines. This is considered one type of Inflammatory Bowel Disease. The exact cause is not known but it is thought to be an abnormal immune response. LPE can also involve the colon and produce symptoms related to colonic dysfunction. Next IBD

Symptoms of LPE include chronic diarrhea that may contain blood and does not seem to respond well to any treatment. Loss of appetite, chronic vomiting, weight loss and enlarged lymph nodes are also noted. Diagnosis is based on history, physical examination, fecal analysis, blood counts, serum chemistries, X-rays including dye studies, and endoscopy including biopsy. The only way, however, to actually get a diagnosis is by performing an intestinal biopsy.

While it is difficult to cure this condition, control is possible if the proper treatment is provided. Feeding of high-quality diets that are either highly digestible, high in fiber or non-allergenic can be tried until the best results are obtained. Special types of antibiotics and cortisone drugs in various doses are often employed; some degree of lifetime therapy will be required. Vitamin therapy is also usually indicated.

Eosinophilic enteritis occurs when millions of eosinophils, a type of white blood cell, infiltrate and line the small intestine. While the cause is not understood, this may be a form of allergic reaction, including a response to food allergens or internal parasites. Eosinophilic enteritis is also considered a type of Inflammatory Bowel Disease and is relatively rare in cats. 

Clinical signs include vomiting, diarrhea that is chronic and may be dark or bloody. Weight loss and poor appetite will also occur. Diagnosis is based on history, physical examination, stool analysis, X-rays including dye studies, blood counts, serum chemistry and endoscopy including biopsy. Biopsy is the only way to obtain this exact diagnosis. Next IBD

First, all cats will need to be on some type of hypoallergenic diet, probably for life. Parasites should be eradicated. Cortisone and cyclophosphamide are often effective in controlling the inflammatory process. Long-term success is usually good with this basic treatment but will be needed for life.

Blockage of the small intestine can occur for many reasons. Those causes, other than from gastrointestinal foreign objects are covered here. String so swallowed, termed a Linear Foreign Body, will often "pleat" and badly block the intestines. Notwithstanding the cause, anything that blocks flow of material through the intestines will create a serious problem.

Obstruction can occur from either inside or outside of the bowels. Causes include tumors and polyps, including those on other organs which press against the bowels, obstruction caused by bowel thickening as in lymphocytic/plasmacytic enteritis, lymphosarcoma and other tumors, abscesses, Intussusception which occurs when one piece of intestine slips inside another piece and starts to decay, torsion where the intestine becomes twisted and strangulation when a piece of intestine gets stuck inside of a hernia. ((Intussusception)) 

The symptoms of blockage will depend upon the severity of the blockage and the location. Some blockages may not be complete, and thusly will produce symptoms that may make diagnosis difficult. Sometimes, the symptoms may come on in a slow and progressive fashion. Obstructions of the stomach and upper part of the intestines will cause repeated vomiting, dehydration, weakness and moderate abdominal pain. Obstruction farther down the intestine may not cause any vomiting but will lead to diarrhea that may become bloody, loss of appetite, abdominal pain, bloating and abnormal posture as if the cat is unable to be comfortable.

Diagnosis is based on history, physical examination which may reveal an abdominal mass, blood counts and serum chemistries, X-rays including dye studies, and ultrasound. As some cases come on slowly, the cat may be treated at first for other possible diseases that cause vomiting and diarrhea. The best rule-of-thumb is that if a problem is being treated symptomatically and the response is not good, there usually is a problem which has not been properly diagnosed, and further tests should be performed. ((Upper GI Study))

Most cats will need to be hospitalized and given IV fluids to correct dehydration and electrolyte disturbances. Once stable, surgical correction of the blockage will be required. Direct removal of a mass or growth, removal of part of the intestine, repair of any holes in the intestines, drugs or chemotherapy of cancers and so forth may all be needed, again, depending upon the specific type of obstruction. Only at surgery can the best course be determined.

Post operative hospital care including fluids, antibiotics, withholding of food and water for several days, followed by a slow and gradual return to normal consumption will be needed. It may be best to feed cats a bland and highly digestible food for up to 2 weeks post surgery. Once past the crisis, 100% recovery is possible for most patients.

When nutrients are not properly absorbed from the intestine it is called malabsorption.

Any dysfunction that alters the actual digestive process is called maldigestion.

Causes of maldigestion include pancreatic exocrine insufficiency, poor bile flow from the liver, increased stomach acidity, and bacterial infections.

Causes of malabsorption are usually diseases that thicken, block or destroy the intestinal lining tissues:

Lymphocytic/Plasmacytic Enteritis

Eosinophilic Enteritis

Giardia

Infectious Enteritis

Histoplasmosis

Internal Parasites

Lymphangiectasia

Bacterial Infections that can directly disrupt bowel function.

Idiopathic Villous Atrophy where the intestine lining withers away for no reason.

Loss of intestine from a prior surgery.

Lymphosarcoma of the intestinal tract.

Symptoms include weight loss or a failure to gain weight, chronic diarrhea that is often quite voluminous and rancid, undigested food in the stool, frequent and large bowel movements and an increased appetite. Diagnosis can be more challenging. Besides history and clinical signs, blood counts and serum chemistries, fecal analysis including digestive enzyme function, special stains during the fecal analysis, and fecal fat analysis are all needed. In many cases, special tests involving the feeding of certain (safe) chemicals and measuring the rate at which they enter the blood will be needed. Biopsy of the intestines may also be required for an exact diagnosis.

As with many other conditions, if an underlying disease can be identified and removed, the best results will be obtained. In most instances, feeding small, frequent meals of a low fat, highly digestible food is advised. Supplementation with certain vitamins, especially the B vitamin group is very important. In some cases the use of a digestive enzyme like viokase or pancreazyme will help. Drugs that slow intestinal flow such as imodium, paragoric and other medications to reduce straining may also be used. Long term and consistent treatment will be critical, but most cats can live a relatively long and healthy life.

PLE is an uncommon disorder characterized by loss of blood proteins into the intestinal tract. Many of the causes of malabsorption/maldigestion can lead to PLE. Certain uncommon defects can also produce this condition. Clinical signs include chronic watery diarrhea, weight loss, poor general condition, occasional vomiting, pale gums and possibly swelling of the feet, legs, and abdomen. Diagnosis is based on history, physical examination, blood counts and serum chemistries including protein levels, intestinal biopsy, fecal analysis and special tests to determine how food is absorbed in the intestine.

If a primary or underlying cause can be diagnosed and treated, then the chance for recovery is good. Primary intestinal defects, however, may be very difficult to control and cure is unlikely. Feeding low fat diets, vitamin supplementation, adding special fat supplements to the diet may all be helpful. The use of diuretics to control fluid retention and plasma transfusions to bolster blood protein levels may also be needed.

INTESTINAL PARASITES

FOOD ALLERGY

Colitis is inflammation of the large bowel or colon. It is quite common, most often brought about by some other offending substance that irritates the bowel. These include the ingestion of table foods or garbage, whipworms, giardia, foreign objects that do not block but that irritate the bowel allowing a bacterial infection to begin, food allergies, the eating of certain plants and systemic fungi. As the bowel becomes inflamed, mucus and blood may be produced and become present in the stool.

The clinical signs of colitis include diarrhea that will often consist of frequent but smaller stools that may be watery, mucoid and/or bloody. The cat may strain to defecate, which is often confused with constipation, and many cats show obvious discomfort. Fever, dehydration, abdominal pain, foreign objects in the stool and an increased need to defecate are also common symptoms. ((Colitis Diarrhea))

It should be understood that cats do on occasion pass blood in their stool for no apparent reason. This is called Idiopathic Hematochezia and is considered normal when sporadic and no other symptoms exist. Diagnosis is based on history, physical examination, fecal analysis, colonic cytology, fecal culture, X-rays and colonoscopy. Many cases of colitis may occur concurrently with cases of enteritis.

Most cases of acute colitis will respond quickly when properly treated. Treatment of intestinal parasites should be done if needed. Giving only liquids for 24-48 hour so the bowel can rest is very important. Then, gradual introductions of a bland, low fat and easily digestible food for a week or two works well. Antibiotics, anti-inflammatory medications, motility modifiers to slow diarrhea and fluids for dehydration also help these patients.

If a cat has recurrent or continuous bouts of colitis, changes in bowel function, alteration of the health of the bowel lining and ulceration are likely to occur. While many possible causes for this condition have been proposed, the exact cause of this inflammatory syndrome has not been determined. Dietary intolerance including food allergy, whipworms, histoplasmosis, inflammatory bowel disease and other more specific causes of colonic disease have all been implicated. Tumors and polyps may also mimic chronic colitis. In some cases no cause may ever be determined.

The symptoms of chronic colitis include chronic diarrhea which includes frequent defecation but passing only small stools, mucus and liquid consistency to the stools, blood in the stool, urgency to defecate, straining to defecate and pain upon defecation. Many cats will otherwise appear normal; a few may loose weigh, have a fever and be sensitive to touch. Diagnosis is based on physical examination, stool analysis, blood counts and serum chemistries, X-rays including dye studies, colonoscopy and colonic biopsy.

Many cases of chronic colitis respond well to the feeding of either a high fiber food or a highly digestible food low in fat. Cats should be on an extremely strict diet, as often any other food will stimulate the colitis. In some cases, special, non-allergenic foods work well. The use of antibiotics can be effective, as has metronidazole in some cases. While it is generally not advised, cortisone like drugs seems to help in a small percentage of cats. Some cats will benefit from the use of stool binders of various types.

Lymphocytic/plasmacytic colitis occurs when millions of lymphocytes and plasmacytes (these are types of white blood cells) infiltrate and line the colon. This will most likely occur in conjunction with lymphocytic/plasmacytic enteritis. This is also considered a type of Inflammatory Bowel Disease. The exact cause is not known, but it is thought to be an abnormal immune response. Next IBD

Symptoms of LPC include chronic diarrhea, which may contain blood, having frequent, small bowel movements, mucoid stools, and a poor response to any general treatment. Loss of appetite, vomiting, weight loss and enlarged lymph nodes may also be noted. Diagnosis is based on history, physical examination, fecal analysis, blood counts, serum chemistries, X-rays including dye studies, and endoscopy including biopsy. The only actual way, however, to actually get an exact diagnosis is by performing a colonic biopsy.

While it is difficult to cure this condition, control is very possible if the proper treatment is provided. Feeding of high-quality diets that are either highly digestible or high fiber or non-allergenic can be tried until the best results are obtained. Special types of antibiotics and cortisone type drugs in various doses are often employed and some degree of lifetime therapy will be required. Vitamin therapy is also indicated in most cases.

Eosinophilic colitis is an Inflammatory Bowel Disease similar to eosinophilic enteritis. Eosinophils, a type of white blood cell, migrate and infiltrate the lining of the colon and interfere with normal colonic function. While the cause is not understood, this may be a form of allergic reaction, including a response to food allergens or internal parasites. It is generally considered and abnormal immune reaction. Next IBD

Clinical signs include diarrhea which may be regular or come and go, blood in the stools, straining to defecate, frequent defecation, mucoid stools and small stool volume. Other symptoms will be present if this is an extension of eosinophilic enteritis. Diagnosis is based on history, physical findings, blood counts, fecal analysis, X-rays, colonoscopy and colonic biopsy.

First, all cats will need to be on some type of hypoallergenic diet, probably for life. Parasites should be eradicated. Cortisone and cyclophosphamide are often effective in controlling the inflammatory process. Long term success is usually good with this basic treatment. Treatment will need to continue for life.

Histiocytic colitis is another type of Inflammatory Colon Disorder, this time characterized by a special type of macrophage, a type of white blood cell, infiltrating and lining to colon. The cause is unknown but may have initiating factors similar to that of chronic colitis. Symptoms include a chronic, bloody, mucoid diarrhea similar to other types of chronic colitis. Other physical and diagnostic findings are also similar. Definitive diagnosis is by colonic biopsy. (see.. treatment of chronic colitis for treatment of this condition.)

HISTOPLASMA COLITIS: Colitis cause by histoplasmosis.

PSEUDOMEMBRANOUS COLITIS: Colitis caused by antibiotic damage to the colon.

TYPHILITIS: Colitis and irritation caused to the cecum, often caused by whipworms.

This is a non-inflammatory dysfunction of the colon that is usually associated with stress or stressful events. The symptoms include a sudden onset of diarrhea that may be mucoid, and in some cases, only mucus may be passed. Straining to defecate, frequent defecation and blood in the stool are also possible. Usually there are no other physical findings. Diagnosis is based on history, physical examination, fecal analysis, fecal cytology, colonoscopy and biopsy, and X-rays. ((Mucoid Diarrhea))

Most cats will do well with a combination of drugs. Mild tranquilizers or sedatives will help to reduce stress levels. Medications that alter bowel motility are also employed. Adding coarse wheat fiber to the diet has also proven highly beneficial in healing to colon although long term use of such may be required.

Pseudocoprostasis literally means "false constipation". In some cats, especially breeds with fine and/or thick coats, hair and fecal material may become matted and impacted onto the area around the anus; actually blocking the flow of feces from the body. Clinical signs will include straining to defecate and some decree of pain. Diagnosis is simple upon physical examination.

Cats may or may not need to be sedated because of the pain involved, and then clipping and cleansing the anal area, giving an enema if needed and using antibiotics and cortisone orally and/or topically to heal the associated irritation. Keeping the area clipped a little extra short should also help to prevent the problem.

In some cats, the colon can become grossly dilated and stop functioning normally, with large quantities of feces being retained in the colon. This is called megacolon. While megacolon can occur at birth in rare cases, most of the time, intestinal foreign objects, tumors or some other blockage of the colon will lead to chronic constipation and megacolon.

Clinical signs include repeated bouts constipation, failure to defecate for several days, straining and repeated attempts to defecate, loss of appetite, vomiting, depression, weakness, abdominal pain, and even possibly passing soft, mucoid and bloody stools on occasion. Diagnosis is based on history, physical examination, X-rays, fecal analysis and colonoscopy. ((Megacolon))

Upon initial presentation, most cats will need enemas and lubrication of the colon so that they can pass impacted feces. Some cats may require manual removal of the feces while under sedation. If the cat is weak and depressed, fluids and electrolytes will also be required. If an underlying problem can be identified and corrected, the megacolon may resolve itself. In most cases, long term use of bran or Metamucil in the diet, oral laxatives or lactulose can keep the pet defecating smoothly. Many cats, however, will need lifetime therapy. In extreme instances, all or part of the colon will need to be removed.

Fecal incontinence is a rare problem whereby a cat is unable to partially or completely control the passage of bowel movements. This often results in feces being passed while the cat is resting, or even while it is walking from place to place. Most cats suffering from this condition will have had anal/rectal surgery, or have advancing, degenerative neuological or muskuloskeletal conditions including cauda equina syndrome, degenerative myelopathy, and degenerative joint disease. The clinical signs are obvious, and diagnosis is based on this history, physical and neurological examination, X-rays and colonoscopy.

Most cases will not be well treated. Loperamide may work to enhance anal tone in some cases. Diets that produce fewer stools, a firm feeding schedule and frequent trips to the litter pan. Some cats have responded to spinal manipulation, acupuncture and surgery.

A rectal prolapse occurs when the inside of the rectum comes outside the body. This usually occurs after heavy straining during bouts of diarrhea, although constipation can also be causative. Many cases occur in kittens with heavy internal parasite loads or enteric bacterial infections. Older cats will prolapse secondary to megacolon, chronic colitis, FUS and colonic tumors. Clinical signs include a raw puffy swelling of variable length at the anus, straining to defecate, and pain upon defecation. Diagnosis is based on physical examination.

Assuming any parasites or infection can be dealt with, many times the prolapsed tissues can be pushed back into the body, and special sutures can be used to hold everything in place for a few days until healing occurs. Medicated ointment may also be needed along with a very soft or mushy food for a week or so.

In some more severe cases, the rectal tissues may be badly damaged or fail to stay in place after reduction. In these cases, surgical removal of the damaged tissues and suturing the healthy tissues back together may also solve the problem. After that, a week or so on a very soft diet and the use of stool softeners will be required so that healing can occur while the bowel heals in place.

A stricture is a restriction upon the rectum. Many times this will involve scar tissue that forms after some other disease or injury has occurred to the rectum or colonic areas. Strictures can also occur if fractures of the pelvic bones impinge upon the rectum/colon or after some type of rectal surgery. In all these situations, the flow of feces throughout the colon will be hindered. Clinical signs include difficulty in passing feces, straining and pain upon defecation, and even failure to defecate. Diagnosis is based on history, physical and rectal examination, X-rays, and colonoscopy.

In most cases, some type of surgery to open the stricture will be required. Soft, low-residue diets and stool softeners may provide symptomatic relief for some cats. Unfortunately, fecal incontinence can be a side effect of any anal/rectal surgery.

While obesity can hardly be considered a disease of the digestive system, other than that of the system working all too well, it is one of the major health concerns for cats in our country. It is estimated that over 40% of all cats qualify as obese. This means that their body weight is at least 15% above normal. The art of nutrition has progressed so well that even cats eating average quality foods get at least an ample supply of calories. Pets on premium foods are often overfed. Many owners choose to show their love for their pets in the form of tidbits and treats that also tend to be fatty. Some cats may feel they need to compete with other cats in the house and consume more food if not fed separately.

Obesity does become more common with age, after neutering or spaying, in certain breeds, and in female cats. Nevertheless, unless there is a metabolic disorder, most cases result from too many groceries consumed and too few calories burned (sounds familiar). How do we know it our cat is overweight? This is a common question asked of every veterinarian.

Since cats come in so many shapes and sizes, it is very difficult to give a one-size-fits-all weight. The best method is to use what is known as Body Score. Body score is a method of relating size and structure to proper weight. On a one-to-five scale, 3 is perfect, 2 is thin, 1 is dangerously thin, 4 is overweight, and 5 is obese. To be ideal weight, you should not be able to see your pet's ribs, but you should be able to feel the ribs with very light pressure on the skin over the chest. The abdomen should not hang down but rather, should be tight and slope up towards the hindlegs nicely. The spine should be slightly visible and there should be no fatty bulges along the back, hips and rump. (sounds familiar again)

As mentioned before, there are a few metabolic disorders commonly associated with obesity. These include hypothyroidism, hyperadrenocorticism and diabetes mellitus. More often, simply being overweight carries with it significant health risks. Obese cats live a life about 30% shorter than lean animals. The risk of heart disease, degenerative joint disease, diabetes mellitus, liver disease, anesthetic risks, infertility, and cancer are all increased by obesity.

If metabolic disease is present, it should be treated. Starting the cat on a high-fiber, low-calorie diet, fed twice a day in exact amounts as advised by your veterinarian, is a first step. Caution must be taken not to reduce obese cats too quickly. Complete cessation of any table treats or "kitty" treats should also be done. "Just a little..." goes a long way with small cats. Encouraging cats to play a bit more should also be tried. Just like with people, it seems to go on easy, but it doesn't want to budge when it is time to leave.

The peritoneal cavity is literally the inside of the abdominal cavity, but outside the organs contained therein. In other words, it is the area between the abdominal wall and the outside lining of the intestines and other abdominal organs. Peritonitis is inflammation and most commonly an infection in this area. This type of inflammation/infection is very serious as the process can quickly multiply spreading to the blood and other organs, leading to shock, organ failure and death.

The causes of peritonitis are diverse and numerous. Infections can be caused by wounds, penetration by foreign objects, uterine rupture as in pyometritis, intestinal damage followed by leakage of intestinal contents following surgery or after damage by intestinal foreign objects, or bowel rupture after an intussusception occurs. Other causes include rupture of the urinary bladder, uterine rupture during pregnancy, rupture of the gall bladder, or inflammation caused during bouts of pancreatitis.

Peritonitis causes symptoms of severe abdominal pain, fever, loss of appetite, weakness, collapse and death. Diagnosis is based on history that may lead to an assumption of peritonitis, physical examination, X-rays, blood counts, culture and cytology of abdominal fluids and surgical investigation. 

If peritonitis is suspected, rapid action is necessary to save most cats. IV fluids, general hospital care and large antibiotic doses are needed. Exploratory abdominal surgery to some degree will be indicated to 1. Determine the cause of the peritonitis if unknown, 2. To repair damage or specific problems as then indicated, and 3. To clean infectious materials from the abdomen.

The inside of the abdomen needs to be cleared of exudates and debris, usually done by putting warm fluids and antibiotics in the abdomen, suctioning them out and repeating the process several times. Sometimes a drain or drain tubes are left in the abdomen and further flushing is performed over several days. If the damage causing the peritonitis is repaired, and the pet recovers from the infection and shock, the long-term prognosis is good.

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