Diagnosis and Management of Chronic Diarrhea in Pets

Chronic diarrhea is a common complaint among pets, and its diagnosis can be challenging due to the numerous potential etiologies involved. As veterinarians, it is essential to employ a comprehensive diagnostic approach to identify the underlying cause of the diarrhea and initiate appropriate therapy.

A thorough history, physical examination, complete blood count, serum chemistry profile, urinalysis, and fecal examination are crucial components of the initial work-up. Fecal examination should include standard fecal flotation, wet-mount preparation, and stained cytology to rule out parasites and other infectious agents.

If the initial evaluation fails to provide a clue as to the etiology, a specific gastrointestinal (GI) evaluation is necessary. Addison's disease, liver disease, and renal disease are just a few examples of systemic or metabolic diseases that can be associated with secondary GI involvement.

Inflammatory bowel disease (IBD) is another common condition diagnosed in dogs and cats. However, it is essential to note that IBD does not describe the etiology, nor does the extent of inflammatory cells parallel the severity of clinical signs.

The potential etiologies of chronic diarrhea are extensive, including parasites, dietary intolerances, metabolic disease, pancreatic disease, bacterial causes, and inflammatory bowel disease. Therefore, a basic approach in the work-up and clinical management of a chronic diarrhea case involves considering these various possibilities and determining if the diarrhea is primary GI disease or secondary to other systemic or metabolic disease.

In many cases, this initial evaluation will determine if the etiology of the diarrhea is predominantly of small bowel or large bowel origin. A comprehensive understanding of the underlying cause of the diarrhea is essential for the development of an effective treatment plan.

By considering these various possibilities and employing a thorough diagnostic approach, veterinarians can provide important practice tips for diagnosing and managing various gastrointestinal disorders associated with diarrhea in pets.

Gram negative rods in stool