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The Chronic Diarrhea Dilemma Continues

Clinician's Brief (Capsule)

Internal Medicine

April 2014

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Cats with GI disease have shown increases in Clostridium spp and decreases in Bifidobacterium spp, Lactobacillus spp, and Bacteroides spp. This may be influenced by dietary changes—including those in fermentable fiber. Fifteen adult cats with chronic diarrhea were divided into 2 groups, each fed 1 of 2 different therapeutic diets as the sole diet for 1 month. The groups were then switched and fed the alternate therapeutic diet for 1 month, with 3 weeks to adapt to the new diet. Fecal microbiome was assessed using 454-pyrosequencing before and after dietary changes. Significant improvements in fecal score (FS) and significant changes in GI microbiota were noted with both diets. In addition, significant associations were found between the microbiome and FS. Bacteria with the strongest correlation to FS included Coriobacteriaceae Slackia spp, Campylobacter upsaliensis, Enterobacteriaceae Raoultella spp, Coriobacteriaceae Collinsella spp, and bacteria of unidentified genera in the families of Clostridiales Lachnospiraceae and Aeromonadales Succinivibrionacease, suggesting increases in these bacteria may be important to gut health. More studies are needed to determine whether improvement resulted from altered microbiome or the altered microbiome resulted from improvement in the diarrhea. Study supported by Nestlé Purina PetCare.

Global Commentary

Very few companion animal veterinarians have not been frustrated by the diagnosis and treatment of chronic diarrhea in cats. Once infection, parasites, intestinal lymphoma, and inflammatory bowel disease have been ruled out, what next? We have known that about 25% of chronic diarrhea in cats can be influenced by dietary change, but reasons for improvement have been unclear. Was it decrease in dietary sensitivity, improvement in intestinal dysbiosis? Many diseases and syndromes in humans are now associated with disruptions in the intestinal microbiome; to this we can add chronic diarrhea in cats and the fact that dietary change may have positive and measurable influence.—Colin F. Burrows, BVetMed, PhD, Hon FRCVS, DACVIM


Fecal microbiota of cats with naturally occurring diarrhea assessed using 16S rRNA gene 454-pyrosequencing before and after dietary treatment. Ramadan Z, Xu H, Laflamme D, et al. JVIM 28:59-65, 2014.

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