This week Jet was brought in for a follow-up. Jet is a 13-year-old male cat with green eyes and a black coat to match his name. I have been seeing Jet regularly for the past six months, ever since his owner brought him in because of persistent diarrhoea. Jet suffers from nutritional malabsorption.

Malabsorption is the general term used to describe a condition where cats fail to fully absorb one or more type of nutrient found in the food that they eat. It happens mostly in the small intestine of the cat where most of the absorption should happen, but it sometimes also affects the large intestine.

A healthy cat will normally digest its food in three successive stages. The first is when the food is broken down into proteins, carbohydrates, fats, vitamins, minerals and electrolytes; the second stage is when the nutrients are absorbed and the last stage is when the nutrients are conveyed to the rest of the cat’s body to give it the strength to thrive.

Unfortunately, some cats do suffer a breakdown in their digestive system. The signs are quite pronounced but not easy to diagnose as malabsorption because there are so many other diseases or conditions that produce the same symptoms.

Symptoms may include persistent soft or watery diarrhoea, vomiting, flatulence, greasy or rancid stools or stools with undigested food in it. The cat may also display an increase in appetite but still steadily lose weight, or it could lose interest in food altogether. It may suffer from abdominal pain, sometimes accompanied by gurgling sounds in the gut or an unusual quantity of flatulence. It might also go to its litter more often and produce more stools than normal for the quantity of food it consumes. A cat suffering from malabsorption may also be depressed, have a dull lifeless coat and there may be signs of greasy fur around its bottom.

Even after malabsorption has been diagnosed, the question remains as to which nutrient or nutrients are not being properly absorbed by the cat’s body

Even after malabsorption has been diagnosed, the question then remains as to which nutrient or nutrients are not being properly absorbed by the cat’s body. The key to solving the riddle is often to find out what in the first place is causing malabsorption in the body. For example, food allergies or intolerances can cause an inflammation in the wall of the bowel. Once identified and eliminated from the diet, the cat usually starts to thrive again.

Malabsorption may also happen simply because of an imbalance of flora and fauna in the gut, which then interferes with the digestive process, or parasitic worms that damage the wall of the gut. There are also several forms of bacterial, fungal, viral or rickettsial infections that can be the underlying cause. Inflammatory bowel disease (IBD), which is also surprisingly common in cats, could also be a cause of malabsorption. A cat with an overactive thyroid may develop malabsorption because of an overactive digestive system. Other more complex diseases such as bowel cancer, liver or pancreatic disease can also interfere with the proper absorption of nutrients. For example, exocrine pancreatic insufficiency is a lack of sufficient digestive enzymes in the digestive tract, and that prevents the food from being properly digested.

Unfortunately, a good 30 to 40 per cent of elderly cats can suffer from malabsorption of protein, fats, vitamin B12 and vitamin E. So, if you have an elderly cat with any of the symptoms mentioned above, or a cat that seems to be losing weight for no reason whatsoever, you should take it to your veterinarian. Be prepared to give as much information as possible about its stools, as this will help the vet identify whether the problem is located within the small or large intestine.

Depending upon the nature of the case, your vet may decide to approach the problem by targeting the most common causes of malabsorption, with treatments such as de-worming, antibiotic or anti-inflammatory treatments, and maybe even probiotics to encourage good bacteria to flourish in the gut. If your vet suspects a food allergy or intolerance, a change in diet might be prescribed until the food allergen is identified. In the case of enzyme insufficiency, oral enzymes that aid the digestive process will be prescribed to be eaten with food. Other approaches may include blood tests, urinalysis, faecal analysis, thyroid function tests, bowel function tests, ultrasound, cytology (examination of the cells), biopsy, endoscopy or biochemical profiling.

The prognosis very much depends on the severity of the case.  Sometimes it is easily treated and may simply need a repeat prescription if symptoms flare up again. With more serious cases, it may be a case of giving the cat as comfortable a life as possible for as long as it does not suffer. Your vet will be happy to offer advice in this regard. What is important is that you follow your veterinarian’s instructions and attend regular follow-ups.

With Jet, his owners are well aware of the score. For the time being, his quality of life remains good, and it is easy to see that they will do everything they can so that he remains as comfortable as can be.

Dr Martin Debattista is a veterinary surgeon.

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