I have 2 cats that have loose stools, it's almost as though they had bowel disease like some humans do. When I wake up in the morning, I'm always certain that I will find loose poop somewhere on the floor, they don't even make it to the litter box. One has had this for years, the other about 6 months now. I do not know what to do with this problem except to clean it up, the cats do not seem to be in any pain and they are not shy about pooping when they have too.

We have something in common. We are both experts with poop. I bet you know more ways how to effectively clean poop out of floors, carpets and crevices than you ever wanted to know. I have one client who told me the most effective way to clean poop out of her type of carpet was to let it dry first, then spatula it up second. I don’t know if that works…never tried it.

Ok, lets gross everyone out first. Here is the bristol poop chart:

If you weren’t grossed out yet, check out the nestle purina poop chart (ahem…fecal scoring system):

From your description, I'm guessing your a 5 or a 6 on either chart. Maybe a 4 on a good day. Well, at least your cat is. Probably not a 7, as it’s difficult for a cat to pass #7’s for a long time without being in some sort of distress, which your cats are not as you have described.

Here’s the thing about poop. The part of your intestinal system that makes the poop has only so many ways to react to a problem. Your colon is kind of like anger from the movie inside out. It’s very binary. No matter what the situation is, your eventually going to overflow or shut down. So there can be many things that cause chronic loose stools, yet it all can look the same on the outside.

So, when dealing with chronic loose stool (chronic means it’s been going on for more that 2 weeks), I'm a pretty regimented guy. I know that unless I cover all the bases, I will be a fooled by the poop. MANY people have been fooled by the poop. As in “we already switched the food, did the fecal test and it made no difference” This is fooled by the poop! We got to be really strategic, and even repeat steps to not get fooled.

Here is what I might do, assuming your cat’s are otherwise healthy and thriving, with no vomiting or weight issues. The diarrhea primer:

Deworm them. Again. I know you’ve done it already but do it again. Trust me on this. Because even if a parasitic infection is not their main issue, it is a contributing issue and will potentially mask the benefits of things you try that actually work! Nothing more frustrating than that. Im often using droncit and/or fendbendazole at doses that eliminate Giardia (a protozoal parasite). It has to be at the right dose to eliminate the intended parasites. Remember, deworming is a process, not a single event. You gotta sequence the medications with the life cycle of the parasite. Which is why you often need to treat every two weeks for 6 weeks or so. It's not me trying to sell you more crap, honest (ha ha ha...sorry the poop jokes never end).

Remember, deworming is a process, not a single event. You gotta sequence the medications with the life cycle of the parasite.

If you get lucky, deworming works. Most often, you have just removed a confounding factor. So next, I want to know if my patients are Tylosin or Metronidazole responsive. Why? First of all, many cats are, and it works fast (often within 3 days). People do not come see me, and pay hard earned money for the slowest solution. So out come theses medications pretty quick. So both the cat and the people get some relief. Why else? It’s a test. Whether it worked or not, I know quickly have an idea of what your cat’s gut is up to and where I need to search next. See, the gut can only react so many ways, and now we are making it talk by knowing the response to either or these medications! You need the right dose - I want the right dose of tylosin to get rid of cryptosporidium and clostridium. It's just as important to have the right dose of metronidazole. These medications have a wide dosage range, so im using specific doses for specific reasons. If it works, and then the diarrhea returns when you take the medication away then I'm starting to suspect inflammatory bowel disease…which leads us to food.

Most people have already changed their cats food several times before they come see me, if they diarrhea has been going on quite some time. They tried the chicken, the beef, the duck, and it doesn't work. Then they tried the more expensive hypoallergenic one. And it didn't work. Ok, two things I want to accomplish with food. First, I want a clean, non-contaminated food that is guaranteed not to have residues of other diets in the can or bag. See, it might say chicken or beef on the bag or tin, or be marketed as hypoallergenic, but unless it’s manufactured to a certain specification, it can have mixtures of other diets in there. It’s why I'm a big fan of Rayne Clinical Nutrition and other diets that manufacture to that sort of spec. I pretty much want some good proteins and fat sources, with limited carbs if I'm trying to determine if a cat has food intolerance or food allergy. Both of which can cause loose stools. Do they get better in a few weeks? Probably food intolerance. But it can take a month or longer to see the effect of food if its related to a hypersensitivity. So many folks might have had them on the right diet…but didn't stick with it long enough. There is a lag time for the gut to catch up and heal. Or we didn’t get rid of the confounding parasites. Frustrating, I know. Sometimes you need to switch gears, and go for a high fibre approach with the food. Sometimes you are adding in probiotics. Some folks go for herbals here.

Fecal tests are important, but be prepared for a bunch of them to come back negative. It’s not every sample of poop that’s going to yield enough organism to make a call. Im also going to do something called a “diarrhea panel”, that will tell me about salmonella and other bacterial overgrowths.

Nothing working yet? I would want my “minimum database” for this kind of problem. A CBC, Biochem, TLI, FPLi, and cobalamine and folate. And Thyroid. And why not Xray and urine if those others didn't quickly clue us in. Cha-ching. I know, I dented your wallet. But this chronic diarrhea is now denting my brain, and I need the info. Because many internal illnesses can play with the gut and cause those 5, 6, 7 type stools. Sometimes here is where you get your answer that you have a small intestinal bacterial overgrowth, suggesting inflammatory bowel disease. Great! We can treat that! Maybe the pancreas isn’t helping out to digest the food properly, or that the thyroid was really high and causing havoc. We can treat that too! Or the calcium is high or blood protein level is low and that means we’e got to dig a bit further. Ughh! And the specialist I might call would really want to make sure they are FelV and FIV negative too if nothing is working. Before they suggest ultrasound or GI biopsies for cat’s that are beginning to become unhealthy.

All of that is to explain is why it’s a crapshoot (ha ha ha) when someone tries or recommends something for your cats diarrhea, and it worked for them and not for you. It’s diarrhea, but so many underlying confounding factors. So getting back to your cats. Since both of your cat’s have the soft stool, I would deworm and eliminate parasites like there was no tomorrow. As I described above. No half ass approach (ha ha ha…sorry). Then figure out if they were tylosin or metronidazole responsive. Then food/probiotic change. Sometimes you need combinations of all the above. It would be strange if they both had developed some awful infiltrative intestinal issue at the same time (i.e. lymphoma).

Finally, make sure you have more than one litter box. Two or three would be great. Behaviourally, there is probably some litter box aversion going on (it’s probably diarrhea land mines all over), especially since they can be bathroom Diva’s. Extra boxes will help.
Good luck!

Dr. Kris