Diarrhea is an intestinal disturbance characterised by the rapid movement of abnormally loose or watery stools (feces). It is not a disease in itself, but a symptom of an underlying disease or disorder. It can affect the small intestine, the large intestine or both. It may be acute (sudden onset), chronic (over a long period of time) or come and go. There may be an increase in the number of bowel movements, an increased amount of feces or watery feces. Feces may also be yellow and frothy in appearance, be mixed with blood (known as 'dysentery') and/or mucus.
Acute diarrhea has a rapid onset and lasts less than 2 - 3 weeks.
Chronic diarrhea lasts longer than 2 - 3 weeks.  Blood and or mucous may or may not be present in the feces.
Diarrhea is a relatively common occurrence in cats and has a number of causes, some of which can be split into several categories:
- Food allergy
- Food intolerance, such as lactose in milk
- Dietary indiscretion (eating something he shouldn't have, such as garbage)
- Sudden change in diet
- Bacterial infection: Salmonellosis, campylobacter, E. Coli, tuberculosis, tularemia
- Viral infection: FIV, FeLV, panleukopenia, rotavirus, pseudorabies
- Protozoa infection: Giardia, cryptosporidium
- Parasitic infection: Liver flukes, parasitic worms such as roundworm and hookworm
- Histoplasmosis (disseminated): A rare fungal infection which usually affect the lungs, in some cases infection can spread throughout the body causing a number of symptoms including diarrhea
- Colitis: Inflammation of the colon
- Inflammatory bowel disease: A group of conditions in which different types of inflammatory cell invade the intestines
- Pancreatitis: Inflammation of the pancreas
- Hyperthyroidism: Caused by a benign hormone secreting tumour of the thyroid gland
- Kidney disease
- Liver disease
- Complications of diabetes
- Blockage: Hairball or foreign object
- Certain medications such as antibiotics, chemotherapy, antihistamines, steroids
- Exocrine pancreatic insufficiency: Failure of the pancreas to secrete appropriate levels of pancreatic enzymes which are necessary for the digestion of food
- Heinz body anemia: A type of anemia (reduced number of red blood cells) characterised by the presence of Heinz bodies on the red blood cells which leads to their destruction by the cat's own immune system
- Poisoning: Zinc, Ibuprofen, uremic, antifreeze, other
- Insect/spider bites or sting
- Anaphylaxis: An acute allergic reaction
- Malabsorption is an inability of the digestive system to absorb nutrients as it should, there are several underlying causes of this including inflammatory bowel disease, exocrine pancreatic insufficiency, blockage, bacterial overgrowth, parasites, certain cancers
Small intestine diarrhea: Volume is increased, frequency 2-3 times normal, no mucus, urgency may be normal to mildly increased. 
Large intestine diarrhea: Volume is normal to decreased, mucus and blood may be present, the urgency is increased and frequency is more than 5 times normal. 
Other symptoms may also occur depending on the underlying cause of diarrhea and may include:
- Loss of appetite (anorexia)
- Increased thirst (due to fluid loss)
- Flatulence (farting)
- Abdominal pain
- Blood, fat or mucus in the stool
- Weight loss
- Increased urgency to defecate and/or defecating outside the litter tray
Mild cases of diarrhea, lasting 24 hours or less, where your cat seems to be otherwise well can be watched carefully at home. As a precaution, take away your cat's food for 12-24 hours to see if the problem resolves. Water should be left out during this time.
Your cat should see a veterinarian for diarrhea if the following occurs:
If vomiting is also present
If diarrhea contains blood
If the diarrhea is black and/or tarry
If he also has a fever
If he is lethargic
If he appears to be in pain (hunched over, pain when touched)
If he is a kitten under 12 months of age
If he has pale gums
Your veterinarian will perform a physical examination of your cat and ask you some questions to determine if the diarrhea is acute or chronic? If there have been any changes to your cat's diet, possible exposure to toxins, other symptoms you may have noticed. The type and colour of diarrhea, along with accompanying symptoms as well as your cat's age can help your veterinarian narrow down a cause. For example a kitten is more likely to have eaten something he shouldn't, a senior cat is at greater risk of hyperthyroidism or cancer.
Tests will vary depending on other symptoms your cat is displaying, some tests your veterinarian may wish to perform include:
- Complete blood count to check for anemia, infection, inflammation.
- Biochemical profile to check for liver disease, kidney disease, pancreatic function, hyperthyroidism etc.
- Urinalysis to check kidney function and level of hydration.
- Multiple fecal examination tests (flotation, cytology, smear, zinc sulfate, culture and sensitivity) to determine if the cause is parasitic, bacterial, protozoal.
- FIV and FeLV tests.
- Thyroid test to evaluate for hyperthyroidism in middle-aged to older cats.
- X-Rays to check for blockage, foreign body or tumour and assess the internal organs.
- Ultrasound to evaluate for cancer or intestinal blockage and assess the internal organs.
- Endoscopy and biopsy. A thin flexible tube with a light and camera is passed into the stomach and small intestine to view these structures. A biopsy may be taken at this time.
- Colonoscopy and biopsy. Similar to the endoscopy, a thin flexible tube is passed into the rectum and colon to view the structures and take a biopsy if necessary.
Treatment naturally depends on the cause of diarrhea.
If the diarrhea is acute, and the cat seems otherwise fit and well, your veterinarian may choose to withhold food for a day or so. Water is still to be provided. After the fasting period, food may be re-introduced but this will usually need to be bland for a few more days.
- Gastrointestinal blockage: Surgery to remove the blockage or laxatives to help it pass.
- Colitis: Eliminate the cause where possible, switch to a highly digestible diet.
- Diet: Avoid switching types of food suddenly. If an allergy is the cause, gradually replacing his diet to a hypoallergenic type. Avoid dairy if lactose tolerance is suspected.
- Exocrine pancreatic insufficiency: Replacing enzymes with a pancreatic enzyme extract, feeding a highly digestible diet, antibiotics if necessary.
- Hyperthyroidism: Surgical removal of the tumour or radioactive iodine treatment to kill the tumour.
- Infection: Antibiotics for bacterial infection, anti-parasitic medications for worms and protozoan infection, supportive care for viral infections.
- Inflammatory bowel disease: Switching to a highly digestible diet, corticosteroids, immunosuppressive drugs.
- Kidney disease: Dietary changes to reduce protein and phosphorous binders.
- Liver disease: Supportive care such as nutritional care and IV fluids, surgery to treat portosystemic shunt.
- Neoplasia (lymphoma, carcinoma, and others): Surgery to remove the tumour if possible and/or chemotherapy to shrink it.
- Pancreatitis: Supportive care such as painkillers, anti-nausea medications and antibiotics if necessary.
- Poisoning is usually treated by removing the toxin (where possible) by inducing vomiting or pumping the stomach, supportive care is commonly necessary.
- Heinz body anemia: Treating the underlying cause, blood transfusions may be necessary for severely anemic cats as well as fluid therapy and supportive care.
- Anaphylaxis: This is a medical emergency. Administration of epinephrine (adrenaline) will be necessary. This counteracts the body's immune response. Supportive care will be necessary while your cat recovers.
- Diabetes complications: Treating the underlying cause and managing diabetes correctly with diet, proper insulin administration and regular monitoring of your cat's blood glucose levels.
- Histoplasmosis: Mild cases may not require treatment, severe infection will require anti-fungal antibiotics as well as supportive care.
- Malabsorption: Finding and treating the underlying cause is necessary such as pancreatic enzyme supplements for cats with exocrine pancreatic deficiency. Supportive care may also be necessary.
Your veterinarian may recommend your cat be fed Hills I/D for a short period. Hills I/D is low in fat, highly digestible and is specifically designed for cats with gastrointestinal disorders.
Other supportive care may include IV fluids to treat dehydration and anti-diarrhea medications.
If the diarrhea is mild and your cat otherwise seems well, you may wish to try treating it at home for a day or so, if symptoms persist or you notice other symptoms, seek veterinary attention.
Never give anti-diarrheal medications to your cat unless your veterinarian has told you it is safe to do so as many human medications are extremely toxic to cats.
Feeding a bland diet of chicken and rice (mix 1 cup cooked chicken breast with 1/2 cup cooked brown rice) or baby food (make sure it contains no onion or garlic, which is toxic to cats) for several days can help give the unsettled digestive tract a chance to rest and recover.
Lactobacillus milk or plain yoghurt:
Lactobacillus, a type of friendly bacteria residing in the intestinal tract of mammals (including cats). These bacteria protect the body against harmful bacteria which can
cause disease. This can be of help to cats with diarrhea, especially if they have been or are on a course of antibiotics which don't discriminate against good and bad bacteria. Giving lactobacillus milk can replace lost helpful bacteria.
Either cooked (steamed or boiled) or canned (not the pie filler type) may be of help in relieving diarrhea. Add 1 tablespoon to food, or plain, if your cat will eat it.
   The Feline Patient - Gary D. Norsworthy, Mitchell A. Crystal, Sharon K. Fooshee and Larry P. Tilley.
Updated 15th March 2017.