First off - and this is important
You need to know what is causing the kitty to have diarrhea. Do not blindly throw treatment options at a cat because it has diarrhea. I know - trust me I know - it is not fun and no one wants to deal with the aftermath so getting it fixed as soon as possible is everyone's first priority. I want you to remember the cat has diarrhea for a reason. Diarrhea happens to 'flush' the intestines of whatever is irritating it. It might be toxins, it might be parasites. It could even be a blockage or constipation. Get your cat to a professional, get a diagnosis. Treat the cause, not the symptom.
Second - and this is important too:
I am not a vet. I do not play one on the internet. I can tell you what I have done, the research I have read, the second-hand accounts (people I know who did things and had them work or not work) and I do my best to always check my source. Sometimes, when people say things so outrageously wrong, I don't, but for the most part I take what I read on the internet with a grain of salt until I can verify.
The major recommendations:
These are the things you will generally hear from 'people on the internet' when you ask for help with diarrhea.
- Pumpkin. Pumpkin is generally one of the first recommendations you will get and it is always followed by the caveat to not give pumpkin pie filling - which is actually VERY good advice. The cat does not need the spices and the sugar in the pie filling. If you ask me (and while you probably didn't, you are on my blog, so I get to tell you) pumpkin itself is not that good of an idea. The theory behind pumpkin is that the fiber in it will bind up the extra water in the colon and slow things down enough to give the body a chance to form a proper stool. Why people don't recommend plain fiber supplements, I'm not sure. Maybe because pumpkin is 'natural' or maybe because it is easy to get. Fiber supplements often come with a bevy of flavorings or additives that aren't safe for cats, so saying 'plain pumpkin' might just be easier.
Will pumpkin work? Sure, but it easily can make the whole situation worse. Cats, as obligate carnivores, can find plant-based ingredients very irritating to their system, and adding pumpkin can easily make things worse. This is not my first choice, not even within the top five.
- Dry Food. I am not 100% sure of the theory behind this one. I see it all the time. All.the.time. Some people say that wet food is 'too rich' for cats and causes diarrhea - but this is contrary to the cat's physiology. Cats, as desert creatures, are designed to get their hydration from their food, and when they eat a dry food diet they are generally chronically dehydrated even when they are provided an excellent source of water, even when they 'drink water regularly'.
I don't know about you, but when I have diarrhea my doctor tells me to get plenty of fluids. To put a cat on a dry food only diet when they have diarrhea seems contrary to all established medical precedent. And then there is the fact that dry food can actually be making the problem worse with all of its plant-based ingredients. I'd rather give pumpkin before trying this.
- Withholding food. Oh, so not a fan of this idea either. Mostly I deal with small neonatal kittens, even kittens as old as three or four months of age, and withholding food scares me. *Scares me* Kittens have so few reserves to begin with and generally they are already not absorbing many nutrients from their food since it is being pumped out nearly as fast as they can get it in. Withholding food goes against everything I know to be true about the health of your kitten. You risk dehydration and malnutrition. This one to me is a huge no. An adult cat who does not have a chronic history of diarrhea and a pretty clear cut case of it ate something it shouldn't have, maybe, but I know I'm not recommending it.
- Boiled meat with rice. This is an old home remedy for dogs. The point of this is to feed a bland diet, to try to combat any dietary indiscretion a dog might have had. Dogs appear to be more prone to pancreatitis by a single meal of something highly fatty or completely inappropriate and the theory is that a low-fat, bland diet will give the dog time to heal. No, just no. While cats do get pancreatitis, they need more than a 'bland diet' to treat it. Most of the time this is not the cause of a cat's diarrhea. Not to mention that rice, being a plant-based food, is inappropriate for an obligate carnivore. Might it work? maybe.. but I'm not recommending this either.
- Bismuth subsalicylate. Okay, you rarely hear anyone say this.. but you might hear Pepto or Kaopectate. Fortunately, this is falling out of favor as people learn there is now acetylsalicylic acid (aka aspirin) in these products now, and aspirin is very toxic to cats. It takes very little to do damage, so this is now a colossally bad idea.
- Yogurt / Probiotics. This recommendation usually accompanies pumpkin; mix pumpkin and yogurt up and give them to the kitty. There are some people who tend to be freaky about giving yogurt because cats are 'lactose intolerant' so usually when you see someone recommending yogurt you see someone else saying not to use it for that reason.
First off, not all cats are lactose intolerant. Second, the fermentation process of milk products to make yogurt consumes the lactose in the milk. Thirdly, intolerant simply means that they might develop some gas and diarrhea if they eat too much of it. You generally have to give a cat a lot of lactose for it to be an issue. Let's just say I wish this one would end. Would I give yogurt to my cat? Absolutely. Do I give it to kittens with issues? Yes... I will say it is nice that it is getting easier to find a full-fat plain yogurt (ten years ago it was near impossible) but these days I am more likely to just give them straight up probiotics. I have them at the house because I take them myself and it is just easier to open up a capsule and give them part of it and take the rest myself. There are even probiotics specifically made for cats if you prefer, although in general those are limited in their scope as they have only one strain of bacteria and when it comes to probiotics a wider variety of strains of bacteria are more helpful.
- Kaolin/Bentonite clay/Pectin. These are products that are designed to absorb the toxins in the body and expel them, which hopefully means the body can calm down long enough to realize they are gone and slow things down. Some of these were why the recommendation for Pepto and Kaopectate were so popular. I have used these, but I have found that they don't work nearly as well as I would like. To me, these are like the pill for the common cold, 7 days with the remedy or a week without. I am not opposed to them, I don't see the harm in giving them short term for a known issue. Know what their function is, though, and don't expect miracles.
- Slippery Elm / SEB. SEB is an herb from a type of elm tree that contains a substance called mucilage; a polysaccharide that becomes a gel when mixed with water.(source) I both like SEB and have problems with it because it is generally recommended that you give it on an empty stomach and give it time to work. This is something I have a very hard time doing with foster kittens. I have some in my cat supplies and I have used it even mixing it with the food, but it is not the first thing I reach for these days. I know a lot of people who use it on a regular basis and love it.
- Raw meat / raw diet. This is my current go to 'cure' for diarrhea in cats. I know I know.. it seems too simple, and too risky, and too strange, and too far against what the vet recommends.. I recommend it because I have seen it work 'miracles' in cats with diarrhea. Cases so bad that the stool leaks out of the cat when it is just laying down. Where the cat's legs are scalded from diarrhea and the cat is miserable. Where the anus is inflamed, where the cat is just wasting away. I don't remember the first time I gave a cat with diarrhea raw food to see if it would help, but I do remember the result. In about a day the cat was significantly better. I remember trying to get the cat back on commercial food after that and the diarrhea returned, so I kept the cat on raw for about a week and tried again and the cat was healed enough to handle it. I have had a half dozen or more situations that were similar. Sometimes they could get off it sooner, sometimes it would take longer for the cat to heal, but they all healed. No more rounds of metronidazole, no more albon. no more forcing medications down the throats of cats who already feel miserable and instead I am feeding them food they want to eat, food that their whole body was designed to eat.
When I make the recommendation of raw to people who are at the end of their rope, they often lament it is too expensive or too complicated, and to them, I say: get raw hamburger or ground chicken. I always say "Yes, it is not complete and balanced, but right now your cat isn't absorbing nutrients from their foods anyway, so give it 24-36 hours, give them two to three meals of raw meat and see what happens."
If there is not an underlying cause (and sometimes even if there is) they often see a dramatic difference in the cat. Even if you are unwilling to feed your cat raw food over its lifetime, this is worth trying.
I can hear you already, what about the parasites and pathogens we have been warned against? Okay, well there hasn't been parasites in the human food chain in a while now. Pork used to be an issue, but they have new biosecurity measures so trichinosis is less of an issue than it has ever been, but knowing your source, getting human grade meats (from your butcher or your grocery store) keeps that down to a minimum. Pathogens, yes. Ecoli and Salmonella are concerning, but not to a cat. Their stomach acid is so strong that it kills most everything it comes in contact with, and its digestive tract is short so the pathogens do not have time to multiply and become an issue. Again, knowing your source will keep this risk to a minimum too. No grocer or butcher wants to be known for selling contaminated meat. Good hygiene and raw meat handling practices keep contamination to a minimum and keeps any that does occur from multiplying and being an issue. Could it happen? yes. I won't lie.. it can. What you should know, though, is there are far more cases of bacterial contamination from commercial foods then there has been from raw.
Treating diarrhea in kittens is not fun, dealing with the aftermath and the consequences of cats who don't quite get how to not stand in the liquid pool after it comes out, so it is easy to become frustrated and annoyed at them, but remember it is not fun for them either.