In straightforward cases like a cat bite abscess, torn dewclaw, or flea allergy dermatitis, getting from diagnosis to discharge can be relatively simple. But when you’re faced with a feline patient showing chronic signs—persistent weight loss, intermittent vomiting, or prolonged diarrhea—the path to a definitive diagnosis becomes less certain.
With chronic cases, even small details can make a big difference in finding the right treatment path. You may wonder if you’re asking the right questions, choosing the appropriate diagnostics, or overlooking a potential red flag that could impact your patient’s outcome.
In these cases, a veterinary clinical decision support tool can be particularly useful in helping you organize your approach and navigate each step confidently.
In this blog post, we’ll explore how a clinical decision support tool like Plumb’s Pro™ can streamline your decision-making process as you work through a case of chronic diarrhea in a cat.
Meet Your Patient and Pet Owner
Today, you’re seeing Kevin, a 14-year-old neutered male domestic medium hair cat who has been having diarrhea for the last 3 months. Yesterday, his owner, Claire, noticed his stool appeared almost black. Kevin is also eating less than usual and has been losing weight.
Despite these issues, Kevin is drinking and urinating normally. He’s on a free-fed chicken-based kibble diet from the grocery store. Claire mentions that Kevin vomits occasionally, though she hasn’t noticed any recent changes in frequency.
On further questioning, Claire confirms she hasn’t seen any frank red blood in Kevin’s stool or noticed him straining to defecate.
She also mentions that he has always seemed healthy and hasn’t seen a veterinarian since she adopted him as a young adult. He’s not up-to-date on vaccinations or parasite prevention, and he is an indoor-only cat with no other pets in the household.
On physical exam, you find that Kevin is underweight, with a body condition score of 3.5/9. He has a poor hair coat, hinting at underlying issues. His heart rate, respiratory rate, and temperature are within normal limits, but his small intestinal loops feel ropy, and he seems mildly uncomfortable on abdominal palpation. Otherwise, his physical exam is unremarkable.
Double-Check Your Steps With Practical Veterinary Guidance
Given Kevin’s history of chronic diarrhea with weight loss, appetite changes, and possible melena, you suspect small intestinal diarrhea. However, with a complex presentation like this, you want to be sure you’re not overlooking any critical details in Kevin’s history.
To ensure you’re on the right track, you turn to Plumb’s Pro™ and open the Dx & Tx monograph on small intestinal diarrhea. Reviewing the clinical history section helps you confirm that you’ve gathered all the relevant background from Claire.
As you review the questionnaire, you confirm Kevin has no history of stool issues, medication use, or specific diet trials, and there have been no recent changes to his diet—no new treats or table scraps introduced. With each confirmation, you feel more assured that you’re piecing together an accurate picture of Kevin’s case, and you’re ready to move forward with confidence.
Find a Clear Path Through Veterinary Diagnostics and Treatment
Now that you have a solid understanding of Kevin’s history, it’s time to decide on your next steps for diagnostics and treatment. To make sure you’re covering all your bases, you turn back to Plumb’s Pro™ and open the algorithm on chronic diarrhea in cats.
The author recommends fecal smear and flotation, CBC, serum chemistry profile, urinalysis, and a thyroxine test, as well as treatment with a broad-spectrum anthelmintic agent.
With Claire on board to proceed, you return to the treatment and management section of the Dx & Tx monograph to select a broad-spectrum dewormer. You see fenbendazole listed as a recommended option, so you review the drug monograph for dosing specifics and use the built-in conversion calculator in Plumb’s Pro™ to calculate the correct dosage.
Support Pet Owners With Clear Recommendations and Practical Guidance
To help Claire feel prepared to manage Kevin’s treatment at home while you wait for laboratory results, you print the fenbendazole drug handout. As you walk her through the handout, you emphasize important points like proper storage, potential side effects, and what to do if she misses a dose.
When you receive the laboratory results the next day, they’re mostly unremarkable—aside from a stress leukogram and hemoconcentration.
Since Kevin’s results don’t point to a specific disease process, you revisit the Plumb’s Pro™ algorithm to figure out the next step in your diagnostic approach.
You contact Claire to recommend measuring serum cobalamin, folate, feline trypsin-like immunoreactivity (fTLI), and feline pancreatic lipase immunoreactivity (fPLI) levels. Claire agrees to proceed.
When the results come in, you see that Kevin’s fTLI, fPLI, and folate levels are normal, but his cobalamin levels are low. You consult the algorithm again and discover that this suggests distal small intestinal disease. The author recommends cobalamin supplementation and a dietary trial as the next steps.
Finalize the Details and Develop a Follow-Up Plan
You consult the cobalamin drug monograph in Plumb’s™ for dosing guidance and potential side effects. To help Claire understand what to expect with treatment, you email her a copy of the drug handout.
Claire opts to bring Kevin back into the clinic weekly for subcutaneous cobalamin injections over the next 6 weeks, after which she’ll bring him in as needed every 1-2 months for maintenance.
You read in the Dx & Tx monograph that novel protein diets are an appropriate first choice for dietary trials in cats as they are generally more palatable. You start Kevin on a novel protein diet, emphasizing the importance of a strict diet trial and letting Claire know you’ll follow up during his cobalamin injection appointments to monitor progress.
If Kevin doesn’t show improvement after the diet trial and cobalamin supplementation, you know the algorithm will guide you through the next diagnostic and treatment steps.
With Plumb’s Pro™, you’ve got all the support you need to confidently approach any case—acute or chronic. To see Plumb’s Pro™ in action, watch a free on-demand demo.