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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Cat
Satisfied Customers: 32783
Experience:  University of California at Davis graduate veterinarian with 45 years of experience.
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I have a cat who we got from the Cats Protection about 6

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I have a cat who we got from the Cats Protection about 6 months ago. They told us she was about 3 years old, she has lost one of her back legs which no-one knows how it happened and her mobility isn't great. When we got her we got told she has a "touch of diahorreah" but every test has come back clear. She has had bloods and scans done and everything has come back clear. Our own vet (who we know well and is amazing) told us they think she is nearer 10 years old, she is now on a special diet of dry gastro food, but she still has issues where she has really bad poop. Because of only having 3 legs she can get herself in a mess which upsets her when we try to clean her up. At the moment she is on steroids which seem to be doing good but a bad episode about once a fortnight upsets her (and us) as she seems ashamed of needing cleaned. Any advice appreciated

Aloha! You're speaking with Dr. Michael Salkin
I'm sorry that your question wasn't answered in a timely manner. A steroid-responsive diarrhea is likely to identify the presence of inflammatory bowel disease (IBD). It's not unusual for break-through symptoms to occur which might necessitate a dosing change or adding another drug such as the antiinflammatory antibiotic metronidazole to her steroid therapy. It's important to note that some IBD patients are also food intolerant and so her special diet of dry gastro food might not be best for her.
Food intolerance/allergy is addressed with prescription hypoallergenic diets. These special foods contain just one novel (rabbit, duck, e.g.) animal protein or proteins that have been chemically altered (hydrolyzed) to the point that Jazzie's immune system doesn't "see" anything to be allergic to. The over the counter hypoallergenic foods too often contain proteins not listed on the label - soy is a common one - and these proteins would confound our evaluation of the efficacy of the hypoallergenic diet. The prescription foods are available from her vet. There are many novel protein foods and a prototypical hydrolyzed protein food is Hill’s Prescription Diet z/d ultra (my preference). A positive response is usually seen within a few weeks if we’ve eliminated the offending food allergen. Food intolerance can arise at any age and even after our patient has been eating the same food for quite some time.
In summary, a dose change of her steroid, adding metronidazole, and/or seeing how a hypoallergenic hydrolyzed diet affects her are all reasonable considerations as you go ahead with Jazzie. Please respond with further questions or concerns if you wish.
Dr. Michael Salkin and other Cat Specialists are ready to help you
Customer: replied 2 years ago.

Thank you so much for your response - we were told the food we have is prescriptive it is Royal Canin gastro intestinal - I can't see anything else on the packet to tell you that may help, but please tell me where to look if it could help. I also have picked up from the Vet today some Royal Canin 100g pouches of wet food. I am not sure if it is a good idea to give her wet food or not? I only want to give her some wet food as she is desperate to mix with our other 2 cats (both of whom are on slight diets and so wet food) and the integration process has been slowed up because of her progress. Her medication is prednisolone if that helps?

Thank you for the additional information. The RC Gastrointestinal food isn't a presumptively hypoallergenic diet but, instead, a more highly digestible and low fat one useful for nonspecific gastrointestinal disorders. I won't argue with success if it helps Jazzie but it won't suffice for testing for a food intolerance as I outlined above.
Wet vs. dry food isn't the issue. Most of us believe that wet foods should provide the bulk of a cat's diet if only because these poor water drinkers benefit from the additional fluid intake.
Yes, prednisolone is the most common of the corticosteroids prescribed to address IBD in cats. Thank you for your kind accept. I appreciate it.
Please continue our conversation if you wish.
Customer: replied 2 years ago.

You are so helpful - thank you! But I am unsure where to go from here?Should I ask my vet to do food intolerance testing? She does drink a lot, but I have been told it is due to dry food diet, age and steroids....

I would first see if an adjustment to her prednisolone dose or adding metronidazole to the prednisolone will suffice to control her diarrhea. After all, the prednisolone appears to be effective - if not completely at this time. Should the above fail, it's reasonable to see if food intolerance testing is of value. Changing food can be a stressor in itself and so I don't jump to food test if a prior therapy has been of value and might just need a bit of tweeking. Her drinking a lot doesn't appear to be due to metabolic disorders because nothing showed up in her biochemical panel but oftentimes I can find things in the testing or tests that should have been run but weren't that others miss. Can you upload a copy of her test results to our conversation? I understand that you might not have a copy of the results at home but her vet should be able to give you one which you could scan into your computer and give me the link or you can photograph the page(s) and upload the images by using the paperclip icon in the toolbar above your message box (not if you're using the chrome browser) or by using an external app such as or

Customer: replied 2 years ago.

Hi and thanks again - we have a long and valued relationship with our vet and am not sure how to get the results without offending them. will try to get them for you as the happiness and welfare of our pusscat is more important

You're welcome. I understand your reticence. Why not say that you'd like to have a copy of Jazzie's test results to have at home to refer to compare with additional testing when performed in the future?
Customer: replied 2 years ago.

Hi there, I have the full history now from our vet by e-mail - is there an address I can e-mail them to as I don't have a scanner here?

You'll need to contact***@******.*** who will help you get that information to me. It can take up to 24 hours but I promise to reply as soon as I review it.
Customer: replied 2 years ago.

I have sent the records there - am a little disappointed reviewing them - I haven't seen them before but I feel a bit let down......

I'll keep that in mind when I review them!
Thank you! The test results are unremarkable but I don't see a biopsy report - something I really, really, need to see. There was a comment about a "reactive lymph node and lymphoid tissue" but no pathology report.
Customer: replied 2 years ago.
I am going to struggle to get that without offending my vet. Jazzie had another moment last night where she walked past the litter tray in the bathroom and pooped on a towel that was left on the floor. It was semi-solid, but the tray was clean and I have no idea why she did that. I have litter trays all over the house - my other 2 cats use their trays in a porch but I have kitten sized (lower sides) ones in the en-suite, the living room and the sunroom which the other cats don't use so are exclusively hers. She usually uses them but I have on occasion found dried up poop in random places although not for a long time
I understand. This doesn't sound like a litter box problem but, instead, marking behavior. I have advanced training in feline behavior. Please peruse my synopsis of this behavior in cats. I must admit that retraining her is going to be a challenge but perhaps after reviewing my notes that I use when lecturing about her behavior you'll have a better idea of how to address it.
Jazzie is clearly exhibiting marking behavior. She is not likely to be eliminating inappropriately due to litterbox aversion or a medical disorder. Marking on a horizontal surface (the towel) is marking behavior (a communicative function) caused by the same stimuli that causes spraying. We’re not sure what cats are trying to communicate to us but we do know that wild cats will mark to announce their presence. It’s reasonable to assume then, that Jazzie is doing so as well. She's essentially "taking ownership" of these areas. The most common cause is increased cat density - in the home or nearby. Emotional problems, such as a stressful relationship with a family member, separation anxiety, anxiety over her status in the existing hierarchy, fear, owner absence, moving, new furniture, inappropriate punishment, teasing, household changes and remodeling in the home are examples of stimuli that can induce anxiety in our cats. The etiology can be difficult to diagnose, especially if the behavior is only manifested intermittently and because the stimuli for her inappropriate eliminative behavior may be imperceptible to you but readily so to her - another cat roaming outside, e.g. If emotional factors are influencing the housesoiling, you might notice other changes such as avoidance, aggression or an alteration in her general temperament.
Treatment involves two major considerations: 1) Remove the cause - easier said than done. You might have to be quite the detective to discern the stimuli for her inappropriate eliminative behavior 2) Prevent her from returning to previously soiled areas by confining her to a very small area with the box and only allowed out when she can be supervised 100% of the time. When confined to a relatively small area, most cats seem to prefer to eliminate in the box rather than soiling the floor. It’s then a matter of confining her long enough for a consistent habit to become established. As a rule of thumb, one week of confinement is usually recommended for every month of soiling. Jazzie should be removed from the confinement area as much as possible for socialization and play, but never allowed out of sight. Food rewards may help when given after she uses her box. If she refuses to use the litterbox when confined to a small area, the confinement area should be changed to a large cage. The floor should be covered with litter, forcing her to use it for elimination. The litter is gradually removed and replaced with a litterbox. Once she has used the litterbox in a confined area for an appropriate amount of time, she can be allowed to have more freedom in the home. Previously soiled areas can be safeguarded by changing the behavioral function of the area by placing food bowls, cat bedding or toys in the area. The area can also be made unacceptable for her by placing a motion-activated alarm or lemon-scented room deodorant in the area. Plastic carpet runners can be placed upside down with the "feet" facing up. Plastic, foil, or double-stick carpet tape can be used to protect specific areas. Removing urine and stool odor is important. Products such as Nature's Miracle which are specifically formulated to work on these types of odors are recommended.
Some cats are extremely sensitive to changes in their environment. They may mark in response to the most minor of alterations. You must strive to keep the home environment as constant as possible. When situations exist that are likely to upset her, you might want to consider confinement, closer supervision and the use of anxiolytic (anti-anxiety) medication such as paroxetine (Paxil) and fluoxetine (Prozac). In fact, most behaviorists feel that without the use of psychotherapeutic drugs our chance of correcting inappropriate marking behavior is near nil. (Personal note: My two cats began marking as kittens. After 6 months of fruitless treatment they became outdoor cats - for 12 years.)
Nobody wants to confine their pet as I've described and if her marking isn't frequent and still tolerable you don't need to take desperate measures. My male urinated on my pillow while I slept - an obvious behavior designed to make sure that his sister and I knew who's bed it really was. He apparently was anxious about his status in the hierarchy of my home.
Success in management with psychotherapeutic drugs is measured by a 70% reduction in adverse events. In other words, if my cat urinated on my pillow 10 times monthly prior to drug administration but only 3 times monthly after drug administration, success in treatment is acknowledged. Needless to say, that didn't please me and I certainly hope that you have better "success" than I.
Please respond with further questions or concerns if you wish.
Customer: replied 2 years ago.

Don't you think that this is related to her diahorrea problem? We were as good as could be at introducing her to our other cats and they all get along ok. We used a child gate and did everything by the book. Even our little hunter Ciara sleeps within a foot of Jazzie. They are very comfortable with each other and have no arguments. The issue the other day was when I was at home and there was nothing to make her react that way.

I cannot give praise for good behaviour via food as I cannot give her treats.....

She can eat, sleep and play with the others and so we don't feel any stress around the house.

We have integrated a few cats into our house and although I see what you are saying about her behaviour I honestly don't believe there are any stress reasons for it

Yes, associating her box with the discomfort of having diarrhea is a consideration. I can't ignore marking behavior, however, which is greatly overrepresented in a multicat household. Cats aren't necessarily visually antagonistic to others when stressed. Submissive cats may only become anxious and anxiety underlies that behavior.
If only they could talk. I tried a shrink's couch but they simply curled up and went to sleep.
Customer: replied 2 years ago.

I don't know how you feel about Jackson Galaxy, but we have taken on board loads of his ideas when we integrate cats. Jazzie is very confident with the other 2 and has even pushed our fat boy out of the sun so that she can lie there. I have moved our cat tree so that the most dominant of our cats loves a different room now. I understand that people don't always get cats but I think we are pretty close. I just want her problem poop to stop so that she isn't upset - the worst thing for me is when she gets herself in a mess.

It seems that you're going to need to better control her (presumptive) IBD/food intolerance for her to stop associating her GI discomfort with her box. This can be done by the measures I outlined earlier. In fact, even if there were a behavioral component to her behavior, it shouldn't be addressed until medical problems are managed as well as possible. I understand your frustration at this time. There's even a risk that she has "learned" to avoid her box at this time and it will be difficult to "unteach" her.