Constipation and Diarrhoea

Oh, good afternoon if you're in the UK. Good morning if you're over in the US. You've got the gorgeous kittens of Dr. Amaya, who's joining us from FelVet. Thank you again to Julianne, who's joining us from Naturally Cats, and myself, Brendan Clarke, from Raw Pet Medics. We are here to bring you an interesting show today. Some people said it should be called The Shit Show. Some people said it should be Problems with Poop. And then we had the sensible side of things from Amaya, who said, please be professional.

Yeah, that was—

I'm going to be juggling kittens. I don't care what you're talking about.

I'm distracted.

Welcome all. Welcome to Dr. Judy's page as well, who's in the early morning. Remember, you can watch this and rewatch this anytime on catch-up. Just follow the link below the advert. We've got an interesting one today because we often get asked about, my cat is having some problems with the litter tray. They're in and out all of the time. And I think it's really useful to have Juliane sort of maybe quizzing us on what she would perceive as an issue that might be totally different to what we would come at clinically. So please, if you've got any comments, if you're joining us on YouTube, then we will see you live, all of us. If you are joining us on Facebook, bear with me because I've got Facebook open separately. Just so that I can actually see you. So welcome, Julianne. What's been happening? Tell us what's going on in your diary.

Wow.

My diary— Amaya's— she's been all consumed with the kittens. I've been consumed with parasites. So we've had fleas started to come home. Yeah, fleas and ticks in our house. So I've gone to my natural remedy first, which is a mixture of green clay powder and neem oil mixed together. Put on the inside of the boys' collars, um, to try to deal with it. But I've just had cuddles with baby Max and there was a flea in his butt fluff, so I'm like, well, that's not working. So, uh, yeah, the plan is this weekend to look at other ways to deal with fleas and ticks. Um, so that— that's my world. It's not really as exciting as Amaya with the kitten.

Well, I had— that's what I'm gonna remember from today.

I had fleas and ticks too. I had them I came full of them.

That's all I could hear through whatever Julianne was saying.

That's my rest. That's my resume for the day, for the week, for the month actually. But it's ending because I, I'm, I'm getting back to work again normally. On Saturday because she's adopted now and I can get my life back again. But I really honor all those people that actually rescue kittens and take care of them because you don't have a life when you have this. If you want to do it, well, why would you want a life?

That is the life. That is the dream. Just surrounded by kittens.

If If you get paid for that and you get, you know, a home full of kittens, I'll be happy, the crazy cat lady forever. But if you want to juggle things up, it's like, should I be a mother or am I just the way I am right now? So I had many questions this past month.

Wonderful, wonderful. What about you, Brendan? Heidi Dixon, who's joining us on Facebook, and Nicola, hi as well to Patricia, it's great that you could join us on YouTube. Please do fire any questions if you've got, you know, anything there. June, Millie, all of you guys joining, it's great that you're still with us and it's always appreciated. So where should we start? I think, Julianne, you've got to start us off here as to what we should be talking about.

Yeah, I think that's a good point. So I will run the show today and So I think what, what we— where I'd like to start is, you know, people— my experience of problems with constipation and diarrhea, despite my own two cats, are, you know, clients coming to me from a behavioral perspective. So, you know, the cat is pooping outside the litter tray, and, you know, guardians a lot of the time will go to, I must change the litter, or, or— and I'm like, no, no, you know, we need to take a step back actually and try to understand why is the cat having that physical response, you know. So I think there is the two-pronged approach almost to dealing with, you know, issues with elimination, because we can come to you guys, come to the vets, and say there's a problem with the poop. But there is also the other part, which is the behavioral, emotional toll it takes. And my experience with Pickle, my cat before Leo and baby Max, she had a lot of problems with constipation, a lot of problems. She was on lactulose. We tried different foods. We ended up bringing in some wet to complement her raw because I was worried, you know, I didn't know as much as I do now. I was worried that we didn't have the ratios right. So, so let's start with constipation because I've got experience of that. And let's— can we talk about, you know, some of the reasons why that happens? So for me with Pickle, I was kind of like, maybe she's old, you know, maybe she's dehydrated. I didn't understand or didn't go into enough of the physiology of it to understand more of it. So I just, at the time, this was many years ago, went to the vets and said, she's having problems pooping. We were given lactulose, you know, and I changed the diet. I tried to do things at home. So let's come to you first, Brendan. Like, what, what has been your experience with constipation? And can you talk a bit about why some of the cats come to your clinic, what they're dealing with.

Yeah, so it's really important. So when you're looking at constipation, that you understand, is that a dietary thing? Is that a physiological thing? What's going on? Are there any nerve problems with that particular cat that may be causing what we call a megacolon? So an inactivity of the colon to be able to actually manipulate the fecal matter into the rectum and then for them to pass normally. So many people immediately think of, oh, you must be having too much bone when we're talking about raw and that's causing the constipation. They've got this rock hard feces, it must be because of the bone. But actually the biggest point about the bowel is control of moisture content within that fecal matter. It's not big enough and flocculated, so it's not got enough chambers in it to be a big fermenting part for cats. You know, it's not got loads of— you know, for us and especially for horses and larger animals, you know, they'll do a lot of fermenting in hindgut areas just to get more nutrients out of the food. Well, it's relatively short and smooth, and it's really about moisture content as much as anything. There will be some bacterial interaction, some absorption, but it's getting the fibre content right that may get the amount of fluid within that faecal matter correct. So if they have that faecal matter in that large bowel for a long time, it can actually become dehydrated. It can get the moisture sucked out if there's not enough fibre in it to maintain that balance. And so we do say, look, be careful with your diet. It's not wrong to think about diet. Is there enough fiber now for cats? That often will come from, are they consuming enough skin, fur, bone, gristle, collagen, all of those sort of things within their diet? Because those are important parts. Collagen is found in all of those areas, and the fiber is really important in modulating. Now, some people will go, actually, there are other ways if you are feeding a raw made-for-you and you need to increase the fiber content, then you may use chia seeds or psyllium husk or some other plant-originated fiber, even pumpkin if your cats will take it, to try and act as that fiber source. But realistically, not necessarily the most natural option for cats. Because they would really only get plant material from gut contents of mice and things, prey that they're eating otherwise. So I think fiber first, certainly be thinking of that. But then I'd be thinking, okay, double check. Has your cat got any back problems? Is it a really short-nosed cat that will sometimes then have hemivertebrae, half vertebrae, or any issues within the back? As well. We sometimes see that, not always, but certainly if there's back pain, any discomfort, any issues with walking on the back legs, they could have popped a disc, they could have caused impairment of the nerves that feed that large bowel and therefore the motility of. And then lastly, I did a project at college. I'm going to pretend that I'm still very young and it was only a few years ago, but which was all about dry eye and there is a condition called Keygaskill syndrome. Sounds very complicated, but it's about how the nerve interactions can actually be affected by the immune system and can attack some of the nodes which control motility down the bowel and actually demyelinate. So, you know, they effectively don't get the nerve innervation to that gut properly. It can also cause dry eye, can also cause megaesophagus, but it can also cause mega colon. So megaesophagus, meaning they just don't control the esophagus very well. So the food pipe into the stomach. So there are a number of diseases that should be looked at before you then say automatically, it must be because whoever's making my raw food is putting too much bone in.

Yeah, yeah, I really appreciate that. And Maya, is there— what about dehydration? Because a lot of people, as the, you know, cats don't drink, and if my cat's got constipated and it's not having enough water, I must squirt water into its mouth and put it in its food and force it down its neck.

You know, not that I've done that, but well, usually what they do, they do that when they are feeding kibble or dry food. And also you have constipated cats that have this a particular prescription diet that it's like fiber, with extra fiber, right? So the problem— I had really several cases where you want to switch foods into— with those, with these cats, and they are expecting such an amount of fiber in their diets that dealing with that constipation makes it really, really hard sometimes. And so If your cat, you think that you should put water into it, first, keep in mind that the water has to come in the food. And this doesn't mean that you should moist the kibble. All right. It means that you should give natural moist food that it's already contained, like raw or even cooked with a little bit soupy if you want to. But But the thing is that if the water comes with the food, it will create an environment that will allow to absorb all the nutrients. And, you know, it creates like the perfect environment for the bacteria to eat everything, to have, you know, it's moist, it is not dry. And when you try to force water or you're trying to feed, you're feeding kibble because it's comfortable, and then you want to add some water, that water actually sweeps everything. And it's, it's like when you're very thirsty that they tell you not to drink too fast, even if you are thirsty, because that water simply will wipe out everything and not give the time to actually utilize that water. So if the cat doesn't want to drink, cats are desert animals, so don't, don't force them. Simply feed them something that already contains the water. My cats actually, they are now starting to drink some water. I used to have a fountain, but now that since they have raw, they're actually not touching the water during the winter. They are only drinking water in the summer because it's too hot, but not because the food is different. Right. So, and I don't want to add any water into, especially into kibble, because then you're creating the perfect environment for bacteria to contaminate that. And then And then with raw food, most cats won't like it if you even add water. Maybe if you want to add something, just add a little bit of bone broth or something that it's tasteful and will give you something to do. But if you're having a constipated cat, for me, one of the first things, first of all, pay attention to it because I see many times it's overlooked. And some other times it's because of the food. So food and fiber, like, like Brendan said, and then just adjust everything else, try to find out where it comes from, not, not simply patch it up with a little bit of lactulose and all the things. Just, there are many things, as Brendan suggested, that you can, you have to look at to find the real diagnosis. And sometimes it's really hard. So be patient because, you know, sometimes I add some fiber into the diet or I try different strategies, and, you know, it takes a while to find the, the actual good one, even for raw-fed cats. And, and yes, don't blame the bone only because there are so many other things that can be happening. And also what you said about the back pain, Brendan, uh, here we have a lot of, um, cats that suffered an accident, a car accident, that went outside, and they, you know, they've been in the streets. Once they get adopted, nobody knows they had a hip issue or anything. So sometimes it's not even noticeable. And then you have constipation as an issue. So I just wanted to add that.

And I think those are, you know, some other useful things to think about. And, you know, great that you talked about incidents and accidents, you know, not being able to crouch properly, you know, that because it's painful, you know, it just causes them not to empty their bowel as regularly. The faeces sits there longer, you know, There's also the incidence, and thanks Patricia for pointing out what's going on with your particular cat, you know, with the sort of constipation and then some diarrhea. You know, we'll talk about that can be an overflow diarrhea. So if you've got a bacterial overgrowth and you suddenly end up with a situation where the bacteria are interrupting the normal motility of the gut because they're releasing toxins. So things like Clostridia can do this, that they are causing issues that paralyze, just like Botox, you know, paralyze the gut from working properly. And that can be a bacterial overgrowth of, you know, the aberrant bacteria. So moderating the microbiome, sometimes using things like Atrantil could be really important. Sounds like you've got a little squeaky You know what? But also then if that feces stays there, you'll get a backup of material the other side of that. And sometimes you'll have a bloat and an explosion of gas and stuff like that that will carry diarrhea past the hard feces and you'll get this squitter that comes out with a lot of straining. And then before you know it, they're back to constipation again.

I'm laughing because it's not funny, but you just reminded me with Pickle, we used to play this, this game called Hunt the Nugget, right? It would be like, look around the downstairs of the house to find where there's a poop nugget, a nugget of poop. Because no matter what we do with the litter tray, because again, that could be a reason why they're not pooing in the tray and which causes a stress response in the body. It's not the right size. If they can't get in there, they can't dig around, they can't turn around inside. But with her, we would, you know, look to see like, where's the— where is there a nugget of poop anywhere? And one day we came home and we went to put the telly on, and in the corner by the TV, there was literally, like you just said, Brendan, this kind of explosion all over the wall. And actually, like, it, it broke my heart at the time when I think back to it now, because there was obviously, like you just shared, a situation where she was constipated, then everything kind of moved through. And how like uncomfortable that must have been for her, you know. So thank you for explaining that sometimes, you know, it's not one or the other. They can actually like kind of almost be like a bit of a flow-through with the two.

And another detail on constipation is that let's say like 80% of the cases that I have of CKD usually run with constipation, and they are worried about the the urea levels. And, uh, you know, the colon has some bacteria that will feed on the urea. So, so, um, if you have constipation with, with a CKD, make sure you, you address that too, because otherwise you'll be playing, you know, trying to help the body reduce the toxins in it, but you're blocking it and causing some intoxication. Because, you know, holding the poop, to say it is kind of holding a toxin, so So don't overlook that because I've seen it so many times and people are like, but, you know, I just called you because I have CKD, not to, you know, to address the constipation. I said, if you want to, if you want to address CKD, you also have to address this at the same time. Otherwise it's pointless. So yeah, that's another thing I wanted to say about constipation.

And like you just said there, Maya, like, you know, when, when humans, you know, sometimes if people go away and they're stressed, you know, they don't like, they go on holiday for a mini break or something for a weekend. They can't poop for a weekend because, you know, there's a lot of stress and strain in the travel and the different rhythm of the body, etc. So again, something to think about, everybody that's watching, you know, if you've like recently moved house or you've taken your cat in the car for a journey that's out of their norm, you know, emotional stress can have that impact on the physical body where everything kind of tightens but pauses. So like Brendan talked about, the motility of the gut, the movement through, could almost be like immediately paralyzed because of the stress reaction throughout the body from the emotional causes.

And sometimes nothing has to happen. It depends on how the cat perceives the environment. So if the environment is already from the beginning, because sometimes, you know, people have to deal with constipation with their cats like for a long time and they never look at how the cat perceives the environment. And this can be, well, it can be difficult to best guess because you've been used to this and the cat has been living there for years. But, but it's also, you have to look into that as well.

And those, I'm so glad you've mentioned it. I know it's a thing for you particularly, Juliane, of how to reduce stress for our cats, especially in the household. You've got so many things out there that you can, if you haven't looked at the herb gardens and everything else that Juliane does, then please do go and have a look those, but from a point of view of just understanding sympathetic stress reduces gut, normal gut function. Okay. And so parasympathetic, you want to encourage. So that can be things that you can do. So you can incorporate just slow movement, grooming, giving them things that encourage them to think about food. So the smell of food, maybe even Heating it up slightly for them. So using more odorous foods, using things that they have to play. So playing a little bit of cat and mouse, literally, that they are thinking about. It's that pre-eating behavior. Even then, being able to chew on things. So getting a little bit of bone material that they can chew on. All of those factors that set them up in their brain to be stimulating the vagal nerve, to getting the gut functioning in a more normal way, actually encourages better motility within the gut. So all of those can be important parts when you go to visit your vet. If you've got constipation, not just reduce bone, give fiber, look at other— give water. You know, but get that behavior, you know, set up right. You know, have you got the litter trays in the right place? Have you got enough litter trays? You know, have you just introduced a new puppy into the house that's causing mayhem?

Or a kitten.

That sounds like personal, Benji.

You know, where are you at with, you know, new kittens in the house, Amaya? You know, have you just taken your cat away on holiday with you and thinking that they're going to treat the new cottage like the same old house that you were living in? Have you just moved home? Have you brought a new partner home?

A baby?

A baby into the home?

Anything can be. That's the problem, right?

Have you just painted the bedroom? How many times have I had, talking about babies coming home, no, the baby hasn't arrived yet, they've just gone and painted the nursery and all of a sudden their cat whose it was their favorite room because it was the spare bedroom, the cat's bedroom, and they've decided quite rudely to take it over for the young baby and paint it.

And call it— what's that baby? Why it's important? Like a human?

You're absolutely right though, it can be something simple, you know, like moving a bookcase, changing something in the home. You know, cats thrive on routine and consistency, and they are incredibly sensitive, you know, physiologically, emotionally, mentally. We think that, you know, they're not, they're not small dogs, and some of them are really resistant, resilient, and quite confident, but some of them aren't. So if you are experiencing constipation, yes, obviously get a vet check done and go with as much information as you can, like we've talked about here. Have a think about— and what I found useful, you guys know I'm a great fan of lists and, you know, organizing and things, is that I will go to the vets and say, look, this is, you know, this is it. Because when I get in that room, I'm stressed with the cat, right? I'm looking at how are they doing, my heart's racing, like I've got to make sure I cover everything, I've got 10 minutes, you know. So I've been many a times to a vet with a list of stuff either on my phone or like, you know, a bit of paper to say, look, this is what I need to share with you, because not every vet is holistic and not every vet will look at things from a holistic perspective. So it's like, what is the symptom you're seeing, what can I treat it with? And if you can go in with as much information as possible that understanding that, you know, you guys have as the vet of that symptom can be greater. So it gives you more of an opportunity to really understand what's going on with the cat, then, so that you can treat it accordingly, right?

Absolutely.

Yeah, that's what I'm looking for.

Yes, thank you. I'm distracted.

To me.

No, no, last year.

But yes, okay, so let's move on.

Actually, I was going to say something about that, that it's a great idea to have the questions written down when you go to the vet, because suddenly you make a chitchat just with the vet for a minute and then you've forgotten everything you wanted to say or everything you want to ask. And then after the consultation, people are calling you like, oh, I forgot this and I forgot that. And suddenly you have 20 emails to answer because you've forgotten about something. So it's, it's, it's healthy for everybody if you just have a list of your questions.

So much. And that's, that's exactly where I was coming in. How do I approach that? History is so important in a consultation, you know. It's not just about clinically examining, if the vet is talking to you about all of the other stuff, they're not just, you know, having a chat about what's going on in life. Yeah, often that is important to them to try and understand what could be causes, inciting causes to your cat's disease. And so, you know, yes, examination of course is important, but, you know, history is just as important as far as I'm concerned, especially when it comes to holistic approach to medicine. So please do think about that before you go to your vet. You know, what's been happening in your cat's life, maybe in your life too, but in your cat's life that's so important that you may not associate with the current issue but is actually important to put in context of your cat's disease.

And your personal questions. I mean, if you have questions that may not, you know, that you need answered for, that's also something you should write down, even if it doesn't, you know, just take the time that you need with a vet to get all your questions answered and then develop a client-vet relationship, which is kind of needed, right?

That's what I was going to say. I mean, I learned painfully with Pickle, we were kind of bouncing to and fro to different vets. And then actually I realized that, you know, when I saw the same vet just by chance 2 appointments like in, in a row, it went— the, the change in that appointment was phenomenal because they said to me, how, and how did this go from last time, and how was that, and how's she been, and is she still doing this? So, you know, I learned many years ago to, to, if possible or where possible, have the same vet, you know. And again, like, not for everybody, you can't always manage that, and that's understandable. But like Amaya said, having a good relationship with your vet, it's important that they understand you know, you and your relationship with your pet so that you can both work together. Because that's what it's all about, isn't it, at the end of the day? Getting the best step forward for you and your animal, you know.

Yeah.

Okay, so let's switch it up a gear. Are there any— before I go on to, uh, diet— thank you, diarrhea— are there any questions? Because I can only see the YouTube comments. Brendan, are there any questions or comments anywhere about constipation?

Uh, I think a lot of people have said thank you so much for the great information. It's making them think a different way and that's all great. Fab about bone. So now, and then you've seen the comments that are coming in. Yeah, organ meats, adding organ meats, things to soften the feces. Sure, they will soften. I think you've got to be a wee bit careful depending on what level of constipation is. I guess if they're managing to pass crumbly feces, then adding organ meats can be useful just to soften things a little. Absolutely, they're quite blood-engorged. You may get slightly dark, tarry feces if you go overboard with that. Adding the fiber things that we talked about can be useful, even up to mushrooms. Certain mushrooms can be useful in those circumstances because they, they act as a fiber too. But again, depends how much you want to stick to normal foods for cats. You know, sticking in broccoli in excess amounts or pumpkin isn't necessarily, you know, something that we would associate as the best way to deliver fiber to your cat. And certainly adding high fiber kibbles, you know, can be problematic. And some of this is problematic if they have got a bowel stuck with feces. You will need to think about Options for using colonics, which is actually adding moisture, excess moisture back into the bowel. So it's a pipe that we place per rectum back up through the anus.

Oh yeah.

What do you mean the action? We got it when Brenda said rectum.

As it goes through the butthole. It's not— Oh my word, Friday afternoon.

And then, and then I'm the sensible one, the professional one that caused constipation in the area.

Come on, at this rate we're gonna make Julianne have to go and lie down in a little red room anyway. From a point of view of, yeah, we moisturize, lubricate, we would have to remove that fecal matter in order to then get them back to being able to function normally again. And, you know, the longer it's been going on, the harder it is to get the function back. So that might even be that they'll have to go back, you know, every few days for the procedure to happen again until we can get them right. And if it's persistent, please, as we said earlier, there could be other causes. You might need to get X-rays, it's worth doing. You might need to even get biopsies of the gut. You may need to do a microbiome analysis. You know, there's other more complex things that may be going on.

Yeah. Is that done under general anaesthetic, Brendan, that colic?

Generally, there's very few cats that strangely will just sit there with their eyes a little bit, eyebrows raised, and go—

I didn't know if they were sedated.

Oh, it's cold.

It's not like a health spa in the back of the surgery.

No, I understand that. I didn't know if they were sedated or whether they are fully knocked out.

So some will cope with sedation, but mostly they will have some light anaesthetic. It's not obviously like an operation where they need to be really under deep anaesthesia. It's not like they've broken a bone or anything like that. But if they're having that level of light anesthesia, it may be worth getting an X-ray done at the same time.

My vets generally say that, like, if they're going under, do everything we can whilst they're under to get a clearer picture. And that's one of the reasons I have to say that my boys are both insured, because like, if we do have to go to the situation where they're under, you know, anesthetic, like it is a question of like, let's explore as best we can. So that makes sense.

Jude's piped up, said good luck to anybody who tried to do a colonic in a cat without sedation.

Trying to get a temperature is bad enough. Okay, so we just over halfway because we've got up at 2, so let's switch it up from constipation to diarrhea. So, uh, Maya, I'm going to come to you on this because I know when we were planning the session, planning the session, you said that you wanted to speak to, uh, diarrhea and how, you know, it can actually be a good thing and not everybody's is going to potentially align with that perspective. So I'm going to hand it over to you to share a bit about that.

Okay, so well, when, when the body decides that whatever is there should be removed, it's, you know, it's when it decides to put more water into it and just get it, get it off, right? So the problem with diarrhea is that for us it's very uncomfortable, smelly, uh, you know, it can, it can get the full house, uh, you know, in a brownish color. And so the thing is that we tend to try to block it right away. And yes, there is a consequence of not dealing with the diarrhea.

Hold on, it's going to jump.

Yeah, anyway, so, um, there is a consequence of diarrhea if it's chronic or if it's happening very falsely, well, uh, profoundly, profusely. That's the word. Thank you. Um, and it's dehydration. So, uh, one of the causes, and that dysbiosis can allow other, you know, bacteria overgrowth, and in the end you can have a very, uh, a more difficult, um, other symptoms like vomiting or, you know, upset stomach, anything else you can have. But in the beginning, actually, diarrhea, it's getting rid of a toxin, right? So the first thing that we need to understand is, okay, if it's one day, allow it to be and make sure that, okay, what's going on? Has he had something that he shouldn't? Uh, can I help with something? Maybe you can— what I usually do if I if I have a recent diarrhea, is to offer some really good white clay. It has to be very good quality. And if the animal actually wants it, I mean, I never force it down, right? It's simply I offer it. And if they feel that they've been intoxicated, usually they will drink the clay with the water, with a bit of water, right? So that will let you know that there's something, you know, upset them in the stomach or the gut or whatever. And if that was not the case, maybe there is an intolerance going on, or maybe something is developing. Maybe it was just stress as well. Again, stress can cause this, you know, like everybody can get— when you get nervous, you know, some things get loose. So of many things we have to understand first, if it's one day, if it's just started, don't panic. It is disgusting. You might get uncomfortable with the thing, but sometimes it just resolves by itself and we should not panic and start treating it because the first thing you will get from a vet, it's metronidazole. And well, at least here, and I heard it just recently and, and I said to my client, cause he went on ER and he said, no, they gave him metronidazole. And I said, Like, we know that the cause of that, of that, actually, the cause of that diarrhea is stress. And you could have done so many other things instead of simply just trying to block it with something that it's, it's like putting a bomb without knowing what you're doing, right? Necessarily. So then we stuck them with probiotics. The same thing. There is a body there that it's trying to fix or trying to remove something, and you start adding things just because, right? So the first thing is, okay, let's see if we can make sure the diet is very digestible, right? Make it easier, simplify it, make sure you're using good quality proteins, even if you, if you feel like maybe it's an intolerance causing this. It's not an intoxication. Maybe you can try a weird, a different protein. You can try sometimes cook it because, you know, some cats actually tolerate it better, some others don't, and some others will prefer to have it raw. But then you can try several things, like when you have an upset gut, you know, we tend to fast a little bit. Not too much if the cat is on kibble, But if it's on raw or natural foods, then you can allow them to fast a little bit and then start with small meals that are simplified just to make sure that the body can resolve it by itself. If that cannot— is not happening, then you should think about, you know, well, maybe we should test, maybe we should look into the bacteria that is causing this, maybe, but not just jump into many probiotics or there are good things. I'm not against probiotics, but, uh, what I'm against is that everybody goes directly to the same one, the, the Enterococcus faecium, for everything. And yes, it would work, but it's not, it's not like the solution for everything. So if you don't find the cause, if you don't know what's happened, then you're not allowing the body to to cure itself, to, you know, get rid of the things and do what it has to do. I don't know if that makes sense.

Yeah, and I would split this up into, from a practice point of view, you know, diarrhea, okay, what's the cause? We'll talk about that in a moment. You've then got diarrhea, what can I do in the emergency, you know, the first point of call situation? And then further down, what are the other things if it's recurrent that we should talk about, you know, to to resolve. And so very much agree with Amaya. I think from a point of view of the causes for dogs, I talked earlier in the week, the biggest cause is transgression of diet. Okay, they usually go and pick something out from under a hedge or whatever, you know, somebody decides to leave their curry on the floor whilst they're watching TV and the dog demolishes it, and hey presto, their gut can't cope with that. You know, cats are a bit more discerning. And tend to not do those dietary transgressions. Julianne, don't tell me. Don't know what your cats are eating. But from a point of view— it was just the face you made. Yeah, but from a point of view— got to go there now. So from a point of view of transgressions, especially with kittens being introduced into the house, you've got to think about, you know, what are those infectious causes that could come in from that? You know, if you've got cats that are going out, if they're known hunters, what could they be picking up? If somebody is feeding them something addictive, that's the only transgression that we get, okay, is where, you know, you've got a really healthy child— sorry, cat— who's being fed wonderfully and what happens is they go around to their best friend's house, their neighbors, and that person decides to give them something equivalent to Haribo or sweets stuffed with cat crack in processed food. And then before you know it, your cat's gobbled a load of that down and the neighbor's thinking, you never feed your cat. And actually, no, you've just given it something really sweet and addictive that their gut flora is not going to cope with. So yes, there is that element. I think infectious cause, certainly if they're hunting, what have they picked up from those situations? We know that high processed foods can increase inflammation. If you're watching this from a point of view of somebody who feeds a kibble or feeds a tinned food because that's all your cats will eat, you know, bear in mind Maya, you did a great presentation on how the gut in an inflamed state is far more predisposed to taking up parasites, to taking up protozoal disease, to taking up infectious— it's far more prone to infection, to viral infection, etc. So yeah, they can have a much more profound response to challenge and that needs to be borne in mind, which means when it comes to the acute treatment, Many, many cats short term will deal with that within 24-48 hours.

Exactly.

So as long as they're not vomiting.

You just have to manage the overall health, right?

Yeah, so as long as they're not vomiting, as long as they've not got huge amounts of blood coming through, and we're not talking streaks of bright red, that's usually lower bowel and, you know, it's just straining and that side of things. We're talking about profuse, watery, red hemorrhagic gastroenteritis. You know, if you've got dehydration, i.e., they're really lethargic with it and their skin tents when you pinch the back of their scruff and it doesn't go back, yeah, those would be— you need to get to your vet. Don't leave that. Don't wait hours and say, oh, it's like, I'll see what tomorrow. Yeah, yeah, no, no, no, just right now. Okay, but literally, if they're otherwise bright they've just got loose stool, okay, then please fluids. So bone broths could be great. Anything that, you know, get electrolytes into them. You can get Dioralyte and mix that up, or you can just add a teaspoon of salt to a pint of boiled water, you know, flavor it with a bit of chicken stock or something like that.

I like a product called Oralade.

Yeah, Oralade.

That's one that actually cats, right, like it very much.

And It's like when you go into a, you know, one of those sandwich stores and you can buy a drink for, you know, that's about yay big for about £3 or get your meal.

Bone broth is much cheaper, but well, if you want to get fancy.

You could actually make a bit of broth and add a bit of salt.

Yeah, that's it.

For like a few pence, you know. That's what I'm going to be doing the second one.

But some cats don't like broth.

No, I was going to say that. Yeah, Leo's really funny. Like, he— we tried different flavors. Pickle loved Oral-Aid. Yeah, really?

Yeah, they do. That's why sometimes it's like, you know, this is cheapest way you can get— you can hydrate it. Yeah, but no, he wants expensive.

Do you do Marmite test? Do you Marmite test your cats?

No, I never do.

What's the Marmite test for cats?

So basically, you know, Marmite's really salty, isn't it? Yeah, that's another thing that some people will use rather than—

oh really?

They'll either use Bovril or Marmite. Okay, so you can just literally present it to the cats, and if they go for it, then you know when you come to make a rehydration solution to use.

Okay, I need to get those because it's not here. Available, but I tasted somebody, somebody brought it from the UK.

Love Marmite.

Yeah, all the New Zealanders watching us are going, no, Vegemite.

Vegemite.

Marmite. Okay.

I love it or I hate it.

Marmite. You know.

Good to know.

So, so those are little cheats. So hydration, really important. I tend to use green clays, so either bentonite or montmorillonite. That's the one. So they're like a riverbed clay that are really useful to coat and salve the intestine. Often sold as an edible clay. You can mix them up into a solution.

It's harder to get here, the good green clay. So that's why I use white, because it's easier to get edible, uh, white clay then.

Okay, so please make sure it's edible. Uh, just be aware, you know, it's a lot of white china clays and stuff will contain quite a lot of arsenic, and arsenicum can have quite a wonderful effect on guts of explosive watery diarrhea. So it's not necessarily—

that's not what we want to—

no.

So to please make sure that you're buying the right stuff if you're getting it online. Okay, so should have edible before it. So look at that. I also will sometimes in those salves mix a little bit of tree bark. So the sort of slippery elm, something like that, can be useful as a karma. German chamomile can be useful in those. Marshmallow root.

Those are all marshmallow root.

Yeah, additions to look at those. Just as a salve in the short term. If they don't eat for a day, I'm not panicking. If they're getting fluids, that's the most important thing at that point. Give that gut a rest, try and feed the enterocytes. Those are the cells that are healing the gut lining. And then slowly introduce new food. Chicken rice is not a thing.

No, thanks. You mentioned that.

Okay, so often talked about. We used to be sold it as, look, well, the rice lecithins will adhere toxins to them, and it's a way, you know, what you need to do is sort of like imagine it's like a gluey material that's going in and hardening them up. There's just so many inflammatory moments to sticky rice that just aren't worth it. All you need is then to have one of the bacterium infecting it, which can release toxins of its own and make things so much worse. You'll end up with a vomiting and diarrhea cat, not just diarrhea. So just be really careful. I would say initially, if they're a chicken lover, you can go to chicken broths and things like that. If they're a fish lover, you can use white fish. Yeah, those sort of things. If you really must simmer it gently in the liquid, then that's fine. But you can often go to little raw elements, small meals frequently, build them back up as they start to improve. That's the acute. And then the chronic, as Amaya said, look, if this is going on or recurrent, don't leave 4 or 5 days. That's too long. You know, pretty much most diarrheas within 72 hours, they will be resolved. If they're not, then something else is going on that you've not checked in with. And then there's other investigations to do. You know, I've not mentioned antibiotics at all. Metronidazole is an antibiotic I have not mentioned at all. There is a big drive, and in the UK they've reduced antibiotic use in small animal side by 50%. Which is well done to the profession. But I think from a point of view of— I still see too many people reaching for antibiotics for diarrhea, and we know broad spectrum ones. Yeah, it's not where you want to be for antibiotic resistance. We want to be sticking to— look, there's many, many other ways to treat diarrheas and go down these acutes. There is one probiotic which I would contest with Amaya is worth in the short term, and that is one that contains— so Restore Flora, which contains Saccharomyces boulardii, which is a type of yeast alongside Bacillus subtilis, you know, HU58, that actually do have healing properties to the gut lining. Too, as well as selectively helping friendly bacteria within the gut. So I would say that's one element. Be careful, not all Saccharomyces boulardii serovars are the same. So do look out for the ones which are the treatment of acute diarrheas.

Yeah, sometimes I have to reach for human ones because they're not available, one that contains everything. But yes, you're right. And also one of the things that we have to look into, if it's chronic, it's the color.

I was going to say that. When Brendan said a minute ago about, you know, the blood and stuff, I was going to— I made a note. I was like, oh, we should talk about the difference in, you know, bright yellow versus bright red or dark brown or whatever. So yeah, go on, Amaya.

Yeah, well, if sometimes it's the pancreas that is inflamed or the fat is not being digested, so you might see like a more light-colored poop, or maybe you will find some blood in it, or very dark ones, or maybe a little bit of greenish color or something. So that will give you a clue a little bit of what organ it's been affected. But in general terms, if the pancreas is affected, if the liver is affected, if the gut is affected, for me, all of them are affected. 'Cause for cats, usually if one is affected, then you have all the others, you know, affected as well. So if we are talking about the pancreas, usually what's going on, it's a lot of inflammation and usually it's because of the diet that, you know, they're having. So again, if I know which organ is affected, it's been affected, what I do is try to again simplify the diet and try to find something to stabilize the, the condition and then figure out what the cat needs at the time. Because again, if you have pancreatic enzymes, can be very useful sometimes, but some of those, they're not going to be helpful. So using all the time the probiotics or the enzymes or everything, it's not going to be helpful. So first, try to find out where is it. Calm the system down. Try to use something that will— it will not cause any more inflammation. See if, for example, if it's too dark, maybe we're talking that it's blood in it and it's digestive blood. So if it's digestive blood, then we are talking about the upper intestines, the— I forgot the word. Well, the first part.

Yeah. So thinking about what's bleeding into the stomach, you know, so where the acid interacts with blood will make it very dark and tarry and that side of things, which is why a lot of blood-rich organs will present coming through. So don't get the mistake of, oh, we've had a load of chicken livers. And now they've got black tarry feces, they must be bleeding from their stomach.

No, and some diarrhea, you know, that sometimes it is, it will look like a diarrhea, especially with liver. If you have a lot of liver altogether, then you might have that. So, uh, again, wait 72 hours to see if that is chronic or not, unless you see the cat that it's lethargic or it needs to, or it has another symptom. But if it's too light, like the light colored, then think about the fat content, but also the carbohydrate content, because we forget about that. And they're always saying, hey, but I need to reduce fat. This has too much fat in it. It has too much fat. Okay. Fat is not always the problem. It is the amount of carbohydrate as well that you're feeding and the cat is stuck with it because they, they are very slow metabolizing those. So, um, make sure to make it as natural as possible. I use whitefish as well and some, um, some pumpkin maybe to start with that. And then I start adding things if I see the need to it. It's always the first week I'm carefully watching what I'm adding to the foods, and then I decide whether if I choose to go with a little bit of lion's mane, maybe, because that's kind of my favorite one too. I'm a very mushroom lady. Uh, and then, and then if I see issues with digestion and I cannot completely, um, control the color of the poop, then I will think about enzymes. Or, uh, I like postbiotics as well, more than Sometimes feeding the right bacteria. There is a product here that it's been developed in the university that it's postbiotics. And actually it's, it's proving to be very successful among some of my patients that simply feeds what, what the bacteria of the colon already metabolizes. So it's, it's a, it's good food for the, for the bacteria that you already have. So if you combine, instead of jumping into all the possible things altogether, my way to go is to slowly add the things. And, and also you can use self-selection in the meantime. If you can say something about that, Julie.

I'm not sure we've got time, actually. I was just about to say, Brendan, is there, is there anything that Maija's mentioned about mushrooms? Is there anything that you would talk to regards to homeopathy to support?

Yeah, so I mean, look, the acute diarrheas, the major ones, you know, trying to make sure, look, if you've got a virus or something like that that's going on, then just using— and you've got a febrile cat, they're usually a little bit lethargic— you can use things like Aconite even in those situations, Belladonna, those sort of remedies. But we generally would think watery diarrhea Things like Arsenicum album, you know, just as a 30C can be really useful going through to if they've overindulged and that's caused a problem. So, you know, they've been sticking their face in the butter dish and, you know, demolishing half a pat of butter or, you know, licking the pâté from the Christmas table or something along those lines. You know, you've got then a situation of Nux vomica can be useful. You know, for the excessive— if they're super nervous and there's lots of straining and maybe some mucus and sort of in and out of the litter tray, Argentum nitricum can be a really useful one in those circumstances. If there's lots of flatulence and, you know, sputtering diarrhea, we've got things like Podophyllum and You can also consider into, if there's a lot of stress again, there's discord within the environment, they've maybe been fighting and resultant diarrhea, stuff, Staphysagria. So you can see immediately there's a whole plethora of remedies which rely upon circumstance that those things go in. I would say probably 90% of clients that know something about homeopathy will have used our Senecum album by the time they come in with a cat with diarrhea.

So yeah, and Nux vomica is also good for vomiting, right?

Just like, yeah, it is, it is.

If there's just, if they're nauseous particularly, you know, I don't want to say if there's vomiting through vomiting, you need to get them checked out at the vet just in case they've swallowed some long thread of something and they've got an obstruction. But if they are just nauseous, maybe off food with diarrhea, Nux Vomica can be really useful.

Okay, awesome.

Awesome. Well, well, it's been a great session, peeps. We have come already like an hour's gone and I know we've got to be good with time for Dr. Judy's page. So thank you to everybody for being here. Brendan, just before we wrap up, are there any questions anything else in the chat that we needed to address with the last minute that we've got?

I think most people were fine. There's some sporadic bouts of diarrhea. Think he has IBD. We've dealt with those with sort of chronic gut health and that side of things, and I'd certainly say look at the videos that we've done on those. There's quite a lot of videos also on the canine side that can be relevant to cats, so please do look at those. Somebody's asked for a last show of the kitten. Okay, before— okay, and then yeah, just of course there are going to be some cats we know through self-selection that will eat some weird and wonderful stuff, you know, the odd cat that will eat chili. Thanks, Jude McCoy. I can only imagine the results of that. I think from a point of view of everybody that's commented, thank you so much. And lastly, before, before we go, I want to say a big thank you to Julianne. He's been a great host, great part of Feline Fridays. It's been a great joy. I know this is your last show. You've asked for, for today. And I always say a big heartfelt thank you from RPM, and I'm sure all the viewers out there. Please put some comments in below if you want to show your appreciation. Lots of love hearts coming up, by the way, Julianne, just so you know. And also, please do remember Julianne is going to be found with Naturally Cats. You can always access— there's loads of historic videos. If you want to get a little fix of Juliane, then either pay— well, do pay attention to her Instagram and everything else that's going on still.

And the books.

And there is a book coming in. I've pulled it up front and center. Come on. So Cat Chakras, you know, it's great if you want some further information. And please do, you know, have a little look, all of the contacts and things. We doing another conference next year, February?

Oh, I don't know about that. That's the million-dollar question people keep asking me, and at the moment I just don't know. So like you said, follow me on Instagram and Facebook, everybody, and you will find out in September if we're going to do another one. It might be online, it might be face-to-face, we might not do one. I don't know just yet.

Oh, there we go. So look, so many people already putting in Lots of stuff there. So please do keep following. I'm sure we'll keep in touch. We'll let you know what she's up to and when there's a conference, etc. Look forward to seeing you again soon. And we'll see you next month. It will be myself and Amaya just coming along, giving you a bit of chat. And I think we're going to find it hard to replace Julianne. So we'll probably be without—

I was going to say, can either of you tell me what date you're doing it next? Month?

No, because you normally organize that. Yeah, you're the person with all of the organization and lists.

We'll simply show up someday.

Like everybody is watching, hopefully they'll be here for you next month.

We'll show up sometime, at some point.

We'll be here, just keep an eye out for the posts.

Yeah, no, just put a post 24 hours before.

Look, it's been great. It's been a real, it's been a real blast. Thank you everybody for being part of it, and thank you to Brendan and Amaya for the opportunity to give cats a voice. It's been brilliant.

That's wonderful, and I'll let you retire to your red room.

Perfect. Amaya, send the kittens over.

Bye!