Why Your Cat May Have a 'Sensitive Stomach'
Does your kitty experience recurring diarrhea and/or constipation? Does she sometimes vomit or appear to be in pain? Digestive issues can occur for a number of reasons, so it's important to rule out this list of conditions. Know what tests your cat may need, along with the best food to feed.
Analysis by Dr. Karen Shaw Becker
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STORY AT-A-GLANCE
- Cats with consistently inconsistent digestive issues often suffer from irritable bowel syndrome (IBS); IBS is a diagnosis of exclusion arrived at after all other potential causes of gastrointestinal symptoms are ruled out
- The hallmark signs of feline IBS are recurring bouts of diarrhea and/or constipation; other symptoms can include vomiting and abdominal pain
- Cats with IBS require a comprehensive healing protocol that addresses dietary issues and appropriate supplements, including microbiome support and prebiotic fiber, if necessary
- To recover and remain in good health, these kitties also require a very low stress, environmentally enriched lifestyle
A popular catch-all term for digestive problems in cats is “sensitive stomach,” the symptoms of which typically describe irritable bowel syndrome (IBS). Interestingly, IBS is often used interchangeably with inflammatory bowel disease (IBD), but they are somewhat different conditions.
Unfortunately, in my experience, untreated sensitive stomach/IBS in cats can progress to full-blown IBD. Whereas with IBD there is chronic inflammation of the bowels, kitties with IBS usually have what I call “consistently intermittent” inflammation, meaning it comes and goes, but does so dependably.
IBS is actually less common in cats than IBD and other gastrointestinal (GI) diseases, but it may not seem so, because when a kitty’s digestive issues aren’t accurately or thoroughly diagnosed, they are often lumped into the category of “sensitive stomach.”
Potential Causes and Symptoms of IBS in Cats
Some of the suspected causes of “true” IBS include:
- Stress
- Dietary intolerances
- Lack of appropriate dietary fiber
- Abnormal colonic myoelectrical activity and motility
- Changes in neural or neurochemical regulation of colonic function
The most common symptoms of irritable bowel syndrome in kitties are intermittent-but-consistent bouts of diarrhea, frequent trips to the litterbox to pass small amounts of poop and mucus, and constipation. Some cats also suffer from abdominal pain, bloating, nausea, and vomiting.
How Irritable Bowel Syndrome in Cats Is Diagnosed
IBS is a diagnosis of exclusion, meaning it’s the diagnosis we arrive at after every other condition with similar symptoms is ruled out. Most GI disorders share a long list of symptoms, so there’s a lot to rule out before deciding a kitty has IBS. Some of the conditions that may need to be ruled out include:
- Intestinal parasites (e.g., giardia, coccidia) or pathogenic bacterial overgrowth
- Inflammatory colitis
- A bacterial, fungal or other type of infection (e.g., pythiosis)
- Cancer of the colon
- Abnormal turning/twisting of the intestine (cecal inversion)
Since inflammatory bowel disease is the number one cause of GI issues in cats, and since diarrhea is a symptom of both IBS and IBD, I almost always check for IBD in cats with recurring GI issues.
Lack of healthy digestion is a common cause of secondary infections and systemic disease. Since over half your kitty's immune function is located in her GI tract, compromised intestines lead to a compromised immune system. Secondary organ failure is common in chronic IBD patients.
Nutritional deficiencies are also a significant risk because GI inflammation greatly interferes with a cat’s ability to efficiently digest and absorb nutrients from the diet. In felines, there's also a correlation between lymphoma of the GI tract and chronic IBD.
To check for IBD, functional GI testing is required, at a minimum. These blood tests provide information on how well the cat is absorbing folate (a water-soluble B vitamin) and cobalamin, another B vitamin that binds to protein.
A low folate level indicates one of two things — either the cat’s ability to absorb nutrients is compromised, or there is disease of the small intestine. If the folate level is too high, it can indicate another problem known as SIBO (small intestinal bacterial overgrowth).
If the cobalamin level is low, it's another indicator that all is not well with the small intestine. Cobalamin levels are a measure of digestion. I also run two more functional tests, TLI and PLI, to assess pancreatic function. Research shows that many cats live with chronic pancreatitis and the sooner it’s identified, the sooner it can be effectively managed.
There is another test known as the "confirming" test for IBD, which involves a biopsy to look for changes in the architecture of the GI tract characteristic of the condition. This isn't my first choice because it's invasive, expensive, and involves anesthesia, but it’s the only option to differentiate lymphoma from IBD, so if profound weight loss has occurred, it’s sometimes necessary.
A Diarrhea Panel can identify why your cat may have recurrent bouts of unexplained loose stools. Bring a dime-sized stool sample to your vet to complete this test, which should be a part of initial diagnostics when determining if there’s an undiagnosed root cause for your cat’s abnormal bowel movements.
A microbiome analysis can be extremely beneficial in identifying microbial imbalances that can contribute to ongoing GI symptoms, and fecal microbiome transplants can be very helpful in correcting dysbiosis associated with IBS. If a dietary ingredient sensitivity is the root cause of GI irritation, it should be identified with a NutriScan food intolerance saliva test.
Dietary Recommendations for Cats With IBS
If your cat is diagnosed with irritable bowel syndrome, I recommend you work with an integrative veterinarian to create a comprehensive protocol to address dietary issues and appropriate supplements that are customized around the results of your cat’s diagnostics.
Most cats with IBS are found to have dysbiosis when their microbiome is evaluated. The entire length of your pet's digestive tract, when healthy, is coated with a good balance of bacteria that protects against foreign invaders, undigested food particles, toxins and parasites.
Healthy levels of friendly gut bacteria serve as a natural defense against pathogenic bacteria and also contain antifungal and antiviral properties. A healthy microbiome also promotes an appropriate immune response to pathogens and is responsible for maintaining a variety of digestive functions.
The more diverse your cat’s diet is, the healthier their microbiome will be. But that’s often part of the root problem: most cats are addicted to one type, flavor and brand of ultraprocessed food, meaning there isn’t the variety of nutrients, foods and fibers needed to maintain GI health.
Additionally, dry and canned cat foods are notoriously contaminated with unwanted tag-alongs, including endocrine disrupting chemicals and Maillard Reaction Products, the unwanted byproducts of high-heat processing.
When gut bacteria are out of whack, the walls of the intestine are essentially unprotected and undernourished. A healthy balance of species-specific bacteria and prebiotic fibers provides a rich source of energy and nourishment for the lining of the GI tract. Microbiome restorative therapy can be a profoundly effective tool to rebalance your cat’s internal terrain, and where I recommend you start, when addressing your cat’s GI dysfunction.
Depending on your kitty’s symptoms, your veterinarian may also recommend a bland diet, to give your cat’s system a break from potentially irritating foods. The bland diet I prefer is a grain-free menu of cooked ground turkey and canned or steamed pumpkin (pure pumpkin, not the filling used in pies) or cooked sweet potato. Make sure to eliminate all grocery store treats at the same time.
When it's safe for your cat to transition away from the bland diet, I recommend working with your integrative vet to create a novel protein diet. This will give the GI tract and immune system ample time to repair and rebuild itself.
Novel protein diets are made with foods your cat hasn’t consumed before. I also recommend giving IBS cats a break from all sources of food contaminants, including high heat processing that creates AGEs (advanced glycation end products), foods that have been genetically modified, added colors and flavors, and synthetic vitamins.
You and your veterinarian should also discuss appropriate supplements, including certain strains of beneficial probiotics and digestive enzymes. There are also numerous nutraceuticals that can be very beneficial in helping to reduce GI inflammation and IBS symptoms.
I absolutely do not recommend that IBS cats stay on steroids as the only treatment plan, which is currently how most cats are managed.
Also provide kitty with filtered water, free from fluoride and chlorine. Eliminate chemical based household cleaning supplies, odor-control and scented litters, and room sprays, plug-ins, and fabric deodorizers.
Dietary Fiber Options
IBS can cause diarrhea and/or constipation, and fiber supplementation can address both symptoms, in addition to addressing food intolerances and microbiome imbalances.
If your cat lived in the wild, her natural prey would provide ample fiber in the form of fur, feathers and predigested gut contents. Since housecats don’t get prey animal fiber in their meals, it can be beneficial to add fiber to an IBS kitty’s diet to help keep things moving smoothly through the digestive tract — not too fast, and not too slow. Good options include:
- Psyllium husk powder — 1/2 teaspoon per 10 pounds of body weight 1-2 times daily on food
- Prebiotic-rich veggies — pureed asparagus, sunchokes, dark green leafies, 1 teaspoon per 10 pounds of body weight 1-2 times daily with food
- Canned or steamed 100% pumpkin — 1 teaspoon per 10 pounds of body weight 1-2 times daily on food
- Acacia fiber — 1/8 teaspoon per 10 pounds of body weight 1-2 times daily
If your cat struggles with extra-dry stools, adding a GI lubricant, in addition to fiber, can also help:
- Coconut oil — 1/2 teaspoon per 10 pounds of body weight 1-2 times daily
- Aloe juice (not the topical gel) — 1/4 teaspoon per 10 pounds of body weight 1-2 times daily on food
It’s also very important that cats with IBS stay well hydrated, especially if a fiber supplement is added. As I mentioned above, make sure your kitty has access to clean, fresh, filtered drinking water at all times. Place a few bowls around the house in areas where she hangs out. You might also want to consider a pet water fountain, since many kitties will drink more from a moving water source. Also consider adding bone broth to her food.
Dry food results in chronically dehydrated colons, so switching to a more moisture-rich diet is important.
Managing Stress in Cats With a ‘Sensitive Stomach’
Since stress plays a role in many feline disorders and is a particular problem for kitties with IBS, one of the best ways to help a cat with a sensitive gut is to make sure her environment and lifestyle are as stress-free as possible.
Enriching your cat’s environment means improving or enhancing his living situation to optimize his health and quality of life. The more comfortable your cat feels in your home, the lower his stress level will be.
Enriching your cat's surroundings means creating minimally stressful living quarters, and reducing or eliminating changes in his life that cause anxiety. Any variation to a kitty's routine is experienced as stressful. Cats need to feel they're in control of their living situation.
Enrichment may also mean adding or changing things in your pet's environment that encourage him to engage in natural feline activities like climbing to a high spot or hunting prey in the form of a cat toy or indoor hunting feeder.
Because change is unnerving for cats, nothing should be forced on them. If you decide to purchase a cat tree, for example, place it in an area of your home where kitty spends a lot of time, and let him discover it on his own terms.
Also consider the electrical stress in your cat’s environment. We tend to underestimate the effect of household radiation and EMFs on sensitive animals. Pets need to be outside in contact with the earth to ground themselves, and many cats never get the opportunity.
Enriching Your Feline Family Member’s Indoor World
There are several components to a cat's indoor environment, and when it comes to enrichment, each should be considered from the perspective of your kitty. These include:
- Places for climbing, scratching, resting and hiding — Cats are natural climbers and scratchers, and your kitty also needs her own resting place and a hiding spot.
- Food, water and litterbox locations — In the wild, felines are both predators and prey for larger animals, which is why they feel most vulnerable while eating, drinking or eliminating. This vulnerability is what causes a fearful response when a cat's food dish or litterbox is in a noisy or high traffic area.
The essentials of your kitty's life — food, water and his bathroom, should be located in a safe, secure location away from any area that is noisy enough to startle him or make him feel trapped and unable to escape. They should also remain in one spot and not be moved from place to place. - Sensory stimulation — Visual stimulation: Some cats can gaze out the window for hours. Others are captivated by fish in an aquarium. Some even enjoy kitty videos.
Auditory stimulation: When you're away from home, provide background noise for kitty that is similar to the ambient sounds she hears when you're home, for example, music or the TV at low volume.
Olfactory stimulation: You can stimulate your cat's keen sense of smell with cat-safe herbs or synthetic feline pheromones. - Consistency in interactions with humans — Your kitty feels most comfortable when his daily routine is predictable. Cats prefer to interact with other creatures (including humans) on their terms, and according to their schedule. Always remember: well-balanced indoor kitties are given the opportunity to feel in control of their environment.
- Same-species friends — This can be a sensitive area. The way cats interact with each other is very different from most other animals. Trying to predict how two or more cats, especially kitties who haven’t grown up together, will get on living under the same roof is nearly impossible.
Problems with intercat aggression can arise when a new cat is brought home, when two cat owners blend their feline families, and even among cats that have lived peacefully together for years.
Because of the complex nature of feline social structures, if you have a multi-cat household and there are problems, or you're hoping to add a new cat to the family, I recommend you talk with your veterinarian or an animal behavior specialist.
Indoor Cats Thrive With Safe Access to Outdoor Spaces
Another way to relieve your cat’s stress and enrich his lifestyle is to make sure he gets to spend some time outdoors in nice weather in controlled situations such as on a leash walk, or inside a protective enclosure like a “catio” (a cat patio). The idea is allow him safe access to the outdoors, as well as the chance to ground himself.
Safe access is key. Allowing your cat to run around loose outside is never a good idea. It presents much more risk to his health and longevity than keeping him indoors.
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