How to manage feline chronic diarrhea, Part II: Treatment
Chronic diarrhea is best managed with targeted therapy based on a specific diagnosis. However, symptomatic or nonspecific therapies are often initially considered for patients that seem to be feeling well otherwise and when preliminary testing fails to establish a definitive diagnosis. Specific and symptomatic medical therapy may be used together to achieve greater success.
ANTIPROTOZOAL THERAPYIn cats with diarrhea caused by Giardia, Cystoisospora, or Tritrichomonas species, an antiparasitic, antiprotozoal, or antimicrobial agent is indicated alone or in combination.
Fenbendazole is a benzimidazole antiparasitic that appears to be an effective option in cats with giardiasis (Table 1), without the hematologic complications associated with albendazole.1 Concern has been expressed regarding the efficacy of fenbendazole against Giardia species in certain cases.2 Although both fenbendazole and metronidazole are recommended as sole therapies for treating giardiasis, the Companion Animal Parasite Council also advocates the combination of fenbendazole at 50 mg/kg once daily with metronidazole at 25 mg/kg twice daily for 5 days.1 Fenbendazole appears to have a wide safety margin but is not FDA-approved for use in cats.3