Abnormal faeces in dogs and cats

Summary

What are abnormal faeces? 

“Faeces” is a Latin word meaning ‘dregs’ or ‘sediment’ and is also known as poo, poop, excrement, stool, bowel movement, defecation, faecal matter and countless other names. All these terms refer to the body’s waste matter which is initially ingested as food, processed with absorption of nutrients in the intestines and passed back out through the anus. Waste matter is comprised mainly of water, undigested food matter, fats, bacteria, salts, minerals and other substances.

While there is a huge range of what is normal when it comes to faeces, being familiar with your dog’s or cat’s toileting habits can be beneficial for the ongoing monitoring of its health. It is important to be aware of both the frequency of bowel movements and what a typical stool looks like when your pet is healthy, so any subtle variations in regularity or appearance of the faeces will be recognised. The smell of the faeces is another indicator of health; although an odour is normal, healthy faeces should not smell extremely foul.

Abnormal frequency or appearance of the faeces can be symptomatic of a large number of underlying conditions, ranging from digestive disorders to liver or kidney disease to dietary sensitivities to parasites. This explains why veterinarians will ask about stool consistency, or even take a stool sample for examination; important information about digestive health and the overall health of the animal can be attained by analysing the faeces.

When it comes to appearance, faeces have four main “C” characteristics: colour, content, consistency, and coating.

Colour

In a healthy animal, faeces should be chocolate brown, although colour can range from deep brown to tan, with normal variations occurring because of different ingredients in the diet. For example, diets high in fibre will often produce a lighter-coloured stool.

If abnormal colours persist for more than two stools, consult the veterinarian. Abnormal stool colours include:

• Black or tar-coloured: may by a sign of bleeding in the upper digestive tract
• Red streaks: can indicate bleeding in the lower digestive tract
• Grey or yellow: may indicate issues with the pancreas, liver, or gallbladder
• Green:  could indicate that the animal is eating grass, perhaps to soothe an upset stomach
• White spots: may be a sign of worms

Content

The content of faeces is assessed by looking at a faecal sample underneath a microscope. Abnormal faecal content may include:

• Worms or worm eggs: long and skinny roundworms or little tapeworm segments, which are shiny, white, and about the size of rice and may possibly be moving.
• Foreign materials (pica, the eating of non-food items, is not uncommon in dogs and cats), such as:
  • In dogs, grass, plastic, rocks, pieces of clothing or toys
  • In cats, pieces of cat toys or other household items, such as thread or dental floss.
• Hair / fur: particularly in cats, big clumps of fur in the stool indicate overgrooming, which can occur as the result of stress, allergies, or skin disease. Hair is the most common item observed in the cat’s stool and is only considered abnormal if excessive quantities are present.

Coating

In a healthy animal, faeces should not have a coating or film over it. A coating may be observed as a trail on the ground after the stool is removed. A coating around the stool could indicate a condition such as bowel inflammation, or colitis. It often occurs in conjunction with diarrhoea.

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Consistency

In a healthy animal, faeces should be well-formed, like play dough, i.e. not too hard or too soft or mushy. Ideally, it should be in log shapes with little segments in it so that if moved, it would break into smaller pieces.

The faecal scoring system is helpful in determining the consistency of the stool; the stool is graded from type 1 to type 7 or 8, where type 1 represents very hard, dry pellets and type 7 or 8 is liquid (see diagram below). According to this scale, the ideal stool has a score of 2. An overly hard stool can be painful to pass and may be a sign of dehydration, while an overly loose stool, or diarrhoea can be accompanied by an increased urge to defecate and straining due to inflammation of the gut.

What is diarrhoea?

Diarrhoea is the rapid movement of ingested material through the intestine, resulting in one or more of the following:

• Increased frequency of bowel movements
• Loose, watery stools
• Increased amount of stool

Diarrhoea is not a disease but a symptom of many different conditions, from minor illnesses to serious or even life-threatening diseases. It is not uncommon for dogs and cats, and there are many reasons why it may occur. While not uncommon, severe bouts of diarrhoea can put puppies, kittens, small dogs, and older animals at risk of dehydration.

Acute diarrhoea

When an episode of diarrhoea comes and goes within a day or two, it is referred to as acute. It can often result from a change in diet, unusual motion such as long car trip or air travel, or as a response to anxiety or a stressful situation.

Chronic diarrhoea

When a dog or cat experiences diarrhoea on a regular basis over the course of two or more weeks, it is referred to as chronic. Chronic diarrhoea can be the result of a number of potentially serious health issues, ranging from organ dysfunction to parasites to infection.

Learn more about diarrhoea in this article.

What is constipation?

Constipation occurs when an animal struggles to defecate or produces small, hard, dry pellets with great effort. Older dogs and cats are more likely to experience constipation, although it can happen to any breed at any age. Ongoing constipation in animals should not be ignored, as there could be a serious cause such as an intestinal blockage or an underlying kidney disease. Additionally, extended periods of constipation can cause serious health problems.

Diet and regular exercise have an impact on normal stool formation and movement through the GI tract. Animals that are overfed, or fed excessive low-quality dry kibble, may consume more fibre and filler than their digestive systems can process. The longer the animal excretes hard, dry faeces, or no faeces, the greater the likelihood that constipation will turn into obstipation. Obstipation (constipation that resists treatment) occurs when there is a backup of faeces in the colon, a condition which can lead to a potentially life-threatening intestinal blockage.

Expert advice from Dr Felicia:

Two common presentations of constipation I see in practice are dogs that have been recently fed a large bone causing straining and discomfort when trying to defecate, and elderly cats with underlying kidney disease having very hard stools that are difficult to pass. Both these patient groups will often require an enema under general anaesthetic to relieve the faecal obstruction so they can defecate normally again.

Read more about constipation in dogs in this article and constipation in cats in this article.

Symptoms of abnormal faeces in dogs and cats

The most obvious sign of abnormal faeces is the presence of diarrhoea or constipation.

The stool of an animal with diarrhoea may have one or more of the following characteristics (characteristics will vary depending on the cause):

• Watery, liquid, puddle-like consistency
• Soft, pudding-like consistency
• Soft, frothy consistency
• Greasy consistency (mucus in the stool)
• Black, tarry in colour (blood in the stool)
• Red in colour (blood in the stool)
• Pungent smell
• Increased volume of stool
• Increased frequency of bowel movements
• Straining to evacuate

Other symptoms that can occur along with diarrhoea include:

• Weight loss
• Vomiting
• Increased gas
• Fever
• Lethargy
• Malaise
• Loss of appetite
• Dehydration
• Abdominal pain

Symptoms of constipation include:

• Infrequent or no defecation
• Small, hard, dry pellets
• Thin, ribbon-like stool
• Straining or crying out in pain when trying to defecate
• Hard, dry, small stools, possibly with some mucous or blood
• Frequent trips to the litter box without producing a stool
• Loss of appetite
• Weight loss
• Lethargy
• Vomiting

Is my dog pooping blood? What does blood look like in my cat’s poop?

Haematochezia, or blood in the stool, can be a frightening sight for any pet owner. The colour of the blood can range from a vivid red to tarry black. Bright red blood is usually more obvious to the naked eye. The brighter red it is, the more likely the source is lower down the digestive tract, in or near the colon.

Darker blood in the stool may not be as noticeable. It usually stems from higher up in the digestive tract, as it has been through the process of digestion, which changes the colour from bright to dark; it may even appear to be almost black, and usually has a tarry, sticky consistency.

Both constipation and diarrhoea can be accompanied by blood in the stool. The appearance of blood in the stool, be a once-off occurrence or a sign of a potentially serious underlying condition. It is prudent to consult the veterinarian – and remember to take along a stool sample.

Expert advice from Dr Felicia:

Treatments and diagnostics for patients with blood in their faeces varies significantly depending on their general health and their age. A physical examination, discussion of your pet’s history and some faecal/blood tests will enable your vet to make an appropriate plan and prescribe the best treatment. Plans may sometimes change if your pet isn’t responding as expected (if diarrhoea persists) with additional testing or imaging to determine the underlying cause.

Causes of abnormal faeces in dogs and cats

Causes of diarrhoea

As diarrhoea is a symptom of a vast array of health problems, it also has multiple causes. Abnormal faeces do not always provide the veterinarian with a specific cause for the abnormality but will prompt further investigation.

Some of the causes of diarrhoea include:

• Abrupt dietary changes
• Ingestion of toxins
• Inflammatory bowel disease (IBD), irritable bowel syndrome (IBS)
• Food intolerance, sensitivity or allergy
• Gastroenteritis (infection and inflammation of the digestive system), this can be bacterial or viral and is more likely in patients fed raw diets.
• Small intestine bacterial overgrowth (SIBO) (excessive bacteria in the small intestine)
• Intestinal parasites, e.g. worms, giardia (which is acquired when water contaminated with faeces is ingested)
• Lymphangiectasia (a pathologic dilation of lymph vessels within the intestines of dogs)
• Colitis (an inflammation or irritation of the colon)
• Indiscriminate eating, pica (eating non-food items), which can also cause bowel obstruction
• Disease of other gastrointestinal organs such as the kidney, liver, pancreas
• Hyperthyroidism (overactive thyroid gland)
• Stress, anxiety
• Unusual motion, e.g. car or air travel

Expert advice from Dr Felicia:

Some medications that your pet may be taking can cause diarrhoea or gastrointestinal upset. These medications may include steroids, antibiotics or non-steroidal anti-inflammatory drugs. If your pet is having diarrhoea after recently starting medication it is best to consult your vet to see if any alternative options may exist.

Diarrhoea can have different characteristics depending on its cause:

• A soft stool with no visible blood or mucous is common and had a large variety of underlying causes including small intestinal disease, diet change, dietary indiscretion, infection or inflammation of the gastrointestinal tract, and even liver or kidney disease.
• A greasy, grey stool may result from too much fat in the animal’s diet, which can trigger pancreatitis (inflammation of the pancreas that can range from very mild to life threatening).
• A black, tarry stool typically indicates the presence of blood somewhere in the upper digestive system. It could be caused by injury, cancer or presence of gastric ulcers in the upper gastrointestinal tract.
• Watery diarrhoea is normally associated with increased frequency of defecation with straining and presence of mucus is associated with disease of the large intestine.

Causes of Constipation

Constipation in dogs and cats can occur for several reasons, including:

• Dehydration
• Dietary issues
• Kidney disease
• Foreign objects blocking the colon, such as string, hairballs or bones
• Diets that lack fibre or contain excessive fibre and filler
• Problems within the colon, e.g. tumours or narrow places
• Spine problems or pain
• Feline megacolon — when the colon gets very large and its muscles no longer squeeze, making hard, dry stool build up inside
• Inactivity
• Painful defecation
• Neurological disorders
• Certain drugs

Causes of blood or mucus in faeces

Blood or mucus in the faeces may be caused by:

• Dietary changes
• Food intolerance
• Inflammatory bowel disease (IBD)
• Intestinal parasites such as Giardia
• Infections
• Trauma or abscess
• Rectal polyps or tumours
• Anal gland abscess or infection
• Constipation or idiopathic feline megacolon
• Poisons or toxins
• Cancer

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How is abnormal faeces in dogs and cats diagnosed?

Diagnosis will usually include a medical history, physical examination and microscopic faecal evaluation. It is important to take a fresh stool sample to your consultation; it will help the vet identify potential underlying causes for the abnormal faeces. The stool sample will be examined for blood, parasites and bacteria. In more serious cases, x-rays, ultrasound, and blood and urine tests may also be conducted.

Medical history

The veterinarian will ask about the animal’s medical history including vaccinations, deworming treatments, contact with other dogs and cats, diet, access to garbage or toxins, and any medications. The more information the owner can provide, the easier it will be to make a diagnosis. A detailed account of the observed symptoms may help to narrow down the possible causes.

Physical examination

The veterinarian will perform a physical exam that may include measuring your pet’s temperature, checking the heart and respiration, looking in the mouth, palpating the abdomen, checking for dehydration and performing a rectal examination.

Laboratory and diagnostic tests

In almost all cases of diarrhoea, the veterinarian will recommend a faecal flotation, a routine veterinary test used to diagnose internal parasites or worms.

If a bacterial infection is suspected, a faecal PCR test may performed to determine if certain pathological bacteria or viruses are present in the digestive tract.

If the animal is showing generalised signs of illness, such as fever, vomiting and lethargy, a complete blood count and biochemistry panel may be performed. Specialised blood tests may also be conducted if a particular disease is suspected. For certain diseases, the only way to make an accurate diagnosis is through microscopic examination of a biopsy (a piece of tissue or a sample of cells removed from the animal).

Expert advice from Dr Felicia:

The amount of testing recommended will likely depend on the age of your pet, the severity and duration of diarrhoea and accompanying signs, such as dehydration, vomiting, loss of appetite and weight loss.

For patients with chronic diarrhoea, usually diagnostics are performed in a step-wise fashion. Sometimes the diagnostic test is seeing how your pet responds to a treatment trial with a change of diet or antibiotics. For patients who do not respond to these trials more blood tests may be the next step, or intestinal biopsies may be recommended. Intestinal biopsies can be taken surgically or via endoscope and require a general anaesthetic so most patients will undergo other less invasive tests prior to this step.

Diagnostic imaging

X-rays may be recommended if a tumour, foreign body, or anatomical problem is suspected. A barium study or ultrasound may also be recommended. Examinations using an endoscope or colonoscopy may be performed in certain cases.

Prognosis

Most healthy dogs and cats experience an occasional episode of loose stool or diarrhoea that resolves within 12 to 24 hours. The underlying cause in most of these cases is indiscriminate eating or stress. Diarrhoea associated with minor conditions usually has an excellent prognosis and can often be resolved quickly with simple treatments.

Diarrhoea that lasts for 24 to 48 hours usually has a good prognosis unless the animal is very young or elderly. But if diarrhoea continues for a longer period, dehydration can result, which can be dangerous. Even diarrhoea caused by mild illnesses may become serious if treatment is not initiated early enough to prevent severe fluid and nutrient losses. Any dog or cat can potentially become very ill from chronic bouts of diarrhoea.

Where diarrhoea is the result of serious or life-threatening illnesses such as organ system failure or cancer, the prognosis is less optimistic.

The prognosis for constipation is usually good, if treatment to alleviate the constipation is initiated promptly, but the longer faeces remain in the colon, the drier, harder and more difficult to eliminate they become.  If obstipation (constipation that resists treatment) occurs, the colon becomes packed with an uncomfortably large amount of faeces, causing unproductive straining, lethargy and appetite loss. In cats, this can result in the swelling of the colon and permanent loss of the colon’s motility and a complete inability to defecate. This can be life-threatening or require risky surgery to attempt to correct.

Treatment for abnormal faeces in dogs and cats

Treatment will be determined by the underlying cause for the abnormal faeces. Because there are many possible causes, there are a variety of treatment options available, most commonly involving medication or dietary management. It is important to provide only medications that have been recommended or prescribed by the veterinarian.

Dietary modification

In most cases of diarrhoea, it is usually recommended provide small, frequent meals of bland and hydrating foods to continue to provide nutrients intestinal tract, while frequently offering small amounts of water to combat dehydration. This may be continued for a few days while seeing if the stool will normalise. Once the stools are solid again then your pet’s regular diet is slowly reintroduced by combining it with the special diet over a few days.

Expert advice from Dr Felicia:

If pets are normally fed dry food/kibble and there is a change to the diet to a home-cooked bland diet, pets will often seem to drink less as their new diet contains much more water than before. The consistency of the faeces will also be different in a dog being fed chicken and rice after previously having kibble only.

In cases of constipation, a veterinarian-approved diet to modify in the fibre content and/or quality of the animal’s diet may be recommended. For some animals, a high fibre diet is beneficial, but for others, a low fibre diet works better, depending on the cause of the constipation. Increasing the water content of the diet may also be recommended, by switching from dry food to canned food or by mixing a little water in with the food.

The vet may also recommend a special diet if there is suspicion that underlying cause is food allergy or intolerance, inflammatory bowel disease (IBD), or colitis. In such cases, a modified diet may be advised moving forward indefinitely or at least in the long term, in order to improve digestibility, avoid certain ingredients, or increase or decrease fibre or fat content of the diet.

Medication

Deworming treatment will be prescribed if intestinal worms are present and in most cases it is necessary to repeat the treatment one or more times over several weeks or months. It is also important to try to remove the worm eggs from the environment.

Antibiotics will be prescribed if the diarrhoea there is suspicion that there is a bacterial infection. They may also be given if there is concern for systemic infection due to the severity of the diarrhoea.

In some cases, medications may be provided to decrease motility, i.e., slow down the rate at which the ingested material moves through the intestine. These drugs should not be given if the animal has ingested a toxin or has a bacterial infection, therefore it is essential to have an accurate diagnosis before using these drugs.

In some cases, medication to control inflammation may be prescribed. In cases of constipation, laxatives, enemas or medication to increase the contractile strength of the large intestine may be recommended.

Rehydration fluids

Severe or prolonged diarrhoea can lead to significant dehydration and electrolyte disturbances. If the animal is dehydrated, hospitalisation may be necessary to provide fluids intravenously, and usually requires a stay of 24 hours or more to replace the fluids lost from diarrhoea. Oral fluids are often inadequate in such cases because they pass through the body too quickly to be sufficiently absorbed.

Expert advice from Dr Felicia:

For patients who are bright and well, with a good appetite, the appropriate supportive care may be a change in diet and probiotics with monitoring for resolution. Patients who don’t resolve will then require additional testing, whereas patients who are older, with weight loss, loss of appetite or vomiting likely warrant further investigation at their initial appointment. Any additional findings of dehydration, abdominal pain, constipation on physical examination will also direct appropriate further diagnostics or treatments such as imaging and blood tests.

In conclusion

Abnormal faeces are a common occurrence in dogs and cats. Owners need to be aware of the normal appearance and frequency of their animal’s bowel movements, so that when there is a change appropriate action can be taken. The appearance of the faeces includes four aspects: colour, consistency, content and coating. A variation in any one of these could indicate an underlying condition that needs to be addressed.

Abnormal faeces commonly take the form of diarrhoea or constipation. These conditions can be symptomatic of other, underlying conditions, such as digestive disorders, parasites, bacterial infections and dietary changes or sensitivities. Therefore, it is recommended to consult the vet if the abnormal faeces continue for more than a day or two, and particularly if the abnormal faeces are accompanied by loss of appetite, vomiting.

Appropriate treatment for abnormal faeces may be initially treated supportively for mild cases, though additional diagnostics should be recommended for more severe or ongoing disease. For example, deworming medication will be prescribed if worms are found, or dietary changes if digestive issues are identified.