​Dear friends, this is a different blog post…. We usually write articles about nutrition and health, but this one is personal – this is the story of my own journey against this horrible disease.
Only those who have a cat with PICA know how devastating this disease is. Unlike any other, there is nothing you can do to prevent or foresee it – it can happen anytime, with horrible consequences.
I decided to write this post as up to now, I really hadn’t heard of a permanent solution, a “cure” for feline PICA… But then a small miracle happened – or was it? We beat it! And I feel I must share our experience as if we can help even one kitty out there…. All she went through might make sense…. Might have been worth it.
Without further ado, here is our story –
Blanket was found on the streets, either abandoned by her mom, or someone, but either way – she came to me as a malnourished soon to be bottle baby – itty bitty, and full of spunk!
It didn’t take much to get her going though – aside from tiny, she wasn’t ill, and good food would bring her to great health. She was quickly transitioned to EZComplete and had a voracious appetite. She grew into a gorgeous, healthy little kitty!
One day, when she was a little over one year old, I went out of town and upon my return I noticed that my blanket (how’s that for “well” chosen name?!) had holes in it! LOTS of holes! I didn’t know what had happened, and started watching all my cats like a hawk. 
​That’s when I caught Blanket eating my couch – yep – the couch. She had already made a huge hole in it and was already munching on the stuffing!
Little by little she started to eat everything – her favorites were cloth items – blankets, sheets, couch, towels, pants, shirts…. But she also ate my wall, the wooden cat tree, my mattress... There wasn’t a way to “keep things away from her” – because that meant not having a bed, a couch, clothes, mats, or even walls. 

Vet trips were done, but there was absolutely nothing wrong with her – she was the picture of health… Which was both good and bad news…. Good because of course you want a healthy baby! Bad because medically there wasn’t anything I could do.
There were theories about how kitties that are abandoned by their moms can develop PICA…. Some people found help by adding lanolin oil to their food, as in some cats this seems to be what is called “Wool suckling pica”, and by replacing this component of the wool – lanolin, you might be able to help to curb the craving... I did that, and I thought it was helping…. If it was, it wasn’t enough.
I also did the best I could to redirect her chewing to Lamb Ears chews – while she DID love that, I wasn’t able to make her chew on that 24x7.
Blanket’s first hospital stay with a blockage was on 10/21/2016 – she was 16 moths old. She started hacking and threw up what I came to call a “thing-ball” (Thing-balls were much like hairballs, but made up of things instead of hair). From that point on, she wouldn’t keep food down anymore, and would just keep vomiting. 
Off to the vet we go – X-rays are done, which show a pattern of gas, but are somewhat inconclusive. Since she went to the vet very early, she spent all day on fluids and getting X-rays to see the progression of the blockage – she finally passed it, and we dodged a major bullet.
Three months later, on 01/07/2017, Blanket passes another thing-ball and starts throwing up. I immediately take her to the ER, who tells me she isn’t blocked, and has gastritis – they want to keep her IV and antibiotics. I ask them to see the X-Rays. There it was, her stomach and intestinal tract all full of gas – when I brought that up, the vet said that nope – that wasn’t a blockage. No one in the ER would do anything other than leave her on fluids/antibiotics.
I took her home with me, as I KNEW that was a misdiagnosis, to wait for my vet on Monday (This was Saturday).
On Monday, at 7am I was on my way to my vet. There was no doubt that was a blockage when my vet saw the x-rays, and the radiology report confirmed the location for the exploratory surgery.
Blanket had ingested a piece of my exercise pants made of Dri-fit, and it had absolutely devasted her gut tract – it was as though she had ingested acid – her gut was paper thin, totally corroded.
A few days later, while Blanket was still in the hospital, my other cat Bugsy started having very similar symptoms…. Which was strange, since Bugsy doesn’t have PICA.
Misdiagnosis after misdiagnosis, to make a long story short, it turns out that Blanket had eaten my pants, thrown up half of it, and since she eats raw meat, Bugsy thought it was a nice lunch – yuck! Ate the meat, along with the other half of the pants that she had thrown up, and ended up blocked too. Now I had her on my vet, and him going through Emergency exploratory surgery at the ER, at the same time (I only foud what happened after Bugsy's surgery, when the ER vet scooped up the other half of the cloth).

​Fast forward to August 2017, seven months later. Blanket again tosses out a thing-ball, and I immediately go off looking for what it could be – I find my shorts, with a huge hole she had eaten (picture on the right). She starts again, throwing up violently. Luckily a day at the vet on fluids made her pass that one – another bullet dodged!
November 01, Blanket hacks and violently throws up dinner. I immediately knew that was bad. Decided to fast her and leave a message to my vet saying we were coming first thing in the morning with a blockage.
Sure enough – Blanket was blocked, and another exploratory surgery was in order. This time she had eaten the tip of my winter glove. It took me weeks to realize that she had fished this glove through a 1” opening on my dresser and eaten the tip of it. That-is-how-bad-she-was.

Anyways, as she is recovering from surgery at home, not even a week later, I catch her eating a bath towel.
I immediately picked up the phone and made the call to her vet that would forever change our lives.
First, I explained to him that I had just caught Blanket eating a towel, and that I was afraid for her life – it was much too soon to have another surgery. Then I said I needed him to keep a very open mind, as that had not been done before – but I had my reasons to think it would work.

• "I need you to remove her molars and pre-molars. I need a full mouth extraction"
• Silence.

I explained my logic – I observed how Blanket chewed, did some research, and got to the conclusion that even if she chewed, she wouldn’t be able to rip and tear the material she was chewing on, greatly reducing, if not eliminating the danger of blockage. He did agree that it made sense.
He met with all the vets in his practice, and all but one agreed with me and him. We scheduled the surgery for as soon as possible, and that day couldn’t come soon enough!
The days leading up to that surgery were excruciating – walking on eggshells doesn’t quite explain what I was feeling. Every day she didn’t hack, every day she didn’t block, was a victory…. And then finally, the day arrived!
I had all these feelings within me – guilt, sadness and relief. Guilt and sadness because I knew I was putting her through pain, and couldn’t explain to her why she was going through that yet again <3…. Relief because if that worked, she would never go through that again! I was finally looking forward to sleeping a full night without the fear of her eating something that could potentially kill her….
Blanket did great through surgery, and the 4 large molars and 4 large pre-molars were removed. 

​We came home, she ate a meal, and few hours later, something very interesting, very telling, happened:
Blanket jumped on the coffee table and incessantly started to look for something to chew. She was completely OCD – desperate. She finally found a dried lamb ear that I had hidden from her, as I was scared of being too rough on her stitches…. Since she was so desperate, I gave it to her and she ran away to chew on it. My instincts kicked in, and I decided to give her a dose of buprenex – that was just too strange... She was just too desperate to chew on something. As soon as the bupe kicked in, she stopped chewing. And that was the last time she chewed on something – the last time.
Folks, Blanket’s PICA wasn’t OCD – it was PAIN.
Even though there was nothing that could be seen through X-rays, and she had no teeth/gum disease, she was in pain, and she chewed to relieve that pain. That became SO clear when I gave her Buprenex and she stopped chewing! And of course as clear as day now, that her teeth are gone, and so is the behavior.
I wasn’t expecting this – I was expecting her not to be able to rip and tear the cloth material…. But the behavior itself is gone.
In hindsight, it all makes sense…. Babies chew to relieve the pain of teething…. Kids with braces chew gum for pain relief…. Why wouldn’t cats?
The issue with cats is that as obligate carnivores, their teeth are made to rip and tear – unlike us that chew in and up and down motion, they chew back and forth – and when they rip, their tongue hooks complete the job in aiding them swallowing whatever they are chewing. The damage is done.
Friends, I don’t know if this is a solution for someone else other than us…. But after going through what we have gone through, I can’t imagine why it’s not possible to think that this might be a physical problem, instead of purely a behavior problem – honestly.
My Blanket is not, by any means, a stressed out kitty – she isn’t OCD in anything else – she has no reason to be. She displays no signs of any OCD behavior – why PICA? Why are all these cats suffering from PICA? Why is no one out there considering the possibility of pain?
I know this might be seen as a radical solution – trust me, I was well judged when I shared this idea in an online group, and I might be judged now – but to me, it was far more radical to know that she would be going through a life of one exploratory surgery after another – she simply wouldn’t survive. 
It might be too soon…. But this is the longest she has been without chewing on something….  Her recovery was very quick, and she didn't skip a beat. As for me? I am finally able to sleep through the night knowing that when I wake up she won’t be blocked. Walking on eggshells is finally behind me. 
Carolina

We are proud to announce that human grade – no additives, no flow agents – powdered EGG YOLK is joining our product line-up!

Are you tired of Hairballs? Did you know that egg yolk is one of the best natural hairball Preventatives? 

As discussed in our article - Hairballs - How Best to Manage Them,  Egg yolks provide many nutritional benefits, but what concerns us as far as hairballs, are specifically the choline and lecithin.
 
Choline. A component of choline is acetylcholine. Acetylcholine acts as a major neurotransmitter for the autonomic nervous system (which includes the GI tract). The stomach and the intestines contain a muscular layer that allows for wave-like contraction of the organs, known as peristalsis. This process propels food through the digest tract. The National Digestive Diseases Information Clearinghouse states that acetylcholine increases the contractions seen in the muscular layer, thus improving peristalsis and pushing food efficiently through the digestive tract. Choline (and its component acetylcholine) improves GI motility, which is what propels hair through so it comes out the proper end.
 
Lecithin. Fat is what binds the hair in the stomach, creating that sticky, often stinky, gooey mess that is a hairball. Lecithin is a fat emulsifier: it emulsifies the fat binding the hairball(s), enabling kitty to pass the ingested hair.
An species appropriate diet, brushing regularly, and adding egg yolk to your kitty's diet are great natural ways to prevent the oh-so-dreaded hairball problems. 

But wait! There is much more! “What's so special about egg yolk?” you ask?
 
Eggs are a nearly perfect food, and the yolk contains the bulk of that nutrition. Discussed as “nature’s multivitamin” in many articles, eggs are truly a powerhouse of nutrition as one of the most nutrient dense foods on the planet. With almost every essential vitamin and mineral our pets’ bodies need, egg yolk is the perfect superfood complement to any diet – and essential in a homemade diet, most notably for choline which almost always come up short without the addition of egg yolk (or whole egg).
 
There is no source of choline richer than egg yolks, with 820mg of choline per 100 grams. Not even beef kidney (the food with the next-highest choline content) rivals that of yolk - egg yolk contains 60% more choline per 100 grams. (!!)

• Choline is vital to proper nerve & muscle function and normal liver metabolism.
• Without adequate choline in the diet, there is a higher-than normal risk of chronic liver damage (and eventual liver failure).
• Choline helps protect against age-related declines in cognitive function. In humans, choline has been shown to play an important role in preserving memory, and low acetylcholine (a component of choline) levels are associated with the development of Alzheimer’s.
• Finally, of particular importance for our cats and ferrets, choline aids gastrointestinal motility, which is why egg yolk is an incredibly effective tool in preventing hairballs, as addressed above.

 
Egg yolks are also one of nature’s richest sources of biotin. Biotin supports healthy metabolism of fatty acids, amino acids, and glucose. It is essential for healthy thyroid and adrenal function, a healthy cardiovascular system – it also protects brain function and fights cognitive decline. However, biotin is probably most renowned for its role in healthy, beautiful skin, hair and nails. In our pets, this means egg yolk will contribute to soft, silky, shiny fur; aiding in resolving dandruff; and helping to prevent cracked dry nails and fungal infections.
 
To learn more about the benefits of egg yolk, we discuss each ingredient in the EZComplete premixes, including egg yolk, here.
 
Of course, the EZComplete fur Cats and EZComplete fur Dogs premixes already contain the egg yolk needed to provide a balanced diet. But if your dog, cat or ferret has a health issue that would benefit from a multivitamin - consider egg yolk! Or if your dog has dandruff, or your cat or ferret is suffering hairballs, consider supplementing with egg yolk.  And as fats moisten stool and increase transit time, if your pet is prone to constipation, reach for the egg yolk. It is a terrific tool for managing chronic constipation. Some pets may also need an osmotic laxative like lactulose, or a bit of fiber. But for our carnivores, this is the species-appropriate place to start.

For those that have pets that do not enjoy natural, raw yolk, or for those of you that need to cook too many eggs to be practical, we've done the work for you. EZ Egg Yolk is a very easy-to-measure and use alternative! 

                                                                                                                                                                                                              

Getting medication and sometimes food into our cats are important skills. Even if our veterinarians show us how in the office, they often make it seem so easy - but once we get home it's a completely different experience. Here Carolina and I (Laurie) share important information about medicating and assist feeding your cats, and the methods we use to accomplish those feats. It wasn't all roses, and it usually results in some emotional trauma (more for us than our cats!), perhaps a mess to clean up, or a wasted, soggy pill. We all have to start somewhere. Hopefully these tips will make it easier.

Let's get started -

Obviously, the easiest method is to get your cat to eat the pill. For tablets and small capsules, this is the raw feeding equivalent of a pill pocket. Thank you, Carolina, for this tip!
 
Meat Pocket
Cut a small piece of meat that is small enough to be bite-sized, but big enough to snip a “pocket” into it with shears (or use a knife if you’re handy with them, I am not). Put pill in pocket, feed to cat - not as part of the meal, you need to ensure kitty eats it. If this method doesn't work, you may need to pill your cat.
 

Medicating with Liquids
For liquids, use the same techniques as for pilling. It is still best to follow the medication with water.


Pilling Kitty

Never pill a plain pill. I always put tablets into a #3 size empty gel cap (example: NOW size 3 empty gelatin capsules), and though it makes it a little slippery, I coat the pill with something, usually a bit of butter. Wet capsules can get stuck in the throat.
 
Pills should NEVER be given alone and dry. Think of your own experience swallowing a pill. It is not just uncomfortable, it can cause physical damage. Strictures are usually not reparable in cats, and over time dry pilling can cause scarring and restriction of the esophagus (to the point a cat must be put on a liquid diet).

If you are using your finger or a piller that doesn’t have a water chaser, to prep for giving the pill, have a little dish ready with a bit of something for them to lap up. Bone broth, meat broth (made for the cats with nothing added, just plain broth), “meat juice” if they like that (what separates from meat during thaw), a little tuna water… whatever works for your cat. Once you’ve gotten the pill down, they need to drink something to wash it down!

Use praise. LOTS of praise. Before, during, and after. Praise your kitty, tell her what you’re doing and why. Tell her WHAT a good girl she is, how much you love her, and don’t stop talking. Calm, sweet, loving, dotted with lots and lots of praise.
 
The main ingredient is confidence. It takes practice, but it won’t be long before you can approach your kitty wherever she is, hold her head, pop the pill in, and it’s over and done with before she realizes it happened. Take a big deep breath, or a few of them. Think “I can do this!” And just go for it. Worst case, your cat spits the pill out and you must try again. But this does NOT hurt your cat, and you will NOT harm your cat.

If you are still nervous, sing, even if you don’t sing. It calms both of you down. Just pick a tune you know, kitty doesn’t care if you sing in key. And sing the stuff you’d talk to her, if you don’t know the words to a song. Kitty doesn’t care if it rhymes or even makes sense.  I no longer need to sing to pill, but I do need to sing trying to get a few of them to do other things (like scuffing them into a crate to go to the vet. I have quite a few still semi-feral cats). I usually sing to the Monty Python Lumberjack song. “You’re a kitty cat and you’re ok! You need this pill so you can play and play…”


Pilling a Cat - Video demonstration by Carolina

Pilling a Cat - Laurie's Method
 
Important notes before we begin:

I am right-handed. If your dominant hand is the left, the point is to use your dominant hand for the work (getting the pill in, using the syringe, or swiping the food) and the other hand to control the cat’s movement.

You can use a piller rather than your finger. Unlike Carolina who is comfortable with a piller, I’m a spaz with one. I use what I feel in the cat’s mouth wtih my finger to know where the pill is. Yes, the cat usually chomps my finger, but rarely do they break skin. If you use a piller, best to use one with a water chaser as demonstrated by Carolina in the video, above.
 
The Process
 
When putting something in a cat’s mouth, it is their natural reaction to back away. Use this to your advantage. Sit behind your kitty, knees bent, butt on your heels, legs in a V shape. Use this position to “hold” kitty in place. There’s nowhere to back up, and your legs help hold the cat in place.

I use my left hand (my non-dominant hand) to hold the head, thumb on top of head, the rest of my hand under the chin, head “cupped” in my hand. You are not hurting your cat: hold firmly! I can manipulate where the head is this way. I have the pill (or if you prefer, a piller) in my right hand (holding the pill with my thumb and index finger). I push the mouth open with my left index finger. Locate the back of the mouth, where the upper and lower jaws hinge together. With your other hand (holding the pill), locate the back of the mouth with your middle finger, so you’re ready with the pill.

Hold the head tilted up with your left hand, it makes this easier.

I push at the hinge of the jaw, into the mouth, with my left (non-dominant hand) index finger. Push firmly. The mouth will open. (I’m already holding the pill in my right hand in the correct position, at the back of the mouth, ready-to-go). I push the pill in from the right side at the back of the mouth with my right (dominant hand) index finger. I stick my finger in the mouth, guiding the pill ALL the way to the back of the mouth, over the hump of the tongue. I push quickly. Just get it over that hump, you'll feel it. Remove finger immediately. Yes, my finger usually gets chomped. It doesn’t hurt much, skin is rarely broken. I have been using my left hand to prevent the cat from thrashing the head around, and my body and legs hold the cat in position, though there may be some wiggling.

As soon as I’ve removed my finger, I hold the mouth closed, and keep the head tilted up (and now your dominant hand is available to help). If you let the head down while pilling, tilt it up again. Holding the mouth closed prevents them from spitting it out, and tilting it up has gravity helping do the work. I hold the mouth closed until they swallow. If they resist swallowing, just stroke the throat gently with your right hand while still holding the head firm with your left. Or you can tilt the head all the way up and blow a gentle puff of air on the nose. As soon as they swallow, you’re done! Praise the heck out of her, and offer the liquid to drink.

Assist Feeding

IF YOUR CAT IS NOT EATING, IT IS UP TO YOU TO GET ALL THE NUTRITION SHE NEEDS INTO HER. Cats' livers are NOT designed to deal with processing fat stores. Without food, your cat starts to release fat and “eat” her own muscles. This fat can flood the liver causing a liver disease called hepatic lipidosis, or “fatty liver” and this IS life-threatening. It also makes your cat not want to eat, and the primary resolution is food. This is not treatable with a medicine. Food IS the medicine.

Assist feeding notes:

When to assist feed. As discussed above, a cat not eating can cause liver disease. Overweight cats are particularly at risk. When a cat has not eaten for 24 hours, or only "picked" at food over a 24 hour period, you need to begin assist feeding. Of course, a vet visit is warranted to discover the cause of the problem. Walking away from food is a sign of nausea in cats, and needs to be addressed and managed. But getting the nutrition your kitty needs into her will help support her best health, no matter the cause. It's important to note that without food, cats often develop acidic tummies, and the cycle of nausea perpetuates itself without food.

What to assist feed. If you need to assist feed your cat, as your cat is already in distress, it is best to continue to use the food you are currently feeding to minimize GI upset. The exception is kibble. Then we recommend using baby food or plain poached chicken breast. Thus, if you feed raw, continue to use that - though if you feed ground with bone, you will have to make a batch substituting eggshell for bone so you can put the food through the syringe. To use eggshell as the source of calcium, use 1/2 teaspoon (3.1 grams) of very finely ground eggshell powder for each one pound (450g) of meat/organs. If using commercial raw, in the U.S. there may be a Rad Cat distributor near you. This is the only commercial raw that is ideal for a syringe as it uses eggshell, not ground bone. If you want a very plain diet, you can use ground meat balanced with eggshell and taurine (1/32nd tsp of very finely ground eggshell powder per ounce (28.35g); for larger batches, one-half teaspoon per pound (450g), and to one of the syringes each day add 250mg of taurine). This can be done with raw or cooked meat. If you feed homecooked, we recommend you assist feed your homecooked food.

Many vets will tell you or encourage you to use prescription food designed to be used in a feeding tube, this makes it easy to use in a syringe. But if your cat has not been on a commercial diet recently, this is likely to cause GI upset, and there really is no need for this. For those new to raw and concerned about using raw when kitty is sick, please read our article Why You SHOULD Feed Your Immune Compromised Cat Raw Food. Having your kitty feel unwell from food simply because it was designed to be used in a syringe makes no sense. The vets that are not anti-raw tell you to keep feeding your cat raw. If YOU feel more comfortable feeding cooked, that's fine. Then cook the food you would feed, just make sure to use eggshell calcium instead of bone. Of course, food made with EZComplete fur Cats works very well in a syringe once prepared for it. When my cats are ill and need to stay at the vet, I take prefilled syringes with raw food, and they assist feed those rather than the canned Rx they would use. And thus my cats don’t get stomach upset from food they are not used to eating. If your vet won’t do that, fill them with baby food. Or poach chicken thigh. By including some fat, this is just as high calorie as the a/d. The a/d has 183 calories per 5.5 ounces, it isn’t a particularly "high calorie" food.

Prepare the food for the syringe. If assist feeding raw or homecooked, you’ll have to run it through the blender with some water. If you feed raw with bone, you will have to make food using eggshell as a substitute for ground bone. See above.

I use a knife to load the syringe from the top. Carolina uses a spoon.  We both prepare as many syringes as we're going to feed in one sitting before we start.

How Much Food?

For the feeding, start by giving a small amount per plunger push: 1ML to 2ML are good amounts to start with until you get the hang of it. I usually give 3ML in one squirt.

For the day. One of the biggest assist feeding mistakes is not getting enough food into your cat. You need to get all of the daily nutrition your cat needs into her. It is best to work up to the full daily quantity by starting with at least half of her daily need on day one. Day two, target three-quarters. On day three, you should start getting her full daily need.  If you are unable to get ALL the food your cat needs into her, please get a feeding tube. Feeding tubes save lives and are completely underutilized in cats. They are a quick procedure with a light anesthetic, and usually very well tolerated by cats, and even most sick cats can manage the procedure. You vet is the best judge of how your cat will handle the procedure. Whether for three days or three weeks, feeding tubes reduce the stress on both of you and ensure your cat gets the nutrition she needs.

Determining the daily food requirement.  As to how much to feed of the course of a day, the math is straightforward. 5ML is one teaspoon of food. Three teaspoons are a tablespoon. So each 15ML syringe is one tablespoon, and that is approximately one half-ounce of food. If your kitty eats 4.5 ounces a day, that means over the course of a day, your cat will need to be fed nine 15ML syringes of food. You can feed one every hour to hour-and-a-half. You can feed two every few hours, and one at the end of the day. You can feed three meals a day of three syringes. Whatever works best with your schedule.
 
Where to Feed. I assist feed in a bathroom. It’s closed, warm, and easy to clean up. And if for some reason the cat gets away from me, I can more easily corral them again.

Assist feeding is messy – more so when you’re still new to it. Have lots of paper towels handy!


Assist Feeding - Carolina's Method

Please note, this video was made before Carolina transitioned her cats to raw food. Now when any of them need assistance eating, Carolina prepares their regular raw food (raw meat + EZComplete fur Cats) to use in the syringe. (I use the same). She uses her Magic Bullet to blend with water into a consistency easy to use in the syringe. I use my small food processor. As food made with EZComplete fur Cats is moist, it doesn't require much water using the Four Paws Easy Feeder syringes featured in the video and discussed here, as you control the width of the tip by where you cut it to create the opening in the cone on the feeder syringe.

Carolina found the BEST syringes: Four Paws Easy Feeder. No rubber, so they never stick. Easy to clean. They’re large enough to be useful, but not so large you can’t handle them – and we both have small hands. Best, you cut the syringe tip to the width you want it, which makes syringing raw food SO much easier. The pack comes with one food syringe with a cone shaped feeding tip and one liquid syringe. I cut the long thin part off the liquid one, and thus I get two food syringes. Carolina finds the tip on that to be too thick - and it is a wide opening, so best to use the cone syringe as a beginner. The syringes are 15ML each. That is half an ounce of food. When assist feeding, it is often best to feed more frequent smaller amounts. But it sure is helpful to be able to feed an ounce at a time (two 15ML syringes). The syringes the vet gives you are meant to be used with a feeding tube, and are very limiting both in terms of how much food you can feed (they're usually 10ML at most) at one time, and the opening is very small, so it's difficult to get food through it.

In this video, Carolina demonstrates how to assist feed using a cat bag. This works to settle and calm the cats, reducing the stress of assist feeding. It also restrains the cat, so you are free to use both hands. It is stressful to assist feed a struggling cat. ...Though as we've found, you may find that after a few meals, your cat realizes she feels better, and settles down (often after initially objecting just on principle).  But this is Carolina's first time assist feeding Lucky (though Carolina was already experienced with assist feeding when this video was made). My Lazlo was the first cat I ever had to assist feed, and at first, of course, he hated it and fought it. But as I got better at it, and he realized he felt better with food in his tummy, he quickly became cooperative and purred throughout - as you can see Lucky is almost enjoying her food, here. Carolina and I think it's important to note: while this is the first time Lucky was assist fed, she is calm and not struggling. Our cats are so sensitive to us, if we approach it with fear and trepidation, we can expect them to object. Approaching it calmly, with love, gentleness and confidence, they respond, as Lucky does.

Assist Feeding - Laurie's Method

The instructions for assist feeding are exactly the same as pilling, only you’re not putting a pill in the mouth, you’re putting the tip of a feeding syringe. And instead of aiming for the throat, tilt the head up with your left hand, so it’s easy to point the tip of the syringe at the roof of the mouth. By pointing at the roof of the mouth, you can be sure you’re not going to make your cat accidentally inhale food.

 
Finger Swiping
 
This can be used for small amounts of food, but it isn’t very efficient. I use this to get slippery elm bark powder “paste” into my CKD cat. I used to use the slippery elm “syrup,” which seems to work much better for nausea than straight slippery elm bark powder. But now I’ve a CKD cat that needs this basically daily, I find it easier to just finger swipe a paste into his mouth – and by replacing water with the George’s Distilled Aloe Vera Juice (now labeled “drink”), he needs less of the paste to be as effective as 3ML to 5ML of the syrup. The usual directions for the paste are one-quarter teaspoon of slippery elm bark powder and one-half teaspoon of water. Stir and let thicken. But now I replace the water with George’s Aloe – and he doesn’t need all of it. I’ve reduced it to 1/8th tsp slippery elm bark powder and one-quarter teaspoon of George’s aloe vera.

Have the paste handy. Follow the instructions for pilling, only rather than holding a pill to put in the mouth, you’re putting a blob of aloe paste on the end of your dominant hand finger. Rather than push a pill all the way into the back of the mouth, you're just “wiping” the paste into the back of the mouth. Open her mouth with the index finger of the hand holding the head as instructed in the pilling section above, and quickly wipe that blob of paste (or food) that's on your other finger into the back of the mouth. No need to push it anywhere. Close the mouth with the left hand, hold the head tilted up, wait for kitty to swallow. Repeat as necessary to get most (or even all) of it in. If you only need the smaller amount paste to help your kitty’s nausea, you should be able to get it done in one or two swipes.

Last week PetFoodIndustry.com published a blog post, "Simple, clean pet food labels: altering the discussion." The very premise of the article is quite ironic: consumer perception is the problem, not the pet foods. It's not that consumers are becoming better educated as to what provides the best promise of long term health to their animal companions. No, on the contrary, the "problem" is the failure of the pet food industry to properly educate the consumer about the existing ingredients in pet foods. After all, pet food is all about the science of nutrition. And, you know, "science is hard." 

The author asks "So, what is driving this clean label trend?" and answers: "Like many things, it is consumer demand, driven by perception. In this case, it is backed by nutritionists who agree that eating a diet made up of whole, unprocessed foods such as fruits and vegetables is better for our health. So, consumers will be compelled to read the labels of processed foods, looking for something that is as close to the original state as possible, but with the convenience of a packaged food."

Consumer demand. Driven by perception. Backed by nutritionists who agree that eating a diet made up of whole, unprocessed foods is better for our health. Well, consider substituting "education" for "perception" and "Informed by" for "backed by" and see what happens. The concept then reads "Like many things, it is consumer demand, driven by education. In this case, it is informed by nutritionists who agree that eating a diet made of of whole, unprocessed foods ... is better for our health."

Is this a bad thing, pet parents wanting to provide their pets healthy, whole foods?

Well, if you are Mars, Nestlé, or Del Monte (with what has been renamed the Big Heart Pet Brands) - the largest pet food companies in the world - the knowledge that a solely processed food diet isn't healthy for us or our pets is a bad thing. As they are all also among the largest food and beverage companies in the world, of course they want to counter the notion that homemade and fresh foods are the best foods for us - and our pets.

But if it is science they want, there is a growing body of it. Just a few weeks ago, a team of Australians from the Charles Perkins Centre and School of Life and Environmental Sciences at The University of Sydney published a report, Nutrition Ecology and Human Health.  The message of the report is straightforward: nutrition science is broken. In a nutshell, while focusing on micronutrients had its place in our understanding of the importance of diet in combating disease, that nutritional model that breaks down nutrition into its components is fundamentally incompatible with the "new suite of nutrition-related diseases."

"Food science" isn't failing just human health. There is - sadly - plenty of evidence the same holds true for our pets. As mentioned in our article, Cat Food vs. Cat Health, it is a relatively recent situation that approximately 60% of pet cats in the U.S. live indoor-only. This means that our little predators are not out hunting field mice, voles, rats, or rabbits. They have become completely dependent on us for their nutritional needs. What this also means is that health problems associated with the typical commercial diet are becoming ever more apparent, especially as access to veterinary care and safety from cars and predators contributes to their longer lives.  Our cats are overweight, blocking from crystals in their urine, suffering dental disease, and GI disorders are rising at alarming rates, with the incidence of inflammatory bowel disease and pancreatitis now making the "Top Ten" lists of VPI Pet Insurance. Our cats are dying primarily of kidney disease and cancer.

Surely food alone does not account for all of these problems. But at Food Fur Life we ask, how healthy would we be if all we ate was dry cereal and/or canned stew – all made with ingredients that weren’t fit for our consumption?  No, Pet Food Industry, the problem is not lack of consumer education as to the "safety" of the ingredients in the diets you provide. Your problem is consumers are learning their carnivorous pets need whole, fresh, quality, species-appropriate foods for their best health, too.

This is why we created Food Fur Life - to make healthy homemade food accessible to everyone. To make it easy for the busiest of pet parents to provide their pets a fresh, truly human-grade meat-based diet based on the prey model. Blending the best of mother nature and science, whether pet parents are time constrained, and feel they don't have the time to make their own  pet food all from scratch, or whether there is concern about "doing it right," we have the solution. And it really is EZ, with EZcomplete.

Most of you must recognize the word "Kefir" from the milk/yogurt aisles in the supermarket.... But do you know what Kefir is? 
The word Kefir derives from the Turkish word keyif, which means "Feeling Good" , and it's believed to be original from the Caucasus Mountains. 
Its history is full of legends, and can be "traced" all the way to the Prophet Mohamed and mentioned by Marco Polo!  
It is also believed Kefir was used as a way to preserve milk by means of fermentation, in the absence of refrigeration and pasteurization.  Kefir grains were added to milk, generally in a goat skin leather bag, and hung by the door. Everyone who went by or through the door, shook the bag with its foot. After 24 hours, the fermented milk was poured, and fresh milk was added to the grains, keeping the fermentation process constant. 

But just what are the Milk Kefir Grains?
Kefir grains are microbially derived protein and polysaccharide matrices that contain cultures of bacteria and yeast that are essential to Kefir fermentation.
The bacteria found in the grains depend of several factors, including the Milk used during fermentation, the fermentation process itself, and even the region where the grains originate from. 
​Mainly  comprised of Lactobacillus, common bacteria strains include: Ref 1, Ref 2, Ref3
Lactobacillus acidophilus, Lactobacillus brevis, Lactobacillus casei, Lactobacillus delbrueckii subsp. bulgaricus
Lactobacillus delbrueckii subsp. delbrueckii, Lactobacillus delbrueckii subsp. lactis, Lactobacillus helveticus, Lactobacillus kefiranofaciens subsp. kefiranofaciens, Lactobacillus kefiri, Lactobacillus paracasei subsp. paracasei, Lactobacillus plantarum, Lactobacillus rhamnosus, Lactobacillus sake, Lactococcus lactis subsp. cremoris, Lactococcus lactis subsp. lactis, Lactococcus lactis, Leuconostoc mesenteroides subsp. cremoris, Leuconostoc mesenteroides subsp. dextranicum, Leuconostoc mesenteroides subsp. mesenteroides
Pseudomonas, Pseudomonas fluorescens, Pseudomonas putida, Streptococcus thermophilus

Yeast Strains:
Candida humilis, Candida Kefyr, Kazachstania unispora, Kazachstania exigua, Kluyveromyces siamensis, Kluyveromyces lactis, Kluyveromyces marxianus, Saccharomyces cerevisiae, Saccharomyces martiniae, Saccharomyces unisporus, Debaryomyces hansenii, Dekkera anomala, Torulaspora delbrueckii, Pichia fermentans, Saccharomyces turicensis, Issatchenkia orientalis and Debaryomyces occidentalis.

Depending on what milk you use and on the quality of the Kefir grains, Kefir can contain anywhere from 1 billion to 10 billion CFU of bacterial/yeast probiotic per ml (cc). That is 5-50 billion CFU per TSP! 
It is important to note that Kefir grains, unlike the name suggests, are very much alive, and as such must be taken care of.... As any alive being, it must be fed - but what does it eat? That is the beauty of it: LACTOSE! 
In kefir, lactic acid bacteria are primarily responsible for the conversion of the lactose present in milk into lactic acid, which results in a pH decrease and milk preservation. Other kefir microbial constituents include lactose-fermenting yeasts that produce ethanol and CO2. Non-lactose fermenting yeast and acetic acid bacteria also participate in the process. After each fermentation "batch", the grains biomass increase in about 5-7%, which is why the bacterial/yeast composition varies according to the milk and process used for fermentation. 
Unlike the original days, the methods used to produce Kefir at home today differ in several ways. Of course no one is leaving a goat skin bag full of milk by the door to be pounded at, for one!
Today Kefir is mostly made in glass jars, kept out of the sunlight to preserve the most amount of vitamins as possible. With that, comes one issue - The grains only feed what they can touch. 
While some will instruct to pour the milk over the grain in a jar, loosely cover it with a cheese cloth or a plastic lid, put the jar in the cabinet and forget about it for the next 24 hours, I beg it differ. By gently mixing the Kefir every so often you are making sure the grains are evenly distributed, therefore more lactose will be consumed, achieving a more thoroughly fermentation process. This is specially important for cats, which are mostly lactose intolerant.
Another way of decreasing the amount of lactose is by doing what is called a "double fermentation" - you simply strain the Kefir after 24 hours into a clean jar, this time closing the lid, and place it into a dark cabinet for another 12-18 hours. The whey will completely separate from the curd, but a smooth texture can be achieved by using a blender. 
Not only Kefir is virtually lactose free, but studies show that Kefir can actually actually improve lactose digestion and tolerance overtime.
The benefits are countless - not only Kefir is a powerful, natural, live probiotic, but it also:
In multiple studies, consumption of kefir or kefiran in an animal model has been associated with an increase in microbes thought of as beneficial, such as Lactobacillus and Bifidobacterium, while simultaneously decreasing harmful microbial species such as Clostridium perfringens​ (1, 2),  Reduces the severity of Giardia , inhibits the adherence of Salmonella typhimurium and E. coli, 1, 2, 3.
Kefir has shown a multitude of antibacterial and anti-fungal activities and has been tested in disk diffusion experiments against a wide range of pathogenic bacterial and fungal species, found to have antimicrobial activity equal to ampicillin, azithromycin, ceftriaxone, amoxicillin, and ketoconazole (Cevikbas et al., 1994; Yüksekdağ et al., 2004; Rodrigues et al., 2005; Huseini et al., 2012).
Kefir also has anti-inflammatory and healing properties, and was effective in postoperative treatments and in patients with gastrointestinal disorders.
​Several studies have shown Kefir to have anti-carcinogenic effects 1, 2, 3, and can also act as an anti-oxidant.
But one of the major ways probiotic products such as kefir are able to produce health benefits is through the modulation of the gastrointestinal immune system.
Kefir has shown in studies anti-allergenic and anti-asthma properties, is capable of decreasing the levels of blood glucose, improving the symptoms of constipation, among many other health benefits.
It's important to note that the quality of traditional kefir is mainly influenced by the microorganisms present in kefir grains and kefir processing conditions. Although scientists and food companies attempted to develop a commercial “kefir-type” beverage produced by different cultures and mesophilic and thermophilic lactic acid bacteria, or even pure cultures isolated from kefir grains, their success when compared to traditional kefir is limited. It is suggested that this limitation is due to the microbial diversity present in kefir grains and their interactions, which can determine the probiotic and therapeutic properties of final product, as well as peculiarities conferred by certain minority groups present in different grains.

How do you acquire Kefir Grains?
Kefir grains are passed on from friends or family, or can also be bought online in sites such as Amazon.
When consuming Kefir, you are drinking history! Think about it - you can't just create those grains out of nowhere.... They have been passed around from one person to another, until that they got to you! And the beauty of it? Every time someone used a different milk, a different processing method, temperature, etc - the microbioma in the grain has changed! 
You will notice that once you start making kefir on a regular basis, your grains will start multiplying exponentially - that's why they are passed around. What else can you do with them? You can eat them - they are just about the most potent probiotic you can get your hands on! 

Feeding Kefir to your Pets:
​We cannot stress enough the need to start SLOWLY. And we mean VERY slowly. Kefir is a very potent probiotic, with many substances your pet has never consumed. 
Dosage:
Give a teaspoon to a tablespoon of kefir to small cats or small dogs a day.
Medium size dogs – 1 – 2 tbsp.
Large dogs – 2 – 3 tbsp.
***Cats specially: Start with 1/8 tsp, and increase every FEW days by doubling the amounts. Give your cat only 1/2 of the dosage for at least one to two weeks before increasing to 3/4 and so on. 
If your cat has any reactions to Kefir, you can try two things:
1- Do a double fermentation - still reacted?
2- Change the milk for goat milk - still reacted? 
Stop giving it. 
I personally had a cat react to kefir, to both Regular Cow's milk and Raw goat milk. I am giving him a break and will try a very slow introduction later on.
My other cat seemed to react when I increased the kefir to 1/2 tsp per meal, however the problem was solved with a slower introduction, and a double fermentation. She is also ok with Goat Milk Kefir. 
I have substituted my cats', mine and my dog's store bought probiotic for Kefir, and everyone is doing terrific!
Kefir has been the perfect addition to the kitties' EZComplete diet - how would it not be with so many wonderful properties?

Don't panic! Just as with people, healthy cats can suffer an “upset stomach” from time-to-time. We may not know the cause, and it doesn’t necessarily mean a trip to the vet is in order. After all, we don’t always run to the doctor immediately if we or one of our children has a bout of diarrhea. The key is to observe your cat’s behavior both in and out of the litter box.  This is at the heart of the distinction between heading to the vet now and taking steps at home to help your kitty get over this quickly.

Where do I start?
When do I take care of this at home?
How do I know if I need to take my cat to see the vet?

Read on!

For Starters....

Put the pumpkin away. Don’t reach for the rice. Head to a health food store, vitamin shop, Whole Foods, pharmacy or chemist and purchase a probiotic called Saccharomyces boulardii, “S boulardii.”  It’s OK – even better – if it has L acidophilus, Bifidobacterium, or other bacterial strains of probiotic in it. It is usually sold without other probiotics as 5 billion CFU or 250mg capsules. This is perfect. We’ll tell you how to use it.

Pick up some chicken breast (if kitty has a chicken sensitivity or allergy, buy turkey breast or pork loin instead). Check the sodium level to make sure the meat isn’t “enhanced” (soaked in a salt solution). If the meat has less than 100mg of sodium per 4oz serving, it is safe to feed your cat. (This is typically a problem only in the U.S.). We’ll explain how to use this after we discuss when it is safe to care for kitty at home and when you need to get your cat to the vet.

First, let’s talk about poop.

Acute Diarrhea vs. Chronic Diarrhea vs. Soft Stools

Acute diarrhea is the abrupt onset of frequent loose or watery stools, more often than normal. Think stomach cramps and lots of trips to the bathroom. It is the body’s method of removing something it wants to be rid of. The most common causes are medicines, a sudden food change, eating something they shouldn’t have, eating too much, a virus, parasites, vaccinations, and stress and/or anxiety. It comes on and lasts for one to three days on average. Acute diarrhea is usually a large bowel problem, and kitty goes to the litter box frequently but may not pass much stool at each visit. There may be fresh blood or mucous in the stool.
 
Chronic diarrhea is usually either a symptom of a medical condition, or due to an irritant to which kitty is constantly or frequently exposed. Poor quality food, grains, poor quality fats, too much fat, food allergies/sensitivities, untreated parasites, gut dysbiosis, inflammatory bowel disease, small intestinal bacterial overgrowth, hyperthyroid, exocrine pancreatic insufficiency (EPI), liver or kidney disease, etc. are often at the root of chronic diarrhea. Chronic diarrhea does not come-and-go (though if your cat has frequent recurring bouts of soft stool or watery stool, that may be an indication of an underlying problem). Chronic diarrhea is usually associated with the small intestine, where poop volume is normal to more-than-usual, and frequency is normal to slightly increased. There is not usually mucous in the poop.
 
Soft stool is not diarrhea. We may never know what caused it, but it is not at all unusual for a cat, on occasion, to have a bowel movement that isn’t normal. The primary difference is kitty is not in the box frequently. It’s just a “not normal” stool texture/consistency being passed when your cat goes to the bathroom. It often only lasts for one or two bowel movements, unless a food change has caused it.
 
Extremely watery stool with straining can be an indication of impacted feces or some type of obstruction in the bowel that only liquid can get around. The straining may cause vomiting. If the problem is due to impacted feces, the issue is actually constipation and the condition is called obstipation. Whatever the cause of the obstruction, a vet visit is required. X-rays are needed to rule obstruction (whether an ingested foreign object, a stuck hairball, or a growth in the intestines) in-or-out, and if the problem is impacted feces, kitty most likely needs an enema.
 
 
What about Mucus and Blood?
 
Seeing blood in or on your cat’s stool is distressing for anyone. But fresh blood and/or mucous due to irritation is not unusual. Mucus has a jelly-like quality and its function is to coat and protect our gastrointestinal tract from mouth to … the other end. Mucus coats the lining, providing lubrication and protection to the underlying tissues. An immune response can cause inflammation, and the body produces excess mucus to help protect and heal. Lining disruption due to inflammation can also, at times, lead to little burst vessels that cause some fresh blood to be present in or on stool. Slippery elm bark powder should be used when there is blood/and or mucus in the stool. See below for instructions.

Do I Need to Run to the Vet?

 That is based on the age, prior health status, and behavior of your pet. Diarrhea in the young, the old, and those whose health is already compromised are at high risk for experiencing complications from diarrhea. Diarrhea can quickly cause dehydration for these cats, putting them in serious danger. Do not attempt to care for them at home without vet guidance.
 
If you have an adult cat otherwise in good health (or with known chronic illness under management), you may just need to take a few steps to help the diarrhea resolve in a few days or less.


In ANY cat, head to the vet if:

•  the stool is very, very dark and tarry (it usually looks almost black and is very, very sticky/tacky). This is indicative of an upper GI bleed
• kitty is not behaving normally, acting “sluggish,” lethargic, or hiding
• kitty is or seems weak or otherwise debilitated
• If severe diarrhea persists for more than 24 hours despite implementing these steps
• If diarrhea continues for more than 3 days
• If stool is just leaking out of kitty
• If there is a lot of blood, or kitty is pooping only blood or only blood and mucus.

 
Your kitty’s eating and behavior patterns are very important. If your cat has diarrhea or soft stool, even if there is a little blood or mucus present, but your cat is otherwise behaving basically normally (though maybe her appetite is a little off), this isn’t an emergency and you can take steps to manage the problem at home. Lethargy or weakness should be considered an emergency.
 
 
The Importance of Proper Hydration
 
Dehydration is the condition diarrhea can cause that makes it potentially life threatening. To check for dehydration, gently pull up on the skin at the back of the neck between the shoulder blades. When released after “tenting” that loose skin a bit, it should pop back into place quickly. If the skin droops back into place slowly, kitty is dehydrated and you should get to the vet quickly, as severe dehydration can be life-threatening.
 
To prevent dehydration:

• Ensure kitty has access to fresh drinking water. Consider using any of these tips to encourage your cat to drink.
• Make bone broth (or use the Stage 1 “meat” broth) and offer a few tablespoons frequently throughout the day (remove the bones!). You can also use an eye dropper to get bone broth into your cat. Unless you are experienced with administration of liquids with a syringe, best to use the eye dropper frequently. Bone broth is very nourishing, soothing, healing and hydrating.
  

Managing the Diarrhea
 
Food
 
First, remove ALL regular food and feed a bland diet. Do NOT feed your kitty her normal food. With the diarrhea, the food is just rushing through her not providing much in the way of nutrition anyway. The bland diet removes any possible dietary sources of upset, and is very easy for your cat to digest. Use the (unenhanced) chicken or turkey breast or pork loin (trimmed of excess fat) to make a bland, simple, low-fat food. Poach the meat in enough water to cook the meat and make a bit of broth. When cooked, either shred the meat, cut or chop it finely, or put it in a food processor or blender with the water used to poach it.
 
Do not include rice. Many vets recommend a “bland diet” of chicken and rice. Rice can ferment in the GI tract, create gas, and make the diarrhea worse.

No Pumpkin? No. While fiber can slow down transit time which helps kitty obtain nutrition and hydration in the face of diarrhea, slippery elm bark powder is a better choice, discussed below.

Feed this plain bland food to your pet in small amounts, 4 to 8 times a day, depending on how much they’ll eat at a time. You can feed this unbalanced, plain food for the few days it should take the diarrhea to subside/resolve.
 
In addition to the bland diet of just poached meat and broth, the next, most important – in fact, critical – aspect of addressing your kitty’s diarrhea is giving your kitty one of the most studied probiotics in the world, Saccharomyces boulardii.

The Probiotic – S boulardii
 
S boulardii, a yeast (in fact, a close cousin to brewer’s yeast with vastly different properties) is a time-tested and proven probiotic strain with many supporting studies including clinical trials indicating its efficacy in the treatment of intestinal infections, the maintenance of inflammatory bowel disease, and the resolution of diarrhea from just about any cause. It is indicated for use with “Travelers Diarrhea,” where e coli, shigella and salmonella account for about 80% of acute diarrhea. (Zanello 2009). It is safe for use in children – and pets. Research published in the past decade has explored and discovered its direct anti-inflammatory and immuno-modulatory activities as well. Please see Saccharomyces Boulardii: Scientific Studies in GI Disease.
 
The many studies of S boulardii indicate it is a very effective anti-diarrheal, and its use “decreases significantly the duration and frequency of diarrhea.” (Zanello 2009). It has been used in the treatment of antibiotic-resistant clostridium difficile infections in cats at U.C. Davis. Clearly the benefits of S boulardii in humans applies equally to cats. This should come as no surprise, as one of the lead researchers in the cat microbiome, Dr. Jan Suchodolski of Texas A&M, indicates “pet specific” probiotics are unnecessary – in fact, the use of researched strains is important as probiotics confer benefit across mammalian species.
 
How does it work? Very simply, S boulardii is not digested or metabolized: it is not absorbed in the gut. It does not act systemically. S boulardii acts locally in the lumen of the intestines. During its passage through the intestines, it mimics the physiological effects of the digestive flora, stimulating healthy immune response, reducing inflammation, and promoting restoration and growth of healthy normal gut flora. “During the intestinal transit, S boulardii interacts with resident microflora and intestinal mucosa. Moreover, experimental studies displayed that S boulardii induces a protection against enteric pathogens, modulates the host immune response, decreases inflammation and hydroelectrolytic secretions, inhibits bacterial toxins, and enhances trophic factors such as brush border membrane enzymes and nutrient transporters.” (Zanello 2009).
 
Thus S boulardii, unlike bacterial probiotics, does not colonize the gut. With dosages discussed in published studies, S boulardii takes about three days to achieve “steady-state” concentrations. When administration is stopped, the yeast is cleared from the colon in about 36 hours. Thus the use discussed here for “emergency treatment” of diarrhea is designed to literally flush the system with S boulardii, enabling it to get to work faster than with twice-a-day dosing.
 
“Emergency Stop Diarrhea” S boulardii Administration for Cats with Severe Diarrhea
 
Probiotics are typically sold in measures of “CFU.” CFU = colony forming units. S boulardii is the exception, it is often sold in mg. Note that 250mg of S boulardii is the same dose as 5 billion CFU.
 
Traditional dosing for therapeutic treatment of diarrhea in adult cats as provided by U.C. Davis is one-half of a 250mg capsule (5 billion CFU) given twice daily. Treatment for kittens is half of the adult dose. It can be given with food; it does not have to be. This is usually sufficient for loose stools of normal frequency. For the “emergency stop diarrhea” approach, we find more frequent dosing of smaller amounts of the probiotic, providing a higher total CFU the first day or two, resolves diarrhea much more quickly.
 
For adult cats (defined here as 9 months of age and older):
 
Give one-quarter of the 250mg / 5 billion CFU capsule every two hours or so. Many cats accept it when mixed into finely ground poached chicken breast / turkey breast / pork loin or meat-only baby food. (Beech Nut, Goya, and Gerber list “meat” and broth or gravy as ingredients. These are fine, they are referring to the water used to cook the meat, and they contain no spices). If your cat does not like the taste of the probiotic, you can syringe after mixing with water. If you are not experienced syringing liquids into your cat, you can use empty #3 gel capsules. Simply fill 10 to 20 of these by transferring the S boulardii from the larger capsules into the smaller ones. These are a size easy to pill your cat. Pill your cat with one #3 capsule filled with S boulardii every two hours or so. For pilling instructions, see How to Pill (Your Cat).
 
This frequent dosing method usually stops diarrhea within 24 – 48 hours, other than when diarrhea is caused by another disease that requires treatment (low B12, exocrine pancreatic insufficiency, hyperthyroidism, as examples). This “loading dose” can be continued for longer if necessary, up to three to four days – but if you do not see substantial improvement in the diarrhea on day 3, it is best to follow-up with your veterinarian.  It is NOT necessary to use this approach, it can be given at “therapeutic” doses as discussed above twice a day (and doubled if you see improvement in stool but diarrhea or soft cow patty stools have not resolved). 
 
When the diarrhea has substantially resolved with use of the emergency stop treatment protocol, begin use of S. boulardii at the therapeutic dose level (2.5 billion CFU twice daily) and continue for at least one week. If stools soften, resume use of S. boulardii at the therapeutic dose as needed. Given its role in improving performance of bacterial probiotics and its anti-inflammatory properties, the use of S boulardii at maintenance levels (anywhere from 500 million CFU to a total of 2.5 billion CFU daily) can be continued indefinitely along with a bacterial probiotic. It confers many health and GI protective benefits, and we use it along with bacterial strains in all of our cats, all the time.
 
For kittens under nine months old, follow the same instructions as for adults, just use half the amount.

Please Note: If diarrhea becomes worse with S boulardii administration, stop use immediately. There can be several reasons for this reaction, however. We have seen cats do poorly with a brand of S boulardii that contains lactose, and switching to a brand like Jarrow without it, the product works quite well. This is most common. We have also seen what is most likely bacterial die-off with the S boulardii. Again, stop administration for 24 hours, and reintroduce it (while continuing to feed the bland diet) slowly. Do not follow the "emergency stop diarrhea" instructions. Use it just twice a day, but at 1/4 of the recommended amount the first day, and 1/2 the recommended amount the second day if kitty did not react to the lower dose. If you do not begin to see improvement even with this slower method of introduction, stop the S boulardii, best to see the vet.

Brands of S boulardii:
 
In the U.S. Jarrow is one of the most widely available. It is combined with MOS (mannanoligosaccharides) which improve its efficacy. Florastor is available in many large chain stores, but it contains lactose, which may exacerbate diarrhea in some cats due to the common lactose intolerance.

Walmart has a store brand very similar to Florastor, called Equate but without the lactose. Renew Life, carried by most Whole Foods stores, has two S boulardii products, one with larch arabinogalactan. Buy the one WITHOUT this ingredient. There are many brands of S boulardii available online: anything with just plan S boulardii in capsules of 3 billion CFU to 5 billion CFU will do.
 
You can click on the pictures to purchase the probiotics from amazon U.S.

In the U.K. and some other countries in Europe, Bioglan is widely available. This contains S boulardii and several bacterial probiotics. The capsules contain 2.5 billion CFU of S boulardii. If you are using Bioglan, be aware that you need to provide twice the dose if following instructions for giving 5 billion CFU capsules.

In Australia, Candex is the name of the S boulardii product widely available. This contains lactose.
 
Even if you need to see your vet, and your cat is put on antibiotics, S boulardii is a wonderful probiotic to administer to your cat as it also helps prevent antibiotic-associated diarrhea. As yeast, not a bacteria, antibiotics do not kill it, and it remains effective.

Slippery Elm Bark Powder (“SEB”)
 
While the S boulardii alone will likely resolve the diarrhea in your cat, if kitty is in discomfort, if there is some blood and/or mucus in the stool, or if kitty is nauseous, slippery elm should be given to your kitty along with the plain diet and S boulardii. The can be given concurrently. SEB both manages nausea and is very soothing and healing to the entire GI tract. This also details why we prefer using slippery elm bark powder over pumpkin when managing diarrhea in our cats.
 
As discussed at Dr. Jean Hofve’s LittleBigCat and in a 2011 review piece, Appalachian Plant Monographs: Ulmus rubra, slippery elm bark powder contains many healing properties:

• demulcent (soothing, mucilage-forming fiber). Mucilage is a substance that when combined with water turns into a lubricating gel (a viscous, soluble fiber that also helps to normalize intestinal action).
• emollient (soothing and protective).  
• nutritive (provides specific nutrients including minerals). SEB contains protein, fat, some carbs, ascorbic acid, beta-carotene, calcium, and trace minerals, all of which are beneficial for recuperating pets. (Slippery elm bark powder often stays down when other food may not, and is often used very effectively in controlling nausea).
• anti-inflammatory/anti-oxidant (scavanges free radicals and reduces damage and inflammation). The bark contains high concentrations of antioxidants, including phytosterols and flavonoids. Slippery elm helps relieve inflammation of essentially any mucus membrane and is used in the treatment of inflammation in lungs (bronchitis / asthma), kidneys, bladder (cystitis, FLUTD symptoms), throat, and of course, the entire GI tract.
  
• astringent (constricting, binding or drying effect). This astringent action from tannins protects both skin and mucus membranes from infection and irritation.

 
In fact, slippery elm doesn’t just help restore normal intestinal function, it reduces inflammation, controls nausea, heals ulcers and gastric lesions, acts as a prebiotic to help manage gut dysbiosis, and it triggers stimulation of nerve endings in the GI tract, which promotes increased mucus secretion to protect and heal the underlying tissues. It lubricates, soothes, and heals, making kitty feel better.

Slippery elm bark powder directions: mix one-quarter teaspoon of loose powder with one-half teaspoon water. Stir until all the powder is mixed with the water. Let it sit for a minute or so. You will see it becomes thick and gelatinous. You can add this to kitty’s plain meat and broth if she’s eating when you are using it to treat diarrhea. If she’s a bit nauseous or inappetent, give it to her about half an hour before a meal, just swipe a little bit at a time into her mouth with your finger (allow her to swallow before swiping in a bit more to get it all (or most of it) into her). You can also add a bit more water as necessary in order to use a food syringe to gently assist-feed your kitty the slippery elm bark/water mixture. During a bout of diarrhea, you can use this mixture three times a day.

Please note, the gelatinous mixture can slow the absorption of any drugs your kitty may be taking. Please separate administration of slippery elm bark powder and any medications by two hours.

Summary
 
Most cats will experience the infrequent bout of diarrhea, often with no identified cause. This is not unusual, and can usually be treated at home. Because the antibiotic most often prescribed for general “diarrhea” in cats (Flagyl, generic metronidazole) is toxic to their systems, using the bland diet, Saccharomyces boulardii (and if you feel a fiber is needed, or if there is some blood and/or mucus present in the diarrhea or kitty is nauseous, then also including slippery elm bark powder) is a gentle, safe, non-toxic, yet generally very effective approach. Given its roles in managing GI inflammation and immune modulation, we encourage you to give S boulardii to your cat along with an L acidophilus- based bacterial probiotic to help maintain a healthy GI tract on a daily basis. At Food Fur Life, we consider daily probiotic administration an important aspect of cat health. And if you are not feeding your cat fresh, minimally processed food, please read up on the benefits, and consider transitioning your kitty to homemade food. Of course, making your own with EZcomplete fur Cats is … easy!

Why are our cats in so much gastric distress?
 
According to VPI Insurance, digestive issues in cats (both vomiting and diarrhea) are consistently ranked as one of the top reasons for a vet visit. Inflammatory Bowel Disease joined them on the list of top 10 reasons for a vet visit each the past two years. This makes three of the top 10 reasons for vet visits related to GI problems in our cats.
 
According to Dr. Gary Norsworthy, who led a study of chronic vomiting in cats, it is so frequent (present in 73% of cats with small bowel disease), many veterinarians and cat owners simply write-it off to

• eating too fast
• having a sensitive stomach
• being just hairballs (hairballs should not be considered normal. They are, in fact, an early warning sign of brewing small bowel disease – IBD or cancer. And if that warning sign gets overlooked, they become a symptom of small bowel disease).
• being “just a puker.”

 
What the heck is going on?

When we have a young child, we would never accept from a doctor that chronic vomiting is because our child is "just a puker." We would never accept that chronic diarrhea is "just how some kids are."

 
What is Feline IBD?

Let’s start with what Feline IBD (Inflammatory Bowel Disease) is. Like that in humans, IBD is a group of diseases involving mild- to severe gastrointestinal (GI) inflammation, and it can lead to lymphoma. This inflammation has been definitively linked to gut dysbiosis (bacterial imbalance in the GI tract). Technically an autoimmune disease, IBD was thought to have a genetic component, but recent research has discovered that the process that triggers IBD is actually transmissible.

GI motility problems (vomiting, diarrhea, constipation) can both cause and be exacerbated by a bacterial imbalance. In IBD, that imbalance has caused inflammation that often impacts nutrient absorption (which is why seeming unexplained weight loss can occur, and why B12 and folate blood serum levels are part of the diagnostic process). In IBD, the symptoms that present are related to where in the GI tract the inflammation is located. Symptoms can come and go, often in cycles of frequent vomiting or a period of diarrhea – which is why the symptoms so often go improperly diagnosed.
 
 
Treatment and Management of IBD: Traditional IBD Management Does Not Address the Underlying Cause
 
The typical approach is for vets to have pet parents use “prescription” diets for sensitive stomachs / high fiber diets for hairballs / hydrolyzed “hypoallergenic” diets, or “limited ingredient” diets and to prescribe goop for hairballs, antacids for stomach upset, and/or anti-emetics (metoclopramide [Reglan], maropitant [Cerenia], ondansetron [Zofran]) to stop the vomiting and nausea; steroids to control inflammation; and Flagyl (metronadizole) to control diarrhea. As Dr. Norsworthy says, “often there is improvement in clinical signs, but rarely are they completely relieved. In addition, the improvement often diminishes over time.”
 
Unfortunately, this traditional treatment of Feline IBD does not address the underlying cause, it treats the symptoms. Not surprisingly, it has been shown that diet is directly related to the gut microbiome in humans: this holds true for cats, too. Healing of the GI tract can only begin by recognizing our cats as the obligate carnivores they are. Feeding them species-appropriate food that supports their proper intestinal pH and bacterial populations is imperative to long term healing.


Diet is the Foundation of Health: this is critical for IBD in cats
 
While it is incorrect to say that a raw diet “cures” Feline IBD, feeding cats the high quality, human grade, fresh meat-and-organ based diet their digestive systems are designed to metabolize enables those systems to return to physiological balance - and when combined with appropriate human grade probiotics to restore healthy intestinal bacteria that has been damaged by many factors apart from diet (including antibiotics, dewormers, vaccinations, stress, etc.) many cats experience healing of the inflammation caused or aggravated by commercial (including "prescription") diets and the alteration in their microbiome.
 
The evidence is only anecdotal at this point, but far too many cats transitioned to a raw diet see their symptoms of IBD (whether vomiting or diarrhea) clear up almost overnight. Notably, the All Feline Hospital says they “started trying commercial raw food diets with amazing results” (in cats with IBD). They further state
 
“We have had cats with confirmed by biopsy IBD that had severe IBD and significant symptoms that had to be on very high doses of steroids just to have some quality of life. Many of these cats had a complete reversal of signs and symptoms by going to an exclusively raw food diet, and were able to either come off of all medications, or at the very least, drastically reduce their medications.”  (Bold, our emphasis)
 
Food processing, the use of thickeners, high temperatures, species-inappropriate foods containing even medium amounts of carbs and/or starches), dry vs wet foods vs raw, protein content – all of these things impact feline gut microflora and thus motility and inflammation in our cats. This means that to best help our kitties heal, we need to feed them the food they were meant to eat: a diet based on fresh, raw, high protein food. (Raw is preferable to cooked, but cook it if you are not comfortable feeding raw: fresh, unprocessed, truly human grade meat and organs – a food with no unnecessary additives – is still better than highly processed food, no matter the perception of quality).
 
Of course, with EZcomplete fur Cats, it is – well – really easy to feed fresh homemade food – and IBD cats are thriving on it.
 
For more information on the treatment and management of IBD in cats, please visit the website Raw Feeding for IBD Cats.


This blog post has been added to the growing collection of educational articles provided by Food Fur Life, LLC  Raw Feeding and IBD in Cats

For those concerned about chicken allergies, it's important to note that the body sees chicken muscle meat and egg yolk as two different proteins. A chicken allergy does not mean your kitty is also allergic to egg yolk!

As discussed in our article Hairballs: How Best to Manage Them, often the butt of jokes, hairballs are a sign the stomach of our kitties is not emptying properly. This is a problem with motility, a problem that can lead to or be a symptom of inflammatory bowel disease and/or small cell intestinal cancer. Hairballs are no laughing matter.

Proper management of hairballs involves

• Transitioning to timed meals (proper gastric emptying that keeps fur moving the right direction is triggered by hunger pangs)
• Transitioning to an all wet- or homemade food diet (easily made with EZcomplete fur Cats!) (kibble is too dry, too highly processed, and often contains too many carbohydrates to be considered an appropriate food for cats)
• Using probiotics and plant-based digestive enzymes to restore gut health and manage inflammaton
• Helping the hair pass with egg yolk or egg yolk lecithin as outlined in our article on managing hairballs (if timed meals, diet, and probiotics did not resolve the problem completely) until the gut fully heals from the inflammation and dysbiosis that is causing the hairballs.

 
In that article, we outline why egg yolk and egg yolk lecithin are the first, best methods for managing hairballs in our cats when help is needed. Since writing that article, however, we’ve found that some kitties do not enjoy the additional raw yolk (Please note, food made with EZcomplete fur Cats already contains egg yolk - and most raw or homemade diets also already contain egg yolk, which provides many essential nutrients), and some IBD cats sensitive to fats in the diet cannot tolerate as much egg yolk lecithin as they actually need to resolve hairballs. Food Fur Life co-founder, Carolina, discovered that using powdered egg yolk instead of additional fresh egg yolk made it not only enjoyable for her cats to eat – she no longer needed to give them egg yolk lecithin! (And Carolina has four long-haired rescue kitties, two with IBD).
 
Hairballs, not surprisingly, are a frequent topic of discussion in the Raw Feeding for IBD Cats Facebook group.  And we’re finding this approach is helping other cats as well. Group member Eric Swanson decided to make his own homemade powdered, dried egg yolk – and it was both a success and a hit with the cats!
 
How much dried, powdered egg yolk to feed? START SMALL or your cat may experience loose stool or diarrhea. As with all new supplements, it is always best to start with a much smaller amount than you intend to use: make sure your cat does not react to the new addition. Start with a pinch of dried powdered yolk on one meal. Day two, try a big pinch. Day three, use 1/8th teaspoon every-other-day, and work up slowly from there. You can work up to as much as one-quarter yolk a day if needed (in addition to what is provided by the diet), but as always, it is best to use the minimum amount necessary to “get the job done.” Egg yolk in the diet provides many health benefits apart from aiding in hairball management (the egg is a powerhouse of nutrition!) and this amount of egg yolk will not throw the diet out of balance no matter what food you feed. For those with cats with Chronic Kidney Disease, one large egg yolk (which, at 1/4 yolk equivalent a day results in the addition of one yolk every four days) contains the same amount of phosphorus as one ounce of muscle meat. This should not be enough to need to adjust the phosphorus binder you are using if you're using one, but you may want to discuss this with your vet.

Recipe / Instructions for Making Homemade Dried, Powdered Egg Yolk
Courtesy of Eric Swanson. Photos preparing dried yolk, also thanks to Eric!
 
Use the highest quality eggs you can. Eggs from organically fed, pastured chickens is obviously ideal, but not necessary.

Eric started with four egg yolks. This recipe works for as many as you care to make.

 1) Hard boil the eggs. (Gently lower eggs into boiling water, and boil on medium heat for 12 minutes)

2) When done, run the hard boiled eggs under cold water.

3) When cool, peel the eggshell. (If you make your own eggshell as a calcium source in your cat’s food, save the peeled shells!)

4) Crumble the yolk in a single layer onto a baking pan or into a baking dish. Eric used a Pyrex glass bakeware dish.

5) Bake at 140F (60C) for 10 hours. If the lowest temperature on your oven is 170F (75C), that's fine, use that and check the yolks after 9 hours to see if they appear to be completely dry. You can stir the yolk after 4 or 5 hours, but it isn't necessary.

6) Remove from the oven (leave it on) and powder the yolk in a food processor or blender. If the yolk is completely dry, you're done! If it feels a tad moist, or a bit "tacky," then

7) Put the now powdered yolk back on the baking sheet / baking dish.

8) Cook the now powdered yolk for up to another two hours so it dries completely.
 
Store in a glass jar in the refrigerator, or a cool, dark place.

Four large fresh egg yolks yielded approximately 11.5 teaspoons of powdered yolk (approximately four tablespoons). In this example, one tablespoon of dried yolk powder is the (approximate) equivalent of one large fresh egg yolk. Depending on how fine your processor makes the powder, you may have different results, so it is best you measure the amount of final dried yolk powder to determine how much powder equates to one fresh egg yolk.
 
We recommend feeding up to one-quarter yolk per day, though this amount may not be necessary for all cats. If hairballs do not resolve at that amount, other steps should be taken rather than feeding more powdered egg yolk.
 
You can, of course, purchase commercially prepared powdered, dried egg yolk (not whole egg). Please check for flow agents, many dried powdered egg yolks use them, and it is better to avoid them if possible. Also make sure you know what the fresh yolk equivalent is of the powder you purchase so you can feed the correct amount to your cat, as the fresh yolk equivalent of commercial powders ranges from one teaspoon to one or two tablespoons.