In brief
Vomiting, diarrhoea or weight loss lasting more than three weeks is not simply a “sensitive stomach”. Chronic enteropathy has several causes, and no single test distinguishes them all.
What chronic enteropathy means
The term describes persistent gastrointestinal disease after important non-gastrointestinal causes and infections have been considered. It includes food-responsive disease, inflammatory enteropathy and intestinal lymphoma, with overlap between categories.
Common signs
- Weight or muscle loss, sometimes despite a normal appetite.
- Recurrent vomiting, including food, fluid or bile.
- Soft, frequent or variable stools.
- Reduced appetite, nausea or food aversion.
- A dull coat, reduced activity or hiding.
A structured investigation
Assessment may include blood and urine tests, faecal testing, thyroid measurement in older cats, pancreatic and vitamin markers, abdominal ultrasound and a carefully controlled diet trial. Endoscopic or surgical biopsies may be needed when the diagnosis will change treatment.
Treatment
Treatment depends on the likely category and severity. It may involve an exclusive therapeutic diet trial, correction of vitamin deficiencies, nausea control, microbiome-directed support, anti-inflammatory or immunosuppressive medication, or chemotherapy for lymphoma. Appetite and nutritional intake must be protected throughout.
Why follow-up matters
Body weight, muscle condition, appetite, vomiting frequency and stool quality are useful response measures. A partial response should trigger reassessment rather than indefinite repetition of the same plan.
Conclusion
Chronic gastrointestinal signs are common but not normal. A stepwise investigation offers the best chance of choosing treatment that fits the individual cat.