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Over the last 10 years, my associates and I have biopsied, via laparotomy, over 700 cats with a history of chronic vomiting (CV; 2× per month or more), chronic diarrhea (CD; >2 months duration), weight loss (WL), or some combination of these. To better exclude abnormal cats, the authors should have included ultrasound-determined small bowel wall thickness as part of the inclusion criteria. [...]it represents tunnel vision on what is happening in the small bowel of cats with small bowel signs. [...]this study's “normal” cohort was likely contaminated by including cats with CSBD, which would easily lead to incorrect conclusions.

Background Chronic diarrhea (CD) is common in cats, with unknown etiology in many cases. Objectives To establish the prevalence of feline coronavirus (FCoV) and other enteropathogens in cats with CD. Animals Veterinarians at a feline specialty practice examined 493 cats with CD. The breed of three (0.6%) was unknown; 373 (75.7%) were non‐purebred, and 117 (23.7%) purebred. Methods Retrospective database review of 586 fecal sample results of an RT‐PCR and PCR diarrheal panel. Results Feline coronavirus was found in 321 (65.1%) of 493 cats with CD. FCoV RNA and Clostridium perfringens toxin DNA were detected in 377 (64.3%) and 319 (54.4%) samples respectively: 206 (35.2%) samples were positive for both pathogens. Feline coronavirus was the sole pathogen detected in 118 (23.9%) cats. Samples from 203 cats under 1 year old were significantly (p = 0.0001) more frequently FCoV positive than samples from older cats (166/224 [74.1%] samples vs. 211/362 [58.3%]). FCoV RT‐PCR positivity peaked in February (p = 0.016) and March (p = 0.0064). Other detected pathogens included Giardia spp. (8.4%; 49/586 samples); Tritrichomonas blagburni (8.4%; 46/586); Cryptosporidium (5.1%; 30/586); Campylobacter jejuni (3.4%; 17/497); Campylobacter coli (1.6%; 8/497); Salmonella spp. (0.8%; 5/586); panleukopenia virus (0.8%; 5/586); and Toxoplasma gondii (0.5%; 3/586). Sixty‐nine cats gave 162 samples: 54/69 (78.3%) cats were FCoV positive, 39/54 (72.2%) persistently so. Conclusions If FCoV is non‐pathogenic, as often assumed, its having the highest rate of positivity in CD cases is difficult to explain. If pathogenic and overlooked, key diagnostic and therapeutic opportunities might be missed.

Consistently, the walls were uniform with measurements well within the normal range. [...]we moved down to the small bowel. In addition to the one normal cat, we had diagnoses of chronic enteritis (usually IBD) in 49%, lymphoma in 46%, mast cell disease in 3%, and adenocarcinoma in 1%. [...]we tell clients that the most common disease is IBD, but lymphoma is clearly the second-most likely differential.

The widespread availability of digital cameras means that most vets have access to a camera capable of producing high quality clinical images. Photography can be a powerful tool in practice. Anne Fawcett and Gary Norsworthy explore how it can be used to document clinical cases, enhance communication with colleagues and specialists, as well as share information with a wider audience.

An 11-year-old neutered male domestic longhair cat was diagnosed with histoplasmosis from fine-needle aspirates of an abdominal lymph node. Lymph node size initially decreased with fluconazole therapy (11.8 mg/kg PO q12h); however, after 13 months of continuous fluconazole therapy, lymphadenomegaly worsened and samples were collected for culture and antifungal susceptibility. The Histoplasma capsulatum isolate had a very high fluconazole minimum inhibitory concentration (MIC) of 64 µg/ml and an itraconazole MIC of 0.06 µg/ml. The owner declined a change to itraconazole and, ultimately, the cat developed neurologic signs and was euthanized. Owing to the initial response to fluconazole followed by treatment failure and high MIC value, acquired fluconazole resistance was suspected. Clinical breakpoints for fluconazole for the dimorphic fungi are not available to define true antifungal resistance. This is the first published report of reduced susceptibility to fluconazole in a cat being treated for histoplasmosis. Fluconazole failure and increases in MIC between pretreatment and long-term treatment isolates are known to occur in humans with histoplasmosis. Practitioners should be aware of this possibility when treating cats with fluconazole (particularly in cases with long-term [>1 year] fluconazole therapy or in cases with disease recrudescence).

In its continuing desire to promote increased practice visits for cats, the American Association of Feline Practitioners (AAFP) has developed the Cat Friendly Practice Program to help practices reduce the stress associated with veterinary visits for cats. In our cat-dedicated examination room, we have a Feliway diffuser (keep the doors closed between appointments) and a digital table-top scale (no reception room weigh-ins).

Many have been frustrated with the seemingly healthy cat that vomits twice a month or twice a week or twice a day. In pursuit of the etiology of this problem, the authors performed endoscopy for several years. Convinced that it had to be a primary gastric problem, they scoped the stomach and took multiple mucosal biopsy samples. The pathologists would report \"mild lymphoplasmacytic gastritis\" or \"Helicobacter gastritis\" or something else not very meaningful, and would find something creative to do to try to solve the problem. It did not take long until a definite finding emerged -- virtually every one of these cats had thickened small bowel walls. Suddenly it clicked. Chronic vomiting in cats is a small bowel Suddenly it clicked, Chronic vomiting in cats is a small bowel disease, not a stomach disorder. It became clear that the gastric examinations and biopsies did not find the answer because they were looking in the wrong place.