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Medically reviewed by Bryan Hayter, DVM, Owner and Medical Director of Aliso Beach Animal Clinic. Last reviewed: September 2026.

Chronic diarrhea is not a diagnosis.

When a dog or cat has loose stool that keeps returning, diarrhea lasting for weeks, frequent bowel movements, mucus or blood in the stool, unexplained weight loss, excessive gas, vomiting, poor appetite or other recurring digestive problems, the goal should not simply be to make the stool firmer.

The more important question is: why is this happening?

At Aliso Beach Animal Clinic in Laguna Beach, we take a diagnosis-driven, integrative approach to chronic gastrointestinal disease. That means combining conventional veterinary diagnostics and treatment with individualized nutrition, microbiome support, veterinary acupuncture and carefully selected supplements when appropriate.

Diet is often central to that plan. In fact, current veterinary internal-medicine guidelines increasingly support dietary therapy as one of the most important first-line treatments for many dogs with chronic enteropathy. But we do not assume that every pet with chronic diarrhea simply has a food sensitivity.

Persistent diarrhea can occur with parasites, Giardia, food-responsive enteropathy, chronic inflammatory enteropathy, intestinal lymphoma, pancreatic insufficiency, acute or chronic pancreatitis, vitamin B12 deficiency, intestinal dysbiosis, Addison’s disease, liver disease, endocrine disorders and other medical conditions.

Our goal is to identify or reasonably exclude those problems first, then create the most appropriate treatment plan for the individual dog or cat.

Learn more about our holistic and integrative veterinary care in Laguna Beach, specialist abdominal ultrasound, cat care and same-day urgent veterinary care.

What Is Considered Chronic Diarrhea?

Veterinary internists generally use the term chronic enteropathy for gastrointestinal signs that persist or repeatedly recur for approximately three weeks or longer after other causes are considered.

Signs can include:

Some pets have obvious diarrhea every day. Others appear normal for a week or two and then relapse repeatedly. Those intermittent cases can still represent an important gastrointestinal disorder.

Our Approach: Diagnose First, Then Build the Treatment Plan

An integrative approach does not mean replacing diagnostic medicine with herbs, supplements or alternative therapies.

At Aliso Beach Animal Clinic, we want to understand what may be causing the diarrhea before deciding which combination of nutrition, medication, supplementation, microbiome support and integrative therapy makes the most sense.

Not every patient needs every test, and the order of testing may change depending on the pet’s age, symptoms, examination findings and severity of illness. A typical chronic diarrhea evaluation may include several of the following steps.

1. Fecal and Parasite Testing

Parasites and infectious organisms should remain on the list of possibilities even in well-cared-for dogs and indoor cats.

Testing may include a fecal examination, Giardia testing and, when appropriate, more specialized fecal antigen or PCR testing.

Potential causes can include:

Advanced fecal PCR panels can be useful in selected patients, but they must be interpreted carefully. Detecting an organism in a stool sample does not automatically prove that organism is causing the clinical signs.

The test result always needs to be interpreted together with the pet’s symptoms, history and other diagnostic findings.

2. CBC, Chemistry Panel, Electrolytes and Urinalysis

A gastrointestinal problem can affect — or be caused by — systems outside the intestine.

A complete blood count and chemistry profile can help us evaluate:

Urinalysis may provide additional information about hydration, kidney function and systemic disease.

Why Albumin Matters

A low blood albumin level is particularly important in a pet with chronic diarrhea.

Severe intestinal disease can sometimes cause protein-losing enteropathy, or PLE, in which protein leaks through the diseased gastrointestinal tract. PLE can require more aggressive investigation and treatment than uncomplicated diarrhea.

3. A GI Panel Can Answer Questions Routine Bloodwork Cannot

Specialized gastrointestinal blood testing can help evaluate pancreatic function, pancreatitis, intestinal absorption and vitamin B12 status.

Depending on the patient and laboratory, a GI panel may include TLI, PLI, cobalamin and folate. In dogs with appropriate clinical signs, cortisol testing may also be recommended to screen for Addison’s disease.

The Texas A&M Gastrointestinal Laboratory offers specialized assays for these conditions and is an important reference laboratory in veterinary gastroenterology.

TLI: Testing for Exocrine Pancreatic Insufficiency

Trypsin-like immunoreactivity, or TLI, evaluates exocrine pancreatic function and is the primary blood test used to diagnose exocrine pancreatic insufficiency, or EPI.

Pets with EPI do not produce enough pancreatic digestive enzymes to properly digest and absorb nutrients.

Possible signs include:

EPI can respond very well to appropriate therapy, but it may be mistaken for primary intestinal disease unless pancreatic function is specifically tested.

Texas A&M notes that cobalamin and folate testing is particularly useful when TLI is evaluated because vitamin B12 deficiency commonly accompanies EPI. Learn more about TLI testing for pancreatic insufficiency.

PLI: Testing for Pancreatitis

Pancreatic lipase immunoreactivity, or PLI, is used when acute or chronic pancreatitis is suspected.

Pancreatitis does not always produce dramatic symptoms. Some pets — particularly cats — can have chronic or recurrent pancreatic inflammation associated with decreased appetite, vomiting, weight loss, lethargy or recurring gastrointestinal signs.

No single test identifies every case of pancreatitis. PLI is therefore interpreted together with the pet’s examination, history, routine laboratory results and, when appropriate, abdominal ultrasound.

Cobalamin: Vitamin B12

Vitamin B12, or cobalamin, is absorbed through the gastrointestinal tract and can become deficient when intestinal or pancreatic disease interferes with normal absorption.

Low B12 may occur with:

When cobalamin is low, replacing it can become an important component of treatment rather than simply an optional vitamin supplement.

Depending on the patient and severity of deficiency, B12 may be supplemented orally or by injection.

More information is available from the Texas A&M Gastrointestinal Laboratory’s cobalamin and folate resource.

Folate

Folate can provide additional information about small-intestinal function and the intestinal environment, although an abnormal folate level by itself does not diagnose one particular disease.

4. Could Intestinal Dysbiosis Be Part of the Problem?

The gastrointestinal tract contains a complex community of bacteria and other microorganisms collectively known as the intestinal microbiome.

A disruption in that community is called dysbiosis.

Dysbiosis is associated with several gastrointestinal disorders and can also develop after treatment with broad-spectrum antibiotics.

In selected patients, specialized testing may be useful. Texas A&M’s Canine and Feline Microbiota Dysbiosis Index uses quantitative PCR to evaluate bacterial groups that commonly change in chronic enteropathy and after broad-spectrum antibiotic exposure.

Microbiome testing should not be interpreted as a stand-alone diagnosis. We use it as one piece of a larger clinical picture.

5. Screening for Addison’s Disease in Dogs With Chronic GI Signs

Addison’s disease, or hypoadrenocorticism, can sometimes look remarkably similar to primary gastrointestinal disease.

Affected dogs may have:

The classic form of Addison’s disease often causes characteristic sodium and potassium changes, but dogs with atypical Addison’s disease may initially have normal electrolytes.

Baseline Cortisol vs. ACTH Stimulation Testing

A baseline cortisol test can be an excellent screening tool in a dog with otherwise unexplained chronic gastrointestinal signs.

A sufficiently high baseline cortisol level can effectively rule out Addison’s disease. A low baseline cortisol level, however, does not diagnose Addison’s disease.

If the baseline result is low, an ACTH stimulation test is generally needed for confirmation.

The Merck Veterinary Manual’s review of Addison’s disease explains that an ACTH stimulation test is required for definitive diagnosis.

Important: cortisol testing evaluates adrenal function. It does not diagnose pancreatic insufficiency. EPI is evaluated with TLI.

6. Abdominal Ultrasound for Chronic Diarrhea

When gastrointestinal signs persist, abdominal ultrasound can provide information that cannot be obtained from routine bloodwork or ordinary X-rays alone.

Ultrasound can allow detailed evaluation of the:

At Aliso Beach Animal Clinic, specialist abdominal ultrasound examinations can be performed at our Laguna Beach hospital by Leyla Fatourechi, DVM, DACVECC, a board-certified veterinary emergency and critical care specialist, when medically indicated and available.

Ultrasound may identify findings associated with intestinal inflammation, pancreatitis, abnormal lymph nodes, masses or disease affecting other abdominal organs.

However, ultrasound has an important limitation:

An ultrasound cannot diagnose microscopic intestinal disease and cannot by itself definitively diagnose inflammatory bowel disease.

What About IBD?

Pet owners frequently use the term IBD, or inflammatory bowel disease, to describe almost any persistent digestive disorder.

Veterinary internal medicine has become more precise about the terminology.

In dogs, current specialists increasingly use the term chronic inflammatory enteropathy, or CIE, because chronic gastrointestinal disease can have several different causes and treatment responses.

A dog with persistent diarrhea may ultimately have:

The 2026 ACVIM-endorsed consensus statement on canine chronic inflammatory enteropathy reflects this updated approach to diagnosis and treatment.

Can Bloodwork or Ultrasound Diagnose IBD?

No.

Blood tests, fecal tests, specialized GI testing and ultrasound can provide extremely useful information. They may help exclude other diseases and determine whether biopsy is warranted.

But these tests cannot examine intestinal tissue at the microscopic level.

A definitive histologic diagnosis of inflammatory intestinal disease requires gastrointestinal biopsy followed by microscopic examination of the tissue by a veterinary pathologist.

Does Every Pet With Chronic Diarrhea Need a Biopsy?

No.

For many stable patients, it is appropriate to begin with fecal testing, baseline laboratory work, appropriate specialized testing and carefully controlled dietary trials.

Biopsy becomes more important when:

Biopsies may be obtained through endoscopy in many patients. Surgical full-thickness biopsies may be more appropriate in selected situations.

If intestinal biopsy is being considered, we may also discuss the timing of corticosteroid or other immunosuppressive treatment because beginning those medications before tissue sampling can sometimes affect interpretation of biopsy findings.

Chronic Diarrhea in Cats Deserves Its Own Approach

Cats are not simply small dogs.

A cat with chronic diarrhea may have:

Depending on the cat’s age, examination and symptoms, diagnostic testing may include:

Learn more about our approach to cat care in Laguna Beach.

IBD vs. Intestinal Lymphoma in Cats

One of the more challenging questions in feline internal medicine is distinguishing inflammatory intestinal disease from low-grade intestinal lymphoma.

Bloodwork and ultrasound are important, but neither can reliably make that distinction by itself.

The Cornell Feline Health Center notes that definitive diagnosis of feline IBD requires gastrointestinal biopsy and microscopic examination.

In difficult cases, histopathology may be supplemented with additional testing such as immunohistochemistry or molecular clonality testing to help differentiate inflammatory lymphocytes from lymphoma.

This is one reason persistent diarrhea, vomiting, reduced appetite and unexplained weight loss in an older cat deserve a thorough evaluation.

Pancreatitis in Cats

Cats with pancreatic disease do not always show the classic vomiting and obvious abdominal pain owners might expect.

Some cats with chronic pancreatitis primarily become quiet, eat less, lose weight or develop subtle recurring digestive signs.

Cornell’s feline pancreatitis resource explains why diagnosis often requires a combination of examination findings, pancreatic lipase testing and diagnostic imaging.

Diet Is Not an Afterthought — It Is Often the Center of Treatment

Dietary therapy is part of conventional veterinary internal medicine.

It is also the cornerstone of the integrative approach we use for many chronic gastrointestinal patients.

Those two ideas are not contradictory.

The 2026 ACVIM-endorsed guidelines recommend therapeutic dietary trials as first-line treatment for many dogs with chronic inflammatory enteropathy whenever appropriate.

Current guidelines recognize several potentially useful diet categories, including:

A clinical response may be seen within approximately 10 to 14 days in some dogs. Current ACVIM guidance recommends that an adequate therapeutic diet trial generally involve at least two weeks of exclusive feeding, and some dogs may need trials of more than one type of therapeutic diet before the best response is identified.

Hydrolyzed-Protein Diets

Hydrolyzed diets contain proteins that have been broken into smaller components designed to reduce recognition by the immune system.

They can be particularly useful when food-responsive enteropathy or an adverse reaction to dietary proteins is suspected.

Novel-Protein Diets

A novel protein is a protein source that the individual pet has not previously eaten.

What counts as novel therefore depends on that animal’s complete diet history.

For example, duck is not truly novel for a dog that has been eating duck treats for several years.

Whole-Food and Home-Prepared Diets

Some families prefer minimally processed or home-prepared whole-food diets, and these may have a role in an individualized integrative gastrointestinal plan.

However, whole-food does not simply mean feeding chicken, rice and vegetables indefinitely.

A long-term home-prepared diet must provide appropriate protein, essential fatty acids, vitamins, minerals and other nutrients.

This is especially important for cats, whose nutritional needs include specific requirements such as taurine and other nutrients that cannot safely be overlooked.

When long-term home cooking is chosen, professional diet formulation may be recommended so the diet is nutritionally complete and balanced.

Highly Digestible Diets

Some gastrointestinal patients benefit from diets designed to improve digestion and nutrient absorption while reducing the amount of undigested material reaching the colon.

Low-Fat Diets

Fat restriction can be useful in selected dogs with pancreatitis, hyperlipidemia, intestinal lymphangiectasia or other fat-responsive gastrointestinal disorders.

Low-fat feeding is not automatically appropriate for every pet with diarrhea, so the diet should match the suspected disease.

Fiber-Responsive Disease

Soluble and fermentable fiber can be extremely useful for selected gastrointestinal patients, particularly some dogs with large-bowel diarrhea.

Psyllium is one option that may be incorporated into the treatment plan when appropriate.

A Dietary Trial Has to Be a Real Trial

If we are using food as both treatment and a diagnostic tool, consistency matters.

During a strict food trial, seemingly small extras may defeat the purpose, including:

We will help determine what your pet can eat, what should be avoided and how long the trial should continue before deciding whether it has been successful.

Conventional Medical Treatment Still Has an Important Role

Integrative medicine does not mean avoiding medication.

It means using the right treatment for the disease that is actually present.

Vitamin B12

Dogs and cats with documented cobalamin deficiency may need oral or injectable vitamin B12 supplementation.

Correcting B12 deficiency can be particularly important in patients with EPI or chronic small-intestinal disease.

Probiotics, Prebiotics and Synbiotics

Selected veterinary probiotics, prebiotics or synbiotic combinations may be incorporated into treatment.

However, probiotic effects are generally strain-specific and product-specific. One probiotic should not automatically be assumed to have the same effects as another.

The yeast probiotic Saccharomyces boulardii has been studied as an adjunct in gastrointestinal disease and may be considered in selected patients.

Microbiome support should complement — not replace — appropriate diagnostic testing, dietary therapy and medical treatment.

Antibiotics

Antibiotics such as metronidazole or tylosin have historically been prescribed frequently for dogs with chronic diarrhea.

There are still situations in which antimicrobial therapy may be medically appropriate.

However, current veterinary internal-medicine recommendations are moving away from automatically prescribing antibiotics for every chronic diarrhea patient.

Broad-spectrum antibiotics can alter the intestinal microbiome, and antibiotic-associated dysbiosis may persist beyond the treatment period.

For this reason, we prefer to have a specific clinical reason for antimicrobial treatment rather than using antibiotics reflexively.

Corticosteroids

Prednisone, prednisolone or, in selected circumstances, budesonide may be used when inflammatory intestinal disease requires anti-inflammatory or immunosuppressive therapy.

These drugs can be extremely useful. They can also have important side effects.

Whenever the patient’s condition allows, we prefer to understand what disease we are treating before committing a pet to prolonged immunosuppression.

Cyclosporine and Other Immunosuppressive Medications

Some patients with significant inflammatory intestinal disease that fails to respond adequately to diet and first-line medication may require additional immunomodulatory or immunosuppressive therapy.

Depending on the diagnosis, options may include medications such as cyclosporine or other immune-modifying drugs.

Treatment is individualized because the medication appropriate for one form of intestinal disease may be inappropriate for another.

For example, a cat ultimately diagnosed with low-grade intestinal lymphoma may require a treatment protocol that differs substantially from treatment for uncomplicated food-responsive enteropathy.

Pancreatic Enzyme Replacement

If testing confirms exocrine pancreatic insufficiency, pancreatic enzyme replacement becomes a central part of treatment.

Associated vitamin B12 deficiency and nutritional needs should also be addressed.

Treatment for Pancreatitis

Pancreatitis treatment may include:

Severe acute pancreatitis may require hospitalization and more intensive supportive care.

Treatment for Addison’s Disease

If a dog is diagnosed with hypoadrenocorticism, adrenal hormone replacement changes the entire treatment plan.

Diet, probiotics and supplements cannot replace the hormones that are deficient in Addison’s disease.

This is exactly why diagnostic testing matters before chronic gastrointestinal signs are assumed to be simply dietary or inflammatory.

Integrative Therapies for Chronic Gastrointestinal Disease

Once serious underlying disease has been investigated, supportive integrative treatments may be layered into the plan when appropriate.

Veterinary Acupuncture

Veterinary acupuncture may be considered as an adjunctive therapy in selected gastrointestinal patients.

Evidence specifically supporting acupuncture for chronic gastrointestinal disease in dogs and cats is more limited than the evidence supporting diagnostic testing and dietary therapy.

For that reason, we do not present acupuncture as a replacement for fecal testing, laboratory work, diet trials, ultrasound, medication or biopsy.

Instead, acupuncture may be incorporated as one part of a larger treatment plan when the veterinarian and pet owner believe it is appropriate for that individual patient.

Dr. Bryan Hayter completed veterinary acupuncture training through the International Veterinary Acupuncture Society.

Supplements We May Discuss for Chronic Diarrhea

There is no universal “gut supplement protocol.”

Supplements should be chosen according to the patient’s diagnosis, diet, medications, laboratory results and individual response.

At Aliso Beach Animal Clinic, our approach is to ask:

What are we trying to accomplish with this supplement, what evidence supports it, is it safe for this patient, and how will we know whether it is helping?

Psyllium

Psyllium provides soluble fiber and may be particularly helpful for selected dogs and cats with large-bowel diarrhea or fiber-responsive gastrointestinal disease.

Veterinary Probiotics and Synbiotics

Selected probiotic organisms, prebiotic fibers and synbiotic combinations may help support the gastrointestinal microbiome in some patients.

Products and bacterial strains are not interchangeable, so selection matters.

Saccharomyces boulardii

Saccharomyces boulardii is a beneficial yeast that may be considered as an adjunctive microbiome therapy for some gastrointestinal patients.

Slippery Elm

Slippery elm contains mucilage and has traditionally been used in integrative medicine as a gastrointestinal demulcent.

Veterinary clinical evidence is much more limited than the evidence supporting appropriate dietary therapy, so we view slippery elm as a possible adjunct, not a primary treatment for undiagnosed chronic diarrhea.

Mucilaginous supplements may also affect the absorption of oral medications. Timing and medication interactions should therefore be discussed with a veterinarian.

Prebiotic Fibers

Certain fermentable fibers can act as substrates for beneficial intestinal bacteria and may help modify the gastrointestinal environment.

The appropriate type and quantity vary significantly between patients.

Omega-3 Fatty Acids

EPA and DHA may be useful as nutritional support in selected inflammatory conditions.

However, additional dietary fat is not appropriate for every gastrointestinal patient, particularly when pancreatitis, intestinal lymphangiectasia or another fat-sensitive disorder is present.

Vitamin B12

When testing documents cobalamin deficiency, B12 replacement should be considered treatment of a demonstrated deficiency rather than simply a general wellness supplement.

Learn more about our approach to veterinary supplements and nutraceutical consultations in Laguna Beach.

Why We Do Not Use the Same Chronic-Diarrhea Protocol for Every Pet

Consider four pets that all arrive with the same complaint: chronic diarrhea.

One dog has exocrine pancreatic insufficiency and needs pancreatic enzymes.

Another dog has food-responsive enteropathy and improves substantially after a correctly selected and strictly followed dietary trial.

A third dog has atypical Addison’s disease.

An older cat has intestinal thickening, weight loss and low vitamin B12 and ultimately requires biopsies to distinguish chronic inflammatory disease from intestinal lymphoma.

Their symptoms may initially look very similar.

Their appropriate treatments are completely different.

That is why we prefer a diagnosis-driven, diet-centered integrative approach rather than giving every gastrointestinal patient the same antibiotic, probiotic, steroid, supplement or bag of food.

When Chronic Diarrhea Suddenly Becomes Urgent

A pet with a long history of gastrointestinal problems can still develop an acute medical emergency.

Call us promptly if your dog or cat develops:

Puppies, kittens, very small pets, geriatric animals and pets with other medical problems can become dehydrated or unstable more quickly.

Aliso Beach Animal Clinic provides same-day urgent veterinary care in Laguna Beach during regular clinic hours.

Walk-ins are welcome when availability allows, but please call before arriving so our team can assess your pet’s condition, confirm availability and prepare for the visit.

Our Laguna Beach hospital can provide diagnostic and supportive care for many urgent gastrointestinal conditions, including laboratory testing, diagnostic imaging, IV fluid therapy and other treatment when appropriate.

We are not a 24-hour emergency hospital.

A pet experiencing collapse, profound weakness, major abdominal distension, severe uncontrolled bleeding, difficulty breathing, severe trauma or another immediately life-threatening condition may need to go directly to a 24-hour emergency facility.

If you are uncertain where your pet should be seen, review our Laguna Beach Pet Emergency & Urgent-Care Guide or call us during business hours.

Integrative Chronic Diarrhea Care in Laguna Beach, Monarch Beach & Coastal Orange County

Aliso Beach Animal Clinic is an independently owned veterinary clinic and animal hospital in Laguna Beach, California.

We care for dogs and cats from Laguna Beach, South Laguna, Aliso Beach, Three Arch Bay, Monarch Beach, Dana Point, Laguna Niguel and surrounding coastal Orange County communities.

Our approach to chronic gastrointestinal disease may bring together:

The goal is not to choose between Western medicine and holistic medicine.

The goal is to determine what is happening, treat the disease that is actually present and use every appropriate tool to help that individual pet feel and function better.

Frequently Asked Questions About Chronic Diarrhea in Dogs & Cats

What tests should a dog with chronic diarrhea have?

Testing depends on the dog’s history, age, examination and severity of illness. A workup may include fecal testing, CBC and chemistry, urinalysis, TLI for exocrine pancreatic insufficiency, PLI for pancreatitis, vitamin B12 and folate, baseline cortisol screening for Addison’s disease and abdominal ultrasound. Some dogs ultimately need gastrointestinal biopsy.

What tests should a cat with chronic diarrhea have?

Cats may need fecal testing, CBC and chemistry, urinalysis, thyroid testing, vitamin B12 and folate, feline TLI and PLI, abdominal ultrasound and sometimes intestinal biopsies. In older cats, differentiating chronic inflammatory intestinal disease from intestinal lymphoma can be particularly important.

Can an abdominal ultrasound diagnose IBD?

No. Ultrasound can identify intestinal thickening, altered intestinal wall layers, abnormal lymph nodes, pancreatic changes, masses and other abnormalities, but it cannot provide a definitive microscopic diagnosis of IBD or chronic inflammatory enteropathy.

Is biopsy the only way to definitively diagnose IBD?

A definitive histologic diagnosis of inflammatory intestinal disease requires gastrointestinal tissue examined under a microscope by a veterinary pathologist. In cats, additional testing such as immunohistochemistry or molecular clonality testing may sometimes be needed when inflammatory disease and low-grade intestinal lymphoma are difficult to distinguish.

Can changing my dog’s food really stop chronic diarrhea?

Yes. Dietary therapy can produce substantial improvement in many dogs with chronic enteropathy. Current ACVIM guidelines recommend therapeutic diet trials as first-line treatment whenever medically appropriate.

How long should a diet trial last?

For canine chronic inflammatory enteropathy, current ACVIM guidance recommends exclusive feeding of a therapeutic diet for at least two weeks as an adequate initial trial. Some dogs require a longer trial or trials of multiple therapeutic diets. Once an effective diet produces remission, it is often continued for considerably longer before any attempt is made to transition away from it.

Is a hydrolyzed diet better than a novel-protein diet?

Not necessarily. Both can be effective. The best choice depends on the individual pet’s previous diet exposure, gastrointestinal signs, medical history and diagnostic findings.

Should every dog with chronic diarrhea receive metronidazole?

No. Antibiotics may be appropriate in selected circumstances, but routine antibiotic treatment is no longer considered the best first step for every stable dog with chronic diarrhea. Diet, diagnostic evaluation and the potential effect of antibiotics on the intestinal microbiome should all be considered.

Can probiotics help chronic diarrhea?

Sometimes. Probiotic effects differ between organisms, strains and products. We prefer selecting microbiome support based on the individual patient rather than assuming that every probiotic has the same effect.

Can low vitamin B12 cause or worsen gastrointestinal problems?

Low cobalamin can accompany chronic intestinal disease or pancreatic insufficiency and may contribute to poor gastrointestinal health. When deficiency is documented, B12 replacement can become an important component of treatment.

What test diagnoses pancreatic insufficiency?

The primary blood test for exocrine pancreatic insufficiency in dogs and cats is TLI, or trypsin-like immunoreactivity.

What test is used for pancreatitis?

Pancreatic lipase immunoreactivity, or PLI, is an important blood test for suspected pancreatitis. Because no single test detects every case, PLI results may be interpreted together with clinical signs, other bloodwork and abdominal ultrasound.

Why would my veterinarian test cortisol for diarrhea?

Addison’s disease can cause recurring vomiting, diarrhea, appetite changes and weight loss in dogs. A baseline cortisol concentration can help rule out Addison’s disease. A low screening cortisol does not confirm Addison’s disease and generally needs to be followed by an ACTH stimulation test.

Does acupuncture treat chronic diarrhea?

Acupuncture may be used as supportive therapy in selected patients, but evidence for chronic gastrointestinal disease is more limited than the evidence for dietary management and conventional diagnostic testing. We use acupuncture as an adjunct rather than a replacement for necessary medical care.

Is slippery elm safe for dogs and cats?

Slippery elm is sometimes used as a gastrointestinal demulcent in integrative medicine, but veterinary clinical evidence is limited. It may also affect absorption of oral medications. We recommend discussing the product, timing and dose with a veterinarian before using it.

When does diarrhea become an urgent veterinary problem?

Repeated diarrhea accompanied by vomiting, weakness, dehydration, abdominal pain, significant blood, black stool, inability to keep water down, loss of appetite or rapid deterioration warrants prompt veterinary attention.

Schedule a Chronic Gastrointestinal Evaluation

If your dog or cat has diarrhea that keeps returning, chronic soft stool, unexplained weight loss, vomiting, excessive gas, appetite changes or another unresolved gastrointestinal problem, the next step is to determine why.

At Aliso Beach Animal Clinic, our approach combines thoughtful diagnostics, individualized nutrition, conventional veterinary medicine and appropriate integrative therapies rather than forcing every gastrointestinal patient into the same treatment protocol.

Aliso Beach Animal Clinic
30816 Coast Highway
Laguna Beach, CA 92651
Directly across from the Montage Laguna Beach

Call: (949) 499-4190

Monday–Friday: 7:30 a.m.–4:30 p.m.
Saturday: 8:00 a.m.–12:00 p.m.
Sunday: Closed

Please call before arriving for an urgent gastrointestinal problem so our team can assess your pet’s condition and prepare appropriately.

Medical Review

Medically reviewed by Bryan Hayter, DVM, Owner and Medical Director of Aliso Beach Animal Clinic. Last reviewed: September 2026.

Dr. Hayter earned his Doctor of Veterinary Medicine degree from Auburn University, completed an internship at the San Diego Zoo and completed veterinary acupuncture training through the International Veterinary Acupuncture Society.

Aliso Beach Animal Clinic is an independently owned veterinary clinic and animal hospital serving Laguna Beach, South Laguna, Monarch Beach, Dana Point, Laguna Niguel and surrounding coastal Orange County communities.

Veterinary Sources & Further Reading