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No one really likes talking about poop. But the reality is that for our pets, the appearance, frequency and quality of their stools can provide insights about their health. Cat fecal exams or “fecals” are important tools veterinarians use both for regular health screening as well as when a cat isn’t feeling so “regular.”
Read on to learn what a fecal exam checks for, how it’s performed, and what the results can tell your vet about your cat’s health.
What Is a Cat Fecal Exam?
The presence of cat litter with a fecal sample does not interfere with most cat fecal exams. Boibin / Shutterstock.com
A cat fecal exam is a type of test on a cat’s stool (feces) that checks for abnormalities that might be affecting their health. Most often, veterinarians are testing for intestinal parasites and sometimes disease-causing bacteria.
There are several different types of fecal exams:
1. Fecal Flotation
A “fecal float” test is one of the most common fecal exams. A sample of stool is mixed with a specific liquid solution in a tube. Items of interest in the stool, like parasite eggs, will float to the surface and stick to a microscope slide sitting on top of the tube. Samples are sometimes spun down in a centrifuge, which sends most of the fecal debris down to the bottom and away from the slide.
2. Fecal PCR
A PCR stands for polymerase chain reaction. There are many types of PCR tests. They essentially detect the presence of genetic material at the molecular level, like DNA.
3. Fecal Culture
Just like a urine or skin culture, a fecal culture checks for bacterial growth. This test can detect specific strains of bacteria and identify which antibiotics they’re sensitive to. Because there are many important, good bacteria in the digestive tract that only cause disease if they overgrow, a culture only detecting their presence can be hard to interpret.
4. Fecal Smear
This test involves collecting a very small amount of fresh stool, mixing it with a small amount of saline solution on a slide, and examining it under a microscope.
What Does a Cat Fecal Exam Show?
Toxocara cati, the cat roundworm, is just one of many intestinal parasites that can be revealed through a fecal exam. olgaru79 / Shutterstock.com
In most cases, a cat fecal exam is checking for intestinal parasites. Some types of fecal exams can also check for the presence of disease-causing bacteria and toxins.
Here is a list of parasites commonly checked for:
Some disease-causing bacteria that might be checked for include:
Salmonella
Coli
Listeria
Campylobacter
Clostridium
Some testing, especially PCR testing, can also check for certain toxins, like the enterotoxin carried by some strains of Clostridium perfringens, or Clostridium difficile toxins A and B.
1. Fecal Flotation
Fecal flotation is used for detecting intestinal parasite eggs. There are different ways of performing a fecal float, but the most common is centrifugation and flotation using zinc sulfate solution.
Fecal flotation tests can be performed in-house at veterinary clinics or sent out to a lab. They can have a quick turnaround time, but they have some disadvantages. Fecal flotation tests require parasite eggs or cysts to be present, but parasites might go through cycles of shedding eggs and not shedding eggs, so it is possible to have a false negative test result.
Fecal floats are also performed directly by a person looking through a microscope, so there can be some error involved depending on the experience of the person preparing and examining the sample. Additionally, fecal flotation cannot check for the presence of disease-causing bacteria.
2. Fecal PCR
As a test that checks for presence of molecular genetic material, a PCR test is superior for detecting many infectious causes of diarrhea. This includes intestinal parasites, disease-causing bacteria like Clostridium and Campylobacter, some bacterial toxins, and viruses.
PCR tests have a very high sensitivity and specificity of about 95%, making it unlikely to have a false negative (or positive) result.
PCR testing for parasites is not dependent on parasite egg shedding cycles, and is also free of human interpretation error.
3. Fecal Culture
A fecal culture can detect specific strains of bacteria, like E. coli or Clostridium. The drawback however is that both E. coli and Clostridium are present in the GI tract of cats normally. Diarrhea can be caused by bacterial overgrowth and imbalance (which is called dysbiosis).
This can make fecal cultures hard to interpret. They can be the most helpful if checking for specific disease-causing bacteria that shouldn’t be present, like Salmonella and Listeria.
4. Fecal Smear
Fecal smears might be used in some cases along with other testing to check for the abnormal presence of parasites or bacteria in stool. Parasite eggs and cysts may be seen, as well as bacteria like Clostridium and Campylobacter.
Fecal smears do rely greatly on the experience and skill of the person preparing and examining the sample. Parasite eggs might be missed depending on shedding cycles, just like with fecal flotation. The presence of bacteria also must be interpreted carefully, just like with a fecal culture.
When Does My Cat Need a Fecal Exam?
Fecal exams for cats are recommended at least annually, as part of a healthy wellness screen. According to Cornell University, intestinal parasites are common in cats with up to 45% of cats being affected by one or more.
Even indoor cats carry some risk for acquiring intestinal parasites. A 2006 study in the Veterinary Record found that up to 15% of potting soil contained hookworm eggs, roundworm eggs, or both.
The tapeworm Dipylidium caninum is acquired from ingesting an infected flea. My own cat Bart acquired this tapeworm after ingesting a flea he caught that jumped off another dog in our apartment complex and made its way inside.
Protozoal parasites like Giardia and Cystoisospora have no preventive medication options and can be easily spread between dogs and cats. Dogs are more likely to pick up some parasites in the outdoor environment, even just on their feet, and present a risk to indoor cats they share a home with.
Outdoor cats should have a fecal exam performed at least twice a year because they have a higher risk of picking up parasites in the outdoor environment. Outdoor cats might also be hunting, increasing the risk of acquiring parasites like Toxoplasma and tapeworms.
Beyond health and wellness screens, a fecal exam should be considered if a cat develops certain health concerns. There can be many causes for the following symptoms listed below, but a fecal exam can help to quickly rule out parasites as a cause and might provide insight about the contribution of disease-causing bacteria.
Acute diarrhea
Chronic diarrhea
Blood in the stool
Wormlike or rice-like pieces in the stool or around the rectum
Vomiting
Weight loss
Poor weight gain (especially in kittens)
Poor appetite
How Is a Cat Fecal Exam Performed?
A fecal tube like this one can be used to collect and transport a stool sample to your vet. Oleksandra Mykhailutsa / Shutterstock.com
Sample Collection
The most common method of providing a fecal sample for your cat is to collect one from your litter box. For fecal flotation, culture, and PCR, the presence of cat litter does not affect the quality of the sample.
A fecal sample should be as fresh as possible and never older than 24 hours. If you know you need to bring a sample to the vet but it might not be for a few hours or the next day, collect a fresh sample, put it in a sealed plastic bag or container, and put it in the refrigerator.
In most cases, because cats share litter boxes, any sample from the box will suffice for the purposes of a general health screen. However, if you have one cat showing signs of stool issues and no other cats in the home appear to be affected, try to collect a sample from that cat if possible.
Anytime you collect a stool sample, never handle it with your bare hands. Wear gloves, or use a plastic bag to collect it. Your vet might also provide you with a collection tube that has a small spoon attached to the lid to help with collection.
In some cases, your vet might choose to collect a fresh sample from your cat directly, either through a rectal exam, or by using a fecal loop to collect a small amount to use. This method is more common with direct fecal smears.
Sample Preparation and Examination
Once a sample is collected, a team member will prepare it to be examined in the hospital or to be sent out to a lab. Veterinary nurses and some veterinary assistants are trained to read fecal flotation samples under the microscope in-house at the clinic. A veterinarian might choose to confirm results. Fecal smears are most often examined directly by a veterinarian.
Time To Expect Results
If your veterinarian performs fecal flotation tests in their clinic, you will have results the same day, sometimes before your appointment is over. To ensure a better standard of results and to save on clinic staff time, many veterinary clinics nowadays send out samples for parasite egg counts to a lab. Results usually take about 24 hours.
Fecal PCR samples and fecal cultures are always sent out to a lab. Fecal flotation and PCR samples typically have a 24-hour turnaround time. Fecal cultures can take at least three to four days for results.
How Does My Vet Use Fecal Exam Results?
The results of a fecal exam might lead directly to a treatment, like this dewormer for tapeworms. Sari ONeal / Shutterstock.com
Your vet will interpret the results of your pet’s fecal exam in light of signs of illness your cat might be showing.
For example, an acute onset of diarrhea in a cat with a finding of a high burden of Giardia may support that Giardia is the cause. It would at least be a good reason to treat for Giardia.
Even if your cat is not showing signs of illness, a positive (abnormal) result on a fecal exam might warrant treatment. A great example is screening a kitten’s stool. Some kittens with parasites like tapeworms, Giardia, and Coccidia might not show signs of illness, at least not at first. Vets will typically treat for the presence of these parasites even if kittens do not appear ill. Over time, parasites can lead to poor growth, malnutrition, and more chronic intestinal issues if they are not addressed.
Medications used to treat for the results on a fecal exam will depend on the finding. This might include:
Any of several dewormers
Certain antibiotics
Probiotics
Dietary therapy
Frequently Asked Questions
How fresh does a stool sample have to be for a cat?
Samples should always be from within the last 24 hours, but a stool sample should be as fresh as possible. If you cannot bring in a stool sample right away or if your cat’s vet exam is later in the day or the next day, put the sample in the refrigerator in a sealed bag or container.
How much does a fecal test cost for a cat?
Fecal exam costs will depend on the type of test being performed. Veterinary costs can vary widely depending on where you live, and this will also affect how much you can expect to pay. Fecal exams cost anywhere from $45 to $90 on average.
In-house fecal flotation tests may cost the least, while a fecal culture may cost the most. Fecal PCRs for general screening are becoming more common and generally cost somewhere in between.
How does a vet get a stool sample from a cat?
Most often, your vet will ask you to bring a stool sample from home. The presence of cat litter will not affect results for most fecal examinations. In some cases, your vet might acquire a fresh sample directly from your cat. Rectal exams can be difficult and stressful for cats, so a small tool called a fecal loop is often used.
A fecal loop is a small, soft tool that can be used to acquire a small amount of stool material rectally when a very small, fresh sample for culture or a direct fecal smear is needed.
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