Malabsorption syndrome

Malabsorption syndrome in cats refers to a collection of disorders characterized by the inability of the small intestine to properly absorb nutrients from digested food. Rather than being a single disease, malabsorption represents the clinical consequence of various underlying conditions that damage or disrupt the normal absorptive function of the intestinal lining. Cats with malabsorption syndrome typically eat adequate or even increased amounts of food yet fail to maintain body weight and condition because nutrients pass through the digestive tract without being absorbed. This condition affects cats of all ages and breeds, though it is most commonly diagnosed in middle-aged to older cats when underlying diseases are more prevalent.

The causes of malabsorption syndrome in cats are numerous and include both diseases affecting the intestinal wall itself and conditions that interfere with the digestive process. Inflammatory bowel disease represents one of the most common underlying causes, as chronic inflammation damages the intestinal lining and impairs its absorptive capacity. Intestinal lymphoma, a cancer of lymphocytes in the intestinal wall, similarly destroys normal tissue architecture and function. Infections, including bacterial overgrowth and certain parasites, can impair absorption. Exocrine pancreatic insufficiency, though less common in cats than dogs, prevents proper digestion of food. Understanding the underlying cause is essential because treatment approaches differ significantly.

The impact of malabsorption syndrome on affected cats is significant and progressive if the underlying cause is not addressed. Poor nutrient absorption leads to weight loss despite adequate food intake, as the cat's body cannot access the calories and nutrients in their food. Deficiencies in specific nutrients including vitamins, minerals, and essential fatty acids develop over time, causing various secondary health problems. Protein loss contributes to muscle wasting and weakened immune function. The chronic diarrhea that often accompanies malabsorption causes ongoing fluid and electrolyte losses. Quality of life diminishes as cats become increasingly debilitated from malnutrition despite appearing to eat well.

Malabsorption syndrome is manageable in many cases, though outcomes depend heavily on the underlying cause and how early treatment is initiated. Some causes, such as certain infections or dietary sensitivities, may be fully correctable with appropriate treatment. Inflammatory bowel disease often responds well to dietary management and medication, allowing cats to regain normal nutritional status. More serious underlying conditions like intestinal lymphoma carry more guarded prognoses, though even these cats may benefit significantly from treatment. Early diagnosis through veterinary evaluation when symptoms first appear provides the best opportunity for successful management. Working with your veterinarian to identify and address the underlying cause of malabsorption is essential for restoring your cat's nutritional health.

The primary causes of malabsorption syndrome involve diseases that either damage the intestinal absorptive surface or interfere with the digestive processes necessary for nutrient uptake. Inflammatory bowel disease stands as one of the most common causes, characterized by infiltration of the intestinal wall with inflammatory cells that disrupt normal tissue structure and function. This inflammation reduces the surface area available for absorption and interferes with the transport mechanisms that move nutrients from the intestinal lumen into the bloodstream. Intestinal lymphoma, the most common intestinal cancer in cats, destroys normal intestinal architecture with malignant lymphocytes, severely compromising absorptive capacity. These two conditions, inflammatory bowel disease and intestinal lymphoma, represent the underlying cause in a significant proportion of feline malabsorption cases.

Infectious causes contribute to malabsorption through various mechanisms of intestinal damage. Bacterial overgrowth in the small intestine, also known as small intestinal bacterial overgrowth or SIBO, alters the intestinal environment and may damage the intestinal lining. Certain intestinal parasites including Giardia can impair absorption by coating the intestinal surface and causing inflammation. Histoplasmosis and other fungal infections affecting the intestinal tract cause granulomatous inflammation that disrupts absorption. Feline coronavirus infection, particularly in cats that develop feline infectious peritonitis involving the intestinal tract, can cause malabsorption. Identifying and treating infectious causes is important because they are often curable with appropriate antimicrobial therapy.

Exocrine pancreatic insufficiency represents a cause of malabsorption that technically involves maldigestion rather than true malabsorption. In this condition, the pancreas fails to produce adequate digestive enzymes, meaning that food cannot be properly broken down into absorbable components. Without these enzymes, fats, proteins, and carbohydrates remain in forms too large to be absorbed regardless of intestinal health. While less common in cats than in dogs, exocrine pancreatic insufficiency does occur and causes classic malabsorption symptoms. This condition is highly treatable with enzyme supplementation.

Risk factors for developing malabsorption syndrome relate primarily to the underlying conditions that cause it. Middle-aged to older cats face increased risk for inflammatory bowel disease and intestinal lymphoma, the most common causes. Cats with chronic gastrointestinal symptoms that have not been adequately investigated and treated may progress to malabsorption as underlying conditions worsen. Certain breed predispositions exist for some underlying conditions, though malabsorption itself does not show strong breed patterns. Cats with poor parasite control face risk from parasitic causes. Previous intestinal surgery or disease may predispose to malabsorption in some cases.

The mechanism of malabsorption involves disruption of the complex process by which nutrients cross from the intestinal lumen into the bloodstream. The small intestine is lined with finger-like projections called villi that dramatically increase surface area for absorption. Each villus is covered with cells called enterocytes that have even smaller projections called microvilli, further increasing absorptive surface. When diseases damage these structures, flatten the villi, or destroy the enterocytes, the available surface area for absorption decreases dramatically. Additionally, the transport proteins and enzymes on the enterocyte surface that actively move nutrients into the cell may be damaged or depleted. The result is that nutrients that have been properly digested cannot be absorbed and pass through the intestinal tract to be lost in the stool.

Early warning signs of malabsorption syndrome often develop gradually and may initially seem like minor digestive issues rather than a serious metabolic problem. Subtle changes in stool quality, including slightly softer stools, increased volume, or mild changes in color, may be the first indications that absorption is compromised. Some cats develop slightly increased appetite as their bodies recognize nutrient deficiencies, though this compensation is inadequate. Coat quality may decline subtly, with fur becoming slightly duller or rougher than usual. Mild weight loss or failure to maintain optimal body condition despite adequate food intake can occur. These early signs are often gradual enough that owners may not recognize them until looking back after the condition has progressed.

The most common symptoms of established malabsorption syndrome relate to the failure to derive nutrition from food combined with changes in bowel function. Chronic diarrhea is a hallmark symptom, typically characterized by increased frequency and volume of stools with soft to watery consistency. The stools may appear pale, greasy, or unusually foul-smelling due to undigested and unabsorbed fat content, a phenomenon called steatorrhea. Weight loss becomes increasingly apparent despite maintained or even increased food intake, representing one of the most characteristic features of malabsorption. Some cats develop ravenous appetites as their bodies attempt to compensate for nutrient losses, while others experience decreased appetite, possibly from nausea or intestinal discomfort.

Behavioral changes in cats with malabsorption reflect the systemic effects of poor nutrition and chronic gastrointestinal disturbance. Reduced energy and activity levels develop as caloric deficits accumulate. Cats may become less playful and more inclined to rest. Some cats become more food-focused, showing increased interest in feeding times or attempting to eat unusual items. Litter box visits may increase in frequency, and cats may begin having accidents if urgency develops. Withdrawal from normal social interactions can occur as cats feel progressively unwell. Overall demeanor shifts from normal contentment to chronic mild malaise that owners often describe as the cat simply not seeming like themselves.

Physical signs of malabsorption become increasingly apparent as the condition progresses. Weight loss is typically the most obvious finding, with visible loss of muscle mass and body fat. The spine, hips, and shoulders become more prominent as covering tissue diminishes. Muscle wasting, particularly over the spine and hindquarters, indicates protein malabsorption. The coat often deteriorates significantly, becoming dull, dry, brittle, or unkempt as essential fatty acid and vitamin deficiencies develop. Some cats develop skin problems including flaking or scaling. Weakness may become apparent, particularly in the hindquarters. Abdominal distension can occur despite overall weight loss due to intestinal changes.

Symptom progression in untreated malabsorption follows a pattern of gradual deterioration as nutritional deficits compound. Early mild symptoms intensify over weeks to months without intervention. Weight loss accelerates as body reserves are depleted. Chronic diarrhea may become increasingly severe. Signs of specific nutrient deficiencies may emerge, including weakness from protein loss, neurological signs from B vitamin deficiency, or bleeding tendencies from vitamin K malabsorption. Secondary conditions including anemia and immune suppression may develop. The overall trajectory is one of progressive debilitation that ultimately becomes life-threatening if the underlying cause is not addressed.

Emergency symptoms requiring immediate veterinary attention include signs of severe deterioration or complications from malabsorption. Profound weakness, collapse, or inability to stand indicates severe debilitation requiring urgent care. Bloody diarrhea suggests possible intestinal hemorrhage or severe mucosal damage. Signs of severe dehydration including skin tenting, sunken eyes, and extreme lethargy need immediate treatment. Neurological signs including seizures, blindness, or severe incoordination may indicate thiamine or other vitamin deficiency reaching critical levels. Any rapid deterioration in a cat with chronic gastrointestinal symptoms warrants urgent evaluation to assess for complications or progression of underlying disease.

The diagnostic process for malabsorption syndrome begins with thorough history taking and physical examination to characterize symptoms and assess nutritional status. Your veterinarian will ask detailed questions about appetite, food intake, weight changes, stool characteristics, and duration of symptoms. Information about diet history, deworming status, and any previous gastrointestinal issues provides important context. Physical examination assesses body condition score, muscle mass, coat quality, hydration status, and abdominal findings. The characteristic combination of poor body condition despite adequate food intake raises suspicion for malabsorption and guides further diagnostic investigation.

Laboratory testing plays a central role in diagnosing malabsorption and identifying underlying causes. A complete blood count may reveal anemia from chronic disease or nutritional deficiency, and changes in white blood cell populations can suggest inflammation or lymphoma. Chemistry panels assess overall organ function and may reveal low protein levels, electrolyte abnormalities, and liver or kidney involvement. Specific tests for intestinal function include serum cobalamin (vitamin B12) and folate levels, which help localize the problem within the intestinal tract and assess severity of malabsorption. Low cobalamin specifically indicates ileal disease or bacterial overgrowth and helps guide diagnosis. Thyroid testing rules out hyperthyroidism, which can cause similar symptoms. Fecal examinations check for parasites that might cause malabsorption.

Advanced diagnostics are usually necessary to identify the specific underlying cause of malabsorption. Abdominal ultrasound allows visualization of the intestinal walls and can detect thickening, layering abnormalities, masses, and lymph node enlargement that suggest specific diseases. Ultrasound findings often guide decisions about further testing and may suggest whether inflammatory bowel disease or lymphoma is more likely. Intestinal biopsy provides definitive diagnosis in most cases and can be obtained either through endoscopy, which examines and samples the intestinal lining through a scope, or through surgical biopsy, which allows full-thickness samples and direct visualization of the intestinal tract. The choice between endoscopic and surgical biopsy depends on clinical findings and suspected underlying conditions.

Differential diagnosis considers the various conditions that could underlie the malabsorption presentation. Inflammatory bowel disease and intestinal lymphoma require differentiation because treatment differs significantly. Exocrine pancreatic insufficiency is diagnosed through measurement of feline trypsin-like immunoreactivity. Food allergies may be investigated through dietary elimination trials. Hyperthyroidism must be ruled out in older cats as it causes weight loss despite increased appetite. Diabetes mellitus presents similarly and is excluded through blood glucose measurement. Renal disease causes weight loss and may cause gastrointestinal symptoms. Chronic parasitism must be excluded through fecal testing. The diagnostic workup systematically evaluates these possibilities to reach an accurate diagnosis guiding appropriate treatment.

Initial treatment for malabsorption syndrome focuses on stabilizing the patient while diagnostic workup proceeds to identify the underlying cause. Cats presenting with significant dehydration require fluid therapy to restore hydration and correct electrolyte imbalances. Nutritional support begins immediately, often with highly digestible therapeutic diets that are more easily absorbed than standard foods. Vitamin supplementation, particularly injectable cobalamin for cats with documented deficiency, may begin before a definitive diagnosis is reached. Anti-nausea medications can help cats with reduced appetite or vomiting. This supportive care improves patient comfort and stability while investigations continue.

Medical management specific to the underlying cause represents the core of malabsorption treatment. For inflammatory bowel disease, treatment typically involves dietary modification combined with immunosuppressive medications such as prednisolone or other corticosteroids. Dietary options include novel protein diets, hydrolyzed protein diets, or high-fiber formulations depending on the specific presentation. Many cats with IBD respond well to this approach and can regain normal nutritional status. For intestinal lymphoma, chemotherapy protocols are employed, with many cats showing good initial response particularly to small-cell lymphoma. Exocrine pancreatic insufficiency is treated with enzyme supplementation added to each meal. Infectious causes receive appropriate antimicrobial therapy.

Surgical intervention may be part of the diagnostic process when surgical biopsy is needed but rarely serves as primary treatment for malabsorption itself. In some cases, masses or segments of severely diseased intestine may be removed surgically, but this is determined based on the specific underlying condition rather than the malabsorption per se. Surgical biopsy allows full-thickness intestinal samples and examination of mesenteric lymph nodes, which may be important for distinguishing inflammatory bowel disease from lymphoma when endoscopic biopsies are inconclusive.

Supportive care continues throughout treatment and is essential for recovery. Cobalamin supplementation is critical for cats with deficiency, as this vitamin is necessary for numerous metabolic processes and its deficiency can prevent response to other treatments. Injectable cobalamin is typically given weekly initially, then tapered as levels normalize. Dietary management supports intestinal healing and maximizes nutrient availability. Probiotics may help restore healthy intestinal bacterial populations. Appetite stimulants can help cats with persistently reduced food intake. Monitoring body weight and condition guides adjustments to nutritional support.

Complementary approaches may enhance conventional treatment for some cats. Probiotic supplementation supports healthy gut microbiome balance. Omega-3 fatty acid supplementation may help reduce intestinal inflammation. Vitamin E and other antioxidants support overall cellular health during recovery. These approaches should complement rather than replace medical management directed at the underlying cause. Some owners explore alternative therapies including acupuncture, which may help with appetite and digestive comfort in some cats.

Treatment decisions involve balancing the goal of addressing the underlying cause with practical considerations. The specific diagnosis significantly influences treatment approach and expected outcomes. Cost considerations are relevant as workup and treatment for malabsorption can be significant, particularly when biopsy and ongoing medication are needed. The cat's overall health and quality of life guide decisions about how aggressively to pursue diagnosis and treatment. Expected outcomes vary widely based on underlying cause, ranging from excellent for treatable conditions like EPI to more guarded for intestinal lymphoma, though many cats with lymphoma also do well with appropriate treatment.

The recovery timeline for malabsorption syndrome depends entirely on the underlying cause and its treatability. Cats with conditions that can be fully corrected, such as exocrine pancreatic insufficiency with enzyme supplementation or parasitic infections with appropriate treatment, may show improvement within one to two weeks and fully recover within a month. Inflammatory bowel disease typically shows initial response to treatment within two to four weeks, though full normalization may take several months and ongoing management is usually required. Intestinal lymphoma may respond to chemotherapy within weeks, but this represents disease management rather than cure. Setting realistic expectations based on the specific diagnosis helps owners prepare for the recovery journey.

Post-treatment care varies based on the underlying condition but universally involves ongoing attention to nutrition and monitoring for symptom recurrence. Cats recovering from malabsorption need consistent access to appropriate therapeutic diets and should not be switched to other foods without veterinary guidance. Medication administration must continue as prescribed, with particular attention to completing any prescribed courses of treatment. Weight monitoring at home using a consistent scale helps track recovery progress. Follow-up veterinary visits assess response to treatment and allow adjustment of the treatment plan as needed. Continuing cobalamin supplementation until levels normalize is important for cats with documented deficiency.

Prognosis factors include the specific underlying cause, the severity and duration of malabsorption before treatment, and the response to initial therapy. Cats with treatable causes like EPI or responsive inflammatory bowel disease generally have excellent prognoses for return to normal quality of life. Those with small-cell intestinal lymphoma often respond well to chemotherapy, with many achieving remission lasting months to years. Large-cell lymphoma carries a more guarded prognosis. Cats that have experienced prolonged malabsorption with severe debilitation face longer recovery periods and may have lasting effects from the extended nutritional deficit. Early diagnosis and treatment generally improve outcomes across all underlying conditions.

The long-term outlook for cats with malabsorption syndrome ranges from excellent to guarded depending on the underlying cause. Cats with successfully treated or well-managed underlying conditions can enjoy good quality of life for years. Many cats with inflammatory bowel disease achieve remission with ongoing dietary and medical management and live normal lifespans. Cats with intestinal lymphoma that responds to treatment often have good quality time, though the disease may eventually progress. Ongoing monitoring remains important for all cats with history of malabsorption, with attention to body weight, stool quality, and overall condition. Regular veterinary check-ups support early detection of any disease progression or recurrence.

Primary prevention of malabsorption syndrome is challenging because many underlying causes cannot be prevented, but certain general measures support intestinal health. Maintaining appropriate parasite prevention eliminates one potential cause of malabsorption and supports overall intestinal health. Feeding high-quality, complete and balanced diets appropriate for your cat's life stage provides optimal nutrition without unnecessary intestinal stress. Avoiding sudden dietary changes that might disrupt intestinal function and maintaining consistent feeding practices supports stable digestion. These general measures cannot prevent conditions like inflammatory bowel disease or lymphoma but promote overall gastrointestinal wellness.

Environmental considerations that support digestive health include minimizing stress, which may influence intestinal inflammation and function. Providing a stable, predictable environment with consistent routines helps reduce stress-related gastrointestinal disturbance. Ensuring adequate litter box access and cleanliness supports normal elimination patterns. Multi-cat household dynamics should be managed to reduce competition-related stress. Indoor housing reduces exposure to parasites and infectious agents that might affect intestinal health. These environmental factors support overall health even if they cannot prevent specific diseases.

Dietary management as a preventive measure focuses on supporting optimal intestinal health throughout life. Feeding an appropriate diet for your cat's life stage ensures nutritional needs are met. Avoiding foods known to cause digestive upset in your individual cat prevents unnecessary intestinal stress. Limiting treats and table foods that might disturb digestive balance is advisable. For cats with sensitive digestion, maintaining a consistent diet rather than frequently rotating foods may help. While specific diets cannot prevent most causes of malabsorption, thoughtful nutritional management supports the intestinal health that may help reduce disease severity if problems develop.

Regular health maintenance through veterinary care enables early detection of conditions that might lead to malabsorption. Annual or twice-yearly wellness examinations provide opportunities to monitor body weight and condition and discuss any digestive concerns. Blood work including cobalamin levels may detect early abnormalities before clinical malabsorption develops. Discussing any changes in appetite, weight, or stool quality promptly with your veterinarian allows early investigation of potential problems. Senior cats benefit from more frequent monitoring as they enter age ranges where intestinal diseases become more common.

Early intervention when gastrointestinal symptoms first appear offers the best opportunity to prevent progression to significant malabsorption. Seeking veterinary evaluation for persistent changes in stool quality, unexplained weight changes, or altered appetite enables early diagnosis of underlying conditions. Beginning treatment before severe intestinal damage and nutritional depletion occur generally improves outcomes. Monitoring cats with known risk factors more closely allows problems to be caught early. While not all causes of malabsorption can be prevented, prompt attention to early symptoms minimizes the health impact of conditions that do develop.

Daily management of cats with malabsorption syndrome centers on consistent implementation of treatment protocols and ongoing monitoring of nutritional status. Feeding the prescribed therapeutic diet at regular intervals supports optimal nutrient delivery to damaged intestines. For cats requiring enzyme supplementation, mixing the appropriate dose with each meal must become routine. Medication administration according to the prescribed schedule maintains therapeutic levels and disease control. Daily observation of appetite, activity level, and general demeanor helps detect any changes that might indicate treatment adjustment is needed. Monitoring stool quality provides ongoing feedback about intestinal function and treatment effectiveness.

Home environment modifications support cats living with malabsorption. Easy access to food and water encourages adequate intake for cats who may be dealing with reduced appetite or increased nutritional needs. Multiple small meals throughout the day rather than one or two large meals may improve nutrient absorption and reduce digestive stress. Providing comfortable, easily accessible resting spots accommodates cats with reduced energy levels during recovery. Litter box placement should account for any increased urgency or frequency of defecation. A calm, low-stress environment supports overall health and may reduce stress-related exacerbation of intestinal inflammation.

Maintaining quality of life for cats with managed malabsorption is achievable with appropriate care. Once stabilized on treatment, many cats return to normal or near-normal activity levels and enjoy good quality of life. Gentle play and interaction appropriate to the cat's energy level provides mental stimulation and social bonding. Environmental enrichment including window views, climbing opportunities, and interactive toys supports mental wellbeing. The goal is not just physical survival but actual enjoyment of daily life. Monitoring your cat's apparent comfort and happiness alongside physical parameters provides a complete picture of how well management is working.

Ongoing monitoring and veterinary communication ensure treatment remains effective over time. Keeping records of body weight, ideally measured weekly during active management, allows early detection of changes. Noting any changes in appetite, stool quality, or behavior provides important information for veterinary visits. Regular follow-up appointments, typically every few months for stable cats or more frequently during active treatment adjustment, allow assessment of response and treatment modification as needed. Laboratory monitoring, including periodic cobalamin levels and other indicated tests, guides ongoing management. Open communication with your veterinary team supports optimal long-term outcomes.

Caregiver support is valuable for owners managing cats with chronic conditions requiring ongoing treatment. Understanding the nature of malabsorption and its treatment helps owners implement management protocols effectively. Learning to recognize signs of disease flare or treatment failure enables prompt response. Financial planning for ongoing treatment costs, which may include specialized food, supplements, and medications, helps ensure sustainable care. Connecting with veterinary support staff for questions and guidance between appointments is valuable. Recognizing that good management can provide cats with excellent quality of life despite their condition encourages consistent long-term care.

Malabsorption syndrome itself does not show clear breed predisposition, as it represents a clinical consequence of various underlying diseases rather than a primary condition. However, some of the underlying causes of malabsorption may occur more frequently in certain breeds. Siamese and related Oriental breeds have been reported to have increased incidence of intestinal diseases including inflammatory bowel disease and intestinal lymphoma, which are major causes of malabsorption. Some studies suggest that purebred cats in general may face elevated risk for inflammatory bowel disease compared to mixed-breed cats, though this remains somewhat controversial. Overall, malabsorption can affect cats of any breed when underlying conditions develop.

Certain categories of cats face elevated risk based on age and other factors. Middle-aged to older cats have higher rates of inflammatory bowel disease and intestinal lymphoma, making them more likely to develop malabsorption. Cats with chronic gastrointestinal symptoms that have not been adequately diagnosed and treated may progress to malabsorption as underlying conditions worsen. Cats with poor parasite control may develop parasitic causes of malabsorption. Those with immune system abnormalities may be more prone to developing intestinal inflammation. Awareness of these risk factors helps guide appropriate monitoring and early intervention.

Screening recommendations focus on monitoring for symptoms rather than breed-specific testing, as no genetic tests predict malabsorption risk. All cats should receive regular veterinary examinations where body weight and condition are assessed and owners can report any digestive concerns. Cats with chronic or recurrent gastrointestinal symptoms warrant diagnostic investigation rather than dismissal as sensitive stomachs. Senior cats benefit from more frequent monitoring and may have baseline blood work including cobalamin levels performed as part of wellness screening. Cats in breed categories associated with higher intestinal disease risk may warrant particularly close attention to any gastrointestinal symptoms. Early investigation of symptoms before significant malabsorption develops generally improves outcomes.

Several conditions frequently co-occur with malabsorption syndrome, reflecting shared underlying diseases and the systemic effects of poor nutrition. Inflammatory bowel disease and intestinal lymphoma are the most common underlying conditions and may involve other gastrointestinal organs including the stomach and colon simultaneously. Chronic pancreatitis frequently accompanies inflammatory bowel disease in cats, a combination sometimes called triaditis when the liver is also involved. Hepatic lipidosis can develop secondary to reduced food intake in cats with malabsorption. Anemia commonly results from chronic disease, nutritional deficiency, or intestinal blood loss. These concurrent conditions must be addressed as part of comprehensive management.

Conditions with similar presentations require differentiation from malabsorption during diagnostic workup. Hyperthyroidism causes weight loss despite good appetite in older cats and must be ruled out through thyroid testing. Diabetes mellitus presents with weight loss, increased appetite, and sometimes diarrhea. Chronic kidney disease causes weight loss and may affect digestion. Intestinal parasites cause diarrhea and weight loss and should be ruled out with fecal testing. Cancer affecting other organ systems may cause weight loss and gastrointestinal symptoms. Accurate diagnosis of the specific condition causing malabsorption symptoms is essential because treatments differ significantly.

Potential complications of malabsorption include secondary problems resulting from chronic nutritional deficiency. Cobalamin deficiency from ileal disease can cause neurological problems if severe and prolonged. Anemia develops from multiple factors including nutritional deficiency and chronic disease. Muscle wasting from protein malabsorption causes weakness and reduced mobility. Immune system compromise from overall nutritional depletion increases susceptibility to infections. Skin and coat problems result from fatty acid and vitamin deficiencies. Preventing these complications through prompt recognition and treatment of malabsorption minimizes the overall impact on feline health. Most complications are reversible with appropriate treatment of the underlying condition.