Chronic Diarrhea Without Other Symptoms

[Richard2121]

So I have posted about this before, but it I am growing increasingly frustrated with the response from any vet I take Richard to. Richard is a 7 month old male kitten. He has a history of URIs and taking antibiotics. He was finally diagnosed with Chlamydophila Felis and treated with doxycylcine for 4 weeks. He has been off the Doxycycline for a few weeks now and I wanted to give his gut some time to reset. The vet saw him last week for his pre-op bloodwork and physical exam prior to getting neutered. He said Richard seems perfectly healthy aside from the diarrhea. With that being said, he wants to pump Richard full of anitbiotics (Tylosin Powder) to resolve a 4 month long case of diarrhea. 1 week in and Richard is permanently traumatized, as any cat would be after using a pill gun and large capsule being forced down his throat. This is the only way I could manage to administer the drug without injury to myself. My problem is I fear he is being traumatized at the mercy of a drug that isn't going to treat the issue. It has not helped yet and I stopped a few days ago because I don't want my cat to be afraid of me when normally he follows me around the house. He has never tested positive for anything via a fecal exam and he was tested for giardia twice and both times it came back negative. The other cats in the household (4 in total) seem to have no problem producing solid stool including a 14 week old kitten who, I'd imagine, should be overwhelmed by intestinal parasites if another one of my cats had them. My next step to take would be a Fecal PCR panel which gets sent out to a lab and is far more sensitive to certain organisms. it costs $250 and between that and all the other food changes recently I am up to my arms in cat related expenses this month. So between the numerous courses of antibiotics and the food changes, I think Richard's gut is pretty much in peril. I am open to any and all suggestions. The vet said this is not urgent. Richard plays all day long, eats 4 meals a day and you would not know anything was wrong with him unless you listened to him use the litter box. His growth is on track and he weighs about 11 pounds but is still very lean and has a long body. Very athletic and his coat is shiny and radiant.

I am considering getting him off Fancy Feast entirely and feeding him Wellness and Freeze-Dried Raw Nuggets by Primal. Mixing in Nexabiotic seems like a good idea too as his gut flora is most likely depleted. I just don't know if a fecal PCR test is going to give us the answer we want and given his health aside from the loose stools, I hesitate to panic. IBD? Food sensitivity? Something WAY worse?

 

[Furballsmom]

Hi!
I personally like your thoughts of wellness, primal and nexabiotic.
Sending you all sorts of good tummy-healing thoughts!!

 

[posiepurrs]

I would insist on a PCR before proceeding to any other medicines. There is absolutely no sense in treating unless you know what you are treating. I would suspect Tritrichamonas feotus, even though the other cats are not presenting with the symptoms.

 

[Richard2121]

I would insist on a PCR before proceeding to any other medicines. There is absolutely no sense in treating unless you know what you are treating. I would suspect Tritrichamonas feotus, even though the other cats are not presenting with the symptoms.

I have heard of Tritrichamonas feotus before and I was reading up on it again via some education articles online. If Richard did have this would I then have to treat all 4 of my cats with Ronidazole? I see that it is extremely bitter tasting and needs to be given in capsules to be most effective. So do I need to brace myself for 7 days of pilling 4 cats twice per day?

 

[She's a witch]

Has he always had diarrhea or did it start at some point? If always, I would do PCR and if it comes back clear, I would start elimination diet starting with elimination of the protein he most commonly eats (my guess would be chicken). Or the other way round due to costs of PCR, but usually elimination diet takes so long to see the results. Back in Europe, common advice I would hear in cases like this would be to feed a cat only raw muscle beef for few days (this would not be nutritionally balanced but few days would not be harmful I hear) - that could give you some indication if the food is the culprit. But I am only repeating advice I did not test (although I fed my cats grocery store raw beef as an addition, it really makes cat poo more solid), plus I don't know if grocery store raw beef is safe for cats in US, you'd need to shop around to find a safe option.

If that started after his chlamydophila treatment, did you try probiotics?

Frankly, I don't really believe the chronic diarrhea like this has no effects on cat's health. Isn't he dehydrated? The blood work came back ok?

 

[Richard2121]

Has he always had diarrhea or did it start at some point? If always, I would do PCR and if it comes back clear, I would start elimination diet starting with elimination of the protein he most commonly eats (my guess would be chicken). Or the other way round due to costs of PCR, but usually elimination diet takes so long to see the results. Back in Europe, common advice I would hear in cases like this would be to feed a cat only raw muscle beef for few days (this would not be nutritionally balanced but few days would not be harmful I hear) - that could give you some indication if the food is the culprit. But I am only repeating advice I did not test (although I fed my cats grocery store raw beef as an addition, it really makes cat poo more solid), plus I don't know if grocery store raw beef is safe for cats in US, you'd need to shop around to find a safe option.

If that started after his chlamydophila treatment, did you try probiotics?

Frankly, I don't really believe the chronic diarrhea like this has no effects on cat's health. Isn't he dehydrated? The blood work came back ok?

He has had diarrhea pretty much since the day we got him almost 5 months ago. He is now nearly 8 months old and January was the first month he was not in the vet at least once or twice since we got him. He has been on Clavimox twice, doxycycline for 4 weeks, and there has been a new addition to the family in the form of a 12 week old kitten about 1.5 months ago. So stress, antibiotics, constant food changes, and URIs.

So the fact that he has no other symptoms and his blood work came back okay is reassuring to a certain degree. But I have been fighting this diarrhea battle for far too long now!

 

[Noirele]

Ok, this feels familiar. My cat was on amoxi/clav, then azithromycin and in the end doxy for a total of 12 weeks. Then diarrhea started, almost 4 months of it. We tried an antibiotic like tylosin with no benefit, then fortiflora, carobin, nucron and many others probiotics avalaible here. We also tried many different canned foods, gastrointestinal diet and new proteins.
In the end, changing food to an anallergenic diet worked. I am not sure why, the vet told me that gut bacteria imbalance, caused by prolonged antibiotic treatment, could led to food sensibility. Anyway, 10 days of anallergenic kibbles and he is fine. I don't know what will happen changing diet again, though.

 

[She's a witch]

I imagine how you feel. I've been there with my cats, the fecal flotation tests came back ok, but since their diarrhea was very Giardia like, I insisted on elisa test and it confirmed the giardia - after 2 months of living my life around my cats' poo, I literally screamed from joy that I finally learned what it was :-) The problem with some parasites' cysts is that they often show themselves in solid stools rather than in liquid, which makes manual testing of diarrhea challenging.
I know diarrhea never smells good, but as a general rule, the one caused by pathogens (either parasites or bacterias) smells worse - that may also be a factor to decide if it's time for PCR testing.
But if this is parasite causing it, it is indeed weird that only one cat shows symptoms since you have other kittens, and kittens are easily prone to them. It is possible though if they are much much stronger that Richard.

Giardia messed with the intestines of one of my cats so badly that the soft poo/diarrhea continued for months. I eventually decided to feed him Royal Canine Gastro Intestinal although I truly hate this company. It helped from the the first day, I fed only that for a month and then another month slowly transitioning back to their usual diet. It was a year ago, and since then their poos are beautiful every day.

 

[1 bruce 1]

As they say, antibiotics kill everything bad bacteria and good. It sounds like he's been on a lot of antibiotics in a very short life and part of me wonders if a good quality pro-biotic powder and a bland type of diet for a while would let his gut rest, re-feed the necessary good bacteria in the GI tract, and help it hopefully begin to resolve itself.

 

[lutece]

My next step to take would be a Fecal PCR panel which gets sent out to a lab and is far more sensitive to certain organisms. it costs $250 and between that and all the other food changes recently I am up to my arms in cat related expenses this month.

Is that what it costs to do it through your vet?

UC Davis charges $127 for their Feline GI/Diarrhea Panel (Clostridium difficile toxins A and B, Cryptosporidium spp, Salmonella spp, Giardia spp, feline coronavirus, feline parvovirus (Panleukopenia), canine parvovirus 2, Tritrichomonas foetus). I have worked with them in the past and received excellent service.
Real-time PCR Research and Diagnostics Core Facility

I don't know what Zoologix charges but you can call them and ask.
Feline diarrhea PCR panel

 

[posiepurrs]

https://projects.ncsu.edu/ncsu/cvm/docs/documents/ownersguide_tfoetus_revised_122009_final.pdf
Here is a link to something that may help if you have questions about TF. I wrote an article for Cat Talk magazine ( The CFA magazine) about TF and used this as well as other articles and talks with Dr Gookins breeder associate as a basis. I honestly believe that TF is much more wide spread than research shows. I spoke to my vet about the testing. If I insisted on using DR Gookins lab he would charge me over $260, while if I used the lab he regularly uses it was less expensive. Since she is the leading researcher on TF if I were to test I would want the sample sent there, just my personal opinion. One thing I did run into when speaking with my vet for my article is ignorance about this problem. The clinic believes a regular stool sample is sufficient to diagnose TF. It is NOT. Better results are achieved from a colon flush or using a laxative like lactulose if a cat has firmer stools. A cat can be asymptomatic and be infected. Just be warned, some vets actually discourage treatment and even suggest putting the cat DOWN! Most of the vets I talked to are afraid to use the ronidazole because they were only familiar with the outdated guidelines for dosage which sometimes create neurological problems. My own vet insists on a release form from the owner. Much more research and education is needed.

 

[She's a witch]

Most of the vets I talked to are afraid to use the ronidazole because they were only familiar with the outdated guidelines for dosage which sometimes create neurological problems. My own vet insists on a release form from the owner. Much more research and education is needed.

Sorry for OT, but my friend has successfully treated tritrichimonas in her cat with Carnidazole. It is much safer than ronidazole but also effective.

 

[Richard2121]

Took in a VERY liquidy stool sample for a Fecal PCR test to be submitted. It was rather fresh, I grabbed the sample right after Richard used the litter box, put it in a container and then in the fridge for a few hours until I could take it to the vet. I am hoping we get a positive result for something that we can treat! I am SO sick of trying things. I am not sure how well versed the vet is with modern approaches to treating TF. If that’s what it turns out to be I will bring up both medications mentioned. He was familiar with the infection and said there is a possibility that this is what Richard has.

 

[Furballsmom]

.

 

[posiepurrs]

Sorry for OT, but my friend has successfully treated tritrichimonas in her cat with Carnidazole. It is much safer than ronidazole but also effective.

I contacted the breeder who works closely with Dr Gookin to inquire if I had missed the research on Carnidazole. He said a few years ago it was touted as a cure all for TF - but testing proved it not to be effective. He said many drugs will put TF into hiding but not eradicate it. Even ronidazole is only 68% effective at
eliminating it. It has the highest success rate so far of the 'zoles (Carnidazole, Rondiazole, secnidazole). Dr Gookin is pursuing other types of drugs.

Took in a VERY liquidy stool sample for a Fecal PCR test to be submitted.

I am happy that you are getting to the bottom of this problem. I hope it is not TF but something much easier to deal with.

 

[Misprints]

I’m running into the same problem with my little furball, too. Healthy weight, healthy appetite, playful — but terrible stool! Home cooked diet + probiotics seems to be promising so far, but it’s too early to tell. Diet change is definitely worth looking into, though. I hope that you can get to the bottom of this soon!

 

[Richard2121]

I’m running into the same problem with my little furball, too. Healthy weight, healthy appetite, playful — but terrible stool! Home cooked diet + probiotics seems to be promising so far, but it’s too early to tell. Diet change is definitely worth looking into, though. I hope that you can get to the bottom of this soon!

As much as I LOVE the idea of diet change, I am owned by 4 young cats. The oldest is 11 months old and the youngest is 14 weeks. I have to feed them the same food every day because otherwise they get jealous and stop eating altogether. So whatever I feed Richard I have to feed the whole clan. I have tried more expensive foods, commercial raw, limited ingredient diets, the whole works. They don't like half of it and the other half makes one of them constipated. I am at the point with their feeding and nutrition that I am waving the white flag. If they eat it and its not dry food then I am happy for now. Eventually I will be able to afford Tiki Cat or Weruva and I can mix that into the rotation as well! On a side note, I also tried feeding Richard on the counter and the others down on the floor so they could not smell his food as well. This worked for awhile but his poop was still very loose even on higher quality wet foods. I am on day 4 of probiotics as well. I figure while I wait for test results I might as well keep trying to fight the fire myself!

 

[Furballsmom]

hang in there!

 

[1 bruce 1]

As much as I LOVE the idea of diet change, I am owned by 4 young cats. The oldest is 11 months old and the youngest is 14 weeks. I have to feed them the same food every day because otherwise they get jealous and stop eating altogether. So whatever I feed Richard I have to feed the whole clan. I have tried more expensive foods, commercial raw, limited ingredient diets, the whole works. They don't like half of it and the other half makes one of them constipated. I am at the point with their feeding and nutrition that I am waving the white flag. If they eat it and its not dry food then I am happy for now. Eventually I will be able to afford Tiki Cat or Weruva and I can mix that into the rotation as well! On a side note, I also tried feeding Richard on the counter and the others down on the floor so they could not smell his food as well. This worked for awhile but his poop was still very loose even on higher quality wet foods. I am on day 4 of probiotics as well. I figure while I wait for test results I might as well keep trying to fight the fire myself!

You're going in heavily armed with a vets help, your own knowledge of him and good old trial and error, which is all you can do right now
Having 1 or 2 cats, feeding isn't usually hard, but when the numbers climb it's like a circus. With 9 inside it's a pain in the butt sometimes because cat A prefers poultry, cat B only likes rabbit and elk, cat C is stuck to the room of the cat that's eating canned food only, cat D can have any protein you please but has to have a lower fat content, cat E can't eat duck organs, and one day you wake up and say "it's just hereditary baldness. Nothing to do with the cats."
As bad is at sounds I hope his test comes back showing something that can be treated and gotten rid of easily and quickly.

 

[Richard2121]

Richards test came back today POSITIVE for Tritrichomonas foetus and so the vet is prescribing Ronidazole but it has to be compounded by an outside pharmacy. The main issue is cost. With 4 cats at home the cost will be very high to treat because others have loose stool occasionally too. The other issue is my vet had not seen these other cats so won’t prescribe any treatment for anyone else until they are “established” and so the medication costs about $90 per cat (almost $400 total) and add another $100 to get the other cats established. I’m not sure what to do because Richard still has to be neutered this weekend which is an additional huge cost. And we have spent about $1000 total on all his issues thus far so I’m ecstatic that we have a diagnosis but I’m unsure if I can afford to treat it right away. What do I do?