Advice needed, has anyone else had this issue...

[isobel]

It has been years since I've posted. Our 3 torties have been very healthy up until 3 months ago. Tia, now 8 1/2 years and strictly indoors, began having (sorry for being so descriptive here) soft stool covered with gel like mucus, sometimes bloody strands about 3 months ago. She also started using the floor for this business, and she will not use the litter box for it any longer. She still urinates in the litter box, but the other is done outside the box.

She's been to vet, and treated with the go-to standard metronidazole and prednisolone. They also changed diet to royal canin for digestive issues.

After a few weeks of meds, the blood seemed to disappear but the diarrhea worsened. I wanted to get her off the pred, having read about long term use and it's contribution to diarrhea. I was avised by someone else that I should get her off the royal canin (which also causes soft stool) and the prednisolone (another contributer), and was told to try probiotic non grain food.

I have had her on Intuition food for the past few weeks, but the diarrhea continues to worsen. We are under snow shutdown here, but I plan to bring her in for bloodwork and I was hoping also an ultra sound to see if this detects anything. Honestly, I am not satisfied with any veterinary care I have found. I don't mean to sound difficult, but it seems everyone's focus is their bottom line and prolonged dragging out of tests and experimental (let's try this) treatment.

Is there something more I should ask for and what specifically should I be looking for with these tests. The back of my mind is telling me she has cancer. She has an appetite and is alert and active, it is just the chronic diarrhea has become worse (sorry again, but it pours out). I notice she looks a bit thinner, although a large cat that needed to decrease in size a bit, this illness is not the answer for that. I am worried about her, and frankly I don't have confidence in vets any longer. Please any advice would be a help here.

Is there something I should be looking for. I brought a stool sample my last trip and they tossed it out. I was told she doesn't have parasites since she is inside so it is not worth testing for that.

I will add, when we adopted our three girls from the no kill shelter in 2016, they were infested with giardia and cryptosporidium and tapeworms. It took 3 months to clean them up, but they have been super healthy since then. Now this new and sudden issue.

Can something like Giardia go dormant for years and then come back? The other 2 girls are healthy, no issues at all. I have to add...not always, but she is sore down there. I heard her meow a couple of times when she does her business. This is now added to the diarrhea.

Many thanks for any advice here.

 

[FriendofFerals]

Giardia can "go dormant"....as in all the live protozoa are gone but dormant eggs are there just waiting for the chance to hatch when the host has a stressful event. I had a horrible case myself thanks to a job requiring a lot of travel to third world locales. I had it so bad I needed 3 rounds of Flagyl (metronidazole) and my gut was totally wiped out, especially since that was after two failed round of Bactrim since they had no clue what was wrong with me.

I rebuilt my gut with probiotics and was OK until a stressful life event a year later and then I had to go through the whole thing all over again. That finally killed the rest of whatever was in there, but even with probiotics and fermented food to assist in the gut biome, I'm now susceptible to IBS episodes---usually after a stressful event. This was not the case before.

So when my senior cat who was formerly feral, infested wth whipworms and who knows what else....I wasn't surprised when he was diagnosed with IBD. He managed to pick up an indoor parasite this year after eating some bug or lizard and had to have Drontal two months in a row to get that under control.

What I learned fro my own experience and my cat is that eggs can be dormant and triggered by stress, magically re-appearing a year or more later. Reall bad infestations can cause IBS/IBD down the road--not caused directly by that, but because their gut lining was compromised in that way, paving the trail for things like food sensitivities, protein sensitivities, etc.

Currently, my IBD cat has to be de-wormed/parasite treated every three months, despite being 100% indoors and my other cats have no problem. He is now sensitive to all proteins except lamb. Hydrolized dry is OK. He's on prednisolone for general inflammation and metronidazole for IBD flares but despite all that he still picked up a parasite and needed Drontal twice this year.

It seems ridiculously improbable but I'm living the reality of it.

 

[isobel]

Thank you so much for this response. I appreciate knowing this about the dormant Giardia. I asked because this issue brought back those horrible memories, it is not normal, uncontrollable and the stench is beyond nauseating. All three girls had it BAD when we adopted them so many years ago. We did relocate 9 months ago, but she was fine until 3 months ago. Delayed stress??? Who can tell with cats. They all seem so fine and handled the move very well. We are a non stress household, no TV, quiet, no kids or visitors. Elderly lifestyle. I will discuss with vet when I call her again tomorrow about the recurring giardia and additional metronidazole. I cannot remember what the vet put them on years ago, but it was a long dose of something else, and once off it, they all cleared up. I will reach out to old vet from 9 years ago for those records.

 

[F+V]

Have you asked for a PCR diarrhea panel? That will show you if she's positive to Giardia or other pathogens.

Metronidazole as with any antibiotics will disrupt gut flora, and one study showed that a month after the cessation of Metronidazole the dysbiosis did not resolve.

https://academic.oup.com/jas/article-abstract/doi/10.1093/jas/skae274/7758358

When my cat started having diarrhea, our vet wanted to treat it with only a very short course of Clavamox (3 days) and Sivomixx probiotics with psyllium husk and gave us hill's and royal canin's digestive care food samples. I also gave him Saccharomyces boulardii. She said if that didn't help, an endoscopy under anesthesia would be the next step

 

[silent meowlook]

Hi. I second the fecal PCR. But, I want to also say that you need a new vet. The comment that she doesn’t need a fecal done because she is indoor is just more proof that there are many veterinarians out there treating cats that have no business doing so. I know I am blunt, but it is so aggravating.

There are things detected in a fecal PCR that aren’t picked up in a normal run of the mill in house fecal.( which, by the way are useless, as most don’t do them the right way) I digress. A fecal PCR can detect different Protozoa and viruses. It is an important test to do.

Ultrasound is important, but only if done by a good board certified internal medicine veterinarian. Regular veterinarians usually only use their ultrasound for obtaining a cysto to get urine, and have no additional training. It just is a waste of time and money without a specialist.

I would be giving the Prednisolone if this was my cat. Regardless of the cause, Prednisolone is well tolerated in cats at a low dose and long term. It doesn’t matter the cause, there is inflammation in the GI tract. The Prednisolone stops or somewhat stops that inflammation. Without it, this, if IBD, could untreated lead to intestinal lymphoma. Which isn’t the end of the world, and cats respond well to treatment.

You will get lots of opinions from people without veterinary degrees, like me, but the bottom line is these people are basing their advice off of a personal experience of maybe 1-5 cats. The majority of cats do very well on low dose Prednisolone for extended times, or even their lifetime. If your vet prescribed it, I would be giving it.

Same with the food. People want to bash the bigger veterinary diets and suggest smaller more privately owned companies. Which company, big or small, had the funds to do extensive veterinary research for each diet. I learned this the hard way when I switched my cat off of hills for a private sourced only in the US diet. He blocked in a couple of days due to alkaline urine caused by an unbalanced diet. That was in 2096 or something after the whole wheat gluten incident that cost many cats their lives.

Regardless of diet, make sure it is canned if they will eat it. A few common allergic response ingredients are chicken, beef, fish. You can try a novel protein source like rabbit or venison, but you must read the labels as many “ rabbit” diets sold commercially also have chicken. Makes no sense. Further proof they don’t know what they are doing.

Dehydration is a real issue with cats with diarrhea. You may want to at next vet visit ask about doing subcutaneous fluids at home if need be.

 

[isobel]

Have you asked for a PCR diarrhea panel? That will show you if she's positive to Giardia or other pathogens.

Metronidazole as with any antibiotics will disrupt gut flora, and one study showed that a month after the cessation of Metronidazole the dysbiosis did not resolve.

https://academic.oup.com/jas/article-abstract/doi/10.1093/jas/skae274/7758358

When my cat started having diarrhea, our vet wanted to treat it with only a very short course of Clavamox (3 days) and Sivomixx probiotics with psyllium husk and gave us hill's and royal canin's digestive care food samples. I also gave him Saccharomyces boulardii. She said if that didn't help, an endoscopy under anesthesia would be the next step

I have not. I called this morning and she is not in today, but back tomorrow. I will ask for this fecal PCR. I think I am in good company here though with the aggravation of trying to find a VET that I have confidence in. The fact that they threw out the fecal I brought (literally fresh as I was walking out the door with my Tia) and said we don't need to do this, is totally frustrating. Sadly, medical care for us humans has degraded to close to this level as well. They've taken the "care" out of it.
Regarding the metronidazole...I looked through my old files and found the 3 girls were treated with it for 14 days, 2 x per day, and after this their stool was "normal"....up until now with Tia.
Also, is the fecal PCR test 100% accurate? I was told years ago that these tests often don't detect anything.
Thank you for your input. We are considering all advice and will certainly ask for the PCR.

 

[isobel]

Hi. I second the fecal PCR. But, I want to also say that you need a new vet. The comment that she doesn’t need a fecal done because she is indoor is just more proof that there are many veterinarians out there treating cats that have no business doing so. I know I am blunt, but it is so aggravating.

There are things detected in a fecal PCR that aren’t picked up in a normal run of the mill in house fecal.( which, by the way are useless, as most don’t do them the right way) I digress. A fecal PCR can detect different Protozoa and viruses. It is an important test to do.

Ultrasound is important, but only if done by a good board certified internal medicine veterinarian. Regular veterinarians usually only use their ultrasound for obtaining a cysto to get urine, and have no additional training. It just is a waste of time and money without a specialist.

I would be giving the Prednisolone if this was my cat. Regardless of the cause, Prednisolone is well tolerated in cats at a low dose and long term. It doesn’t matter the cause, there is inflammation in the GI tract. The Prednisolone stops or somewhat stops that inflammation. Without it, this, if IBD, could untreated lead to intestinal lymphoma. Which isn’t the end of the world, and cats respond well to treatment.

You will get lots of opinions from people without veterinary degrees, like me, but the bottom line is these people are basing their advice off of a personal experience of maybe 1-5 cats. The majority of cats do very well on low dose Prednisolone for extended times, or even their lifetime. If your vet prescribed it, I would be giving it.

Same with the food. People want to bash the bigger veterinary diets and suggest smaller more privately owned companies. Which company, big or small, had the funds to do extensive veterinary research for each diet. I learned this the hard way when I switched my cat off of hills for a private sourced only in the US diet. He blocked in a couple of days due to alkaline urine caused by an unbalanced diet. That was in 2096 or something after the whole wheat gluten incident that cost many cats their lives.

Regardless of diet, make sure it is canned if they will eat it. A few common allergic response ingredients are chicken, beef, fish. You can try a novel protein source like rabbit or venison, but you must read the labels as many “ rabbit” diets sold commercially also have chicken. Makes no sense. Further proof they don’t know what they are doing.

Dehydration is a real issue with cats with diarrhea. You may want to at next vet visit ask about doing subcutaneous fluids at home if need be.

Thank you for this...I was confusing the PCR test with regular fecal test which often does not detect anything and just a waste of time, money, and fresh poop. I will have the PCR done. I appreciate knowing about the ultrasound as well. This is part of the frustration in finding a vet you can trust. Many not necessarily qualified for a particular task. I read the prednosilone can cause other problems with long term use (diabetes & liver function). Also it seemed to add to the diarrhea problem so I discontinued it. It seemed to make her a bit lethargic too. Regarding the food, she does like canned, so I am going to keep her on this. I ordered the S Boulardii (spelling??) +MOS from Jarrow that I used to give them. Will get back on track with it. I appreciate your advice and will reconsider the Pred.

 

[isobel]

UPDATE: I received results from PCR test this morning and all was negative. Also, when I visited the vet to drop the fecal for the PCR, they convinced me to try another food, Science Diet, GI Biome, which I was opposed to after reviewing the ingredient list. Despite my opposition, I opted to try it out. Tia has been on this SD GI Biome dry kibble along with 1 small can of the GI Biome wet food (again, the same science diet brand) for 24 hours. To my surprise, this morning was the first normal stool, yes the 1st in 3 LONG months! There were no signs at all of diarrhea. As skeptical as I was trying it, I am now hoping this food helps to heal her intestine/gut and get her health back on track. I thought I should update on this because it seems others are having the same issue. This is a higher fiber food. I am still awaiting the S Bourlardii in the mail, but with all the snow in our region the shipment is delayed. When it gets here I will incorporate that into her diet as well. Thank you to everyone for posting advice. It is a big help, and the PCR brings peace of mind knowing that nasty Giardia (or any other culprets) have been dormant.

 

[fionasmom]

Thank you for letting us know that there has been improvement and I hope that this continues.

 

[isobel]

Thanks fionasmom...we looked good yesterday. Bit of a relapse today :-( but will continue and give this perhaps a chance to heal.