Another case of constant diarrhea... Suggestions?

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BellaBlue82

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Hi all,
Nico has had almost constant diarrhea since his bad UTI late October. He was on cephalosporin and then Baytril for 10 days, which cured his UTI but sadly ruined his GI tract. I've been trying everything.... S. Boulardii, Proviable, Hills Biome food, sub-q fluids, B12. He's also on Cerenia, Mirtaz, and antacid since the GI upset makes his tummy upset too.

Is there anything else I can be doing, or does this just need to run it's course? It's been a few weeks, I just don't know if there is any end in sight. 😞
 

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I imagine those antibiotics really did a number on him and this is a result of that. It's kind of surprising that the things you have tried have not worked yet, but it could be that he needs to be on a very bland diet for a week or two to really give his digestive system a break. All that being said, have you had a fecal exam done on him since the UTI to make sure he doesn't have any parasite causing the issue?

Here is a similar thread. Pay particular attention to post #26 in the thread which has some great info in it: Question about good alternatives
 
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BellaBlue82

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I imagine those antibiotics really did a number on him and this is a result of that. It's kind of surprising that the things you have tried have not worked yet, but it could be that he needs to be on a very bland diet for a week or two to really give his digestive system a break. All that being said, have you had a fecal exam done on him since the UTI to make sure he doesn't have any parasite causing the issue?

Here is a similar thread. Pay particular attention to post #26 in the thread which has some great info in it: Question about good alternatives
Thank you so much!! Yeah the vet mentioned he is most likely having a bout of antibiotic induced colitis. The poor guy. 😞 He did have a fecal test done on Monday, no bacteria or parasites. But she did mention he has nothing - no good or bad bacteria, no natural flora present. So he's basically rebuilding from scratch. I may try the bland diet to see if that helps him at all.

Every once in a while he has a somewhat formed poo, but then goes right back to liquid and mucus. No blood tho, thankfully. I also have some bupenorphine that I give him on his particularly bad days, it seems to help. But I don't want to give him too much since I know that can be contraindicative.

I think I'm going to change his current supplement over to the one mentioned in that post since it contains both s. Boulardii and other probiotics. That plus the bland diet I'm hoping will help. I may also try the digestive enzymes, to help him hold onto the nutrition from his food.
 
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I was also curious about slippery elm bark, I was reading about its properties and thought that may help coat his tummy so he doesn't feel as sick. I'm curious if there is a specific brand that is better than others? And is there a power I can mix with one of his duck lickable treats, or capsules perhaps I can open up?
 

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I would get some cans of RX gastro food from the vet. (We feed Royal Canin Gastrointestinal) Continue adding S. boulardii twice a day. Be consistent. Back off on any treats.
 
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I would get some cans of RX gastro food from the vet. (We feed Royal Canin Gastrointestinal) Continue adding S. boulardii twice a day. Be consistent. Back off on any treats.
I have Hills Rx Gastro Biome, I'm just having a hard time getting him to eat it. I think I might puree it with some water, he seems to go after the soupier food. 😉
Thanks, I am not giving up on this yet!! I dont think I was giving him enough S. Boulardii at first, after what I had read today. This is only the second day of full dosing. Keeping my fingers crossed, he still had watery poo, however it was more of a normal brown color tonight and he only went twice today! I'll take that as a win, he was going almost 4-5 times a day.
 

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S. boulardii smells very yeasty, too. He may be overwhelmed by the smell (I am!). I give about 1/8-1/4 capsule each feeding. It's not scientific. You might see if you can get a couple of cans of the RC Gastro from the vet. All my kitties love it.
 
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BellaBlue82

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S. boulardii smells very yeasty, too. He may be overwhelmed by the smell (I am!). I give about 1/8-1/4 capsule each feeding. It's not scientific. You might see if you can get a couple of cans of the RC Gastro from the vet. All my kitties love it.
Lol yeah it doesn't smell too great. 🤐
Thanks, I'll ask her on Monday. He's usually not too particular, but with not feeling the best his palate is extra delicate. Hopefully he will like the RC gastro!
 

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I have not tried this but I have read on the forums that some people have used KittyBiome™ Gut Restore Supplement for really bad cases like this. You basically get fecal material in a pill to help seed your cats gut.
 
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I have not tried this but I have read on the forums that some people have used KittyBiome™ Gut Restore Supplement for really bad cases like this. You basically get fecal material in a pill to help seed your cats gut.
I was reading about that as well. I'm not sure if I would be able to handle that financially, but if he doesn't improve soon I may have to look into it. On a positive note, he is hanging out with us tonight. He hasn't done that in weeks.
 

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mrsgreenjeens

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I was also curious about slippery elm bark, I was reading about its properties and thought that may help coat his tummy so he doesn't feel as sick. I'm curious if there is a specific brand that is better than others? And is there a power I can mix with one of his duck lickable treats, or capsules perhaps I can open up?
SEB does come in powder form and also capsules. Just make sure it isn't fill of additives as so many supplements are. You want to look for pure SEB. You should be able to find it at a health food store if you decide to use it. Just don't give it within a couple hours of any prescription drugs as it can interfere with them.

That's great that he's started socializing again!
 
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BellaBlue82

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SEB does come in powder form and also capsules. Just make sure it isn't fill of additives as so many supplements are. You want to look for pure SEB. You should be able to find it at a health food store if you decide to use it. Just don't give it within a couple hours of any prescription drugs as it can interfere with them.

That's great that he's started socializing again!
Thank you! I have a health food store down the street from me, I'll take a look and see if I can find it there.

Keep your fingers crossed, no diarrhea yet today. 🤞
 

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I was reading about that as well. I'm not sure if I would be able to handle that financially, but if he doesn't improve soon I may have to look into it. On a positive note, he is hanging out with us tonight. He hasn't done that in weeks.
You should email [email protected] and confirm with them. But my feeling is that they will tell you to hold off on the Gut Restore Supplement while he is having active diarrhea. They will also likely recommend their Gut Maintenance Protocol instead. It is s. boulardii with a prebiotic (FOS) that encourages the (re)growth of good bacteria lost to antibiotics. What makes their s. boulardii product special is that it also includes a bacteriophage (eats bacteria) ingredient that specifically targets E. coli populations. E. coli is found in healthy cats and usually doesn't present a problem. But in those who have undergone a course of antibiotics, the E. coli populations can flourish because many of those antibiotics do nothing against E. coli. To make matters worse, E. coli feeds off dead intestinal lining cells which are shed during inflammation. Inflammation feeds more inflammation. S. boulardii will help starve out the E. coli. But that extra ingredient is why I recommend AnimalBiome's product over any other s. boulardii product.

KittyBiome™ GMP – AnimalBiome

The other reason I like AnimalBiome's product is that they are already in cat-friendly capsules. My Betty will pill herself as long as I twist her capsules in a little bit of Hills A/D and drop it on a textured surface so she can't simply lick the food off it. Hills A/D is a high calories recovery food meant to be highly appealing for sick cats and those recovering from something that's put them off their regular food. Betty only ever gets the tiny amount to coat her capsules--unless she ever goes off her regular food and needs it for its original purpose. As a medicine coat, two cans of A/D lasts us the week. It could probably last longer. But I don't like handling it, and I find it difficult to twist her pills in, after the third or fourth day.


I would also recommend that you discontinue the antacids. You may find that that alone is the missing piece. Digestion and the first line of immune defense relies on stomach acid. You could also be creating an environment where some unhelpful strains are surviving and thriving, while those needed for a healthy biome aren't getting the correct conditions to flourish. In other words, the antacid could be disruptive to the biome like antibiotics. Perhaps not to the same magnitude. But I've seen it in my own personal experience. I was stress-eating Tums (chewable calcium antacid tablets) for a time. My mornings revolved around messy poops--multi-round affairs. When I stopped abusing the antacids, the poops firmed up. So try this one first. Look into SEB or an anti-nausea drug like ondansetron if you think he needs some nausea relief. But the antacid probably isn't doing what you think it's doing anyway.

Antacids – IBDKitties
 
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You should email [email protected] and confirm with them. But my feeling is that they will tell you to hold off on the Gut Restore Supplement while he is having active diarrhea. They will also likely recommend their Gut Maintenance Protocol instead. It is s. boulardii with a prebiotic (FOS) that encourages the (re)growth of good bacteria lost to antibiotics. What makes their s. boulardii product special is that it also includes a bacteriophage (eats bacteria) ingredient that specifically targets E. coli populations. E. coli is found in healthy cats and usually doesn't present a problem. But in those who have undergone a course of antibiotics, the E. coli populations can flourish because many of those antibiotics do nothing against E. coli. To make matters worse, E. coli feeds off dead intestinal lining cells which are shed during inflammation. Inflammation feeds more inflammation. S. boulardii will help starve out the E. coli. But that extra ingredient is why I recommend AnimalBiome's product over any other s. boulardii product.

KittyBiome™ GMP – AnimalBiome

The other reason I like AnimalBiome's product is that they are already in cat-friendly capsules. My Betty will pill herself as long as I twist her capsules in a little bit of Hills A/D and drop it on a textured surface so she can't simply lick the food off it. Hills A/D is a high calories recovery food meant to be highly appealing for sick cats and those recovering from something that's put them off their regular food. Betty only ever gets the tiny amount to coat her capsules--unless she ever goes off her regular food and needs it for its original purpose. As a medicine coat, two cans of A/D lasts us the week. It could probably last longer. But I don't like handling it, and I find it difficult to twist her pills in, after the third or fourth day.


I would also recommend that you discontinue the antacids. You may find that that alone is the missing piece. Digestion and the first line of immune defense relies on stomach acid. You could also be creating an environment where some unhelpful strains are surviving and thriving, while those needed for a healthy biome aren't getting the correct conditions to flourish. In other words, the antacid could be disruptive to the biome like antibiotics. Perhaps not to the same magnitude. But I've seen it in my own personal experience. I was stress-eating Tums (chewable calcium antacid tablets) for a time. My mornings revolved around messy poops--multi-round affairs. When I stopped abusing the antacids, the poops firmed up. So try this one first. Look into SEB or an anti-nausea drug like ondansetron if you think he needs some nausea relief. But the antacid probably isn't doing what you think it's doing anyway.

Antacids – IBDKitties
Wow, I had no idea antacids could be doing the opposite of my goal. He's only been on it for 5 days - mainly because Cerenia contributes to the lethargy and inappetence, so I wanted to try and stop giving him that for a bit. Sadly, I tried to get ondesetron for him, but all the local vets aren't willing to prescribe it. 😤 I didn't give him famotadine this AM, so hopefully it's a good sign and I can stop both all together.

He is actually doing a little better today!! No D word yesterday (first time in WEEKS) and I found a BM in the cat pan this morning... It looked the most formed I've seen yet!! I'm going to wait and see if we continue to improve on his current supplements, but if I see any back sliding I will get my hands on some of the Gut Restore. It sounds bad, but I've already spent over $1500 this month in multiple vet trips, medicine, supplements, so I want to see if he keeps this progress before I divulge into anything else. I also feel like the consistency of keeping up with his food intake and supplement intake has been the biggest help. Now if only his appetite would get better... Lol baby steps.
 
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Ok, so today I checked the cat box... Normal looking poos!!! However he did get sick today, ugh. And still only eating in small amounts at a time. I'm holding off on the antacid and Cerenia, I only gave him Mirtazipine. I'm patiently waiting for my order of SEB to see if that will help the nausea.
 
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Ugh, well that didn't last long. Vomit three times this afternoon, along with yellowish watery diarrhea with mucus. I've emailed Animal Biome and will also be calling my vet tomorrow. This will have been almost four weeks of what seems like palliative care, and can't continue. I'm thinking he may need medicine for the diarrhea, beside the supplements. 😔
 

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Ugh, well that didn't last long. Vomit three times this afternoon, along with yellowish watery diarrhea with mucus. I've emailed Animal Biome and will also be calling my vet tomorrow. This will have been almost four weeks of what seems like palliative care, and can't continue. I'm thinking he may need medicine for the diarrhea, beside the supplements. 😔
Medicine for the diarrhea is often an antibiotic (metronidazole.) That just isn't going to work as it's going to blow away the good bacteria and create conditions for bad bacteria like E. coli to flourish. S. boulardii (and abstaining from the antacids) is perhaps the best medicine. But it takes time to rebuild a biome even with the fecal transplant supplement.

My recommendations as a stranger on the Internet (worth what you paid for them 😹) :

1. Contact Animal Biome and ask them whether they recommend the Gut Restore with his diarrhea or if they think he should start GMP (or Gut Cleanse, another of their products) first.

2. Have you discussed the possibility that this may be IBD or lymphoma with your vet? Especially because he is also vomiting, I would recommend an ultrasound. This is probably not just a rough patch after his UTI and Baytril course.

3. If you cannot afford an ultrasound at this time, I would recommend a limited ingredient, preferably single protein, food trial. My two best recommendations for food trials would be Rawz and Mouser. Mouser isn't single protein. But every cat SHOULD be able to handle mouse. In order to have the best chance at success, you should pick a protein and eliminate all other foods and treats that aren't in that protein. Rabbit is a common starting point. You may try turkey first. If you can stabilize him on turkey, that's going to weather food shortages a lot better than rabbit.

You can buy both Rawz and Mouser by the single can from Incredible Pets. This way you can run it past your guy without having to go in on a case first.

Search: 52 results found for "rawz"

(Rawz sounds like raw. But it is not a raw food. It's simply a high quality canned food. "The next best thing to raw.")

4. You may also consider him on homemade food. You will want to use a recipe or a supplement completer. Simply giving him chicken or chicken and rice is not going to do it. But you can give him plain chicken, boiled or poached, for a few days simply to see if it improves his vomiting and stools. If it does, it's probably another ingredient in his food that's giving him issues. If it doesn't, you'll probably want to try something other than chicken.

Here's a site that has recipes for raw and cooked:
Making Cat Food

And here's a powder completer to add to meat and liver:
Know What You Feed Your Cat - Shop Online

If you're going to use a protein other than chicken, I recommend the Alnutrin Egg-free with Eggshell Calcium. Most powder supplement completers include egg yolk. This is the only one I know of that found a replacement for the nutrients provided by egg yolk in a non-egg ingredient (the eggshell is just the calcium from eggshells and is not the same as the protein in egg yolks from a food trials point of view.)

You can use freeze-dried liver in place of fresh liver in these recipes at 1/3 the called for amount. If the recipe asks for 45 grams of fresh liver, you can use 15 grams of freeze dried liver. You can find freeze dried liver in novel proteins often in the dog treats or dog training section. As long as freeze-dried liver is the only ingredient, it doesn't matter whether the label says for dogs or for cats.
 
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Medicine for the diarrhea is often an antibiotic (metronidazole.) That just isn't going to work as it's going to blow away the good bacteria and create conditions for bad bacteria like E. coli to flourish. S. boulardii (and abstaining from the antacids) is perhaps the best medicine. But it takes time to rebuild a biome even with the fecal transplant supplement.

My recommendations as a stranger on the Internet (worth what you paid for them 😹) :

1. Contact Animal Biome and ask them whether they recommend the Gut Restore with his diarrhea or if they think he should start GMP (or Gut Cleanse, another of their products) first.

2. Have you discussed the possibility that this may be IBD or lymphoma with your vet? Especially because he is also vomiting, I would recommend an ultrasound. This is probably not just a rough patch after his UTI and Baytril course.

3. If you cannot afford an ultrasound at this time, I would recommend a limited ingredient, preferably single protein, food trial. My two best recommendations for food trials would be Rawz and Mouser. Mouser isn't single protein. But every cat SHOULD be able to handle mouse. In order to have the best chance at success, you should pick a protein and eliminate all other foods and treats that aren't in that protein. Rabbit is a common starting point. You may try turkey first. If you can stabilize him on turkey, that's going to weather food shortages a lot better than rabbit.

You can buy both Rawz and Mouser by the single can from Incredible Pets. This way you can run it past your guy without having to go in on a case first.

Search: 52 results found for "rawz"

(Rawz sounds like raw. But it is not a raw food. It's simply a high quality canned food. "The next best thing to raw.")

4. You may also consider him on homemade food. You will want to use a recipe or a supplement completer. Simply giving him chicken or chicken and rice is not going to do it. But you can give him plain chicken, boiled or poached, for a few days simply to see if it improves his vomiting and stools. If it does, it's probably another ingredient in his food that's giving him issues. If it doesn't, you'll probably want to try something other than chicken.

Here's a site that has recipes for raw and cooked:
Making Cat Food

And here's a powder completer to add to meat and liver:
Know What You Feed Your Cat - Shop Online

If you're going to use a protein other than chicken, I recommend the Alnutrin Egg-free with Eggshell Calcium. Most powder supplement completers include egg yolk. This is the only one I know of that found a replacement for the nutrients provided by egg yolk in a non-egg ingredient (the eggshell is just the calcium from eggshells and is not the same as the protein in egg yolks from a food trials point of view.)

You can use freeze-dried liver in place of fresh liver in these recipes at 1/3 the called for amount. If the recipe asks for 45 grams of fresh liver, you can use 15 grams of freeze dried liver. You can find freeze dried liver in novel proteins often in the dog treats or dog training section. As long as freeze-dried liver is the only ingredient, it doesn't matter whether the label says for dogs or for cats.
Thanks, I have contacted them just waiting to hear back.
I sent another message to my vet as well, to see if she thinks it's IBD. He's 15 and never had any issues like this before now, so I'd be shocked if he developed it out of the blue. I'm honestly thinking it's C. Diff or E. Coli. (I work in the hospital, and C.diff can be scary. I think that's why I'M freaking out!) He did have an US at his last we visit, and all they saw was major inflammation.
I will look into those food options. I have tried rabbit duck and venison before, but he doesn't seem to like them. He loves salmon, but I know he can't eat that constantly. I do think he could benefit from a single source diet right now.... If I could ever get him interested in eating!!
That's part of what is nagging at me, this boy has had a hearty appetite since we found him at 1 yr old... He could eat anything, and none of it ever made him sick. He only ever had hairballs. And now this... It's just not like him. 😔
 

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Thanks, I have contacted them just waiting to hear back.
I sent another message to my vet as well, to see if she thinks it's IBD. He's 15 and never had any issues like this before now, so I'd be shocked if he developed it out of the blue. I'm honestly thinking it's C. Diff or E. Coli. (I work in the hospital, and C.diff can be scary. I think that's why I'M freaking out!) He did have an US at his last we visit, and all they saw was major inflammation.
I will look into those food options. I have tried rabbit duck and venison before, but he doesn't seem to like them. He loves salmon, but I know he can't eat that constantly. I do think he could benefit from a single source diet right now.... If I could ever get him interested in eating!!
That's part of what is nagging at me, this boy has had a hearty appetite since we found him at 1 yr old... He could eat anything, and none of it ever made him sick. He only ever had hairballs. And now this... It's just not like him. 😔
If you are concerned about c. diff or e. coli, you can submit a stool sample (if you can collect one solid enough) for a Diarrhea PCR. That will test for the presence of these strains as well as certain toxins they produce. Cats can have clostridium in their gut that isn't causing issues. That's why they test for the enterotoxins too. The best medicine for c. diff and/or e. coli? S. boulardii! But it takes time. My last cat, Krista, she had a summer of c. diff. Metronidazole did nothing for her. S. boulardii, and a whole lot of it (2 human sized capsules spread over four or more meals a day) was what got her through it. It took a couple of months. That's also why AB's Gut Maintenance Protocol is a two month supply.

Krista also had a recurrence of liquid poops that turned out to be her previously well-managed IBD progressing into lymphoma. It took me a long time to catch because I thought it was simply her clostridium coming back. It wasn't until she was losing weight dramatically and relentlessly that I was able to convince myself and her vet that this was something different. If he's already had an ultrasound that indicated inflammation, why hasn't he started steroids yet? That could shore up his vomiting and his appetite. It may even help with his diarrhea if that's caused by the inflammation rather than being the cause of the inflammation.

Often times it's not the protein but the recipe that a cat objects to. If you tried rabbit, turkey, and venison in one brand, that maybe only says he doesn't like that brand. I would definitely encourage you to try again with Rawz and once more with Mouser. It certainly helps that Incredible Pets sells by the can.
 
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