Help with these test results / Clostridium infection not going away?

JBMMBJ

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So, my kitten has been having diarrhea and finally we have the results from the lab, I requested a PCR to be done. From my understanding (he’s a 12 week old Ragdoll), he tested positive for Clostridium and Feline Coronavirus. However, the vet that was in charge of him was not at the clinic and cannot communicate the results. I asked to be able to speak to another vet since I’m very worried about him and his constant diarrhea, but I had no luck.

If anyone can help me, I would really appreciate it.
For what he tested positive, it says:

Feline Coronavirus RealPCR - Positive

C. perfringens Alpha Toxin (CPA) Gene - Positive

C. perfringens Alpha Toxin (CPA) Gene Quantity - 745 (HIGH LEVELS OF CPA GENE COPIES PRESENT)

C. perfringens Enterotoxin (CPE) Gene - POSITIVE

C. perfringens Enterotoxin (CPE) Gene Quantity - 1277 (HIGH LEVELS OF CPE GENE COPIES PRESENT)

Now, I am particularly worried about the Felice Coronavirus but from my understanding it is very common? Is there anything that could be done about this?

And for the Clostridium, how is it usually treated? Is it dangerous?

Anything would help. Thank you very much!
 

daftcat75

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Clostridium is dangerous in that the constant diarrhea is dehydrating and he may not be digesting his food fully. He's probably losing weight if he hasn't already. It's also a really nasty infection to fight. It tends to be more resistant to antibiotics than other infections. Vets often prescribe an antibiotic called metronidazole which, itself, causes diarrhea because it kills good gut bacteria with the bad. Also, not many cats eat well on the metro. Give it anyways because you'll need whatever help you can get against the clostridium. Your guy may need the help of an anti-nausea and/or appetite stimulant while he's taking metro (or another antibiotic.)

But you'll also want to start him on saccharomyces boulardii. This is the real rock star and will probably go a lot further than the metro. It is a yeast-based probiotic that will survive the metro and help crowd out the clostridium.

More on s. boulardii:
My Cat Has Diarrhea - What Do I Do?

And the gold standard for s. boulardii is the Jarrow brand with the MOS prebiotic.
https://www.amazon.com/dp/B07NW49TC7/?tag=thecatsite

Here's another retailer if you have a Vitamin Shoppe near you:
Vitamin Shoppe

Otherwise, you should be able to find this brand wherever you would go for vitamins or probiotics (GNC, Whole Foods, etc.) It doesn't require refrigeration. But you may end up finding it in the refrigerated section with other probiotics that do require refrigeration.

It took about a month at two pills a day (1/2 a pill mixed into food 4 times a day) to get Krista through her clostridium infection. Hopefully your boy likes the taste of the s. boulardii like Krista did. He'll be eating a lot of it over the next month. However, even without the metro (or whatever antibiotic your vet prescribes), you should see almost overnight improvement from the s. boulardii. But it doesn't colonize like other probiotics meaning it stops working when you stop giving it. When his poops return to normal without the s. boulardii, that's when he's done with the clostridium. You may give a maintenance dose of s. boulardii (if he still likes the stuff) if you're nervous or concerned about taking him off of it once you've got the infection beat.
 
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JBMMBJ

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From what I have read this is a gram positive infection that responds well to amoxicillin or tylosin. Clostridium perfringens - Cat
Was he tested for tritrichamobas feotus?
Thank you for your reply! He was indeed tested for T. foetus and he is negative. How long does it usually take with those antibiotics?
 
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JBMMBJ

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Clostridium is dangerous in that the constant diarrhea is dehydrating and he may not be digesting his food fully. He's probably losing weight if he hasn't already. It's also a really nasty infection to fight. It tends to be more resistant to antibiotics than other infections. Vets often prescribe an antibiotic called metronidazole which, itself, causes diarrhea because it kills good gut bacteria with the bad. Also, not many cats eat well on the metro. Give it anyways because you'll need whatever help you can get against the clostridium. Your guy may need the help of an anti-nausea and/or appetite stimulant while he's taking metro (or another antibiotic.)

But you'll also want to start him on saccharomyces boulardii. This is the real rock star and will probably go a lot further than the metro. It is a yeast-based probiotic that will survive the metro and help crowd out the clostridium.

More on s. boulardii:
My Cat Has Diarrhea - What Do I Do?

And the gold standard for s. boulardii is the Jarrow brand with the MOS prebiotic.
https://www.amazon.com/dp/B07NW49TC7/?tag=thecatsite

Here's another retailer if you have a Vitamin Shoppe near you:
Vitamin Shoppe

Otherwise, you should be able to find this brand wherever you would go for vitamins or probiotics (GNC, Whole Foods, etc.) It doesn't require refrigeration. But you may end up finding it in the refrigerated section with other probiotics that do require refrigeration.

It took about a month at two pills a day (1/2 a pill mixed into food 4 times a day) to get Krista through her clostridium infection. Hopefully your boy likes the taste of the s. boulardii like Krista did. He'll be eating a lot of it over the next month. However, even without the metro (or whatever antibiotic your vet prescribes), you should see almost overnight improvement from the s. boulardii. But it doesn't colonize like other probiotics meaning it stops working when you stop giving it. When his poops return to normal without the s. boulardii, that's when he's done with the clostridium. You may give a maintenance dose of s. boulardii (if he still likes the stuff) if you're nervous or concerned about taking him off of it once you've got the infection beat.
Thank you for your reply! We started giving him Metrodinazole because the vet thought he had Giardia initially. I was told to give him that medication for five days only, and so stopped Saturday. I believe his stools are definitely better, not liquid anymore but semi solid.

If I give him S. Boulardii, would I know if the treatment is working though (the antibiotics)? Also, should I give him a probiotic at the same time (like Proviable)?

I also wanted to ask if cats have to be retested for Clostridium to make sure the infection is gone?

He did lose a bit of weight, but is really eating a lot and also drinking. I’m just upset how according to the vet this is not “urgent” I guess. So thank you for the reply/advice!
 

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Hi. The above members have covered the most important aspects, but I did want to address your question about the coronavirus. It is found in nearly 80% of the cat population, and for the most part means nothing. Coronavirus can mutate to FIP, but it happens pretty rarely given the amount of cats that are positive for the coronavirus itself. The most often mutations occur in cats when they are younger than 2 years old as they are still developing their immune system. The other most frequent occurrence is in elderly cats - but, most of those cases happen because some other illness has compromised their immune system, allowing the virus to mutate.

So, the biggest issue and most important issue is to get the Clostridium treated and eradicated. I would put any concerns you have about the coronavirus aside.
 

daftcat75

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Thank you for your reply! We started giving him Metrodinazole because the vet thought he had Giardia initially. I was told to give him that medication for five days only, and so stopped Saturday. I believe his stools are definitely better, not liquid anymore but semi solid.

If I give him S. Boulardii, would I know if the treatment is working though (the antibiotics)? Also, should I give him a probiotic at the same time (like Proviable)?

I also wanted to ask if cats have to be retested for Clostridium to make sure the infection is gone?

He did lose a bit of weight, but is really eating a lot and also drinking. I’m just upset how according to the vet this is not “urgent” I guess. So thank you for the reply/advice!
Don't bother with probiotics while you are giving antibiotics. The antibiotics will kill the probiotics. S. boulardii, being yeast instead of bacteria, is the exception. S. boulardii can be and should be given along side the antibiotics, any time you need to give antibiotics, to prevent or lessen the effects of the antibiotic on good gut bacteria. In Krista's case, I gave her the s. boulardii for a month. I brought in a solid stool sample and the vet said, "I don't even need to waste your money on a re-test. If she still had clostridium in a meaningful amount, that sample would not be solid." Give him the s. boulardii until he's back to normal stools again. If his stools become loose again when you discontinue the s. boulardii, start it up again. You can give Proviable when you're done with the metro or any other antibiotics.
 
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JBMMBJ

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Hi. The above members have covered the most important aspects, but I did want to address your question about the coronavirus. It is found in nearly 80% of the cat population, and for the most part means nothing. Coronavirus can mutate to FIP, but it happens pretty rarely given the amount of cats that are positive for the coronavirus itself. The most often mutations occur in cats when they are younger than 2 years old as they are still developing their immune system. The other most frequent occurrence is in elderly cats - but, most of those cases happen because some other illness has compromised their immune system, allowing the virus to mutate.

So, the biggest issue and most important issue is to get the Clostridium treated and eradicated. I would put any concerns you have about the coronavirus aside.
Thank you very much for this reply. I am indeed (and have always been) worried about FIP, and know it happens rarely, however I was really hoping he could test negative for Coronavirus. Will he always have it, or is it possible it may go away if he develops antibodies? I’m not sure if this sounds stupid, but I was just wondering about it.

Something else I wanted to ask, he was vaccinated for FVRCP, is this related to Feline Coronavirus? Is it possible that’s why he tested positive? On the results it says that “Vaccination with a modified live coronavirus vaccine may result in a positive result for up to a few weeks post vaccination”.
Thank you!
 

kittenmittens84

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Thank you very much for this reply. I am indeed (and have always been) worried about FIP, and know it happens rarely, however I was really hoping he could test negative for Coronavirus. Will he always have it, or is it possible it may go away if he develops antibodies? I’m not sure if this sounds stupid, but I was just wondering about it.

Something else I wanted to ask, he was vaccinated for FVRCP, is this related to Feline Coronavirus? Is it possible that’s why he tested positive? On the results it says that “Vaccination with a modified live coronavirus vaccine may result in a positive result for up to a few weeks post vaccination”.
Thank you!
FVRCP is not related, unfortunately there’s no effective vaccine for FIP or FCOV (which is the virus that causes FIP, and what they tested your cat for.) There used to be an FIP vaccine but it didn’t really work so they stopped making it.
FVRCP protects against FHV (a feline herpesvirus), feline calcivirus, and panleuk/feline distemper which is caused by a parvovirus.

FCOV spreads easily between cats that share a household/living space, so if you got your cat from a shelter or a breeder that’s likely where it came from. It’s endemic among cats and 99% of the time causes no issues or even symptoms at all.
 
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JBMMBJ

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Don't bother with probiotics while you are giving antibiotics. The antibiotics will kill the probiotics. S. boulardii, being yeast instead of bacteria, is the exception. S. boulardii can be and should be given along side the antibiotics, any time you need to give antibiotics, to prevent or lessen the effects of the antibiotic on good gut bacteria. In Krista's case, I gave her the s. boulardii for a month. I brought in a solid stool sample and the vet said, "I don't even need to waste your money on a re-test. If she still had clostridium in a meaningful amount, that sample would not be solid." Give him the s. boulardii until he's back to normal stools again. If his stools become loose again when you discontinue the s. boulardii, start it up again. You can give Proviable when you're done with the metro or any other antibiotics.
Great, thank you so much!
I have two questions, I hope that’s okay.

The first, do you know how much S. Boulardii I should give him? (He’s 12 weeks old and around 2.5lbs, but I have to weigh him again to make sure exactly).

And second, with Clostridium do I have to disinfect the house/litter box and change litter frequently to prevent re-infection, like in Giardia? Or what should I do to make sure he does not get infected again?

Thank you!
 
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JBMMBJ

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FVRCP is not related, unfortunately there’s no effective vaccine for FIP or FCOV (which is the virus that causes FIP, and what they tested your cat for.) There used to be an FIP vaccine but it didn’t really work so they stopped making it.
FVRCP protects against FHV (a feline herpesvirus), feline calcivirus, and panleuk/feline distemper which is caused by a parvovirus.

FCOV spreads easily between cats that share a household/living space, so if you got your cat from a shelter or a breeder that’s likely where it came from. It’s endemic among cats and 99% of the time causes no issues or even symptoms at all.
Thank you! Yes I did get my kitten from a breeder, I talked to her and she said they never had a case of FIP. I guess that is what I’m most concerned about, even though I know it rarely happens. So for the Coronavirus there’s nothing I can do at all?
 

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So for the Coronavirus there’s nothing I can do at all?
If a cat tests positive for it, it is in their system for life, but as K kittenmittens84 pretty much alluded to, it simply stays inactive. There is no treatment, as there is technically nothing to treat. It is essentially harmless for most cats. "Back burner" this issue and work on the real issue with the Clostridium. I'll defer your questions to those members who are already providing you great assistance in that area!
 

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Didn’t read replies. You need to call the office and demand to speak to the Veterinarian. This is a bunch of kitty litter! You paid for the tests and that includes the review from the vet of the tests and explaining it to you.
 

daftcat75

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Great, thank you so much!
I have two questions, I hope that’s okay.

The first, do you know how much S. Boulardii I should give him? (He’s 12 weeks old and around 2.5lbs, but I have to weigh him again to make sure exactly).

And second, with Clostridium do I have to disinfect the house/litter box and change litter frequently to prevent re-infection, like in Giardia? Or what should I do to make sure he does not get infected again?

Thank you!
S. boulardii doesn't have a practical toxicity. He'll probably tire of eating the stuff before you find its upper limit. He's a little guy (1/3 of Krista's size.) I gave Krista half a pill four times a day. You may want to start half a pill twice a day or 1/4 pill, 4 times a day. I believe 1 pill is a little larger than 1/8 tsp. It's actually a capsule and you'll empty out the powder into his food. If you have the dash-pinch-smidgen measuring spoons, 1 pill will be approximately (slightly more) than 1 dash (1/8 tsp.) Half a pill would be 1 pinch and a 1/4 pill would be 1 smidgen. I highly recommend getting these spoons if you don't have them.

I don't think you need to thoroughly clean your home like giardia. And I'm not sure what you need to do to prevent reinfection. In Krista's case, I'm about 98% certain she got it from an undercooked turkey drumstick in the slow cooker making her meat stock. For her, I never used whole cuts in the slow cooker for her again--only nearly stripped bones with just a little meat for flavor and treats (no more than I could be certain was thoroughly cooked through at the end of the cook.) For your guy? I have no idea how he may have gotten clostridium. So I'm not sure how to avoid it.
 
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JBMMBJ

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posiepurrs

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We started giving him Metrodinazole because the vet thought he had Giardia initially. I was told to give him that medication for five days only, and so stopped Saturday. I believe his stools are definitely better, not liquid anymore but semi solid.
Just an FYI: Fenbenazole is the treatment of choice for giardia. Metrodinazole sometimes does not clear it, but most vets insist on using it. When I dealt with giardia in my cattery my vet prescribed fenbenazole, which is sold at Tractor Supply under the name Safeguard (a goat wormer). He allowed me to get it from Tractor Supply since it was MUCH less expensive and told me how much to give each cat.
 
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JBMMBJ

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S. boulardii doesn't have a practical toxicity. He'll probably tire of eating the stuff before you find its upper limit. He's a little guy (1/3 of Krista's size.) I gave Krista half a pill four times a day. You may want to start half a pill twice a day or 1/4 pill, 4 times a day. I believe 1 pill is a little larger than 1/8 tsp. It's actually a capsule and you'll empty out the powder into his food. If you have the dash-pinch-smidgen measuring spoons, 1 pill will be approximately (slightly more) than 1 dash (1/8 tsp.) Half a pill would be 1 pinch and a 1/4 pill would be 1 smidgen. I highly recommend getting these spoons if you don't have them.

I don't think you need to thoroughly clean your home like giardia. And I'm not sure what you need to do to prevent reinfection. In Krista's case, I'm about 98% certain she got it from an undercooked turkey drumstick in the slow cooker making her meat stock. For her, I never used whole cuts in the slow cooker for her again--only nearly stripped bones with just a little meat for flavor and treats (no more than I could be certain was thoroughly cooked through at the end of the cook.) For your guy? I have no idea how he may have gotten clostridium. So I'm not sure how to avoid it.
Thank you for your help, yesterday I went to buy Jarrow S. Boulardii and gave him 1/4, and this morning his stools were solid. Since starting Metrodinazole last week he has definitely improved. Today the vet should call me to discuss the antibiotics/therapy they want to give my kitten, so we’ll see. For when he’s done, is Proviable DC a good probiotic to rebuild good flora? Thank you!
 
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JBMMBJ

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Just an FYI: Fenbenazole is the treatment of choice for giardia. Metrodinazole sometimes does not clear it, but most vets insist on using it. When I dealt with giardia in my cattery my vet prescribed fenbenazole, which is sold at Tractor Supply under the name Safeguard (a goat wormer). He allowed me to get it from Tractor Supply since it was MUCH less expensive and told me how much to give each cat.
Great to know, in case my kitten ever gets this parasite (hopefully not). Thank you!
 
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JBMMBJ

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S. boulardii doesn't have a practical toxicity. He'll probably tire of eating the stuff before you find its upper limit. He's a little guy (1/3 of Krista's size.) I gave Krista half a pill four times a day. You may want to start half a pill twice a day or 1/4 pill, 4 times a day. I believe 1 pill is a little larger than 1/8 tsp. It's actually a capsule and you'll empty out the powder into his food. If you have the dash-pinch-smidgen measuring spoons, 1 pill will be approximately (slightly more) than 1 dash (1/8 tsp.) Half a pill would be 1 pinch and a 1/4 pill would be 1 smidgen. I highly recommend getting these spoons if you don't have them.

I don't think you need to thoroughly clean your home like giardia. And I'm not sure what you need to do to prevent reinfection. In Krista's case, I'm about 98% certain she got it from an undercooked turkey drumstick in the slow cooker making her meat stock. For her, I never used whole cuts in the slow cooker for her again--only nearly stripped bones with just a little meat for flavor and treats (no more than I could be certain was thoroughly cooked through at the end of the cook.) For your guy? I have no idea how he may have gotten clostridium. So I'm not sure how to avoid it.
Just wanted to add that the vet called me, asked me how my kitten is doing and I probably made the mistake to say he’s doing much better and doesn’t really have diarrhea anymore. So the vet told me not to give him any antibiotics anymore and just see if the diarrhea comes back. I mean, he had Metrodinazole only for 5 days, so does this sound like good advice? Shouldn’t he have antibiotics for longer?
 
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