Lethargy After Eating, Intestinal Inflammation

[Selarah]

Hi all. Hoping to get some input.

I’ll try to make a long story short.

We took in a stray kitty. Have been doing all we can to find his owners since he has a collar (no ID, chip or tattoo) and has been neutered. During this time we’ve been letting him come and go as he pleases. We decided some weeks later it would be best to temporarily feed him since he’s been begging so much and see him outside eating mice all the time. We started feeding him Nutro wholesome essentials kibble and had no problems that we noticed. Month later we ran out of that food and couldn’t find it again here in our small town so I had to find something new to feed him. I read wet food is better for him and began feeding him a smorgasbord of wet foods. He gobbles everything but we noticed he started acting sick (lethargic) and at one point had bad diarrhea one night. The next night he looked so horrible we took him to pet emergency. Lots of money and tests later, the X-rays revealed his entire intestinal track had inflammation. She suspected the inflammation could be from the worms he had *we noticed worms on his rear earlier in the week end and got him de-wormed at the vet* or possible bacterial infection. He stayed 24 hrs on IV fluids and meds *metronidazole* totally different kitty the first few days being back. Playful and spunky. Unfortunately, we are back to him acting lethargic and it’s only after he eats. Luckily no diarrhea that I’ve noticed nor vomiting.
I feel so bad for changing his food so rapidly on him, and I have done so a few times trying to find one that doesn’t make him feel so ill/inflamed. Eventually the vet recommended hill digestive care I/d, so I have him on that kibble. I’ve been trying to feed him little amounts of limited ingredient wet food too, but he is still acting the same. It’s been a little over a week since getting him back from the vet and four days being off the medication they gave us, and coming up on a week of being on that kibble. *but I’ve also fed him a couple different small amounts of wet foods too*
I am kind of wondering if it’s still possibly worms or parasites? I see no indication of them around his rear or in his stool at all.
Or is it just food sensitivities or food changes? Going from eating mice only to sudden various cat foods?
God forbid, could he have IBS even though he doesn’t vomit or have diarrhea?
I am trying to stick to this one kibble for him, maybe I should stop the addition of wet food?

I’m not really sure what to do for him at this point. But I know from these same changes in demeanor, he the intestinal inflammation has returned. Should I be urgently worried about this?
It looks like no one is claiming him and we really enjoy the fluffy guy, so we’d like to continue trying to help him Any advice from you guys would be greatly appreciated.

 

[Furballsmom]

Hi!
What about canned food only, no kibble for a few days?
Can you also try 50:50 unseasoned boiled chicken and rice for a couple days?
Can you add some goat milk? It is sort of a super food for kitties.

 

[Selarah]

Hi!
Thank you for the tip about the raw goats milk. A quick phone call to the pet store here they have a powdered kind. Will that be sufficient? Or would any raw goats milk from the grocery store do?

 

[Furballsmom]

I think any raw will be good, whichever is easiest for you

 

[mrsgreenjeens]

As far as the worms go, how long ago was he dewormed? You do have to deworm two or three times to make sure you get them all, since the dewormer only kills the adults.

that being said, this does seem to be food related, as you said. Can you order the dry food that seems to work for him on-line? I don't normally suggest people feed dry food vs wet food, but since he didn't have this issue on the Nutro Wholesome Essentials, maybe that's the ticket. It does have lots of ingredients that would be an issue IF he has IBD or food allergies, but it could be he is sensitive to Carrageenan or Guar Gum, which are in most wet foods . So I would leither look for wet foods without those two ingredients, or try to order that dry food over the internet. Here is a thread for people looking specifically for that type of wet food: Canned food without Carrageenan or Guar Gum? That thread is old, so be sure to read to the end, as things have changed!

Let us know how it goes

 

[Selarah]

As far as the worms go, how long ago was he dewormed? You do have to deworm two or three times to make sure you get them all, since the dewormer only kills the adults.

that being said, this does seem to be food related, as you said. Can you order the dry food that seems to work for him on-line? I don't normally suggest people feed dry food vs wet food, but since he didn't have this issue on the Nutro Wholesome Essentials, maybe that's the ticket. It does have lots of ingredients that would be an issue IF he has IBD or food allergies, but it could be he is sensitive to Carrageenan or Guar Gum, which are in most wet foods . So I would leither look for wet foods without those two ingredients, or try to order that dry food over the internet. Here is a thread for people looking specifically for that type of wet food: Canned food without Carrageenan or Guar Gum? That thread is old, so be sure to read to the end, as things have changed!

Let us know how it goes

Hello mrsgreenjeens .

He was de-wormed on the 13th or 14th of Aug. The vet used profender, is that still true to worm him so soon again? We don't see any signs of worms in feces or rear. He mentioned to bring him back for another round in 3 months. That being said, I really don't ever want to use that de-wormer on him again after reading so many horror stories. The vet also applied it on a spot that he was able to lick; he didn't have any obvious symptoms after licking it, just a disgusted face and a moment of panic. I wasn't told by the vet he shouldn't lick it but later read he shouldnt for 24 hours... great . Anyway, would I be able to switch to a pill kind for him if he needs to be de-wormed again after profender?

I did end up able to run into the city to buy it again, however he turned his nose up to it and wasn't keen at all to eat it. I tried various times. Right now I feel it's not the right thing for him to eat the vet kibble either after much discussion with others. He also has not been keen at all to eat, but has since its all I have been putting out for him. He used to only hunt and eat raw mice and was fine. How on earth is eating corn, barely, wheat and highly processed chicken meal at all going to make him feel better?! Right now I have him on something he loves: Instinct LID wet, so far he gobbles it all down; turkey, rabbit and duck(which I haven't tried yet, but I suspect he will love it just as much). He really likes it so far, thank goodness. So I will stay dedicated on that one and see how he does.

The guy here at the health pet food store said to stop all the changes *hes been through a lot dietary changes, stresses and routine changes to his life in such a small amount of time* He said to let him settle down at least for 3-5 weeks on this new food and see how he does. It's hard to not to worry & want to do everything for him, but I have to be patient.

 

[Jem]

Have you thought about keeping him on a raw diet? You can get fresh, dehydrated, where you just add water, and raw diet supplements to add to food if you want to make it yourself. I don't feed raw so I'm not much more help than this, but there are several on this site who do feed raw that I hope contribute to this thread. Maybe start a new thread asking specifically about raw diets to get their attention?

 

[Selarah]

Have you thought about keeping him on a raw diet? You can get fresh, dehydrated, where you just add water, and raw diet supplements to add to food if you want to make it yourself. I don't feed raw so I'm not much more help than this, but there are several on this site who do feed raw that I hope contribute to this thread. Maybe start a new thread asking specifically about raw diets to get their attention?

Hi Jem
It's funny you should say that, but yeah, I have thought about it and have joined a FB group dedicated to raw feeding. The guy at the store recommened it and so has another girl at another store who feeds her cats raw. A few others have said the same. It's something I have been considering. I have had mixed responses from people saying to transition slowly, to get him on it right away! Someone sent me a link on how to do it, but I have yet to fully read it. But I'm not so sure how to go about it yet. I really would love to transition him to raw though, for sure.

 

[Jem]

Well, and again, not a raw diet expert by any means, if he has been having so many issues with all the different canned foods and kibble, and is so used to eating mice, I would think a relatively quick switch over would not make him any worse. But that is just my own reasoning. Maybe ask what type of protein is closest to mice?

 

[Furballsmom]

Can you try Rad Cat, or Primal? Those would be good over the counter choices that are ready made, so to speak...

 

[daftcat75]

Have you had him tested for pancreatitis? It tends to come along with intestinal inflammation and its symptoms are diarrhea, weight loss, lethargy, and vomiting. Does he also seem pained or distressed after eating?

The test for pancreatitis is Spec fPL (or fPLi.) It's not part of the standard blood work but an extra test to add on. My Krista went to three different vets and only the third suggested we test for it. Thank goodness we found this vet.

As for food, me and Krista love Tiki Cat. They have plenty of flavors that are meat in meat broth plus vitamins and supplements. No gums or starches or other unusable ingredients that are going to have to come out of your cat, one end or another. We especially love the tuna and pumpkin or tuna with shrimp and pumpkin flavors as the pumpkin combats both diarrhea and constipation.

 

[daftcat75]

Sometimes the symptoms are just lethargy and anorexia (not eating), or simply ADR ("ain't doing right"). Just seems off.

 

[mrsgreenjeens]

Hello mrsgreenjeens .

He was de-wormed on the 13th or 14th of Aug. The vet used profender, is that still true to worm him so soon again? We don't see any signs of worms in feces or rear. He mentioned to bring him back for another round in 3 months. That being said, I really don't ever want to use that de-wormer on him again after reading so many horror stories. The vet also applied it on a spot that he was able to lick; he didn't have any obvious symptoms after licking it, just a disgusted face and a moment of panic. I wasn't told by the vet he shouldn't lick it but later read he shouldnt for 24 hours... great . Anyway, would I be able to switch to a pill kind for him if he needs to be de-wormed again after profender?

I did end up able to run into the city to buy it again, however he turned his nose up to it and wasn't keen at all to eat it. I tried various times. Right now I feel it's not the right thing for him to eat the vet kibble either after much discussion with others. He also has not been keen at all to eat, but has since its all I have been putting out for him. He used to only hunt and eat raw mice and was fine. How on earth is eating corn, barely, wheat and highly processed chicken meal at all going to make him feel better?! Right now I have him on something he loves: Instinct LID wet, so far he gobbles it all down; turkey, rabbit and duck(which I haven't tried yet, but I suspect he will love it just as much). He really likes it so far, thank goodness. So I will stay dedicated on that one and see how he does.

The guy here at the health pet food store said to stop all the changes *hes been through a lot dietary changes, stresses and routine changes to his life in such a small amount of time* He said to let him settle down at least for 3-5 weeks on this new food and see how he does. It's hard to not to worry & want to do everything for him, but I have to be patient.

OK, as for the de-worming, I didn't realize your Vet used a TOPICAL dewormer (didn't even know such a thing existed until you posted this ) That topical dewormer is supposed to be a one-time only. How great is that? The only issue I see here is that it's supposed to be applied on the back of their neck, where they can't lick it. How on earth was this furbaby able to lick it? Anyway, lethargy IS one of the possible side effects . So, is he STILL lethargic, or not? Since you may have two different things going on here (de-wormer and/or food issues), it's hard to know what is causing what. Since you are now feeding the limited ingredient food only, are you seeing a difference? I would say to stick with that food for a couple more weeks, feeding only one specific protein even, and I'd use rabbit as that is one that most cats are not sensitive to. If he still has issues, then you might try raw, since you're thinking about it anyway.

You might not believe it, but you can actually buy ground mouse! Or even whole mice that have been humanely euthanized. (I know....gross, but it's the circle of life) Here's a link to the place that sells them: Home Page | Hare Today, Gone Tomorrow Of course, if you aren't in the United States, this won't help you. I actually feed raw to one of my cats, and I currently use dehydrated food that I rehydrate. One of the foods I feed is Stella and Chewy rabbit, if you want to check into that. It's very easy, and you can always start by giving him one of two pieces in the dehydrated form as a treat to see how he'll react. My other cat loves it dehydrated, but won't eat it rehydrated. So I give him a few pieces everyday as a snack, then give him his wet food with extra water added in to rehydrate him

 

[Jem]

Or even whole mice that have been humanely euthanized.

OMG! I can't belive I didn't think of that! I have a friggin' snake, who eats mice and rats! Got them in the freezer at this very moment!

 

[Selarah]

Well, and again, not a raw diet expert by any means, if he has been having so many issues with all the different canned foods and kibble, and is so used to eating mice, I would think a relatively quick switch over would not make him any worse. But that is just my own reasoning. Maybe ask what type of protein is closest to mice?

That’s trueee. I did buy frozen mice for him too. I have yet to give him one lol.

Can you try Rad Cat, or Primal? Those would be good over the counter choices that are ready made, so to speak...

Hi Furballsmom !

I don’t believe I can get RadCat, I am in Canada. I have seen the primal stuff around here, And a few other brands I could try!

Have you had him tested for pancreatitis? It tends to come along with intestinal inflammation and its symptoms are diarrhea, weight loss, lethargy, and vomiting. Does he also seem pained or distressed after eating?


The test for pancreatitis is Spec fPL (or fPLi.) It's not part of the standard blood work but an extra test to add on. My Krista went to three different vets and only the third suggested we test for it. Thank goodness we found this vet.


As for food, me and Krista love Tiki Cat. They have plenty of flavors that are meat in meat broth plus vitamins and supplements. No gums or starches or other unusable ingredients that are going to have to come out of your cat, one end or another. We especially love the tuna and pumpkin or tuna with shrimp and pumpkin flavors as the pumpkin combats both diarrhea and constipation.

Yikes, that sounds really scary. I’m glad your kitty is okay now. What symptoms did your cat have? This kitty has actually gained weight, no diarrhea or vomiting and still eating well, full meat (instinct LID rabbit about 5-6 oz a day) still plays and gallops around outside. I just notice subtle differences in him like bouts of lethargy, mostly after eating; a kind of sickly lethargy, not just a normal sleepy. He takes a good nap afterwards. Few hours later he seems better again. I think the change in diet is diminishing it so far. It’s only been a day or two though, a bit early to make any proper assessment. I will for sure keep a closer eye on him for pancreatitis symptoms and if he doesn’t improve ask them to test for it.

I did check out Tiki Cat, but the ones I checked out at the store had xanthum gum in it if I’m not mistaken. I see on the website some variety’s look perfect. Thanks, once he gets bored of this rabbit I’ll try those ones out!

OK, as for the de-worming, I didn't realize your Vet used a TOPICAL dewormer (didn't even know such a thing existed until you posted this


) That topical dewormer is supposed to be a one-time only. How great is that? The only issue I see here is that it's supposed to be applied on the back of their neck, where they can't lick it. How on earth was this furbaby able to lick it? Anyway, lethargy IS one of the possible side effects


. So, is he STILL lethargic, or not? Since you may have two different things going on here (de-wormer and/or food issues), it's hard to know what is causing what. Since you are now feeding the limited ingredient food only, are you seeing a difference? I would say to stick with that food for a couple more weeks, feeding only one specific protein even, and I'd use rabbit as that is one that most cats are not sensitive to. If he still has issues, then you might try raw, since you're thinking about it anyway.


You might not believe it, but you can actually buy ground mouse! Or even whole mice that have been humanely euthanized. (I know....gross, but it's the circle of life) Here's a link to the place that sells them: Home Page | Hare Today, Gone Tomorrow Of course, if you aren't in the United States, this won't help you. I actually feed raw to one of my cats, and I currently use dehydrated food that I rehydrate. One of the foods I feed is Stella and Chewy rabbit, if you want to check into that. It's very easy, and you can always start by giving him one of two pieces in the dehydrated form as a treat to see how he'll react. My other cat loves it dehydrated, but won't eat it rehydrated. So I give him a few pieces everyday as a snack, then give him his wet food with extra water added in to rehydrate him

Yeah, isn’t that crazy? Lol. Oh man, well the vet didn’t put it behind his neck!! He applied it closer to his shoulder blades and lower, totally was able to lick it. Poor thing. His lethargy actually started before the de-wormer, around the time I abruptly changed his food all over the place. At the time I thought the lethargy was from the worms. He is for sure not near as bad as before. I unfortunately didn’t know diet changes are hard on them just until recently, that’s when he was doing the worst. He was on medication that temporarily helped. When I brought him home I was still changing his food on him and then again last week went on vet prescribed food for a week. I am going against what they are recommending because I can’t see how highly processed kibble with wheat, corn, barley and meat meal is any good for him; and he definitely didn’t enjoy it nor did he seem any better on it. It’s just the last couple of days I have him on only Instinct rabbit.

That’s amazing they sell mice ground omg! I wonder if he would eat it. I am in Canada, so I guess sadly I can’t get it . I do however have frozen mice waiting to be de thawed. I haven’t tried feeding them to him yet, I am very curious if he’ll eat it!! I did see that Stella and chewy! Doesn’t it have fruits and veggies in it though? I was so tempted to buy it for him. So it’s all raw? Would be a nice way to get used to the idea of feeding him raw.

 

[Selarah]

I ment to say 5-8oz.

I do have to say, today he seems much more improved. More alert, not hiding in weird places, snuggling/purring and certainly more active/playful tonight. Doing more of his usual behaviors. Keeping fingers crossed he keeps this up!

 

[daftcat75]

Yikes, that sounds really scary. I’m glad your kitty is okay now. What symptoms did your cat have? This kitty has actually gained weight, no diarrhea or vomiting and still eating well, full meat (instinct LID rabbit about 5-6 oz a day) still plays and gallops around outside. I just notice subtle differences in him like bouts of lethargy, mostly after eating; a kind of sickly lethargy, not just a normal sleepy. He takes a good nap afterwards. Few hours later he seems better again. I think the change in diet is diminishing it so far. It’s only been a day or two though, a bit early to make any proper assessment. I will for sure keep a closer eye on him for pancreatitis symptoms and if he doesn’t improve ask them to test for it.

I did check out Tiki Cat, but the ones I checked out at the store had xanthum gum in it if I’m not mistaken. I see on the website some variety’s look perfect. Thanks, once he gets bored of this rabbit I’ll try those ones out!

My Krista also has IBD. It was likely the IBD that caused the pancreatitis. As I was able to control the IBD, she still wasn’t getting better. She was still lethargic, but not hiding. Responsive, but minimally interactive. She lost her play drive. We’ve adjusted her med stack and started her on B-12 and it seems to be making a difference.

From what you describe, I think it could be simple stomach upset, either from current diet or getting all the prior diet out of him. I’ve read somewhere that it takes a few weeks to flush out food allergens after a diet change. It’s probably the same even without allergens.

Krista didn’t do so well on Instinct. We tried the venison and it just meant I now had cranberries in her vomit. A week on the Instinct and she stopped eating. I was able to restart her with treat tuna (tuna in water, nutritionally incomplete) and from there to Tiki Cat. There are a few Tiki flavors with a gum or two but that’s still nothing compared to the garbage ingredients in most of the foods out there. Many of them seem to be formulated to bait the one with the wallet rather than the one who eats it. I looked up the LID rabbit and I question the inclusion of peas and pea protein. Cats don’t need vegetables or vegetable protein sources. Cats eat grass to bring things up, not because they have a salad craving. Also the clay in the food, while soothing for cats with IBD, it may be additional non-nutritive bulk. The lethargy could just be simple stomach upset that is not irritating enough to produce vomiting or diarrhea yet.

Give him a few weeks to stabilize after all the diet changes. Try to keep him on a single diet during this time. Don’t worry about boredom. Just eliminate variables. If he still shows lethargy after eating, you can re-do the blood work and ask for fPL and B-12 status. If those come back clear, you’ll have to consider the food as being the culprit. Unless he stops eating altogether, stage in food changes slowly over a week, and try to give the new food a month before switching to another food unless he’s just not doing well on the new food.

 

[Selarah]

My Krista also has IBD. It was likely the IBD that caused the pancreatitis. As I was able to control the IBD, she still wasn’t getting better. She was still lethargic, but not hiding. Responsive, but minimally interactive. She lost her play drive. We’ve adjusted her med stack and started her on B-12 and it seems to be making a difference.

From what you describe, I think it could be simple stomach upset, either from current diet or getting all the prior diet out of him. I’ve read somewhere that it takes a few weeks to flush out food allergens after a diet change. It’s probably the same even without allergens.

Krista didn’t do so well on Instinct. We tried the venison and it just meant I now had cranberries in her vomit. A week on the Instinct and she stopped eating. I was able to restart her with treat tuna (tuna in water, nutritionally incomplete) and from there to Tiki Cat. There are a few Tiki flavors with a gum or two but that’s still nothing compared to the garbage ingredients in most of the foods out there. Many of them seem to be formulated to bait the one with the wallet rather than the one who eats it. I looked up the LID rabbit and I question the inclusion of peas and pea protein. Cats don’t need vegetables or vegetable protein sources. Cats eat grass to bring things up, not because they have a salad craving. Also the clay in the food, while soothing for cats with IBD, it may be additional non-nutritive bulk. The lethargy could just be simple stomach upset that is not irritating enough to produce vomiting or diarrhea yet.

Give him a few weeks to stabilize after all the diet changes. Try to keep him on a single diet during this time. Don’t worry about boredom. Just eliminate variables. If he still shows lethargy after eating, you can re-do the blood work and ask for fPL and B-12 status. If those come back clear, you’ll have to consider the food as being the culprit. Unless he stops eating altogether, stage in food changes slowly over a week, and try to give the new food a month before switching to another food unless he’s just not doing well on the new food.

Thank-you so much, this is incredibly helpful.

This morning I had to entice him to eat the rabbit by topping it with freeze dried lamb treat crumbled on top, so I’m not sure if he will keep eating it at all. And I only did that because I have nothing else to feed him and the store with all the big variety is 1.5 hours away. I find it strange that I had to do that because he loved it the last couple of days without much reaction. (Spouse addicently fed him left over canned turkey flavor last night we wanted to avoid giving him in case of the fowl allergy, I wonder if that has something to do with it?) I also questioned the peas but I figured it would be better than xanthum gum. I tried giving him paw lickin chicken wervua brand awhile ago and he stopped eating that too. I am not sure if it was the chicken or the xanthum gum.

He was very eager to go outside right after eating this morning, but I decided to keep him inside to see how he reacts. Shortly after meowing at the door he came to lay on the bed with us at least, however, sort of moody looking out the window not wanting to be touched. Cleaning himself. I suppose it’s better than usual since he was seeking out hiding places. I went to go open the door to outside and now he isn’t interested. I guess I’m having a hard time deciding if he’s lethargic or not.

The store does have a large assortment of tiki cat, perhaps I should pick up some of that to try. We suspect he may have a bird/fowl allergy because while he was well/ before we started feeding he had no interest in hunting birds; but maybe that’s nothing, but he wasn’t interested in a lot of food containing chicken either. Then again that could have been the other ingredients in it.

If he does stop eating all together and refuses to eat this, do I just put him on new stuff?

Thanks so much for your feedback daftcat75

 

[Furballsmom]

If he does stop eating all together and refuses to eat this, do I just put him on new stuff?

Find whatever he will eat - that's the important thing.

Maybe some things here below might help to entice him, or at least will keep nutrients going in him;

Try making this;
tent test for dehydration and home-made pedialyte recipe - The Daily Kitten

Also, try making one of these;
Kitten Glop Recipes - Supplementing Cats and Kittens with nutritious formula you make at home: presented by Bengal Cat breeder Foothill Felines. --This website has a number of kitten glop recipes, with ingredients that you may very well have in your house.

These can be used on their own or combined with food. Also, if you heat the food a little - stir it so there aren't any hot spots from the microwave. Or you could heat some water, about a tablespoon, and add that to canned food. A shot glass works to stir it all up.

• Chicken, beef or ham flavored baby food such as Gerber Stage 2 - make sure there is no garlic or onions in the ingredients

• Tuna and/or the juice, a low mercury/low/no sodium brand is called SafeCatch

• Salmon, mackerel

• Sardines (make sure there are no bones)

• boiled cut up chicken or turkey with no seasonings

• canned kitten food any brand - it's usually smelly. See if it's eaten on its own, then maybe mix it in or put on top

• Try mixing in Kitten Milk Replacer - there are recipes on the internet or store bought

• Fish, tuna or BBQ flavored canned wet food (I personally have never seen BBQ flavors, but...)

• Lickable cat treats or pouch treat 'gravy' poured over the food

• kitten glop (recipes in website link above)
• Bonito flakes
• fortiflora
• fish oil
• green beans, asparagus mushed up

• goat milk, or no lactose cow milk
• whole cooked eggs (the white must always be cooked) or raw egg yolk now and then
• broth with no salt and no garlic or onion or seasonings of any kind
• There are also commercial toppers, Applaws is a brand that can work well as a topper
  
• Some good treats would be freeze dried Purebites, Orijen, Meowtinis, Meowables

• There are also Lickimats that you could spread types of soft food onto, even plain unflavored yogurt, and even freeze it. Licking something can help a cat to feel better emotionally The LickiMat - Food Puzzles for Cats
• shredded cheddar cheese

 

[daftcat75]

Because my cat has IBD, I am very particular about ingredients. If she has a reaction to something, how am I to know what caused that reaction if there's four different proteins, three gums, a starch, and a handful of vegetables and/or grains?

For a "limited ingredient" food, the Instinct has two proteins, a vegetable, and a non-nutritive clay. If I gave this to my Krista and she vomited it back, does that mean she doesn't do well with rabbit or she doesn't do well with peas? or with clay?

That's why I like the Tiki Cat Grill line. The Ahi Tuna, Ahi Tuna with Crab, Ahi Tuna with Shrimp, and Wild Salmon are all fish in fish broth plus vitamins. Assuming she's not allergic to the vitamin-minerals-oil base they use to make all their formulas nutritionally complete, I only have to worry about the one or two proteins. And since they have an Ahi Tuna flavor by itself, we can rule out the tuna if she has a reaction to the shrimp or crab flavors.