Max - Chronic Diarrhea And Neg Tests

[maxmeezu]

Hello all,

Happy to have found this forum! Looking for any advice / comments on my cat's health. I'd love to hear if anyone has been in a similar situation and any recommendations for how to proceed, or what to talk to my vet about. Thanks in advance!

About: My cat has had chronic diarrhea since I brought him home in October - he's about 9 months now. He's otherwise healthy (sometimes mild sniffles), and seems to be growing fine. He's about 11 or 12 pounds, mainecoon breed, and came from a cattery. He's been to the vet several times but she doesn't really know what to do except recommend more extensive tests - but even she thinks many of the options are improbable causes.

Diarrhea: consistently very soft poo, comes out with a liquidy squirty sound, multiple times a day (sometimes 4-5x a day), doesn't smell great either. When he has to go, it seems rather urgent. It doesn't seem comfortable for him, and it frequently gets all over his paws and rear floof.

Treatment thus far: He's been on 3 rounds of antibiotics. It's cleared up shortly, for a few days, then it turns soft again.

Tests: He's had two fecals and a tritrichomonas test - all came back negative.

Diet: Switched food brands several times, currently he's been on a limited ingredient diet (rabbit and pea) for a couple weeks now with no improvement.

The vet said we could try the z/d hydrolyzed protein diet, do another course of antibiotics, run more extensive PCR tests (toxoplasma, clostridium, cryto, etc), deworm again, test for FIP, FELV, FIV... Costs are really adding up, yikes!

I don't know what are more likely causes, or if I should bite the bullet on my next paycheck and run everything to finally figure this out... Any advice would be much appreciated.

 

[Antonio65]

Hi and welcome!
I'd rule FIP out, because you say your cat has been having running poop for about 4 months now, and I think that if your cat had FIP you should have realized of that by now.
FIV and FeLV could also be, but a test can be done in a few minutes at any vet practice. The cost should also be on the low end of the list.

Did the fecal test look for giardia too? And how many times was the fecal test done?
A vet once told me that a single test might show negative even if the parasites do live there, because eggs or spores or whatever it is are not shedded constantly.

Have you given him any probiotic or any direct treatment for diarrhea?
I also guess that your cat could be dehydrated from the continuous diarrhea. Have you ever given him fluid to compensate for the dehydration?

Is your cat fine? Is he eating and acting normally?

 

[maxmeezu]

Hi Antonio - Thanks so much for your reply and insights.

I'll do the FIV and FeLV tests (scheduled an apt for sat) - would be good to rule them out, and I'm happy to hear they are fast and cheap. I agree about FIP - my last cat died from this in 2011 and it was not a drawn out process.

The fecal should have covered giardia - I had the fecal test done in November and again last week. The last test I mixed poo from the current day and the day before in case he wasn't shedding parasites one of the days. *Should* have covered that, but false negs are always an option, right? I think we'll try a two week course of antibiotics as well.

He was on probiotics for a while as well - he's not right now because I wanted to rule out food allergies and keep him on a limited protein diet. The vet suggested pumpkin as well, it could help but I don't think the root cause is a fiber issue since it's been so consistent and ongoing.

He's been eating and drinking well, he's extremely high energy and has gained about 5 lbs in 4 months, so I believe him to be mostly in good health otherwise. This has just been going on for far too long!

 

[Antonio65]

You did all you can do, it seems, congratulations on your commitment!

At this point I'd go for a allergy or intolerance to one or more ingredients.
Have you considered an ultrasound scan of the abdomen to see what is going on in his bowels? It could be an IBD of the lower tract.

 

[maxmeezu]

Okay, I'll keep going with tests. Will update here if / when they figure out what's going on.

Ultrasound is an option, I'll ask the vet about it.

Thanks again.

 

[duckpond]

Good luck with getting the problem solved, diarrhea can be hard to figure out the reason. Maybe try a different brand of food, if the vet oks it? Peas are very hard on one of my cats, potatoes are on another one I honestly dont have a problem with my guys and grains, other than one gains weight if the food is high carb, but thats with all carbs.

Right now i feed all my guys Dr. Elseys dry food, chicken flavor, no one has any digestive issues, and they all seem to like it. Its quite high protein and low carb, so dont let the price scare you. my guys dont eat a lot of it as it seems to fill them up, and satisfy their need for protein. This is also the first food that all 4 of my cats like

 

[maxmeezu]

Hi Duckpond - this seems like very helpful advice. I'll certainly look into the food you've recommended, that seems like a good option. Even better if the kitties love it!

He's been on the rabbit/pea diet about two weeks now with no improvement. The internet tells me that it can take 8-12 weeks on a new diet for "symptoms" to clear up, but I think they are referring mainly to skin issues in this context. I would think digestive issues would clear up sooner? Any recommendations for how to test a new diet before moving onto the next option, in terms of poo problems? I asked my vet about it today but she gave me a rather textbook "it depends" answer. Probably true, but there's a few diets I could try, and I can't feasibly spend 12 weeks on each one.

 

[kittyluv387]

I was also going to suggest giardia. It wasn't part of the routine fecal for me. I had to ask for it.

That being said my kitty Benny was similar to yours. I adopted him as an older kitten at 5 months. He had chronic diarrhea and the vet couldn't figure out why. The diarrhea would clear up with antibiotics only to return. I experimented with food and ultimately the only thing that worked was 100% raw white meat diet(chicken, turkey, rabbit, pheasant). I use primal and vital essentials.

Ps if a food is REALLY helping you'll see it within 3-5 days. I honestly saw 100% improvement with the raw food within a day.

 

[maxmeezu]

I'll ask specifically about the giardia. I can't recall if the fecal tests covered that or not, thanks for bringing that up.

Ok thanks maybe I'll do a week or so maximum on new diets before switching to the next if needed. I also really think poo issue should be directly related to the current diet... would expect it to clear up fairly soon with a more agreeable diet.

 

[epona]

Honestly one of my boys had terrible trouble with soft stools when he was younger - it wasn't watery or anything that was due to severe illness, it is just some foods that we were offering him were a bit too rich and his stools were soft. It took us a while to find a diet he was ok on - which actually *wasn't* a so-called hypoallergenic diet - rabbit, duck, and venison give him really soft stools. Turns out he does best on a diet that is mostly chicken.

If there is nothing clinically wrong with your kitty (I assume they have tested for parasites, and giardia?), and just sensitive digestion issues, it may take a little while to figure out what food he can tolerate best.

 

[kittyluv387]

Oh and i wanted to mention probiotics. You can try that too. The S. Boulardii strain is considered an emergency diarrhea stopper, and can be used for cats. I came accross this suggestion in an internet search. My cat got resolved after raw food so i didn't need to try it but you could try looking into it.

 

[maxmeezu]

Hi Epona, sounds like a similar situation. Were your cat's stools soft every time, or did it vary much from day to day? I've tried 4 different food brands and none have seemed to have any effect for better or worse - he's just consistently very soft. I'm gonna do more testing for bacterial causes and change up his diet in the meantime. I'll try more probiotics as well. Thanks for the additional suggestions.

 

[maxmeezu]

Interim update:

Still soft / liquidy stool.

Max has tested neg for just about everything (total of 3 fecals, 2 tritrich tests, and a panel of others). Edit: he did test pos for coronavirus, or one of them did, since the poo was mixed - which is extremely common.

Currently on Clavamox and probiotics but it isn't helping.

It's not diet because my second cat only lasted a couple weeks before having the same poo issue. Now I have two kitties exploding in the litter box.

Vet doesn't know what to do at this point except recommend repeat tests in case of false negatives. The price for these is really adding up.

They are also struggling with congestion, which I'm not sure is related.

Might try to find another vet for a second opinion (really like my current vet and she's been talking with an internist about Max) and / or do a second PCR panel (~$400, ouch).

I don't feel much closer to resolving this and it's getting discouraging...

 

[maggiedemi]

Is he on all dry food diet?

 

[epona]

If it's not a food sensitivity thing like I described above with Sonic...

I did have a problem a couple of years ago where my guys all got some sort of tummy bug and all had very soft stools for a few weeks - it wasn't like a major medical emergency type explosive diarrhoea and they didn't have any other symptoms indicating serious illness, but obviously needed sorting out. A few weeks on a prescription diet for gastric problems and pro-biotic supplement as instructed by our vet got them back to normal stools, but it was really worrying to have all of them affected at once. And messy.

 

[cat princesses]

I went thru a stage with one of my cats with figuring out her soft poop issues. What worked for me was giving her weekly b12 injections. You will need a RX from the vet and a RX for the syringe needles but if you google b12 for IBD or chronic diarrhea you can read more. I also mix S. Boullardi 1 capsule in baby food daily and she licks that off the spoon. I feed raw as well - I really like the Rad Cat brand. I also feed Weruva cats in the kitchen wet food. Eventually her poops firmed up and I still maintain giving the b12 shot and the S. Boullardi. I like the gerber turkey baby food ( no onions or garlic ) and I will put a small spoonful in a glass dish and heat for 5 seconds in the microwave prior to mixing in the s boullardi capsule.
I also agree with others on a possible food allergy.

 

[maxmeezu]

They're on nearly all soft food... I've switched brands several times and tried a limited ingredient diet for several weeks. And definitely not a food allergy since it was passed onto the newer cat.

I'll keep going with the probiotics and talk to the vet about some of the things mentioned here, thanks!

Curious if anyone has experienced something like this and identified a parasitic / infectious cause.

 

[maxmeezu]

Wanted to update this thread for the community - they were both treated for TF (Tritrichomonas foetus) and the diarrhea cleared up. The congestion seems to be a separate issue, probably viral. They've been doing much better for a few months now though, eating and pooping normally, and gained a bunch of weight after the treatment. The diarrhea cleared up while they were on meds and didn't come back.

I really think this problem is far more prevalent than is currently diagnosed. My cats tested neg for this 3x but the vet trusted her instincts on this (she's great, I'm so lucky). If you have a cat with chronic diarrhea, really look into this. A lot of vets won't treat without a positive diagnosis but, in my experience, the tests were very flawed. I hope this helps others out there.

 

[kittyluv387]

So what was the treatment for TF?

 

[maxmeezu]

Treatment was with ronidazole. The literature will tell you there's a fairly high chance of neurotoxicity effects, although those tend to be self-limiting. Max had very mild ataxia a few days into the treatment - the vet recommended lowering the dosage and continuing (we started out with a fairly high dose), and Meezu was fine with it. If anyone PMs me I'd be happy to connect you with my vet.