Soft unformed stool and Metronidazole

[hummys]

Hi, my boy is 12 years old and except for diabetes in remission and 2 pounds overweight, he’s healthy as far as we know. He takes Jackson Galaxy Complete Cat Probiotics every other day and 1-TDC every other day for his oral health (he had 11 teeth removed last year due to resorption and started these after surgery).

Over the past month, his stools started getting soft. Most were formed, but some softer, wetter. For the past 2 weeks, they’ve all turned pancake batter soft. We had scheduled a vet appointment, but I thought the situation was getting worse when I noticed his anus getting red and irritated (no blood). Not sure if it was from the wet stool or my rubbing (even though I thought I was gentle) or something worse. We scheduled an appointment with another vet (same office, but not his regular one) for an ASAP appointment and had our visit last Friday. They did an exam, did a proper sanitary trim, put some antifungal ointment on, and took our stool sample for testing.

In the meantime, I started him on Jarrow Saccharomyces Boulardii + MOS last Sunday. Started with ¼ capsule and raised the dosage to ½ capsule twice a day. After taking that for 2 days, his stools were mostly formed, but as the week has progressed, they are back to some formed, some unformed. I’ll mention that he’s still going his usual twice a day so it’s not diarrhea, just unformed. I’ve started to keep a diary of his foods and the corresponding movement to see if I can see a correlation with any food in particular. He eats a variety of proteins, only wet or freeze dried that are low, low carb and low fat with no fillers. I’m going to start him on only one protein for a week or so to see if that maybe helps.

Heard back from the vet today and was told that the PCR came back negative for everything. She wants to start him on a 5 day dose of Metronidazole. I’m always cautious to start him on medicines and would like to treat the issue and not just the symptoms. Apologies for the length, but any advice would be welcome.

 

[misterginja]

Hi, my boy is 12 years old and except for diabetes in remission and 2 pounds overweight, he’s healthy as far as we know. He takes Jackson Galaxy Complete Cat Probiotics every other day and 1-TDC every other day for his oral health (he had 11 teeth removed last year due to resorption and started these after surgery).

Over the past month, his stools started getting soft. Most were formed, but some softer, wetter. For the past 2 weeks, they’ve all turned pancake batter soft. We had scheduled a vet appointment, but I thought the situation was getting worse when I noticed his anus getting red and irritated (no blood). Not sure if it was from the wet stool or my rubbing (even though I thought I was gentle) or something worse. We scheduled an appointment with another vet (same office, but not his regular one) for an ASAP appointment and had our visit last Friday. They did an exam, did a proper sanitary trim, put some antifungal ointment on, and took our stool sample for testing.

In the meantime, I started him on Jarrow Saccharomyces Boulardii + MOS last Sunday. Started with ¼ capsule and raised the dosage to ½ capsule twice a day. After taking that for 2 days, his stools were mostly formed, but as the week has progressed, they are back to some formed, some unformed. I’ll mention that he’s still going his usual twice a day so it’s not diarrhea, just unformed. I’ve started to keep a diary of his foods and the corresponding movement to see if I can see a correlation with any food in particular. He eats a variety of proteins, only wet or freeze dried that are low, low carb and low fat with no fillers. I’m going to start him on only one protein for a week or so to see if that maybe helps.

Heard back from the vet today and was told that the PCR came back negative for everything. She wants to start him on a 5 day dose of Metronidazole. I’m always cautious to start him on medicines and would like to treat the issue and not just the symptoms. Apologies for the length, but any advice would be welcome.

Hi, sorry to hear your boy is having this issue. I’m also interested in what others have to say about your situation.

Just sharing that this has also recently happened with my 11 year old boy, with the exception of times being sick, his stool has always been well-formed. That is until I had to change his food to a new brand. Ever since, his poo has been too soft (not all the way over to diarrhea, but getting close, in addition to some diarrhea). I’m attributing it to the 2 new ingredients in his food, agar-agar and/or coconut oil.

Could there be an ingredient in the food your boy is eating that seems like it’s minor, but is not agreeing with his digestive system? Sometimes those plant-based fillers in the grain-free foods are the culprit, moreso than what the main protein is. Companies have been adding some strange ingredients to the canned foods. I agree with you to treat the issue rather than constantly the symptoms!

 

[FeebysOwner]

Hi! I think your idea of restricting his food intake to a specific protein is a good place to start. Sometimes, cats can develop an intolerance to food that they have been used to eating. I would also recommend you chart the ingredients in all of the foods you are feeding him to look for other possible sources having to do with ingredients above and beyond the proteins - they may not be the issue, but other ingredients might be. The thing with using only a specific food to rule out others as a probable cause is that it can take longer than just a few days, sometimes even weeks for that to sort itself out, so patience and fortitude are you best advocates here.

If you do choose to try the Metronidazole, keep up with the s.boulardii. It is one of the few probiotics that are not rendered less effective with an antibiotic, which is what Metro is.

 

[hummys]

Thank you both. Appreciate the suggestions. I just started a spreadsheet to keep track of all of the ingredients, not just the protein. I try not to give him anything with agar-agar, but because I keep him restricted due to his diabetes, I sometimes let him cheat with something really tasty if his blood glucose levels are good. Unfortunately, the foods he thinks are really tasty have some ingredients I’d prefer him not to have. I’ve thought about a raw diet. I tried it once and he didn’t want anything to do with it. Probably my fault because I didn’t introduce it properly. Not sure what to do about the metronidazole.

 

[FeebysOwner]

I guess, if I were you, I'd ask the vet what they hope to accomplish with the Metro, given the results of the fecal PCR. Is it a shot in the dark, so to speak? Of course, depending on what all was tested with the PCR, there could have been bacteria that was missed. Maybe more dialog with the vet will tell you whether or not to proceed with the Metro or go another direction with the food changes.

I take it he had a full senior blood work and urinalysis too?

 

[hummys]

Our vet said that the first vet ran a comprehensive PCR, more than they usually test for... according to her. I have the report and they tested for 22 parasites, all not detected. She definitely recommended starting the Metro and definitely as a shot in the dark (my words not hers). She said that usually that clears "it" up and that sometimes once cats are on this for a short 5 day course, that's all it takes. Of course, I said I would think that depends on the cause. So she suggests trying the Metro first and then trying to limit food changes. But, she was only talking about the protein. She also didn't agree with me giving him the s.boulardi because she said she doesn't like dosing animals with human supplements. I explained what it was and that I wasn't giving him the people dose, but rather a dose appropriate for cats. She wasn't familar with s.boulardii and wrote it down so she could look it up.

They did not do blood work or urinalysis. This was what they considered an emergency appointment before a holiday weekend. They were going to look at his rear and do the fecal test only. They suggested that we come back for the blood work at a regular appointment depending on the outcome of the fecal test. The vet that we were able to see for that appointment on a Friday (who said that she would call us during the week when the results were in) was no longer working at this practice 6 days later. We actually received a call from the front desk giving us the test results. She said "I'm sure you were told that today is Dr.'s last day here". We were not told. Front desk person told me that the vet said she would give us Metro if I wanted. If I wanted? When I said that I didn't want to drug him unless I know what I'm drugging him for, she started talking about an ultrasound. Yikes! Have all respect for the front desk staff, but I want to discuss my cat's health with his vet directly. I'm pretty sure that this all would have been handled better had his regular vet been there for the initial appointment. But, I was so happy to have someone look at him since he was so irritated that I took the appointment.

 

[daftcat75]

This is something of a controversial opinion and probably not very popular yet. But I believe there is a link between oral health and gut health and that many tooth resorption cats may also go on to have digestive issues too.

I really don't like metro because...

a. It is going to kill good bacteria with the bad.
b. There are gaps in what metro is effective against.
c. Metro will allow bad actors to flourish in the absence of competition caused by a. and b. In oversimplified example, if metro is effective against three of four strains in your cat's gut, the fourth strain will survive and thrive in the absence of the other three. Obviously there are much more than four strains in your cat's gut. But when some competition is eliminated, survivors whether they are good or bad actors will have more resources to grow their numbers. Because of metro's gaps, some bad actors will strengthen their numbers.

I know some vets prescribe metro because it has an anti-inflammatory effect. But so does s. boulardii. And so does steroids. I'd rather try steroids before metro. But I'd also want to do more testing first to rule out anything else that can be ruled out.

You could do an ultrasound. At this point, for how long he's had soft stools, it's probably going to show inflammation. An ultrasound isn't a bad idea anyway to rule out other concerns. Assuming nothing else was found in bloodwork or ultrasound, it would be at this point where you would probably get the dubious diagnosis of "likely IBD or lymphoma".

If he's currently maintaining his weight and his eating and drinking are otherwise fine, I would give the s. boulardii a chance and I would also have a look at both the protein and non-protein components (the carbs e.g. gums, grains, and starches) in his food. If you can do a novel protein diet especially with a clean recipe like Rawz or Mouser, I would try that before metro or steroids (the usual starting point for treating IBD/lymphoma.)

I would also recommend Rawz single protein pates or Mouser which are not single protein. But mouse is about as ideal a protein you can get for a cat. I also consider that a novel protein. Unless your guy is an avid outdoor hunter, he's probably not eaten many mice. What I like about both Rawz pates (not so much the shreds) and Mouser is that they avoid nonsense carbs and gums. Mouser uses tomato paste and Rawz uses fenugreek seeds. But those don't tend to give cats grief like many of the other gums in foods. If you currently feed foods with carrageenan, agar agar, or xanthan gum, those would be foods I would try to replace. The first two are known irritants and the third has been implicated in soft stools in both cats and people. Despite it's foreboding name, guar gum is probably the most benign gum. I would choose that one over any of the others every time.

If you're in the US, Incredible Pets sells both Mouser and Rawz by the can. You can run a few flavors past your guy without committing to whole cases.
Search: 10 results found for "mouser" - Incredible Pets

I would keep giving him the s. boulardii. You can give that to him at the maintenance dose for the rest of his life if he likes or even tolerates the stuff. My Betty doesn't like the taste. But she's a pro at taking capsules. Once a month I repack about 10 Jarrow human (size 0 or 00) capsules into 50 cat (size 4) capsules. She lovingly and willingly takes two a day along with her other meds.

 

[heatherwillard0614]

Over the past month, his stools started getting soft. Most were formed, but some softer, wetter. For the past 2 weeks, they’ve all turned pancake batter soft. We had scheduled a vet appointment, but I thought the situation was getting worse when I noticed his anus getting red and irritated (no blood).

Hello this is all going to sound a little strange and I don't know if this is a possibility just popped in my head reading this.
I know when my child was in diapers he had a stint of diarrhea and his little butt was red and irritated started blistering... This was due to the acid in the stool because it was way too liquidy even changing him as soon as he went. I talked to his pediatrician and she had me buy a liquid antacid that u or I would drink use a cotton ball and dabbed his behind let it dry then put diaper on. It literally cleared up over night.
Idk if you can do this with an animal I would ask your vet if you can do this with the antacid if he is really irritated.. but like i said that was the first thing that popped up in my head lol sorry I don't have any info regarding your original questions and concerns. I hope he gets to feeling better soon.

 

[hummys]

Thank you! I did a lot or research switching his food around with the diabetes, but never heard of Rawz or Mouser. Doing a quick search, there’s a shop not too far from my house (we’re in New Jersey) that carries Rawz pates. I’ll stop by in the morning and pick up a few to see if my fussy boy will eat it. And then I’ll try that and keep up with the s. boulardii. So far, he doesn’t mind it in his food. He’s eating, drinking, and maintaining his weight as normal.

 

[Margot Lane]

Keep us posted, this is a very helpful thread. I keep my cat’s poops firm with a dab of pumpkin. (Tiki Cat’s tummy topper, but not too much). Some cat foods have the pumpkin mixed in, which is great!

 

[daftcat75]

Keep us posted, this is a very helpful thread. I keep my cat’s poops firm with a dab of pumpkin. (Tiki Cat’s tummy topper, but not too much). Some cat foods have the pumpkin mixed in, which is great!

Rawz makes a rabbit with pumpkin pate. Interestingly Krista didn’t care much for pumpkin added. But she liked that rabbit and pumpkin pate.

 

[hummys]

Didn’t realize that it’s been so long since I updated. Things are better, but not totally. Over the past 3+ weeks, I’ve given him S. Boulardii every day - ½ capsule, twice daily. That’s helped somewhat. His stools got firmer and somewhat formed. They went from pancake batter to formed, but very soft. Then he would go from wet formed back to pancake batter. I tried stopping the S. Boulardii for a few days and then starting it again. No difference really. Better with it, but not consistent. I decided to start him on the Metro pills. At least that’s what I thought. He wasn’t having any of it. Spit the pill out no matter how small or how I tried to hide it. Then tried the liquid Metro, chicken flavored. Again, wouldn’t eat, even small doses. He’s diabetic in remission and I’m very careful about his food selection. But I’ve tried favorite foods, forbidden foods and various edible strategies all with no luck.

I’ve been keeping a diary of the foods he’s eating (along with a BM diary). For the most part, switched him to Rawz pates with some Instinct limited ingredients pate and Koha pates. The last two aren’t as clean as Rawz, but they have limited additives. He also gets a nugget of Primal freeze dried as a snack before bedtime. I’ve kept the proteins to chicken, turkey, duck and rabbit. Perhaps that’s not limited enough and I should try sticking to one protein? Or the Rawz only?

For the past 4-5 days, he’s had wet, but mostly formed stools. And then yesterday back to pancake batter. Not as loose as before, thicker, but batter. Today, not as bad, somewhat formed. If this is coming from food, I really can’t tell which one. I set up my spreadsheet differently yesterday with more details about ingredients to see if I can narrow it down more.

He’s still acting normal, happy as can be - eating, playing. But surely this can’t be comfortable for him and worrisome for me that it’s something serious. We are scheduled to go to the vet on Wednesday for blood work and urinalysis. Wondering if you have any additional suggestions? Is there is something in particular that I should be sure he’s tested or checked for? Welcome any advice. Apologies for the long post, but wanted to give as much detail as possible. Thanks so much.

 

[daftcat75]

Didn’t realize that it’s been so long since I updated. Things are better, but not totally. Over the past 3+ weeks, I’ve given him S. Boulardii every day - ½ capsule, twice daily. That’s helped somewhat. His stools got firmer and somewhat formed. They went from pancake batter to formed, but very soft. Then he would go from wet formed back to pancake batter. I tried stopping the S. Boulardii for a few days and then starting it again. No difference really. Better with it, but not consistent. I decided to start him on the Metro pills. At least that’s what I thought. He wasn’t having any of it. Spit the pill out no matter how small or how I tried to hide it. Then tried the liquid Metro, chicken flavored. Again, wouldn’t eat, even small doses. He’s diabetic in remission and I’m very careful about his food selection. But I’ve tried favorite foods, forbidden foods and various edible strategies all with no luck.

I’ve been keeping a diary of the foods he’s eating (along with a BM diary). For the most part, switched him to Rawz pates with some Instinct limited ingredients pate and Koha pates. The last two aren’t as clean as Rawz, but they have limited additives. He also gets a nugget of Primal freeze dried as a snack before bedtime. I’ve kept the proteins to chicken, turkey, duck and rabbit. Perhaps that’s not limited enough and I should try sticking to one protein? Or the Rawz only?

For the past 4-5 days, he’s had wet, but mostly formed stools. And then yesterday back to pancake batter. Not as loose as before, thicker, but batter. Today, not as bad, somewhat formed. If this is coming from food, I really can’t tell which one. I set up my spreadsheet differently yesterday with more details about ingredients to see if I can narrow it down more.

He’s still acting normal, happy as can be - eating, playing. But surely this can’t be comfortable for him and worrisome for me that it’s something serious. We are scheduled to go to the vet on Wednesday for blood work and urinalysis. Wondering if you have any additional suggestions? Is there is something in particular that I should be sure he’s tested or checked for? Welcome any advice. Apologies for the long post, but wanted to give as much detail as possible. Thanks so much.

The idea behind limited ingredient diet is to limit the universe of ingredients so that you can more easily play detective. Feeding him four brands and four proteins is not a limited diet. Choose one brand and one protein. I recommend Rawz rabbit. Give it at least a month. Some sites say you need to give it up to thirteen weeks. But you'll know if it's just not working. If you are giving him treats, find a single ingredient meat treat in the same protein. So if you went with rabbit, find a freeze-dried rabbit meat treat. Sometimes you have to go into the dog section to find these. But as long as the protein is the only ingredient, it doesn't matter if it was in the dog or cat section. Rabbit is rabbit. I recommend Rawz because, in my experience, both Instinct and Koha include more problematic ingredients such as an extra plant protein or starch, or a problematic gum. Rawz, in my opinion, is really the gold standard for a clean recipe. Mouser is a newcomer that also has a clean recipe. The inclusion of mouse meat in every recipe does make it a little less limited. But unless your cat is a former feral, a barn cat, or an active hunter, mouse is probably a novel protein for him. You could try Mouser in the rabbit and mouse variety. But one at a time. Rawz or Mouser. Don't try to feed both (or another brand or another protein) until you have at least one good food. You have given that good food a long enough trial and determined it is working for him. Then you can try to add another food. If poop goes back to batter or worse, you can reasonably conclude that the new food is not a good food for him. Then, because you have a good food, you can ask, was it the brand or the protein? When you decide to try a new food, it should be in the same protein as the good food, or it should be in the same brand. That way you won't be left trying to solve for both variables at the same time. If your guy absolutely will not eat the same single food and needs more variety than that, I would stick to one brand but try one or two more proteins (as few as you can get away with.) This way you are only adding one or two more ingredients (the different proteins) to his ingredients universe rather than the whole basket of additives and nonsense that comes with another brand.

 

[hummys]

Had no clue where to start. So helpful and easy to follow. Thanks so much.