Still has chronic diarrhea after treatment

[F+V]

Yes, and I'm wondering how does a cat get C. Perf.??? He was on Tylan for over two weeks and still had diarrhea... sometimes watery. :-( His regular vet was on vacation so the partner vet prescribed Metronidazole and Endosorb. He had a couple of almost normal stools but had soft piles of diarrhea in between. Nothing seems to stop the diarrhea. :-( There are only 2 pills of Metronidazole left so he has been on it since 8/21. Oh no, I just looked on the label and it said to give it twice a day! I messed up! Checked my log book and I started out giving it twice a day but then ended up only once a day. I think I know why that happened... I read that you had to give it separate from other meds by 2 to 4 hrs. because of a possible interaction. I wrote the times down and forgot that it was to be giving twice a day. Maybe that's why it didn't stop the diarrhea. I'm old and forgetful... I thought I had been doing a good job but not this. :-(

A cat could contract C. Perf through several routes. This site summarizes it. Cats can become infected by contaminated food or water, through feces of infeced animals, coming into contact with source of environments outdoors, or having weakened immune systems or pre-existing gastrointestinal issues.

If your vet is certain that Jengo's diarrhea is caused only by C. Perf, a proper use of antibiotics should get rid of it and his diarrhea should stop once you discontinue the meds. You will need another fecal exam to see if meds have led to resolution. If it's caused by something else, IBD for example, you will need to focus on IBD treatment. Prolonged and incorrect use of antibiotics are dangerous. I made a similar mistake with my boy's antibiotic too. Instruction was to give 2 pills daily for 5 days but each pill was neatly split in two, so I was counting one pill as two for the first few days... Jengo has been on antibiotics for a while now, so it's time to test his feces again.

You are right. Certain drugs have possible interactions, but your vet should know. I always do my research before giving new medicine to find out more about interactions, intervals, side effects, etc.

 

[Sillycat41]

A cat could contract C. Perf through several routes. This site summarizes it. Cats can become infected by contaminated food or water, through feces of infeced animals, coming into contact with source of environments outdoors, or having weakened immune systems or pre-existing gastrointestinal issues.

If your vet is certain that Jengo's diarrhea is caused only by C. Perf, a proper use of antibiotics should get rid of it and his diarrhea should stop once you discontinue the meds. You will need another fecal exam to see if meds have led to resolution. If it's caused by something else, IBD for example, you will need to focus on IBD treatment. Prolonged and incorrect use of antibiotics are dangerous. I made a similar mistake with my boy's antibiotic too. Instruction was to give 2 pills daily for 5 days but each pill was neatly split in two, so I was counting one pill as two for the first few days... Jengo has been on antibiotics for a while now, so it's time to test his feces again.

You are right. Certain drugs have possible interactions, but your vet should know. I always do my research before giving new medicine to find out more about interactions, intervals, side effects, etc.

Thanks for your comments. Don't think Jengo had access to any contaminated food or water. Since he's an indoor only cat, I often wonder if we could be tracking something in on our shoes... like animal feces... ie squirrel, chipmunk, etc. I put dates on open cans of food that I refrigerate so I don't keep them too long. Maybe it is from his IBD problem although it's been under control for a long time.

The testing the vet did confirmed C. Pref. ($200)... took Tylosin for 2+ weeks and just finished the Metronidazole but he still has loose stools with lumps even today. :-( Had an almost normal stool yesterday though. You said "... his diarrhea should stop once you discontinue the meds." Hope this is true. Another $200 test will... ugh. My savings are draining fast. :-(

I read that a bland diet can help so I've occasionally been feeding him Gerber's chicken with Taurine added.

I always look up drug interaction before I give him (or myself) any meds. Found that the Metronidazole and Budesonide shouldn't be taken together. The vet who prescribed the Metronidazole didn't say anything about taking them separately. We really have to do our own research!! Anyway, that's part of the reason I messed up on the twice a day dosing... tried to separate these two drugs by several hours. Like you, I always read about side effects too. Thanks again.

 

[F+V]

Thanks for your comments. Don't think Jengo had access to any contaminated food or water. Since he's an indoor only cat, I often wonder if we could be tracking something in on our shoes... like animal feces... ie squirrel, chipmunk, etc. I put dates on open cans of food that I refrigerate so I don't keep them too long. Maybe it is from his IBD problem although it's been under control for a long time.

The testing the vet did confirmed C. Pref. ($200)... took Tylosin for 2+ weeks and just finished the Metronidazole but he still has loose stools with lumps even today. :-( Had an almost normal stool yesterday though. You said "... his diarrhea should stop once you discontinue the meds." Hope this is true. Another $200 test will... ugh. My savings are draining fast. :-(

I read that a bland diet can help so I've occasionally been feeding him Gerber's chicken with Taurine added.

I always look up drug interaction before I give him (or myself) any meds. Found that the Metronidazole and Budesonide shouldn't be taken together. The vet who prescribed the Metronidazole didn't say anything about taking them separately. We really have to do our own research!! Anyway, that's part of the reason I messed up on the twice a day dosing... tried to separate these two drugs by several hours. Like you, I always read about side effects too. Thanks again.

That's fantastic news that his stool was almost normal!
The fecal test is pricey but hopefully the results will show Tylosin and Metronidazole got rid of C. Perf and that was indeed causing diarrhea. Even if it's still there, a colony forming unit should have come down if meds were effective.

I've learned that we can't blindly trust vets. The antibiotic they prescribed was to give twice a day, a minimum of 10 hours apart but they didn't tell me that. Maybe it's not that big of a deal but still... Also Baytril is known to potentially cause blindness in cats but I was told it would be prescribed to treat either C. Perf or Campylobacter jejuni.

 

[Sillycat41]

That's fantastic news that his stool was almost normal!
The fecal test is pricey but hopefully the results will show Tylosin and Metronidazole got rid of C. Perf and that was indeed causing diarrhea. Even if it's still there, a colony forming unit should have come down if meds were effective.

I've learned that we can't blindly trust vets. The antibiotic they prescribed was to give twice a day, a minimum of 10 hours apart but they didn't tell me that. Maybe it's not that big of a deal but still... Also Baytril is known to potentially cause blindness in cats but I was told it would be prescribed to treat either C. Perf or Campylobacter jejuni.

Still it makes me nervous that he has soft stools in between almost normal ones. I'm so afraid the diarrhea will start up again now that he has had the last Metronidazole... especially since I messed up and wasn't giving it twice a day. :-( Guess I'll find out in the next couple of days. I think I'll continue giving him the S. Boulardii though... many on the cat forums say that alone worked for their cat's diarrhea.
Hopefully my vet will get back to me today... he was off yesterday. I emailed him about not giving the meds correctly... will see what he says to do next.

I agree... we can't blindly trust the vets... they make mistakes too. I would also be very hesitant to give Baytril if blindness is a possible side effect!! All meds have side effects so we have to weigh the pros and cons, but blindness isn't one I would take a chance with.

Thanks for corresponding. Barb

 

[F+V]

Please keep up updated

 

[Sillycat41]

Please keep up updated

The vet responded to my email yesterday and said that we have to give Jengo around round of Metronidazole. I asked him 3 questions and he only answered one. It's so frustrating when the vet doesn't take the time to answer and I have to ask again. Wish I could find another vet but there is a shortage in our city and none of the others are taking on new clients. :-(

I was up half the night worrying about Jengo as he seems so weak. He was a bit perkier this morning and ate a lot for breakfast. I'm so afraid that his life is being cut short because of lack of proper care. I have 15 tabs open on my computer with articles to read. I keep searching for answers but feel like I'm spinning my wheels and time is running out. My heart is breaking. :-(

 

[FeebysOwner]

I'm so afraid that his life is being cut short because of lack of proper care.

Be careful with feeling this way, for all the obvious reasons. There have been missteps along the way by all involved, including you. It is natural for people to make mistakes and not be perfect, even vets. I know you have only tried to do the best you can for Jengo. And, with all that I have read in your thread, I don't believe the vet has done anything that would suggest they weren't doing what they thought best. All the information about side effects with medications is a given and applies to most, if not all, of them. There would be no meds administered at all if side effects were used as the only gauge in giving them.

You are spinning your wheels in a manner of speaking - you are driving yourself crazy with all the information you have acquired, much of which may not even be applicable. All of this has only served to make things more confusing for you and let frustration, worry, and anxiety consume you. You said you have no other vets available, so try to trust this one and continue to work with them to let them try to help Jengo.

I am not saying any of this as chastisement - but rather as someone who is concerned about Jengo's and your welfare. The calmer and more in control you are of your emotions, the better for both Jengo and you. I wish nothing but the best for both of you.

 

[F+V]

The vet responded to my email yesterday and said that we have to give Jengo around round of Metronidazole. I asked him 3 questions and he only answered one. It's so frustrating when the vet doesn't take the time to answer and I have to ask again. Wish I could find another vet but there is a shortage in our city and none of the others are taking on new clients. :-(

I was up half the night worrying about Jengo as he seems so weak. He was a bit perkier this morning and ate a lot for breakfast. I'm so afraid that his life is being cut short because of lack of proper care. I have 15 tabs open on my computer with articles to read. I keep searching for answers but feel like I'm spinning my wheels and time is running out. My heart is breaking. :-(

I wonder why your vet still wants to give him Metronidazole without retesting his stool for bacteria or ultrasound. Has his diarrhea stopped/improved after he ran out of Metronidazole? It may take up to a week to see if the condition subsides. In the past vets would often prescribe Metronidazole in a blanket manner to stop diarrhea, but nowadays Tylosin or Enrofloxacin (baytril) are used, and we know that the use of antibiotics will cause dysbiosis. It's been known that taking Tylosin or Metrodiazole for 14 days cause dysbiosis and even 56 days after stopping Tylosin an imbalance in the microbiota was still present according to some studies by Pilla et al., 2020, Cerquetella et al., 2020. I can't find articles now... Why don't you give kittybiome's gut health test a try?

I didn't realize vets were so busy they had to turn down new patients! I know you have trust issues with the other vet who misdiagnosed his heart disease but might be worth getting a second opinion. In my opinion vets or any professionals who can't address all the questions are not very reliable... You can also make an appointment with him and go talk to him in person by yourself to get answers.

I've been there myself, worrying about my cats all day & night and gathering all the information I could possibly find. But what makes you think that he's getting weak day by day? From what you told us, he hasn't lost much weight, hasn't lost appetite, hasn't puked?

 

[silent meowlook]

Hi. I am sorry your senior kitty is having these problems.
It sounds like, from what you describe, that your cat isn’t getting his medical issues addressed by your vets in a timely manner or with the seriousness this deserves. Unless i misunderstood.
I will say, that some veterinarians look at an 18 year old cat and don’t see much in the way of a future. This is not a good way to think for your cat, but it is because some vets lack the specialized knowledge and training needed to care for senior cats. I don’t know if this is the case or not.
All cats with kidney disease should have their blood pressure checked. It should be done in the exam room with you there using a Doppler snd head phones. Several readings should be taken. A cat with normal blood pressure may have a slight increase due to the stress of the visit. A blood pressure of 140 could be seen from stress, so you usually wouldn’t treat. But a blood pressure of 180, well that was high to begin with, so you would treat.
Refractory IBD, that isn’t responding to treatment with steroids often needs the steroids increased or to have an additional medication added like Chlorambucil. Chlorambucil is a chemotherapy drug that comes in pill form and can be used to treat not just small cell lymphoma of the intestines, but also IBD that isn’t responding to standard steroid treatment.

It sounds like you are already giving vitamin b12 injections, so that is good. It also sounds like you ran a GI panel at some point. Also good information there.

The bacteria that has overgrown in the intestines can be caused by many things including a weak immune system, diet changes resulting in changes to the natural gut flora.

Some people do swear by probiotics and or prebiotics. Honestly, for my cats and the cats I have worked with, it didn’t seem to help.

The bacteria he has, C.Perf is helped by a high fiber diet. That is great, but then you have to remember that most cases of IBD seem to originate from inflammation due to an allergic response often to a protein, but it could be another substance in the food. Now, you can try the prescription limited antigen novel protein diet like the Royal Canin canned Rabbit,Venison, or Duck. But also it is far more important he eat something instead of nothing. So you can only do what you can and he must eat to live.

I know it’s enough yo make your head explode.

Metronidazole is a good GI antibiotic. It also treats the strain of bacteria that your cat has an overgrowth of. That being said, all medications do have potential side effects and it is best given after food. My cat has been on it for a year, but only once a day.

If you are using a phosphate binder, it should be applied to every meal in order to bind the phosphate in each feeding.

SQ fluids are very good to use at home as long as you make sure the previous fluids are absorbed before giving more.

Kidney disease progresses sadly. So, if the creatinine and BUN are climbing, it isn’t unexpected and maybe the disease process as opposed to the medication.

You can read so much information online it will make your head spin. But the bottom line is that you aren’t a veterinarian and don’t have the education and experience to figure this all out. Even most regular veterinarians don’t. Geriatric cats with multiple disease processes are hard. And that is where often you can save yourself, and your cat allot of time by seeing a specialist. You should be able to ask your vet for a referral. If one isn’t available in your area, look for a feline only veterinarian. If none, at least try to
get another opinion.

I wish you and your cat only the best and hope everything going on becomes manageable soon.

 

[Sillycat41]

Be careful with feeling this way, for all the obvious reasons. There have been missteps along the way by all involved, including you. It is natural for people to make mistakes and not be perfect, even vets. I know you have only tried to do the best you can for Jengo. And, with all that I have read in your thread, I don't believe the vet has done anything that would suggest they weren't doing what they thought best. All the information about side effects with medications is a given and applies to most, if not all, of them. There would be no meds administered at all if side effects were used as the only gauge in giving them.

You are spinning your wheels in a manner of speaking - you are driving yourself crazy with all the information you have acquired, much of which may not even be applicable. All of this has only served to make things more confusing for you and let frustration, worry, and anxiety consume you. You said you have no other vets available, so try to trust this one and continue to work with them to let them try to help Jengo.

I am not saying any of this as chastisement - but rather as someone who is concerned about Jengo's and your welfare. The calmer and more in control you are of your emotions, the better for both Jengo and you. I wish nothing but the best for both of you.

I can't help it... it's my personality. :-( I've always been disorganized and a procrastinator so I have to take much of the blame. I'll be 80 in Jan. and I don't think I can change now. I just get so frustrated with my vet... he's very slow at answering. I know that he is very busy, but some health issue can't wait. I'm afraid that I'm going to lose Jengo because of not getting him the help he needs soon enough.

I wrote to the vet on Sept. 2 and he didn't respond for two days and then only answered one of my 3 questions. He said that we have to do another rounds of antibiotics because Jengo still has watery diarrhea, but he didn't okay the Chewy prescription yet. In the meantime Jengo doesn't feel well from the upset intestines.

I know what you mean about that no meds would be administered if we were afraid of the side effects. We have to take a chance but it is worrisome.

I have so many stacks of articles that I printed out, web site articles that I've read, and comments from people on the cat forums that I am overwhelmed!! I keep hoping to find a way to "fix" the problem. Yes, I'm confused, frustrated and anxious all the time. I've wasted so much money buying products that someone swears helped their cats and then reading that the products is useless.

Thanks for your concern and thoughts. I appreciate it. I feel so alone in this battle to keep my best friend alive and comfortable in his final days.

 

[FeebysOwner]

I wrote to the vet on Sept. 2 and he didn't respond for two days and then only answered one of my 3 questions. He said that we have to do another rounds of antibiotics because Jengo still has watery diarrhea, but he didn't okay the Chewy prescription yet. In the meantime Jengo doesn't feel well from the upset intestines.

I ordered meds through Chewy and let them reach out to the vet. But, I also called the vet and told them to expect a request from Chewy. If your vet has associates or perhaps even one of the office folks can push the prescription through, especially when they check Jengo's records and see he has gotten the med before. I think it helped me get the prescription OK'd back to Chewy.

I understand what you are saying. I just wanted to give you some reassurance that while it is OK to worry, you have to take some time to just breathe and relax a little from time to time.

 

[Sillycat41]

I wonder why your vet still wants to give him Metronidazole without retesting his stool for bacteria or ultrasound. Has his diarrhea stopped/improved after he ran out of Metronidazole? It may take up to a week to see if the condition subsides. In the past vets would often prescribe Metronidazole in a blanket manner to stop diarrhea, but nowadays Tylosin or Enrofloxacin (baytril) are used, and we know that the use of antibiotics will cause dysbiosis. It's been known that taking Tylosin or Metrodiazole for 14 days cause dysbiosis and even 56 days after stopping Tylosin an imbalance in the microbiota was still present according to some studies by Pilla et al., 2020, Cerquetella et al., 2020. I can't find articles now... Why don't you give kittybiome's gut health test a try?

I didn't realize vets were so busy they had to turn down new patients! I know you have trust issues with the other vet who misdiagnosed his heart disease but might be worth getting a second opinion. In my opinion vets or any professionals who can't address all the questions are not very reliable... You can also make an appointment with him and go talk to him in person by yourself to get answers.

I've been there myself, worrying about my cats all day & night and gathering all the information I could possibly find. But what makes you think that he's getting weak day by day? From what you told us, he hasn't lost much weight, hasn't lost appetite, hasn't puked?

I think the reason the vet wants to give him Metronidazole again is because I messed up the dosage schedule. I started out giving him 2 a day as instructed but since I had to space them out because of a possible drug interaction, I ended up only giving it only once a day. I didn't catch me mistake until after a week. The vet probably wants him on the recommended dose for two weeks. :-(

The diarrhea has been going on for over 2 1/2 months. Jengo was on Tylosin for a couple of weeks but it didn't seem to help so the vet switched to Metronidazole. I asked about doing an ultra-sound but he put it off for now.

To answer your question: no, I haven't noticed any change in his stools. Sometimes they are formed with a little soft, other times they are very soft with lumps, and sometimes watery with lumps. It's been a week since we ran out of Metronidazole so I guess it hasn't subsided.

I am not familiar with the term "in a blanket manner"??? As for dysbiosis... I am worried about the long use of anti-biotics. I'm sure that intestinal biomes are all out of wack by now. I am going to try that kittybiome test. Don't know why the vets don't suggest that???

Yes, in our small city there is a shortage of vets and if you aren't established with one you are out of luck. The nearest emergency vet clinic is 185 miles away. :-( There were 4 vets in the clinic I have been going to for 30 years. The youngest vet moved away and one of the older partners is semi-retired. That puts a lot of pressure on the two regulars left. Just to get an appt. for a regular wellness checkup takes months! The vet who misdiagnosed his heart is very young... in her early 30s so not much experience compared to my older vet who is 69 yrs old. I'm going to call around on Monday and see if I can get a second opinion from a new vet.

I think he is getting weaker becasue he weaves and wobbles when he walks. He can't jump very high any more either so I worry about him falling. Had to block the stairs so he won't try to climb up and down. I spent yesterday taping boxes together to make more steps to his favorite resting places. His appetite is still pretty good... he begs for food when he's hungry but he doesn't eat much at one time. I syringe feed him a couple of times a day to make sure he gets enough.

In May he weighed 8.6# and now he's down to 8.2# and very skinny. I think that having diarrhea for such a long time that he wasn't getting enough nutrition. I looked for supplements online to maybe put some weight on him, but didn't order them because the first ingredient was corn syrup!! I'm trying to give him extra meals instead but so far no weight gain. :-(

He does vomit occasionally... maybe once a week and it's usually clear foam. He gets Ondransetron twice a day but if he goes too long between meals... more than 4 hrs. he tends to vomit. I try to feed him every 3 hrs... even during the night.

Sorry this got so long. I do appreciate your comments. Thanks again.

 

[Sillycat41]

Hi. I am sorry your senior kitty is having these problems.
It sounds like, from what you describe, that your cat isn’t getting his medical issues addressed by your vets in a timely manner or with the seriousness this deserves. Unless i misunderstood.
I will say, that some veterinarians look at an 18 year old cat and don’t see much in the way of a future. This is not a good way to think for your cat, but it is because some vets lack the specialized knowledge and training needed to care for senior cats. I don’t know if this is the case or not.
All cats with kidney disease should have their blood pressure checked. It should be done in the exam room with you there using a Doppler snd head phones. Several readings should be taken. A cat with normal blood pressure may have a slight increase due to the stress of the visit. A blood pressure of 140 could be seen from stress, so you usually wouldn’t treat. But a blood pressure of 180, well that was high to begin with, so you would treat.
Refractory IBD, that isn’t responding to treatment with steroids often needs the steroids increased or to have an additional medication added like Chlorambucil. Chlorambucil is a chemotherapy drug that comes in pill form and can be used to treat not just small cell lymphoma of the intestines, but also IBD that isn’t responding to standard steroid treatment.

It sounds like you are already giving vitamin b12 injections, so that is good. It also sounds like you ran a GI panel at some point. Also good information there.

The bacteria that has overgrown in the intestines can be caused by many things including a weak immune system, diet changes resulting in changes to the natural gut flora.

Some people do swear by probiotics and or prebiotics. Honestly, for my cats and the cats I have worked with, it didn’t seem to help.

The bacteria he has, C.Perf is helped by a high fiber diet. That is great, but then you have to remember that most cases of IBD seem to originate from inflammation due to an allergic response often to a protein, but it could be another substance in the food. Now, you can try the prescription limited antigen novel protein diet like the Royal Canin canned Rabbit,Venison, or Duck. But also it is far more important he eat something instead of nothing. So you can only do what you can and he must eat to live.

I know it’s enough yo make your head explode.

Metronidazole is a good GI antibiotic. It also treats the strain of bacteria that your cat has an overgrowth of. That being said, all medications do have potential side effects and it is best given after food. My cat has been on it for a year, but only once a day.

If you are using a phosphate binder, it should be applied to every meal in order to bind the phosphate in each feeding.

SQ fluids are very good to use at home as long as you make sure the previous fluids are absorbed before giving more.

Kidney disease progresses sadly. So, if the creatinine and BUN are climbing, it isn’t unexpected and maybe the disease process as opposed to the medication.

You can read so much information online it will make your head spin. But the bottom line is that you aren’t a veterinarian and don’t have the education and experience to figure this all out. Even most regular veterinarians don’t. Geriatric cats with multiple disease processes are hard. And that is where often you can save yourself, and your cat allot of time by seeing a specialist. You should be able to ask your vet for a referral. If one isn’t available in your area, look for a feline only veterinarian. If none, at least try to
get another opinion.

I wish you and your cat only the best and hope everything going on becomes manageable soon.

Thanks for your comments. You are right... I'm getting the same impression... that the vet has pretty much written him off because of all his health problems. I get more positive info from online cat forums. He doesn't say anything about how bad things are, but when he was on vacation the other vet made a comment that Jengo's kidney numbers were not good. I don't think they want to put any time and effort into prolonging a cat's life when he's 18 yrs old. :-( The pet owner is the one who values the cat's life... the vet just wants to do routine things.

I have asked both vet's that I'm been too about checking his blood pressure... several times... but they say it wouldn't be an accurate reading. I know that high blood pressure with kidney disease is a problem because my late brother died of kidney failure. I wish the blood pressure monitors for pets didn't cost so much. I'll have to call around on Monday and see if another vet will accept a new client. I need answers now!

Jengo was on Prednisolone for years... various doses down to a low dose every other day. He seems to do okay on it but when this episode of chronic diarrhea started and had red blood in it, the vet increased the dose for a week. Then he decided to switch to Budesonide instead of Pred. ??? There hasn't been any blood in his stools lately so I asked if we could reduce the dose but haven't gotten a response from the vet yet.
I don't know what the term "refractory IBD" means. ?? What do you mean about him not responding to the steroids? Is that just about vomiting? Or is the IBD the cause of the chronic diarrhea?

I have been giving Jengo probiotics... the Proviable that the vet recommended and I also tried Jarrow S. Boulardii MOS that some onine say successfully treated their cats diarrhea. I can't tell if it's helping or not because he still has some diarrhea in between almost normal stools.

I have been adding psyllium to his meals for added fiber. He seems stable for a long time on the foods I feed him but maybe I should try novel proteins again. The trouble is I will have to syringe feed him because he doesn't like the taste of the ones I've tried in the past. He refuses to eat prescription diet no matter how gradual I add it in. I'll have to try again with some novel proteins.

What dose of Metronidazole has your cat been on for a year? Yes, I put Phos-Bind in each of his meals that aren't low phosphorus ones. Someone mentioned giving it once a day, but that doesn't make sense to me.

I give him sub-Q fluids twice a day because I don't want to give him too much at one time. Also because he seems to be dehydrating more easily... don't want him to be dry for too long.

You're right... my head is ready to explode! Too much info to sort thru. I appreciate the help I get on this site. I'd like to take him to a veterinary specialist, but there are none nearby. There is a shortage of regular vets in this area so I would have to drive 190 miles one way to a specialist and it's hard to get an appt. with them in a timely manner as they are als overwhelmed. It's very sad but that's the situation here. I'm going to lose my Jengo boy sooner because of living in a remote area. Sad... breaks my heart.

I know that you are just giving your opinion. I appreciate it because it gives me ideas and questions to ask my vet... if he ever calls. :-(
Thanks again.

 

[Sillycat41]

I ordered meds through Chewy and let them reach out to the vet. But, I also called the vet and told them to expect a request from Chewy. If your vet has associates or perhaps even one of the office folks can push the prescription through, especially when they check Jengo's records and see he has gotten the med before. I think it helped me get the prescription OK'd back to Chewy.

I understand what you are saying. I just wanted to give you some reassurance that while it is OK to worry, you have to take some time to just breathe and relax a little from time to time.

I also order most of Jengo's meds through Chewy, but the first round of Metronidazole was from the vet clinic. It's a 110 mile round trip to pick up more so I ask him to tell me how many pills and the mg for this round so I could order from Chewy. I made the mistake of questioning the strength because I read online that for his weight he didn't need what we gave him last time. That was a week ago and the vwt still hasn't responded. :-( I'll have to call on Monday and see if one of the technicians can okay it since it is in their records. Guess I shouldn't have asked how many pills and dose... just ordered the same amount. :-(

I can't relax because I'm always worried... he is so wobbly that I blocked off the stairs and made steps out of boxes so he can get up on his favorite spots to sleep. He is so skinny and weak.. wish something could be done about that because he's still sharp mentally and still enjoys eating. The thyroid test results aren't back yet. Maybe if he has hyperthyroidism and it can be treated that he'll gain some weight back... I'm hoping for something like that.

Thanks so much for your support. It helps to know that others have gone thru similar situations and can give suggestions when I'm too stressed to deal with things. Take care now

 

[FeebysOwner]

Thanks so much for your support. It helps to know that others have gone thru similar situations and can give suggestions when I'm too stressed to deal with things. Take care now

All you can do is what you can do, without over doing anything. I will say this again, and try not to say it anymore - his issues go beyond diarrhea; it isn't the primary reason why he is skinny or weak. He hasn't even lost that much weight over the past 4-5 months to cause skinniness or weakness.

Take the information you get from this site with a grain of salt, don't be reactionary to it or consider it gospel - and above and beyond all else, try to work with the vet you have.

 

[F+V]

I think the reason the vet wants to give him Metronidazole again is because I messed up the dosage schedule. I started out giving him 2 a day as instructed but since I had to space them out because of a possible drug interaction, I ended up only giving it only once a day. I didn't catch me mistake until after a week. The vet probably wants him on the recommended dose for two weeks. :-(

The diarrhea has been going on for over 2 1/2 months. Jengo was on Tylosin for a couple of weeks but it didn't seem to help so the vet switched to Metronidazole. I asked about doing an ultra-sound but he put it off for now.

To answer your question: no, I haven't noticed any change in his stools. Sometimes they are formed with a little soft, other times they are very soft with lumps, and sometimes watery with lumps. It's been a week since we ran out of Metronidazole so I guess it hasn't subsided.

I am not familiar with the term "in a blanket manner"??? As for dysbiosis... I am worried about the long use of anti-biotics. I'm sure that intestinal biomes are all out of wack by now. I am going to try that kittybiome test. Don't know why the vets don't suggest that???

Yes, in our small city there is a shortage of vets and if you aren't established with one you are out of luck. The nearest emergency vet clinic is 185 miles away. :-( There were 4 vets in the clinic I have been going to for 30 years. The youngest vet moved away and one of the older partners is semi-retired. That puts a lot of pressure on the two regulars left. Just to get an appt. for a regular wellness checkup takes months! The vet who misdiagnosed his heart is very young... in her early 30s so not much experience compared to my older vet who is 69 yrs old. I'm going to call around on Monday and see if I can get a second opinion from a new vet.

I think he is getting weaker becasue he weaves and wobbles when he walks. He can't jump very high any more either so I worry about him falling. Had to block the stairs so he won't try to climb up and down. I spent yesterday taping boxes together to make more steps to his favorite resting places. His appetite is still pretty good... he begs for food when he's hungry but he doesn't eat much at one time. I syringe feed him a couple of times a day to make sure he gets enough.

In May he weighed 8.6# and now he's down to 8.2# and very skinny. I think that having diarrhea for such a long time that he wasn't getting enough nutrition. I looked for supplements online to maybe put some weight on him, but didn't order them because the first ingredient was corn syrup!! I'm trying to give him extra meals instead but so far no weight gain. :-(

He does vomit occasionally... maybe once a week and it's usually clear foam. He gets Ondransetron twice a day but if he goes too long between meals... more than 4 hrs. he tends to vomit. I try to feed him every 3 hrs... even during the night.

Sorry this got so long. I do appreciate your comments. Thanks again.

How's he today?

As for Metronidazole, this page says under under medication section "Metronidazole (Flagyl) is an antibiotic and antiprotozoal medication that’s frequently prescribed for cats—for example, to treat gum disease, bacterial infection, and even unexplained diarrhea. But this particular drug has been found to cause long-term damage to the gut microbiome, and is less effective for many GI conditions than previously thought." So I wouldn't get myself in a fret over the lack of this medicine. He was already on Tylosin for a couple weeks.... Vets do not suggest the use of the gut health test because I think that's not what they learn in vet school... the same way many vets don't recommend feeding raw meat diet to cats.

Your regular 69 year old vet may have more experience but he may not be up to date with the current treatment protocols. I would go back to the young vet in her early 30s if you couldn't get any appointment with another vet. Like I said diagnosing heart diseases requires experiences and skills, but she may still be able to help Jengo with ultrasound.

Wobbling could be just a sign of aging or arthritis. Have you looked up Cosequin for his joint health?

Not losing an appetite is a very good thing, besides he hasn't lost that much weight and like you said the persistent diarrhea isn't helping with his weight. Both my cats lost 4% of their weight in 10 days! They gained 5% soon after though. Ondransetron twice a day or any medicine might be too much for a cat with a kidney disease, so dosage need to be adjusted accordingly.

 

[silent meowlook]

Hi.
I don’t suggest reducing the steroids, but talking to your vet about adding to them with maybe something like Chlorambucil. It is used in cases of severe IBD that is not responding to steroids. But, you continue with the steroids.

As for the feeding, if he eats what you are feeding, stick with that. If it ain’t broke, don’t fix it. So, if he may not eat a novel protein source, don’t upset things by trying.

The diarrhea has to be figured out and stopped.

My cat gets:
Prednisolone 5 mg eod
Chlorambucil 2 mg 2 x a week
Methimazole ( for hyperthyroid) 2.5 mg AM 2.0 mg PM
Metronidazole 50 mg once a day
And other medications for her asthma
She also gets SQ fluids 50 ml twice a day and monthly Vitamin B12 injections.
This has been for 3 years except the Metronidazole has been about a year.

 

[Sillycat41]

All you can do is what you can do, without over doing anything. I will say this again, and try not to say it anymore - his issues go beyond diarrhea; it isn't the primary reason why he is skinny or weak. He hasn't even lost that much weight over the past 4-5 months to cause skinniness or weakness.

Take the information you get from this site with a grain of salt, don't be reactionary to it or consider it gospel - and above and beyond all else, try to work with the vet you have.

I am stressed out trying to save him and keep his health problems from getting worse. I'd keep him around for a while longer... he's the coolest, smartest cat I've ever had. I've grown super close to him from being his nurse for a couple of years. He still cuddles, sits on my lap and head bumps me... plus shows an interest in his surroundings. His top weight in his prime was 11.5 lbs... he was fit and trim. So sad to see him weak and wobbly. I'd like to work with my vet but he hard to get in touch with. He still hasn't answered my email from a week ago about ordered more antibiotics. :-(

 

[Sillycat41]

How's he today?

As for Metronidazole, this page says under under medication section "Metronidazole (Flagyl) is an antibiotic and antiprotozoal medication that’s frequently prescribed for cats—for example, to treat gum disease, bacterial infection, and even unexplained diarrhea. But this particular drug has been found to cause long-term damage to the gut microbiome, and is less effective for many GI conditions than previously thought." So I wouldn't get myself in a fret over the lack of this medicine. He was already on Tylosin for a couple weeks.... Vets do not suggest the use of the gut health test because I think that's not what they learn in vet school... the same way many vets don't recommend feeding raw meat diet to cats.

Your regular 69 year old vet may have more experience but he may not be up to date with the current treatment protocols. I would go back to the young vet in her early 30s if you couldn't get any appointment with another vet. Like I said diagnosing heart diseases requires experiences and skills, but she may still be able to help Jengo with ultrasound.

Wobbling could be just a sign of aging or arthritis. Have you looked up Cosequin for his joint health?

Not losing an appetite is a very good thing, besides he hasn't lost that much weight and like you said the persistent diarrhea isn't helping with his weight. Both my cats lost 4% of their weight in 10 days! They gained 5% soon after though. Ondransetron twice a day or any medicine might be too much for a cat with a kidney disease, so dosage need to be adjusted accordingly.

How's he today?

As for Metronidazole, this page says under under medication section "Metronidazole (Flagyl) is an antibiotic and antiprotozoal medication that’s frequently prescribed for cats—for example, to treat gum disease, bacterial infection, and even unexplained diarrhea. But this particular drug has been found to cause long-term damage to the gut microbiome, and is less effective for many GI conditions than previously thought." So I wouldn't get myself in a fret over the lack of this medicine. He was already on Tylosin for a couple weeks.... Vets do not suggest the use of the gut health test because I think that's not what they learn in vet school... the same way many vets don't recommend feeding raw meat diet to cats.

Your regular 69 year old vet may have more experience but he may not be up to date with the current treatment protocols. I would go back to the young vet in her early 30s if you couldn't get any appointment with another vet. Like I said diagnosing heart diseases requires experiences and skills, but she may still be able to help Jengo with ultrasound.

Wobbling could be just a sign of aging or arthritis. Have you looked up Cosequin for his joint health?

Not losing an appetite is a very good thing, besides he hasn't lost that much weight and like you said the persistent diarrhea isn't helping with his weight. Both my cats lost 4% of their weight in 10 days! They gained 5% soon after though. Ondransetron twice a day or any medicine might be too much for a cat with a kidney disease, so dosage need to be adjusted accordingly.

He had another off day... slept a lot. From what I've been reading lately, being on antibiotics for a long time can really mess up the gut. He has been having formed but soft stools since we ran out of Metron... only a couple really watery. I'm hoping that things are settling down and giving probiotics will help restore his gut health.

Maybe it is time for another ultrasound. The young vet does them but she also put him on a heart med for a month before doing an ultrasound and then said he didn't need the med. Not sure I trust her judgment any more. May call another vet clinic and see if I can get a second opinion on Jengo's treatment.

Jengo first started kicking his rear legs out back in Jan. I think. It gradually got more frequent to the point where he did it every day. The vet thought it might be caused by arthritis and started him on Adequan injections. He had one a week for a month the one a month for a couple of months. I didn't notice any difference at all so we quit giving it. I bought some Cosequin treats for him but he won't eat them.

Since he was diagnosed with CRF and lost some weight, it was pretty stable at 8.9# for a long time. I weighed him this morning and he's now down to 8.2# from 8.5# in April (I think). I'm sure having chronic diarrhea made things worse. I wish I could put some weight on him. Checked into supplements but they don't get very good reviews.

Thanks for sharing your experience. Take care now.

 

[Sillycat41]

Hi.
I don’t suggest reducing the steroids, but talking to your vet about adding to them with maybe something like Chlorambucil. It is used in cases of severe IBD that is not responding to steroids. But, you continue with the steroids.

As for the feeding, if he eats what you are feeding, stick with that. If it ain’t broke, don’t fix it. So, if he may not eat a novel protein source, don’t upset things by trying.

The diarrhea has to be figured out and stopped.

My cat gets:
Prednisolone 5 mg eod
Chlorambucil 2 mg 2 x a week
Methimazole ( for hyperthyroid) 2.5 mg AM 2.0 mg PM
Metronidazole 50 mg once a day
And other medications for her asthma
She also gets SQ fluids 50 ml twice a day and monthly Vitamin B12 injections.
This has been for 3 years except the Metronidazole has been about a year.

Yeah, I'd like to talk to my vet... have a list of question for him... but he is so hard to contact. :-( What is concerned a severe case of IBD??? Are you saying that is what caused the chronic diarrhea???

Jengo has always been a fussy eater so I let him eat what he likes for several meal and syringe feed the better choices. It would be really difficult to switch him to all novel proteins.

Thanks for sharing the meds your cat is on. I gives me an idea of what others are doing so I can compare. I'm still waiting for the results of the thyroid test he had done on Aug. 29th. They said it would take longer to get the results because of the Labor Day holiday, but you'd think they'd be back by now!

Thanks again. Take care.