Still has chronic diarrhea after treatment

[F+V]

For what it's worth I think you are very tech savvy at your age. My grandmother didn't even know to use the Internet.

 

[Jabzilla]

For the Animal Biome test, you buy the kit and follow the instructions inside once it arrives. They provide everything you need for collecting a poop sample and sending it back to them. Once they've tested it, they will post your cat's results on your account that you make with their website. It's VERY in depth. It shows you an example of a healthy, balanced feline microbiome and how your cat compares. They give information on the many different families of bacteria, including the function that they serve in the body. The results will show you how much of each bacteria family your cat has, be it a proper amount, too much, or not enough. It also has a section where it shows and talks about any harmful bacteria your cat may have. If the C Perf is still around in an unhealthy amount, it will show up in that category along with how much of it is there. In addition to all of that, the test results will also include advice on what can be done to bring your cat's microbiome into balance, be it a change in the food, adding a certain type of fiber, doing a round of Gut Restore, etc. Like F+V said, you will also get consultation with one of Animal Biome's scientists once the results are in so you can ask them questions and talk to them about the results. You will get far more involved information than what the PCR test will give you at the vet.

 

[Sillycat41]

I believe you had the PCR diarrhea panel done before the 28th because you wrote he tested positive to c. perf when you created this thread on the 20th.

As with any medications, the elimination half-life is greatly prolonged in cats with impaired renal function. I hope your vet knew Jengo had CKD when prescribing Metro. And you did the right thing by calling the vet. He didn't experience the severe side effects before because you weren't giving him the full dosage. He was on Tylan before, so c. perf pathogen should have already been treated if it was effective. Like I said the only way to find out is via another fecal test. The last thing you want is giving him meds he doesn't need...

Okay, I remember now... we dropped off a stool sample for testing before his appt.

Yes Jengo has been seeing this vet his whole life... he diagnosed his CKD. I was thinking the same thing... that Jengo didn't have severe side effects of the Metron because I messed up the dosage. He was only on 50 mg twice a day for a couple of days and then 50 mg once a day for almost two weeks.

It didn't have much effect on his diarrhea either but that's when the vet said we need to do another course at the right dosage. I did some research on Metronidazole yesterday and found a dosage chart and dosage calculator. For a cat of 8# it said the dose should be 24mg !! "Felines with liver or kidney disease may also be at risk for adverse reactions when taking Metronidazole."!! Another site said: "Felines are more susceptible to the toxic effects of Metronidazole and even a small overdose can lead to serious health problems." !! Wish I'd never given him this drug!

Unfortunately he is still having watery (squirting) diarrhea so the vet said to try the Tylan again with probiotics. I'm so afraid I'm going to lose him because he's so thin now and I can't seem to put any weight back on him. :-(

 

[F+V]

Okay, I remember now... we dropped off a stool sample for testing before his appt.

Yes Jengo has been seeing this vet his whole life... he diagnosed his CKD. I was thinking the same thing... that Jengo didn't have severe side effects of the Metron because I messed up the dosage. He was only on 50 mg twice a day for a couple of days and then 50 mg once a day for almost two weeks.

It didn't have much effect on his diarrhea either but that's when the vet said we need to do another course at the right dosage. I did some research on Metronidazole yesterday and found a dosage chart and dosage calculator. For a cat of 8# it said the dose should be 24mg !! "Felines with liver or kidney disease may also be at risk for adverse reactions when taking Metronidazole."!! Another site said: "Felines are more susceptible to the toxic effects of Metronidazole and even a small overdose can lead to serious health problems." !! Wish I'd never given him this drug!

Unfortunately he is still having watery (squirting) diarrhea so the vet said to try the Tylan again with probiotics. I'm so afraid I'm going to lose him because he's so thin now and I can't seem to put any weight back on him. :-(

That's scary that your vets sound very reckless... good thing you discovered the dosage warnings. But Metronidazole and Tylosin tend to be gentler on the gut compared to many other antibiotics such as Amoxicillin. It's worth noting that Tylosin (Tylan) has anti-inflammatory properties, which can help soothe the gut. I feel like a broken record and am not affiliated with Kitty Biome, but if I was in your shoe, I'd get the Health Test asap and start from there. I'd also get Felix Flora from Adored Beast because that can be used during the antibiotic treatment. I don't know what's going on with Jengo but sounds like he's suffering from the side effects of recent Metro.
Has he been eating? How's he acting?

 

[F+V]

If the diarrhea is still caused by c. perfringens, alternative treatment option is phage therapy. Product like these AnimalBiome® Gut Cleanse and KittyBiome™ GMP – AnimalBiome contain bacteriophages called PreforPro which specifically targets and kills only harmful bacteria like e.coli, c. perf, and similar gram-negative bacteria.

 

[Sillycat41]

That's scary that your vets sound very reckless... good thing you discovered the dosage warnings. But Metronidazole and Tylosin tend to be gentler on the gut compared to many other antibiotics such as Amoxicillin. It's worth noting that Tylosin (Tylan) has anti-inflammatory properties, which can help soothe the gut. I feel like a broken record and am not affiliated with Kitty Biome, but if I was in your shoe, I'd get the Health Test asap and start from there. I'd also get Felix Flora from Adored Beast because that can be used during the antibiotic treatment. I don't know what's going on with Jengo but sounds like he's suffering from the side effects of recent Metro.
Has he been eating? How's he acting?

The vet claims that his dosage chart is correct, but I noticed a difference in Jengo so who is right?!!? He has perked up a bit since I quit the Metron so I still think it was the problem. Maybe it is listed as gentle compared to other antibiotics, but the fact that he has other health issue like CRF could have made him more sensitive to it. I am going to get that Health Test inspite of my vet saying it's not worth it. Jengo is worth it!!! I read that S. Bouldardii can be used with antibiotic treatment but his is off all that stuff for a few days... still has diarrhea though. I need to introduce things slowly to tell which product is helping. He was on too many things. I'm giving him slippery elm syrup to help heal his gut inflammation. He still begs for food but sleeps a lot... hanging in there. If only we could stop the diarrhea. :-(

 

[F+V]

The vet claims that his dosage chart is correct, but I noticed a difference in Jengo so who is right?!!? He has perked up a bit since I quit the Metron so I still think it was the problem. Maybe it is listed as gentle compared to other antibiotics, but the fact that he has other health issue like CRF could have made him more sensitive to it. I am going to get that Health Test inspite of my vet saying it's not worth it. Jengo is worth it!!! I read that S. Bouldardii can be used with antibiotic treatment but his is off all that stuff for a few days... still has diarrhea though. I need to introduce things slowly to tell which product is helping. He was on too many things. I'm giving him slippery elm syrup to help heal his gut inflammation. He still begs for food but sleeps a lot... hanging in there. If only we could stop the diarrhea. :-(

You know him better than anyone else, and of course Jengo is worth every penny! I spend significantly more time, effort, and money on diet, supplements, research and medical for my kitties out of necessity than my human children

I don't think you need to stop s.boulardii if you are giving him the right amount. (e.g., one or two jarrows pills daily) If anything you will probably need to introduce other probiotics like the ones I've recommended. Make make sure the slippery elm syrup is alcohol free and that you are measuring the correct dosage.

 

[silent meowlook]

Hypertension

 

[Sillycat41]

Hypertension

Thanks

 

[Sillycat41]

For what it's worth I think you are very tech savvy at your age. My grandmother didn't even know to use the Internet.

 

[Sillycat41]

You know him better than anyone else, and of course Jengo is worth every penny! I spend significantly more time, effort, and money on diet, supplements, research and medical for my kitties out of necessity than my human children

I don't think you need to stop s.boulardii if you are giving him the right amount. (e.g., one or two jarrows pills daily) If anything you will probably need to introduce other probiotics like the ones I've recommended. Make make sure the slippery elm syrup is alcohol free and that you are measuring the correct dosage.

I'm way behind on responding. You mentioned giving him one or two Jarrow pills daily. Maybe I haven't been giving him enough. I open the capsules because they are too big for him to swallow and put as much as I can get into a #4 capsule... that's probably only about 1/6 a Jarrow capsule. I ordered other probiotics... coming soon.

Also I used powdered slippery elm and mix it with water. Hoping it settles down the gurgling noise in his intestines.

 

[F+V]

I'm way behind on responding. You mentioned giving him one or two Jarrow pills daily. Maybe I haven't been giving him enough. I open the capsules because they are too big for him to swallow and put as much as I can get into a #4 capsule... that's probably only about 1/6 a Jarrow capsule. I ordered other probiotics... coming soon.

Also I used powdered slippery elm and mix it with water. Hoping it settles down the gurgling noise in his intestines.

Both S.boulardii and Bacillus Boagulans can be mixed into food because they are acid stable. They don't have to be given in an enteric coated capsules to reach intestines. I give him a capsule a day because he's a big boy at 16.5 lbs (not fat). Maybe you can start with 1/2 capsule mixed in with his food and increase that up to 1 capsule per day if you don't see any improvement?

I don't know the correct dose for powdered slippery elm but there are many references online as to how to make tea or syrup for cats.
Just make sure you give slippery elm on an empty stomach and 1- 2 hours apart from food, supplements or medicines because of its mucilaginous properties which create a coating in the digestive tract and that soothing layer can interfere with the absorption of other substances. You can give probiotics with slippery elm though.

How did the vet appointment go on Wednesday?

 

[Sillycat41]

Both S.boulardii and Bacillus Boagulans can be mixed into food because they are acid stable. They don't have to be given in an enteric coated capsules to reach intestines. I give him a capsule a day because he's a big boy at 16.5 lbs (not fat). Maybe you can start with 1/2 capsule mixed in with his food and increase that up to 1 capsule per day if you don't see any improvement?

I don't know the correct dose for powdered slippery elm but there are many references online as to how to make tea or syrup for cats.
Just make sure you give slippery elm on an empty stomach and 1- 2 hours apart from food, supplements or medicines because of its mucilaginous properties which create a coating in the digestive tract and that soothing layer can interfere with the absorption of other substances. You can give probiotics with slippery elm though.

How did the vet appointment go on Wednesday?

Jengo is only 8# now so would 1/2 capsule would twice a day then. I've been putting it in capsules because I'm afraid that he'll taste it in his food. I throw out more cat food because of picky cats! How long before you think I should notice a difference? The vet wants him on the anti-biotics still but I don't think they are helping at all... plus I read that they can cause diarrhea. I'd rather just use the probiotics and hope that they eventually calm things down. I read that it can take time though. :-(

I started to give him slippery elm syrup between meals but since I feed him every 3 hours it is really difficult... I have to keep waking him up from a nap and the poor guy was getting upset with me. Too much poking, prodding and pilling. :-( So the slippery elm wouldn't interfere with the probiotics?? Maybe I should give them together.

About the Wednesday vet appointment for an ultra-sound... I cancelled it because he would have had to be without food for 15 hours! I couldn't do that to him since he begs for food every 3 hours... even during the night. I get up to feed him 3 or 4 times during the night. No way would I get any sleep if I didn't feed him for 15 hours! Also the vet said that if she detected lymphoma that he would have to see an oncologist. There are not specialty vets in my area and just couldn't drag him off on a 190 miles (one way) trip to the nearest specialist.

So that's where we stand now. Thanks for your help. Barb

 

[F+V]

Yes, you can give probiotics and slippery elm together!
Does he eat wet food? If so, try mixing the probiotic powder in his food to see if he eats. You could even add his favorite treat on top to entice him.

I see that you are in a quite difficult situation, but getting Jengo to fast for 15 hours might be the only option to get to the bottom of this. Right now you could be blindly pilling him and disturbing his sleep. If his symptoms turn out to be caused by lymphoma, giving him s.boulardii for a year wouldn't resolve the issue and you need to review and adjust the treatment plan accordingly and as early as possible before he suddenly deteriorates.

Have you tried the health test in the meantime? If I were you, I'd find out if c. perf was still in his gut asap to determine if that's really causing his persistent diarrhea. You might even discover other pathogens that wreaked havoc on his gut or find out that he could be negative to c. perf after being on tylan and metro for weeks. I'm not sure giving s.boulaardi and random probiotics alone will conquer the overgrowth of harmful bacteria in his gut. I didn't see any effect of s.boulardii while my boy was on an antibiotics.
Getting the mobile vet to check his blood pressure at least once a month, ideally every 2 weeks is also important since his BP was elevated the last time. It's a good thing that he has an appetite though.

 

[Sillycat41]

Yes, you can give probiotics and slippery elm together!
Does he eat wet food? If so, try mixing the probiotic powder in his food to see if he eats. You could even add his favorite treat on top to entice him.

I see that you are in a quite difficult situation, but getting Jengo to fast for 15 hours might be the only option to get to the bottom of this. Right now you could be blindly pilling him and disturbing his sleep. If his symptoms turn out to be caused by lymphoma, giving him s.boulardii for a year wouldn't resolve the issue and you need to review and adjust the treatment plan accordingly and as early as possible before he suddenly deteriorates.

Have you tried the health test in the meantime? If I were you, I'd find out if c. perf was still in his gut asap to determine if that's really causing his persistent diarrhea. You might even discover other pathogens that wreaked havoc on his gut or find out that he could be negative to c. perf after being on tylan and metro for weeks. I'm not sure giving s.boulaardi and random probiotics alone will conquer the overgrowth of harmful bacteria in his gut. I didn't see any effect of s.boulardii while my boy was on an antibiotics.
Getting the mobile vet to check his blood pressure at least once a month, ideally every 2 weeks is also important since his BP was elevated the last time. It's a good thing that he has an appetite though.

Jengo only eats wet food... has for years. Occasionally snacks on a couple of pieces of our other cat's dry. I did try to sprinkle the probiotics on his food, but he detects it and won't eat. I think the best way to get it in him is to syringe feed some baby food with it. I usually syringe feed a couple of meals a day for more nutrition but I'm already putting other meds in it. Will have to get more baby food and need to find out how much Taurine to add to it. He's never been interested in treats so that won't work.

Not sure what you meant by "blindly pilling him and disturbing his sleep"??? Guess you mean giving him the wrong pills for his condition. But his sleep isn't disturbed... mine is! He wakes me up every couple of hours during the night when he's hungry. I dutifully get up and fix him a small meal, then he goes back to sleep. I wouldn't get any sleep if I had to withhold food from him during the night and I don't have the heart to put him in another room since he has always slept with us. Besides he's a howler when he wants something.

I understand what you are saying about getting the ultrasound done, but if he does have lymphoma I'm not sure I could go thru with the treatments since the local vets are experienced with it. Also he's so thin and weak now that I really doubt if he has another year in him. :-( I worry about him falling and getting hurt... have blocked off the stairs and put boxes around for steps but sometimes he still has trouble navigating. His kidney numbers are pretty high so I assume that he will more likely die of kidney failure and not lymphoma.

I even question whether he has IBD because he doesn't have the classic symptoms and has never had a biopsy to confirm it. Maybe he just has colitis like his brother. I'm going to take him or a sample in for another C. Perf. test to see if he still has it. I'm waiting to hear from a vet from Cornell Univ. this morning. They has a consultation service and I sent all his paperwork and health info the other day along with a payment of $55 for the consult. An internist is scheduled to call and discuss his health.

I found out that there are two mobile vets... one in a city 40 miles north and one 40 miles south of where I live. Neither one of them will drive out here. :-( I wanted to line them up for when the future so I don't have to drive him to the clinic in he final hours, but they aren't interested even for an extra fee. Sad.

Thanks for your comments... appreciate it. Take care now.

 

[F+V]

It goes without saying that's ultimately your decision to not get ultrasound done and deal with what ensues given Jengo's health and age. Reaching out to Cornel vets was a good idea. I do hope they can give you something you already don't know, but without imaging coupled with your inaccessibility to advanced veterinary care in your area, I'm not sure any of what they may suggest would be of any significant help. If you decide to take him to the vet for another fecal test, though I believe it would be less stressful for Jengo if you collected his stool at home, get the blood pressure measured in the consultation room with you again. I'm surprised your vet who diagnosed him with CKD hasn't prescribed BP meds.
I thought you found a mobile vet that could come and measure blood pressure... that's unfortunate they are not willing to come to you. You must be in a really remote area... that's great for your cats if they can go outside. Our cats absolutely loved going outside every day and that was their only purpose in life before we moved abroad. Now they are depressed inside the house all day every day... but it's only temporary..

 

[Sillycat41]

It goes without saying that's ultimately your decision to not get ultrasound done and deal with what ensues given Jengo's health and age. Reaching out to Cornel vets was a good idea. I do hope they can give you something you already don't know, but without imaging coupled with your inaccessibility to advanced veterinary care in your area, I'm not sure any of what they may suggest would be of any significant help. If you decide to take him to the vet for another fecal test, though I believe it would be less stressful for Jengo if you collected his stool at home, get the blood pressure measured in the consultation room with you again. I'm surprised your vet who diagnosed him with CKD hasn't prescribed BP meds.
I thought you found a mobile vet that could come and measure blood pressure... that's unfortunate they are not willing to come to you. You must be in a really remote area... that's great for your cats if they can go outside. Our cats absolutely loved going outside every day and that was their only purpose in life before we moved abroad. Now they are depressed inside the house all day every day... but it's only temporary..

Update on the week from Hell: The Cornell vet was supposed to get in touch with me before last Friday. They asked what time I preferred and told them 8 AM to 1 PM. Well, the vet called at 6:30 PM and I missed the call. :-( Called back within 10 minutes and got an answering service. Left a message and a gal returned my call and said that the vet who was supposed to call didn't work for Cornell any more. Later the vet called back and left a message saying she'd call Saturday morning... she didn't. Sunday afternoon around 4:30 PM I finally got the call. Not very organized!!

Anyway, she wasn't much help... said the those microbiome tests are a waste of money and a gimick to get people to buy their probiotics. Also said that he should have the ultrasound to find out what it going on and then to see an oncologist if he has lymphoma. There are no specialty vets within a couple hundreds miles of here. Told me that I was doing pretty much all that could be done for him other than getting a more accurate blood pressure reading. Also suggested feeding him hydrolyzed prescription diet because anything else would shorten his life.

So basically I'm on my own and have to make a decision on where to go from here. I've been searching online for a novel protein because I read that diarrhea related to IBD can be caused by food sensitivity. It's hard to find novel proteins that don't have chicken or other meats in them. Plus I hate to buy a case of something that he won't eat. The local pet shops don't sell novel protein cat food.

Now I'm trying to decide whether to try Solensia. Not sure whether his leg weakness is caused by arthritis or muscle loss. I suppose it would be worth a try since the Cornell vet said it wouldn't harm his kidneys. I did order a supplement called Rebound to get more nutrients in him since the diarrhea has made him weak.

I should take another fecal sample in like you said. Need to make sure that the C. Perf. is gone. I have been giving him psyllium in several meals a day and his stools are more formed with some soft.

I am worried about his blood pressure though. I was surprised that the vet didn't want to put him on meds because it was 180 - 200. Yes, there are two mobiled vets in the U.P. but neither one wants to drive out this far. I even suggested that they charge mileage but never got an answer. :-(

I live in Michigan's Upper Peninsula out in the country. My cats are indoor cats though as we have lots of predators around here... wolves, coyotes, martens, weasels, eagles, hawks, etc. Outdoor cats don't live very long around here. :-(

How about you... where did you move to?? We have a cat wheel that is great for indoor cat entertainment and exercise.

Later... Barb

 

[F+V]

Oh dear... well at least you gave it a try. I'm sorry they weren't very helpful, but not all hope is lost.

I still believe the health test gives you more detailed overall picture of his gut health for less money from the comfort of your own home than IDEXX diarrhea PCR panel but either one of those will tell you if he still has the pathogen. Besides, you tried conventional treatment and didn't see results, so why not try one of their products? I think I told you this but both my cats tested positive to C. Perf as well as C. jejuni via IDEXX diarrhea PCR panel but they were asymptomatic so the vet at the teaching vet hospital didn't put them on antibiotics. I also showed my regular vet at cat clinic their test results, and she said the presence of these bacteria was normal. The only difference is that your results indicated that c. perf had a high level of toxicity and Jengo has had persistent diarrhea. So even if the next results show that he's still positive to c. perf, don't rush to give him antibiotics unless it's still dominating his gut at a toxic level like the last results showed.

For his joint health, why don't you try Cosequin? You can open the capsule and mix the powder in his food. Of course Solensia is another option but that's a monthly shot. Omega 3 is also great for many thing including joints, heart, kidneys, etc.
If you can find holistic vet or vets that are practicing Traditional Chinese Veterinary Medicine (TCVM) , they might offer you alternative treatments. Find a TCVM-Trained Veterinarian to Authorize Your Herbs - TCVM Pet Supply
VetFinder – Find a Holistic Veterinarian – AHVMA

Maybe his diarrhea is gradually going away with psyllum husk, s.boulardii and other probiotics you've been giving him and now that he's off Tylan? You can go back to the clinic where you had his BP taken and measure his BP again, and ask for meds for his high BP? I There seems only one blood pressure monitoring device for pets on the market for consumers but you can try:
https://www.amazon.com/dp/B08NT84PVT/?tag=thecatsite

U.P. must be very scenic and quiet. I would love to live in a place like that some day as long as there are no predators. We moved from Australia to Japan 1.5 year ago. Before the move I let my cats go out during the day but can't do that here because there are way too many strays and also traffic. I've always lived in big cities like london, nyc, tokyo, sydney but these days I'm longing for something quiet surrounded by nature. We'd be moving to the Netherlands in a few years!