Young Cat, Diarrhea, Malabsorption, Food Suggestions?

[maxmeezu]

My cat Meezu, he's just over one year old - he's been having worsening diarrhea for about 2 months now, and losing weight. He's at least 3-4 lbs underweight at this point. I've been to two vets and tried so many things... any advice would be helpful.

Symptoms:

• Diarrhea
• Losing weight
• Gurgly stomach
• Flatulence when pooing
• Seems depressed / naseous
• Appetite recently diminished, but he's still eating a lot and always seem hungry.
• Symptoms seem to be worsening since Oct

My current vet suspects he has some sort of malabsorption issue. We're going to do a GI panel soon that will test for EPI so I should have results by next week. If that's neg though, I'm completely at a loss, and he seems to be wasting away.

Here's what we've tried:

• Fecal panel - all neg
• Blood panel - normal levels
• Ultrasound - inflammation in small intestine and enlarged lymph nodes
• Metronidazole - didn't really help
• Prednisolone - doesn't seem to be helping
• Probiotics (fortiflora)
• i/d diet - not much effect, also he's a bit of a picky eater
• B-12 injections - maybe helps a bit for a day or two after?
• Gastric panel - TBD

Some more history: He's always been thin since I got him as a kitten, with a very laid-back personality - both kind of unusual for the breed (maine coon). He's always eaten A LOT and with gigantic poops. He had tritrichomonas (along with his "brother" Max) but that was treated and fully cleared up a long time ago. Max has no digestive issues that I'm aware of at this time so it's highly unlikely it's anything communicable. He was doing really well for a few months between the tritrich and october. The vet thinks he might have a long term issue that's gotten recently worse. She thinks it's unlikely it's a food allergy since it started recently.

Anyhow, food. I'm trying to keep him on the i/d diet mixed 50/50 with merrick backcountry kitten soft food, with some plain boiled chicken for an appetite stimulant. But I also kind of have to feed him whatever I can get him to eat. He can be picky but he still eats quite a bit. But whatever I feed him he just seems to get worse. I'm hoping the community here may have some suggestions... I'm about willing to try just about anything.

 

[catsknowme]

What a perplexing problem! Have you tried adding pumpkin or the water from boiled white rice? I boil my rice for an hour. Does your vet use herbal medicine (I'm thinking slippery elm and marshmallow root.

 

[Noirele]

Wait for the gastric panel. I mean, my cat has a similar history with the same symptoms and I've got the result yesterday. High folates, so they suspect SIBO with or without EPI. I think it's a strong possibility at this point.
You could also rule out allergy, even if it started recently: it may happen.
Seeing a gastroenterologist it's a lifesaver in cases of chronic diarrhea, which can be extremely hard do diagnose. Anyway, how many times did you test the stool? Some parasites, like Giardia, are not easy to find: even in human you may need at least 3 samples.

 

[maxmeezu]

Thank you both for the kind and thoughtful replies. We got the results back from the gastric panel today and the vet said it indicates his small intestine isn’t working. Still not sure of the root cause of all this, but it gives us some direction. I’m hesitant to go through with an endoscopic biopsy...

Noirele, his folates were low, I’m not very familiar with SIBO, but based on your info, it doesn’t seem in line with his results?

She recommended a limited ingredient or hydrolyzed diet for several weeks with nothing else (no treats, poor fella), so I’ve ordered the food and we’ll see how this goes.

 

[SiameseMummy]

I hope you find an answer to this very soon!

I dont want to scare you but I had a cat who had exactly the same symptoms and was diagnosed with EPI. Once we got the diagnosis and got her on the Lypex supplements she quickly gained weight and all symptoms disappeared after a couple of weeks.

However, 2 years later she was diagnosed with restrictive cardiomyopathy and sadly passed away just after her 3rd birthday. There was no genetic history of heart conditions (or EPI for that matter) but my vet reckons that the reason she got this is because she was starved of nutrients at such a young age.

Please keep an eye on her breathing rate once you have found a solurto this mystery!

It's very unlikely you'll end up with the same issue but seeing the picture of your kitty being so skinny reminds me how my girl looked before diagnosis. Sending good thoughts!

 

[SiameseMummy]

Here she is just before her EPI diagnosis (she's the one on the left).



And here she is after diagnoses and on the supplements

 

[maxmeezu]

What beautiful cats! She looks amazingly improved after the diagnosis. It’s sad she passed but I’m glad her last few years were healthy.

I had been thinking it was potentially EPI but the vet says the test results received today don’t indicate any pancreas disregulation. Which I suppose is good but I was hoping for an answer...

 

[SiameseMummy]

It was such an incredible transformation and although her life was sadly too short she was definitely a happy and vibrant cat

I can totally understand about wanting a diagnosis. Although my girl was diagnosed with a chronic, incurable condition we were so happy to have an answer and that it was a manageable condition.

I hope you get your answers soon. Sending all the good vibes!

 

[maxmeezu]

Update on kitty:

Still not digesting food well and having pudding poops, but the vet expects improvement would be slow.

He’s on the hills z/d hydrolyzed diet, wet food only. He eats about 3 cans (5.5 oz) daily and always seems hungry. I gave him some of the z/d dry food at first, but that didn’t go well at all and seemed to cause him quite a bit of intestinal pain. He weighs about 11.8 lbs, and is still super skinny. He seems to have a decent amount of energy right now, compared to his previous lethargy, but that’s difficult to quantity.

Weekly B12, with daily probiotics and metronidazole.

My vet referred me to a gastroenterologist if he doesn’t improve soon. I’m considering this option at this point, but I’ll wait another week or so and see the z/d diet starts to help.

 

[Courtforshort27]

I am so sorry for your poor kitty! He is so beautiful! I hope the s/d has improved his stools, as this is what I am feeding my cats as well. The only advice I have is tring canned pumpkin but I have seen this already mentioned. I do have a question for you though, for my cats have been battling “giardia” for 8 months. I think it is actually T. Foetus, as all the symptoms are present after multiple rounds of panacur and metronidazole in all of my 3 cats. Did you treat using Ronidazole? And did you do anything for disinfection? I have been doing the whole steaming, bleaching, emptying the boxes daily, and washing bedding but I can’t find much info for tritrichimonas but it is reassuring to know your cats had it and were treated!

 

[maxmeezu]

Courtforshort27 thanks for checking in! I’m so sorry you’re going through all this with your cat fam.

The s/d diet didn’t work at all with him, I tried the z/d for several weeks without improvement either. I switched to raw food last week and he was better the next day with solid poops ever since then - and he’s gained 3 lbs back in the last 10 days (totally crazy, it’s like having a new kitten). So we’re finally on the right track!! This was all after it was identified as a small intestinal issue though, and if it had been a parasite, I’m sure the other cat would have been infected after three months of messy poos.

Yours might actually have TF! I really feel like it’s underdiagnosed - in part because vets don’t have much experience with it, and also the tests give a lot of false negatives and they don’t like to treat without a pos diagnosis since the treatment is so harsh - I’m very grateful my vet had the instinct to go ahead with it. It was ronidazole and it cleared up really well for both of them. If you want more info on the details of dosing I might be able to dig them up. They were treated with several course of various antibiotics (clavamox, metronidazole, doxycycline) before ronidazole with either no effect or a slight brief effect.

For disinfection, I didn’t go overboard since my vet said it wasn’t necessary for TF (like in the case of giardia). I just used a small amount of litter, bought the plastic litter box liners, and changed the whole thing every couple days. Litter is relatively cheap at least. I hope this is a little helpful - I fully know that dealing with chronic conditions, especially diarrhea, is incredibly frustrating.

 

[Courtforshort27]

That’s great to hear the raw diet has firmed up his poos! I’m sure he’s feeling much better. I have been meaning to switch mine to raw for awhile now but am slowly trying to make the transition from dry to canned and then from canned to raw. After my cat’s first negative stool sample for giardia yesterday, I sent a fecal PCR out and should have the results back this week, so if T. Foetus is the culprit hopefully they’ll find it. And what you said about the disinfecting was really helpful and definitely eased my stress. My vet is aware of the treatment/dosage and said if I can beat giardia then I can beat this! There isn’t much information out there on it probably because it is so under diagnosed! But you have been so helpful