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Need advice about Ronidazole PLEASE!!

post #1 of 26
Thread Starter 
I have a 14 week old kitten who has had diarrhea for over 3 weeks now. She has been on every possible antibiotic and is now on Ronidazole. She has been on it for 3 days and is still experiencing fecal "leaking" and severe diarrrhea. For those who have had cats on this drug before, how long does it take for the drug to kick in and see the diarrhea decrease/go away?? IS there any chance it could actually be making the diarrhea worse? Thank you for your help, I am so desperate for answers!!
post #2 of 26
Why is your kitten on Ronidazole? Does she have Tri-Trich? To my knowledge that drug is only indicated to treat the very specific parasite, tri trichomonas foetus.

Most antibiotics will cause minor to moderate loose stool. The antibiotics kill the good flora in the cats gut. It takes awhile for these to grow back once the antibiotics are stopped. There are products available to assist with that re-growth and speed things along.

If your kitten was being treated for loose stool all along, I guess I don't understand the antibiotics then switching to a medication against a parasite.
post #3 of 26
Thread Starter 
The vets are thinking it must be tri-trich. She has all the symptoms of it and they're at a loss for what else it could be. They've treated her for coccidia, giardia, worms, even though she tests negative for everything. They've had her on clavomax, flagyl, albon, and one other one I forget the name of. Nothing has helped her for more than a day or two. She has now been on i/d canned food for about 10 days. I appreciate any ideas you might have!!
post #4 of 26
Poor kitty. Could it be food allergies? Loads of cats are allergic to fish and grains that are in cat foods sometimes. That is a lot of antibiotic for a small kitten.
I agree with the above poster in that her healthy flora have to be out of balance.
post #5 of 26
I would ask your Vet to confirm Tri-Trich before treating with Ronidazole. This medication is a bit dangerous and can cause side effects or death if not administered in the exact dosage. To my knowledge still not yet approved by the FDA for use in cats.

Tri-Trich is only reliably identified by using what is called a "pouch test". A fecal sample is taken and placed inside the pouch in some fluid. It takes two weeks for the sample to process, then it is observed under a microscope. If there is any movement of a parasite, Tri-Trich is confirmed.

Check this link: http://www.biomeddiagnostics.com/pil...Tfoetus-feline
post #6 of 26
Quote:
Originally Posted by Kai Bengals View Post
Tri-Trich is only reliably identified by using what is called a "pouch test". A fecal sample is taken and placed inside the pouch in some fluid. It takes two weeks for the sample to process, then it is observed under a microscope. If there is any movement of a parasite, Tri-Trich is confirmed.

Check this link: http://www.biomeddiagnostics.com/pil...Tfoetus-feline
Actually this site appears to be a bit out of date. The gold standard of TTF testing is now the PCR test and takes about a week to get back. Here is the guide on diagnosis and treatment of TTF directly from Dr. Gookin's site. The PCR test is the test I'm currently waiting on the results from and hope to have them back today.

http://www.cvm.ncsu.edu/docs/PDFS/go...ised042808.pdf

wrknight1 - I'm sorry your kitty is going through this. Mine is going through this as well and my vet put her back on Albon a couple of days ago just to help a bit until we get our results back. It isn't the best thing in the world but nothing else has helped and with the Albon her stool now has a slight shape to it. She had been treated with Albon before for coccidia so we knew it got the diarrhea under control for the meantime. I'm sorry to hear that nothing has been able to help your kitty. Here is a good website and they even have an email for support. From what I've seen, the Ronidiazole usually helps within a few days so that has me a bit concerned for your kitty. They definitely should have tested first IMO.

http://www.tffelines.com/
post #7 of 26
Hmm, don't know why you think the PCR is the gold standard. Can you elaborate?
The In-Pouch is the prefered method amongst the breeding community and their Vets.

I'd be interested to know if switching to PCR is worthwhile. Please fill me in.

I'm very familiar with Dr Gookin' work with T.feotus, but her article doesn't really say what extra benefit there is other than sensitivity and having ot go through a Vet. Which would be normal for me anyway.
post #8 of 26
Quote:
Originally Posted by Kai Bengals View Post
Hmm, don't know why you think the PCR is the gold standard. Can you elaborate?
The In-Pouch is the prefered method amongst the breeding community and their Vets.

I'd be interested to know if switching to PCR is worthwhile. Please fill me in.

I'm very familiar with Dr Gookin' work with T.feotus, but her article doesn't really say what extra benefit there is other than sensitivity and having ot go through a Vet. Which would be normal for me anyway.
This was told to me by my breeder but I also interpret it as such from the information I've read on it. If you look at the three different tests on Dr. Gookin's site, they are listed in order of sensitivity with the in-pouch being listed as "very good" but the PCR test being listed as "excellent". The PCR is also what my vet advised. HTH!
post #9 of 26
What you cat needs is a probiotic. The antibiotics are killing the good flora in her gut and a probiotic will put it back in. I use Jarro-Dophilus plus FOS (12 billion per gram). That will clear up the loose stools within a day or 2. There are lots of brands out there that I'm sure work. Bil Bac I think is another one although I've never tried it. Good luck!
post #10 of 26
I have some experience with Tritrich as my two cats were just diagnosed with this parasite. They are 2 yr. old Persians that came from a cattery and they have had diarhhea since we got them. We have had all the tests, used probiotics, slippery elm, Transfer Factor and Metronidazole for almost two years. Both myself and my Vet have been in contact with Jody Gookin at NCSU, she is the leading researcher and expert on TF. I strongly recommend that anyone with ongoing loose stools in thier cats go to her website and learn about this parasite. PCR is the most accurate, but it is expensive, the pouch test is also good but both need special handling and a lab that is experienced in testing for this, false negatives are common. We have held off testing because I did not want to use Ronidazole (RDZ)unless absolutely necessary, it has some pretty serious side effects. RDZ should NEVER be given without a positive diagnosis, and then only under a good Vet's care. Dr. Gookin has just recently changed the dose recommendation for RDZ to help lessen the chances of neuro toxic side effects to once a day. I am not posting her link as it is already on previous posts, please visit it for accurate information. This is serious enough that I will be taking a week off work to watch my girls for side effects, but then that's me. I just hope it works and they tolerate it so we can get them cleared and hopefully healthy. Most vets are still undeducated on Tritrich so getting help can be a challenge, I found it on my by researching then made my Vet aware, as well as the cattery.
Good luck
post #11 of 26
You might consider giving Baycox in case he has coccidia, you only have to give it once and it kills the parasite. I put my 2 kittens who had coccidia on albon for 28 days which didn't work so I then tried baycox. The first two times I tried it at the recommended dose didn't work so I doubled it and waala, it's a miracle, months without diarrhea. Now every time I see a solid poop, it's like having a baby.
post #12 of 26
Hello,

I have seen some folk have used this medication. I just wondered if anyone had talked about long term side effects (It can cause cancer in humans so what does it do to cats) and wondered if the medication had cured the problem. There is so little known about this but it is becoming more prevalent in the uk.

Thanks
post #13 of 26
Since I'm always interested in the side effects of medications and checking for side effects is the first thing I do when one of my cats is put on medication, I did a quick search. Part of what I found:

An excellent article:
http://www.fabcats.org/breeders/info...ichomonas.html

Quote:
A recent study by Dr Jody Gookin at the North Carolina State University (who has performed most of the work on this infection in cats) identified that ronidazole and tinadazole (antibiotics similar but not the same as metronidazole) may have efficacy against T foetus infection in cats (JVIM, 2006;20:536; Am J Vet Res, 2007; 68:1085). From limited studies ronidazole appears to be more effective than tinadazole. Ronidazole appears to be relatively safe, although a small number of patients have developed neurological signs e.g. twitching and seizures, which have resolved on stopping the drug. (The neurological signs are similar to those seen in some kittens, or cats with liver disease, when they are given standard or high doses of metronidazole). However, ronidazole is not licensed for use in cats; it should only be used with caution and with informed, signed, owner consent. Initial studies suggested that a dose of 30-50mg/kg once to twice daily for two weeks is capable of both resolving clinical signs and potentially eradicating the T foetus. However, keeping to the lower end of the dose is advisable (30mg/kg), as is giving it only once daily, and reducing it even further for young kittens or cats with hepatopathy; (10mg/kg once daily for two weeks). To ensure that each kitten receives the correct dose, and so reduce the risk of side effects, it is also important to weigh the kittens prior to ordering the reformulated capsules. The bitterness of the powder means that it must be placed in capsules prior to administration.

Ronidazole (10% powder preparation) is commonly used to treat trichomoniasis in birds (e.g. pigeons). However, it is not available in this form in the UK, and the consistency of the 10% formulation is difficult to guarantee. Therefore, we have gained permission from the Veterinary Medicines Directorate (VMD) to use 100% pure chemical grade ronidazole to treat T foetus infected cats. This is the form that is now used in the USA. In the UK it can be obtained upon receipt of a signed named-animal prescription as capsules from Nova Laboratories, Tel: 0116 223 0099; Fax: 0116 223 0120: email: sales@novalabs.co.uk. While the VMD have agreed to our use of this chemical in these cats, they strongly recommend that detailed records are maintained and that no cat is treated without first obtaining informed, signed, owner consent. In addition, we should compile data on all potential adverse effects: send case information on any potential adverse effects to Danielle.Gunn-Moore@ed.ac.uk.

Care should be exercised in the use of ronidazole, as there are very few studies of its use in cats, and long-term studies in other species have suggested some potential toxicity concerns. (In many countries its use in food-producing animals has been banned to minimise human exposure). Careful handling of the drug is therefore advised. It should never be given to pregnant queens (or queens about to be put to stud): it is very teratogenic and may result in a number of different and severe defects. Anyone handling ronidazole should wear gloves (especially if they are a woman of reproductive age).
Since the diarrhoea usually resolves over time, and is often more of an inconvenience than being associated with significant adverse effects in affected cats, it may not be necessary or advisable to treat all affected cats with ronidazole. Using a simple highly digestible diet or a high fibre diet may result in improved faecal consistency, and this may be sufficient to control the clinical signs in some cats.

http://webdvm.lifelearn.com/clinics/...ew&pageid=1339

Quote:
Owners should wear gloves when administering ronidazole and when cleaning up the litter box during treatment and for 3 days after treatment is completed. Ronidazole is a potentially mutagenic, carcinogenic, and embryo-toxic substance in humans when they are exposed to it over long periods of time. Short term exposure during a typical 14 day course of treatment is not thought to pose significant risks to either the pet or its owner.
http://www.cat-health-guide.org/diarrhea-in-cat.html

Quote:
Treatment for tritrichomonas does not exist. Antibiotics might be prescribed for treatment of possible infection. Dietary change sometimes helps. One medication that is sometimes used, but not approved in cats is Ronidazole. There are potential side effects (liver damage, nerve damage) so be sure to discuss them with your veterinarian before treatment begins.
post #14 of 26
PS: My post above was a reply to catmaddu, who this morning posted:

Quote:
Hello,

I have seen some folk have used this medication. I just wondered if anyone had talked about long term side effects (It can cause cancer in humans so what does it do to cats) and wondered if the medication had cured the problem. There is so little known about this but it is becoming more prevalent in the uk.

Thanks
I'd just like to add that, catmanddo, I'm sorry, I have no personal experience with this medication.
post #15 of 26

After a year of various treatment, I took my cat to an internal medicine vet. Even though the test for T-foetus had come back negative, the vet said the symptoms were on the mark and since any next steps are invasive and expensive, she recommended the Ronidazole treatment first. Today was the 14th day of treatment, so I can tell you what has happened.

 

After a few days I noticed the explosiveness of the diarrhea was less. Rather than just fecal incontinence, he attempts a BM where he digs a hole and strains to go. At this point he still has diarrhea and there is some bleeding, but but much less of both. His anus is still healing from extreme infection too. I called Dave, who helps people with this, asking the same question you did. He said it often takes several weeks after the treatment is finished for the diarrhea to stop, and seeing any change at all during treatment is a very good sign. The reassurance really helped me stay the course and today I celebrated the last day with high hopes that the problem may be solved. PM me for info on how to contact Dave.

post #16 of 26

To Hatdance-wondering what the dose was, I am part of a rescue group, my place is for recovery/transitional, and I have recently aquired a 14 month old kitty that has been diagnosed with tri-trich AND ghiardia.

Our normal dosing of most meds is .1 ml per pound of weright.

Is this the same?

Thanks

post #17 of 26

I am currently treating my cats with Ronidazole as 2 of the 3 have presented with symptoms of Tri-trich.  Over the past 3 years, we tested for an array of different parasites and all are negative including tests for tri-trich!  My cats receive 30mg/kg once a day.  We have treated for 8 days so far and I have seen a dramatic improvement in bowel movements in 1 of the 2 presenting cats.  The second, I have yet to "catch" but a hoping to see a similar response

 

Would love to hear other people's experience with ronidazole.  We have not seen any side effects.

 

post #18 of 26
Quote:
Originally Posted by river View Post

You might consider giving Baycox in case he has coccidia, you only have to give it once and it kills the parasite. I put my 2 kittens who had coccidia on albon for 28 days which didn't work so I then tried baycox. The first two times I tried it at the recommended dose didn't work so I doubled it and waala, it's a miracle, months without diarrhea. Now every time I see a solid poop, it's like having a baby.


Baycox isn't available for cats in the U.S.

 

For what it's worth, we treated Sugar for giardia, first with Panacur and then with flagyl, and the diarrhea continued throught the treatment.  When we quit, her stools firmed up about 3 days later.  She did test positive for giardia before we started it.  I'm convinced the antibiotics prevented normal gut flora reestablishment.

 

post #19 of 26

Hi,

 

Just wanted to say my two cats both just over 1 Years old suffered from constant diarehha since i got them when they were 12 weeks old and tried everything with the vet, but finally was put on a University Trail of Rinodazole as its the only way to get it in the UK.

 

One of the cats has just got better with time and his stools are fine now ( funny thing is he had it the worst by far but its took nearly a year to go on its own) so i only administered it to one of my cats. She made improvement within 2 days and has shown no side effects at all and looks much better now, and has gained weight, i guess time will tell.

 

Im now chasing the vets as they have charged me a stupid amount for the drug, althou i was told as its a University Trail and my cats were like test animals that i wouldnt have to pay a thing :(

 

 

post #20 of 26

Boots has had cociddia when I adopted him in 2005. He was treated

When I got him from the shelter he had all the normal shelter maladies he needed to be treated for.

He was with me for 5 years. Right from the start his BM has been watery and extremly smelly. At times he had some droppings on the floor. I had his stool checked by different Vet clinics, with no results. The main diagnosis was IBS, irritable Bowel Syndrom. I had him on Iams, Veterinary formula- Intestinal low Residue with no results. When Iams was discontinued  I went with Hills I/D.

Then things got worse, he had more than the usual blood drops in his stool and he started soiling outside the box.He lost weight in a short time.To another Vet. All the tests again. Diagnose colitis. It was getting worse, he was on Metronidazole 100mg. and Hills Feline Z/D. He stopped eating and looked so miserable and skinny.In desperation I  went to a Holistic & Organic Pet Food Market. The lady told me to stop everything  and just give him the fish she gave me. Within 24 hours he was looking better. It is one year later now and he is on fish and mostly rabbit! food. (no kidding). He got bored with the fish.. and likes the rabbit better...

He is as healthy as a horse. Unfortunately for my wallet, the other cat eats rabbit now too, so it is not cheap, but oh so worth it.

 

Recently I found a home for his brother, who was in the shelter for the past 6 years. Guess what, his new mom, just went through the same as we did. After all the tests he was given Ronidazole 120 mg. and he stopped eating and lost a lot of weight. They were not quite through with the medication, as he was loosing too much weight and stopped eating all together. Now he too is eating well. I do not know if this medication helped to destroy whatever he had, but he seems well right now.

 

I wish they had more research in feline medicine. I do not have answers, but I was so desperate that I tried anything to make him better. Was it the Metronidazole or the Ronidazole that destroyed whatever it was, who knows. All I know it made them terribly sick before they got better.

 

 

post #21 of 26

My 4 month old kittens are bengals and one named Asia came to me with both coccidia and Tritrichomonas foetus,  TTF.  I first had to worm Asia for Coccidia with Albon because she presented with coccidia initially and this was confirmed through a fecal test. – I then wormed her for Giardia with panacur because she continued to have diarrhea after the Albon was administered (there was no confirmed Giardia).  The diarrhea continued until today so I continued investigating other causes.   I read all of the literature from Jody Gookin regarding TTF and then I ordered the pouch method – they are inexpensive.  I swabbed the inside of the colon of each cat with a q tip, and milked the q tip into the separate pouches.  Then the pouches go in a dark place at 98 degrees for 24 hours.   And then they are removed from the heat and put in another dark place at room temperature for 24 hours.  The only parasite that grows in the pouches is TTF.  I examined the parasites and their unique swimming motion under a microscope at 75 power.  I then took the pouches to my veterinarian this morning and he also confirmed the presence of TTF (I had to have him read the literature and watch a video on the TTF movement).   Giardia's movement looks like falling leaves, and TTF have a different way of swimming.   Apparently the only drug effective on TTF is a 14 day course of Ronidizole.  And the drug has some serious possible side effects. 

 

What I noticed is that the cats both have lost some appetite and have taken to sleeping quite a bit.   Today was day 5 of the 14 day ronidizole course.  The compounding pharmacy had to precisely measure out the amounts or Ronidizole in capsules.  The pharmacy tried to get me to take the liquid Ronidizole- but Dr. Gookin is very specific about getting the stuff in capsules.  Also Ronidizole is a carcinogen so they suggest you wear gloves, and double bag the fecal matter from the litter boxes.  Stools are firming up nicely now.  Make sure you read Jody Gookin's information 

 

http://www.cvm.ncsu.edu/docs/personnel/gookin_jody.html

 

http://www.cvm.ncsu.edu/docs/documents/ownersguide_tfoetus_revised_122009_final.pdf

post #22 of 26
I have a 5 1/2 month old Maine Coon that I purchased from a high dollar cattery that has been sick since the day I got her. She recently tested positive for Tritrichomonas foetus. She will be starting her Ronidizole treatment. They prescribed her 95mg once a day for 14 days. Most everything I have read says it's better to stay at a low dose around 30mg. I'm a little concerned at the mg. Can any of you tell me what dose of mg. your cats took ? My cat currently weighs right at 8lbs.
post #23 of 26

PCR testing is more accurate and the parasite does not need to be living. They test for specific RNA of the organism. see:

http://www.cvm.tamu.edu/gilab/assays/tritrichomonas.shtml

I have been struggling with trying to get a diagnosis and treatment for my cat for 3 months. I suspected T Foetus but could not convince the vet. I also tried to convince her to use ronidazole last month but she refused.Finally she has relented since we have been treating for 3 months, in about 4 days I will have the drug. My question is is there any way to administer this drug in capsule form? The vet assistant said try coating it with oil. I don't want to stop efficacy by doing that.

post #24 of 26
I rehomed two 6 month old Maine coons three years ago, one turned out to have feline flu and the male, who was suffering the worst diarrhoea I've ever seen, after £200 worth of faecal tests proved positive for tritrich. The vet put him on a trial of ronidazole, which cost another £200, as well as some sachets of something to replace the good bacteria. It was hard going trying to get the ronidazole down him, no way would he eat tablets, I ended up mixing the ronidazole powder in small portions of tuna. The result - from the very first dose his diarrhoea stopped. It was a miracle drug for us. We feed him royal canin sensitive dry food and three years on he's still as good as gold.
post #25 of 26

Dear sparkx.

I have just been reading you comment about your 2 maine coons. I have just brought a snowshoe kitten and has tested for Tritrich so has now been put on Ronidazole. I was a bit shocked to see you paid 200 pound for the medication. My vet only charged me 15 pound. 

post #26 of 26

 I have just brought a snowshoe kitten and has tested for Tritrich so has now been put on Ronidazole. My kitty has been on her meds' for 3 days now and her stools are looking a little better. She has however become very skittish and gets very worried about strange sounds. My daughter was cuddling her and she heard a sound. She flew in the air and scratched my daughter as she tried to get away. She then run upstairs if fear. I have never seen her act this way. Would this be the medication. I would like to know if I need to stop giving her this medication.

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