Bacterial Overgrowth - need lots more help!

I've already written in another thread about my 19 year-old cat named Zero.  Very briefly, she's had IBD for about 3 years or so, but it's been kept under control with diet and a tiny dose of prednisolone.  The past several weeks, though, her symptoms have been cycling from awful diarrhea to almost normal and then back to diarrhea again.  I've tried everything but can't get it under control. The vet prescribed flagyl in the beginning, but I had a horrendous time giving it to Zero and I was also afraid that it would make things worse.

NOW, though, Zero is looking worse than ever - she's lost too much weight and her fur is a mess.  Also, her bum really hurts her and even though she eats, she has no energy.  So yesterday I spoke to her vet again and gave her every detail of what's been happening.  I really though she'd just come back with comments about Zero's age, quality of life, etc. etc., but I had to try.  Surprisingly, she told me that she's now positive that Zero has intentinal bacterial overgrowth and that if I start up again with the flagyl and stick with it, she should be fine within a week or two.  I'm relieved and determined, but last night I gave Zero her first dose of the flagyl (it's compounded into a liquid that's chicken flavored).  She has ALWAYS hated being forced to do anything, and last night she went absolutely balistic!  I held her in my left arm and tried to put the syringe in the side of her mouth - as I've done with other cats easily.  Zero screamed, growled, twisted herself around and around and even peed down my back (I still don't know how that happened).  I was able to get the medicine in her mouth, but when I found her a few minutes later she hadn't swallowed it and was just letting it drool out of her open mouth.  The worst part - the part that has me terrified to try again tonight - is that she went into a strange "absent" state where she just stared at nothing and I couldn't get any response from her.  It lasted less than a minute, but I was positive that she'd had a heart attack or a stroke!

I'm determined to get that medicine in her, but as I said, I'm terrified to try again!  Last time I tried giving it to her I tried adding it to small amounts of her favorite foods, but she's always been able to detect even a molecule of anything "foreign" in her food.  And this has been going on so long now that I have to make sure she gets a full dose every day.  Any ideas anyone can give me about how to accomplish this would be a godsend - please help us!!!!

Also, does anyone know how this bacterial overgrowth happened?  She does have IBD, but what could have caused this to happen?  I know the vet thinks it's the raw food I give Zero once a day, but I'm not convinced.  Plus, I have been giving her probiotics every day.  I learned here, though, that I should use human grade probiotics rather than the cat-specific ones I have, so I'm going out later to get the Natural Factors at the health food store.

Oh, and is this bacterial overgrowth contagious among cats?  My other cat started with diarrhea yesterday.  The two cats do not hang out together (Zero hates him - she has for 17 years now!), but Clyde does pee in Zero's box once in a while....

Again, thank you SO MUCH for getting this far in my ramblings and for any advise you may have!

Why is the vet convinced it's bacterial overgrowth and not a worse than usual flare-up of IBD? Have you discussed/tried increasing the pred dosage to see if that helps?

I understand that Flagyl is just awful tasting, and mixing it with food does not work. The taste is very hard to disguise. I assume you can pill Zero since she's on pred? I would get the pill form of Flagyl and put it in a small gelatin capsule and pill her so she can't taste it. Have you tried Pill Pockets or anything similar? You could also try a pill popper device to get the pill further back in mouth so she can't taste it.

desperate4zero said:

Also, does anyone know how this bacterial overgrowth happened?  She does have IBD, but what could have caused this to happen?  I know the vet thinks it's the raw food I give Zero once a day, but I'm not convinced. 

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Have you only tried the liquid Flagyl, or have you tried giving her Metronidazole (Flagyl) in pill form inside a pill pocket, some (spray) cheese, tuna, liverwurst, etc.? The tablets are supposed to be very bitter.

One of our members uses a cat bag to give meds and has even posted a video showing how she does it. Maybe that would work for Zero?
Why I Love my cat Bag - video

We adopted a young (9-month-old) shelter cat back in March who has been diagnosed with IBD (we had the biopsies done). He was having an awful time with recurring diarrhea, and a lab test determined that enterohemorrhagic E coli had colonized his intestines. According to his vets and everything I've read about it online and off, that is caused by raw or undercooked meat or contaminated vegetables/fruit, so it's possible, though not necessarily the case, that raw food might be the culprit, as your vet believes. We don't know what Mogli was fed or may have eaten before we got him. Zero's immune system may be weak due to her advanced age and unable to deal with the bacterial load. Pets have gotten all sorts of nasty things from cooked commercial food, though, too.

ETA: The gelatine capsules vball recommended would be worth a try.

My cat Oreo also has IBD and is currently going through one of these diarrhea cycles.( She was diagnosed by biopsy and endoscopy. That is the best diagnostic way to determine IBD.)

She is on Royal Canin hypoallergenic food.

A thorough fecal panel can determine what type of baterial overgrowth is present.

There is a form of metronizadole that is a cream. It is applied to the flap of one of a cat's ears. Just one ear. And it has worked on Oreo who HATES pills and liquid metronizadole(Flagyl). Ask your vet for this form of this antibiotic.

Good luck, I KNOW what you are going through.

Liz and Oreo

Hondo, TX
 

Thank you all for your advise!  I guess I'm lucky that I've never had this problem with any of my cats before.  A couple were very cooperative and let me pill them and/or use liquid medication.  All my cats have used/are using pill pockets.  Zero, on the other hand, has never been successfully pilled in 19 years - not by me or by any vet!  She takes her felimazole and her prednisolone (which we did double, by the way, with no luck) as long as they are each sandwiched perfectly between 1/2 a soft treat and 1/2 a pill pocket.  For some reason any taste she gets from those pills doesn't bother her.  She did refuse to take any pills at all for a couple of days, but thankfully those are okay now.  I tried that with the metronizadole tablet a few times, but she flat out refused to even try it.  So I tried just pilling her with it, but she just foamed and and threw it back up.  That's why we went to the liquid.  I've heard about the gelatin capsules, but wouldn't those have to be pilled? Would her teetch puncture the gel caps if I used her treat/pill pocket recipe?  I like the idea of the cream - I'm going to email our vet now to see if that's a possibility (thanks Liz!).  Zero can't have the Royal Canin food - or any of the prescription foods - because she's so intolerent of so many ingredients.

I'm looking forward to seeing the video you mentioned, jcat!  I've never heard of a cat bag for medication, but I'll try anything until I find something that works for my tiny tyrant!  Oh, and I may have to agree with you and the vet about the raw food.  All my cats ate the raw for one of their 2 meals a few years ago, but maybe Zero is too old now.  I, too, did a ton of research before I tried it and there are a lot of specialists who don't think cat's with compromised immune systems should eat raw.

I'm going to chat with the vet now (I hope).  I've got to get control of my tiny ball of fur and get the medicine into her tonight!  Thank you all for your help!  

yes bacterial overgrowth can cause IBD and yes it can be spread. Be careful that the flagyl didn't cause a seizure. I understand the drooling because of the bitter taste but the reaction concerns me as it can in rare instances cause seizures, it did it to my Alex. Ask the vet if Flagyl comes in a transdermal so you can put it on her ears instead. But yes, a gelcap is a great way to do it also. I used to dip mine into cottage cheese and use a pill gun so it slid down her throat. 

I just have to shout from the rooftops that tonight Zero ingested 25mg of flagyl in pill form without even knowing it!  I'm not saying the battle is over - she got 1/2 the pill instead of a whole one (as originally prescribed before she got so sick), and it may have just been a lucky break.   But the fact that at least some of the medicine is in her system tonight and that she had no trauma today over it is, for now, a victory I wanted to share with all of you who are being so helpful!

To be safe, I stayed where I could see her for about 30 minutes afterward to make sure there was no seizure-type reaction.  Right now she's sleeping comfortably after a bit of her nighttime food and a quick bath!

Now I have hope for tomorrow...... 

I just wrote about a "new" wrinkle, but it disappeard somewhere!  So, here goes again....

 Zero DID take her pill Friday night seemingly without incident, and I thought she'd done it again Saturday morning.  However, late Saturday afternoon, I found that morning's 1/2 tablet on the bed - licked clean of the treat/pill pocket part, but definitely none of the pill had made it into her mouth.  I was very disappointed, but just took it away without her noticing and tried again last night.  Once again, I sat near her as she took all her medications, acting like it was any other night and I had no concerns about her ability to take them.  Once again, she took the flagyl along with her other pills, seemingly without incident.  I stayed near her for a few more minutes to see if she was going to cough it back up, but nothing happened, so I left to get her nighttime food.

When I came back to her about 10 minutes or less later, I found her up on a window perch that she never uses (she's positive her brother's cooties are all over it!), and she looked really strange.  She was responsive, but her eyes were very glassy and half shut, and her whole body looked terrified.  When I asked her what was wrong, she just kept glancing down at the bed where she'd taken her pills, then slowly turning away.  I knew that something had happened after I'd left the room.  I checked everywhere to see if she'd again coughed up the pill, but she hadn't.  Then I remembered what you'd said about possible seizures, and I'm convinced that once the pill started to dissolve in her stomach, whatever had happened with the liquid had happened again - possibly another seizure.

So, now I'm obviously too afraid to give her any more of that medication and am basically back where we started.  I'm going to talk to our vet tomorrow to see if she can prescribe a totally different medication.  I'd been discussing the idea of a transdermal gel with her, but now that's out, too.

Today, Zero is suspicious of absolutely anything I give her to put in her mouth.  Yesterday I bought her a really good probiotic and mixed it with her food this morning, but she ate only a very small amount.  So I just gave her her favorite "kitty glop" with some of the probiotic stirred in, but she took off when I put it down for her.

I hope the vet can come up with something magical - I feel like I'm in a never-ending nightmare and right now don't see any good end to this.  And more importantly, I refuse to let Zero continue to be sick because of one medication she can't tolerate.  Finally (and childishly), seeing the mistrust Zero has in me and in anything I do for her breaks my heart.  After 19 years of caring for her, I can't help but wonder if and for how long all of this is going to undermine our relationship....

Okay I would definitely not give her anymore Flagyl! She sounds like she is having some kind of seizure if not a bad reaction. I know this is so trying right now, I wish I could tell you it's going to get easier quicker. The vet may have another medication for you that I'm not aware of but for now I'm glad you're not giving that pill anymore. It's rare that it causes seizures but it happens and it happened to my Alex. I'm so sorry all of this is happening. I know how devastating this all is. 

Oh, no. Surely the vet can give her something else that'll work?

things to find for diarrhea and bacterial overgrowth are unfortunately very limited. Hoping he has another medication. I only know of Flagyl but I'm sure there's got to be something. 

Was a PCR test done on her stool (well, diarrhea) to determine what is in it?

Here is a discussion in the raw forum, where treatments for C. perfigrens and C. difficile are discussed - I think jcat mentioned the treatment for her rescue kitty's type of E. coli ( though it seems to be a general help for bacterial overgrowth: http://www.bioiberica.com/News/Pets..._in_long_treatments_of_chronic_diarrheas.html ), and for the OP's cat, ultimately the problem was an actual bacteria, so even though she's in Australia, you may want to find out the name of the medicine used to discuss with your vet: http://www.thecatsite.com/t/259419/kittens-raw-and-clostridium-safety

Many of us have also had success with DiaGel. Carolina uses this for her IBD kitty. http://www.revivalanimal.com/DiaGel.html

LDG said:

Was a PCR test done on her stool (well, diarrhea) to determine what is in it?

Here is a discussion in the raw forum, where treatments for C. perfigrens and C. difficile are discussed - I think jcat mentioned the treatment for her rescue kitty's type of E. coli ( though it seems to be a general help for bacterial overgrowth: http://www.bioiberica.com/News/Pets..._in_long_treatments_of_chronic_diarrheas.html ), and for the OP's cat, ultimately the problem was an actual bacteria, so even though she's in Australia, you may want to find out the name of the medicine used to discuss with your vet: http://www.thecatsite.com/t/259419/kittens-raw-and-clostridium-safety

Many of us have also had success with DiaGel. Carolina uses this for her IBD kitty. http://www.revivalanimal.com/DiaGel.html

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Mogli got Marbocyl (Marbofloxacin) for 10 days for the E coli and has been taking Entero-Chronic for IBD. Unfortunately, I think the latter is only available in Europe. The Marbocyl is great because it's small meat-flavored tablets you can just stick in food. Marbofloxacin is sold under the name Zeniquin in the U.S.. The tablets look different, so they might also not be flavored.

Hi Desperateforzero

I've just begun giving Flagyl to one of our feral cats.  I cut the pill into small pieces & put them into a #4 capsule (one of the smallest-can be bought online via "empty caps company" about $18 for 1,000 pc.)  After loading the capsules I squeezed it together as small as possible, then wiped down the outside of the capsule before putting it back in the pill container.  I've always dreaded a day when I might have to pill this guy but so far so good.  I used a thin piller for cats (amazon $4-looks like a pen) and held the top of his head, opening his mouth, stuck the piller in, popped out the pill far back in his mouth, and he didn't even know anything happened.  He just swallowed it.  No bad taste, no reaction.  I hope it continues to go this way (he has costridium overgrowth-probably ate rotten meat outside before we took him in.)

Another drug if you can't use flagyl is Tylan.  I believe the vet can give you that already in capsules.  I used Tylan transdermally on my cats ears for a month and it did nothing.  My vet says that's because the antibiotic type drugs sometimes don't work well given that way.  Maybe it varies with different cats.  But if I did Tylan again I would go the capsule route.

After creating my cats capsules I had some "flagyl dust" left on the tray.  I picked it up on my finger & tasted.  Yuck!  I had a bitter taste in my mouth for a couple of hours.  Coffee was horrible as the bitterness of the coffee was tripled by the flagyl taste in my mouth.  This is just from a little speck of flagyl so I imagine a whole pill has to be a nightmare for a cat to taste.  I would bet the taste alone could make them look out of it for a couple of hours.  Maybe that's what happened with zero.

Hope this helps.  James