Chronic Diarrhea

Sebastian has had chronic diarrhea (flatulence and runny stool) since we brought him home from the shelter two years ago.  He had parasites including giardia, which were eliminated using antibiotics.  I had him retested 10 days ago.  No parasites were found, but he still has runny stool and occasional flatulence.  For over a year, he has been eating canned Instinct Rabbit and Instinct Lamb by Nature's Variety.  These are grain free and gluten free foods.

A week ago, I started adding a probiotic to his food - Acidophilus with Lactis by Nature's Bounty.  This is meant for humans and contains 1 Billion organisms at time of manufacture.  I give him about one human dose per day. It's a waffer than I pulverize and sprinkle in his food.  He gobbles it up. So far, I'm not noticing any change in his BMs, but as I said, it's only been one week.

I've tried making him stay inside because he loves a fresh mouse and is a very good hunter.  Nothing I have tried has worked.

About once every 3 months, Sebastian may get lucky and have one normal BM, followed by more diarrhea.

I'm treating this as IBS.  A vet specialist wants to do exploratory surgery.  I'm not willing to spend the money.  I have already spent over $500 on vet bills and have nothing to show for it.

Any suggestions would be appreciated.

Have you considered feeding raw? Even though NVI is a good food, it still does contain 5% veggies/other stuff including peas which have been known to be a problem for some cats.

Also, there are better probiotics out there. This one might be more helpful for your cat.

to TCS!

Have you tried an elimination diet in case the problem is a food intolerance? Were the tests for parasites done at the vet's office or sent to an outside lab? We had a similar experience with our cat, and after two negative SNAP tests I asked that his stool be tested for "everything" at an outside lab. He had been diagnosed and treated for coccidia while he was still at the shelter. It turned out that hemorrhagic E coli had colonized his bowels. Ten days of antibiotics cleared up the EHEC and stopped the flatulence, though the diarrhea continued, but wasn't nearly as bad. The vet did biopsies by endoscopy when he had to be knocked out to have a tooth fixed, and he was diagnosed with IBD.

He's now on a prescription low-fat, unique protein (kangaroo, rabbit and reindeer on alternate days) diet and has been getting a European nutroceutical called Entero-Chronic (corticosteroids are more commonly used in the U.S. for IBD, but we're in Europe). The combination has really worked for him. Right now I'm attempting to add grain-free beef to his diet in small quantities, but it's too early to say whether he can tolerate it.

Some cats with chronic diarrhea have done very well on a raw diet (which the nutritionist and vet say is too fatty for our cat, so it's not a "one-size-fits-all" cure). You might want to check out the Raw Feeding for Cats forum and talk to your vet about it.

I tried raw diet once.  He wouldn't touch it.

Testing for parasites was done at an outside lab a year ago.  10 days ago, I used my local vet who can now do this in-house.  I don't know exactly what they did.  I took them 3 consecutive days of samples. They said he was negative on parasites including giardia.

I haven't done elimination...not sure how I would do that.  Please explain.  I tried fasting for 24 hours.  It helped for a day.  Stool was a little firmer.  Of course the problem returned the next day.

My regular vet put Sebastian on Hills prescription.  No change.  The vet specialist put him on Royal Canin prescription.  No change.

One of my previous tabbies had chronic diarrhea for about 2 years, from when she was around 9 months old. I tried loads of different cat foods on the market but not successfully. My vet at the time treated her as having bacterial infections and inflamed bowel and prescribed her antibiotics every couple of months. I never felt very happy about it. Eventually I decided to try a higher than normal protein diet. It worked a treat and she was a happy cat right up to the age of 21 1/2 with no further digestive problems. 

An elimination diet is used to rule out (or confirm) food allergies. You feed your cat a unique protein, meaning something he's never had before, for about ten weeks. If the stomach upset and/or diarrhea clear up during that period, a food intolerance is very likely. Then another protein is slowly added by mixing it with the first over a period of several days, and you wait another few weeks to see whether the problem recurs. Normally you use a single unique protein like duck, rabbit, venison, kangaroo or horse. It's a rather long process that can take months or even a year. There are prescription diets for it, but also commercial ones like Natural Balance Limited Ingredient Diets. Most contain a unique protein and an unusual carbohydrate source, e.g., duck and peas, venison and potatoes.

I know a woman whose cat can't tolerate any proteins other than horse meat, so that's what she's been eating for six years.

This summarizes it: Feline Food Allergy Elimination Diet Procedures

I actually tried Natural Balance Limited Duck & Peas (Dry formula). No help.  Is there a 100% protein (or close to 100%) commercial cat food?  I am considering Nature's Variety frozen medallions - Venison.  But the ingredients include: Venison, Lamb Heart, Lamb Liver, Ground Lamb Bone, Apples, Carrots, Butternut Squash, Ground Flaxseed, Montmorillonite Clay, Pumpkinseeds, Broccoli, Lettuce, Spinach, Dried Kelp, Apple Cider Vinegar, Parsley, Honey, Salmon Oil, Olive Oil, Blueberries, Alfalfa Sprouts, Persimmons, Inulin, Rosemary, Sage, Clove.

Short of killing a field dressing a deer (or horse), how am I supposed to eliminate all of these ingredients?
 

I just read thru Feline Food Allergy Elimination Diet Procedures.  One note: my cat doesn't scratch, have hair loss, skin irritation or show other outward signs of an allergy.

Inflammation can show in different ways. If parasites are ruled out, then diet is the logical place to look next. There are different issues with most of the commercial canned foods. Nature's Variety has all those pesky other unnecessary ingredients in all their products. EVO has carrageenan and is very high fat. Hound & Gatos has xanthan gum which is made from corn. Tiki Cat is very low fat and right now only has chicken for non-fish flavors. I have heard good things about By Nature Organics but haven't tried it. For cats with digestive issues, that's why raw is recommended and often works. It's difficult to eliminate all the possible culprits without going raw usually home-made.

What kind of raw did you try in the past? Did you only offer it the one time? Most older cats will need to be transitioned to raw. Compared to stinky commercial foods, raw doesn't have much smell/appeal at first. Also most cats learn at a young age what "food" is, and it can be difficult to persuade them that something new is safe and good to eat.

Venison and pea is the only one I've used - I think it was Hills Science Plan. Not sure what other ingredients were in it (the people I got my baby from gave me some in case he got upset when I first got him).

I tried raw chicken one time. Our meat grinder was broken, so we cut it into tiny pieces.  After a few sniffs, he turned away and never came back.  I guess I should have put some feathers on it and stood it in the yard near the bird bath.

Could I try raw, ground turkey from the grocery store? I don't think he has ever had turkey.
 

Generally, transition consists of putting a tiny bit of raw with his regular wet food, either mixed in if he will accept it or off to the side if he won't eat the food with the raw in it. Then you gradually increase the raw to 100%. With some cats, that could be a few days. Others, a few months up to a year for stubborn kitties.

Generally pre-ground raw from a grocery store is not recommended. You don't know how long it's been sitting there or how it was handled. You could ask the butcher to grind fresh meat for you.

What would be the concerns about "how ground turkey or beef is handled"?  Contamination with other meats?  Shelf life?  I would probably buy it, break it down into small portions, freeze it, and thaw it as needed. 

Just curious....how does one go about getting fresh horse meat?
 

Here's a comparison of By Nature Organics Chicken vs Nature's Variety Raw Chicken.  Anything standout as good, bad:

By Nature ingredients: Organic Chicken, Organic Chicken Livers, Water, Organic Pea Flour, Organic Guar Gum, Organic Locust Bean Gum, Dicalcium Phosphate, Potassium Chloride, Taurine, Salt, Calcium Carbonate, Choline Chloride, Vitamin E Supplement, Zinc Proteinate (Chelated Source of Zinc), Copper Proteinate (Chelated Source of Copper), Manganese Proteinate (Chelated Source of Manganese), Sodium Selenite, d-Calcium Pantothenate, Vitamin A Acetate, Riboflavin Supplement, Ethylenediamine Dihydriodide, Vitamin B-12 Supplement, Biotin, Vitamin D-3 Supplement, Pyridoxine Hydrochloride, Thiamine Mononitrate, Folic Acid, Menadione Dimethylpyrimidinol Bisulfite.

Nature's Variety: Chicken (including Ground Chicken Bone), Turkey, Turkey Liver, Turkey Heart, Apples, Carrots, Butternut Squash, Ground Flaxseed, Montmorillonite Clay, Broccoli, Lettuce, Spinach, Dried Kelp, Apple Cider Vinegar, Parsley, Honey, Salmon Oil, Mixed Tocopherols, Olive Oil, Rosemary Extract, Blueberries, Alfalfa Sprouts, Persimmons, Inulin, Rosemary, Sage, Clove.

Crude Protein as a percentage:

By Nature:  9%
Nature's Variety: 15%

As soon as meat is ground, there is more surface area for bacteria. You don't know how long it's been since it was ground. Sometimes pink slime is added. If you take freshly ground meat and freeze it, the chances of bacterial contamination are less.

There are places you can order different meats from, like Hare Today and My Pet Carnivore. However, horse is not common.

I think both By Nature and NVI are good products. For your cat, I would try By Nature simply because it's a more limited ingredient list. The only thing really objectionable is the pea flour.