Still coping with diarrhea after 10 days

So, I am writing this new post for my cat Bibi, initially I thought he might have had a urinary problem but I am pretty sure he is fine on this sense. So his licking problem seemed to be due to diarrhea and the vet visit confirmed no worms, no giardia and his blood work resulted in no issues with his organs functionality such as liver etc.

So the possibilities that were left with the vet would have been pancreatitis, for which they would need to run a different test. Or ? I guess some temporary something, or eventually some foreign item for which we would need to do x-rays.

Now I am not an expert about pancreatitis in fact I don't know anything about it but I've read it often comes with loss of appetite, vomit and fever, and my cat has none of these. 

So I have kept checking on Bibi, he has no fever, has good appetite, in fact he seemed to eat a lot more recently, he does pee, he seems overall well except his diarrhea, the dehydration, and the resulting discomfort which makes him lick, and now his butt skin is very red. And although I tried to help him and put bum-cream on it, he just would lick it off and I don't think a cone-collar would make him feel any happier.

He's been given Metronidazole twice a day, (we developed a team-work technique to make him swallow it) and is been fed only boiled chicken and gerber turkey or chicken baby food. I removed any too-much-corn-dry-food and I have now realized that I can mix the baby food with water and he drinks it all up. I actually was able to mix fortiflora as well with it. This helped a lot because otherwise he would have needed another subcutaneous fluids. So instead this way he drank a full cup of water just with one jar of baby food.

I assume this is about the amount of water that a subcutaneous injection would give him, can anyone help me understand if that is reasonable thinking or if a subcutaneous fluids would have been better for any reason? It seemed to me to have helped him a lot since the vet explained his tired eyes with third eyelid a result of the dehydration. So I could tell that the day after he drank the full cup of water and baby food his eyes looked much better, and he overall looked better. So In the last two days he's had this full cup of water and baby food twice a day and yesterday I actually bought pedyalite to use. Today he seemed even more hydrated according to my test on pinching his skin and his fur overall seemed very soft.

I am assuming the continuing diarrhea could be caused by the Metronidazole, since the color of it is a decent medium dark brown and I don't see blood on it. However, he will be done with the Metronidazole in a few more days after which I would bring him back to vet if his stool doesn't get better. 

I was considering giving him some plain yogurt but I am afraid this might upset him since he does appear to be lactose intolerant. I looked for a yogurt with lactase enzymes but the only one they had was peach or strawberry and didn't even seem to have the yogurt cultures in it. I bought fage total 2%, it says it has: Grade A pasteurized skimmed milk and cream and live active yogurt cultures, only. Is it good to give him a little of this or not?
 

Anything else I should do? Thank you!
 

Has the vet tested him for tritrichomonas foetus?  http://www.highgait.com/page/page/3485008.htm

I might have to ask or to figure it out from the label of the bill. It says: Hyperthyroid Feline (Superchem/CBC,T4, Free T4) - RefLab (ES). It doesn't  say anything  else but the vet explained it was a combined blood test that would cover a number of functions.

(Edit) on the fecal exams, I don't know however I would assume that if they do a fecal flotation, then check it, they would be able to see any kind of protozoa cells that shouldn't be there. However I have heard that results are not always accurate such that the animal might be infected but the protozoa cells might have not shed into the feces. However in case of very soft stool I would assume that if there is anything living in there, there would be their cells in the poop. In any case I will ask and/or keep it on the list of what to check next time we get in.

Others can better advise you on probiotics since I don't use them.

My cats' diarrhea didn't respond to metro either. Especially the cat that had it the worst. I had to do a diet change to help my cats. Since mine went on a homemade diet there has been no diarrhea.

As far as the water, adding water to the food is a great idea. Furthermore, I know from nursing that we would rather patients get nutrition and fluids from ingesting them. That isn't to say that subQ fluids don't have their place when helping a dehydrated cat, but if you're getting an additional 16 oz of water in him a day then I'd say you're doing great!

I'd also consider the testing that Stephanie mentioned.

Tritrich requires a special test, so it probably hasn't been run.  You might want to ask the vet for the test.  @Carolina is the woman to ask about stuff for the hiney and probiotics to help with diarrhea.

I would also like to add that cats cannot live on baby food alone, for too long that is.  If he has been fed ONLY baby food and/or boiled chicken now for 10 days, he needs more "cat type food".  I would definitely stay away from any dry foods, but if you can find it, maybe try Natural Planet or By Nature Organix, something like that that is nutritionally complete, just in case it isn't a parasite.  You might be able to find these at a natural pet store.

Also, feeding yogurt is fine.  Even though cats are usually lactose intolerant, yogurt is different.  One with live cultures is what you want.  But better yet is a multi strain probiotic that you can mix right into his food.  Many of us give our furkids the same ones we take ourselves, only we give them 1/2 the human dosage.   Of course, IF his issue is parasite related the probiotic will not help.  

I'm wondering, since he is constantly licking at his behind, if he might have a problem with his anal glands.  When they don't form a good stool, then the glands don't "self express", so it could be they need to be manually expressed (by a well trained person!).  Have you had this checked out?  Just a thought

Thanks for all the valuable help. I did consider the anal glands issue since the diarrhea might make it impossible for them to normally express, I had watched videos and was willing to take a look at it myself, but my husband refused to assist me so I didn't. I also had assumed the vet would have done that, and we were going to bring him the next day. So, then since the vet didn't consider that as an issue, I though it was probably not a case to consider. I will talk about this to the vet next time. I did offer normal wet cat food every once (more like he seemed interested in it when I fed to the other cat and they switched their bowls) and will make sure to do this tonight as well. He will be off the antibiotics starting now and I really hope to see improvement. I will give him a little bit of the yogurt I bought.

You may need to mix some of the extremely tasty baby food INTO the cat food in order to get him back to eating it again

So now there's still the problem with the diarrhea. I'm attaching a link to another thread, where a cat seemed to have a very similar issue.  Guess what it turned out to be?  The T Foetus that Stephanie mentioned above!  And that does take special testing.  Here is that thread:  http://www.thecatsite.com/t/264288/sick-kitten-tips-or-advice-please

We have been dealing with diarrhea here for almost a week. It has passed from one cat to the next until we are finally on the fifth (and last) one. Oh, how fun it has been.

Have you tried mixing a little raw pumpkin in with the baby food? Usually, it is recommended for constipation, but it helps treat both ends of the poop spectrum. I have been feeding it to my kitties and it works well. I guess in your case, it would be treating the symptoms and not the underlying cause of the diarrhea, but it may give your baby a bit of relief until you can determine what is causing the problem.

I hope you and the vet can get your kitty feeling better soon.

Bibi is still having the same diarrhea except it became more consistent in color and consistency. Before the Metronidazole it was almost orange and looked like "bubbly". During the Metronidazole it was smooth, somewhat liquid but darker brown and now that he stopped that, is back to light brown sometimes more yellowish and other time somewhat darker.

I am trying to figure out how to have this GI panel done, but at the same time I am somewhat scared about the risks of neurotoxicosis due to the treatment with ronidazole. Somewhat more than for the T. foetus itself which apparently is so very much common, except most cats cope with it and don't show severe diarrhea. I am also concerned with his anal region and will try pumpkin or anything I can to help him cope a bit until we get to figure out what's the next step. Yogurt didn't seem to help much. I should have some chicken cat food with pumpkin already in it and will take a look, otherwise can you recommend me what kind of pumpkin should I get and how to mix it with his food? I also read that rice should also help, should I try to mix it with his food? You say just raw pumpkin? I mash it and mix the baby food?

I am of course also getting paranoid about my other cats that live together with Bibi. One of my other cats had diarrhea problems in the past, amoxicillin somewhat helped, we though it was coccidia, fecal tests never revealed if it actually was. She's been fine overall but had another case earlier this year but it eventually resolved. I had all of them treated with ponazuril, except for Fireball which is the half-stray and I couldn't give it to him. The other cats don't seem to have diarrhea at the current moment.

Bibi is overall well and eats and everything, I pay attention to try to give him plenty of fluids, and fortiflora. I also bought lactose free milk thinking he would like it and get fluids, but he didn't seem to want any, I also bought some good dry food with no or little grains, but am I supposed not to give him dry food?

Thanks everyone.

Ok, for the pumpkin, take canned pumpkin (not pumpkin pie mix, but the canned pumpkin that you would use if you were making a pie from scratch), then mix maybe a teaspoon into whatever he is eating, at every meal.

Rice does help too.  But this would be homemade chicken and rice, no spices, salt or anything.   Just poach a chicken breast, then boil some WHITE rice in that same water.  Shred the chicken breast and mix with the rice and serve it to him.  But if he has T. Foetus, it won't make THAT go away .

Most people have really good luck with the Ronidazole.  Does he have an underlying condition that worries you? 

The Fortiflora isn't really all that good as a Probiotic.  You could try giving him a better one.  If you take probiotics, you can give him what you take.  That's what WE do.  All my cats get one capsule per day, just sprinkled into their food.  I give them these

He does not have any underlying condition that justifies my concerns. He is about 2.5 years old and seems in overall good health. He has gained quite some weight in the last few months, probably due to being neutered but maybe this sickness has also made him eat more, which is odd.

OK then.  I would probably have that PCR GI Panel done, and if it comes back positive for T Foetus, then discuss the next steps with your Vet. Discuss the pros and cons of the Ronidazole, etc.  But my understanding is that's the best treatment, and if taken EXACTLY as prescribed, the risks are minimal.  It does sound pretty scary, especially because the pill giver (YOU) is supposed to wear gloves when giving it, but sometimes you just have to weigh the options.  A lifetime of diarrhea and sore anus or 

That's where honest discussions with a trusted Vet are valuable

So far there hasn't been a lot dramatic changes but slow progress on this. He is doing ok, his stool has somewhat become more firm. His butt is back on pink and not so red and he doesn't lick it as often. He gets a bowl of baby food mixed with pedyalite (and sometimes fortiflora) every morning and he loves it. He also gets to eat normal cat canned food in the evening (sometimes the one with pumpkin) or boiled chicken with chicken broth. I have been closing him the bathroom every couple of days to check on his stool and pee, but that's about it. Last stool were still yellowish and soft but properly shaped, so we were somewhat happy.

I think that he looks better.
 


This is how he looked like when he was sick and tired -pinkish third eyelid showing- 

 I will probably consider having the PCR GI Panel and will get informed and everything about it in the future.

He has thanked me for taking care of him during this illness of him, he even sat in bed with me for some minutes and purred to me rubbing him.

How is Bibi doing?

Hi, and thank you for caring about Bibi,

He is doing ok in the sense that his butt looks normal and bright pink and he doesn't seem much annoyed or licking it at all anymore. And he is overall looking fine other than certainly more lethargic than usual, but I attribute that to him having being recently neutered. 

But I confirmed today that his poop is still pretty yellow and soft, not liquid, just jelly like. Also, it looks like not smooth but like if it has small brighter white "grains" in it. Its kind of odd, I wish I knew what it means.  

I still haven't  called my vets to see if or where/how I can have the PCR GI panel but am still considering I should just do it and take care of him.

If he has small white grains in his stool, he probably has Tapeworms.  That can cause softer stools.

That's odd because I usually know how tapeworms look like and this is not like it. I can give him a tapeworm tab, I think I tried to give him some a month ago but failed at having him swallow it all. He actually was tested for worms last month when I had him at the vet and they said he was clear. These I saw are like very little round white grains. I didn't test if they are more solid of the rest of the poop but I assumed they are only white colored and the same softness, kind of like the jelly poop is "bubbly". I should take it and look it in the microscope. I keep telling myself to do this. Just being crazy busy lately  but now I will have more time and will definitely take care of him

Penelopess said:

 
That's odd because I usually know how tapeworms look like and this is not like it. I can give him a tapeworm tab, I think I tried to give him some a month ago but failed at having him swallow it all. He actually was tested for worms last month when I had him at the vet and they said he was clear. These I saw are like very little round white grains. I didn't test if they are more solid of the rest of the poop but I assumed they are only white colored and the same softness, kind of like the jelly poop is "bubbly". I should take it and look it in the microscope. I keep telling myself to do this. Just being crazy busy lately  but now I will have more time and will definitely take care of him

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So didn't look like worm larvae, huh, because that was my first thought too. 

Exactly what brand of food are you feeding him?  I ask because of the fact that you say his "stools" are yellowish and still not quite formed.  This can indicate his food is either very high in fiber or a low quality.  Are they really stinky still?  I really think you need to rule out the T Foetus, but obviously that's your choice.  Is he maintaining his weight?  Does he appear to have good energy for a young cat, etc.  You responded that he is doing ok, which lead me to believe that he could be better (other than firmer poops).  Maybe it's just me reading something into your post

Hi and thank you for offering your help in figuring out how to help Bibi. He is not losing weight, nor appetite. He really gained weight in the last months, he was neutered in early October and have obviously gained weight since. He had more appetite and became more lethargic, such as he sleeps all day and although he wanders outside in the evening, he also comes back inside at about 3 or 5 am. The first month after being neutered he seemed not much different than before, then in November all these changes have started to show, eating a lot more, sleeping a lot more and then I noticed him licking his butt and being annoyed by it, and that is when I figured something was not right.

He normally eats Friskies poultry and/or fancy feast and also weruva brand wet food, mostly the gravy kind - he has always eaten these and are their favorites - (I usually alternate these 3 brands). They like purina kitten or cat chow as dry food - I do offer them others (alternate) but eventually I notice they like this one a lot more-. I recently bought dry food with no grains such as eukanuba or other grain free brand but they do not like it nearly as much as the purina chow. Lately I have been giving them boiled chicken more often to try to help him with his problem, also giving him chicken broth to make him get fluids. I also give him gerber baby food mixed with pedyalite. I gave this to him daily for a while when he was dehydrated and now I give him once or twice a week if he looks like he "needs it". Sometimes he does this thing where he licks his nose a lot and I noticed he was doing this also when he was sick with bad diarrhea and dehydrated. He was doing it this morning and that suggested me it was time to give him the gerber with the pedialite.

In terms of his energy, it seems ok to me, but of course is hard to tell and there have been some changes in himself and his routine so he is not easy to tell. He became more affectionate, more demanding me directly for food, and somehow these are the things that makes me think that "it could be better" since in the past years he has been 'more affectionate' only when he was sick (like one time he was bitten and has an abscess and was getting fever and he came sleep in bed with us -I immediately knew something was not right, because usually there was no way to have him stay in bed with us-). So, for me it could be better if he was more ignoring of me. It would make me think he is fine. 

Like: at 6am if I wake up to go to the restroom he comes rub himself at my feet and such to get food, my husband says he always did that, but I know he wouldn't do it every single night like he does now. The fact is that many changes have happened in general and it is difficult to tell how much and to which point his behavioral changes are due to his condition or due to a number of other factors and changes. 
For example he started to go hide and sleep all day inside my closet. But that could be because we have people doing remodeling work and he liked to hide from them, in fact most of the time he would go there when the people started working in the morning and come when they leave in the evening. But then other times he goes there even if the workers are not here. At the same time today he slept all day on his cat tree instead of the closet, and there was no workers around.

In terms of energy he does have energy to go out in the backyard and jump the fence and all things like usual. Sometimes he chases around my other cats also is also playful with the other cats or with us if we play with them.