Chronic diarrhea; God help us all

doughnuts

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Sorry for the graphic thread name, but I am losing my mind over here.  The shortest possible version of the story:

I took the cat in for a dental cleaning about six months ago.  He was fine that night, then the next day fell into an insane spiral of poor health.  He started hiding under the bed and refusing to eat.  He had the runs.  He ended up at the cat ER, hooked up to an IV, with a low-grade fever.  Eventually he regained his health (following a week of my giving him subcutaneous fluids), but for one thing:  his eating (at first) and his poop.  They found no parasites in his poop, nor could they find anything else wrong with him (no blockages, etc.).   To be fair, his poop has never been perfect, but it has at least been manageable.  Following the dental cleaning, it took about a month for him to be willing to eat his kibble again.  He's always preferred canned food, and I'm aware it's better for him, but he was on kibble for reasons I won't go into here.  Anyway, following the cleaning he would only eat canned, and he had constant diarrhea.  The vet put him on two rounds of metronidazole.  That did nothing except clear up the odour.  He was put on i/d and then w/d.  He received probiotics.  Minor improvement.  Finally, I started reading forums online and decided to listen to all the raw food champions I found. 

Instant. Cure.  Like, that very evening. I gave him some raw tuna, and presto!  He had a normal poop.  And not a normal poop for him -- an actual normal poop!  It was a miracle.  I bought a bag of frozen raw food from the store to see how he'd like such a diet, and he took to it immediately. He'd bite of chunks and then run with them to other parts of the kitchen in his excitement.  He was pooping like once every two days, perfect little logs with little odour.  Hurray!

Until he started throwing it up about three weeks later.  First it was just every few meals, then it was every other meal, then it was every meal, and eventually I couldn't even give him half a raw pellet without him puking all over, horrible streaks of pink on my floor.  So the raw was out.  We returned to canned food, but it gave him the runs, big time, even after a week on said food.  We returned to the kibble, which he mysteriously now loved again, and which improved things slightly.  Throughout all this puking and loose stool-ing, he has otherwise been normal:  alert (perky, even), demanding to go outdoors or to jump on people, sitting out in the open as usual, etc.  Normal cat with loose stools, as it were. 

Which are now even looser.  I give up. I have tried cooking him chicken  following a recipe I found online. He ate that for about a week, and his stools improved a little, though they weren't the perfect little logs we got with the raw.  I tried mixing in raw tuna (his favourite) or chicken livers (his second favourite) every few days just to firm things up. That worked, until it didn't.  After a long consultation with a seemingly knowledgeable guy at the pet store, we're now trying Orijen food and Evo canned.  I swear the stool is looser than ever, and moreover, he has a new trick:  stepping in it while trying to bury it and then tracking poop all over the floor.  Fantastic.

I am exhausted.  I am pregnant.  I am at my wits' end.  I'm taking him to a new vet (I love my vet, but I figure if they can't figure it out, maybe a new set of ideas will help here) this week, but in the meantime (it is, after all, the weekend), any ideas?  Should I try to reintroduce the raw food again, but a lot slower?  I don't want to have to wash my floors with bleach every time he poops while I'm out (I can catch him in time if I'm home and prevent the disaster). 

Thanks for any insight y'all might have!
 

stephanietx

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First of all, take a deep breath!  There are many people here who have battled and are currently battling diarrhea woes, so you're not alone!

I would ask the vet to run a test for Tritrichomonas Foetida, it's a parasite that isn't found in a regular fecal test.  It requires a special test.  Secondly, he could still be stressed from all that's happened, so a Feliway diffuser or 2 might be a worthwhile investment to help him de-stress. 

The changing foods may be part of the problem, especially dry food, not so much the wet food.  I do agree with the food choices you've made as both are great foods, but changing dry foods suddenly can cause stomach upset and diarrhea.  Also, he may not be able to tolerate the grain free diet.  (I have one like that.)

Right now, you can try a bland diet.  Boil some chicken and then shred it up. Add in some of the broth to make it the consistency of tuna salad or oatmeal and feed him that.  See if that helps settle his tummy and make his poops more tootsie roll-ish.  You can also add a bit of plain canned pumpkin (not pumpkin pie spice) and/or a bit of plain yogurt to help with the diarrhea. 
 

catwoman707

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I highly suspect parasites causing his abnormal poops/diarrhea.

In rescue, I have dealt with diarrhea more than I can begin to talk about, some of them being hardcore, seemingly impossible to ever get normal poops from.

BUT....countless times the fecal has turned up clean, well despite this I treated with ponazuril, and the majority of the time the problem diarrhea gone! The few times it wasn't I then gave ronidazole.

95% of the time, one or the other has cleared up the poop.

So it's not a bad idea to check out a new vet if the current one doesn't offer meds that will not harm but can only help.

Parasite cysts can hide in organs and only be found when they are being shed. Even tested 2-3 times they can easily be missed.
 

raintyger

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I agree with stephanietx that all the changes in the food could be upsetting his digestive tract.

Has the vet recommended any probiotics or mentioned IBD? Has there been any tests run (bloodwork? urinalysis?)
 

mrsgreenjeens

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And when you were feeding raw and he started throwing up, what exactly were you feeding him?  Was it a specific brand, a specific protein, a specific organ meat?  Some cats cannot tolerate raw beef, or red meat for that matter.  Some cannot tolerate an entire meal of liver.  Some cannot eat chicken unless it is organic.  Some cannot eat Primal or Natures Menu, etc. 

I would definitely give probiotics a try, and also make sure he doesn't have T Foetus, as Stephanie suggested (and CatWoman
....that last antibiotic knocks out T Foetus)
 

vball91

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How old is he?

I wonder if his vomiting after 3 weeks of raw is something I have seen here a few times that no one can really explain. Some cats who transition to raw (sometimes very quickly like your did) go through a transition period where they seem to vomit a lot. One theory is that raw food diet creates a more acidic system. Anyway, what happened with these cats is that they needed a re-start with raw. They were put on a non-raw diet for a while and then were gradually reintroduced to raw, and all was fine.

I suspect that your cat has IBD, and some common ingredient or two in the commercial wet and dry foods is causing the loose stools. The fact that raw worked so well before the vomiting started is a big clue. I would try adding probiotics and reintroduce raw gradually.
 
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doughnuts

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Thanks for all the replies and suggestions!  I'll definitely ask the vet to look for T. foetus when we go, and will perhaps also try to slowly reintroduce the raw.  When he responded so well to it months ago I also figured he must be allergic to something in the other foods.  To answer questions, the cat is an orange tabby going on 14 years old.  He's also fat (I think he's about 14 lbs right now, down from 16 in the past).  We're wondering how it's possible for him to take in less food than he seems to excrete, yet weigh so much.  He seems to defy the laws of physics, here...

When he got the raw he was eating Nature's Variety (the only kind I can get in town); he started on the rabbit and also tried venison and the chicken.  I put him back on the rabbit, which he'd started with and had never thrown up, but he ultimately threw that one up, too.  He can eat a whole bowl of raw chicken livers or raw tuna no problem, meanwhile.  Also he's routinely changed foods throughout his life with little to no ill effect. I just grab whatever's available and he happily eats it, and in the past, anyway, it's usually not been a problem for his GI tract.

I seem to think the vet did some blood work back in July and it all came up clean.  In any event, he was mystified because he could turn up no clear medical reason for the problem.  He suggested the cat had had a pancreatic infection at the time that was healing itself.  At least, that was the best explanation he could come up with.

Of course, as soon as I posted my initial question the cat's digestive system decided to play games.  He's now alternating between complete and utter liquid that smells absolutely awful and little logs that are almost where you'd want them to be.  Bizarre.
 

mrsgreenjeens

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Very bizarre.  You mentioned that at one time you had him on probiotics.  Do you still?  I would definitely put him on them, and keep him on them unless you see an issue.  Here is an article concerning giving cats probiotics:  http://www.thecatsite.com/a/should-i-give-my-cat-probiotics

And here's a thread discussing types of probiotics:  http://www.thecatsite.com/t/262587/probiotics-search-human-grade-and-cfus

There is also the possibility he could use some digestive enzymes, but if it's possible he has pancreatitis or IBD, I would probably discuss the use of this with a Vet before starting it.  I use it when feeding my furkids, but they don't have any digestive issues (I started using it when I started them on raw, and just continue it because I've got it
)

As to the raw you were feeding, the Nature's Variety is higher in bone content than most commercial raw diets, and that could be why it resolved his diarrhea so quickly.  It makes some cats constipated.  But that shouldn't cause constant vomiting
.  And since you were switching around the proteins, that shouldn't have caused it either, unless you were doing it quickly, without him getting used to each protein.  With raw, it's kind of like switching kibble, with some cats you need to add new proteins slowly, mixing the new protein slowly into an old protein so their bodies can adjust to it.  And as I stated before, some cats simply cannot tolerate an entire meal of organ meat.  Mine can't.  They will immediately throw it up even though they like it.  For them, it needs to be mixed with some other meat.  As to feeding raw tuna, is this sushi grade tuna?  I, personally, don't know of anyone who feeds their cats raw tuna.  Mine love canned tuna, but I very seldom give them any, only when I'm desperate to get them to eat, and then I mainly  just use the juice. 
 

cprcheetah

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Definitely could be all the food changes.  But could also be something like Irritible or Inflammatory Bowel Disease.  www.ibdkitties.net is a website with lots of information about it.  He may have a food hypersensitiivity which is why he improved on the raw because there are less ingredients in it.  Have you tried a limited ingredient diet? 
 
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doughnuts

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Yeah, I had him on probiotics on the vet's recommendation but because there was no effect I didn't buy more when the vet's supply ran out.  Eventually I bought a jar of the stuff at the local pet store, again to no effect, so I stopped out of sheer laziness.  Now I've put him back on them.  To still no effect.  But I guess I might as well keep it up since it doesn't seem to hurt him out of some vague hope it'll finally help.

I did not know that about changing proteins.  The vomiting problem did start when he got a new bag of food, different meat.  The tuna was tuna steak from the fish counter.  He's the world's fanciest-fed cat.  He's also eaten scallops to no ill effect (the people at the store look at me funny when I order two scallops, but if it stops the poop, I don't care how much it costs.  Such is the level of my desperation).
 
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doughnuts

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Update:  the vet has diagnosed the cat with a case of clostridium. He has been given a shot of penicillin, and I get to give him amoxicillin for a week.  They took blood and are sending it off for testing to rule out any other causes as well.  Here's hoping this works and there's nothing else wrong (the vet, unfortunately, suspects more).

Thanks for all the responses!
 
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doughnuts

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Interesting; thanks!  I Googled Clostridium as well and his symptoms match the description perfectly.  So I'm hopeful, anyway.

In a moment of perfect hilarity, the office called to tell me the cat was ready to be picked up, so I went over.  But it was taking them forever to bring him out.  Finally, someone emerged and explained that he'd pooped (well, they said "pottied."  When did "potty" become a verb?) right as they were ready to put him in the carrier and they were cleaning him up.  Next the vet emerged.

"I see what you mean," he said, very gravely.  At least now they know they have a fresh stool sample, anyway.
 

mrsgreenjeens

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Always good to know there is a REAL reason for what is going on.  Now hopefully he is on the mend
 
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doughnuts

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Well, so far no change.  Perhaps I'm just impatient.
 
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doughnuts

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Though at least he has stopped stepping in it, thank God.
 

reggie2011

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Have you maybe tried a different vet? From your original post it sounds kind of like there have been longtime problems that have become exacerbated in the last few months.

Regular diarrhea and dietary issues could be the result of Inflammatory Bowel Disease. In fact a lot of the symptoms and treatments you've tried seem like they match the symptoms/treatments for IBD :

http://www.expertvet.com/articles/inflammatory-bowel-disease

Check out that article and maybe consider getting a second opinion from a different vet? 
 
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