Post-Unilateral Thyroidectomy

My 10 year old cat pal Vivian was diagnosed with hyperthyroidism and a large benign tumor on one lobe of her thyroid gland three weeks ago. She had the tumor and one lobe of her thyroid gland removed surgically, along with six (more) bad teeth. She recovered nicely from the surgery itself, but still has some loose stools, although they are somewhat improved. She is sleeping a lot more, presumably because the surgery her put into hypothyroid mode, and the vet said it will take time for the remaining lobe of her thyroid to take over - fingers crossed there. The continued loose stool t is troubling me. The vet said this is a symptom she would NOT expect Vivian to have post-surgery and suggested mixing some rice with her food to firm up the stool. Vivian normally eats Hills ID dry food (for sensitive systems). So I bought some canned ID and mixed in a small amount of minced cooked rice, she ate a bit this a.m. - her appetite has not been great but she does eat. Anyone have experience mixing rice with canned cat food to firm up a loose stool? Up until a few months ago Vivian enjoyed nearly 10 years of perfect tootsie roll logs, but she can't seem to shake this new trend. 

My guess is that the loose stool is actually being caused by antibiotics she received (or maybe is STILL receiving) from the surgery.  Antibiotics are famous for causing bowel issue.  If I were you, I would give her some probiotics mixed in with her food, as well as the rice.  And, yes, i have heard of using rice as a "fix" for diarrhea in cats.  Normally, though, the advise is to boil up a chicken breast (using no salt or spices or anything), then while it's cooling, cook the rice in the broth.  Then shred up the cooled chicken, or puree it or fix it however your cat likes it, and  mix in some of the rice and more broth until it's a consistency your cat likes, and feed it to them for a few days.*

*NOTE  This is NOT nutritionally complete for cats, so you should not do this for too long, however it's ok for 3 or 4 days. 

As to probiotics, I give my cats the same ones WE take...give them 1/2 capsule in the morning and 1/2 at night, just mixed into their wet food.  I do this everyday just keep their digestive tracts running smoothly.

Thank you. I will ask the vet about probiotics, she did mention them one other time when my other cat had a nasty case of the runs while on antibiotics. She also said I could try giving him half the antibiotic dose for twice as long, which is what I did. Yes, I have seen antibiotics wreak havoc on cats' digestive systems many times. Vivian's trouble started as a symptom of her hyperthyroidism this summer and has just not really resolved - it's better than it was, but not where I'd like her to be. Just getting her to eat canned food, and then canned food with rice in it is a little bit of luck every time she takes some, as she is pretty set in her dry kibble ways, even with the very few teeth she has left. Hoping the rice helps and doesn't make matters worse because it's a grain she can't digest. I guess the idea is to bulk up the stool without further upsetting her system. She may have had antibiotics during surgery three weeks ago, but I brought her home the same day, and she hasn't been on any antibiotic, so I don't see that being an issue.

OK, I'm with you now .  The  diarrhea was a symptom of the hyperthyroidism

OK, did she possibly get Convenia as the antibiotic?  It's a long lasting one, and it can cause diarrhea, so it's possible that's what's causing her to still have it .  otherwise, If the rice upsets her stomach since it's something she can't normally digest, you can try canned pumpkin.  Maybe just a teaspoon mixed into her food with each meal.  Some cats LOVE pumpkin...you'll see it in canned food often) 

So the rice was a disaster, it gave Vivian audible liquid diarrhea, so I abandoned that strategy and contacted the vet.  Now the vet has given me a week's worth of forti flora probiotic to mix with canned food twice a day. It is also an appetite stimulant, so hopefully Vivian will eat more food and put on some weight. She has been eating all along, but it's a question of how much she eats and how much nutrition is absorbed into her system. If the loose and frequent stools were caused by hyperthyroidism, the surgery should have addressed that by now. There is no record on my receipt from her surgery and hospital stay that she was given any antibiotic, so I'm not at all sure a probiotic is the answer to her problem. Could the balance of bacteria in her digestive system get messed up because of thyroid related diarrhea and correct itself with the aid of probiotics? We'll see. Does anyone have experience with this?  Right now she's back to loose stools with occasional diarrhea and a sometimes a spot of blood. 

Can you just put her back on the dry I/D and sprinkle the FortiFlora on that?  Is your Vet against you feeding her the food in the form of dry?  The only reason I'm suggesting feeding it to her in that form is because dry food can help with diarrhea since it's DRY.  In older cats, it often will actually cause constipation since cats aren't known for drinking lots of water....that's why we often try to get people to feed their cats wet food.  But in the case where a cat has constant diarrhea and there seems to be no reason for it (Vet cannot find any issues), then sometimes DRY food might be the answer, at least until her thyroidectomy self corrects the issue, if that's going to happen .

BTW, I realize she doesn't have many teeth, but some cats with no teeth at all still eat kibble , so that shouldn't be an issue.  OR, did you try adding pumpkin to her canned food to see if that helped?   Or what about trying a limited ingredient canned food?  Maybe there's something in the canned I/D that her system doesn't like (sounds like it).  Natures Variety makes limited ingredient foods, and Royal Canin makes hypoallergenic foods, although I think they require a prescription, but that should be easy enough to get from your Vet. 

for both YOU and Vivien   .  Dealing with ongoing diarrhea cannot be fun either of you.

The vet would have no problem with me sprinkling forti flora on dry food, my cats normally eat dry ID - even Vivian with her limited number of teeth does fine with kibble. The vet's only recommendation was to feed her whatever she will eat because she needs to put on some weight.  I just feel like since it's a powder it's more likely to get consumed mixed with canned food than settling to the bottom of the dry food bowl. I have another cat with some respiratory issues who has started on lysene, so I give Willis a little canned food with lysene twice a day at the same time Vivian gets her forti flora. What a hassle - he doesn't really like to eat his and requires much coaxing, and she likes hers but doesn't finish even a spoonful so I have to offer it to her again a little while later. We do this dance in the morning and evening, before and after work, so I sure do hope it ends up helping somebody. The little bit of canned food she gets doesn't seem to make her BM's more or less loose, they're loose on dry ID as well as canned. I actually would think the water content in canned food would be good for a cat with diarrhea who loses a lot of water and is at greater risk for dehydration. Anyway, she drinks water so at least that's good. I have not tried the pumpkin but haven't forgotten about it. As for a change in food, that might be the next thing we try if the forti flora doesn't work. Will need to be very careful with that since my other cat Willis has a very sensitive digestive system and ID was the only food that didn't make him sick years ago when we were dealing with his issues. It's tricky when you have more than one cat with special dietary needs, until a few months ago we also had our girl Nina with kidney disease and the dietary needs that go along with that. For a very long time I was feeding her a special diet behind closed doors. Would really prefer not to go down that road again, but am prepared to do whatever it takes I guess. I am hoping for the best, but preparing for the worst, with the forti flora. 

FortiFlora is NOT the end-all, be-all.  For some cats, it does help diarrhea, but as a probiotic, there are a LOT better ones out there.  I do use it on occasion, just as a food topper when one of mine gets picky .

I currently have three cats (also lost one to kidney disease a couple of years ago ), and all three of them east something different .  NOT because of health issues, per se, but mainly because they are just so darned picky .  Thankfully they all eat wet food, but not the SAME wet food, darn it. 

If you're concerned with Vivien getting all her Fortiflora with dry food, if there is some left in the bottom of her bowl, then you could always mix the packet with a tiny bit of water to make a gravy and I'll bet she'd lap it up, assuming she likes it at all.  Two of mine love it, one hates it. 

If you were to switch to a limited ingredient food, Willis could probably eat that too with no issues.  Sounds like he may have IBD, since he has a very sensitive digestive system.  Hard to know for sure. 

Vivian was given fortiflora twice a day for one week, as her vet instructed, and sadly but not unexpectedly it has had no effect on her loose and frequent stool. She is still eating and drinking okay, sleeping a lot - any diarrhea caused by hyperthyroidism should have cleared by now. In my most recent exchange with the vet she said her main concern at this point is a malabsorption issue. She recommends a blood test TLI, folate, B12 and an additional test for pancreatitis if I want to pay an additional  $70. All together this is a $300 blood test that would indicate pancreatic insufficiency, pancreatitis or disease of the intestine which may or may not be caused by bacterial overgrowth and treatable with antibiotic. If I understand correctly. Which it is highly possible I do not. It's complicated. I do have Vivian's lab results from before her thyroid surgery. There were several numbers out of normal range, but the vet said most if not all of them could be caused by hyperthyroidism: low BUN, low creatinine, low albumin are all symptoms of malnutrition. This can happen when raised metabolism causes food to race through digestive tract without time for absorption of nutrients. 

Of concern is also higher than normal monocyte, which can signal infection. It seems Vivian could have a disease or problem in her digestive system that happened at the same time as her hyperthyroidism and which has not been addressed by the thyroidectomy. 

Although the vet didn't mention it, Vivian's blood test from September also showed changes in liver values. I'm guessing we are looking at things most likely to cause loose stools and weight loss. Of course I will do whatever testing could help Vivian, except possibly surgical biopsies, but I feel like we are at the beginning of what could be a really long process of elimination. Any experience with this test (TLI, folate, B12) on a cat with loose stool and weight loss?

Cat Pal said:

t I feel like we are at the beginning of what could be a really long process of elimination. Any experience with this test (TLI, folate, B12) on a cat with loose stool and weight loss?

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I'm thinking you might get more responses to this if you were to start up a new thread having to do specifically with THIS matter.  Many people knowing nothing about the Thyroid may simply pass up this thread, not knowing the issues are about diarrhea, which MANY cat lovers deal with 

I'm sorry to hear so far nothing is working..  so far 

BTW, if it IS pancreatic insufficienty (malabsorption), I believe you would need to mix digestive enzymes into her food to help her.  I do that with my senior's food just to help her gain weight, but she doesn't have diarrhea.  Is Vivian losing weight?  That's usually a clear sign of that issue. 

Thank you - maybe when I get some extra time I'll start a new thread - and yes Vivian has lost significant weight since her ordeal began in the summer. 

The blood test will rule out - or in - pancreatic insufficiency. I feel like if that was the problem at least we could take steps to address it as opposed to everything else we've tried that hasn't helped. 

Cat Pal said:

 
Thank you - maybe when I get some extra time I'll start a new thread - and yes Vivian has lost significant weight since her ordeal began in the summer. 

The blood test will rule out - or in - pancreatic insufficiency. I feel like if that was the problem at least we could take steps to address it as opposed to everything else we've tried that hasn't helped. 

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Just cut and paste your last post into a new thread in the Health Forum with a new title (may "controlled diarrhea - possible pancreatic insufficiency" or something like that)  Shouldn't take much time.  You can always refer anyone to THIS thread for questions.

Yes, I hope you can get some answers soon.