back to runny stools after finishing 10 days of metronidazole

Hello everyone. We got 6 month old kitten 2 month ago. He never had normal stools- always very soft,smelly and alot of it. All his stool test came back normal but vet prescribed metronidazole anyway. Miracle med. From the very first day on this med stool got back to normal. When we finished yesterday - running again. Can't afford to go to the vet again. Please help. He is on wet grain free food twice a day and grain free dry all the time

Did the vet test his stool for giardia?  A friend of mine had a kitten with similar symptoms and while the metronidazole worked while he was taking it, evidently he needed a much longer course of it and also some probiotics.  This one has been most helpful:  Saccharomyces boulardii.  It is tasteless and mixes into the food, but don't get the Yarrow brand as it is orange flavored and cats do not like it.

I will ask my friend how long she had to treat her cat before getting a full cure.

http://www.swansonvitamins.com/nutr...GYw5t-vxlmNVKpfv-m-P056Y7n64_HJwoRBoCFPbw_wcB

Yes, the S boulardii helps normalize intestinal function. It is used in hospital settings to fight antibiotic resistant C diff. It is one of the most researched probiotics in existence. It is a yeast-based probiotic, so does not colonize the gut, which is why it is very important to give it twice a day. A TCS member used it to treat C perf in her cats with nothing else, and I used it to treat coccidia in kittens with nothing else.

The Jarrow brand is bitter, but that is because of the MOS (mannan-oligosaccharides). I'm not sure what Red Top Rescue is saying about orange flavor if referring to Jarrow? It isn't. But cats often won't eat it sprinkled onto food.

Here is information on "stop diarrhea" instructions - the idea is to use a "loading dose" to flush the intestines with the S boulardii. It is not digested, it passes undigested into the intestines where it resides in the lumen and helps restore normal function. http://www.ibdkitties.net/Probiotics.html

After that few days, please note the instructions for use in kittens, depending on which brand you decide to use.

And if you're concerned about safety and how it works or what it does, here is further information: http://www.thecatsite.com/t/283161/saccharomyces-boulardii-use-for-diarrhea-and-gi-disease-incl-ibd

Thank you very much for the info. Vet just gave us yesterday another 14 days of metro and fortiflora. You think this probiotic wouldn't work as good as s boulardii?

Fortiflora is a completely different type of probiotic, used for a different reason. It is also mostly animal digest, and has only one active strain of bacteria in it. When using a bacterial probitic to re-establish gut flora, I prefer one that has multiple strains with proven benefit, most notably L acidophilus, L rhamnosus, L plantarum, and bifidobacterium. Fortiflora does help some cats with antibiotic-associated diarrhea, which is really what it's designed to do. S boulardii, in my experience, is far more effective at that, though. A big difference is that S boulardii some cats don't like, whereas Fortiflora is often used to entice cats that are inappetant to eat. It's that animal digest in there - a nasty ingredient (IMO), but it's what they spray on kibble to make cats want to eat it. Many use both - the S boulardii because it tends to be effective, and the Fortiflora, because it makes it smell good.

if this round of metro doesn't "take," I would consider other options, and get the testing done to look for giardia and the PCR test to look for clostridium, coccidia, T foetus, etc. Metro is not meant for long term use as it is a class 3 cancer agent in the EU, and it is genotoxic and potentially neurotoxic. The abnormal cells did go back to normal after six days when an animal was given a 7 day course, but there aren't long term studies. It often seems like a magic pill, but vets forget to inform us of the potential problems with using many meds, especially in ways they weren't meant to be used. For instance, if the problem is giardia, clearly it is metro-resistant, and panacur should be used. Right now, without fecal testing, your kitty is being treated without a diagnosis... IMO, it is much safer to do that with something like S boulardii, as it has shown to resolve things like C diff - as in positive on a PCR test before its use, and negative after a month. With no side-effects. So the way I see it, if you want to use antibiotics or anti-protozoa type meds that can be toxic to the body with many potential rather nasty side-effects, find out what you're trying to kill first so you use the correct weapon against it. :nod:

Sorry I didn't explain the situation well. We didn't do PCR but we did in-house stool test after unsuccessful 4 days treatment of panacur and it came back negative ( including giardia).

ask your vet to test for tritrichomonas foetus, my kitten had loose smelly stools that only got better while she was on metronidazole, soon as the meds stopped the smelly loose poo came back. all her fecals were negative too. the vet tried probiotics,diet changes nothing helped. I spent over a thousand dollars on bloodwork,fecals meds,foods, finally we did a test for TF and she was positive for TF which causes large bowel diarrhea. the cat will gain weight,be active normal in every way with TF except for loose smelly stools that temporarily respond to metronidazole. after treatment with RONIDAZOLE the kitty has normal stools. if I had tested and treated sooner I would have saved a lot of money, TF isn't tested for in standard fecal tests, a specialized test for TF is the only way to detect the protozoa . you can get more info on TF symptoms,treatment, test costs etc at http://www.cvm.ncsu.edu/docs/personnel/gookin_jody.html  if this link doesn't work go to NC State University College of Veterinary Medicine  Dr.Jody Gookin DVM

When my male kitty was about the same age as your kitty, he developed the same problem.  We were also feeding him grain free wet twice daily and grain free dry through the day.  We also did the metro a couple of times with the same results after finishing a course.  Turns out he can't handle a totally grain free diet!  The vet put him on Royal Canin's Gastroinstestinal HE (dry) and that did the trick!  Initially we gave him the grain free wet and just the Rx dry food, but once his stools firmed up consistently, we started reducing the amount of the Rx food and increasing the amount of the grain free dry food so that now he eats approximately 95% grain free and the other 5% is the Rx food that keeps his stool firm.

Thanks. I was thinking that maybe he doesn't tolerate some of the food ingredients or like a lot of people suggested he needs to get further testing done

I'm not sure he needs further testing.  You could ask your vet for a sample of some prescription food for sensitive tummies and see if that helps first.

Thanks. We tried Royal Canine wet food once - he didn't like it. What do you think is more important - I mean effective for the sensitive stomach issues -wet or dry food? Any kind you would recommend?

I used a royal canin dry food  the bag says Royal Canin Special  Diet 33, it is a special diet that has fiber and flora to promote healthy firmer stool, and Pro-Pectalin for cats  while i was waiting for test results and during treatment for TF but I must say loose,cowpie,smelly stools that return after treatment on metronidazole is a classic symptom of TRITRICHOMONAS FOETUS in cats and doesn't show up on a routine fecal. also coccidia can be hard to catch on routine fecals that's why a pcr test on a fresh fecal sample  collected at the vets office would be the best way to go! Protozoan parasites can often be misdiagnosed as food intolerances. 

Thanks. I makes me feel better than I know what way to go. Uncertainty and just trying out everything that doesn't work is the most frustrating

Did you ask the vet for the prescription brand of food?  They should have a small sample bag that you can try.  We continue to feed my guy grain-free canned and a mix of grain-free & the Rx food dry.  You definitely want to try to keep as much wet food in his diet as possible.  It might be something in the dry food causing the issue.  Ask your vet about the prescription RC Gastro HE and see if you can get a sample bag.

I agree with the PCR test.  The IDEXX 2627.  TF is in about 20% of the cat population.  We had it in our cattery about 8 years ago and successfully treated it.  Vets don't mention it much because they may not be up to date with current information.  Here is a link to the best source of information.  http://www.cvm.ncsu.edu/docs/documents/ownersguide_tfoetus_revised_122009_final.pdf

We actually used the pouch test and microscope to confirm that we had it.

I would wait at least 2-3 weeks after all meds are stopped before taking the test.  I would also test before assuming the cat needs special food.

stephanietx said:

Did you ask the vet for the prescription brand of food?  They should have a small sample bag that you can try.  We continue to feed my guy grain-free canned and a mix of grain-free & the Rx food dry.  You definitely want to try to keep as much wet food in his diet as possible.  It might be something in the dry food causing the issue.  Ask your vet about the prescription RC Gastro HE and see if you can get a sample bag.

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my Vet doesn't have samples but they accept it back if my kitty doesn't like it. Didn't try prescription dry but he hated prescription wet gastrointestinal food.
I have a question about wet food: I feel it needs to be good grain free food but I'm not sure about what kind. I've heard if I change it too often ( chicken to seafood for example) that may cause his digestive problems. But for me it seems if I stick with the same kind he can create some deficiency or develop allergy.

innaur said:

Thanks. I makes me feel better than I know what way to go. Uncertainty and just trying out everything that doesn't work is the most frustrating

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  the first vet I went to diagnosed my cat with a food allergy,intolerance and when I gave the cat diagel and the stools were firm turds in a mucusy liquid on the diagel I new this something else .  so then I went to a vet at the same practice that specialized in gastrointestinal and urological medicine  this vet told me TF is very often misdiagnosed as food allergy or intolerance and he is seeing a lot more cats infected with TF.I wish I had tested my cat sooner I would have saved a lot of money  that I spent on foods and treatments that never resolved the problem. PCR TEST or a TFpouch test is probably the way to go 

Thanks

I'm planning to do pcr test when we will be done with second round of metro and know for sure it didn't help. But unfortunately I do think he might have some allergies / sensitivities because he has some kind of crasts on his skin. They don't seem to bother him

Try the prescription dry and see if that settles his tummy.  As for the wet, we feed Innova EVO turkey & chicken and the venison varieties.