Rescue kitten with diarrhoea

Columbine · Mar 14, 2015

I've been posting in the ferals and strays forum about my newest addition - a 9 months-ish kitten called Asha. She's been with me for a week and a half now. When I caught her she was in a bit of a state - drastically underweight (2.5kg instead of 4kg), infected bite wounds on her paw, drastically dehydrated (almost no colour)...the list goes on. At least she tested negative for FIV and FeLV.

Anyway, she had her checkup on Tuesday and things were going well. She was infection free, her colour was a lot better, she'd gained 0.5kg (a lot of that will be rehydration)...In short, things were looking good.

Tuesday night she had beef and chicken cat food (I've been mostly feeding nature's menu pouches - grain free, 70% meat plus broth and vits/mins). Wednesday morning she had explosive liquid diarrhoea. I put her onto poached chicken with some of the poaching water and a little goat's yogurt for probiotics, and later introduced a little pumpkin too (well...I'm in the UK and can't get canned pumpkin, but I found this food that seemed to fit the bill. http://applaws.co.uk/product/cat-tin-chicken-breast-with-pumpkin/ I know it's a complimentary food, but I think it's essentially the same as a home made chicken breast and pumpkin mix). I gave her 24 hrs before calling the vet in the hope that it was simply a bad reaction to beef.

She still wasn't right on Wednesday, so I spoke to the vet. I didn't want to take her straight back in case the diarrhoea was partially a stress reaction. The vet said to continue with what I was doing and see how she goes.

On Thursday there was a marked improvement in the bm consistency, and Asha was more like herself. By Friday, her bm was absolutely normal. I kept her on the chicken, pumpkin and yogurt to be sure that things were properly settled. I did ease off with the yogurt towards the end of the day. She was *ravenous* yesterday, and kept asking for more food. I fed her as much as she asked for.

This morning, my mum went in to see Asha, and found that she'd had a bout of messy diarrhoea overnight (I still crate her at night since her room isn't as cat proof as I'd ideally like it to be). It was all over the tray, on the vetbed, on her blanket and on one of her toys. She was desperate for breakfast so I gave her more or the chicken breast, pumpkin and yogurt mixture, with plenty of yogurt this time. She hasn't had a bm since overnight.

I'm really worried about her. I'm concerned that it may be IBD. There's a related issue too - she's peeing like crazy. I clean her litter box at least four - five times a day because she's living so close to it - just in the one room. On at least 3 of those occasions, I take out the same amount of urine that I get from Shadow's litter tray in 24 hrs (I know it should be twice a day to clean it, but I forget sometimes. Bad mummy!).

Have spoken to the vet. They just said to keep feeding what I'm feeding and see how she goes. They're hoping it's all still stress related.

Has anyone else ever come across this set of symptoms? Is there anything obvious that I've missed?

Sorry this is so long. I'm just worried about my new furbaby. Thanks for reading.

stephenq · Mar 14, 2015

Columbine said:
I've been posting in the ferals and strays forum about my newest addition - a 9 months-ish kitten called Asha. She's been with me for a week and a half now. When I caught her she was in a bit of a state - drastically underweight (2.5kg instead of 4kg), infected bite wounds on her paw, drastically dehydrated (almost no colour)...the list goes on. At least she tested negative for FIV and FeLV.

Anyway, she had her checkup on Tuesday and things were going well. She was infection free, her colour was a lot better, she'd gained 0.5kg (a lot of that will be rehydration)...In short, things were looking good.

Tuesday night she had beef and chicken cat food (I've been mostly feeding nature's menu pouches - grain free, 70% meat plus broth and vits/mins). Wednesday morning she had explosive liquid diarrhoea. I put her onto poached chicken with some of the poaching water and a little goat's yogurt for probiotics, and later introduced a little pumpkin too (well...I'm in the UK and can't get canned pumpkin, but I found this food that seemed to fit the bill. http://applaws.co.uk/product/cat-tin-chicken-breast-with-pumpkin/ I know it's a complimentary food, but I think it's essentially the same as a home made chicken breast and pumpkin mix). I gave her 24 hrs before calling the vet in the hope that it was simply a bad reaction to beef.

She still wasn't right on Wednesday, so I spoke to the vet. I didn't want to take her straight back in case the diarrhoea was partially a stress reaction. The vet said to continue with what I was doing and see how she goes.

On Thursday there was a marked improvement in the bm consistency, and Asha was more like herself. By Friday, her bm was absolutely normal. I kept her on the chicken, pumpkin and yogurt to be sure that things were properly settled. I did ease off with the yogurt towards the end of the day. She was *ravenous* yesterday, and kept asking for more food. I fed her as much as she asked for.

This morning, my mum went in to see Asha, and found that she'd had a bout of messy diarrhoea overnight (I still crate her at night since her room isn't as cat proof as I'd ideally like it to be). It was all over the tray, on the vetbed, on her blanket and on one of her toys. She was desperate for breakfast so I gave her more or the chicken breast, pumpkin and yogurt mixture, with plenty of yogurt this time. She hasn't had a bm since overnight.

I'm really worried about her. I'm concerned that it may be IBD. There's a related issue too - she's peeing like crazy. I clean her litter box at least four - five times a day because she's living so close to it - just in the one room. On at least 3 of those occasions, I take out the same amount of urine that I get from Shadow's litter tray in 24 hrs (I know it should be twice a day to clean it, but I forget sometimes. Bad mummy!).

Have spoken to the vet. They just said to keep feeding what I'm feeding and see how she goes. They're hoping it's all still stress related.

Has anyone else ever come across this set of symptoms? Is there anything obvious that I've missed?

Sorry this is so long. I'm just worried about my new furbaby. Thanks for reading.

Has the vet tested her feces, specifically a PCR test?

Columbine · Mar 14, 2015

No, they haven't asked for a stool sample yet. I think vets in the UK are slower to run a lot of these tests than US vets. It seems that way from reading posts here anyway.

stephenq · Mar 14, 2015

Columbine said:
No, they haven't asked for a stool sample yet. I think vets in the UK are slower to run a lot of these tests than US vets. It seems that way from reading posts here anyway.

Wow, that's shocking. Parasites are very common in cats who've had exposure to other cats, been outside or eaten mice. STep one is testing a fecal sample, not step 5. And i would insist on a PCR test, that's a polymarese chain reaction testing and it is definitive for what its testing for, unlike flotation tests etc that are done in house. It's easy to do, not expensive, and takes a couple of days at a lab. Personally I wouldn't use a vet who didn't do PCR testing.

See the link

https://ca.idexx.com/smallanimal/reference-laboratories/testmenu/innovative-tests/real-pcr.html

jcat · Mar 14, 2015

I agree with StephenQ - a fecal sample should definitely be tested. If the results are negative, wait a few days and have another test done. Something like giardia, which can cause intermittent diarrhea like you describe, won't show up in every sample.

Columbine · Mar 14, 2015

I see your point. Things are different over here though. It wouldn't matter which vet I went to in my area - the attitudes towards testing are the same. I've used my current veterinary practice for 18 years (cats, dogs and horses) and have never had an issue with their care or standards.

I think doing fewer tests is a general thing in this country - its the same with doctors as vets! I do really appreciate your suggestion, I just can't reform the way things are done single handedly.

The vet did say he could totally rule out worms of any sort as the wormer she had is highly effective and won't have left any worms alive in her system.

I'll give Asha the weekend and see how she does. She's just had another bm. It was soft and mucus, but it was all in the right place. If things are no better by Monday I'll definitely ask about a PCR test.

She's just come and got on my lap, which means she's feeling a little better. She'll only come next to me if she doesn't feel right. I'm really hoping things will sort themselves out...I just scare easily when it comes to my little one.

stephenq · Mar 14, 2015

Columbine said:
I see your point. Things are different over here though. It wouldn't matter which vet I went to in my area - the attitudes towards testing are the same. I've used my current veterinary practice for 18 years (cats, dogs and horses) and have never had an issue with their care or standards.

I think doing fewer tests is a general thing in this country - its the same with doctors as vets! I do really appreciate your suggestion, I just can't reform the way things are done single handedly.

The vet did say he could totally rule out worms of any sort as the wormer she had is highly effective and won't have left any worms alive in her system.

I'll give Asha the weekend and see how she does. She's just had another bm. It was soft and mucus, but it was all in the right place. If things are no better by Monday I'll definitely ask about a PCR test.

She's just come and got on my lap, which means she's feeling a little better. She'll only come next to me if she doesn't feel right. I'm really hoping things will sort themselves out...I just scare easily when it comes to my little one.

Does your cat go outside, or have contact possibly with other cats? Giardia and Coccidia are the 2 most common parasites that you want to rule out, and if you can rule them out then you can work on other diagnoses. If on the other hand your cats are strictly indoors only, then I could see in theory postponing testing and working on other possibilities, ie, something the cat ate, food intolerance, etc.

I understand your plight about testing, but i also don't understand your vets

Columbine · Mar 14, 2015

Since I caught Asha, she's strictly an indoor only cat. I do have another cat but Asha's in isolation at the moment, and I've no plans to start introductions until I'm certain she can't pass anything on to Shadow (or my two dogs for that matter).

I think the vets (and I've spoken to two different ones - its a big practice) feel that stress is the most likely cause at present. Before I caught Asha, she was on a farm, and was being bullied by another semi feral to such an extent that she was all but trapped in a cellar (possibly with rat poison). I think its because of these circumstances that the vets are looking first to stress as a cause.

I should also add that it's 2pm here and the vets only work a half day on Saturday, except for emergencies. I'll definitely ask about the testing on Monday if things haven't cleared up by then.

mspurr · Mar 14, 2015

you should probably have a PCR fecal test done, giardia, coccidia are common parasites, and a lot of cats can also have tritrichomonas foetus as well all of these protozoan parasites have symptoms of diarrhea and can be easily treated with meds. I would rule out parasites before beginning diet changes and looking at IBD. Pro Pectalin paste can be useful it has clay to absorb excess water in the intestines and flora to promote a healthy digestive tract.

Columbine · Mar 14, 2015

I really appreciate everyone's help and advice. Unless things deteriorate rapidly Asha's not an emergency case. I will definitely be calling the vets on Monday morning, and I'll be asking about the tests and parasites. In the meantime, all I can do is keep her on a light diet and clean her litter tray immediately after she has a poo. There's no prospect of her coming into contact with any other animals at the moment, so I can at least be sure that nothing can be allowed to spread.

stephenq · Mar 14, 2015

Columbine said:
I really appreciate everyone's help and advice. Unless things deteriorate rapidly Asha's not an emergency case. I will definitely be calling the vets on Monday morning, and I'll be asking about the tests and parasites. In the meantime, all I can do is keep her on a light diet and clean her litter tray immediately after she has a poo. There's no prospect of her coming into contact with any other animals at the moment, so I can at least be sure that nothing can be allowed to spread.

OK so were her stools normal when you got her or did they become bad after you got her? I agree it isn't an emergency and can wait until monday. And thanks for the purraise

Columbine · Mar 14, 2015

She spent her first night at the vet. They didn't say anything about her stools (and I asked how she got on with a litter tray). She had liquid diarrhoea following her wormer, but was then absolutely normal until she had the beef cat food.

stephenq · Mar 15, 2015

Right well as a stray kitten its still most likely to be giardia or coccidia, neither condition resolves on its own. Even absent a diagnosis, vets in the usa will often prescribe a treatment prophylactically in advance of a diagnosis. Two articles below:

http://www.thecatsite.com/a/giardia-and-giardiasis-in-cats

http://www.thecatsite.com/a/identif...dopted-from-animal-shelters-and-rescue-groups

Columbine · Mar 15, 2015

Having read those articles, she does seem to fit the profile for giardia/giardiasis. Thankfully, she's not showing signs of dehydration. I'll definitely bring that up with the vet tomorrow. Thanks

kittymomma1122 · Mar 15, 2015

Make sure to specifically ask for those testing. They are not run in normal fecal studies. I had to pay extra for those testings with my cats. My vet tested stools and ruled that out first. Then went on to stress/change in home and then went to change in diet. Mine ended up being what I think was a bad batch of food. I immediately bought new food of a known protein with Probotics and it cleared them all up.

stephenq · Mar 15, 2015

Columbine said:
Having read those articles, she does seem to fit the profile for giardia/giardiasis. Thankfully, she's not showing signs of dehydration. I'll definitely bring that up with the vet tomorrow. Thanks

OK good luck and keep us updated. I've seen kittens die of untreated giardia/coccidia, eventually it can detrou the lining of the intestines and cause intestinal failure - unlikely in a 9 month old, even very unlikely (I've seen death in 8-10 week old kittens) but regardless these are serious illnesses especially if untreated, and they are easy to treat (although sometimes take time).

Flagyl (metronidazole) or Panacur (fenbendazole) is for Giardia, and Albon (Sulfadimethoxine) is for coccidia.

Flotation tests for parasites (done in house) are less than fully reliable, modern vet practice is to do a PCR (Polymerase chain reaction) test that is completely definitive for what its testing. A neg PCR test for giardia and coccidia means the cat is free of the parasites, and since PCR tests don't generate false positives, a pos test means they have it (see link in prior post). PCR testing is a test of DNA that is amplified.

Another parasite to consider is Tritrichomonas foetus. http://vetmed.tamu.edu/gilab/service/assays/tritrichomonas

Columbine · Mar 15, 2015

stephenq Stupid question:with the swab test, is it an anal swab? Can it be diagnosed via a stool sample? I'm just thinking that Asha's still difficult about where you handle her if it's not her idea/on her terms. She had to be sedated to allow a full examination of her injuries (she'd been living the feral lifestyle for at least 4-5 months). I'd just be a little concerned about another sedation so soon, and if there's another way around the situation I'd prefer to know it before I speak to the vet. It's always so much easier when you know the right questions to ask.

btw - no bm today so far (and it's 2.45pm here). Don't know if that's good, bad or indifferent.

One more thing - Asha had a week long course of antibiotics to clear up infected wounds on her paw. I can't remember which on it was. Is that likely to have any bearing on her current situation?

stephenq · Mar 15, 2015

Columbine said:
@StephenQ Stupid question:with the swab test, is it an anal swab? Can it be diagnosed via a stool sample? I'm just thinking that Asha's still difficult about where you handle her if it's not her idea/on her terms. She had to be sedated to allow a full examination of her injuries (she'd been living the feral lifestyle for at least 4-5 months). I'd just be a little concerned about another sedation so soon, and if there's another way around the situation I'd prefer to know it before I speak to the vet. It's always so much easier when you know the right questions to ask.

btw - no bm today so far (and it's 2.45pm here). Don't know if that's good, bad or indifferent.

One more thing - Asha had a week long course of antibiotics to clear up infected wounds on her paw. I can't remember which on it was. Is that likely to have any bearing on her current situation?

Hi

No not an anal swab, you just provide a stool sample. And yes, antibiotics can cause diarrhea, so if the diarrhea started after the antibiotic therapy was begun, that could be the cause.

Columbine · Mar 15, 2015

Thank you for all the info. Sorry if I'm being dense (on very strong pain meds today and brain not working too well

). The issue did start about the same time as she finished her antibiotics.

I'm still hoping it's all a reaction to all the changes she's had recently, not least being able to get enough to eat for the first time in months. I'll still be speaking to the vet tomorrow to ask about these parasites, testing etc.

Thank you for your help and patience

puck · Mar 15, 2015

You got Asha a week and a half ago, finished the antibiotics before the recheck appointment that confirmed her wound had healed and she'd gained weight, but her diarrhea is persisting beyond completion of oral antibiotics, correct?

If so, veterinary probiotics with higher colony counts of beneficial bacteria is standard treatment during or after antibiotic administration. Proviable by Nutramax Labs and FortiFlora by Purina are effective, Proviable the better option but FortiFlora is flavored and more palatable for cats.

Sometimes, a fecal sample that is soft or watery may not contain the eggs that are identifiable via microscopy to diagnose parasitic infections, including giardia cysts and coccidia eggs, or the parasites' life cycle is not currently shedding eggs that are visible on these tests. Often, broad spectrum treatment for worms/giardia is started even if no eggs/cysts are seen on microscopy. Fenbendazole (brands Panacur/Safeguard) cover rounds/hooks and giardia. Same for coccidia, prophylactically starting treatment, Albon, whether cells are seen on the fecal slide or not.

A direct slide, a gram stained slide, and a flotation by centrifugation slide are standard workup for diarrhea diagnostics. You can ask that all 3 be ordered and reviewed closely, without waiting for a vet to recommend it first. A proliferation of "bad flora" in the small intestine can be difficult to return to normal population without probiotics and targeted antibiotics for GI flora (metronidazole). Tylosin (tylan powder) is very effective to treat these bacteria, namely sporulating clostridia, but it's severely bitter. Their dose is less than 1/16th teaspoon Tylan and must be well masked in stinky soft food or delivered via gelcap due to terrible taste. Not all vets carry Tylan or use it, but metronidazole is widely stocked and prescribed.

Having pale mucous membranes when you caught her a couple weeks ago indicates anemia. Tacky, rubbery feeling to the mucous membranes indicates dehydration. If she was anemic, dehydrated, and having diarrhea, parasites are a strong diagnosis to rule out.

again, we often start them on Proviable, Panacur, Albon, and metronidazole/Tylan even if we don't find eggs/cysts via microscopy as these treatments don't worsen diarrhea, don't contribute to nausea or dehydration, and can improve GI health overall. If your vets say all her fecal diagnostics were negative, ask them to recommend/prescribe treatments prophylactically. You can ask them to check a PCV/TS as this is fast, inexpensive, and easy way to see if she's still anemic or slightly dehydrated. Persistent diarrhea may have dried her out a little, and she needs a supportive bolus of subcutaneous fluid.

Good luck getting her diarrhea resolved. It can be trying, especially when they're low body condition and really can't afford to lose any water or weight. Glad she wound up with you, at least, and not struggling for resources and basic survival anymore!

Rescue kitten with diarrhoea

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