long term soft stool

mpsmom

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I have a senior cat (18yo) that has had soft, stinky poop for several months now. His bloodwork was normal, including thyroid, except lymphocytes were a little low (667 where not supposed to be lower than 850). Fecal O&P and Giardia nothing seen and negative (respectively). Urinalysis normal. Tried a round of flagyl, didn't do anything. Any suggestions on what I/we should look at next?
 

betsygee

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I have a 12 year old who is like that.  She's 'healthy' according to the vet and according to blood work.  I started giving her pumpkin and they've firmed up.  I don't know what the problem was, but the pumpkin solved it.  
 

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I have a senior cat (18yo) that has had soft, stinky poop for several months now. His bloodwork was normal, including thyroid, except lymphocytes were a little low (667 where not supposed to be lower than 850). Fecal O&P and Giardia nothing seen and negative (respectively). Urinalysis normal. Tried a round of flagyl, didn't do anything. Any suggestions on what I/we should look at next?
Hi

Was IBD discussed?
 
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mpsmom

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No, what would be the protocol for that (IBS)?
 
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mpsmom

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I forgot to mention, he also has the sniffles, so I'm not sure about IBS.
 

stephenq

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I forgot to mention, he also has the sniffles, so I'm not sure about IBS.
Hmmmm, for an indoor cat who doesn't contact other cats to get the sniffles (sounds like possible URI) is unusual.  

Does he have contact with other cats?

Does he go outside?

What does your cat eat?  Including treats.

If he does go outside then i would want to do PCR testing of his stool at an outside lab (polymerase chain reaction) which amplifies the DNA of any offending parasites and is basically definitive where in house testing is not especially for giardia, coccidia and Tritrichomonas foetus

But if you were sure it wasn't worms or parasites then early stage IBD is usually diagnosed presumptively based on symptoms and  some basic treatments and if the basic treatments work then you have a working diagnosis.

Was there any change to your cat's diet, stress etc when this all started?

You could try canned pumpkin as noted above by  @betsygee  but if that doesn't help then you can discuss with your vet some basic things like trying a prescription novel protein diet in case your cat is having an immune response to ingredients in the current food.  If that doesn't work vets often go to Tylosin an antibiotic that can re-balance the intestinal bacteria, or probiotics although generally not at the same time.

If none of that worked given your cat's age i would personally skip any type of intestinal biopsy, but i would consider a 1-2 week course of prednisolone, and if that worked, then you have a good idea of what is wrong.
 
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mpsmom

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Hmmmm, for an indoor cat who doesn't contact other cats to get the sniffles (sounds like possible URI) is unusual.  


Does he have contact with other cats?


Does he go outside?


What does your cat eat?  Including treats.



If he does go outside then i would want to do PCR testing of his stool at an outside lab (polymerase chain reaction) which amplifies the DNA of any offending parasites and is basically definitive where in house testing is not especially for giardia, coccidia and Tritrichomonas foetus



But if you were sure it wasn't worms or parasites then early stage IBD is usually diagnosed presumptively based on symptoms and some basic treatments and if the basic treatments work then you have a working diagnosis.



Was there any change to your cat's diet, stress etc when this all started?



You could try canned pumpkin as noted above by  @betsygee but if that doesn't help then you can discuss with your vet some basic things like trying a prescription novel protein diet in case your cat is having an immune response to ingredients in the current food.  If that doesn't work vets often go to Tylosin an antibiotic that can re-balance the intestinal bacteria, or probiotics although generally not at the same time.



If none of that worked given your cat's age i would personally skip any type of intestinal biopsy, but i would consider a 1-2 week course of prednisolone, and if that worked, then you have a good idea of what is wrong.
He does go outside and could possibly have contact with other cats, if the other cats approached him (he's not one to go after other cats). He also has 3 other cats in his own house that do not have any of the symptoms after all this time, so I'm guessing it's not something contagious. He eats grocery store food, 9-lives, friskies, meow mix, mostly dry with can thrown in a few times a week, but he's not a big canned foodie, mostly likes the juice. Occasional human food, chicken, pork, steak and regular cat treats, pounce, temptations, whiskers, etc. His labwork was sent out for the giardia and parasite testing. The 1-2 week course of prednisolone, if that worked, would that indicate it was/is IBS? Is it possible that the sniffles and soft stool have nothing to do with each other? And, is it possible that an upper respiratory infection is something that's not contagious to the other cats? I had a dog (actually 2 because they kept swapping) that had spirochetes. The one who came with the problem, was treated with many, many rounds of antibiotics that had no affect, he was also eating 5 cups of food a day (maintaining weight) when it should have been more like 3. It wasn't until I got him and took him to my favorite vet (who unfortunately has since retired) that he looked at the stool under a scope instead of a fecal float and diagnosed spirochetes. One round of a different antibiotic and he had solid poop for the first time in 12 months. I can't help but wonder if it's something as simple as that with my cat...
 

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 It wasn't until I got him and took him to my favorite vet (who unfortunately has since retired) that he looked at the stool under a scope instead of a fecal float and diagnosed spirochetes. One round of a different antibiotic and he had solid poop for the first time in 12 months. I can't help but wonder if it's something as simple as that with my cat...
Ok if the stool was sent out for testing then probably PCR testing which is good, so if those test were negative then that's a solid result.  But i'd want to make sure it was PCR testing and that they test for everything, giardia, coccidia, Tritrichomonas foetus.  And was he dewormed when all this started? If not that's worth doing too.

All that's below i'd do in consultation with my vet.

Given his age and the wide variety of foods he's getting, if it was me the first thing i'd try and do now is quiet down his stomach and see if that works.  He's getting a lot of different types of foods both human and feline, he's a senior and he just may not be able to handle it.

Step 1 - 24 hour Fast, just water. (not everyone is willing to do this and if you're one of them then proceed to step 2)  The fast will help settle him down.

Step 2, introduce and limit his food to a very gentle chicken and rice diet. Boiled chicken, no skin, boiled rice, mashed up and served with nothing else except water for about 3 days.  If this works then slowly reintroduce one  wet food and one  dry food, something not too rich and easy to digest like Iams chicken wet and dry.  Or you could go with a prescription sensitive stomach food by Hill's or Royal Canin.  If that all works then you dodged a bullet and you're done.  Also, very gentle treats like rehydrated chicken breast (comes in a jar at pet stores).  Alternatives to the boiled chicken and rice would be human baby food chicken flavor stage one only.  ANd you could always add some canned pumpkin too.

If the above didn't work then i'd be looking at a prescription novel protein, novel carb (like rabbit and peas) (any only the prescription versions can guarantee by DNA testing that they are 100% of the correction animals) and see if that works.  If it does, then that's diagnostic for IBD (or IBS if you prefer).  If the food switch doesn't work then as i said above i'd be looking at increasingly effective IBD treatments, like Tylosin or Prednisolone, but if I had the money you could do an ultrasound of the intestine and if they sound thickening with loss of layering that would support an IBD diagnosis.  
 
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mpsmom

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But i'd want to make sure it was PCR testing and that they test for everything, giardia, coccidia, Tritrichomonas foetus.  And was he dewormed when all this started? If not that's worth doing too.
It appears it was tested just for giardia and i guess, scoped for ova and parasites. He was not dewormed, wouldn't something show up in his poop if he did have worms? I buy a 13-16lb bag of food and often 2 at the same time, so it's not like he's getting a different food every week or even every month. And, for treats (human), unlike 2 of the piggy cats, it's probably a couple times a month. Although, you bring up a good point... I had a cat with a tumor on his liver (another sr that I lost in April)... he started losing weight and all he really wanted to eat were treats so all the cats were getting treats a LOT. I don't remember when I started buying lots of treats for Sammy or it that coincided with Trey's poops, but they could coincide. If Trey did have something respiratory, would that manifest in soft stools? He's not coughing, but I've seen him sneeze and fluid come out of his nose.
 

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But i'd want to make sure it was PCR testing and that they test for everything, giardia, coccidia, Tritrichomonas foetus.  And was he dewormed when all this started? If not that's worth doing too
It appears it was tested just for giardia and i guess, scoped for ova and parasites. He was not dewormed, wouldn't something show up in his poop if he did have worms? I buy a 13-16lb bag of food and often 2 at the same time, so it's not like he's getting a different food every week or even every month. And, for treats (human), unlike 2 of the piggy cats, it's probably a couple times a month. Although, you bring up a good point... I had a cat with a tumor on his liver (another sr that I lost in April)... he started losing weight and all he really wanted to eat were treats so all the cats were getting treats a LOT. I don't remember when I started buying lots of treats for Sammy or it that coincided with Trey's poops, but they could coincide. If Trey did have something respiratory, would that manifest in soft stools? He's not coughing, but I've seen him sneeze and fluid come out of his nose.
Sorry for the delay in replying!

The sneezing and the poop are not related, but the sneezing could be a URI. Is he loosing weight?

Worms would often show up in stool but not always so i would always deworm if an indoor/outdoor cat started getting soft stool.
 
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mpsmom

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Sorry for the delay in replying!


The sneezing and the poop are not related, but the sneezing could be a URI. Is he loosing weight?


Worms would often show up in stool but not always so i would always deworm if an indoor/outdoor cat started getting soft stool.
Ok, so it sounds like there are possibly 2 things going on... the runny nose and the soft poop. He may have lost a little, but he's always been a long, lanky boy. As far as the runny nose, if they listened to his lungs at the last visit, would they have heard something that indicated a URI or what is the diagnostic for that? Appreciate your time.
 

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Sorry for the delay in replying!

The sneezing and the poop are not related, but the sneezing could be a URI. Is he loosing weight?

Worms would often show up in stool but not always so i would always deworm if an indoor/outdoor cat started getting soft stool.
Ok, so it sounds like there are possibly 2 things going on... the runny nose and the soft poop. He may have lost a little, but he's always been a long, lanky boy. As far as the runny nose, if they listened to his lungs at the last visit, would they have heard something that indicated a URI or what is the diagnostic for that? Appreciate your time.
Agreed, 2 things going on. No, most URI's don't enter the lungs, they are diagnosed by sneezing, discharge from nose and eyes, typically.
 
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mpsmom

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Update: After $400 of testing, blood and a repeat stool, she's pretty sure he doesn't have giardia, but the blood work did indicate possible pancreatitis. Chicken and egg scenario, not sure whether the pancreatitis caused the ibd or the ibd caused the pancreantitis. For now, he's on cosequin for his sore hips and probiotics. The thing is, once again, what they did was a fecal float and I keep thinking about my dog with the spirochetes that they didn't see until they scoped the poop.
 
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mpsmom

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How was pancreatitis diagnosis made? Was Spec fpl run?  It is said to be the most accurate test.
Don't recall specifically, but it was a marker on his bloodwork that was either high or low. He finished out a month of probiotics and a dewormer that ended over a week ago (for some reason, I still had half a bottle left after 5 days, so gave him another 2-3 days). Still got soft serve poop.

How long can a cat live with Leptospirosis and, how likely is it that if one cat has had spirochetes for over a year that some of the other's haven't picked it up? His symptoms seem to fit and I've had 2 dogs that have had spirochetes. I tried looking back over my vet statements for which antibiotic was given to the dogs, but receipts just show RX.
 

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A friend of mine adopted a kitten from the shelter who had spirochetes, but it was a different species and was treated with tylosin.  My friend reported that these bacterium are very small and hard to see, so her vet found it by doing a gram stain.   I had these links bookmarked and I am concerned that this sort of bacterium can be passed from cats to humans so ask your vet but I think you want to be extra careful sanitizing everything with a bleach solution. Please keep us posted.

http://www.merckvetmanual.com/mvm/g...ew_of_leptospirosis.html?qt=spirochete&alt=sh

https://www.vetinfo.com/symptoms-of-leptospirosis-in-cats.html
 
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