Blood in stool

Hi guys, this is my first time posting here. So here is the problem I am facing:

Cat profile:

- Izu

- 5.4 kg

~7 years-old

-Indoor only

- Feed with Royal Canin fit32 for about 3~4 years

- No changes in energy or appetite

- Vomits at least twice a month

- As we have another cat, they both lick each other very often

August  2015

- I realized there was some blood in his stool then I took him to a new vet 

- Diagnosed with colitis  (no tests, besides a blood test, were made. The vet simple told me it was colitis ).

- Prescribed Sulfasalazine for 10 days

- After that, I saw no more blood, although I was no very rigid in tracking it...

January begin of month 2016

- I saw blood again in his stool

- Took him to his regular vet who said the blood could be due to giardia.

- He was prescribed Giardicid 500mb for 5 days.

January end of month- 2016

- He is still having blood in his stool

- His regular vet asked for a ultrasound 

- Ultrasound came fine, we just found some urine sediments in his bladder and we was prescribed enroflaxacin for it

- Vet suggested to change diet. She recommended Hills w/d

March 2016

-  We used Hills w/d for 1 month, but no changes to the blood stool

-  2 weeks ago I switched to farmina natural & delicious, hoping that some grain-free diet would improve his situation, but I can still he blood in his stool

- His stools are softer than before and he is really not into wet food

- **Usually the blood will be only in the last stool*

Now:

I´m taking him to the vet this week, so we can have a urine test and check if everything is ok. 

Last time, his vet told me we would maybe need to do a colonoscopy, if the changes in diet did not work...

I really would not like to do the colonoscopy, I´m a little affraid of it since it involves anesthesia and it seems a very invasive procedure for a cat.

Do you guys could give me any advice regarding this situation? What else should I try/do?

Btw, I live in Brazil. Thx!

Here are some pictures:

19/01

*
19/01


06/02


14/02


01/03


20/03

I'm sorry! This seems like one of those symptoms that can have a variety of causes and it can take a while to rule them out one by one.

I looked up Giardicid, and it looks like it's metranidazole, which is what I've had the best success with for giardia, although there are different strains and some are resistant to some medications, so sometimes one medication will work when another one fails. A PCR panel is the only test that will tell you for sure that he does not have any parasites anymore (if he ever did have them). Another thing to note is that if he's going outside at all, he could be re-exposed to a parasite and being reinfected even after he's been treated for it.

It's also possible that he has an allergy or sensitivity to one or more ingredients. Grains are common culprits, but he could even be chicken that's irritating him. If you can find a limited ingredient food with a novel protein, like rabbit, venison, duck, pork, etc, that would be the BEST way to be sure his problem is food related. Read the ingredients of the food very carefully. You don't want any corn, rice, yeast, or chicken products. I think some cats are even allergic to egg. Wet food is going to be the best for this, and just because he doesn't like one flavor or brand does not mean he does not like all wet food, so keep trying! I'm not sure what brands are available to you, but Nature's Variety Instinct, Merrick, Natural Balance, and Blue Buffalo all have LID lines. It could take a few weeks for the allergens to get out of his system, though, so you would need to give it a month of just feeding this food. and NOTHING ELSE. If the blood disappears, then you know one of the ingredients from before was causing the irritation.You can do some trial and error if you want to switch him to a different food or just keep feeding the limited ingredient food, it's up to you. But then you would know his problem was with the food and you don't need to do further testing.

If there is no change on that diet after several weeks, then I think your next option is to follow the vet's recommendation, because it could be something more serious. Have the vet explain to you all of your options and all of the conditions it could be. There may be something else you can rule out before trying the colonoscopy. But remember, a colonoscopy is a pretty safe procedure. At most they'd do a biopsy of a suspicious polyp, which is just the removal of enough tissue for testing. Mostly it just gives the vet a chance to examine the insides of the cat, and otherwise healthy cats with a good vet do fine under anesthesia.

Molly92 said:

 
It's also possible that he has an allergy or sensitivity to one or more ingredients. Grains are common culprits, but he could even be chicken that's irritating him. If you can find a limited ingredient food with a novel protein, like rabbit, venison, duck, pork, etc, that would be the BEST way to be sure his problem is food related. Read the ingredients of the food very carefully. You don't want any corn, rice, yeast, or chicken products. I think some cats are even allergic to egg. Wet food is going to be the best for this, and just because he doesn't like one flavor or brand does not mean he does not like all wet food, so keep trying! I'm not sure what brands are available to you, but Nature's Variety Instinct, Merrick, Natural Balance, and Blue Buffalo all have LID lines. It could take a few weeks for the allergens to get out of his system, though, so you would need to give it a month of just feeding this food. and NOTHING ELSE. If the blood disappears, then you know one of the ingredients from before was causing the irritation.You can do some trial and error if you want to switch him to a different food or just keep feeding the limited ingredient food, it's up to you. But then you would know his problem was with the food and you don't need to do further testing.

Click to expand...

Molly92 has already summarized a lot of what I'd suggest, too. We had a very similar situation with our previous cat as you have with Izu: Brooksie started having bloody stools when she was around Izu's age and your pictures look very familiar. The vets didn't know what to do: they weren't very knowledgeable about feline nutrition so also just slapped a "colitis" diagnosis on our cat and told us it wasn't very serious. It can get serious so it's good that you're trying to treat it now! Our cat lived many more years (to 16 or 17!) with symptoms on-and-off. Only toward the end did we realize it was most likely fish and/or grains (I think it was probably both) that were bothering her. She most likely had IBD for many of those years: she had lots of other serious health issues that made it difficult to get a real diagnosis but she somehow stayed pretty active until her last year.

As for what to do, Molly92 is right that it may take some time for all Izu's symptoms to go away; the two weeks Izu has been on the new food may not be enough to have full results. It sounds like there's some improvement, right? The Royal Canin and Hills dry foods (you were feeding dry food, right? It sounds like that's Izu's strong preference?) both have a ton of grains so if it's a grain that he's sensitive to, he may have had quite a bit of irritation.

A slightly slower variation of Molly92's method--because of an extra step--might be to first eliminate the "easy" non-meat ingredients from Izu's diet, the ones I think of as common causers of sensitivities: corn, rice, yeast, wheat, carrageenan, potato, and peas. We were able to notice a difference in our previous cat's symptoms just be eliminating all grains. Some cats might have more than one sensitivity. If that doesn't work, I'd go to the novel protein, trying something like rabbit or duck in a food without grains, carrageenan, potatoes, or peas, if that's at all possible. As Molly92 mentioned, chicken is a common problem protein. Fish is, too.

Good luck!

I agree that it could be IBD, my cat Mia had some blood in her stools before she was diagnosed with that. Hopefully the new diet will help. Make sure it's a grain free wet food only, dry food isn't as good.

Molly92 said:

It's also possible that he has an allergy or sensitivity to one or more ingredients. Grains are common culprits, but he could even be chicken that's irritating him. If you can find a limited ingredient food with a novel protein, like rabbit, venison, duck, pork, etc, that would be the BEST way to be sure his problem is food related. Read the ingredients of the food very carefully. You don't want any corn, rice, yeast, or chicken products. I think some cats are even allergic to egg. Wet food is going to be the best for this, and just because he doesn't like one flavor or brand does not mean he does not like all wet food, so keep trying! 

Click to expand...

Yeah, that was why I was changing Izu´s food so often in the last few weeks. I was trying to rule out anything related to food allergies.  We've changed his food to this one: http://www.farmina.com/us/cat-food/15-natural-&-delicious-grain-free-feline.htm

Izu and my other cat really loved this food! As it says it grain-free I think I will stick to it for sometime and see the results. Since this food seems to contain  more proteins than the ones we were giving here, I´ve realized that his stools are blacker than before ( maybe because the food is also black ?).

As for the other food brands, I haven´t found them here in Brazil =/

But as for the wet food, I really want to introduce it to his diet. We are moving to a new place in 3 months and the younger cat is not coming with us, so maybe I could start feeding Izu just with wet food.

If there is no change on that diet after several weeks, then I think your next option is to follow the vet's recommendation, because it could be something more serious. Have the vet explain to you all of your options and all of the conditions it could be. There may be something else you can rule out before trying the colonoscopy. But remember, a colonoscopy is a pretty safe procedure. At most they'd do a biopsy of a suspicious polyp, which is just the removal of enough tissue for testing. Mostly it just gives the vet a chance to examine the insides of the cat, and otherwise healthy cats with a good vet do fine under anesthesia.

Click to expand...

Good to know that this is a pretty safe procedure. I was really affraid something might happen to him, especially because of anesthesia.

LisaHE said:

 
Molly92 has already summarized a lot of what I'd suggest, too. We had a very similar situation with our previous cat as you have with Izu: Brooksie started having bloody stools when she was around Izu's age and your pictures look very familiar. The vets didn't know what to do: they weren't very knowledgeable about feline nutrition so also just slapped a "colitis" diagnosis on our cat and told us it wasn't very serious. It can get serious so it's good that you're trying to treat it now! Our cat lived many more years (to 16 or 17!) with symptoms on-and-off. Only toward the end did we realize it was most likely fish and/or grains (I think it was probably both) that were bothering her. She most likely had IBD for many of those years: she had lots of other serious health issues that made it difficult to get a real diagnosis but she somehow stayed pretty active until her last year.

Click to expand...

Yeah, I don´t think the many vets here know too much about feline nutrition. Many dont seem to know about the grain related problems. 

I will take a look at what are the ingredientes used in this dry food I´m giving to him.

Now, like I told you before, we went to the vet last week.

I´ve told her that we were still seeing blood on his stool and this time she wanted to rule out collitis. So, she prescribed him prednisolone. 

It is a medicine used for humans to treat  a variety inflammatory conditions.

I´ve been giving him 10mg of it a day, split in 2 doses.  

Results

Well, in the firsts days nothing changed... But in the last few days, I have not seen any blood in his stool or on his rectum.

I´m not always there when he goes to the litter box, but when I clean it there´s no sign of blood.

The vet told me to contact her a week later to tell about the results. From what I could understand, if he was getting better she would reduce the mg of prednisolone and we would track his improvements in the nexts months.

Even though this problem seems to be getting better, should I still ask for a colonoscopy or I am a little bit paranoid with that?

thx for all the responses!

So what is the latest?

I would suggest looking into the following things based on what you can afford:

1. A stool sample test
2. A blood test to check his B12/folate. This can give a clue to IBD/small cell lymphoma of the intestinal track if he is not absorbing those properly.
3. A hypoallergenic diet such as Hills Z/D
4. If it continues, a trip to a specialty hospital for a possible endoscopy for a biopsy/final diagnosis.

Prednisolone is used to treat IBD and as a complimentary treatment to small cell intestinal lymphoma. If it is working well, that is probably a good clue it is one of those two ailments. If it is lymphoma, he would need complimentary chemotherapy. The prognosis for small cell lymphoma is pretty good, with most cats living for years and IBD prognosis is also pretty good, with it just being a chronic condition you have to live with. Watch out for signs of diabetes from the prednisolone, such as frequent urination or increased thirst/hunger.

Of course these are all suggestions and non-veterinary advice and should not be taken as such.

My baby girl finally had a "normal" stool. Took about 2 weeks but she also had a cold. Sneezing, runny eye. Added some white rice to her food, 1/16 tsp of pure vitamin C, 1/4 tsp L-lysine to each meal. Plus 1/16 tsp vit c in homemade chicken broth. Whew! Won't be forgetting the L-lysine ever again, and back to the regular diet