Please help!--kitten w/ recurring diarrhea despite many visits to vet, changes in diet, and medicati

anjayenunciates

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This is my kitten Sir Montgomery Hemingway--Monty for short.  He is 5 months old, polydactyl on all 4 paws, and likely a Siamese + Snow Bengal Mix.  He is updated on his shots/vaccinations (except for rabies due to age, and being neutered due to age), does not/has never had worms, and has tested negative for all FIV, etc. type health issues.  He is very alert, affectionate, playful, and energetic--no lethargy out of this little man AT ALL.

However, little Monty is having some MAJOR GI issues.  I'll try to break everything down concisely below (a lot has happened):

**Day of 3/26/16--We picked up Monty from the rescue he was at, in the CA desert, about 2.5 hour from where we live.  He was dirty when we got him (rescue had him in a big crate in a garage), had some eye boogers, and a little bit of a runny nose.  He was sneezing, but was still alert, affectionate, and, of course, extremely cute.  The rescue told us she felt he may be part bengal and, thus, she had been feeding him a raw diet.  In the car, Monty poo'd on my lap, and in the cat carrier.  We called the vet and were told that it is likely due to stress, since cats don't travel well, and he was in the car for a long time.  When we got home, we bathed Monty (he totally hated it, but poo was everywhere from the car ride), and he acclimated to the house.  

**Night of 3/26/16--After feeding Monty (who rigorously at his food) Blue Buffalo Kitten Food (we are aware changing foods for kittens may cause diarrhea, now), for the day, he still had diarrhea, suddenly with a watery red-tinge to it.  We were wiping the little's butt almost every 30 minutes due to anal leakage.  Assuming this was blood, we took him to an ER vet at 2AM, and were told the diarrhea was indeed, likely due to stress from moving, the car ride, and the new food, and to please give Monty 0.4 of Metronidazle (antibiotic) 2x a day for 7 days.  Monty tested negative for parasites like Giardia and etc.

**Afternoon of 3/28/16--Because Monty was still having diarrhea, with somewhat less leakage between bowel movements, we look him to another vet.  He was given a clean bill of health, other than likely having some GI issues, and was prescribed 0.9 ml/day Panacur (dewormer/for parasitic infections) for 5 days.  We were also given Revolution (flea/tick) as well.  During this visit, Monty's ears were cleaned as well.

**Afternoon of 3/31/16--Since Monty was still having the same amount of diarrhea, we took him back to the vet, this time prepared with a stool sample from home.  The stool sample was sent off to a lab (results pending now), Monty's ears were re-checked, and an ear infection was found, for which he was prescribed 2 drops of Tresaderm (antimicrobial/antifungal/corticiosteroid) 2x/day in each ear for 7 days.  At this point in time, Monty was put on a strict diet--MRX Hills Feline I/D (Gastrointestional), and 1 packet of powdered Advita (probiotic), to be put on his food daily.  We were advised to mix his current food (Blue Buffalo) with the new food 50/50, so that he could slowly acclimate to the new food, while also adding the probiotic.  The vet and staff did not seem very concerned due to how playful, alert, and all around normal kitten-like Monty was while in the office.  We were told we would get results from the fecal exam soon, and that if the fecal exam did not give us any answers, our next step would be to get an xray.

**Night of 3/31/16--Monty did not eat the combination of the two foods with the probiotic.  We tried having Monty eat the new food by itself, which he did not eat.  We then tried the old food by itself, which he ate some of, until we added the probiotic.  We then tried the new food by itself, which he ate if we pointed him to the bowl and sat with him while he ate (somehow, he is extremely obedient).  However, he has not been eating near as much as he used to on the Blue Buffalo food.

**Day of 4/2/16--Monty is now eating the Hills food more regularly, but he is definitely having some anal leakage over night, and after he has a bowel movement.  He will poo in a semi solid form, leave the litter box for 5-10 minutes, go back in the litter box, and have a liquid poo--its almost like the second bowel movement hasn't been in his colon long enough to solidify.  He strains during the second poo, and it sometimes has a thin, reddish tinge to it.  He is definitely better in terms of anal leakage, and pooping in general than he was a week ago, but we have yet to see a completely solid poop since he has been with us.  

We really love Monty, and he is worth spending the money on--we want him to get better.  We are doing our absolute best to get him the care he needs.  However, at this point, we do feel helpless.  We've had him on antibiotics,  probiotics, special food--you name it--and he is not better.  He is not stressed in our home--he is very happy--so the likelihood of him having stress diarrhea a week later doesn't seem likely.  If you have any comments, questions, concerns, etc., please help us!  We want our little man in tip top shape as soon as possible.

Thanks!
 

misterwhiskers

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Has he been fully tested for parasites? Including giardia? Dewormed as well? Some parasites are a little more stubborn than others.

Another kind of off the wall idea to consider is constipation. Sounds weird but I (ahem) had this issue a few months back, and it presented with 3 weeks of diarrhea. It was a partial blockage, and sometimes this presents as diarrhea in people. Not sure if it's the same with kittens, but maybe you could ask.

Have you tried Fortiflora or another probiotic especially designed for cats, or plain yoghurt?

Edit: just saw the part where you claim he's never had worms. I've had 8 cats, most since kittenhood, and you must presume that all kittens have worms and need dewormed. Especially if he was fed a raw diet! Which also increases his chances of contracting toxoplasmosis; it's the #1 way humans get it.
 
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anjayenunciates

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Has he been fully tested for parasites? Including giardia? Dewormed as well? Some parasites are a little more stubborn than others.

Another kind of off the wall idea to consider is constipation. Sounds weird but I (ahem) had this issue a few months back, and it presented with 3 weeks of diarrhea. It was a partial blockage, and sometimes this presents as diarrhea in people. Not sure if it's the same with kittens, but maybe you could ask.

Have you tried Fortiflora or another probiotic especially designed for cats, or plain yoghurt?

Edit: just saw the part where you claim he's never had worms. I've had 8 cats, most since kittenhood, and you must presume that all kittens have worms and need dewormed. Especially if he was fed a raw diet! Which also increases his chances of contracting toxoplasmosis; it's the #1 way humans get it.
Hi!

He was tested for parasites on 3/26/16 and results were negative for all.  He finished 5 days of Panacur (de-wormer) about a day ago.  

We have Advita (probiotic), which is to be sprinkled on his food.  However, he won't eat his food with it on there.  

:(
 

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I would bet he has parasites, despite the tests at the vet coming back negative. Kittens from rescues get diarrhea-causing parasites really easily, and in house parasite tests commonly come back as false negatives, leading owners to jump through hoops changing food, etc, when actually it's parasites that were missed. Giardia and coccidia are most common, but it sounds like he was exposed to a lot of stuff in the shelter so he may have more than one. Metronidazole and Panacur treat a lot of these, but not all of them, and even some of those strains are more resistant and need multiple rounds of treatment. Stress can also make the symptoms worse. What test is being done on the sample that was sent out the lab? A PCR test is going to be the most accurate and detailed. This actually identifies parasitic DNA in the stool rather than looking for the parasites under a microscope. Also, what color is his stool, aside from reddish? This can sometimes help in a diagnosis.
 
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anjayenunciates

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I would bet he has parasites, despite the tests at the vet coming back negative. Kittens from rescues get diarrhea-causing parasites really easily, and in house parasite tests commonly come back as false negatives, leading owners to jump through hoops changing food, etc, when actually it's parasites that were missed. Giardia and coccidia are most common, but it sounds like he was exposed to a lot of stuff in the shelter so he may have more than one. Metronidazole and Panacur treat a lot of these, but not all of them, and even some of those strains are more resistant and need multiple rounds of treatment. Stress can also make the symptoms worse. What test is being done on the sample that was sent out the lab? A PCR test is going to be the most accurate and detailed. This actually identifies parasitic DNA in the stool rather than looking for the parasites under a microscope. Also, what color is his stool, aside from reddish? This can sometimes help in a diagnosis.
Hi!

Monty was never at an actual shelter--he was in a foster home from the time he was surrendered.  There were no other cats at the foster home, just Monty.  We asked the vet if he might have salmonella from a raw food diet, which he was on at the rescue, but were told his symptoms would be way worse if that was the case--since he is not lethargic, no vomiting--nothing, except for loose stool.  

An advanced fecal culture (that's what the paperwork says) is being done on his stool.  It is apparently so advanced they had to send it to a separate lab, because they are unable to test it as thoroughly on site.  

His stool started out as a yellow/brown color.  It is now very normal brown in color, without the reddish tinge--like a mix of milk and dark chocolate, for lack of a better color description.  However, it smells REALLY bad.  I can't even describe the smell.  He is also really gassy--so much that we can hear him passing gas.
 

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I'm glad to see you posted in this forum, @anjayenunciates!

It does sound like Monty's improved considerably in a relatively short time (though I know the past week probably felt much longer to you and I also know it often feels like there's not nearly enough improvement until a cat's all better!), but of course right now it's difficult to say if it's from the antibiotics, the new food, or both. If one or the other or both are resolving the problem, it may still take some time for his digestive system to settle down and start functioning more normally. I hope, for everyone's sake, that that happens soon!

Once you do get to a point where you're ready to start feeding him regular food, just ask for suggestions: I and lots of other Cat Site members feed our cats commercial or homemade raw foods, often in combination with high-protein, low-carb canned foods. That seems to work well for a lot of cats with sensitive digestive systems. Our cat with the particularly sensitive stomach, by the way, had very smelly gas when we first adopted her but it improved when we took the dry food out of the cats' diet and almost completely went away after we took out all their foods with potato.

Fingers crossed that Monty continues to get better!
 

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So, this is shelter medicine and not from a vet, but shelters do sometimes have more experience with young kittens than vets do. Here is what I've been taught: the yellow/brown color, blood in the stool, and horrible smell point to coccidia, which is unfortunately a very hardy parasite. The medications he's been on can also change stool color (and ironically cause diarrhea) as well. Treatment for coccidia is usually Albon for 3 weeks, without skipping a dose, and 40% of cats have a more resistant coccidia and need to be treated again. Disinfection (of litter boxes and scoops) needs to be done with a 10% ammonia, 90% water solution, because bleach does NOT kill coccidia. The foster could have been using contaminated supplies that were not treated with ammonia. It's also possible that he had the parasite before he was surrendered. Parasites thrive on carbohydrates, so if he was being fed an all-raw diet with no carbohydrates, the stools might have been almost normal while he was with the foster. Parasites are not usually life-threatening in otherwise healthy and well cared-for cats, but they obviously do need to be addressed. Except for extreme cases, kittens with parasites that I've seen are very lively and would like to pretend there is nothing wrong with them at all!

I'm not sure what "advanced fecal culture" means, but PCR tests are done by separate facilities, so hopefully that is what's being done. It will definitely be interesting to see what those results are.

Probiotics will definitely be good for him. They may even help fight off whatever parasites he might have in addition to replenishing his gut flora. If he doesn't like the taste of the advita, you can get human probiotics that come in capsules and have a relatively tasteless powder inside them. Open the capsules, and sprinkle about 1/3 - 1/2 on his food. Acidophilus is the main strain that tends to help cats the most and it often comes with bifidus, which is also fine. Flortiforta is a probiotic that cats usually enjoy but it's not very high quality when it comes to the actual strain of bacteria in it.

Monty is adorable, by the way. I'm sorry this whole process has been so frustrating!
 
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posiepurrs

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When they did the fecal test was it a complete diarrhea panel? That includes testing for Trichamonas Foetus (hope I spelled that correctly). A cat infected can have leakage, bloody runny stools and still act healthy.  Standard testing for giardia and Coccidia will not diagnose TF. The test needs to be done at a lab - not the vets office.
 

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I don't know if anyone has said this, but I HATE Panacur.
When my dog was having diarrhea, he did have some worms so that's what they gave him, and it made my poor dog so sick his rump bled.
The vets office swore it wasn't Panacur because "it doesn't do that", and when our other female had some stomach problems they gave it to her as well, same results of violent diarrhea.
It took us weeks to get them each back on track, of course this might not be the case because "it doesn't do that", but I refuse to give it to any of my animals anymor.
I honestly believe it is just too strong for their tummies, especially for animals who aren't exactly infested to begin with.
 

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haleyds haleyds , I'm sorry that happened to your pups! I've used Panacur dozens of times without issue, but no medication is without risk of some kind.

I'm curious exactly what panel your vet sent out for. See if you can get a list of what parasites/protozoan are looked for in the test.

It is possible that this test comes back negative, but he still has something. It just depends on the shedding cycle.

However, if all checks out ok, I would look at putting him on a limited ingredient canned diet (Nature's Variety Instinct and Wild Calling are good options for this) or a raw diet (you could do commercial or use a freeze-dried diet like Primal or Stella & Chewy's). His system may be more sensitive.
 

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You've received lots of good info here. Not much more I could add except about the probiotic. If he won't eat it on his food, you can mix it with a little water and use a (needleless) syringe and syringe it to him. I have done this with Robin with success.
 

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I don't think anyone will be surprised if it turns out to be coccidia. I've treated coccidia in kittens with a yeast-based probiotic called Saccharomyces boulardii. It is a very close cousin of brewer's yeast, and one of the most researched probiotic strains in the world, used in hospitals to treat antibiotic resistant C diff.

It is THE primary protocol in managing diarrhea in the facebook group I co-founded with another TC user, Carolina, who treated her cats for C perf with it.

Here is a collection of scientific studies I'd put together on it: http://www.thecatsite.com/t/283161/saccharomyces-boulardii-use-for-diarrhea-and-gi-disease-incl-ibd

Carolina's experience with it: http://www.thecatsite.com/t/259985/trouble-in-raw-paradise-clostridium-perfringens-and-my-cats

It is actually approved by the FDA for claims that it treats "Travelers Diarrhea." That would cover most parasites, I'd think.

Here is the webMD on it: http://www.webmd.com/vitamins-suppl...&activeingredientname=saccharomyces boulardii
 

PushPurrCatPaws

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You've gotten some great advice here, I hope Monty gets better soon! He looks like a wonderful kitty!

If he has parasites and/or a bacterial infection, sometimes it can take much more than a week or two on meds for things to resolve. I hope his upcoming test results help to clarify things!

Some things I would recommend, though, besides the abovementioned posts, is that I would worry about him not getting enough fluids, after having diarrhea for many weeks. Pay close attention to his energy level and demeanor and appetite, etc., and if any of those go downhill before your scheduled vet visit on Friday, take him in sooner! Also, in my experience, 5 months is not too young to have him neutered, and a rabies shot should not be far away either. :) Good luck!
 
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anjayenunciates

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You've gotten some great advice here, I hope Monty gets better soon! He looks like a wonderful kitty!

If he has parasites and/or a bacterial infection, sometimes it can take much more than a week or two on meds for things to resolve. I hope his upcoming test results help to clarify things!

Some things I would recommend, though, besides the aboveme ntioned posts, is that I would worry about him not getting enough fluids, after having diarrhea for many weeks. Pay close attention to his energy level and demeanor and appetite, etc., and if any of those go downhill before your scheduled vet visit on Friday, take him in sooner! Also, in my experience, 5 months is not too young to have him neutered, and a rabies shot should not be far away either.
Good luck!
Thank you so much!  Hopefully we get results any day now.

Luckily, he is drinking normally--he goes through lots of water in a day.  He is still really energetic and active, thank god.  Only issue has been appetite, but I think it is due to changes in food--the addition of the probiotic--more than anything.

I believe they are waiting until 6 months to neuter him.  However, they won't even continue his vaccinations until his GI issues have resolved.  Fingers crossed it all clears up soon so that he can get back on the vaccination and neuter track!
 
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anjayenunciates

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Update!

This morning (around 9am), I gave Monty 1/2 a can of the wet food with 1/2 a packet of Advita mixed in.  He has just now finished the half (it is 7:30pm), but he is definitely eating and drinking much more normally.  We haven't seen any leakage today either.  Even better, is that my boyfriend says he hasn't seen any liquid diarrhea from Monty today either, just soft stools.  It sounds like our little guy might actually be on the mend!  Fingers crossed it keeps up.  

Also, he really likes his cat condo!

 
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lisahe

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Update!

This morning (around 9am), I gave Monty 1/2 a can of the wet food with 1/2 a packet of Advita mixed in.  He has just now finished the half (it is 7:30pm), but he is definitely eating and drinking much more normally.  We haven't seen any leakage today either.  Even better, is that my boyfriend says he hasn't seen any liquid diarrhea from Monty today either, just soft stools.  It sounds like our little guy might actually be on the mend!  Fingers crossed it keeps up.  

Also, he really likes his cat condo!
I'm so glad to hear he seems to be doing better! That's very good news. And I like his condo!
 
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anjayenunciates

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Update--we aren't having any leakage anymore, and Monty is eating 1 can of wet food and package of probiotics each day.  However, he is still having liquid poos.  He goes to the vet tomorrow--fingers crossed we get an answer from the fecal panel.
 

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Hi, I'm just reading through your thread, &  catching up. It sounds like the wet food is helping, especially w/ the probiotic! (now that it can get in his system)  I hope you get good results at today's visit. 
 
 
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