Peace Corps kitty, African medical mystery

I have a 1 year old cat named Rose that I got here in Africa. She's my best buddy and little baby and keeps me company through the very lonely times at my site. I am serving in the peace corps so have very limited food options, but I serve her a mix of wet and dry cat food. She is indoor only and has her full series of kitten vaccinations and has been dewormed and vaccinated for rabies. Vet care is limited here, and I think have exhausted most of my options on that front, so I am turning to you to see if we can crowdsource. There are two vets in the country, one in a large city near me and the other in the capital, which would be a multi day trip for both of us on public transportation and I don't even have a real carrier. The vet in this story is the one in the large city. If we can't figure things out I will got to the other vet but would like to avoid doing so for obvious reasons.

Rose developed diarrhea and gas about 8 weeks ago. Her appetite is normal and she is very playful. We went to the vet and she had a small fever. She was given antibiotic injections and was better within two days, so I took her home. A few days later the diarrhea was back. I took her back to the vet for antibiotic injections and because I didn't want to leave her overnight, he gave her pills. I started to boil her water and cleaned everything with bleach. She kept throwing up the pills so we went back to the vet for more injections and to run some tests. She had a small fever again but the antibiotics cleared that up (as well as the diarrhea) almost immediately again. The vet strongly believed it was bacterial due to the immediate reaction to antibiotics but did a stool test to check for parasites and a blood test to look for any white blood cell problems indicating a virus anyway. Both were completely normal, and he told me that that's enough proof for him that it's bacterial. I asked about FLV, he said it would have shown something on the blood test and plus it's rare in this part of the world anyways (huh! The more you know). This time, he sent me home with antibiotic syrup instead of pills and basically said he's not sure what's going on, but since it's not getting worse and it's not a virus he's not really worried. Again, cleaned everything with bleach, boiled water, etc. She was great for three days but then just had diarrhea again this morning. I've starting giving her the antibiotic syrup but I can't afford to keep going into the city for injections every week or 2. Not only is it expensive but it's exhausting and stressful for both Rose and me. I've ordered a real carrier from America but that will take weeks to get here, and I can't do a multi day journey on public transportation to see the second vet without it. Please help me. Does anyone have any idea what's going on? Has this happened to anyone before? I need her to be healthy to take her home with me so we've got to figure it out. I'm feeding her the best cat food I can find and doing everything else I can think of. Thanks.

My goodness, I'm so sorry little Rose is going through such a difficult time, as well as yourself.  Many of us here know how exhausting it can be to take care of a little one.  But I can't imagine being so far away from a vet.

I personally don't have any experience with this type of illness, however, can you ask your vet if there's something you can give her to harden the stool.

Could it be the frequent trips to the vet are adding to the stress?

I'm sure a more experienced member will chime in with advice.

I wish you and sweet Rose all the best as you prepare for your journey.

Please keep us updated.  

Best to you, Hope & my sweet girl Chestnut

Thank you so much for your kind words. I sometimes forget what it's like to be around cat lovers as the locals here don't really understand the concept of pets ("No, she's like my child, I am not going to eat her! And neither will you!"). I can ask the doctor about imodium if the antibiotic doesn't seem to be helping. I don't believe the stress of rural African public buses and vet visits is causing the diarrhea as it starts a few days after the vet, but I am reluctant to keep taking her without a specific goal as it's a full day adventure (the city is near-ish to me, not really that close) and she hates it. The only thing that's keeping me sane is that it a) is responding to antibiotics at least temporarily and b) doesn't seem to be too serious, whatever it is. But I don't want her to be having stomach issues. As an American living in rural Africa I know all about those. I will be going home in about 7 months and am planning on sending her about a month ahead of me, so I just have to get her to that point.
Oh and I didn't mention this as it's not super relevant but she was spayed at 5 months. I'm going to try to imbed some pictures so you can see her!

She is absolutely beautiful! Thank you for taking care of her!! It is really a blessing for both of you..

Diarrhea can be caused by so many things. Is she acting normally?

Eating normally? Playing?

I am unsure what it could be, especially with your limited resources. 

What type of food are you feeding? Does it contain a lot of grains?

Can you try some boiled chicken mixed with some rice, just to see if it could bind her up for a day or two. I would not give her any people medicine like Immodium or Pepto Bismol.. NO.. dangerous for cats..

Is she vomiting? Can you switch foods to something with better ingredients? 

She could also be having diarrhea as in a reaction to the antibiotics.. Do you have access to any probiotics? Even some plain yogurt?

@LTS3

@catwoman707

any ideas?

I wish you well, hopefully someone will be on here soon to advise you properly... 

((hugs))

PS.. I just thought of something.. Do you have access to a can of Pumpkin?

I mean the Plain Pumpkin... not the Pumpkin pie stuff.. or baby jar plain pumpkin or butternut squash?

Pumpkin can help with bowel issues.. the fever, I am not sure about...

She's a cutie!

You got some great leads already, I'm just gonna throw in my 2 cents.

About the water, you said you boiled it, do you boil it every time?

I'm guessing it's very hot where you are, so maybe she needs you to change her water more often, like 2 or 3 times a day?

Wow all this help is awesome! Keep it coming guys! To answer a few questions:
-since the antibiotics fix the diarrhea I don't believe they are making it worse.
-she is eating and playing more or less normally
-I have been boiling her water since this whole thing started. It's actually winter here right now (60s/70s) so I don't think it's heat related.

It's some type of very stubborn bacteria and it's driving both of us crazy! I will look into pumpkin, chicken (she's finicky so she might not go for that), switching the food...but that last one will be tough, there are only a few brands available here, none of them very good.

Glad to be of some help!

I was thinking about her food.

Did you change anything in her diet right before she had the diarrhea? Like a new brand, a new type (dry/wet) that she still eats?

Maybe some type of proteins that doesn't agree with her?

Or maybe she ate some bad food, but if she's not vomiting, I'm not really sure...

If you need help with the brands that are "less worse" for her, let us know, I'm sure we can figure something out

I have not changed her diet. We normally do catmore dry food and purina wet food packets. I've also seen whisksas at the store, but I don't know if that's any better. I occasionally see Bob Martin (or maybe it's Tom Martin) but not that often. There's one fancy food (4 in 1 or something?) that I'd love to buy for her, but it's about $10 and as a peace corps volunteer I am only paid $200 a month, and vet bills are sucking me dry these days.

You could try changing the food.. perhaps not do the chicken for a while.. I do not think Purina is a very good food, although I think it is better than Whiskas... I know you are limited in your selection.  Do they have Fancy Feast Classics there? That is very inexpensive, in the states. The classic version is not a bad food...and Sheba is a fairly good food also....

It could be that she somehow developed an allergy to something in the food. It could be an additive or such..

I think I would try the pumpkin or baby squash first.. It may help.. If not, I would try something without chicken.. if that does not help, I would try a different food, something without chicken...

It is very hard for me to think of things that you have over there...

trying to think of someone who can help you....What part of Africa are you in?

If none of the advisors come on, I will try to think of someone specific to help...

I'm going to theorize that it may be coccidia or giardia. Both respond to antibiotics but it doesn't kill the parasites so it's a short-lived improvement. You need metronidazole, hopefully the vet can get some. If the vet can do fecal tests to confirm, that would be best, but if not, I don't think it would be bad to use metro without a firm diagnosis.

Here's a good resource for people who aren't near a vet: http://www.merckvetmanual.com/mvm/index.html it would even be good for the vet to look at .

So I just double checked and the antibiotic syrup that he gave me and that I just started her on is metronidazole! He said 1.5 ml a day for seven days. Does that sound right? I don't know if this is the antibiotic he was injecting. He isn't a western trained vet but he has been very helpful. I will keep administering the metronidazole and will let you know. He said the stool test looked for giardia etc but didn't see anything...but, to quote Blood Diamond, TIA. So who knows.
Thank you for that resource! I know it will get a lot of use here over the next six months.
I'd rather not say where I am specifically, but I am in Southern Africa, a place with a low expat population and one airport that only has a few flights a day. We occasionally get South African brands here but they are always overpriced and not regularly stocked.

I should've automatically thought of coccidia or giardia..  They are so widespread everywhere. I immediately thought of the food issue because that is what I have dealt with on my guy.. 

I guess I am just mouthing off from my experience and not looking at things globally.. at the entire cat.. 

I am glad @willow  came on to suggest it.. and to give a link to the Merck manual.. It is a something I think I am going to bookmark also..

Keep us updated... thanks Willow...

theirway11 said:

I have a 1 year old cat named Rose that I got here in Africa. She's my best buddy and little baby and keeps me company through the very lonely times at my site. I am serving in the peace corps so have very limited food options, but I serve her a mix of wet and dry cat food. She is indoor only and has her full series of kitten vaccinations and has been dewormed and vaccinated for rabies. Vet care is limited here, and I think have exhausted most of my options on that front, so I am turning to you to see if we can crowdsource. There are two vets in the country, one in a large city near me and the other in the capital, which would be a multi day trip for both of us on public transportation and I don't even have a real carrier. The vet in this story is the one in the large city. If we can't figure things out I will got to the other vet but would like to avoid doing so for obvious reasons.

Rose developed diarrhea and gas about 8 weeks ago. Her appetite is normal and she is very playful. We went to the vet and she had a small fever. She was given antibiotic injections and was better within two days, so I took her home. A few days later the diarrhea was back. I took her back to the vet for antibiotic injections and because I didn't want to leave her overnight, he gave her pills. I started to boil her water and cleaned everything with bleach. She kept throwing up the pills so we went back to the vet for more injections and to run some tests. She had a small fever again but the antibiotics cleared that up (as well as the diarrhea) almost immediately again. The vet strongly believed it was bacterial due to the immediate reaction to antibiotics but did a stool test to check for parasites and a blood test to look for any white blood cell problems indicating a virus anyway. Both were completely normal, and he told me that that's enough proof for him that it's bacterial. I asked about FLV, he said it would have shown something on the blood test and plus it's rare in this part of the world anyways (huh! The more you know). This time, he sent me home with antibiotic syrup instead of pills and basically said he's not sure what's going on, but since it's not getting worse and it's not a virus he's not really worried. Again, cleaned everything with bleach, boiled water, etc. She was great for three days but then just had diarrhea again this morning. I've starting giving her the antibiotic syrup but I can't afford to keep going into the city for injections every week or 2. Not only is it expensive but it's exhausting and stressful for both Rose and me. I've ordered a real carrier from America but that will take weeks to get here, and I can't do a multi day journey on public transportation to see the second vet without it. Please help me. Does anyone have any idea what's going on? Has this happened to anyone before? I need her to be healthy to take her home with me so we've got to figure it out. I'm feeding her the best cat food I can find and doing everything else I can think of. Thanks.

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Hey there over in SA!! It warms my heart that you and Miss Rose have found each other in this lonely time, you surely find great comfort and companionship in one another

Here is an over all view of the picture.

Technically, and in average situations, 80% of diarrhea is caused by diet, whether change, allergy, etc.

The other 20% is parasitic.

Now, in rescue however I'm sure it differs since I get cats and kittens from every nook and hole possible, so parasites are much more common.

To throw a number out there I would say about 40% who come to me have parasites, all have worms of course, that's a given, but also coccidia, giardia, which are the most common, coccidia by far more than giardia.

Parasites often do not show up in fecal tests due to their cyclic shedding, when dormant they are hiding and do not appear in the poop at that time.

The fact that she temporarily responds to antibiotics/metronidazole tells alot, meaning I doubt it is diet related, and likely gut bacterial imbalance, excess bad bacteria.

Sure wish I could recommend ponazuril but seriously doubt that's possible! (it's a paste made for horses for coccidia then diluted for cats)

Metronidazole will def help, but often times it needs the treatment repeated, once the initial treatment is completed, within a couple weeks it sometimes comes back, and if that happens, catch it fast and get her started on treatment again before it returns full blown.

Now, what throws me off to be honest, is you saying when she started having diarrhea she has gas too. Gas is clearly an intestinal issue, usually when there is a sudden food change or addition, the digestion is harder and causes gas and diarrhea.

Also want to add here that anytime an antibiotic is given, it kills the gut bacteria yes, but doesn't differentiate between the good bacteria and the bad, it kills it all, causing a total imbalance that takes literally months to balance out again on it's own.

So she needs a probiotic, which isn't likely for where you are, but giving her plain yogurt will feed her the good bacteria again.

If this were me in your shoes, here is what I would do.

Continue with the metro of course. But assuming it is available there, I would stop all food and feed only Gerber or Beechnut chicken or turkey only baby food with cooked white rice in it and a spoon of yogurt.

3 days of nothing but this. What this does is gets her system to calm down and stop reacting to whatever it is upsetting her. 

Her diarrhea should stop by the 3rd day as well.

Then do a gradual change back to her normal diet, adding just one at a time and watch for a reaction to it.

Example is adding some of the wet food in with the baby food/rice/yogurt, maybe 50/50 for a day, 2 is even better. 

Then start adding in a bit of dry, taking the dry a bit slower than the wet though.

At any point you see it coming back, take away the last food you added to her diet.

See if she goes back to normal, if so, perfect.

If not, take her back to just the baby food and rice/yogurt again.

Wait to make sure she no longer has diarrhea, then trying a different wet food.

Continue with the yogurt for as long as you can, not sure how easy that is or not, but 2 weeks of a heaping spoon per day is excellent.

If you had access to the foods we do I would put her on a limited ingredient diet until I figured out just what it is she is sensitive to, but this way works too.

Meanwhile hopefully the metronidazole has done it's job (if there was one to do!) 

This will allow both bases to be covered, whether diet or parasites, she will be straightened out

Is this possible?

That's extremely helpful catwoman707

Unfortunately I am not in South Africa so food selection is quite limited. I will be going into the larger city for a grocery run sometime in the next week (currently waiting to get my living allowance) and I will check to see what is available there. I looked for greek yogurt last time but didn't find anything but you never know! I hope the metro starts working in the meantime.
And to thank you all, here's a picture of Rosie napping in my mosquito net.

Yogurt and kefir are pretty easy to make. You need some kind of starter but I'm sure there's a way to do it without ordering starter off Amazon . Or else nobody would have figured out how to do it in the past, right? If the people where you live consume any kind of fermented dairy, that would be the stuff. Just something to get the good bacteria in her gut going again.

catwoman707 how quickly should the metro work if this is giardia/coccidia? I've been doing it for 2 days now and she still has diarrhea...

Metro is rather slow to work on the diarrhea. Several days at least, that's one of my gripes about it.

Too bad you aren't able to do the restricted diet thing along with the metro treatments, but then again this way will help tell what the root of the problem is too.

We all get anxious for the diarrhea to end, it's smelly and not nice! Hopefully she shows a good reaction to it soon!!

Can you get goats milk?  Preferably raw (if you are reasonably sure its from healthy goats and taken under reasonably hygienic conditions, that is)

Bottled or powdered works too, but its not the same edge.

Its always a good supplement, and may even help against some conditions, as being fresh and raw, it does contain some antibacterial properties.

If you have noticed if she manages cow milk - raw unpasteruzed cow milk may work by the similiar reason.

Usually we dont recommend cow milk - many cats dont manage this.   Although there are some indicies processed cow milk from cows of modern type is the worst.

Thus, raw full fat cow milk from non european "primitive" cows is probably more OK - perhaps even entirely OK.

Mild full fat plain youghurt is digestible for cats, and is also useful supplement when taking antibiotics.  Classical home remedy for humans and for cats.  If you cant get a good probiotic, this will do, as mentioned earlier in the tread.  Cant hurt, may help.

If she has much diarrhea, a pedialyte is always wise and good.  If you can buy, so flavorless clear pedialyte for babies is best.  The same as for children babies.

If you cant, so some homemade pedialyte works good too...  Best is to use glucose sugar and a combo of different salts.

If you cant find glucose sugar proper, so honey does contains much glucose sugar - half or almost half...   As salt source the easiest is probably to use minerale water. You see on teh label if it contains different salts.

In a  33ml/cc bottle of minerale water, you add  half+ soup spoon of honey...  Mix it together, easiest by warming up some.

And you have a terrific homemade pedialyte.  Works nicely for humans and for cats.

Diarrheas, throwing fits,  throwing influensa where you throw as soon you drink - the trick is to give just a few drops a time, but often.

Works also in lethargic cats and humans,   and also with them practically dying, when the body begans to shunt down and is not longer digesting food - but may still sometimes  be saved giving this pedialyte.

The same advices are thus essentially for you as working with the Peace Corps and helping emaciated humans and humans in very bad shape.

This wont alone help them, but its a nice "inbetween" step to give and support them.

@theirway11  

Thanks StefanZ . Since the diarrhea
Is only once per day at her normal poop time I am not super worried about dehydration but I will continue to keep any eye on it. My host family keeps goats, I will look into milking one myself (how many times has that sentence been written here?!).

theirway11 said:

Thanks @Stefanz. Since the diarrhea
Is only once per day at her normal poop time I am not super worried about dehydration but I will continue to keep any eye on it. My host family keeps goats, I will look into milking one myself (how many times has that sentence been written here?!).

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Probably the first time, I think.  At least, its the first time I do see it.