Help with chronic Giardia please - nothing has worked

mudskippa

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Hi,

I'm looking for help for my 15-yr old female Tortoiseshell. She tested positive for Giardia in August and it is now nearly the end of November. Nothing we have tried has worked and she has lost an awful amount of weight.

First we tried 3 rounds of Metronidazole - increasing in length each time (3 days, 5 days, 10 days)

Then 2 rounds of Pancur (5 days, 8 days)

Then I read that Secnidazole has a near 100% cure rate and has been used by vets and catteries in the US with great results. You can't easily buy it in this country (I'm in the UK) but I managed to find a pigeon dewormer which contains Secnidazole, Rondazole and Diclazuril. I checked all the dosages to make sure it was safe to give to my cat and it was. So she's had 2 rounds of that. (the other ingredients should have cleared up anything else nasty like Trichomoniasis or Coccidiosis) 

In the meantime, I have bleached the entire house several times and boil washed any fabric she has sat on, put her on a probiotic, given her 2 baths with Chlorhexidine shampoo, wiped her down with Chlorhexidine wipes, bleached her litter trays twice and switched from kitty litter to newspaper and kitchen roll, which can be easily bagged and discarded - although she goes on the floor more often than not. I clear up all faeces as soon as I can (I'm at home most of the time, so it usually gets done pretty immediately). She doesn't really go outside but I have eliminated all sources of standing water near the house just in case. She is on a diet of plain chicken and good-quality grain free wet food.

Her stool seems to improve on all these treatments, but then goes back to runny either halfway through treatment or as soon as we stop dosing. I know she must still have giardia and it's not just diarrhoea because her poop has that awful characteristic sweet-but-yucky smell.

She has been a healthy cat all her life until the last few years. She tends to get a UTI about once every 2 years since getting older, but meds solve that easily. She developed Hyperthyroidism, which we successfully treated for good with Radioactive Iodine Therapy. She was back to being a happy, healthy cat after treatment. And now a couple of years later, this.

She has lost a lot of weight now and I am so worried. Everything she eats just seems to pass straight through her. What else can I do? I'm worried about going back to the vet because it stresses my cat out so much and I'm scared she'll say the next option is a biopsy, which I don't want to put my cat through.

Obviously I will go back to my vet if I need to. But I think she'll just recommend a biopsy or more meds which don't work and make her lethargic and a bit incontinent.

Can Giardia be untreatable in some cats? Is there a way of helping her put weight back on? I have read up on this extensively, including posts on this forum. But I wondered if anyone had any specific advice in this case?

Many thanks for any help or suggestions.
 

jcat

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Our shelter and several others in Germany have had cases of giardia that was resistant to Metro and Fenbenol/Panacur;Secnidazole isn't available except for in the pigeon stuff, as you learned. Two cases in cats persisted for over a year.

Quite by accident we had cases cured when Convenia was administered for 3 weeks in a row for other infections. The contract vet did some research and found that other vets had had the same experience. It's definitely off label use, and the producer currently isn't interested in conducting a long-term clinical study, but since that accidental discovery last year the vet has used it; it didn't cure one 9-month-old cat (nor did yet another two rounds of Panacur, so the hope is her immune system will strengthen as she matures), but worked for the others..It might be worthwhile talking to your vet about it, but be aware that Convenia isn't without risks.

You're doing the right thing with boil-washing all textiles. We use a steam cleaner on litter boxes (on the first and last days of each round of treatment), floors and walls and wear disposable gloves and booties in the room(s) so as not to spread giardia.

You have my profound sympathy. Mega :vibes: for your girl!
 
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mudskippa

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Thank you so much J-Cat. I'm glad to be able to have something else to suggest to my vet.

Giardia going on for a year?? How did you manage to keep the cats from starving to death? My poor cat has lost so much weight that I'm frightened for her.

Thank you as well for your kind wishes. I love my cat so much. It breaks my heart to see her so unwell.

X
 

posiepurrs

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Even though she tested positive for giardia I would have her tested for tritrichomonas feotus ( sorry for not spelling that correctly). They can both be present and cause much the same symptoms. We had giardia in my cattery once, but none of the cats lost weight. I treated with fenbendazole twice and everyone was cleared. Here in the US it is sold as Safeguard, a goat dewormer. I used it with my vets blessings. Rondazole, the current go to drug for T. F. is only 60-70% effective in treating it, but there is research on a new treatment being conducted. Hopefully in a year or two they will release a new treatment.
 
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mudskippa

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Thank you Posie. They did two different tests on her stool, so I think the vet covered everything. Or does it take a blood sample to detect that?

My cat did have a couple of doses of Ronidazole when I gave her the pigeon wormer @ 30mg/kg but I  don't know if that's enough for treatment of   tritrichomonas feotus.

I will ask the vet about that too.

Thanks for your help! X
 

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We had a terrible time diagnosing our 3 newly adopted shelter kitties.  A PCR test finally revealed they all three were infected with Giardia and Cryptosporidium....2 nasty parasites eliminate.  This was (diagnosed "after" a 5 day round of Panacur.

The 2nd treatment the vet prescribed was Tylosin 200 mg suspension for the Crypto.  Still ongoing (23 days into it now).  For the Giardia they were treated with both Metronidazole 100 mg suspension, Panacur suspension, and ProBiostatin (a probiotic that is supposed to create a hostile environment in which the Giardia cannot survive).

We adopted these kitties on September 20th and they have had nothing but chronic diarrhea despite all the treatment (ongoing). 

They have not lost weight though....they have actually gained slightly, but 2 are still growing kittens.   I did not like reading the side affects of the Metro and Panacur....especially with repeated use.  If it were me, I would have a CBC done to eliminate perhaps another problem, especially given the fact that your kitty is 15 years old. 

We are not sure if we've combated the Giardia yet, as it is still too early to retest.  They all still have chronic diarrhea, but I am told if it is lighter in color and not at pungent it is likely the Crypto causing that.  My understanding is the diarrhea associated with the Giardia is darker in appearance and extremely foul smelling, which is what theirs used to be like. 

To boot, we found new "worms" in their stool this morning.   Never ends.

I am feeling your pain with the Giardia.  I hope you find a resolution soon.
 
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mudskippa

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Thank you Isobel. My sympathies to you too. It is really hard dealing with this. I'm glad your little ones are not losing weight.

There may well be something else behind my poor cat's inability to clear the Giardia, but I am 100% sure she still has Giardia because once you've been around the smell for a bit you KNOW immediately what it is. Unfortunately my cat's diarrhoea still smells very much like Giardia :(

I will look up the meds and the other illness you mentioned as well.

Best of luck with your kitties X
 
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mudskippa

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Anymore suggestions? Many thanks to all who have replied so far. I am off to the vets with her tonight as she has really watery diarrhoea now and is straining so much that it's causing her bottom to bleed :(

I started her on Prozyme Digestive Enzymes yesterday in addition to the probiotics she's already on and we've continued with the 10% Fenbendazole today - might as well.

I wonder if there is any other way of boosting her immunity. She must have something else going on or maybe it's just because she's a senior cat. I think she could definitely use an immunity boost either way.

The Probiotcs don't seem to be doing anything except making her fur shinier and more fluffy, but not helping her stomach. X
 

isobel

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Glad you are heading to vet....don't give up on her. The vet gave us probiostatin pro biotic because they said the probiostatin created a harsher environment for the Giardia. Our girls were on a combination of metronidazole 100mg suspenension 2X per day dosed by weight, and panacur suspension 2X per day dosed by weight as well. This was for 5 days. If it were my kitty I would have a CBC & PCR done to rule out any underlying issues or additional parasites. The cbc ran us $260 and the PCR $110...per kitty, but we got answers. The PCR tested for coccidia, crypto, tritrichonomas,giardia, among other things. The CBC ruled out any imbalance in the blood that might insinuate cancer, pancreatic issue, f leuk, fiv....etc We are 1 month into medicating, sanatizing, fanny washing after potty, etc...only now are we seeing liquid stool starting to firm up. They are finished with giardia treatment but ongoing for the crypto. Also using jarrow s boullardii + MOS probiotic for the past week. (Per advice from catsite blog). Our girls don't go outdoors at all...strict no no in our home, but these parasites were rampant in the shelter where we adopted them :-( Hang in there. It is extremely frustrating and I feel your pain. You are doing good to test her further.
 

isobel

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I should also add that our oldest girl Annabelle had and extremely raw bottom and was actually leaking. I was told this is common with that very watery diarrhea. We actually had to keep her at the vet for 10 days for monitoring, and they kept a collar on her to prevent her constantly grooming the area. We are still keeping her separated from the kittens and we bought a large kennel to keep her isolated until we are sure she is "cleared". Better conditions here at home and she is continuing to improve.
 
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mudskippa

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Thanks Isobel - I was wondering if the vet might take her in for treatment though I don't imagine I'd be able to afford any boarding costs, easily since I'm off sick myself with something else (unrelated to Giardia!). My other half also wondered about a collar. Although I wipe her bottom, tail and back legs as best I can with chlorhexidene wipes,  she doesn't like it and I can't do it if she 'goes' when I'm out so she might be ingesting some of the cysts no matter how hard I try to keep on top of things,

I have found I am sleeping almost like a cat myself now! Half-awake until the early hours, my ears cocked for the sound of scratching on the floor, which means she has been - either in the litter tray or out of it. I was up at 4:30am yesterday bleaching the floor after one of her accidents. Whatever happens, I won't give up on her - she's been with me 15 years and I love her to bits.

I hope the vet will be able to suggest something. So glad Annabelle is doing better X
 

isobel

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Yeap...same here.  I have been sleeping on the couch for a month and I am up every time I hear the little diggers in the box which is 2 - 3 times a night X 3 cats.  It is truly taking its toll on me.

My understanding, and I am no pro, but bleach does not kill Giardia cysts.   I have been using ammonia water (I use about a 20 - 25% solution, but I think you only need a 10% solution.)  Also all of the carpets and upholstered furnishings have been shampooed steam cleaned after isolating the cats from those areas.  Scratching posts as well.  
 
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mudskippa

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Gosh, I really feel for you Isobel. I've only got the one to care for, so I can't imagine having 3 runny cats!

I've heard about the quaterary ammonium cleaners, but I've found it really hard to find any here - even on the UK Amazon or ebay. I can't get out and about too much with my illness so I rely a lot on online deliveries and what's in stock.

I know boiling water kills cysts and bleach does have some effect too. I'm not a great fan of bleach myself, but it does kill all sorts of other nasties and disguises the lingering small of giardia poop, so I use boiling water with it straight from the kettle. I live with 4 other people and I don't want them to have to live in a Giardia-smelling environment, so the bleach does its job there.

Fingers, toes and paws crossed that the vet will be able to offer something more for her. I've got another poop sample to take in - fresh from the kitchen floor :( I'm dreading taking her in TBH. She really hates the vets and I can just see her either pooing or weeing in the cat carrier or on the exam table!

 
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mudskippa

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Thanks for everyone's suggestions. My vet said to try the metronidazole and fenbendazole again. So I stepped in and mentioned what  J-cat said about the Convenia and she was willing to try it, so my cat has come home with a 2-week shot of Convenia and a plastic collar to stick her licking her bottom and we're going to go back in two weeks for another shot. In the meantime she said may as well keep on with the Fenbendazole.

She did an on-the-spot Giardia test which proved negative, but as anyone who has been through this knows, that doesn't necessarily mean she doesn't have it. So we'll do another test in two weeks which she'll send off to the bigger lab to do a more complex test.

So the plan at the moment is to see how the injections and collar help. If they aren't helping she will test for TF, which I mentioned - she said it's usually kittens that get it, but it is possible in adult cats. She said the previous test we did would have identified any other parasites so she definitely doesn't have any other nasties.

I can not think everyone enough for their input - I'm so glad we're trying something different now, as we weren't getting anywhere with metronidazole or fenbendazole alone. So fingers crossed....X.
 
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