I'm desperate for advice about my cat's diarrhea

[desperate4zero]

My 19 year-old cat (Zero) was diagnosed with IBD about 3 years ago. It's been under control with a diet overhaul and a small dose of prednisone.  Until now.  She started having diarrhea a couple of weeks ago for no apparent reason.  I pulled out the usual "fixes" of smaller, more frequent meals, added supplements, and a slight increase in her prednisone. At first nothing worked and she was starting to lose weight, so I called the vet.  She gave me a prescription for flagyl, but after I researched it and then saw how terribly stressed Zero got when I tried to give it to her, I decided to stop. She has always been an indoor only cat and has had no contact with outdoor animals for many years. Since the flagyl was to take care of giarda and the side effects could be diarrhea and loss of appetite, I was afraid to try it since she didn't have an ounce of weight to spare and already wasn't eating well. As of now, she is having diarrhea every few days and basically normal ones every other day, and she's getting better about eating (although I still need to find a way to make her gain some weight). The biggest problem, I think, is that her bum is extremely sore and it hurts her to poop. Then she licks herself obsessively.  The vet recommended I use warm compresses and a diaper ointment, which I've done for the past few days. Zero hates it when I touch her where it hurts and she hates the feeling of the ointment. The past 2 nights she's tried to lick off whatever I put on, and now I think ingesting that is contributing to more diarrhea. So, I'm looking for advise mostly about what to do about her painful bum and about what I can give her to keep the diarrhea away and help her gain back some weight and strength. Sorry about my long-winded story, but I'd be so grateful for any help out there....

 

[vball91]

Sorry to hear that your kitty feels so poorly right now. Could I ask exactly what her diet is and what the dosage of prednisolone is? Those are the first areas to look at to see if tweaking is necessary.

 

[desperate4zero]

Thanks so much for reading my post.  Zero has a lot of food intolerences, so she eats only Nature's Variety Instinct canned food once a day and Nature's Variety Instinct raw organic chicken once a day.  In between I offer her baby food and/or cooked chicken, and as of a week ago I've been making "kitty glop" and trying to get her to drink some of that 3 or more tims a day.  Her usual dose of prednisone is 2.5mg once a day, but I increase it to twice a day when her IBD flares up.  She also gets 5mg of felimazole twice a day.

 

[vball91]

Her diet is pretty good although a novel protein or full raw may help some at this point. I know you're probably reluctant to make changes but she could have developed more food intolerances.

I would talk to your vet about increasing the pred to 10mg a day temporarily to see if it will bring the current flare under control. Does she also have a thyroid issue (felimazole)?

As for her painful bum, pure aloe vera juice may be more soothing and less irritating than the ointment

 

[desperate4zero]

You're right - I am afraid to make too many food changes, even though it has crossed my mind that she may be overloaded with chicken.  Nature's Variety Instinct raw is the only brand I'm very familiar with, and every one of their raw proteins other than their organic chicken has some form of fish oil, which Zero absolutely can't tolerate. For awhile she ate Stella & Chewy's freeze-dried food, but then she decided to refuse it.  I'm torn about whether I should try new foods now or just let her have anyhting she'll agree to eat.  I should tell you that she is very manipulative with me, so if she gets any hint that I really want her to eat something, she'll flat out refuse. So I have to work hard at acting as though I'm indifferent about what she does!  Also, she has no clue that she's a cat and would really prefer to eat only people food.

I am toying with the idea of increasing her prednisolone, but a few months ago she was (I think) left on 10 mg/day for too long, which in itself upset her whole system.  I hate the idea of prednisolone only because I've been on it so often and I know how miserable I feel and act on it.  I always hoped I'd be able to get her offf completely, although the vet told me that wasn't likely.

And yes, she's been on felimazole for hyperthyroidism for around 8 years at varying doses.

She is definitely better than she was when this episode started a couple of weeks ago.  But every time I think she's back to normal (other than her weight), she'll suddenly start the diarrhea again.  And because she's gotten so tiny (partly age), I feel that she has no reserves to fall back on the next time she gets sick.

Would the aloe vera be less likely to irritate her system than the diaper ointment, do you think?  I also read a response from a vet to a similar problem saying that the cat in question could have 1/4 immodium ad every 12 hours and that preparation-h wipes could be used....I don't know if I'm brave enough for that yet....

 

[vball91]

Aloe vera juice has also been safely administered internally (the kind with no preservatives), so I don't think it would upset her system even if it was ingested a little. The product I have seen recommended most is Lily of the Desert inner fillet.

I don't know about the immodium or prep-h. I haven't heard of those being used on cats.

The only thing I can think of that might be helpful is probiotics? Have you ever tried that? A lot of us on here use a human grade one, the Natural Factors Acidophilus/Bifidus Double Strength one.

I also thought of canned pure pumpkin which is useful for both diarrhea and constipation, but given the food issues, I'm not sure how well it would be tolerated.

 

[vball91]

Oh, and if your cat likes people food, have you tried giving her any plain raw or cooked meat? A diet of just one meat for a few days, either cooked or raw, may help resolve the diarrhea since it would eliminate virtually all of the ingredients that could be causing the flare.

 

[desperate4zero]

Thanks - I will definitely try the aloe vera and the probiotics. Do you buy "Natural Factors" in a store or online?  I have tried a supplement that contained probiotics, but I stopped because it has so many other ingredients.  I have used pumpkin in the past (in fact I have some here), but I'm so afraid that any deviation in what food she will eat will prevent her from eating.

See, I have created what people tell me is a spoiled monster!  Zero has taken almost complete control of her environment (to include me) over the years so that she alone dictates what goes and what doesn't.  If I give her a food that she's always liked but add a speck of anything "healthy", she'll smell it, give me " THE LOOK", stomp away and refuse to eat anything at all (as a punishment to me)!  She's particularly good at knowing when it's REALLY important to me that she eat something, and that becomes an automatic refusal!  And as hard as I'm trying, she is well aware that for some reason what she does and doesn't eat is a big deal to me right now, so she's even more suspect and finicky than usual..... So, yes, I created a controlling Diva and now take orders from 7 lbs. of fluff!

I really like the idea of trying just one "people" meat for a few days.  Unfortunately, chicken is old news to her.  I recently discovered she likes Nature's Variety new pork flavor, so maybe I'll try getting a pork loin and giving her just that for as long as she'll let me.  I've also started keeping a record of everything she eats to include amounts, times, etc.  We've become used to a variety of foods/flavors each day it's gotten hard to remember exactly what's happening.

Again, thanks so much for your help!

 

[vball91]

I can find the Natural Factors at a local health food store (Natural Grocers) in the refrigerated section, but it's available online as well (Amazon is my friend).

I do think that cats pick up on our emotions, so I try to relax and practice deep breaths before feeding my cat (the transition to raw is a rocky road for us). If you do try pork (or any other homesmade meat), just make sure it's not enhanced with a flavor/sodium solution. I and many others find it difficult to find unenhanced pork. All meat you buy for cats should have less than 100mg sodium per serving.

I also started keeping a food/health journal for my cat when I started the raw transition. It's too hard to keep track of everything without one, and my memory is not as good as it once was! Good luck!

 

[desperate4zero]

One more question - has anybody used Flagyl for your cats with IBD?  As I said, I chose not to give it to Zero because I didn't think the potential side effects were worth it.  However, our vet did prescribe it for her when I called her the first time.  Right now Zero is refusing to take any of her medications most of the time, so if I have to piss her off by throwing her felimazole and prednisolone pills down her throat, maybe I should go ahead and squirt the Flagyl compound down at the same time.  I'm so afraid to make the wrong decision and would greatly appreciate any input from people who have used it (or decided not to) for their fuzzy ones....

 

[vball91]

Flagyl (metronidazole) is an antibiotic frequently prescribed for IBD. The thinking is that there may be an infectious component to IBD. My thinking is that traditional medicine doesn't really know why many of these inflammatory diseases occur. They tend to throw medications at the symptoms to see what works and metronidazole has been shown to be effective in many IBD cases. However, I don't think there's a good understanding of why it works. Like all medications, risks versus benefit need to be understood before use. I have heard that it is awful tasting though.

 

[desperate4zero]

I agree with you - especially since it was prescribed over the telephone, and I told the vet that Zero did not have a fever or any other sign of infection at the time.  For most things I love our vet, but I do find that when it comes to Zero lately, she's treating her age and not always her symptoms.  Actually, I'm coming to believe that she's treating ME and not Zero at all - she knows that Zero is the mainstay of my life and I think she doesn't ever want me to accuse her of not having done enough.  Of course, I could be wrong and unfair, but my gut tells me not to put all our hope in her.

I didn't start the Flagyl because the info sheet was very clear that the most common side effects "include stomach upset, loss of appetite, constipation", etc.  I obviously don't want to make the situation worse - Zero's tiny enough already!

The tablets are extremely bitter, so our vet had the pharmacy compound it into a liquid that is supposed to taste like chicken.  I did taste a drop and to me it did taste like very sweet chicken.  But Zero has always gone absolutely nuts when I have to force her mouth open and put somethinjg down her throat.  I can do it if I have to, but the stress on Zero is so intense that I need to be sure that the process is worth it.  And I'm not at all sure about this stuff.....

Thanks again - you have been such great help and support.  I've even been able to calm down a bit the past couple of days!

 

[vball91]

You probably already know this since you sound very knowledgeable about cat care, but as a precaution, please be careful about squirting any liquids "down her throat." Unlike pills, liquids should be put in side of mouth and swallowed naturally. Down the throat risks aspiration.

How is Zero doing? Any better or worse? One other thing you might try is looking for a good holistic vet trained in Chinese medicine. I am a believer in using a combination of allopathic and holistic medicine to cover all the bases.

 

[desperate4zero]

It's me again!  I want to say that Zero is quite a bit better.  Her stools range from normal to a bit soft, but she only goes about once a day, so it's not the frequent, explosive kind anymore.  She definitely has a much better appetite and is keeping me hopping by insisting that I come up with new meals and snacks every day!  Thankfully she hasn't yet caught on to the fact that I'm using basically the same ingredients each time (because there are so few things she can tolerate).

However, I'm afraid that we may have just circled right back to the beginning.  All along she has been very uncooperative about letting me look at or, god forbid, touch her bum.  Because her poops went back to a normal size and she hasn't been constantly licking like she was before, I thought that issue had resolved.  Now I think I may have been wrong.  Today she has been yelling to me every five minutes, and I finally realized that she seemed to be doing that on her way into or just coming out of her box, where she's just peed.  There has been no poop as of yet.  I'm kind of scared that the whole cycle is going to start again:  her bum hurts, so she holds off on pooping; when she can't hold it anymore, it comes out as diarrhea - small amounts several times a day; this in turn makes her bum hurt even more, etc. etc.  I tried again just to lift her tail so I could see if she was red and swollen again, but as usual she became very indignent and took off to hide from me.  Now she's back to avoiding me as much as possible just in case I might want to try something again!  Because I'm alone, I can't seem to hold her tightly enough AND get a look at her backside at the same time - much less put any medicine on her.  Has anyone had this kind of trouble with a real Diva?  Now I'm desperate to figure out how to start the entire nightmare all over again....