Hi everyone,
I'm hoping you might be able to help me with some thoughts/advice/words of kindness. I've spent a lot of time reading TCS posts about similar issues to what I've been experiencing and some of them have been really helpful, thank you!
I adopted two 7.5 month old kittens from a shelter in August. They were 3.5 months when they were removed from a multi-cat household (5 cats in total). They settled in with me very well, for the first 6 weeks of living with me they had consistently healthy stools. They are indoor boys. After 4 weeks I changed their food (to switch them to wet- Katkin). If anything their stool quality improved. Two weeks after the food change (2 days after I had started feeding them a slightly larger quantity of Katkin), I arrived home from work to find one of them (T) unwell - vomiting, diarrhea, fever and abdominal pain (hunched over). Took him to the vet and he was given anti-emetic injection. Both cats wormed again as a precaution. The following day his brother (N) became ill too, he vomited once and slept for a long period. I kept them on Katkin. Three days later, as they both seemed to be getting a lot better (both had unformed stools still though), T suddenly had another episode of fever and vomiting. Back to vets who advised I change their food to bland food diet. Stools didn't harden after several days, so I took in stool sample (single sample). This came back negative (culture test). For the following few weeks, both cats' stools remained half/half diarrhea/formed, never returning fully to normal. After a while I started to wonder if they were intolerant to something in the bland food (I've been feeding wet/dry mix) so started to transition them back incredibly slowly (over 2-3 weeks) onto their normal wet food (which their stool had always seemed healthier on when first introduced). About 2 weeks into this, on the day that I increased this from about 18% of daily calories to 33%, T had another episode of fever (confirmed by vet) and vomiting. Antibiotics were prescribed (metronidazole) for both cats. PCR stool sample (3 day) also collected (mixed sample from both cats). Throughout this course of metronidazole, stools remain half formed. Near the end of this course, I received a call from the vet with the PCR results. They'd tested negative for everything (test included FCV, toxoplasmosis, tritrichomonas foetus, giardia, salmonella, FPL) apart from clostridium perfringens alpha toxin which they tested positive for. The vet stressed that the lab had said that these results should be interpreted with caution, because c. perf. can be found in the guts of healthy cats, so it wasn't possible to know whether it was the cause of illness. Vet said that she would prescribe amoxicillin, as although metronidazole can be used to treat c. perf, cats can show neurological symptoms if kept on it for too long. They started taking amoxicillin the night after they had finished the metronidazole course that morning. Neither of their stools hardened up fully on this, it continued to be half formed really. However, frequency did decrease. I should say also - even when they have both had bad diarrhea they always do manage to go in their litter box. Shortly after they had finished this 2 week course, T's pooing frequency went from once a day to twice. By day 3, N had liquid diarrhoea suddenly. I called the vet on this day. I had taken another 3 day mixed stool sample as they were coming to the end of the course of amoxicillin but we were still waiting for the results of this. She agreed to prescribe 5 more days of amoxicillin as it had seemed to control things for the boys. Very quickly after starting amoxicillin again, stools firmed up again for both. It's strange how much their symptoms perfectly track one another. During this period, they stopped having the 'soft serve' bit at the end of their poo, and instead produced 'logs' which were dark brown on the outside and a lighter brown more mucusy poo on the inside. It seemed better than it had been. They finished these antibiotics 2 days ago, although T vomited up his breakfast (it was vomiting, not regurgitation) immediately after the last dose. He's never been sick before other than in the three flare-ups (during which he was very evidently ill with fever). This time there seemed to be no illness, he was running and playing and wanting more food almost immediately, and that night his poo was the same as it had been on the antibiotics (reasonably good). So I'm not sure where that came from or how relevant it is. Now, 72 hours post-finishing amoxicillin (and still waiting for the most recent PCR test results), as predicted, the poo is worsening again. T was really straining to poo tonight and produced a poo which was reasonably formed, but with a huge jelly-like bit of light-mid brown mucus in it. It was the kind of mucus that didn't even leave a mark on the plastic scoop if you touched it. He's been playing happily this evening again and eating/drinking usually but I am feeling so deflated and hopeless about all this.
It's hard to see an end in sight as this has been going on for nearly 10 weeks now (the boys are 11 months old now). They are such lovely boys and I love them very much, but I live on my own and I feel like I experience near constant stress and anxiety about whether I am going to arrive home to T in that terrible state again. He hasn't actually had a full-flare up since before the antibiotics, but as his poo is worsening, it doesn't make me feel confident he won't do.
Throughout all this time appetite has been really good for both and they continue to be on the Hills ID bland diet (wet and dry). I really really don't want to keep them on it long-term though, particularly as it doesn't seem to have done any wonders for them either! Both cats are a really healthy weight which is great. I've been giving them s boulardii (twice daily to ensure it's always in their system) + probiotics every day for a couple of weeks now but with no observable impact (Nexabiotic). I also give them additional fibre (75% psyllium husk + other probiotics) mixed in with their wet food twice daily as fibre is meant to create an environment not favourable to clostridium.
Last time I spoke to the vet, it felt a bit like she was out of options for treating the clostridium itself. She stressed again that it may not be the cause of the illness. My gut feeling tells me that it is likely though, because of the timing of the three flare-ups which all coincided with an increase in Katkin amount (high protein, low fibre - perfect for clostridium to grow in). It would also explain why both boys suddenly became ill initially at nearly exactly the same time (2 weeks after they had started Katkin - I am guessing it was just enough time potentially for the clostridium p. to grow to a dangerous level?). The vet has offered some other options which are to try treating this as 'pure IBD' by treating them with injected steroids (which would last 5-7 days) or with oral steroids. The disadvantage of this is that if it is clostridium p. causing the symptoms of the illness, then it could 'knock' them further and allow it to flourish. Advantage of oral over injectable is that they can be stopped if the boys worsen. Vet has said another option could be oxytetracyline which is v effective at reducing inflammation (but it's not effective for c. perf). Obviously there are lots of tests that could be done ie scans, but I really don't have the money for those and have thrown so much at this already - I am 60% of the way through the insurance limit. Previously the vets have always said it would be so unlikely for both cats to have developed IBD at the same time - and I agree - so I can't help but think that these 'IBD' treatments might be the wrong route to take.
At the moment I am still waiting for the PCR test and I have a strong feeling it will come back as positive which won't leave me much the wiser about what is causing their issues.
Based on all your experiences, does anyone have thoughts about why amoxicillin seems to be 'controlling' whatever it is causing the issue. Interestingly, their poo 2-3 days off amoxicillin seems almost worse (way more mucusy) than it did when they were not on antibiotics before c. perf. was identified as being the issue. This makes me wonder whether rather than reaching for more treatment (more antibiotics, or steroids), I should give them some time (potentially on a 100% chicken diet to rest their gut for a bit? But this is also a further change of food...) without anything, to see whether this helps to 'reset' them. That said, that is effectively what I tried to do before they were prescribed antibiotics, and it never did resolve.
Any thoughts/advice would be so appreciated. The worry about my boys is really taking its toll on me and I can't see an end in sight right now!
I'm hoping you might be able to help me with some thoughts/advice/words of kindness. I've spent a lot of time reading TCS posts about similar issues to what I've been experiencing and some of them have been really helpful, thank you!
I adopted two 7.5 month old kittens from a shelter in August. They were 3.5 months when they were removed from a multi-cat household (5 cats in total). They settled in with me very well, for the first 6 weeks of living with me they had consistently healthy stools. They are indoor boys. After 4 weeks I changed their food (to switch them to wet- Katkin). If anything their stool quality improved. Two weeks after the food change (2 days after I had started feeding them a slightly larger quantity of Katkin), I arrived home from work to find one of them (T) unwell - vomiting, diarrhea, fever and abdominal pain (hunched over). Took him to the vet and he was given anti-emetic injection. Both cats wormed again as a precaution. The following day his brother (N) became ill too, he vomited once and slept for a long period. I kept them on Katkin. Three days later, as they both seemed to be getting a lot better (both had unformed stools still though), T suddenly had another episode of fever and vomiting. Back to vets who advised I change their food to bland food diet. Stools didn't harden after several days, so I took in stool sample (single sample). This came back negative (culture test). For the following few weeks, both cats' stools remained half/half diarrhea/formed, never returning fully to normal. After a while I started to wonder if they were intolerant to something in the bland food (I've been feeding wet/dry mix) so started to transition them back incredibly slowly (over 2-3 weeks) onto their normal wet food (which their stool had always seemed healthier on when first introduced). About 2 weeks into this, on the day that I increased this from about 18% of daily calories to 33%, T had another episode of fever (confirmed by vet) and vomiting. Antibiotics were prescribed (metronidazole) for both cats. PCR stool sample (3 day) also collected (mixed sample from both cats). Throughout this course of metronidazole, stools remain half formed. Near the end of this course, I received a call from the vet with the PCR results. They'd tested negative for everything (test included FCV, toxoplasmosis, tritrichomonas foetus, giardia, salmonella, FPL) apart from clostridium perfringens alpha toxin which they tested positive for. The vet stressed that the lab had said that these results should be interpreted with caution, because c. perf. can be found in the guts of healthy cats, so it wasn't possible to know whether it was the cause of illness. Vet said that she would prescribe amoxicillin, as although metronidazole can be used to treat c. perf, cats can show neurological symptoms if kept on it for too long. They started taking amoxicillin the night after they had finished the metronidazole course that morning. Neither of their stools hardened up fully on this, it continued to be half formed really. However, frequency did decrease. I should say also - even when they have both had bad diarrhea they always do manage to go in their litter box. Shortly after they had finished this 2 week course, T's pooing frequency went from once a day to twice. By day 3, N had liquid diarrhoea suddenly. I called the vet on this day. I had taken another 3 day mixed stool sample as they were coming to the end of the course of amoxicillin but we were still waiting for the results of this. She agreed to prescribe 5 more days of amoxicillin as it had seemed to control things for the boys. Very quickly after starting amoxicillin again, stools firmed up again for both. It's strange how much their symptoms perfectly track one another. During this period, they stopped having the 'soft serve' bit at the end of their poo, and instead produced 'logs' which were dark brown on the outside and a lighter brown more mucusy poo on the inside. It seemed better than it had been. They finished these antibiotics 2 days ago, although T vomited up his breakfast (it was vomiting, not regurgitation) immediately after the last dose. He's never been sick before other than in the three flare-ups (during which he was very evidently ill with fever). This time there seemed to be no illness, he was running and playing and wanting more food almost immediately, and that night his poo was the same as it had been on the antibiotics (reasonably good). So I'm not sure where that came from or how relevant it is. Now, 72 hours post-finishing amoxicillin (and still waiting for the most recent PCR test results), as predicted, the poo is worsening again. T was really straining to poo tonight and produced a poo which was reasonably formed, but with a huge jelly-like bit of light-mid brown mucus in it. It was the kind of mucus that didn't even leave a mark on the plastic scoop if you touched it. He's been playing happily this evening again and eating/drinking usually but I am feeling so deflated and hopeless about all this.
It's hard to see an end in sight as this has been going on for nearly 10 weeks now (the boys are 11 months old now). They are such lovely boys and I love them very much, but I live on my own and I feel like I experience near constant stress and anxiety about whether I am going to arrive home to T in that terrible state again. He hasn't actually had a full-flare up since before the antibiotics, but as his poo is worsening, it doesn't make me feel confident he won't do.
Throughout all this time appetite has been really good for both and they continue to be on the Hills ID bland diet (wet and dry). I really really don't want to keep them on it long-term though, particularly as it doesn't seem to have done any wonders for them either! Both cats are a really healthy weight which is great. I've been giving them s boulardii (twice daily to ensure it's always in their system) + probiotics every day for a couple of weeks now but with no observable impact (Nexabiotic). I also give them additional fibre (75% psyllium husk + other probiotics) mixed in with their wet food twice daily as fibre is meant to create an environment not favourable to clostridium.
Last time I spoke to the vet, it felt a bit like she was out of options for treating the clostridium itself. She stressed again that it may not be the cause of the illness. My gut feeling tells me that it is likely though, because of the timing of the three flare-ups which all coincided with an increase in Katkin amount (high protein, low fibre - perfect for clostridium to grow in). It would also explain why both boys suddenly became ill initially at nearly exactly the same time (2 weeks after they had started Katkin - I am guessing it was just enough time potentially for the clostridium p. to grow to a dangerous level?). The vet has offered some other options which are to try treating this as 'pure IBD' by treating them with injected steroids (which would last 5-7 days) or with oral steroids. The disadvantage of this is that if it is clostridium p. causing the symptoms of the illness, then it could 'knock' them further and allow it to flourish. Advantage of oral over injectable is that they can be stopped if the boys worsen. Vet has said another option could be oxytetracyline which is v effective at reducing inflammation (but it's not effective for c. perf). Obviously there are lots of tests that could be done ie scans, but I really don't have the money for those and have thrown so much at this already - I am 60% of the way through the insurance limit. Previously the vets have always said it would be so unlikely for both cats to have developed IBD at the same time - and I agree - so I can't help but think that these 'IBD' treatments might be the wrong route to take.
At the moment I am still waiting for the PCR test and I have a strong feeling it will come back as positive which won't leave me much the wiser about what is causing their issues.
Based on all your experiences, does anyone have thoughts about why amoxicillin seems to be 'controlling' whatever it is causing the issue. Interestingly, their poo 2-3 days off amoxicillin seems almost worse (way more mucusy) than it did when they were not on antibiotics before c. perf. was identified as being the issue. This makes me wonder whether rather than reaching for more treatment (more antibiotics, or steroids), I should give them some time (potentially on a 100% chicken diet to rest their gut for a bit? But this is also a further change of food...) without anything, to see whether this helps to 'reset' them. That said, that is effectively what I tried to do before they were prescribed antibiotics, and it never did resolve.
Any thoughts/advice would be so appreciated. The worry about my boys is really taking its toll on me and I can't see an end in sight right now!
. This hurts me to do it, BUT, he does seem much improved, and I'm not able to give him any of the other items I'm supposed to be giving him (psyllium, s. boulardi with MOS) even with the FortiFlora anymore, so am hoping just the higher fiber food is going to help him get rid of it. 
