Diarrhoea

Re: Diarrhoea

Anthony Todd — Sat, 24 Nov 2012 14:46:32 GMT

[quote user="Kate Richardson"]Not necessarily. [/quote]

For sure, but then I did my diet trials as the first line, way before much inflammatory response I suppose.

I wish that was the modern, "gold standard" approach.....

Not long 'til qually, and there's always the rugby.

Re: Diarrhoea

Kate Richardson — Sat, 24 Nov 2012 13:43:05 GMT

[quote user="Anthony Todd"]

[quote user="robloxley"]Give the cat a chance![/quote]

Well with a diet trial you get nothing for a couple of days or more, then a solid stool! That's if it is the diet, if not then start your investigation in earnest.

This has been going on since May, remember...

[/quote]

Not necessarily. Chronic stimulation from dietary antigens can lead to varied degrees of inflammation in the intestinal walls which may require anti-inflammatory treatment to resolve. Until the inflammation is gone, the diarrhoea will persist. Yes, it is important to remove the causative agent (assuming in this case it is dietary and in some cases the diarrhoea will resolve simply by doing so, but it is rarely (in my experience) within 2 days! I totally agree a diet trial is well worth doing very early on the investigation/trial therapy stage.

Re: Diarrhoea

Anthony Todd — Sat, 24 Nov 2012 12:11:19 GMT

[quote user="robloxley"]Give the cat a chance![/quote]

Well with a diet trial you get nothing for a couple of days or more, then a solid stool! That's if it is the diet, if not then start your investigation in earnest.

This has been going on since May, remember...

Also, usually, with all these medications the vet adds diet advice as an aside "cut out milk" is the usual, [same with FLUDT] which is the actual cure, but the diet or anti-stress drug or whatever pharmaceutical always gets the credit and the fee!

Re: Diarrhoea

Rob Loxley — Sat, 24 Nov 2012 00:20:32 GMT

[quote user="Anthony Todd"]

[quote user="Mindaugas Steponavicius"]thank you so much for your reply,[/quote]

Did the D+ stop with the treatment?

[/quote]

Give the cat a chance!

Re: Diarrhoea

Anthony Todd — Fri, 23 Nov 2012 17:19:49 GMT

[quote user="Mindaugas Steponavicius"]thank you so much for your reply,[/quote]

Did the D+ stop with the treatment? Did you find giardia?

Re: Diarrhoea

Richard Carter — Fri, 23 Nov 2012 13:32:28 GMT

no - low dose - 2.5mg/ cat (1/2 pred 5mg) bid, reducing. Just trying to get the intestines working again reabsorbing fluid with some improved comfort

Re: Diarrhoea

Mindaugas Steponavicius — Thu, 22 Nov 2012 22:23:09 GMT

Dear Richard

thank you so much for your reply, re the dosage of the prednisolone, are we going for purely anti-inflammatory? so would that be 2.5mg/kg or 2.5mg per cat?

regards

Minda

Re: Diarrhoea

Mark Hedberg — Wed, 21 Nov 2012 22:52:47 GMT

I agree, the sachet means dosing is simplest. Close enough, anyway. Prednisolone I would suggest on the following schedule; 1/2 tab twice daily 3 days, half tablet once daily three days, then half tablet every other day. The longer dose intervals are associated with a lower incidence of side effects.

Make sure the owner thoroughly cleans the feeding dishes (hot soapy water) and disinfects the litter tray (clorox, bleach, whatever) to avoid any potential reinfection.

Re: Diarrhoea

Richard Carter — Wed, 21 Nov 2012 17:47:24 GMT

Can see giardia in faecal float - cysts about 1/4 size worm eggs

Tend to use the 10% panacur liquid formulation by syringe - 1.8ml p.o sid but 1g sachet are 222mg - fairly close. I would definitely give a cortisone rx pred 2.5mg bid 5d/ reducing over 2 weeks as will be all sorts of secondary gut changes by now affecting re-absorption of fluid not to mention the plain discomfort of swollen git lining with chronic diarrhoea.

also give metronidazole routinely in chronic cat diarrhoeas as opportunistic bacteria are just that. Food gravy and jelly free, no dairy as mentioned previously before heading off onto fancy prescription diets

Re: Diarrhoea

Mindaugas Steponavicius — Wed, 21 Nov 2012 17:25:43 GMT

Dear Mark

I going to try ruling giardia then. My cat is 3.5kg bw. Shall I give Panacur 1g sachets daily for 10 days or would you recomend a different dose?

Kind regards

Mindaugas

p. s. Owner says that on Veroflox cat's motions look more formed, but we can't keep the cat on Veroflox the rest of the life.

Re: Diarrhoea

Anthony Todd — Wed, 21 Nov 2012 15:48:12 GMT

Geez, you're not using those lethal steroids again are you?

Why we don't apply Pareto's 80/20 principle to diagnosis I don't know, [I googled it]. But with animal diagnosis it's probably 95/5.

Yeah, I can never understand why some always go for the rarest, most sinister, most expensive diagnosis without completely eliminating the common causes of a condition.

One of my mentors [Bill Doole] used to say "my horses only get ordinary things wrong with them"

and then there's the adage "Common diseases are common"

Re: Diarrhoea

Clive Ansell — Wed, 21 Nov 2012 15:31:37 GMT

[quote user="Anthony Todd"]

[quote user="Clive Ansell"]venison based diet [/quote]

I have always assumed dogs and cats were always sensitive to one allergen/sensitiser only and not everything except one??

Any sort of references etc. on multiple dietary allergies??

[/quote]

no references,

This cat had numerous dietary trials with the standard commercial sensitivity diets (chicken/duck/fish/rice etc), which didn't help. Allergy testing showed +ve ab titres to almost every food tested for. The success of the venison diet was found by trial and error.

I had another case, a second opinion, in a middle age vomiting otherwise healthy cat where a pyloric tumour had been diagnosed based only on radiography. Responded fantastically well to initially prednisolone and long term to a duck and rice diet.

Re: Diarrhoea

Anthony Todd — Wed, 21 Nov 2012 15:12:45 GMT

[quote user="Clive Ansell"]venison based diet [/quote]

I have always assumed dogs and cats were always sensitive to one allergen/sensitiser only and not everything except one??

Any sort of references etc. on multiple dietary allergies??

Had a cat that vomited it's food immediately, had all the tests including stomach biopsies as above. Turned out to vomit only dried food and the referring vet had already noted "no vomiting on tinned food" but over £1000 later.....

Re: Diarrhoea

Clive Ansell — Wed, 21 Nov 2012 14:28:11 GMT

Reminds me of case several years ago, chronic diarrhoea a young Bengal cat. No response to treatment and dietary trials, extensive work up including gut biopsies, turned out in the end to be sensitive/allergic to pretty much everything except venison. Waltham made a venison based diet at the time which worked very well. We later discovered that all the litter mates and the mother had the same condition, which the breeder forgot to mention at the £1200 sale!

Re: Diarrhoea

Mark Hedberg — Wed, 21 Nov 2012 13:49:04 GMT

[quote user="Anthony Todd"]

[quote user="Kate Richardson"]I agree with hypoallergenic diet[/quote]

I remember Colin Burrows at Florida saying that of the dogs with chronic diarrhoea referred to him at Florida 90% [from memory] were simple dietary sensitivity.

[/quote]

I was at a different conference with different specialist but I heard the same 90%+ figure. :)

Re: Diarrhoea

Anthony Todd — Wed, 21 Nov 2012 13:44:19 GMT

[quote user="Kate Richardson"]I agree with hypoallergenic diet[/quote]

Trouble with those is that they are not a single ingredient so there is still a possibility of "sensitivity" to one of the ingredients. A single source ie boiled chicken or fish is definitive. Of course the cat may be chicken sensitive so last straw is to try fish or vice versa.

A single protein source also gets the idea across of "single" to the indulgent owner [" just a lick of milk can't hurt etc."]

I forgot to mention to starve the cat, water only for 48 hours to start. And in multicat households they all have to suffer, or be diligently separated from the test food source and vice versa.

Only if the diarrhoea persists would I explore the plethora of diagnoses and treatments suggested so far, and I am sure there will be more to come....

Crikey, the OP case has been going on since May so a decent, simple, cheap, diet trial is mandatory before the laboratory and pharmacy.

I remember Colin Burrows at Florida saying that of the dogs with chronic diarrhoea referred to him at Florida 90% [from memory] were simple dietary sensitivity.

Re: Diarrhoea

patrick murphy — Wed, 21 Nov 2012 13:23:55 GMT

at the LVS in triaditis and diarrhea lectures it would appear that if you name a test, he will tell you why it is wrong for us to believe in it.

he did say that Tylosin was available in UK is that the large animal suspension?

Re: Diarrhoea

Mindaugas Steponavicius — Wed, 21 Nov 2012 13:00:23 GMT

It was a PCR. NEGATIVE.

Re: Diarrhoea

Bob Russell — Wed, 21 Nov 2012 12:03:41 GMT

Almost all of our problem diarrhoeas test positive for giardia and respond to fenbendazole!

Re: Diarrhoea

Kate Richardson — Wed, 21 Nov 2012 11:48:46 GMT

I agree with hypoallergenic diet and fenbendazole treatment trial, but can I ask, what T Foetus test did you do? Was it the PCR? if not, may be worth repeating T foetus PCR test as more accurate.

Re: Diarrhoea

Anthony Dennison — Wed, 21 Nov 2012 11:37:56 GMT

I'd trial the fenbendazole too, usually one of my first steps with young animals and chronic diarrhoea.

Re: Diarrhoea

Martin Atkinson — Wed, 21 Nov 2012 10:36:07 GMT

I agree with the general advice above, campylobactor is often an incidental finding in cats. If all other tests for parasites are negative and no improvement with diet, although the cat is a bit older than usual it could be coronovirus, they can take ages to clear up - 6 months is the longest I've had, you just have to hang in there and placate the owner.

Re: Diarrhoea

Hannah Wynne Richards — Wed, 21 Nov 2012 09:29:48 GMT

Try B12

Wynne

Re: Diarrhoea

Anthony Todd — Wed, 21 Nov 2012 07:22:12 GMT

[quote user="robloxley"]

Diet trial?

[/quote]

Yep. 99 times out of 98 it's the diet in a healthy cat, particularly a young one.

Easiest way is to start on boiled chicken or boiled fish and water ONLY!! Owner compliance is the hardest part. If faeces go to solid keep on for a week then add things one at a time. Of course milk is the most likely culprit but liver and tins also a good bet.

Trouble is the obvious solution is cheap and not very "medical" when you're a highly trained VS and know of the many differentials and treatments......

I'd love to know how many solid stooling cats are +ve for "pathogens"

Re: Diarrhoea

Rob Loxley — Tue, 20 Nov 2012 23:29:19 GMT

Diet trial?