'Evaluation not Possible' on PCR

RE: 'Evaluation not Possible' on PCR

Richard Carter — Thu, 31 Dec 2015 11:38:04 GMT

also get nice litter tray full of proper soil with leaves/ compost and everything to get a full range of the various bacteria, fungi, mycoplasmas etc that make up kitty gut flora

RE: 'Evaluation not Possible' on PCR

Anthony Todd — Wed, 30 Dec 2015 13:00:44 GMT

[quote user="Andrew Kent"]Like Martin I would worry about using steroids in a case like this[/quote]

Yes, even me too. Some obvious things:

Does the 3Kg "kitten" go outside? ie

Does it have access to other food indoors or at the neighbours?

No milk at all, I hope!

And I found a single protein source [only boiled chicken or fish] much more diagnostic than a prescription diet.

If steroids are going to make a difference they'd do so with one trial jab, and B12 would be a good additive too.

Grill the owner about dietary management, so often someone is giving the kitten "just a small saucer of milk".

Sorry, you've probably been through all these but it is surprising how often the obvious isn't until mentioned.

RE: 'Evaluation not Possible' on PCR

Andrew Kent — Wed, 30 Dec 2015 12:25:43 GMT

Hi Anthony,

Like Martin I would worry about using steroids in a case like this - in a kitten it is unlikely to be true IBD so the indication is much less.

I think tritrich still has to be a strong contender so would repeat the PCR for this - owing to the issues last time I would probably do this on a colon flush details here: https://cvm.ncsu.edu/research/labs/clinical-sciences/tfoetus/#tabsPnl1-tab-1

If that is negative I would look at a 'proper' diet trial - so probably with Purina HA or similar.

Some young kittens have diarrhoea which is difficult to explain and manage but if the above fails then cholestyramine (which is a bile-acid sequestrant) can help to control the signs whilst waiting for the kitten to grown out of it.

Andy

RE: 'Evaluation not Possible' on PCR

Martin Atkinson — Wed, 30 Dec 2015 11:03:01 GMT

Wot Wynne says then if no joy I would repeat the faecal tests preferably with coronovirus PCR. You say he's had dietary trials but with what and for how long? Have you given probiotics for up to 3 weeks which is sometimes needed for recovery of normal bacterial flora? What chance the owner is a campylobactor carrier and is reinfecting the cat? Are there other pets in the home, if so what is their status? If all else fails you may need to take biopsies by endoscope to start with then full thickness. I'm not happy with steroids without a diagnosis.

RE: 'Evaluation not Possible' on PCR

Hannah Wynne Richards — Wed, 30 Dec 2015 10:52:49 GMT

Another course of erythromycin, and an injection of B12?

Wynne

RE: 'Evaluation not Possible' on PCR

Anthony Dennison — Wed, 30 Dec 2015 10:28:45 GMT

Update on this case:

The cat's diarrhoea improved a little (but not entirely) on erythromycin but then got worse again as soon as it stopped. Thinking it possibly could be tritrichomonas, I dispensed a course of metronidazole and fenbendazole. This also didn't improve the situation.

I saw the kitten back on Christmas eve, and he is growing, but is now dribbling liquid faeces, which his making his perineum red raw. I'm putting the cat on RC gastrointestinal rather than just commercially available 'hypoallergenic' diets long term, and also started prednisolone at just under 1mg/kg/day (3kg cat, 2.5mg pred daily).

Spoke to the owner today, no difference in diarrhoea (though the cat hasn't started the food yet) and perineum is still sore. Owner is a human nurse and has some fucidin H at home, which I've suggested she uses on the sore skin, and I'm increasing the steroid dose to 5mg SID. Is there anything else I should or could be doing? Poor cat is miserable with it's sore arse.

RE: 'Evaluation not Possible' on PCR

Thomas Johnson — Tue, 24 Nov 2015 15:08:33 GMT

[quote user="skatealexia"]

Might be worth phoning the lab r.e. their interpretation of it.

[/quote]

I vaguely remember speaking to Idexx about this a couple of years ago, from what I remember it's the equivalent of a negative control and means that for some reason the test hasn't run properly.

RE: 'Evaluation not Possible' on PCR

Martin Atkinson — Mon, 23 Nov 2015 08:52:23 GMT

[quote user="Michael Woodhouse"]

Graham Bilbrough I think is the Idexx guy.

[/quote]Graham was certainly instrumental in developing the Cardiopet NT-proBNP test but not sure about his involvement in PCR testing. Anyway, the last I'd heard he'd moved to Idexx USA.

RE: 'Evaluation not Possible' on PCR

Michael Woodhouse — Sat, 21 Nov 2015 21:37:29 GMT

Graham Bilbrough I think is the Idexx guy.

RE: 'Evaluation not Possible' on PCR

Martin Atkinson — Fri, 20 Nov 2015 10:01:08 GMT

[quote user="Anthony Dennison"] but the Tritrich PCR was not possible due to 'a lack of nucleic acid proteins'.[/quote]Is this not just a roundabout way of saying its negative but with a cop out? After all its the nucleic acid proteins they're looking for to perform a PCR.

RE: 'Evaluation not Possible' on PCR

John Flynn — Thu, 19 Nov 2015 19:45:23 GMT

I'm not sure that "nucleic acid proteins" makes sense to me, but ignoring that, the gist would seem to me to be that there was a lack of DNA/RNA and as such the test wasn't readible. This would be more suggestive of inadequate sampling to me. I don't know much/anything about this organism, but perhaps a saline soaked swab rubbed about intra-rectally would be better than a faecal sample?

If phoning the lab to clarify (which sounds sensible), I'd ask at the same time if a repeat sample can be done half-price

RE: 'Evaluation not Possible' on PCR

skatealexia — Thu, 19 Nov 2015 13:13:16 GMT

Might be worth phoning the lab r.e. their interpretation of it.