How JustAnswer Works:
  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site.
    Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.
Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Cat Veterinary
Satisfied Customers: 24396
Experience:  University of California at Davis graduate veterinarian with 44 years of experience.
55012488
Type Your Cat Veterinary Question Here...
Dr. Michael Salkin is online now
A new question is answered every 9 seconds

Dr Salkin The new vet wants to do that pcr test and a rectal

Customer Question

Dr Salkin The new vet wants to do that pcr test for parasites for Iubi and a rectal exam. He wants to do a rectal loop procedure to retrieve stool so that it would be fresh for the pcr test. That just plainly worries me. Isn't that extremely uncomfortable
for the kitty? Isn't that going to cause additional inflammation for an inflamed bowel?
Submitted: 1 year ago.
Category: Cat Veterinary
Expert:  Dr. Michael Salkin replied 1 year ago.

The loop is a very thin and flexible wire that Lubi will hardly feel. Passing stool would be more abrasive than the wire. Don't give it a second thought, Andreea.

Customer: replied 1 year ago.
Ok we did that. Now this is going to be a weird question: after that rectal loop she keeps loosing stool little tiny pieces and she keeps cleaning herself. I feel that stuff keeps coming and you can imagine the smell and the carpet... Is this normal?
Expert:  Dr. Michael Salkin replied 1 year ago.

The poor thing was violated! It sounds as if her already irritated rectum was irritated more by the loop. Thankfully, that area heals rapidly when traumatized.

Customer: replied 1 year ago.
But why do you think that she leaks? What is that caused by? Do you think that the tech just did not remove enough of the stool and basically left it there?
Customer: replied 1 year ago.
What should I do ?
Expert:  Dr. Michael Salkin replied 1 year ago.

Inflammation can result in fecal incontinence just as inflammation in the urinary tract can result in urinary incontinence. The tincture of time should take care of her. There's nothing of value for you to do at home unless you want to see how metronidazole affects her at this time. That's not unreasonable dosed at 1/4 of a 250 mg tablet twice daily for a few days.

Customer: replied 1 year ago.
The vet just sent in a prescription of metro into cvs. She just went to the bathroom and she produced a huge one maybe now there is nothing else pressing the sphincter.
But I will still give her the metronidazole
Customer: replied 1 year ago.
Can I use cleaning wipes on her? She smells horrible. Should I use non alcohol ones? Just asking cause she might leak herself after
Expert:  Dr. Michael Salkin replied 1 year ago.

Yes, non-alcohol baby wipes are safe.

Customer: replied 1 year ago.
hey. are you available to talk? I have answers to my cats problems!!!
Customer: replied 1 year ago.
I requested a phone consult:)
Expert:  Dr. Michael Salkin replied 1 year ago.

I regret that my state board of veterinary examiners doesn't allow my speaking with customers by phone in this venue. Please stay in this conversation, Andreea. Mea culpa.

Customer: replied 1 year ago.
Oh then how come this one popped up?
well that's fine:)
Expert:  Dr. Michael Salkin replied 1 year ago.

Some vets aren't restricted by their governing bodies...particularly those working from outside the country. The site doesn't distinguish between one vet or the other so you can imagine how many times I have to type this...

Customer: replied 1 year ago.
sooooooooooo I found what caused our continued worry and frenzy:
Tritrichomonas Foetus
and Feline Coronavirus
the vet says treatment is rinadazole but that he does recommend just waiting because the medication is known to cause neurological side effects in cats!
and that after a few years the cats will get used to this problem and will have less symptoms
and what I could do would be just some probiotics to just keep remissions at a minimum- it is not a treatment.
I told him I will talk to my advisor( which is you) and I will let him know what we will do.
what are we doing here Dr Salkin?
Expert:  Dr. Michael Salkin replied 1 year ago.

Here's the scoop on Tritrichomonas. I'm not concerned with coronavirus which isn't likely to be the causitive agent. I could find that virus in most every cat I tested.

The most effective drug for the treatment of T. foetus in cats is ronidazole. The drug has a bitter taste and should be compounded into capsules. Veterinary staff and owners should wear gloves when handling ronidazole. If a confirmed relapse occurs, another course of treatment may eliminate the parasite. Diarrhea may take several weeks to resolve after elimination of the parasite because significant colitis is often present. Effectiveness of treatment can be evaluated by performing fecal PCR tests 2 and 20 weeks after the end of treatment. Nonspecifc treatment for diarrhea is unhelpful and may prolong the duration of diarrhea.

An important and potentially serious adverse effect of ronidazole administration in cats is a reversible neurotoxicity. Onset of signs often begins within 1 week of the onset of therapy and may last between 1-4 weeks after cessation of therapy. These signs can include depression, ataxia, seizures, behavioral changes, weakness, hyperesthesia, and trembling. Neurotoxicosis usually requires only supportive care along with discontinuation of the drug. The neurologically affected cat should be retested for the parasite because it may have been eliminated.

I believe that many of the neurotoxicity cases were simply overdosed. The newer recommendation of 13.6 mg/lb daily for 2 weeks is now the treatment of choice and one that I would recommend. Please note that these infections often spontaneously resolve but this can take up to 2 years or longer.

Customer: replied 1 year ago.
ok that is exactly what I was told. so wha should we do with the cats? what would you do knowing their history?
Expert:  Dr. Michael Salkin replied 1 year ago.

I would treat them. I can't even imagine not treating when 2 years of diarrhea might be the alternative. Neurotoxicity isn't life-threatening...worrisome, perhaps, but so is 2 years of the s***s!

Customer: replied 1 year ago.
can we do 10mg/lbs to avoid neurotoxicity? or what can we do to avoid neurotoxicity?
can we have this infection now?
Expert:  Dr. Michael Salkin replied 1 year ago.

I can't recommend underdosing. If a cat is going to react adversely to 13.6 mg/lb it's likely to do so at 10 mg/lb as well.

Customer: replied 1 year ago.
what percentage of cats react adversely?
Expert:  Dr. Michael Salkin replied 1 year ago.

That's a good question. I don't see any studies or literature to that effect. For what it's worth once I switched to the lower dose posted above, all of my patients did well.

Customer: replied 1 year ago.
are vets in US that do a higher dose maybe?
where did you find this dosage? I want to print it and have it ready in case he wants to put us on more. I will not accept more
Expert:  Dr. Michael Salkin replied 1 year ago.

Not necessarily in or out of the US. The original dose was interpolated from other species and turned out to be unnecessarily high. The newest dose can be found in Clinical Veterinary Advisor, 3rd Ed., Cote', 2015, in Plumb's Veterinary Drug Handbook, 8th ed., 2015, and in The Cat, Little, 2012.

Customer: replied 1 year ago.
now it is 30mg/kg?
Expert:  Dr. Michael Salkin replied 1 year ago.

Yes. 30 mg/kg = 13.6 mg/lb.

Customer: replied 1 year ago.
what were cats treated with before? 50mg/kg?
Expert:  Dr. Michael Salkin replied 1 year ago.

I believe that's correct. It's been over 5 years that I've been dosing at 30 mg/kg.

Customer: replied 1 year ago.
this is kinda of a stupid question but on December 22 my husband and I will travel abroad for 3 weeks and we will have a pet sitter. Shuld we maybe do this after we come back? cause I read that if they have neurotoxicity the symptoms might last for weeks in some cases.
Expert:  Dr. Michael Salkin replied 1 year ago.

Yes, lest you worry about the cats when you should be worry free while you're traveling.

Customer: replied 1 year ago.
yeah I think we will do this in January. now how do you think they got this? were they born with it? did we do something?
Expert:  Dr. Michael Salkin replied 1 year ago.

A cat becomes infected through the use of a shared litter box with an infected cat. After walking into the box, the parasite is transferred from the infected feces of one cat to the paws of the other. Infection then occurs through ingestion of the trophozoites during grooming. You didn't do it. You're in the clear.

Customer: replied 1 year ago.
could that mean that I didn't clean the litter box often enough? Cause sometimes we sure do get lazy about that
Expert:  Dr. Michael Salkin replied 1 year ago.

No, I can't expect you to clean the box within seconds every time a cat poops....