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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Cat Veterinary
Satisfied Customers: 28935
Experience:  University of California at Davis graduate veterinarian with 45 years of experience.
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I have an 11 month cat that I adopted 5 months ago. "Poppy"

Customer Question

I have an 11 month cat that I adopted 5 months ago. "Poppy" has had chronic diarreah for the at least 3-4 of these months (if not the whole time). She also shows strange behavior of crouching to the ground as her back crawls. She will cry loudly and take off darting. She rapidly licks her sides and tail base. (Thought this could be feline hyperstesia, but we don't know)
Originally I thought the food (blue buffalo) was causing the issue and switched gradually to Purina Pro Plan since it was less rich.
It didn't seem to make anything better and poppy was defecating liquid stools outside the litterbox 3-4 times a week.
The vet recommended fortifora and a switch to royal canin high energy GI. This did not go over at all, and out of desperation I switch to Weruva exclusively.
Poppy has been on Weruva for 3 weeks, 2-3 packets of fortiflora a day. She was prescribed gabapentin for pain. (100mg/day) but I have slowly increased this to 300mg/day be she was still showing signs of pain on 100mg and 200mg. 300mg is the amount needed for her to keep eating and acting normal.
The vet has also prescribed Veraflox to help harden the stools. Poppy has been on this for 1 week.
Nothing has helped.
Additional changes have been going from clay to walnut litter. Spraying feliway 1-2 times a day for anxiety.
Her stools were tested and nothing showed as a problem.
The vet recommends radiographs as the next step.
Any thoughts? I want her to be back to normal and without the gas/diarreah issues.
Submitted: 2 years ago.
Category: Cat Veterinary
Expert:  Dr. Michael Salkin replied 2 years ago.
Aloha! You're speaking with Dr. Michael Salkin
I'm sorry for the delay in responding to you. I see that you requested me but I've been away from my computer. The most important problem at this time is her chronic diarrhea and so I'm going to concentrate on that problem in our conversation.
Her behavior of back crawling, vocalizing, darting away, and licking herself madly does indicate hyperesthesia. The gabapentin is one of many drugs I might try in these cats and it appears to be helpful for Poppy. Here's a thorough review of the feline hyperesthesia syndrome for you: http://www.veterinarypartner.com/Content.plx?P=A&S=0&C=0&A=2873
There are many protocols for addressing chronic diarrhea. Here's what I would do - particularly in such a young cat...
1) Presumptively treat for gastrointestinal parasites. Fecal ova and parasite exams are too often falsely negative. I would dose Poppy with fenbendazole (Panacur) once daily for 5 consecutive days. Fenbendazole is broad spectrum against the common nematodes - roundworms, hookworms - and also will treat the protozoan Giardia. You can find fenbendazole over the counter in pet stores now. It will say for dogs only which you can ignore. The dose is the same as in dogs but I'd like her to receive 5 consecutive days of it. If you didn't see a positive response...
2) See how a presumptively hypoallergenic diet affects Poppy. You've changed diets but not to a presumptively hypoallergenic diet. Food intolerance/allergy is addressed with prescription hypoallergenic diets. These special foods contain just one novel (rabbit, duck, e.g.) animal protein or proteins that have been chemically altered (hydrolyzed) to the point that Poppy's immune system doesn't "see" anything to be allergic to. The over the counter hypoallergenic foods too often contain proteins not listed on the label - soy is a common one - and these proteins would confound our evaluation of the efficacy of the hypoallergenic diet. The prescription foods are available from her vet. There are many novel protein foods and a prototypical hydrolyzed protein food is Hill’s Prescription Diet z/d ultra (my preference). A positive response is usually seen within a few weeks if we’ve eliminated the offending food allergen. Food intolerance can arise at any age and even after our patient has been eating the same food for quite some time. If you didn't see a positive response...
3) Perform diagnostics in the form of blood and urine tests and special testing for the rarer GI parasites. For example, a basic diagnostic panel plus FeLV (feline leukemia virus) and FIV (kitty AIDS) testing as performed by our reference lab plus PCR (a DNA-based) testing for both the uncommon parasites Tritrichomonas foetus and Cryptosporidium. If nothing untoward is found...
4) Don't treat with any more antibiotics. Poppy didn't suffer from a Veroflox-susceptible infection and bacterial infections, while possible -
Salmonella, Campylobacter, e.g. - aren't likely to cause lifelong diarrhea. The same PCR testing can also test for those bacteria if Poppy's vet wants to be all-inclusive in his/her testing.
5) Scoping and biopsy of these patients may be necessary to identify the etiology. We're looking for inflammatory bowel disease and colitis that might only be identified by biopsy.
Please respond with further questions or concerns if you wish.
Customer: replied 2 years ago.
Thank you. I will try the recommendations for the diarrhea
Expert:  Dr. Michael Salkin replied 2 years ago.
You're welcome. I can't set a follow-up in this venue and so would appreciate your returning to our conversation with an update - even after rating - at a time of your choosing.