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I have a 3-yr old female cat that developed diarrhea,

I have a 3-yr...

I have a 3-yr old female cat that developed diarrhea, sometime severe, over the past 3-wks. About two months ago she had both inner ears scraped at a clinic to remove polyps. Following surgery she was on ant-biotics for 30 days. We now have her on Synacore and Metronidazole. This is the second round of the Metronidazole. The first time it was a 1/4 tab twice per day. We were on the track to a firm stool. Within a week the end of that first course the diarrhea came back. We are now on a two week schedule of the med of 1/4 tab twice per day. Prior to the surgery and for the six weeks after she had a normal stool. We have a pump operated pet waterer with a charcoal filter. Are we getting a bacterial growth in the water due to bacteria growth in the system? We have another cat, same age, not affected. I clean the system, with water only, frequently. Change the filter every 2-weeks.

Veterinarian's Assistant: I'll do all I can to help. There are all sorts of infections the cat can pick up. I'll have you talk to the Veterinarian who'll sort out what is wrong and help you decide what to do about it. What is the cat's name?

CiCi. Also should point out that both cats have always been indoor, they are never outside.

Veterinarian's Assistant: Is there anything else important you think the Veterinarian should know about CiCi?

She was a rescue cat we adopted in Feb 2017. Don't know her prior history

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Answered in 5 minutes by:
12/13/2017
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Cat Veterinary
Satisfied Customers: 35,538
Experience: University of California at Davis graduate veterinarian with 45 years of experience.
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You're speaking with Dr. Michael Salkin. Welcome to JustAnswer. I'm currently typing up my reply. Please be patient. This may take a few minutes.

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I'm sorry to hear of this with Cici. To answer you directly, if their waterer had become contaminating, I would have expected both cats to be symptomatic. I have two concerns. The first is that 30 days of antibiotics was likely to cause a dysbiosis - imbalance of gastrointestinal flora - which resulted in Cici's diarrhea. This can be self-limiting and so the use of more antibiotics such as metronidazole - at least for the first couple of weeks from the onset of diarrhea - must be circumspect. Because you did see a good response to metronidazole, however, it wasn't unreasonable to continue administering it if only because metronidazole has an immunomodulary effect (alters the local immune system in the GI tract thereby reducing inflammation) as wel as being an antibiotic. My second concern is that there's now inflammatory bowel disease (IBD) present which appears to be an immume-mediated and perhaps stress-related inflammation in the GI tract. IBD often responds to metronidazole although a glucocorticoid (steroid) such as prednisolone might be considered in addition to the metronidazole or as a sole therapy drug. In the case of IBD the smallest dose of metronidazole and/or prednisone given as infrequently as possible to control gastrontestinal disturbances - inappetence, diarrhea and/or vomiting, is the correct dose. Confirmation of IBD requires scoping and biopsy of these patients but most of us will make the call for IBD when we see a positive reponse to those drugs. The diagnosis of dysbiosis challenging and usually diagnosed empirically. A positive response to a course of oral antibiotics such as tylosin, enrofloxacin, or metronidazole suggests dysbiosis (but also IBD when tylosin or metronidazole is used). Please respond with further questions or concerns if you wish.

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errata: two concerns, not to concerns

well, not wel

dysbiosis is challenging, not dysbiosis challenging

Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Cat Veterinary
Satisfied Customers: 35,538
Experience: University of California at Davis graduate veterinarian with 45 years of experience.
Verified
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Thank you for your kind accept. I appreciate it. I can't set a follow-up in this venue so please return to our conversation - even after rating - with an update at your convenience. You can bookmark this page for ease of return.

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Hi,

I'm just following up on our conversation about your pet. How is everything going?

Dr. Michael Salkin
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