Ask the Vet: Persistent Diarrhea in Cats
2004
I am fostering a nine-month-old kitten for a no-kill cat rescue. The kitten has had smelly diarrhea for months. She has had several positive fecal tests for Coccidia and has been treated with Albon. She also had a positive fecal test for Giardia and was treated with Panacur and Flagyl. After she finished the Flagyl, her diarrhea came back full tilt. Follow up fecal tests did not show Coccidia any more, but continued to show Giardia! Our veterinarian put her back on a higher dose of Flagyl, but when she finished taking the medicine the diarrhea came back worse than before. The cat's attitude, appetite and activity are fine, but she can't seem to get rid of this diarrhea. Is there anything else I can do to help this poor kitten? We are not comfortable putting her up for adoption until she is better.
Thank you,
Amy
Dear Amy,
It sounds like you have been taking wonderful care of this kitten - she is lucky to have such a dedicated foster caregiver.
Chronic diarrhea is not an uncommon occurrence, especially if the kitten came from a multiple cat environment (such as a cattery or a shelter). Coccidiosis and Giardiosis have been well documented culprits of chronic diarrhea in cats and kittens and are usually responsive to appropriate therapy as prescribed by your shelter's veterinarian.
Tritrichomonas foetus1, 3, 4, another cause of chronic diarrhea in cats, is currently under investigation. It is a protozoal organism that has been easily mistaken for Giardia when observed under the microscope.1 Unfortunately, this organism has not been responsive to antimicrobial therapy, and cats can take up to three years (average of five months) to recover.3 It has been known to cause a waxing and waning, cow pie form of diarrhea that may have a strong odor to it as well as blood and mucus.2,3 Fecal consistency may improve with antimicrobial therapy, but once medication is stopped the diarrhea usually recurs worse than before since antimicrobial therapy does not eliminate the infection.2, 3, 4
The mode of transmission is from cat to cat through the fecal-oral route,3 so keeping infected cats isolated from other cats is a good idea. Disinfecting with dilute bleach has been shown to kill the organism, however daily disinfecting does not appear to alter the course of the infection in affected cats.3 The good news is, so long as there isn't a co-existing condition (i.e., cryptosporidiosis, FeLV, FIV...), cats infected with Tritrichomonas foetus have been known to spontaneously recover. It may take some time, however.
I hope this helps.
Laurie Peek, DVM
References:
1. Gookin, J. et al. Use of commercially available culture system for diagnosis of Tritrichomonas foetus infection in cats. JAVMA 2003 May 15; 222 (10):1376-1379.
2. Gookin, J. et al. Experimental infection of cats with Tritrichomonas foetus. Am J Vet Res 2001;62:1673-1832.
3. Gookin J. Trichomoniasis in cats: Recognition and Resilience, In Proceedings, 19th Annual Meeting of the American College of Veterinary Internal Medicine, Denver, CO, May 2001.
4. Gookin, J. et al. Diarrhea associated with trichomoniasis in cats. JAVMA 1999 Nov 15; 218 (10): 1450-4.
