GA Chronic diarrhea, diagnosed IBD. Nothing is helping!

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BellaBlue82

BellaBlue82

Member Since 2021
Hi all, it has been a rough few months. Severe UTI in October, took Baytril, fried his GI tract. We have tried probiotics, animal biome, Flagyl, SEB, S. Boulardii, and now trying budesonide and Tylosin. Ultrasound x-ray and PCR stool test all came back negative, except for some inflammation. No lymphoma suspected at this point.

He's been on budesonide for almost a week, and I was seeing more formed stools versus his watery stools. But then the vet said to start him on Tylosin too, and today he is not responding well at all. Multiple trips to potty, runny watery stools, lots of gas. I'm not continuing the Tylosin, it seems to have just made him worse.

I'm going to try Hills Z/D at the vets suggestion. We both know it's not the best food for diabetics, but I have to get his GI tract to calm down some.

Has anyone else experienced such a resistant diarrhea before? It's really scaring me and I'm honestly just not sure what else to do for him.

I have B12, ringers bag, Cerenia all on deck for when he gets really bad bouts. Like today, of course. Ugh and when he is not feeling that great I hesitate to put him through more torture of constant testing. This poor guy...
 
I am sorry for what you both have been thru and still going thru. Getting his gut microbiome in good order is key. So, adding daily probiotics and (limiting the use of antibiotics until absolutely medically necessary) is the first step. Have you tried adding canned pumpkin to his food? In my personal experience over 2 decades, I have used canned pumpkin and Fortiflora supplement for my kitties. Pumpkin helps in case of constipation and Diarrhea. I would also add Fortiflora to his food. Please try these and let us know if that helps.
 
Purrfectothecat said:
I am sorry for what you both have been thru and still going thru. Getting his gut microbiome in good order is key. So, adding daily probiotics and (limiting the use of antibiotics until absolutely medically necessary) is the first step. Have you tried adding canned pumpkin to his food? In my personal experience over 2 decades, I have used canned pumpkin and Fortiflora supplement for my kitties. Pumpkin helps in case of constipation and Diarrhea. I would also add Fortiflora to his food. Please try these and let us know if that helps.
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Thank you, it has certainly been a challenge. At our last vet visit last week, the vet mentioned about holding off on probiotics for a bit. Since he was so inflamed and nauseous, he would just throw them back up. Hopefully I can start to incorporate them into his diet again soon.

I will see if I can add some pumpkin into his diet as well. He's being very picky eater lately but I will try anything!
 
Just an FYI -- FortiFlora is not great as probiotics go. It does not have the necessary amount of the better organisms that promote gut health. Rather, it may entice a cat to eat since the main ingredient is the coating that is put on dry cat food. It's not detrimental but there are much better options if a cat is having serious diarrhea.
 
Sienne and Gabby (GA) said:
Just an FYI -- FortiFlora is not great as probiotics go. It does not have the necessary amount of the better organisms that promote gut health. Rather, it may entice a cat to eat since the main ingredient is the coating that is put on dry cat food. It's not detrimental but there are much better options if a cat is having serious diarrhea.
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I have read that as well, and truly only use fortiflora as an enticement to eat.
I was using Proviable DC and S. Boulardii, but due the his level of inflammation he got sick after each dose. At the vets recommendation we put supplements on pause until we can get the inflammation down.
Sadly the Tylosin and Flagyl just seemed to make him worse - mucusy and bloody stool, along with projectile vomiting. So we're sadly at the mercy of the inflammation at this point. I have seen some minor improvements with the budesonide, but something set him off yesterday and made him really sick.
I'm trying to incorporate some Z/D food into his regular food, he's just being very picky on eating lately. So if I have to give him just FF gourmet naturals to get him to eat, then that's what I go with for that particular feeding.
 
Slippery Elm can help with constipation as well as diarrhea, it can also help sooth the mucus membranes and lining of the stomach so it could be worth a shot. It has to be given at least 2 hours before or after any other oral meds as it can slow the absorption
 
Carole & Indigo said:
Slippery Elm can help with constipation as well as diarrhea, it can also help sooth the mucus membranes and lining of the stomach so it could be worth a shot. It has to be given at least 2 hours before or after any other oral meds as it can slow the absorption
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Thanks! I did purchase some in powder form, and am giving in small doses. I started that today to see if it will help.
 
When Sheba was in remission she got chronic diarrhoea. Did all sorts of tests, nothing showed up. The vet talked me into trying the Hills Zd which didn’t do much except raise the BG.
In the end I changed her food and the problem was solved. I changed her to a raw diet and she was fine from then on as far as diarrhoea went.
 
Bron and Sheba (GA) said:
When Sheba was in remission she got chronic diarrhoea. Did all sorts of tests, nothing showed up. The vet talked me into trying the Hills Zd which didn’t do much except raise the BG.
In the end I changed her food and the problem was solved. I changed her to a raw diet and she was fine from then on as far as diarrhoea went.
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This is honestly what I'm thinking. Regardless of how it came about, it's really seems like he's intolerant to his food. He's been on it for years, but that means nothing from what I've read.
I did try to feed raw, but he is just so picky right now! Ugh transitioning food while sick is so tough. I bet if he was feeling more himself, I'd have a better shot at it.
I've heard good things about Rawz canned wet food, and it's a novel protein/ limited ingredient food. I bought a few cans to try the novel protein route; my hopes are if I can get this situation to settle down, that will give more opportunity to try raw later.
 
Sienne and Gabby (GA) said:
It sounds like trying novel proteins may be a good idea. I'd also make sure whatever your feeding doesn't contain any gums or carrageenan. Both of those products can cause GI issues. ZiwiPeak is one brand that doesn't contain either.
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Thank you for the additional suggestion!
I've been doing a lot of reading lately lol, both on what can trigger issues AND on food labels. :bookworm:
 
Sienne and Gabby (GA) said:
There is an excellent website, Raw Feeding for IBD Cats.
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Thanks for this very informative link, Sienne; I need to read a lot and the section on meds and supplements is great. After 4 days of Metronidazole, my Ti-Mousse is degrading... so I'm stopping it.

Sorry @BellaBlue82 if I'm hijacking your thread, my Ti-Mousse is having continuous bloody stools ... I hope you find a solution for your cute little boy!
 
Purrfectothecat said:
I am sorry for what you both have been thru and still going thru. Getting his gut microbiome in good order is key. So, adding daily probiotics and (limiting the use of antibiotics until absolutely medically necessary) is the first step. Have you tried adding canned pumpkin to his food? In my personal experience over 2 decades, I have used canned pumpkin and Fortiflora supplement for my kitties. Pumpkin helps in case of constipation and Diarrhea. I would also add Fortiflora to his food. Please try these and let us know if that helps.
Click to expand...
Pumpkin is not recommended for cats with IBD. It can actually cause the IBD to flare up
 
BellaBlue82 said:
This is honestly what I'm thinking. Regardless of how it came about, it's really seems like he's intolerant to his food. He's been on it for years, but that means nothing from what I've read.
I did try to feed raw, but he is just so picky right now! Ugh transitioning food while sick is so tough. I bet if he was feeling more himself, I'd have a better shot at it.
I've heard good things about Rawz canned wet food, and it's a novel protein/ limited ingredient food. I bought a few cans to try the novel protein route; my hopes are if I can get this situation to settle down, that will give more opportunity to try raw later.
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Rawz is a good option, just don’t give her the one with pumpkin in it
 
I know you said you’re holding off on the probiotics. I’m not sure I agree with that, but with Minnie’s IBD she was on S Boulardii and a human IBD specific probiotic called Visbiome. You might want to check it out. Her nutritionist put her on it and it helped tremendously. I gave her 1/4 a capsule a day:

https://www.visbiome.com/
 
Ale & Minnie (GA) said:
I know you said you’re holding off on the probiotics. I’m not sure I agree with that, but with Minnie’s IBD she was on S Boulardii and a human IBD specific probiotic called Visbiome. You might want to check it out. Her nutritionist put her on it and it helped tremendously. I gave her 1/4 a capsule a day:

https://www.visbiome.com/
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Thank you so much for all the tips, I will stay away from pumpkin products for now!
Ah thank you, I was wondering if there was a more beneficial probiotic out there. I will take a look at that one. Hopefully within the next week I can slowly start to introduce probiotics back in.
 
Ti-Mousse and Pepe said:
Thanks for this very informative link, Sienne; I need to read a lot and the section on meds and supplements is great. After 4 days of Metronidazole, my Ti-Mousse is degrading... so I'm stopping it.

Sorry @BellaBlue82 if I'm hijacking your thread, my Ti-Mousse is having continuous bloody stools ... I hope you find a solution for your cute little boy!
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No worries Ti-mouse, I can totally understand. Nico was having very mucousy stools with some blood in them, and it was pretty unnerving. The vet prescribed antibiotics that are supposed to target diarrhea and inflammation only made him worse, unfortunately which set him back further.
I wish you look with your kitty too!!
 
When my Maggie gets food with chicken in it, she gets diarrhea. Immediately. When my Yeti gets food with any fish in it, he gets diarrhea. Immediately. We keep them on a food with neither, and we have no diarrhea. (found a turkey flavor that's free of both chicken and fish. So with Maggie, it's not the broad classification of "poultry", it is specifically chicken.) We have an old cat, Lamborghini, who gets his favorite special flavors, which include fish and chicken, he gets fed in a closed room so no one else gets into his food, but if we goof and someone does (they will try to hide in the room at feeding time), we see diarrhea with a few hours.
The food he's eaten for years may have changed formulation or ingredients or ingredient sources. So trying limited ingredients and novel proteins is probably a good idea.
 
Gracie85 said:
When my Maggie gets food with chicken in it, she gets diarrhea. Immediately. When my Yeti gets food with any fish in it, he gets diarrhea. Immediately. We keep them on a food with neither, and we have no diarrhea. (found a turkey flavor that's free of both chicken and fish. So with Maggie, it's not the broad classification of "poultry", it is specifically chicken.) We have an old cat, Lamborghini, who gets his favorite special flavors, which include fish and chicken, he gets fed in a closed room so no one else gets into his food, but if we goof and someone does (they will try to hide in the room at feeding time), we see diarrhea with a few hours.
The food he's eaten for years may have changed formulation or ingredients or ingredient sources. So trying limited ingredients and novel proteins is probably a good idea.
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Thank you! I was thinking that as well.
I have an order of some Rawz rabbit pate, Rawz duck pate, and Mouser Mouse and rabbit coming in a few days.
He did not like the Hills Z/D, of course.
I feel bad, it seems like now every time he poos, he doesn't feel good immediately after and wants to hide. I'm sure he's just so uncomfortable. He seems to vomit once a day too, sometimes a little bit of food, sometimes white foam. I'm not sure if it's stomach acid or food intolerance. This is while on Cerenia. I'm hoping against hope we can help him feel better soon. ❤️
 
I think I was not giving the Cerenia properly. We're now on a schedule where I give it daily, and I've broken down the budesonide into half doses and give in the Am and one in the Pm. He seems to tolerate that a little better.

The vet is awesome, she told me put whatever medicine and Rx items you need in your Chewy order and I will approve it. So I have two ringers bags, IV line, needles, B12 for shots, Cerenia and mirtazipine coming in another day or two. This will keep me stocked for a few weeks through the holidays. ❤️
 
I think we're on the right track now. Cerenia is being given daily and seems to be working so far. Budesonide is being increased to 1mg twice a day since he does seem to be responding to it, but still has some looseness in his stools. B12 is helping with his attitude, as well as the mirtazapine tablets. He's on 1/8 of a dose to help with appetite, nausea and overall demeanor. We started slowly implementing the supplements back in too, very very low dose to start off so we don't trigger his sensitive tummy.
Of course he has turned his nose up to most of the "fancy" foods I've bought (his sister Sadie has helped herself to some though so it's not going to waste LOL.) We're just staying with Fancy Feast Turkey pate for now, since he likes that brand and there is no fish byproduct.
Keeping my fingers crossed that we can make some improvements in a few weeks of this regimen.
 
Just curious about others IBD journeys? Was it this difficult to get them back on track to regular BMs? My vet keeps telling me to give it time, his flare up was so severe it's going to take longer due to that and his diabetes. I feel bad that it's taking so long for him to feel better, though it's only going to be two weeks on Monday of his new treatment regimen.
 
BellaBlue82 said:
Ultrasound x-ray and PCR stool test all came back negative, except for some inflammation. No lymphoma suspected at this point.
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Small cell lymphoma does not show up in x-ray or look any different from IBD on ultrasound. I was "lucky" that my three SCL kitties were vomiters, not diarrhea. Different part of the bowels involved. The current SCL kitty actually has both IBD and small cell. I was treating for IBD, she did great for a year, then got worse again. She had another issue where the vet suggested an endoscopy to diagnose a problem. I suggested the endoscopy vet should take a few samples while he was in there. Those samples added the SCL to the picture. Treating for SCL stopped the vomits. If the novel protein and better probiotics (I give Visbiome too) don't solve the problem, you might have the vet do a little more diagnosis. Don't let the words small cell lymphoma throw you, current kitty is 4.5 years in remission with proper treatment.
 
Same here. Minnie’s issue was more about vomiting although she did have the ocasional diarrhea but the daily S Boulardii helped and when she had an episode, I’d give her metronidazole for a few days until it cleared up.
 
Thank you all, knowing others have gone through this (crappy as it is) gives me solace and hope. He had his first solid poo the other day!! I was small and with some "soft serve" as I call it, but hey I'll take any positives. We progressed from total watery poo to more formed poo. Fingers crossed!!
I'm also treating him to turkey today for Christmas. He's eaten a few handfuls so far. He came out this morning for his Santa Cat gifts, played with them some, and slept on the ottoman. ❤️
 
Quick update. Nico was doing great this past week, was having small but firm stools again. That was until yesterday around lunch time. He seems hungry, but did not want to eat. I waited until 5pm and ended up syringe feeding. He still seems hungry, but does not want to eat. I tried to see if he pooped, but I don't think he has since Wednesday morning. I'm wondering if we swung in the opposite direction somehow and he's now constipated?? I don't want to give miralax right now, simply because I don't want him to go back to diarrhea. I did give sub-q fluids with B12, Mirtaz, Cerenia, and some plain vasoline on the nose.
I'm just curious if anyone has experienced this swing in their IBD cats.
 
I can speak for the not wanting to eat part. Minnie was fine on the daily anti nausea for about a year and then that stopped working. Even with both Cerenia and ondansetron and that’s when I had to add the budesonide because she ended up in the er and came home with a feeding tube since nothing would get her to eat. She did go back and forth between loose stools and constipation so it was a balancing act. Sometimes she’d be on metronidazole to control the diarrhea and then a few weeks later on fiber and miralax. Can you try some fiber before giving him miralax?
 
Ale & Minnie (GA) said:
I can speak for the not wanting to eat part. Minnie was fine on the daily anti nausea for about a year and then that stopped working. Even with both Cerenia and ondansetron and that’s when I had to add the budesonide because she ended up in the er and came home with a feeding tube since nothing would get her to eat. She did go back and forth between loose stools and constipation so it was a balancing act. Sometimes she’d be on metronidazole to control the diarrhea and then a few weeks later on fiber and miralax. Can you try some fiber before giving him miralax?
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I was curious about this, as I'm wondering if the Cerenia stopped working for Nico. He hasn't wanted to eat the past few days, and today threw up after almost two weeks of being fine. I have also been giving mirtazapine, and read that combined with ondansetron could cause seratonin issues. Sadly I think I'm stuck waiting until tomorrow so I can have a discussion with his vet about possibly changing his medication and possible interactions.
 
Cerenia isn't the best med for nausea, ondansetron is much better. I belong to a small cell lymphoma group, and lots of people give both ondansetron and mirtazapine. The only caution is that both drugs bind to the same receptor, so might not be as effective in anti nausea when combined. You typically want to give an anti nausea drug first, wait a while, then give the appetite stimulant. An appy stim to a nauseous cat can turn them off of food. As for the "warnings" you read, there are also studies that show those warnings are unwarranted. One of the papers is here.
 
Wendy&Neko said:
Cerenia isn't the best med for nausea, ondansetron is much better. I belong to a small cell lymphoma group, and lots of people give both ondansetron and mirtazapine. The only caution is that both drugs bind to the same receptor, so might not be as effective in anti nausea when combined. You typically want to give an anti nausea drug first, wait a while, then give the appetite stimulant. An appy stim to a nauseous cat can turn them off of food. As for the "warnings" you read, there are also studies that show those warnings are unwarranted. One of the papers is here.
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Thank you for this! I was honestly starting to get worried I may not be able to switch him. He gets such a low dose of Mirtaz now, so I think I can balance timing so they aren't given together. Fingers crossed the Convo with the vet tomorrow goes well and we can try the ondansetron.
 
Ale & Minnie (GA) said:
I agree. Ondansetron is what worked for Minnie and she took it daily. Cerenia was added when she go on one of her not wanting to eat periods but I personally never thought it did much
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Yeah, I'm starting to notice it doesn't seem to be doing much. TBH I think the B12 is doing more for his nausea/appetite than Cerenia.
 
Ok, Vet okayed trying the zofran (generic.) She said start with 1mg for now, can go up to 2mg a day to try it out. We're also increasing the B12 shots to twice a week from once a week.
 
How much does your kitty weigh? Dosing of ondansetron is 0.5-1.0 mg per kg of cat every 6-8 hours. It doesn't last the full day. At least two times per day is the minimum. The 1 mg dosing would be good for a 2-4 lb cat. LOL. Yes, many vets underdose it. That was unfortunately my experience with Neko's vet too. More details on dosing on table 9 of the article in this post: (2016) ISFM Consensus Guidelines: Diagnosis & Management of Feline Chronic Kidney Disease

Was your kitty's B12 levels blood tested before starting B12? Not all cats need supplementing, though interesting you are seeing improvement.
 
Wendy&Neko said:
How much does your kitty weigh? Dosing of ondansetron is 0.5-1.0 mg per kg of cat every 6-8 hours. It doesn't last the full day. At least two times per day is the minimum. The 1 mg dosing would be good for a 2-4 lb cat. LOL. Yes, many vets underdose it. That was unfortunately my experience with Neko's vet too. More details on dosing on table 9 of the article in this post: (2016) ISFM Consensus Guidelines: Diagnosis & Management of Feline Chronic Kidney Disease

Was your kitty's B12 levels blood tested before starting B12? Not all cats need supplementing, though interesting you are seeing improvement.
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He is down 4lbs, now only at 10 lb total. He lost another pound in three weeks, is very tired and lethargic on the days where B12 is running out. We only started the B12 shots last week I want to say? And his amounts were very low. She said it should help with his appetite and mood.
As for the zofran, she wants to start low for now just to avoid any interactions with the Mirtaz or blood pressure pills. I know interactions are rare, but this guy has had horrible reactions to weird stuff in the past so we're taking it slow. She did say if all goes well, we can admin twice a day and hopefully stop the Mirtaz all together.
On a positive note, we are back to all solid BMs! The supplements are helping I think, and we may be able to start lowering the budesonide soon.
 
OK, he's about 4.5 kg, so he might need to "graduate" to at least 2, possible 4 mg of ondansetron. I found that if I got the ondansetron dosing right, I didn't need to give Miritaz. We've seen lots of people do the amlodipine and ondsetron combo as well, quite common for kidney cats.

Awesome poop news though. :)
 
Wendy&Neko said:
OK, he's about 4.5 kg, so he might need to "graduate" to at least 2, possible 4 mg of ondansetron. I found that if I got the ondansetron dosing right, I didn't need to give Miritaz. We've seen lots of people do the amlodipine and ondsetron combo as well, quite common for kidney cats.

Awesome poop news though. :)
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So we've increased to 4 mg today, doing ok so far. Gave 1mg in the am, and it helped for a little bit... Then I thought about this and figured it wouldn't hurt to give him another 1mg! That seemed to do the trick. So I gave him the other 2 mg this afternoon. Hopefully it helps improve things a little bit more.
 
I wanted to thank everyone here for their advice, support, and kind words over the past few years.

Nico became very compromised and decided he had enough. Though we rigorously tried to treat him, his little body just didn't have it in him to fight one more medical issue. He let us know on Sunday he was done fighting. He stopped eating and drinking, and just looked checked out. We helped him pas over the rainbow bridge today, giving our last kisses as he fell asleep.
 
I am so sorry for your loss. Nico knows you love him very much and tried to do everything you could to help him.

Fly free sweet Nico and watch over everyone who loves you.

cat_wings>o
 
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