Very confused and at a loss!

[taramartin]

Hi there -
I'm so glad to find a forum like this one! I could really use some advice with my dear cat Lily. I'll try and keep this short, so if you need more info, just let me know.

We're having some serious issues with little Lily, and both me and my vet clinic (all 3 of the doctors) are at a loss as to what to do.

Some background:

* she was born with a rare dental disease where her body thinks her teeth are foreign objects, and therefore attack the roots and make the gums screaming red and painful...and the teeth eventually fall out. Her first vet said that while her gums/teeth were bad, it wasn't something to really worry about. She was 1 at the time. They quoted me $5,000 to remove her teeth. YIKES! Despite this dental issue, she always ate dry food, and seems to prefer it over wet, surprisingly. (she gets both wet and dry food)

* When she was a year old, we got another cat, Angus. He likes her, she's not his biggest fan. If he gets too close, she swipes at him or growls, but mostly, they leave each other alone. The doggie is universally loved in the house - Lily sleeps against him, while Angus cleans his ears. Quite the picture.

About a year ago, at 3 years old, she started pooping around the house in miscellaneous places. I figured she didn't like the clay litter, so I tried pretty much every kind on the market - newspaper, wheat, corn, crystals, scented, un-scented; and started to clean the boxes once a day. This didn't help the problem. So I added another box, which brought the total to 4. (overkill for 2 cats, I thought - but worth a shot!) It was a bit better for a while, but then everything went real bad. It got to a point that she left me a pile to clean every single morning. [very occasionally is was diarrhea]

Then, one day, she started peeing around the house too. And in really obvious places - the bath mat, welcome mat, in the centre of the dog's bed...peeyew...and 2 weeks later we took her into a new vet.

She had a blood test, urinalysis, fecal...nothing. All normal. So, we bit the bullet and had her teeth removed which the vet thought could be the issue. This was a month ago now.

She has been confined to a roomy bathroom since her surgery, with her own window, litter, toys, bed and food dish. She's happier since the surgery, and seems to enjoy being in the bathroom.

The problem: she's STILL pooping outside of the box. And, 99% of the time, is explosive diarrhea. I mean, it's <i>everywhere</i>. It will happen in the morning and at night for 3 or 4 or 5 days in a row, and then she'll be find for 3 or 4 days straight.

I took her back to the vet, and they gave me 3 different types of food. She loved the medi-cal hypoallergenic stuff, so I bought her a bunch of cans and fed her that only.

It's been 2 weeks since she's started the food, and she's STILL having the diarrhea problem. I called the vet AGAIN, and now they're recommending different - and expensive - foods for her. I have since gotten her grain-free wet food.

Thing is, I don't think food is the problem. I've landed on "attracting" litter - with a soothing/calming lavender scent. She likes it. She now uses the litter box to pee, and doesn't mind using the box, but pooping is a free-for-all.

Does she have something like IBS? Is it behavioural? Any other ideas?
Thank you so much!
I don't want to give up on my girl - but it's frustrating, stressful and tiring!

[Superdude]

I know this sounds like the dumbest reply ever, but we had a dog that ate toliet paper for some reason. It gave him the poopsies. Is it possible your cat is eating toliet paper?

[taramartin]

I know this sounds like the dumbest reply ever, but we had a dog that ate toliet paper for some reason. It gave him the poopsies. Is it possible your cat is eating toliet paper?

Not at all - any reply is welcomed!
But no, she's not eating toilet paper...

[Traci]

Are you referring to stomatitis? And, were ALL of her teeth removed, and if so, all at once?

Why is she still confined to the bathroom, is it due to her surgery or because she is inappropriately eliminating? (surgery (full) recovery only takes approx 2-3 weeks if that for a dental such as this)

What were you feeding her prior, name/brand, and any other types included?

Did you ever give treats, human foods, or does she get into plants or things she's not supposed to?

Did any of the three vets do a comprehensive fecal exam to check for parasites and bacteria? (i.e., giardia, salmonella, e-coli, campylobacter, toxo, etc)

Do you give supplements, additional fiber or probiotics? If so, was your vet aware of them?

The diarrhea needs to be addressed immediately and effectively by your vet. Frequent or irretractable diarrhea causes serious dehydration, which can affect other organ function, mainly liver and kidneys.

When you say blood test, what exactly did this entail, a full blood chemical profile and CBC or something else? Was an immunological profile ever done? (needs to be sent to an outside lab). Was she ever tested for FELV/FIV?

Is there undue stress in the environment?

Has the diarrhea ever been accompanied with vomiting, lethargy or other signs of illness?

It's possible this could be IBD, but in a cat this young, it would be fairly rare. One would want to attempt a trial diet with a novel source of protein, one which kitty has never been exposed to, try to stay away from lamb, beef, and dairy products. Ask the vet about a trial course of acidophilus to sprinkle on her food (or metamucil powder, be CAREFUL here with this and ONLY upon direction and doseage from your vet). Before anything, get a full fecal exam done and consider discussing an immunological profile to rule out other virals, bacterials or fungal diseases. Also rule out potential painful illnesses, such as the mouth, if she has painful gums, or lesions elsewhere in the mouth, throat, esophagus, she may not be "gumming" her food entirely, and she might have malabsorption problems.

There are several of the common veterinary diets you can try, the following are comparable cost/effectiveness: Hill's Prescription diets, Eukanuba Veterinary, Purina Veterinary and Royal Canin Veterinary diets. Each has one or more specific diets geared for metabolism, food allergies, digestibility. Get samples of at least two, and at least give three weeks to determine effectiveness, and do NOT feed anything else other than the prescribed diet. Don't assume grain in the diets is a bad thing, there are energy sources from grain products, and in cats it is rare to have grain-related allergies. Other ingredients in lesser-quality brand diets can be problematic for cats.

First things first, get a fecal exam done, consider an immunological profile, and consider a feline specialist for a new opinion.

[taramartin]

Wow! Thanks so much for this post, Traci!
I'll respond in blue...

Are you referring to stomatitis? I don't think so, no. It had a really long name and had 'gingivitis' at the end. Sorry - I'll try and get the clinical name for you tomorrow. And, were ALL of her teeth removed, and if so, all at once? Yep, they removed all of her teeth, in one shot, except her 4 canines.

Why is she still confined to the bathroom, is it due to her surgery or because she is inappropriately eliminating? (surgery (full) recovery only takes approx 2-3 weeks if that for a dental such as this)After the surgery I was worried the other cat would bug her, or want to play and would stress her out. She's confined now mainly because of the inappropriate elimination, though.
The surgery was done on August 20th.

What were you feeding her prior, name/brand, and any other types included? I was feeding her mostly Nutro, indoor cat dry, and Friskies (crappy, I know) wet. She had been on this food since she was 1 1/2, or so...

Did you ever give treats, human foods, or does she get into plants or things she's not supposed to? The only think she used to get other than her food was Temptation treats. And not very often.

Did any of the three vets do a comprehensive fecal exam to check for parasites and bacteria? (i.e., giardia, salmonella, e-coli, campylobacter, toxo, etc) That's a good question. They simply told me they were doing a 'full wellness' test, and fecal & urinalysis was additional. (they definitely checked for parasites - I specifically remember them saying she was free and clear of them) I'll find out if they looked into the other items, though!

Do you give supplements, additional fiber or probiotics? If so, was your vet aware of them?I don't, no! My vet never mentioned them, as a matter of fact. SO many good things to ask about!

The diarrhea needs to be addressed immediately and effectively by your vet. Frequent or irretractable diarrhea causes serious dehydration, which can affect other organ function, mainly liver and kidneys.I know - it's worrysome. However in the last 3 days she has been leaving a big pile on the floor near the window - not sure why she's not using the litter when she had for these issues before...

When you say blood test, what exactly did this entail, a full blood chemical profile and CBC or something else? Was an immunological profile ever done? (needs to be sent to an outside lab). Was she ever tested for FELV/FIV? She was tested for FELV/FIV - but the rest, again, I'll add to my list of questions!

Is there undue stress in the environment? No changes in the environment whatsoever in the last couple of years, actually. It worried me that the other cat was stressing her out, which is one of the reasons why she's in the bathroom. But this doesn't seem to be the case...

Has the diarrhea ever been accompanied with vomiting, lethargy or other signs of illness?No, thankfully. She's bright and playful and chatting and purring; even minutes after her episode.

It's possible this could be IBD, but in a cat this young, it would be fairly rare. One would want to attempt a trial diet with a novel source of protein, one which kitty has never been exposed to, try to stay away from lamb, beef, and dairy products. Ask the vet about a trial course of acidophilus to sprinkle on her food (or metamucil powder, be CAREFUL here with this and ONLY upon direction and doseage from your vet). Before anything, get a full fecal exam done and consider discussing an immunological profile to rule out other virals, bacterials or fungal diseases. Also rule out potential painful illnesses, such as the mouth, if she has painful gums, or lesions elsewhere in the mouth, throat, esophagus, she may not be "gumming" her food entirely, and she might have malabsorption problems.

There are several of the common veterinary diets you can try, the following are comparable cost/effectiveness: Hill's Prescription diets, Eukanuba Veterinary, Purina Veterinary and Royal Canin Veterinary diets. Each has one or more specific diets geared for metabolism, food allergies, digestibility. Get samples of at least two, and at least give three weeks to determine effectiveness, and do NOT feed anything else other than the prescribed diet. Don't assume grain in the diets is a bad thing, there are energy sources from grain products, and in cats it is rare to have grain-related allergies. Other ingredients in lesser-quality brand diets can be problematic for cats. She's taking a holistic brand of wet food right now - she loves it! But I'll look into these options, for sure!

First things first, get a fecal exam done, consider an immunological profile, and consider a feline specialist for a new opinion.
I will look into all of these things first thing tomorrow.
Thank you, thank you! I'll keep you posted!

[Traci]

Well, I was not suggesting you give supplements, only unless the vet suggested them for a specific purpose. Just wanted to rule out supplements as a possible link, because you can never count on the quality or additional additives in supplements.

I would never recommend any Nutro brand for any pet. They have a history of causing diarrhea and vomiting in pets, especially cats. Not to mention their business practices, constantly changing "formulas, and their history of not responding to their consumers.

Likewise, "holistic" diets are not without problems, mainly deficiencies and excesses in ingredients, vitamins and unnecessary "fad" ingredients, most of which have no sound evidence they are appropriate or effective for anything. Hype sells but at what cost.

Heed your vet's advice on a proper veterinary diet. These diets are specifically formulated for the intended purpose/condition and have a good history of success. Part of the cost involved with a prescription diet is the fact that they ARE clinically researched and have sound science and reputation behind them. There are a number of veterinary diets available to choose from and most importantly, to determine palatability and effectiveness for the condition treated.

I suspect there might be an immune-related stomatitis present to some degree, and she may not have been able to fight occuring bacteria in her mouth, therefore also bacteria in her GI tract. Your vet might suggest trying soley a new veterinary prescription diet, or maybe even adding probiotics, but be careful because the natural intestinal flora can get altered with repeated use of, or inappropriate use of probiotics.

In any event, that full fecal exam and immunology profile should be discussed with your vet, or a new feline specialist ASAP to rule out various virals or bacteria that your vet hasn't defined at this point. If at first, a trial diet of a hypoallergenic or GI-based prescription diet doesn't provide results, an ultrasound or other diagnostics may be prudent for checking for inflammation (to help rule out IBD), but if your vet isn't experienced enough with feline IBD, see a feline specialist immediately. Your vet should refer you and transfer copies of Lily's health records/treatment records to the specialist for review.

If any of the vets suggest an endoscopy as the diagnostic for IBD, ask about more less-invasive tests first. Usually, it is the appropriate diet one wants to try first to gauge response, then other meds like antiinflammatories, cisapride, lactulose can be added on at some point, if needed.

Also want to add, if she has diarrhea or even loose stools, she can't make it to the litterbox in time, and it could also be because she doesn't like stool stuck on her fur, which happens occasionally with litter in the box when kitties have diarrhea. One tip I like to suggest is that instead of litter, try folding over paper towels in the litterbox and see if she will use them that way, change them whenever used. Easy and simple.

[taramartin]

An update:

The explosive diahrrea has ended - thankfully, and knock on wood - it's been well over a week since the last episode. The food & tooth-removal surgery-healing seems to have made a difference, which makes me very happy.

I had her secluded away from the dog and other cat for about 5 weeks, and have released her into the main house for good behaviour (sounds like jail!) on Monday.

All was well on Tuesday, but has started pooping in various places in the house. AGAIN! Yesterday morning she went in the basement, and this morning in the living room. She always uses the litter to pee...and to poop sometimes.

Litter is cleaned twice a day and I'm using cat attract & soothing litter...the SAME box that was in the bathroom with her. (she likes it)

I'm convinced this has GOT to be a behavioural situation, not an illness of any sort.

She despises the other cat and even now threatens the dog. (this is new) She may have clawed the dog last night - he had a pretty bad cut on his chest. Perhaps she's acting out because she hates them?

Is there anything I can do for her - other than taking her into the vet for hundreds upon hundreds of dollars of tests?

Lily has always been a bit...weird. She's sweet and affectionate one second, and the next her eyes go black, she bites me as hard as she can and tries to claw at my face. I always try to play with her and brush her, and pet her as long as she'll let me...Try and make her feel included and loved... And I never yell or stress her out in any way...

My only options as I see them right now are: 1- make her an outdoor cat, so she can poop and pee wherever she wants or 2- give her away.

I don't like either option, but am at a loss. STILL!

[Traci]

Get her back to your vet for a recheck, that should have been recommended by him anyway after an extensive oral surgery. You need to rule out the possibility of inflammed gums or bacteria still occuring.

Is she eating sufficiently? Is she having any trouble eating? Did you get her on a veterinary diet or are you still feeding the holistic diet?

Most importantly, have you discussed with your vet the things I recommended you ask/persue?

While stress could be an issue for behavioral problems, you need to find out what those stresses are. You first said she gets along with the dog, but now she doesn't? Has the dog aggrivated or intimidated her in any way? Are you home often enough to observe the behavior and interaction amoung ALL the pets? What steps have you taken to ensure the two cats have a secure and interesting environment? Do you set aside valuable time to engage them together in playtime and activities? The more you can encourage play and activity for them in the same space together, the more apt they are to feel less apprehensive toward each other. If the other cat is intimidating or aggressive to her in any way, you need to address that and find ways to stimulate his energy other than his being focused on her directly.

Her eliminating in obvious places is her way of alerting you to something she is displeased with, stressed about, unhappy about. Is it one or both of the other pets, or is it your routine, is the environment calm or is it hectic, she could even dislike the current litter you're using (again, try using the folded over paper towels I mentioned, at least temporarily to see what she does)....make sure the litterboxes are in private, quiet areas away from heavy foot traffic, away from loud appliances, and kept away from the dog. Likewise, make sure the cats and the dog's food and water dishes are in seperate areas and the dog cannot get to the cat's dishes. Make sure she has at least one room in the home she can retreat to, one that contains her favorite toys, a kitty bed or scratching post etc. but not necessarily confined in the bathroom! Put up all bath mats, towels, articles of clothing etc because they are prime articles any cat will urinate on. Use an enzymatic cleaner like Petastic to clean areas where she has marked. If she can still smell scents of marked areas, she will continue to eliminate at or near those areas. Make sure the other cat and the dog are also not marking unbeknownst to you.

Observe the environment carefully and determine what is occuring directly before or during an elimination incident. Just because YOU don't feel there are stressors for her doesn't mean SHE doesn't think there are. Have you observed her in the litterbox? Does she scratch and scratch and scratch before she finally goes, or does she avoid it altogether? Is she prone to hiding and withdrawal moreso than normal? If so, then something is stressing her.

First things first, get her back to your vet for a recheck, discuss the tests I mentioned, discuss getting her on an appropriate diet and be more keen to her environment to look for stressors that are causing her upset.

Putting her outdoors is the last thing you should do. Not only is this counterproductive, but she will feel threatened, scared, confused and it certainly will NOT resolve this issue. Giving her away is also counterproductive since you would then inflict more distress and harmful stress (inciting illness), how is that fair to her? She is trying to tell you something, it's up to you to observe, find the clues and work toward acceptable solutions. You adopted her for life and she's soley dependant upon you to help her. If your vet isn't addressing this appropriately or isn't concerned, you need to see a new vet who is committed to her health and behavior well-being.