Having a problem with Dax . . . msg

[Laurie and Tasha]

Hi everyone -

Sorry it's been so long.

I am having a real humdinger of a problem with Dax (she is 3 1/2 years old, BTW)

On March 28th, I took a very bloody stool sample to the vet for analysis - it came back positive for coccidia. How she got it remains a mystery - all other cats came back negative, she is strictly indoors, and I have no houseplants for her to eat. Okay, everyone is on a two week course of Albon.

April 15th, I take a pretty normal looking stool sample back to the vet, and they say they are not seeing any eggs, but still see adult coccidia. Dax takes another two week course of Albon.

May 7th, another stool sample to the vet - it comes back negative for coccidia. I am not really happy about the way the stool looks - is half normal, and half mushy.

June 10th, I still am suspicious about the way her stool is looking, and take in another sample. Negative.

June 20th, very bloody, foul smelling stool sample to the vet - negative for coccidia. Vet prescribes 5 doses of Panacur, 125 mg twice daily of metronidozole for two weeks, and Hills Z/D diet for a month (trying to rule out food allergy).

She won't eat the Z/D food (Tasha loves it, however) and after about three days, her urine starts to get dark with blood (an uncommon side effect of metronidozole, I am told), so we discontinue. Three days after stopping the metronidozole, I notice her stool looks like a puddle of cake batter. Not watery, or bloody (so far as I can tell).

Her appetite is great, she is very alert and active, and is showing no outward signs of any illness.

I keep asking my vet if the coccidia could still be there, but not being picked up during the fecal floatation process, and she needs more Albon or something stronger that will kill them. He doesn't seem very interested in that idea. He mentioned colitis, IBD, lymphoma , and recommended an endoscopy if we can't get to the cause. I am very puzzled about what to do next. Please help?

Love,

Laurie and Tasha, Kira, Phoebe, Dax, Silver, and little Sami

[Traci]

Hey Laurie (great to see you)

Has your vet tested for toxo or cryptosporidium yet? If not, I would suggest that be done before an endoscopy. These are two differentials that would be a common rule-outs concerning coccidia. It could be unrelated altogether, so ask about a potential feline serology before optiong for endoscopy. If these fail to reveal any immunological, viral or fungal problems, then your next step would probably be the endoscopy, or, you could attempt a different trial hypoallergenic diet as a conservative measure. You know there are other veterinary hypoallergenic diets available, ask your vet about her own success rates with these cases.

If lymphoma, that might be detected through bloodwork, serology or even x-rays, but if it's hidden, an endoscopy may be the only way to reveal it.

[Guest]

Please, what is cryptosporidium? I know about toxoplasmosis, but have never heard of this other . . .

What do you think of the idea that she could still have the coccidia and they are just not showing up in the test they are doing?

I wonder if there is any antidiarrheal that I can give her - I was told not to give her Imodium. Might something like kaopectate help at all?

[Traci]

Cryptosporidium is a protozoa similar to coccidia, but can be misdiagnosed due to low numbers on the slide, in which they should be examined under a very high power of the microscope. Symptoms are also similar to coccidia, and probably wouldn't require albon, since it is usually self-limiting, but in a severe case, other meds might be applied, especially fluid and rehydration support if severely dehydrated or if the patient has lost a significant amount of weight. Severe would include an immunocompromised pet, or very stressed, or even a sudden change in diet. (had you recently changed her diet prior to the coccidia diagnosis?)

Both coccidia and cryptosporidium can be diagnosed by fecal floats in your vet's lab, but because cryptosporidium are easily missed, more than one fecal may be needed (much more frequent than for coccidia). Yes, it's possible that the coccidia has not resolved, and you may need yet another negative result to confirm, but I would still want to rule out other protozoa, toxo, maybe even malabsorption. In my opinion, Dax is too young to develop IBD, and doesn't fit the picture, but of course, it may yet be a possibility.

Apparently, one can no longer give kaopectate to cats, because 'improved' formations now contain subsalicylates, the same ingredient in pepto, toxic to cats. Ask your vet for other more milder anti-diarrheals.