Species: Cat Breed: American shorthair m Age: 6-12 months
I am hoping for confirmation that we are on the right track with treating our two 11 month old kittens that we adopted 2 months ago from 2 separate rescues. Both are feline leuk virus and FIV negative.
One cat came to us with extremely stinky diarrhea, varying from soft to liquid and a bad smell. Within a week the second cat also had diarrhea. Occasional small amounts of vomiting seen (~twice/wk), mostly free of food & not just after eating. Stools are medium brown color with no signs of blood. Generally twice per day. They have had no fevers and are growing quickly. Both cats have consistently eaten well and had good energy and look well in every way.
A 14 day course of albon was empirically given and the stools of both cats became normal. Within days of stopping treatment, the diarrhea returned. An O & P was performed and found to be negative. Metronidazole was prescribed (1 ml of 50 mg/ml) bid for 14 days, with fully formed stools the last 5 days of treatment. Diarrhea returned with discontinuation of med. PCR stool analysis showed positive results for coronavirus (unspecified if FIP or enteric), C perfringens toxin, and Cryptosporidium. It was negative for the rest of the panel (Giardia, Salmonella, Toxo, Tritrichomonas). We are now back on metronidazole for 4 weeks.
Questions: Do you agree with treating just for the C perfringens at this point? Does the medication regimens we have been through point to one likely culprit in this? How likely is it that the Crypto is nonclinical? Does C perfringens cause stinky stools like Crypto--that is why we initially thought it might be coccidia. Do you have any advice on cleaning couches, catboxes etc that the cats use? As I understand it, Crypto oocytes can only be eliminated by 139 degrees or -70 or dessication and not bleach. How impossible is it to eliminate Crypto completely. Lastly, can the crypto oocytes be passed to my beloved parrot who spends most of his time out of the cage? It is very hard to wash my hands between all cat and bird activities... After more than 2 months of dealing with all this, we are at our wits end. Thank you so much for any advice!
Dr. Marie replied:
I don't think I have ever seen a cat test positive for clostridium and cryptosporidium! You have asked some great questions, so hopefully I can help you with my answer.
Let's talk first about cryptosporidium. We really don't know the best way to treat this parasite. Over 100 different types of medications have been tested in veterinary research and vets still can't agree on the best treatment. The treatment that we tend to use the most is tylosin which is an antibiotic powder that you can put in the food. It needs to be given twice daily for a total of 28 days.
With that being said, cryptosporidium is what is called an opportunistic parasite. This means that often if a cat is diagnosed with cyrptosporidium AND something else, if you can cure the "something else" then the cat will take care of the crypto themselves.
So, rather than subjecting them to 28 days of medicine they may not need, I think it is a good idea to treat the clostridium and then see how things are going.
There are a number of treatments for clostridium. The metronidazole should take care of things. Some vets will use amoxicillin or even the tylosin mentioned above.
If the cats still have diarrhea after the metronidazole is done then you may want to ask your vet for tylosin.
You asked whether the cryptosporidium is likely to be transmitted to your parrot. The newest research is suggesting that cryptosporidium is host specific which means that it is very unlikely to spread from a cat to a bird.
One of the things that I would highly recommend you to talk to your vet about is giving probiotics to these cats. Probiotics are very helpful in treating chronic diarrhea.
I just did some research for you on what to use to help clean the environment. You are right that bleach does not tend to work well. There are really not any products that you could use in your home to help. A steam autoclave works and certain chemicals that are only available in labs can be effective. The general consensus from vets though is that we don't really need to be worried about crypto in the environment. It is not common to see an animal become re-infected with crypto. To quote a well known veterinary bacteriologist when asked about cleaning the environment of a puppy that had crypto:
The overall risk is likely very low as long as there are not piles of feces harbouring large numbers of Crypto that a new puppy could ingest.
I hope this answers your questions, and I hope these guys are all better soon!
Dr. Marie.
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Dr. Marie is a veterinarian who practices in a busy animal hospital in Ottawa, Ontario. She created Ask A Vet Question as a resource for good, accurate veterinary advice online. Dr. Marie treats dogs, cats, hamsters, guinea pigs, and rats. She has been a vet since 1999.
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