Thank you Janet,
If these kitens has had diarrhea for weeks that has not responded to diet changes, then this is likely a chronic problem instead of one being related to diet. Now when a kitten has chronic soft feces or diarrhea, we can see a number of causative agents. This includes bacteria, viruses (coronavirus, rotavirus, panleukopenia, etc), parasites (GI worms and the protozoa like coccidia, giardia and also cryptosporidia, tritrichomonas), nutritional sensitivities, stress, and toxins. Of course, as this continues, toxins would be less likely. As well, if they have been wormed with good quality wormer, then hopefully we can at least rule out GI worms. And just to note, seeing a bit of fresh blood or red discoloration is not unexpected if they have had chronic diarrhea, as it is likely starting to irritate their colon which leads to that bit of fresh blod you are seeing.
Now since you have already wormed and even if they have been switched to a different diets, since they are still having diarrhea, we do have to consider that we can see some cats have diarrhea due to dietary sensitivities. In this case, you can try and see if their stools can be settled with a light/easily digestible diet. Examples of this would be boiled chicken, scrambled eggs (made with water and not milk), meat baby food (do avoid the ones with garlic powder in the ingredients) or there are also veterinary prescription diets that can be used in cases like Hill’s I/D or Royal Canin’s sensitivity. Usually feeding an easily digestible diet to cats with food sensitivities can give you a hint if perhaps the current diets are the culprit.
As well, do keep a close eye on their water intake and their hydration. (Since they won't have the body reserves of an adult.) To check their hydration status to make sure they are not becoming dehydrated there are a few things we can test at home. One is whether the eyes appear sunken, if the gums are tacky instead of wet/moist, and whether they have a "skin tent" when you lift the skin. To see how to check these parameters for dehydration, you can find a wee video on this HERE. ( They use a big dog but it makes it easier to see and the principles are exactly the same) If you are seeing any signs of dehydration already, then you do want to have your we ones seen by their vet before this gets out of control.
If you are concerned that they are becoming dehydrated from the fluid loss via diarrhea, you can try and encourage them to drink but offering fresh water or even low-sodium chicken broth. If they are not amenable to these, you can syringe feed pedialyte. Pedialyte is good here (though aim for a flavourless one since cats don’t love fruit) because it will get both fluids and lost electrolytes back into your kittens. A typical maintenance rate for hydration in an animal is 48mls per kilogram of weight a day. If you do give syringe pedialyte, this should obviously be divided up into multiple offerings through the day rather then all at once. This value will give you the total they need for the day and is a good starting point to give you an idea of the feline daily requirement. (we aren’t calculating losses, so you can add an equivalent volume to match how much diarrhea is being producing). If they vomit when you have given pedialyte, then therapy should be discontinued (since we don’t want vomiting because of our intervention).
Finally, as long as you aren't seeing profuse blood in the feces, you can consider trying them today on a cat safe anti-diarrheals. As I am sure you appreciate, these would not be a cure if the diarrhea is being caused by an infectious agent (ie bacteria will require antibiotics, parasites or protozoa will require anti-parasitic treatment, etc). Still it can slow the diarrhea to aid the body to absorb more water/nutrients then it would have if the diarrhea were unchecked. Furthermore, these treatments will coat the GI and could just settle the GI upset. In regards ***** ***** options for your wee ones, the one we most commonly use is Kaolin/Kaopectate (More Info/Dose) available from your local pharmacy or, Protexin Pro-Fiber (which is available OTC at vet practices; example) would be another option. Do avoid using PeptoBismol or any anti-diarrheas that contain aspirin or Loperamide (as they can cause adverse issues when used). In regards ***** ***** safe options, they both will slow diarrhea and the Pro-Fiber has the bonus of providing support to the delicate good bacteria of the GI. So, you can consider trying these as a short term means of trying to soothe their upset GI.
If you find that after your worming and a trial on a bland diet but the signs doesn't settle them down, then we’d need to consider involving the vet to rule out those other causes for this chronic diarrhea presentation. And if you do have to go down that route, then a fresh fecal sample can be key to helping you determine the underlying cause for this diarrhea. Ideally, we'd want to have the sample sent to the lab for examination and culture. The lab will be able to rule out parasites, protozoa, test for viruses and culture the feces for pathogenic bacteria. This enables us to isolate the causative agent and use targeted treatment to clear it for them. And to keep costs down, you can pool a sample from both to be tested as one sample.
Therefore, in your kittens' situation it sounds like we have a chronic agent that has been causing diarrhea these past weeks. Therefore, we want to take a step by step approach to determine the cause and address it. Therefore, further to worming, do consider trying them on an easily digestible diet. If you do this and don't see the signs settling within a few days, then that tells us we are likely looking at one of the other infectious processes. And in that case, we'd want to consider having your vet examine them at that stage and have them send off a fecal sample. This will allow you to pinpoint the cause of the diarrhea, and the vet will be able to cover the kittens with the appropriate treatment to settle the diarrhea once and for all.
I hope this information is helpful.
If you need any additional information, do not hesitate to ask!
All the best,
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