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Dr. Joey
Dr. Joey, Board Certified
Category: Cat
Satisfied Customers: 4942
Experience:  15 yrs in practice, specialist canine/feline medicine
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My 6 year old devon rex cat has had chronic daily diarrhea and was diagnosed wi

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Hey there, my 6 year old devon rex cat has had chronic daily diarrhea and was diagnosed with Coronavirus and Clostridium Perfringens Enterotoxin December 2014. My vet gave him Flagyl for two weeks, no change so then started him on Tyolsin twice a day for three months. Still no change. His stool was tested again last week and he is still positive. My vet said to keep him on the Tylosin twice a day and Flagyl every 12 hours for two weeks. I am surprised there has not been any change after being on tylosin for so long and I"m worried we may be missing something. I'm curious to know your thoughts. and any other recommendations or knowledge you might have on the subject. Thanks
Hello I am Dr. Joey. Thanks for trusting me to help you and your pet today. I am a licensed veterinarian with over 15 years of experience. I look forward to working with you. I am sorry the expert you requested does not appear to be available right now.
Excellent of you to ask these questions at this time. I do think reassessing the diagnosis is very important at this point. Let me first make some comments about the two things Louie testing "positive" for. First, coronavirus is no longer a test commonly recommended since about 90% of cats will test "positive" for this as this is a virus that most cats are exposed to, and it means nothing. It does not tell us if a cat has FIP (feline infectious peritonitis) which seems doubtful in your cat's case (his condition would have progressed to severe long ago). Second Clostridium perfrigens? The vast majority of cats, diarrheic or normal, are shedding C. perfringens. So, it does not mean much to say a cat is "positive" for this. And it sounds as if Louie has been appropriately treated between the Tylan and metronidazole.
Yes, now it is time to look to other causes of chronic diarrhea such as inflammatory bowel disease or food allergy or another issues like chronic pancreatitis or Tritrichomonas infection (which is an unusual parasite that particularly affects purebred cats) within the digestive tract. You do need to have a discussion with your vet, if not had already, about further testing such as screening for Tritrichomonas with a stool test and chronic pancreatitis (blood test) and then if those are negative to biopsy the digestive tract. I am a big fan of either surgical biopsies or endoscopic biopsies. These can lead to a diagnosis of the cause.
His case sounds most suspicious to be inflammatory bowel disease, which sometimes might improve a bit on the drugs prescribed but there are far better medications and dietary therapy to help.
In the meantime, if not already done, he should be on a probiotic supplement daily (such as Fortiflora or Proviable) to try to replenish the normal bacterial (the good bacteria) into the digestive tract. If you did not want further testing but to continue conservative therapy then you could also look at doing a diet trial. Some cats respond better to a higher fiber diet with this problem, whereas others need a hypoallergenic diet (such as one of our hydrolyzed prescription diets like Hill's z/d).
I am at a point I need to know what questions you have. We can continue our dialogue in this setting.
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