My kitten's diarrhea won't stop despite vet treatments. What now?

I am sorry to hear that Oliver is having prolonged diarrhea. It is good you are not ignoring it as it can be a sign of underlying issues. The steps taken so far- deworming, probiotics and diet change are all great first steps for common causes of diarrhea in kittens. As it sounds like he has had no change, I would proceed to look for less common problems. You can ask your vet about sending out a more involved parasite screen- typically sending one to the lab. I would specifically ask about tritrichomonas and giardia screening as well. In the meantime your vet may want to try a different dewormer and/or diet change (like a hydrolyzed food) as well. If all this is negative and the diarrhea persists, your vet may want to do some imaging such as an ultrasound. I hope this helps and he is back to normal soon!

That is a very difficult situation. You may talk to your vet about treating for giardia (even if the test was negative), IBD, food allergies, an aggressive dewormer, running a GI panel, or referral to a specialist in internal medicine. The next step may be biopsies through exploratory surgery or endoscopy. Many cats with diarrhea of unknown cause will respond to a prescription hypoallergenic diet.

I would recommend that you have Goose re-evaluated by the vet since their treatment didn't work. Diarrhea in kittens is commonly caused by intestinal parasites or food intolerance. They should perform a fecal intestinal parasite screen. Even if it is normal, empirical treatment for the intestinal parasites common in your area may be warranted.

I recommend to call your veterinarian. When pets don't respond to treatment as expected, it can mean that the real cause of illness has not been identified. The veterinarian may try a different medication or recommend further diagnostics such as a fecal culture, parasite testing or ultrasound. Mia may also need additional testing of the liver such as a bile acids or endocrine testing. I hope this helps and please feel free to post any additional questions.

There are several things I try for diarrhea that is not responding to typical treatments - sometimes I give the medications for a longer duration, sometimes I'll try a different antibiotic, and sometimes I'll try a different diet (which it sounds like your vet is attempting with the EN). Your vet might also want to retest a stool sample - sometimes with diarrhea there just isn't enough actual feces to get a positive results. Chronic diarrhea can also be caused by inflammatory bowel disease which is a more severe form of IBS and ultrasound and special blood testing can help diagnose this. Corticosteroid medications and B12 injections are often the recommended treatments for IBD.

It could be that the diarrhea worsening is independent of the metronidazole as this drug does not help all cases of diarrhea, dependent on the cause. But since it is new it would be best to stop until you can speak with your vet. Has your kitty had a work up for these symptoms? Chronic vomiting and diarrhea are common symptoms of several things, but most notably GI disease. It would be abnormal for a cat to need chronic medication for vomiting unless there is a disease process there. Just to help a little, a work up for an older kitty with these signs could include bloodwork with thyroid testing, an abdominal ultrasound, and sampling if needed (dependent on ultrasound). If there is an underlying disease that can be treated your kitty may feel better and need less medications eventually. I hope this helps and thank you for using Petco Pet Education Center, formerly Petcoach!

Thanks for using Petco Pet Education Center, formerly Petcoach. The next steps for me would be a deworming and switching to a prescription GI diet to see if that helps. If no improvement, abdominal ultrasound and full bloodwork are indicated. Best wishes to you and Sven!