Doesn't All Poop Smell Bad?

Poor Maximus, errrr...Maxine. He/she came in as a rambunctious boy kitten and went home newly "diagnosed" as a little girl. "Max" works for both boys and girls, thank goodness.

Max came in with his her big sister, a geriatric Siamese kitty named Lexi who is rather vocal about her predicament-having to live with and raise a rascal-y kitten is one thing. Going on a car ride and visiting the vet is entirely different. Both look to be very well cared for-I think Max has scored getting this family to live with.

Unfortunately Max has a bit of a problem-not that he even cares about it. He is very busy and energetic and yes, terrorizing all his brothers and sisters as any good kitten should. But his problem could become an issue for him over time, resulting in dehydration, electrolyte imbalances, weakness and failure to gain weight or worse. Max has diarrhea.

Now in an otherwise healthy adult animal, diarrhea wouldn't be a big deal; even in Max I am not worrying too much. Her owners are concerned, and rightly so, because it has been going on for some time now, and if it was attributable to just a simple diet or environment change as they originally thought (very common in newly adopted kittens and puppies) it certainly should have resolved by now. Instead it may even be a little worse, and boy is it stinky!

So, yes, all poop smells pretty bad. But the diarrhea remnant left behind on her fluffy bum hair is particularly foul-and she just isn't keeping up with grooming herself like she should. Max had been given some de-worming medications at the pet store that sold her, but testing her feces for parasites was still a good idea. We talked a little about this procedure in the "Ewww, Gross" blog a while ago. Having had diarrhea for so long, her distal colon was pretty empty, so we sent home a collection device for her owners to bring back after she gives them a fresh sample. In the mean time we were able to perform a test for giradia; Max tested positive for this. This was likely contributing to the diarrhea.

Giardia is a protozoa-a single celled organism found in the environment where it has been shed through the feces of infested animals. It is the reason we have to boil our water from streams and lakes when we go camping in the mountains. Contaminated water, especially puddles at dog parks, are a major source of infection for our dogs and cats that we see in practice. We humans can contract it from our pets, but again, it is by way of the feces. After ingestion, it can take 5 to 12 days for the new host's body to shed the organism in the feces, but diarrhea can occur even before this. Diarrhea can range from mild to severe, with the above mentioned electrolyte and hydration problems resulting in very young, geriatric or otherwise debilitated animals. It is not generally associated with bloody feces. It does appear to be more common in kennel or crowded situations.

Although it can be difficult to diagnose giardia via a traditional fecal flotation test, it is possible to identify the organism on a direct smear microscopic examination of the feces. It shows up best if it is stained with iodine. There is a very good test that does not rely on direct identification of the organism but rather an immunologic test for giardia proteins. It is an ELISA test similar to a pregnancy test you take at home. It only takes a few minutes and is done while you wait during an office visit. That is how we identified Max's infestation.

Treatment of giardia can be frustrating. We start by using a broad spectrum dewormer (even though giardia is not a worm) called fenbendazole (Panacur.) Metronidazole, an antimicrobial medication, has been used, but can have neurologic side effects that are rather extreme, especially in cats. Giradia cysts can stick to the fur of the patient, so re-infestation is possible. We will let Max's owners know they should give her at least one bath during her treatment period.

Not all pets (or humans) will have diarrhe when infested with giardia. We like to test all of our new puppies and kittens, some of our most vulnerable patients, at their first visit with us and at any time we have an unexplained diarrhea, particularly an intermittant or on again, off-again diarrhea. There has been a vaccine developed to try and prevent giardia infestation, but it has not been found to be very effective and is not recommended in most situations. Decontaminating the environment is very difficult, especially with the possibility of re-infestation by wildlife, although a 1:32 bleach solution will kill giardia cysts.

Max is on her way to recovery, going home with some Panacur granules for her owners to add to her food for 6 days. We also gave her some probiotics to help replenish the "good" bacteria in her intestines. If her diarrhea does not resolve after this treatment, we will search further for any other possibilities. Max's poop should go back to just being normal-smelly, not giardia-stinky.

Peace,
DrReneigh