Feline Trichomonosis And Differential Diagnosis For Indy
AnimalCare 
Nov 13, 2019 
AnimalCare, NGOs 
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I posted for help and suggestions at a raw feeding FB group and someone shared that her cats had feline trichomonosis.
So I looked it up and found this link: https://www.americanveterinarian.com/news/update-on-feline-trichomonosis-to-treat-or-not-to-treat
Diarrhea associated with T. foetus can be semi-soft but may be mucoid or bloody and is usually not accompanied by other signs (eg, weight loss). Although the diarrhea can recur intermittently for years, it can also resolve on its own.
Indy’s stools are mucoid, blood-tinged and yes, so far, he had no weight loss.
Treatment and Prognosis
The only medication shown to have efficacy against T. foetus is ronidazole. However, ronidazole has a relatively narrow safety margin in cats, so careful dosing is required to reduce the risk for adverse effects associated with neurotoxicity (including ataxia and seizures).
This doesn’t sound good.
And finally, it says:
Perhaps the biggest question regarding treatment is whether it is necessary for infected cats. The authors commented that an estimated 88% of infected cats experience spontaneous resolution of their diarrhea within 2 years, although these cats may remain PCR positive. When one considers the potential for ronidazole-associated toxicity, it may seem prudent to consider not treating positive cats at all.
Hmm…. Two years??
So far, what differential diagnosis do we have for Indy?
1 Poor gastrointestinal health since young. GI tract messed up by being fed kibble and canned. Needs time to adjust to raw now.
2 Food intolerance – but of what? Chicken? Fish oil? Egg yolk?
3 Giardiasis – already treated with Metronidazole and earlier, with Clavamox and anti-protozoa medication. But Indy had no weight loss.
Giardia infection in cats may lead to weight loss, chronic intermittent diarrhea and fatty stool. The stool may range from soft to watery, often has a greenish tinge to it, and occasionally contains blood. Infected cats tend to have excess mucus in the feces. … Most cats do not have a fever but may be less active.
Indy is certainly not “less active”.
The worst symptoms of giardiasis typically last for five to seven days, as long as diagnosis and treatment is not delayed. Symptoms can take as long as several months to completely go away after treatment because the intestine needs to repair itself.
4 Trichomonosis – https://www.sciencedaily.com/releases/2017/03/170320104032.htm
Over the past two decades, the protozoan Tritrichomonas foetus has come to be recognised as a cause of chronic colitis in cats in many countries worldwide. Today trichomonosis is regarded as one of the most common infectious causes of large bowel diarrhea. Affected cats are usually young (median age 1 year), and maintain good health and body condition, but they exhibit a waxing and waning diarrhea. Characteristically, faeces are ‘cow pie’ in consistency and often contain mucus and/or blood. In many cats, the diarrhea will spontaneously resolve without treatment after several months, but in some cases it continues to wax and wane for many years.
The above description fits what Indy has, except for the “median age 1 year”. Indy is 11 years old.
An update: Another possibility…
5 Feline Coccidiosis: https://www.petsandparasites.org/cat-owners/coccidia
Indy, which one is it?
1, 2, 3 or 4? Or 5?
If I could pick one, I sure hope it’s just No. 1. Then, there isn’t much to worry about.
But if indeed it is trichomonosis, the link above suggests it might be prudent not to treat since the medication is toxic. As long as Indy is comfortable and not in pain, I’m okay in not treating since there are potential risks involved.
But if it’s coccidiosis, the treatment is sulfonamides, an antibiotic. However, Indy’s symptoms fit trichomonosis more than coccidiosis.
We’ll ride out the storm together, Indy.
Source: https://myanimalcare.org/2019/11/13/feline-trichomonosis-and..
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