Thanks guys. It is difficult to always know exactly the right thing to do. But reading lots on here, it seems my vet is doing the right thing - test poop, antibiotics, metronidazole, then PCR testing for TF. I really hope he is well soon and that if it DOES turn out to be TF, at least I know I've ruled everything else out first (which is what I guess they have to do).

Bkilgore - hope all goes well for you at the vets - keep me posted

Lisa
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_________________
Lollo

Sorry if I've missed anything but doing a poop test and not finding anything is not the reason to give antis.
Of course they should be testing but they should be full panel testing as lollo has said to include TF.

My vet said to me only the other day that 10-15years ago when he was dealing with diarrhea in cats & testing everything to be negative he firmly believes the majority were actually down to TF.

At the end of the day its wasting your time and money.

I just hope you get to the bottom of it (pardon the pun)

Thanks for that. I do agree but also don't think I did anything wrong by believing my vet's course of action. I understand that with hindsight I should have perhaps said no to the antibiotics and demanded a PCR test now but truly believed him when he said although it is possible it is TF he doesn't think it is. We will see if he's proved wrong

Lisa
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I absolutely am not knocking Lisa in any way - lets make that clear.

Lisa we all post because we want the best for you and your cat - you've done nothing wrong at all - so please don't ever think you have x

Bengaldaddy

I know and understand you are not saying I have done something wrong. I just feel that perhaps with hindsight I COULD have refused ABs and demanded a PCR test. I just trusted my vet knew best. I appreciate your input always and don't think for one minute you said anything wrong :)

Lacemoat

Again I appreciate any input and and advice I just wish I could turn back the clock and demanded the test! We live and learn.....

Lisa
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I only state it the way i do because i was you 3 years ago and i spent months sorting out this issue until my vets finally tested for TF. So i treated with antibiotic after antibiotic... only difference was, my vets don't use Metronidazole unless results indicate the problem is sensitive to it... but they had lots of other pills and food changes..... so i go from experience and hope the other people don't fall into the same trap again.


I always recommend a full Fecal PCR screen not just TF because i know it isn't always TF. A full screen will detect many things which a standard 'in house' test will not. The Idexx test i recommend is:
Test code 3258

http://www.idexx.com//view/xhtml/en_us/ ... EN=0#Tests

Diarrhea RealPCR™ Panel (Comprehensive Plus)—Feline
Campylobacter coli, Campylobacter jejuni, Clostridium perfringens enterotoxin A (CPEA) gene Quant, Clostridium perfringens enterotoxin (CPE) gene Quant, Cryptosporidium spp., feline coronavirus (FCoV), feline panleukopenia virus, Giardia spp., Salmonella spp., Toxoplasma gondii and Tritrichomonas foetus RealPCR™ tests. If the RealPCR™ test is positive for Campylobacter spp. or Salmonella spp., a culture on selective media (with susceptibilities for Salmonella) will be automatically performed at no additional charge. Includes quantification of Clostridium perfringens enterotoxin (CPEA and CPE) genes if PCR positive.

_________________
Lollo

Thanks Lollo.

I'll let you know how I get on.

Lisa
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I have just called PetPlan and they said that although I have to pay the first £65 for any claim from Saturday just gone, as the claim is for a continuing illness, I will get my original £85 back that I paid when under the 4 weeks free insurance. Pretty happy now!!

Lisa
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Update....

I have just spoken to the vet. He is NOT putting Rio on Metronidazole now. He said the lab in Bristol does the PCR check for TF. I said that you have to wait 2 weeks for the antibiotics they are on now (amoxicillin) to get out of their system and he said you don't. I was adamant (you'll be pleased to hear that Bengaldaddy ;)) and he said he will check with what the lab say. I told the vet I will take in a 3 day sample of both of them and get this checked. Cost is £85 for the both of them. He said that I have to have both checked (rather than pool the poop in one sample) as they won't give me the ronidazole for both unless they test positive for it.

So, good news in one way. I just have to wait now for just over 2 1/2 weeks (they are on amoxicillin now until Friday) and then can get the poop samples sent off for testing.

I have cut and pasted the following information from the webpage of the lab in Bristol that will be testing Rio and Chilli for TF -

More recently faecal PCR has been recommended as the diagnostic test of choice for TF infection, being more sensitive than both direct examination and culture by the InPouch™ method. However, PCR on faeces can be problematic due to the PCR-inhibitory effect of many substances that are co-purified with the DNA during extraction.

A real-time quantitative (Q)PCR has recently been developed by the Molecular Diagnostic Unit, Langford Veterinary Services for the detection and quantification of TF in faecal samples. This new multiplex assay is the first to use an internal amplification control PCR alongside the TF PCR, enabling detection of any inhibitory substances present in the extracted DNA, which could cause false negative TF results.

The use of QPCR in this new assay also allows us to report the relative amount of TF present in the faeces, which may be useful in monitoring the response to treatment.




I would appreciate any comments on this!!!

Lisa
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I have attended Langfords for breeder seminars and it was there that i learned about waiting till antibiotics are out of their system.

My only slight concern is, whether it tests for other things as well. I paid £65 for a test with Idexx which i mentioned above that screens for all the possible infections. In my opinion this is better than just screening for TF. So check if that is all the Langfords one does.

The problem with testing them individiually is that you will have to isolate them from testing to 2 weeks after the course of Ronidazole is finished (assuming one is positive and the other negative). If you sample both independently and don't isolate, how do you know that the positive one will not have passed the TF on to the negative one before the results come back? Then you will have two positive cats and one being treated. Chances that the TF will get passed back to the treated one at the end of treatment are quite high.

If there is no way you can realistically separate them you have two options.
1. Treat one and not the other and keep your fingers crossed
2. Treat both of them regardless of the result.

As it seems your vet would not be willing to do number two then you have another option, that is to sample poo from both kittens into two pots but making sure there is a little from each in both pots.

I can kind of understand where your vet is coming from as Ronidazole is not necessarily a nice drug. However, vets have the luxury of not living in the situation and the possibilty of keeping brothers apart for up to 4 weeks is not something they have to consider. Ronidazole treatment has been refined over the last few years and is now much safer to use providing it is used in the currently recommended dosage. This is 30-50mg per kg per day in one dose. For 14 days. Kittens should be on the lowest dose they can. Capsules are made up for each kitten depending on their weight. You must assess their neurological status daily by the use of an interactive toy. Assess how the jump and land and whether they can follow the toy well. Any changes and consult your vet with a view to discontinuing treatment. Give Ronidazole at the same time each day and play with them at the same time each day so it is a fair test.


Regarding your vet being adamant that antibiotics don't affect the result:
How come, after the first lot of antibiotics, did the issue resolve itself only to resurface nearly 2 weeks later?? TF is rarely shed in firm poo, only soft/runny/liquid poo.

_________________
Lollo

[quote="lollo2304"]I have attended Langfords for breeder seminars and it was there that i learned about waiting till antibiotics are out of their system.

My only slight concern is, whether it tests for other things as well. I paid £65 for a test with Idexx which i mentioned above that screens for all the possible infections. In my opinion this is better than just screening for TF. So check if that is all the Langfords one does.

The problem with testing them individiually is that you will have to isolate them from testing to 2 weeks after the course of Ronidazole is finished (assuming one is positive and the other negative). If you sample both independently and don't isolate, how do you know that the positive one will not have passed the TF on to the negative one before the results come back? Then you will have two positive cats and one being treated. Chances that the TF will get passed back to the treated one at the end of treatment are quite high.

If there is no way you can realistically separate them you have two options.
1. Treat one and not the other and keep your fingers crossed
2. Treat both of them regardless of the result.

As it seems your vet would not be willing to do number two then you have another option, that is to sample poo from both kittens into two pots but making sure there is a little from each in both pots.

I would definitely go with the option of putting a little poo from each in to both pots!!!

Also, regarding the test, the vet said the test for both of them is £85. I will ask him if this is for the TF test only or if it covers other things too.

I will let you know what he says as he promised to email me regarding the waiting for antibiotics to come out of the system as he was going to contact the lab and then let me know.

Thanks guys!!

Lisa
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Ok so the vet has now got back to me with the following -

I have discussed the TF faecal PCR test with a vet specialising in clinical pathology at the lab in Langford. For the PCR they prefer a fresh faecal sample as the DNA needed for the test will degrade with time so the fresher the better. A 3 day pooled sample is more appropriate for isolating other infections/parasite (e.g. giardia), but not for the PCR test for TF. The other query about antibiotics- as the antibiotic is amox/clav this really should not affect the results at all -they have kindly sent me a research paper showing this. This makes things a lot easier for us as far as testing TF is concerned because we do not need to pool samples and do not need to worry about recent use for antibiotics. Another important thing to note is the test is run on a Tuesday, however once the faeces arrives at the lab they isolate the DNA- so as long as the sample arrives at the lab fresh is does not have to arrive on the Monday or Tuesday.

I also got your query about Idexx test code 3258 – we do not use Idexx laboratory routinely so I am unsure what this test covers. I believe another vet here sent a sample for general analysis that was unremarkable. If you could let me know what the Idexx test code 3258 is then I will get back to you on that one. It may cover the things we have tested already but with the possibility of intermittent shedding there is no harm in repeating these tests.



What are your thoughts on this please? Do I wait 2 weeks for the ABs to get out of his system or do I do as the vet says and get a sample in as soon as possible for testing?? HELP!!!

Thanks

Lisa
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