Dear Siouxsie, Thomas and Dahlia:
I adopted a kitten about six months ago. The reason I adopted this particular kitten was because he was active. I took him to the vet for his first checkup and they discovered he had a respiratory infection. They treated him for that. They wanted me to bring in a stool sample to test. His test came back positive, but no one from the vet contacted me. They claimed they called, but I have an answering machine and if they did call they didn't leave a message. In September, Billy (the kitten) started to get sick; he was always laying around the house barely moving. I took him back to the vet and that's when I discovered he had parasites in his stool in June. They treated him for that by giving him a shot. They told me they took another stool sample and it came back negative.

But then, Billy seemed to get worse. I took him to another vet and discovered his fecal sample was positive and he still had worms. They treated him for that and told me he would get better. A week later, my kitten still walks around like he's about to die. I took him to the vet today and now they tell me he has a bowel infection. I have spent so much money on this kitten in such a short period of time, I have almost given up hope. He walks around looking so sad and depressed, and it is depressing me to see him this way. I don't know what to do. It appears as if these vets are guessing what's wrong with him instead of actually testing him to find out what's really wrong with him. I was wandering, could he possibly be feeling better, but because he has been sick for so long now he just thinks he's sick? I don't know. Please help!

~Talana

Siouxsie: You and Billy sure have been through a tough time, Talana. We think you did the right thing by taking Billy to a different vet, though. It sounds as if the other clinic may not have been doing quite as well by you and Billy as one would hope.

Thomas: There could have been any number of reasons why you didn't get the phone message about Billy's fecal sample -- maybe the person making the call dialed the wrong number, for example. The injection they gave may only have worked for certain types of worms, but not all the types that he had. But in any case, we do think that you've done the right thing by taking him to this new clinic.

Dahlia: Billy could have developed an infection in his bowel from having worms for a long time, too. But the good news is that infections can be treated.

Siouxsie: It's not always easy to make a diagnosis like an infection in the intestines. Veterinarians are trained to make diagnoses based on the most likely problem. Diagnostic logic follows the old saying, "If you hear hoofbeats outside your window, think horses, not zebras." (Well, unless you live on the African savannah, of course.)

Thomas: If Billy presented with diarrhea and lethargy, for example, and a stool sample revealed that he had worms, almost every vet on the planet would treat for worms first and see if that took care of the symptoms.

Dahlia: Over the course of a few months, it's possible that Billy might have become reinfected with worms. First of all, most worming is done in two doses two weeks apart. The second dose kills any worms that hatched from eggs that were still in the intestines when the first dose killed the adult worms.

Siouxsie: And some worms and parasites can live outside the body, too. If you didn't clean Billy's litterbox with bleach and replace the kitty litter once he'd been wormed, it's possible that he could have reinfected himself when cleaning his paws or something.

Thomas: And, as we said, some worm medications are only effective for certain types of worms.

Dahlia: We're pretty sure Billy isn't just acting sick because he's used to feeling sick. We cats don't operate that way. We're very much "in the moment" creatures, and we act how we feel in that moment.

Siouxsie: In fact, most cats won't act sick at all unless they're feeling really bad.

Thomas: We think that if you treat him for the infection and follow all the vet's instructions, Billy will start feeling better pretty soon.

Dahlia: You can also try feeding him a tablespoon or so of lowfat plain, unsweetened yogurt to help grow "healthy bacteria" in his intestines and help his digestion get back on track. Mommy gave me yogurt when I had to take antibiotics, and I thought it was really yummy.

Siouxsie: Billy may be looking so ill because he's undernourished. If he's had worms and now his intestines aren't working right because of an infection, he probably hasn't gotten all the vitamins and minerals he needs to grow into a healthy cat.

Thomas: We assume you're feeding Billy kitten food in the amount recommended on the bag, can or pouch. You'd be amazed at how much a growing kitten can eat.

Dahlia: I eat more than Siouxsie and Thomas, and I'm half their size! That's 'cause I want to be big and strong like them someday.

Siouxsie: We'd recommend you talk to your vet about vitamins for Billy. He or she might be able to recommend a brand or type of nutritional supplement that would suit Billy's special needs.

Thomas: You might also try feeding him bland food, like chicken baby food (read the ingredient list and make sure there's no onion or garlic powder in it), as a treat. That should get him eating and help him put some weight on.

Dahlia: And don't be afraid to leave dry food down and let Billy eat as much as he wants. If you feed him canned food, you'll want to pick that up and clean his dish after 20 minutes or so; canned food gets nasty if it's left out too long.

Siouxsie: Talana, you don't mention where you adopted Billy. If you adopted him from an animal shelter or a breeder, he should have been tested for certain illnesses like Feline Leukemia (FeLV) and Feline Immunodeficiency Virus (FIV). He may also have had some of his early shots.

Thomas: But if you adopted him from an individual whose cat had kittens and who's trying to find homes for the babies, you're going to have to do some more health screening.

Dahlia: If Billy hasn't had a blood test for FeLV and FIV, your vet should definitely do that. Both of these viruses can cause problems with the immune system and make it hard for kitties to fight off infections.

Siouxsie: If Billy turns out to be positive for FIV, he could enjoy many years of good health. But you'd still have to be extra careful to monitor him -- even the slightest sniffle in an FIV-positive cat is a reason for a trip to the vet.

Thomas: If he's positive for feline leukemia, the picture may not be so rosy. Kittens with FeLV tend to be prone to all kinds of infections and as a result their lives can be quite short.

Dahlia: But on the other hand, it could just be that Billy got sick from having worms for so long, and that treating him with the right medicine could bring him around quickly! So please, don't despair.

Siouxsie: If it turns out that Billy has a more chronic intestinal problem like Irritable Bowel Disorder, there are ways to manage that too, with nutrition and possibly support from a holistic veterinarian.

Thomas: A while back, we wrote a column about ways to deal with Irritable Bowel Disorder, and then the next week, a reader wrote back to tell us her IBD treatment success story.

Dahlia: Don't give up on Billy or on your vet, Talana. We know it can be discouraging when you spend a lot of money and put your kitty through a lot of treatment, seemingly without results. Vets are human beings too, and sometimes they make mistakes. But we're sure your vet is doing the best he or she can to help Billy get back to health. Please let us know how everything turns out.

Got a question? Need some advice? E-mail us at advice@paws-and-effect.com. None of the material in this column is meant to be a substitute for regular veterinary care.