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Hi Heather,
I don’t know of course fully what you and your vet have looked to rule out so far. Seeing soft stool with fresh blood typically localizes this disorder to the large bowel.
If this was a patient I was seeing for the first time, I would focus first on intestinal parasites, even at 4 months of age. Fecal PCR testing which looks for the DNA of parasites has become more common in recent years and allows for a very high sensitivity. We have found kittens with disorders caused by organisms like Cryptosporidium, Tritrichomonas, Giardia, and others that would commonly be missed in traditional fecal exams and especially with in-clinic fecal flotations, which some clinics still utilize.
Even with effective treatment for parasites, it is possible for some residual inflammation to remain if they caused a fair amount of tissue damage and malabsorption before being treated. Dietary therapy in the form of a highly digestible diet (not so much hypoallergenic) can help to appease inflamed tissue.
Intestinal parasitism can also throw off the biome and balance. Probiotics can be a really important part of re-establishing balance, especially for a young kitten where establishing that is very important.
If parasites are thought to be out of the picture, focusing on the biome balance to me is next most important.
The GI biome of very young kittens is still developing and all else besides, it is generally important to try a variety of proteins to make the GI tract more adaptable and flexible. This is the main principle behind rotating diets.
A healthy biome requires healthy gut bacteria. There is a way to test for imbalance with a blood test that Texas A&M offers that checks for folate (B9) and cobalamin (B12). High levels of folate and low levels of cobalamin can support a finding of intestinal dysbiosis where pathogenic/disease-causing bacteria outnumber healthy bacteria.
Some cats with a chronic GI disturbance may also only have low B12. Supplementing B12 alone in some cats (even those with large intestinal disease) has demonstrated improvements.
The large intestine can also be responsive to fiber supplementation. I’ve not had to consider fiber supplementation for too many kittens (vs. senior cats) but may be worth bringing up in conversation.
Dietary allergy is possible but my concern is that your investigations may have brought it in too prominently too early. Actual dietary allergy is uncommon (though not impossible) at such an early age. In most cases, this develops a little bit later in young adulthood.
Most dietary protein allergies lead to small intestinal disease, which is essentially what inflammatory bowel disease (IBD) is. The colon being affected singly or concurrently has been reported though it is thought to be less common.
As far as the GPH/bioresonance testing goes, you have to understand that this is not something that is supported by medical convention. Bioresonance is not a science and is more of an unfounded theory. While I am a supporter of some alternative therapies, bioresonance does not have good scientific evidence to support its reliability as a test that can be used to make medical decisions. If you work with a conventional medicine vet, it’s important to realize that they may find these “sensitivity” results to be of little clinical value. This may be different if you work with a holistic/alternative/complimentary med vet.
It’s very unclear what a ‘sensitivity” in this context really means. Medical professionals have raised the concern that these “sensitivities” may not truly represent problems contributing to GI disturbance and may lead to unnecessary food avoidance. Even GPH states that the “sensitivities” do not indicate causation of illness.
The very long list you provided and your own comments supports that. There is essentially no protein you can “safely” feed here including some that are conventionally considered more hypoallergenic like pork, duck, lamb, and salmon and you’re understandably frustrated by how limited a diet you’d have to feed to avoid all of the items listed.
Diagnosing food allergies is best done with dietary trials or a food challenge where a single protein is eliminated at a time. Even IgG antibody testing through blood sampling is not very accurate for food allergies. Looking to diagnose any kind of dietary allergy through hair or saliva samples would be even less so.
Now, if you do believe in the validity of bioresonance testing for food sensitivity that is your choice of course. But you will have a lot of difficulty, as I think you’ve already found, trying to find a balanced diet that is going to fit. A homemade diet I don’t feel is appropriate for kittens either and can invite other nutritional imbalances that will affect growth and health.
It’s also important to realize that if you work with a conventional medicine veterinarian (as opposed to holistic or alternative/complimentary medicine), that they may have difficulty counseling you on incorporating these sensitivity results into a medical plan.
Depending on what you’ve already discussed with your vet, I would work through the different categories of rule outs for your kitten’s clinical signs that are more common and/or more easily treatable (a week of a dewormer is more simple than a six week diet trial). Perhaps you do end up getting down to diet trials and find that a protein allergy (like chicken) is a cause. But overall, you want to make sure that all other potential causes are worked through and not focus overmuch on just one area at the cost of other potential rule outs.