Hey pal.
I hope you are well. It is a brilliant question. There is no doubt that this organism can cause clinical signs. However, this parasite has also been reported in clinically healthy cats. Clinical signs include chronic, intermittent, bloody, and mucoid diarrhoea lasting from 1 day to 8 years!
The treatment of choice is ronidazole, a nitroimidazole related to metronidazole, which is the only drug with demonstrated efficacy against T. foetus, although published evidence is limited. Ronidazole is not licensed for use in cats. There has been recent debate about the appropriate dose; currently 30 mg/kg daily orally for 2 weeks is recommended. This dosage is lower than some previous recommendations but reduces the risk of side effects, which comprise neurotoxic signs (as with high doses of metronidazole) such as lethargy, inappetence, ataxia, seizures and/or tremors. Accurate weight measurement of the cat to be treated is important to ensure appropriate doses are given. It can take several weeks for cats to respond to treatment since elimination of infection does not always occur. Relapses following treatment or treatment failure can occur in up to 25% of treated cats; treatment failure does not appear to be more likely in multicat households. Preliminary data suggest that the addition of a probiotic to ronidazole therapy could reduce the likelihood of T. foetus relapse. The diarrhoea will usually resolve spontaneously even in untreated cats although this can take several months or longer.
So, in short. It all comes down to the individual patient. I would measure folate, cobalamin and TLI if possible. This will help with other treatment interventions, but also help with understanding other compounding factors. I would try all ‘benign’ treatments if possible. Hydrolysed diet (Purina HA in growing animal) and a probiotic are both worth trying. There are possible clinical signs and they are documented:
https://pubmed.ncbi.nlm.nih.gov/31796193/
If all else fails I would consider treatment in this case.
Hope that helps.
Scott 🙂
