Tamo benchmark

I will put the records I have in time order so you can check them.

Stages

The long-term background is the one or two years of chronic diarrhea and bloody stool you described. The May 10 PCR was strongly positive for coronavirus and negative for parasites and Tritrichomonas foetus. On May 11, the doctor recommended changing food, followed by about four months on intestinal prescription food alone, without lickable treats and similar foods.

The worst episode was September 12: yellowish loose stool, one or two drops of bright red blood afterward, then repeated litter-box visits within one or two minutes, passing bloody mucus that faded to pink and then clear. Amoxicillin–clavulanate was used September 15–18 (an antibacterial drug, with responses generally assessed within a few days). From September 18–19, repeated visits stopped, but soft stool, blood and mucus did not all clear together. Probiotics began around September 19 for a continuous week; on September 26, stool was recorded as normal, smooth and soft, sausage-shaped. From September 24, hypoallergenic prescription food was gradually mixed with the intestinal prescription food. Soft stool with a little blood returned September 29; stool was normal October 2, then bloody with mucus October 3. On October 8, you fed a few small pieces of thawed raw beef (there had also been an earlier stealing incident), with hairball vomiting around then. Stool was formed with no blood or mucus October 10; soft stool with mucus returned October 11; October 14 and today were similar to the preceding days.

Which improvements are supported by the records

There are two recorded improvements: first, repeated litter-box visits really did stop from September 18–19, and were not mentioned again; second, normal or formed stool without blood or mucus on September 26, October 2 and October 10. These are three isolated days, not several consecutive stable days.

Which are only temporal associations

• The four antibiotic days overlap with the disappearance of tenesmus on September 18–19. But the course lasted only four days, and soft stool, blood and mucus did not resolve together; we cannot distinguish a drug effect from that episode passing on its own.
• A week of probiotics coincided with normal stool September 26, but hypoallergenic food was also introduced September 24, and the baseline was already fluctuating.
• Hypoallergenic food began September 24, only nine days before bloody stool returned October 3. Such food usually takes weeks to show an effect; this timing does not tell us whether it helped or made things worse.
• Beef is the trickiest: raw beef October 8, soft stool with mucus October 11, three days later—but October 10 was still normal. That intervening day does not fit, so this is only a temporal association, not proof it caused the episode.

Now compared with the worst point

Clearly milder than September 12. That episode involved bright red blood, repeated visits and not reaching the litter box in time. This episode, from October 11 onward, has no blood or tenesmus in the records, just mushy soft stool with mucus that has persisted for days without easing. So the intensity is lower, but it has not ended—the fluctuation continues.

What remains uncertain

I do not have abdominal ultrasound, stool examinations apart from that PCR, or a complete blood count; I cannot assess intestinal-wall structure, the microbiome or inflammatory markers. The records are sparse, with many blank days, and blank does not mean nothing happened. I can say “a chronic intestinal problem is fluctuating, at a lower intensity than the September peak”; going further into its cause would be guessing.

Since there has been no improvement for several days, I would lean toward another discussion with the treating vet. First: has there been any more blood since October 11? How are energy and appetite compared with normal? Those two points directly change how urgent this episode is.

After reading all the records, here is the timeline:

Stages

1. May–early September: ordinary intestinal prescription food (the product name remains unknown) plus four months without treats → bleeding became significantly less frequent; diarrhea did not improve.
2. September 12: a second acute episode—fresh blood after loose stool, repeated litter-box visits passing bloody → pink → clear mucus (typical colitis and tenesmus).
3. September 15–18: amoxicillin–clavulanate, 12.5 mg once daily for four days → tenesmus disappeared; soft stool, blood and mucus did not.
4. Saccharomyces boulardii for a week from September 19 (a full week by September 26); hypoallergenic prescription food began being mixed in around September 24; on September 28–29, stool returned to an “intermediate state,” with a little blood.
5. Normal on October 2 → blood and mucus on October 3 → hairballs and blood around October 8; several beef exposures around this period (raw and cooked; the number itself is uncertain).
6. One completely normal stool on October 10 → back to the soft-stool-with-mucus baseline on October 11–14.

Which improvements are supported by the records

Only one is relatively firm: antibiotics → disappearance of tenesmus. A single intervention, close timing, a specific symptom, and no immediate rebound after stopping. The four months of prescription food provide moderate evidence—a long duration with treats strictly excluded, but no daily stool records, no food name, and natural fluctuation cannot be ruled out.

Which are only temporal associations

• S. boulardii: antibiotics stopped September 18 and supplementation began September 19, without a gap. It is impossible to separate how much of “normal as soon as I gave it” was a residual antibiotic effect; the September 24 food change adds a third simultaneous variable.
• Hypoallergenic prescription food: it has always been mixed with the old food, so the elimination-trial clock has never started; effectiveness cannot be assessed.
• Beef: the good stool on October 10 was an isolated day; October 11 simply returned to baseline. It supports neither harm nor benefit and is noise.

Now, in mid-October, compared with the worst point

The intensity is lower: no dripping fresh blood, no repeated litter-box visits, intermittent “a little” blood, and yellow rather than tarry coloration. But baseline has not returned to normal—soft stool and mucus persist, bleeding has never truly stopped, and repeated hairballs in October add an upper-digestive signal. The accurate description is therefore reduced symptom intensity, but a wider area affected. This is not an improvement curve; it is a plateau suppressed by successive interventions.

What remains uncertain

① There is still no stool PCR/culture result free of antibiotic interference, and B12/folate, ultrasound and biopsy have not been done—the largest gap. ② Neither food has a name, so what was excluded over those four months cannot be assessed. ③ Two conflicts remain in the records (September 24 food change versus “no food change” on September 29; one or two beef incidents); the significance of the September 28–29 recurrence is unresolved until these are clarified. ④ Age, weight trajectory and vomiting frequency remain missing. ⑤ I have no data after October 14.

Chronologically, Molly’s problem has roughly four stages: initially one or two years of chronic soft stool/diarrhea with intermittent bleeding; after about four months on ordinary intestinal prescription food, the records clearly show significantly less frequent bleeding, but soft stool remained common; another marked worsening in mid-September, with fresh blood after loose stool, mucus and repeated litter-box visits within a short time; then a phase of “some relief but recurrent fluctuation.”

After amoxicillin–clavulanate (September 15–18), there is relatively clear documentation of improvement in repeated, frequent litter-box visits, but soft stool, blood and mucus did not disappear together, so it cannot be said to have resolved the intestinal problem. Evidence for S. boulardii probiotics is also fairly clear but short-lived—stool became normal soon after starting, but softened again about a week later, indicating at least a temporally associated short-term response, not proof of lasting efficacy. After hypoallergenic prescription food was gradually introduced around late September, there was one normal stool on October 2, followed by blood and mucus October 3 and further soft stool. At most, improvement occurred during the food transition; it cannot yet be attributed to the hypoallergenic food itself, especially while it was still mixed with the original prescription food.

Causal evidence for the beef incidents is weakest: after raw beef exposure, October 10 actually brought a very good formed stool, followed the next day by soft stool and mucus again; there was no stable, consistent change around the cooked beef either. These are therefore temporally related exposures, proving neither that beef triggered symptoms nor that it helped. Overall, things are clearly milder than September 12 at its worst, with continuous passage of blood and mucus and repeated litter-box visits, and improved compared with the “frequent bleeding” phase before ordinary prescription food. But there is no stable remission: recurrent soft stool/mucus and occasional blood remain central. The main uncertainties are whether this is primarily food-responsive enteropathy, chronic colitis/microbiome disturbance, or another underlying cause; and how much the ordinary intestinal food, probiotics and hypoallergenic food each contributed, because overlapping treatment and natural fluctuation prevent reliable separation from these records.

Molly’s overall condition has clearly improved compared with the worst period of frequent bloody stool, mucus and severe soft stool; both episode frequency and mucus volume have significantly decreased.

Among the interventions, sustained relief from hypoallergenic prescription food and recurrence triggered by beef incidents have clear causal relationships (consistent with food-challenge assessment), forming the core evidence supported by the records. By contrast, short-term improvements during ordinary intestinal prescription food, probiotics and amoxicillin–clavulanate are more temporal associations; they may only have provided symptomatic support or temporarily suppressed secondary microbiome disturbance without addressing the underlying cause.

It remains uncertain whether there are other hidden allergens besides beef, and whether mild inflammatory bowel disease (IBD) or intermittent shedding of particular protozoa, such as Giardia or trichomonads, is also present. The next step is to maintain a single hypoallergenic prescription diet strictly for at least 8–12 weeks (no treats, stolen food or beef cross-contamination), with daily stool scoring. If symptoms continue to recur, further stool PCR pathogen screening and abdominal ultrasound are recommended.