Reoccurring Diarrhea

 Hi! Sorry to hear about Lexie's trouble.

I am not in a position to really give advise, but I can give some ideas from my experience and reading.

From my reading up on diarrhea my understanding is that usually large intestine diarrhea would present with mucous, while small intestine diarrhea would not.

 It would be logical to assume that since the poop got firm while on the meds, that the meds are helping and since your vet wrote you a refill, he expected the possibility that longer treatment might be needed. So I would go on with the medication.

Meanwhile though, just as a note from my own experience, not to say yours is the same case. Our Jasmine had bad stools since she came to use. They always cleared with antibiotics, but then returned to diarrhea. No parasites ever found, nor any other cause ever found. However--and that's a long story--much later on it turned out that she has irritable bowel syndrome, that she had it probably since ever, and that it's being cause by food sensitivity.

Dogs can develop allergy to particular ingredient over time. That's why often rotating different foods is recommended.

I don't want to advise you to go through the expense of many tests, but here is what I'd try:
- finish up the second treatment of the meds
- discuss with your veterinarian possibility of ingredient sensitivity and change of protein source. You can do it with trial and error approach, or you can get an allergy blood test. Some vets believe in one approach, some in the other. We went wit the blood test. It's faster than food trials, and worked for us.

Do not accept the diarrhea though, because there is a cause for everything and just needs to be found.

I'd think though, that if it is not an infection (which it well can be), it really could be acquired ingredient sensitivity.

One thing that never hurts is adding some probiotics to the diet.

Hope that helps :-)

Jana

Jana, Thanks for your input.  I have started giving her yogurt everyday in addition to cottage cheese, which I figured wouldnt hurt.  I thought about allergies as well.  I do think that if the diarrhea continues after the meds are completed, we will do bloodwork.  I just want an answer as quickly as possible so that she can be treated and not have to endure the diarrhea.  I think/hope the bloodwork would pinpoint things a lot quicker than eliminating things from her diet. 

Thanks for your help!

Michelle

 Dear Michelle.

re: probiotics
I am assuming that your dog is used to dairy and this shouldn't be a problem. My dog had issues with dairy, and it also affected her ability to absorb calcium. Personally I would consider other probiotic source. There are several products out there. We are using FortiFlora. That is not to say that your dog must have same issues as mine.

re: allergies
Yes, the blood test is the fastest way to get change on their way if that's the case.

There could be other reasons for diarrhea, but to me parasites (which you seem to have already excluded), infection or allergies would be the most common.

 Jana

mish1000

They also checked her stool sample for any parasites and found none.  He felt that it was Colitis and was happening in her large insestine.  Immediately after taking the meds she started having her normal hard stools.  After the 7th day I took her off the pills.  Two days later she started having diarrhea again.  Same as last time.  The vet originally prescribed enough pills for 10 days plus a refill.  I put her back on the pills as I feel she was not on them long enough. 

Metranydazole, a/k/a Flagyl - is an antibiotic AND an anti-inflammatory for the gut.  The problem is if you don't finish the course of any antibiotic, and then skip a few days (or even worse a week or two) the body becomes resistant to that antibiotic.  Meaning if the infection cells/bacteria/whatever SURVIVE the antibiotic they then are usually resistant to that antibiotic.  The infection sort of saying "Ok, I lived thru THIS so I can ignore it"

That's why you always hear so much about "finishing" a course of antibiotics or not using a leftover antibiotic.  It's honestly good advice.

mish1000

She only gets home cooked food.  Mostly poultry with brown rice and assorted veggies mixed in, (carrots, sweet potatoes, zucchini, broccoli, cauliflower etc.) 

I home-cook too -- however -- both chicken and rice are inflammatories.  Now that's going to differ depending on what vet/doctor you ask, but I have seen a LOT of sense and success with TCVM (traditional Chinese veterinary medicine) and I also go to a DOM (Doctor of Oriental Medicine) for myself.  Eastern medicine maintains that chicken is a "hot" meat -- meaning it will increase inflammation if there is any.  Where we Westerners say lots and lots about "allergies" and food switch all over the place, the Eastern medicine simply says there's  nothing wrong with chicken UNLESS the body is already inflamed or looking to an excuse to BE inflamed.  Then chicken will worsen it.

Same thing with rice.

Brown rice, in particular, is very very hard to digest.  We rationalize and say it's more nutritious than white rice, but it is, also, an inflammatory food.  So I generally don't give either to the dogs.  I use almost no grain at all (and less and less as time passes, in fact).  Mostly I use beef or fish or lamb and some turkey or pork.  But the rest of it is veggie -- a huge variety in fact.  Everything from turnip, collard greens, kale, cabbage, broccoli, cauliflower, tomato, green beans, bok choy, cellery, some carrot, sweet potato, white potato, squashes of ALL varieties and beyond.  Veggies can be really rich so I try to balance it all the way around (I vary colors, above/below ground grown, veggie types, watch the cal/phos ratio, etc.)

If I want "bland" I'd probably use white potato not rice.  (and make sure there is no 'green' in the skin - that's a biggie)

Cranberry is mostly glucose.  That's why it works for UTI's -- because the glucose bonds with infection cells and makes them too slick to stick to the urinary tract. 

However -- I also use D-Mannose ... probably more than cranberry simply because it's super effective.  I might add cranberry or tomato if somebuddy's GOT a uti just to keep the urine more acid so they are more comfy (because **most** uti's cau flourish in a too-alkaline urine)

Rather than telling you exactly what food to and not to use, I'm going to suggest you find a TCVM vet and use them for complimentary therapy -- not to replace your vet.  But rather to ADD to in order to better balance everything from diet to the digestive tract.

There are Chinese herbs that can absolutely ROCK for helping calm down collitis (been there, done that LIVE IT myself)

But when you describe diarreha to the vet typically if you tell them it's simply sort of "soft serve" poop -- not really formed but they can wait until you get outside to do it -- typically that's large intestine.  But if it's explosive diarreha -- that's typically small intestine.  The small intestine is part of the digestive tract ... but if food races thru there and NO water is taken out that's a probablem all the way up in the small intestine.  But if it's simply that not quite enough water is taken out of the fecal matter for it to be properly formed -- that's large intestine.

So .... somewhere in there is the story.  If the dog can barely wait to get outside and diarreha "happens" fast ... that's something to tell the vet for sure.  Describing consistency, color, etc. -- that's always something a vet needs to hear.

The above is right -- when you see mucus, that's irritation and inflammation in the intestinal tract -- that's the body's effort to "protect" from irritation somewhere.  And typically that's large intestine (because usually if it's small intestine it goes thru TOO FAST for mucus to stick to be honest). 

mish1000

Am I giving her too much cranberry?  Too many vitamins?  Is her diet wrong?  Could she have an infection that did not clear up? When she had the bladder infection a few years ago, the first dose of antibiotics did not clear it up and she was on them again for a longer period of time.  Could that be the case here?  I plan on giving her the rest of these med's and if it continues having blood work done.  Is that my best route?    

Honestly -- it could be any of that.  But for ME, Bloodwork would be absolutely first and foremost.  And I wouldn't just do a few values "in house".  I would ask for a COMPLETE full "super chem" panel to be done (or whatever is the biggest blood panel the lab your vet uses calls it).  Bloodwork is all about comparison -- it's not just one or two levels that might be high or low -- but it's all about the ratios all the various components make with each other.  So the more information you give the vet the more likely the vet is to be able to find it.  And if levels are "normal" it is NOT a waste.  Because then later on you'll KNOW what the level was then at least.

Bloodwork to determine food allergies?  usually pretty unreliable.  And I honestly disagree greatly with the whole emphasis on "allergies" -- because I think the issue is deeper than that.  I think what is often termed 'allergy' is more often an sensitivity -- maybe that thing is just wrong NOW.  Because of some reason the body is inflamed - I'd rather find the cause of the inflammation than chase "allergens". 

Calliecritters,

Thanks!  You always are so informative.  We put Lexie back on the meds over 10 days ago.  (Originally the vet said to only give them for 7 days, which we did).  We finished the 2nd dosage of meds on Thursday morning.  Last night at 2:30 am she had me up taking her outside.  Although she seems in a hurry to go outside, she still takes her time going and has to find the right spot, which leads me to believe it is not an explosive kind of thing.  Her poop was mushy, like masked potatoes, but I did notice a few chunks in it (a couple raw carrotts from yesterday as a treat). 

Tomorrow I have to take my mother for surgery, but Daddy is calling the vet.  We plan on getting her in and asking for full bloodwork.  When she was on the meds she was completely normal.  Even now, she is still active, playful eating and drinking like normal.  It's just that her stools are loose.  Is there anything else I need the vet to do?  I also plan on taking a stool sample and asking for a smear test rather than a float test.  They checked her stool sample last time but I am not certain which method was used to test it.  The vet left a message the next day that there were no parasites.  It's my understanding that there could still be worms???  (She is on heartworm pills but I hear that does not prevent all worms). 

Any additional info you can share would be appreciated.  I want to go to the vet tomorrow with as much info as possible. 

Thanks!

mish1000

Although she seems in a hurry to go outside, she still takes her time going and has to find the right spot, which leads me to believe it is not an explosive kind of thing.  Her poop was mushy, like masked potatoes, but I did notice a few chunks in it (a couple raw carrotts from yesterday as a treat). 

You are right -- that's not "explosive" poop so be sure to tell the vet that. So it's a large intestine thing, (generally that's a good thing)

She may lack fiber -- you might try adding just a bit of plain pumpkin (not pie filling -- just plain canned pumpkin -- and it doesn't take much - try a teaspoon to start -- divide a can into several baggies to freeze until you find the right amount for her -- then you can take out a baggie which will supply a couple of days use and not have it go to waste).

Some of the high quality dog foods are SO devoid of bulk that it leads to either mushy or small poops and then you get anal gland problems as well.

mish1000

The vet left a message the next day that there were no parasites.  It's my understanding that there could still be worms???  (She is on heartworm pills but I hear that does not prevent all worms). 

There are some parasites, like giardia or even grain mites, that you won't catch unless they look at it under a scope AND do a float.

There are many types of parasites.  Heartworm prevention -- if you use HeartGuard -- may ONLY deal with heartworm.  If you use Interceptor that deals with hooks and whips and some others.  But even then things like tapeworm are unphazed (because they don't live in the blood).

When you ask for full bloodwork ask for a "full chem panel" or whatever words their lab translates to.  ie you want it sent out and the full range.  It's not a waste if you've never done one because then it provides a "baseline" if something else goes wrong later.  I'd give my right arm to know what Tink's hematacrit was when we brought her home last year -- but we never did bloodwork then so I have to be satisfied with "now".  It's a bit more expensive but you'll never regret it if there's trouble later and it can often tell the vet things *now* that are just not quite right.

Thanks Calliecritter!  I feel a bit better after "talking" to you.  She is running aroung the house now acting as though she never had me up all night!  I did give her 1 teaspoon of Pepto at 11:00.  She ate her morning treat and has drank some water.  Acting as if nothing is wrong.

I did have a full chem panel done when she was "fixed" before her first birthday.  A friend of mine had told me to do so, that way I would always have something to compare it to.  So we will visit the vet tomorrow and get it done again.  We are very fortunate that cost is not an issue, as she is our only child.  We simply just want to get to the bottom of this and get her back to normal.  I guess it just concerns me that she has always had really healthy bowel movements, nice and firm and that this just happened over night.  We do walk her where some other dogs have been and she does tend to sniff their deposits, although we pull her away when we realize what she is doing.  Also, we live on about 3 1/2 acres and have deer frequent our yard, so she may come in contact with their deposits as well.  I wonder if she could have picked something up from them?  Would that show up with bloodwork?  She is never outside without one of us, but again, sometimes we dont realize what shes sniffing until she has sniffed! 

I am anxious to get to the bottom of this so that we can do whatever needed to get her back to good health.  She is our life!  These creatures are pure Love and do not deserve to have anything go wrong with them.  Thanks again for your help.

Honestly, you might try the TCVM -- it really truly can help bowel issues SO much.  http://www.tcvm.com -- there is a locator on the left.  If you need help let me know.

Wanted to post an update on Lexie's progress.  Took her to the vet this afternoon.  She did not have a bowel movement today so we had nothing to check.  All of her vitals are good.  The doctor said she seems like a very healthy dog.  He thinks that she has colitis.  He ordered a Super Chem Screen, T4 and Cbc and put her back on the Metronidazole (125mg) twice a day.  He wants her on that med for 7 days then would like to wean her off to one dosage a day for 10 days.  He thinks that either she was not on it long enough, or that she may need a low dose to keep it under control.  He will call tomorrow with the blood results. 

My plan of action is to see if the bloodwork shows anything.  Then I plan on waiting out this period of medication until it's finished.  If the loose stools continue I have located the nearest TCVM about a half an hour away.  I will take her there and see what they have to say.

Now for the really strange part:  Yesterday and today my mom's dog (a toy poodle) had diarrhea.  Her's was very runny.  She eats Royal Canine mixed with chicken breast.  She is Lexie's only playmate.  At first I thought they had the same thing.  My vet feels that it is just a coinsidence and not the same thing as he checked Lexie's stool sample for parisites and worms including whip worms and found nothing.  My mom has not changed anything in her dogs diet.  She is acting the same and eating normally.  We both go to the same clinic but do not share the same vet.  My mother had knee surgery today and was not able to take her little one in to the vet.  She called them and they also gave her dogs some chewable medication (the name escapes me at this time) and two cans of mild dog food.  Could they have the same thing, or is it just too weird???  Your thoughts?

 Thanks!

Just wondering how Lexie is doing.  Did you get the results back yet? 

Perhaps it might be the water they're drinking.  If they play tegether maybe they're getting water from the same source.

Hope all gets well.

Johnny & Tessy

gut bacteria can be caused by MANY things -- stress (an owner in pain who is trying to organize life so they can have surgery, etc. could be stressful) -- even drinking out of the same puddle!!!  It could be the same thing, but that doesn't make it dire -- and the two could react minorly different TO the same thing.

Lexie's doing great.  I got a copy of her bloodwork today.  Everything is wonderful.  I wish my bloodwork was as good.  I plan on keeping her on two doses of her med.'s a day for seven days.  Then I plan on taking her down to one dose a day for 10 days.  Then we plan on taking her off of them altogether.  In the meantime I plan on taking her over Christmas break to a TCVM.  There is one about a half an hour away.  My husband and I talked about it last night.  We just want to see what other options are out there.  We would love to be able to treat her without the use of med.'s.  I figure at the very least, if I get some diet advice from the TCV it will be worth it. 

Thanks for asking.  BTW, my mom's dog is doing better.  My mom had surgery on Monday and the thought did occur to me that her dog may be upset over the confusion at her home.  We will see..........

Thanks!