Diarrhoea

[Guest My dog stinks]

My springer spaniel ha had diarrhoea for at least 8 months. he has had lots of tests etc and medications, but still the problem persists. His bowel movements are very powerful and liquid. He is currently on a low residue dry food diet prescribed by the vet; still no improvement. I am about to start him a weeks course of cortisone tablets to see if that helps. He is otherwise healthy, happy, hungry (always) and not losing lots of weight. He is about 29 kg 4 weeks ago. Does anybody have any ideas, the vet seems to have run out of ideas, his next step is to do a bowel biopsy Any suggestions would be appreciated.

[Toohey]

Hi and welcome. What an unfortunate problem for both of you. Glad to hear he still appears happy and healthy, but I'd be keeping a close eye on his weight.

Can I ask what diets you have tried prior to the vet prescribed food?

Have you tried a natural diet of bones, raw vegies, yoghurt etc?

[Guest My dog stinks]

he was eating raw bones, chicken wings and necks etc. He is not keen on raw vegies. I hadn't tried him on yoghurt but after reading some info on the forum, I am going to try him on some natural..... how much per day?

[Toohey]

Yoghurt might help, but it's not normal for the dog to have consistently runny poos, especially when being fed raw bones. Might be worth getting a second opinion, although if he does have an inflammatory bowel problem, steroids might help.

Hang around here and hopefully the more knowledgeable people will be along to offer their thoughts.

I have cockers and give them a dessertspoon of yoghurt 2 or 3 times a week.

[Steve]

What is the vet saying is the cause of this ? Has he done stool sample tests for endo parasites and other things like this .What kind of tests have been done ?

This is not normal for a dog to have poos like you describe for so long without a good reason. There are things in your kitchen you can add which will kind of firm the poos up etc but if you dont know whats causing it this may just mean you trap whatever the problem is inside and cause a bigger problem .

[Guest My dog stinks]

The vet has taken an X ray of his gut and blood tests. At first they were treating it as guardia( not sure of spelling), but the medication did not clear it up. He is going to do a poop sample in 3 weeks when the cortisone has gone from his system.

[Toohey]

That seems unusual that they would treat for Guardia without testing for it first. I assumed when you said he had lots of tests that stool samples would have been first on the list. Especially after 8 months of the runs.

Why do you think the vet is treating first before looking for a cause? Sounds like a bit of a guessing game. The dog could have a permanent resident bug in his gut that could be blasted out in one hit with the right antibiotic.

Although, I don't think Guardia always shows up in stool studies.

[shmoo]

I would be demanding a poo test about now!!

poor dog... having the runs for 8 months!

[Guest My dog stinks]

What are they looking for in a poop test?

[Toohey]

A poop test, or stool sample test, is when you take in specimens of your dog's poo in a jar, preferably three specimens over three days, and they are sent off to a lab to be studied to see if there are any parasitic bacteria living in the dog's intestine which would cause his diarrhoea.

This test should have been done in the beginning of your dog's treatment and will determine if there is something nasty living in there (in your dog's gut), what it is, and what the correct treatment to get rid of it is.

I think this should be done before the dog is commenced on steroid treatment, especially if the vet does not know what is wrong.

I think if your vet has not done this test yet, it is time to find another vet for a different opinion, and take a poo sample with you when you go.

[InspectorRex]

I cannot believe your Vet has not done a faecal analysis( poo sample sent to lab). that was the first thing my Vet did with our dog.

I am not a Vet so I am not going to add to the confusion your are already in and try to guess what your dog has.

Demand a faecel test be done asap! you are the one footing the bill after all.

If it comes back with soemthing along the lines of IBD(inflammatory bowel disorder) the first thing yout Vet will probably get you to do is increase the soluble fibre in your dog's diet. this is easy and cheap. I use 1teaspoon of Psyillum Husk( gluten free ) in the food daily and it is so cheap, about $5 for 500gms

[Guest My dog stinks]

Thanks for the advice, I would have thought that a stool sample would have been the first thing to do, but I relied on my vet. Now maybe I will seek a second opinion!

[Guest My dog stinks]

Does the psyillum count as a cereal. From what I have read, the best way to start combatting the problem is with BARF. Plus, how do you get a dog to eat the psyillum?

[Toohey]

Sorry Inspector Rex but I wouldn't give him psyllium. A high fibre diet will most likely exacerbate his diarrhoea.

MDS, you need to find out why your dog has this problem, then come back and ask Steve for advice on his diet. She is the expert on remedies and diet here.

Edited August 30, 2004 by Toohey

[Rappie]

I have to be quick at the moment, but will have more time later tonight...

First "faecal analysis" is a pretty generic term. There's a couple of sorts and not all go to a lab. A faecal flotation is done in house using a microscope and looks for protozoa and parasite eggs and is usually done fairly soon after diarrhoea doesn't appear to be resolving (ie. a couple of days). Then theres faecal culture which is what I think a couple of people are referring to - it is of most use if you know what you are looking for. Faeces are chock full of bacteria, so growing things is relatively easy - but growing the right thing and having it show its face as a problem is more difficult.

The other thing I noticed is people referring to IBD - this is a diagnosis of exclusion which means that you trial all the other therapies that should work, and when they don't then you take a biopsy of the intestine. This just confirms that it is IBD rather than some other process - IBD is idiopathic meaning that there isn't just one cause - rather just confirmation that you're dealing with something thats difficult to manage.

[Steve]

I was hoping you'd come in on this one Rappie . Surely if the dogs had runny poos for this length of time and they are talking the type of meds they are there should be some kind of diagnosis

Im reluctant to give any kind of suggestions until there's a reason given for the problem .

Big difference to just a quick bout of the trots to what we are talking about here.

[Guest My dog stinks]

So, this is what I am going to do..... ditch my expensive dry dog food, feed him raw chicken and visit another vet armed with a fresh (and smelly poop sample ) Toby will not like this, as he is a real guts and would quite happily eat and eat and eat..... then he starts to bark, but that's another problem!

[Rappie]

Surely if the dogs had runny poos for this length of time and they are talking the type of meds they are there should be some kind of diagnosis 

You'd think so Steve, but sometimes it just doesn't happen that way. This is one of those cases that goes in the category of complicated diarrhoea. From what I've read, the vet is doing the right things but I feel may not be thoroughly explaining what they are thinking and doing.

For uncomplicated diarrhoea the treatment is as most people would guess (through dealining with it themselves if nothing else) withholding food for 12-24 hours, gradually reintroducing highly digestible food (like chicken and rice, or cottage cheese and rice etc). Depending on whether there is likely gastritis or whether the diarrhoea is originating from the small or large bowel, an enteric mixture like Peptosyl might be added.

When diarrhoea becomes complicated, so does the diagnosis and treatment. There's a great many things that can cause it, some sinister and some not so sinister. The aim of diagnostic plans is then to start with the most likely causes, see if they can be identified, if not, move onto the next one. Often this is done therapeutically, so treatment trials - easiest first......if small intestinal bacterial overgrowth is suspected then antibiotics may be given, so even if it were some other bacterial problem - a positive response to treatment might narrow it down a little. As for the faecal culture - a great many cases will grow Salmonella - certainly can cause diarrhoea but its also normal gut flora, just like E.coli (but nearly all young animals can be killed by it.....). So its only if you're looking for something specific that it really becomes more useful to rule things in or out and thats really what making a diagnosis like this is about, getting the greatest amount of information with the least, or the most appropriate tests.

It would be interesting to know if the radiographic series included a contrast study, but it would show if there were something grossly (as opposed to microscopically long). The next step after that I suppose could be ultrasound to check out the structure of the intestinal wall, lymph nodes, stomach etc for other small masses or thickening. Exploratory laparotomy is always on the list somewhere (even if at the very bottom) because you can always tell a lot more by actually seeing and palpating and biopsying everything that you can - theres no other way to do it. Then at least you can get a histologic (microscopic) diagnosis but often, that only puts a name on something that you still need to work out how to treat - and even then individual dogs will respond differently.

As an example - we have a Cavalier King Charles that comes in to work who has had chronic episodic vomiting and diarrhoea for 2 or 3 years. We've done treatments trials and found him to be stable on Hill's i/d - then it started behaving differently so he was referred to a nearby specialist centre. There they did intestinal biopsy, examined the inside of the stomach and so on and found that the lining showed intense inflammation and ulceration as did the intestine. Definately the prime candidate for the diarrhoea? The pathology report said that apart from a change in structure of a couple of the glands it was essentially normal. I guess the point of this story is to just show how difficult things can become, we've got a diagnosis of "normal" but there is definately something happening......so what to do? Find something that works, treat the symptoms, stick with the treatments that result in an improvement.

Unfortunately....if it is IBD, the nature of the gut being inflamed impairs its ability to function hence the need to anti-inflammatory and immunosuppressive drugs like corticosteroids or azathioprine or cyclosporine. Also, added fibre can both help and hinder - really depends on which part of the bowel is affected. Sometimes it can bind really watery diarrhoea, sometimes it can make it worse. Also, although I know you all love your BARF (nothing against it!) the presence of food that makes the intestine work can increase the irritation to the gut lining and exacerbate the inflammation - hence food trials with low residue food, or food trials based on ingredient exlusion - sometimes it is a reflection of an atopy problem.

Edit to add: My Dog Stinks - if you are going to go to another vet, consider asking your own vet for a referral to a specialist. If not, let the other vet know why you are seeking another opinion so that they can obtain your dogs record from your vet. That way the vet giving the second opinion will have a clue what has been done etc and you'll save a bit of money from not having to redo tests.

Edited August 30, 2004 by Rappie

[Steve]

I will also add that I sold a kitten once to a lady that absolutely adored it. I sent it home with all of my diet suggestions[ of course BARF] but at the first vet visit the vet told her the diet wasnt good enough and sold her some commercial food.

She rang some weeks later very upset because the kitten had runny poos [i cant spell die a rear] for several weeks It had been treated by the vet by changeing the commercial food brand but symptoms were still the same. To cut a long story short it turned out that the kitten never had die a rear in the first place but just normal for what poos are like with commercial food . It was just that she had experienced non smelly drier poos with the BARF . The vet was going by what she said and didnt take a look for hmself . Sounds simple but some tmes what seems to be a problem may be a normal thing for some foods.

You can try feeding nothing else but mashed pumpkin mixed with some natural yoghurt , honey and corn flour for about 48 hours and see if that makes any difference. Might be an idea to add some staminade or similar to the drinking water for a day or two as well . Just a little to replentish any lost electrolytes and a childrens vitamin . You canalso buy some prebiotics from the health food store which gives lots of natural flora and helps a lot if its a bacterial problem. If that makes any difference you can begin to slowly introduce other foods I usually add some cottage cheese and just a little human grade beef mince the next day and if all is well add a little more pet chicken mince over the next day or two. Then if there's no problems within about a week a normal BARF diet can be put into place. NO CARBO HYDRATES AT ALL FOR AT LEAST 2 WEEKS .

Come back and let us know how you go.

[Guest My dog stinks]

Thank you so much, Steve. I will try that straight away. I have never fed him commercial food before vet suggested it; he was always on fresh food, whatever was cheap at the time!