Dog With Consistently Runny Tummy

[_PL_]

Powerlegs, I'll hold onto your suggestion for round 2. It is difficult to feed bones in a multi-dog household, when one dog isn't supposed to have bones.

It will take some time before we can see if these changes have a positive effect, so now I have to be patient.

It's not vital, just the only treat I can give them while they're on such a strict barf pattie diet. Roo tendon chews haven't really caused any dramas when I get brave enough to test them. Stopping the dogs from scavenging things like a bit of kibble someone has put in the bed for later is the hardest part :laugh:

I was slightly disappointed by the results from Z/D and would probably only use it again if I really had to. The dogs get bored of it within a week...... Actually no, they get bored of it as soon as I order a large bag. Brats! lol

Wishing you luck :) you'll get there in the end.

[persephone]

I've had a dog with Inflammatory Bowel Disease, he had to be on Ultra ZD and meds, it was a lengthy time for diagnosis - special diets etc etc. Finally an endoscopy which gave the answer.

You could try just the ZD diet, that's good for a lot of dogs with dodgy tums.

From the Op's first post ...

The vet thought it might be a food allergy so he suggested feeding Hills Science Z/D. Veli is now on his third bag with no improvement...

[Her Majesty Dogmad]

I've had a dog with Inflammatory Bowel Disease, he had to be on Ultra ZD and meds, it was a lengthy time for diagnosis - special diets etc etc. Finally an endoscopy which gave the answer.

You could try just the ZD diet, that's good for a lot of dogs with dodgy tums.

From the Op's first post ...

The vet thought it might be a food allergy so he suggested feeding Hills Science Z/D. Veli is now on his third bag with no improvement...

Oops. My dog with IBD couldn't have the ZD either, only the Ultra ZD or he got the runs still.

[Mrs Rusty Bucket]

My dog when she was about 6 months old started getting the runs on a regular basis... I swapped her main food from Advance to Nutro Natural choice - and that helped. No idea why - I think they were both chicken and rice, tho sometimes I do lamb and rice. She's on lamb and rice black hawk at the moment.

When I was at the vet trying to get the problem sorted, the vet nurse/receptionist suggested hills science something - and I made her read the ingredients and then explain how that was better than boiled chicken and rice for settling a dog's tummy. It was full of things that are bad - in my opinion and hers. She'd never read the ingredients - just assumed it would be ok (no wheat or corn or all that).

This is their "sensitive stomach" ingredients. Starts off with rice and corn - sigh.

http://www.hillspet.com.au/en-au/products/sd-canine-adult-sensitive-stomach-dry.html

[Mum to Emma]

And have a tube of Prokolin+ paste on hand (I have to get mine from the UK, it passes customs no problem)

OT, but why is it that products such as Prokolin+ or even "human" products such as Pepto Bismol and Kaopetcate are not available in Australia? Pepto and Kaopetcate and common products in the US, probably even available at supermarkets. Yet here they're effectively banned. I know that the overpriced veterinary equivalent is available. So as usual we're paying too much for so-called veterinary products when the cheaper "human" equivalent would be just as good.

Is it the 'nanny state' at work?

[kamuzz]

Nowstarin, is that the bug we sometimes get in our drinking water? Will ask the vet.

Dogmad, there is only one Z/D on the Hills Science page. Will check the bag tonight to see if it says Ultra.

[aliwake]

Giardia is a parasite - water is one way you can get it I think. When my boy had it he had vomiting and diarrhoea, but he was quite a small pup, so in an older dog it could be responsible for the runs alone. but there's plenty of other parasites out there that could be causing problems. A comprehensive faecal screen might be worth considering.

[_PL_]

And have a tube of Prokolin+ paste on hand (I have to get mine from the UK, it passes customs no problem)

OT, but why is it that products such as Prokolin+ or even "human" products such as Pepto Bismol and Kaopetcate are not available in Australia? Pepto and Kaopetcate and common products in the US, probably even available at supermarkets. Yet here they're effectively banned. I know that the overpriced veterinary equivalent is available. So as usual we're paying too much for so-called veterinary products when the cheaper "human" equivalent would be just as good.

Is it the 'nanny state' at work?

Maybe they're not here because they're so gross. :laugh: bleerk

But so much of the human stuff now has artificial sweetener which means it's unsuitable for animals anyway. Like electrolytes for example.That reeeally annoys me.

Pretty much safest in the kaopectate style stuff for animals on shelves right now is the pet product Peptosyl. Not too dear, no prescription and stops the trots if it's just a simple tummy upset but I wasn't going to suggest it here because of the pinky frothy milkshake-like mess it makes when they spit it back at you. .

Edited June 17, 2014 by Powerlegs

[brightstar123]

This can be a really frustrating problem to deal with, I've had a similar situation with my own Lab, GSD and Bengal cat.

As others have mentioned, if your vet is at the point of considering an abdominal ultrasound and a biopsy, I would hope that the following has been performed:

Complete blood count and biochemistry panel to rule out systemic causes, full faecal exam/culture (parasites/clostridia etc), TLI testing for exocrine pancreatic insufficiency and some therapeutic trials (dietary, antibiotic, anti-parasitic).

Your vet is correct in that fenbendazole is the best drug to use to rule out giardia (which can be tricky to diagnose) and roundworm/hookworm/whipworm. It may be worth repeating the treatment a few times several weeks apart, given the life cycle of helminth parasites. At least three sequential faecal exams should be performed to ensure treatment success.

TLI testing can be done, although in this case it doesn't sound like your dog has the common signs of pancreatic insufficiency, such as ravenous appetite, poor growth, weight loss, poor hair coat and profuse foul-smelling pale stools.

What your vet would have been trying to determine is whether the diarrhoea is due to small bowel or large bowel disease (small bowel often associated with weight loss, no mucous in the stool, no blood in the stool or black digested blood, no straining, normal frequency; large bowel with increased frequency or urgency, fresh red blood and/or mucous in the stool, normal weight/body condition and sometimes straining) and then the possible causes.

If your dog is otherwise in good health (normal appetite and energy levels, no weight loss etc), I would be performing more thorough therapeutic trials:

1) Treatment with fenbendazole as discussed.

2) 4-6wk course of antibiotics (metronidazole, oxytetracycline or tylosin) with a change in the antibiotic after 2wks if there is not a significant improvement. Idiopathic (unknown cause) antibiotic responsive diarrhoea (ARD) is increasingly diagnosed (although particularly in GSDs) and it does sound possible here if there was some response to the metronidazole. ARD can also be due to small intestinal bacterial overgrowth. Some dogs and cats with chronic ARD will eventually just grow out of the diarrhoea, due to increased maturity of the immune system, although some may need to be on antibiotics long-term. Testing folate and cobalamin and performing a duodenal juice culture can help confirm a diagnosis of ARD, although a drug trial is cheaper and easier!

3) Then: strict dietary trial for 6wks (either homemade diet with a novel protein ie a protein your dog would never have eaten eg rabbit, venison, duck etc plus rice or mashed potato (gluten-free carb) or perhaps a commercial hydrolyzed diet eg Royal Canin Hypoallergenic) then reintroduce the original diet to see problems return, thus confirming the diagnosis. I personally prefer a homemade diet as you have complete control over the diet. Obviously this is not a properly balanced diet but given the short time period of the trial it's not a problem.

If these steps have been performed I would then proceed to an ultrasound and endoscopic biopsy. Biopsy is the only way to fully confirm a diagnosis of IBD and to determine the type of inflammation occurring.

This is the way I proceeded with my Bengal with protozoal parasites and idiopathic ARD, who had horrible bloody diarrhoea for at least a year. He eventually just grew out of it and we were able to discontinue the antibiotics. The GSD also responded to long term antibiotics and a low fat highly digestible diet. The lab actually responded to a complete sudden change to a raw diet (with a fairly high bone component initially) but this is not something I would necessarily recommend for your dog without knowing more information! Changing to a raw diet is basically a half-way attempt at an strict elimination dietary trial (in that you are removing grains, additives etc from the diet but you are still including common proteins, which surprisingly can be the cause of the allergy in many dogs - beef is a common one). So I would recommend being thorough and just going with the novel protein diet if there's no response to the fenbendazole and antibiotic trial.

Hope this helps, good luck!

[kamuzz]

Thanks for your post brightstar123 - really appreciate your response.

And now I have options to discuss with my vet, which makes me feel much better about poor Veli.

He is too thin. He was lean when he came from his breeder but I think he has lost more weight since then. He is weighing in at around 23.5 kg. (My other setter is too heavy at 30 kg.) His coat is fine and his stools don't stink. And he seems to generally be in good health - he is bright eyed and happy to be involved in normal activities.

Off to pick up the Fenbendazole tomorrow. He still has another week of his current course of Metronidazole to go, so I'll ask the vet about extending it or swapping him to another one as per your suggestion.

Edited June 18, 2014 by kamuzz

[persephone]

has he had stools/urine tested ?

[OSoSwift]

I would try protexin and put him on chicken and rice longer term. If he is okay on that I would do a correctly monitored elimination diet via your vet.

[kamuzz]

persephone - not at this point, no. All his blood work was normal.

OSoSwift - there have been a few studies published showing that protexin doesn't have effect on the gut so this vet clinic no longer recommends protexin. I will try the Inner Health as per Scottsmum's suggestion.

And yes, after reading everyone's thoughts I decided to put him back on chicken and rice and see how that worked.

So in summary:

- he gets his Fenbendazole tomorrow

- he stays on his Metronidazole until Wed and I have asked the vet if we should extend this or switch to another anti-biotic as per brightstar123's suggestion

- he is getting the Inner Health Plus Dairy Free probiotic as per Scottsmum's suggestion

- he will get chicken and rice for at least the next 4 days, and possibly longer

Edited June 18, 2014 by kamuzz

[brightstar123]

Now that you mention he is underweight (is his weight stable? Is he continuing to lose weight?) I would bump small intestinal disease up to the top of the list. Was serum albumin tested? That would help tell us if your dog has a protein-losing enteropathy (most common causes of this are IBD, lymphangiectasia, lymphoma). If I saw a dog that was continuing to lose weight with chronic diarrhoea and decreasing albumin, I would probably take a more aggressive response - especially if you feel as though his condition is declining quickly. An ultrasound and biopsy would then be appropriate, instead of a 6wk food trial. Any vomiting? How's his appetite and energy levels?

English Setters are beautiful dogs, I'd love one! I'm sure an answer will be found :)

[kamuzz]

Well, Veli was getting 6 cups of z/d ultra a day, and not putting any weight on. He probably hasn't lost much weight, but I feel like I was pouring food into him with no result.

I don't remember the vet saying anything about albumin, will have to check this.

No sign of vomiting. And his energy levels are fine.

When I spoke to the vet this afternoon - before I'd read your post unfortunately - he was happy for me to put Veli back onto chicken and rice and then touch base with him on Monday with a progress report.

[brightstar123]

Of course it's difficult to tell without examining your dog, but I would stick to the original plan. It doesn't sound like he's wasting away (obviously 6 cups/day is a lot though!) and if his energy is good, there's no vomiting, normal thirst/appetite then it sounds like it would be safe to do the trials. Your vet may not have checked albumin and it's really sequential tests that reveal the most (ie decreasing albumin levels over time). It would be nice to know though.

It's a complex problem and different vets have different (entirely reasonable) approaches, it sounds like you are in capable hands, let us know how it goes!

[CavsRcute]

When my girl had the runs I found chicken and rice would help for a couple of days but would then become worse than before..

I put her on white fish and potato, fixed the runs and she never had chicken again and no more runs

[kamuzz]

Just popping in with an update.

Yes, brightstar123 the vet had checked his albumin levels as part of the original blood work-up.

We put Veli back onto chicken and rice from Wednesday evening. He is staying on this until our next vet appointment which is Wednesday. Currently he is on Fenbendazole, Metronidazole and the Inner Health Plus Dairy Free probiotic with his food. The Fenbendazole finishes today.

What I didn't realise is that the Z/D Ultra is grain-free.

Edited June 23, 2014 by kamuzz

[White Shepherd mom]

A colleague's small dog had constant runny poo and was losing weight despite having a healthy appetite. She was active and happy in every other way. The vet told him she has EPI - Exocrine Pancreatic Insufficiency.

"EPI, Exocrine Pancreatic Insufficiency, is the inability of the acinar cells of the exocrine pancreas to produce and secrete the necessary enzymes needed to digest food. These main enzymes are:.

· Amylase for digestion of carbohydrates (sugars & starches in grains, fruits & vegetables),

· Lipases for digestion of fat.

· Trypsin and Proteases for digestion of proteins.

EPI, is sometimes referred to as Pancreatic Hypoplasia or Pancreatic Acinar Atrophy (PAA).

Or EPI can also be the secondary condition of a chronic illness, such as chronic pancreatitis.

EPI is when a dog's exocrine part of the pancreas is atrophied and can no longer produce these pancreatic digestive enzymes. Some food particles then remain undigested causing SIBO and unabsorbed resulting in a dog, who although is eating copious amounts of food, is constantly undernourished and can literally waste away. Without proper treatment, the EPI dog cansuffer greatly and even die a painful death from malnourishment, starvation or organ failure.

With EPI, organ, immune, nervous and all other body systems may become compromised to one degree or another. A lack of nutrients sometimes even results in temperament changes which may express themselves in fear and/or aggression.

It is a devastating, frustrating disease that is all too often misdiagnosed. Symptoms usually do not appear until anywhere between 80% and 95% of the exocrine pancreas acinar cells are destroyed. What makes this disease even harder to diagnose is that not all dogs display any or all of the symptoms all of the time. Any breed can have EPI, not just GSDs... see http://www.epi4dogs.com/notjustgsds.htm."

Sorry, I can't remember whether you said your dog was tested for this?

ETA, I believe he gives her Creon (sp) tablets and Thrive D and she is back to her normal weight and poo production! Have a look at this site for symptoms, etc. www.epi4dogs.com

Edited June 26, 2014 by White Shepherd mom

[kamuzz]

Popping back in to update this thread.

We have had a lot of help from a fantastic DOLer who is welcome to "out" herself in this thread if she would like to

In summary we have tried

- various forms of antibiotics

- tested him for everything the vet could think of (including EPI)

- wormed him

- tried a raw diet

- tried him on what we hoped was a novel source of protein (goat)

- had an ultrasound of his gut

and nothing seemed to help or give us any pointers as to what could be wrong.

Don't click on this link if you are eating - this is how runny his poo is http://i167.photobucket.com/albums/u156/kamuzz/Veli/Poop/IMG_00681_zpsf6f2b895.jpg

My vet would like to perform an intestinal biopsy but I am reluctant to put him through this procedure.

Currently he is on a treatment trial to see if steroids will help. On Friday we started him on Losec (to try and minimise the effects of the steroids) and from Saturday he has been on prednisolone. (If my maths is right, he is starting off on 60 mg for the first week, then 30 mg for the second week)

He is currently on dry food - the Royal Canin Gastro Intestinal Low Fat.

Apparently the steroids normally make the dog hungry. Seems to have had the opposite effect on Veli and he is now picking at this food. Hopefully his appetite will return to normal soon.