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Dr. Andy
Dr. Andy, Medical Director
Category: Dog Veterinary
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Experience:  UC Davis graduate, emphasis in dermatology, internal medicine, pain management
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My dog keeps having uncontrollable diarrhea every week or so.

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My dog keeps having uncontrollable diarrhea every week or so. The first few times I went to a vet and got rxs for EN dog food and metronidazole. The fecal parasite tests and blood'tests all came back negative, and she doesn't have a fever. She seems to get better with treatment, but when she goes off meds it comes back. We haven't changed her dog food other than the EN. She is 3. What else could be causing this?
Submitted: 5 years ago.
Category: Dog Veterinary
Expert:  Dr. Andy replied 5 years ago.
Hello,
I am sorry to hear about this concern.
My primary thoughts would be:

- Dietary indiscretion (eating something you do not know about)
- Stomach or intestinal foreign body
- Something that was given to them (new food, new treat, human food)
- Intestinal parasitism (not just the worms, but the microscopic bugs like Giardia and Coccidia). They can cause vomiting also.
- Toxin exposure would be less likely, unless you have reason to suspect exposure to a chemical.
- Less commonly, endocrine diseases.

So, for testing.
1. Recheck the fecal test using these guidelines:

Bring in a fresh poop sample to the veterinarian. Ideally, within a few hours. Request that it be sent “OUT” to the laboratory instead of being looked at in the hospital (more accurate that way). We are not interested in only worm eggs, but also checking for the very common microscopic bugs like giardia and coccidia. These types of parasites will not be cured with over-the-counter dewormers. Giardia can also be difficult to identify on routine fecal tests, so ask your vet if they always add a “giardia elisa” to the fecal test.

2. Make sure there are no other treats, food, dog bones, etc...being fed.
Nothing else

3. A fecal pathogen profile test may be needed. This is to check for more difficult to identify organisms that are not readily seen on fecal testing. Your vet will be familiar.

4. Possibly some testing for endocrine disease. That could include a ACTH test for Addison's. Your vet should also be familiar.

5. Possibly a TLI test. This is a test assessing for EPI (exocrine pancreatic insufficiency). Where the pancreas is not producing the proper enzymes for proper metabolism.

Best guesses.
Good Luck
Dr. Andy

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The answer provided is for information only. Unfortunately, I cannot legally prescribe medications or offer a definitive diagnosis without performing a physical examination. If you have any concerns please contact your primary veterinarian, or contact an ER facility if this is an emergency. REMEMBER: Even after you click "ACCEPT" and your question closes, you can still review our discussion.
Customer: replied 5 years ago.
The fecal parasite tests that we had sent out of the hospital came back negative for giardia, this was very clear to me from my vet. Would a fecal pathogen profile be able to identify anything else, or is that the same test? Also, she hasn't vomited at all, has a healthy appetite, and acts as if she feels fine. Right now we have her on Purina dog chow. Do you know of any other dry dog foods that are better for more sentitive stomachs? Or would changing the food be a bad idea right now?
I just have a hard time believing that it's a food sensitivity when we didn't change her food that she has been on for the last 2 years and she has gotten sick several times in the last 6-8 weeks. I will look into the other tests you recommended, although since my vet lingo is sub-par we may have already done these tests all blood work was negative and my vet mentioned that they were testing for some sort of pancreatic disorder probably the same thing you mentioned. Are there any other culprits that could be at play
play? We do live in the southeastern us if that helps. We haven't recovered any ticks from her
Expert:  Dr. Andy replied 5 years ago.
Yes, would identify other possible parasites.

Example:
http://www.idexx.com/pubwebresources/pdf/en_us/smallanimal/reference-laboratories/diagnostic-updates/realpcr-canine-feline-diarrhea-panels.pdf

For sensitive stomachs:
Royal Canin Intestinal "high energy" or "low fat" --> prescription diets
Science Diet I/D intestinal
Science Diet Sensitive stomach

That's about all I can add, but Addison's disease or the pancreatic condition called EPI would be the other suspicions.

Dr. Andy

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I greatly appreciate when you click “ACCEPT” if you have found the advice helpful or informative, so I may receive credit for the answer. Receiving feedback and bonuses is happily welcomed.
The answer provided is for information only. Unfortunately, I cannot legally prescribe medications or offer a definitive diagnosis without performing a physical examination. If you have any concerns please contact your primary veterinarian, or contact an ER facility if this is an emergency. REMEMBER: Even after you click "ACCEPT" and your question closes, you can still review our discussion.
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