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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 24467
Experience:  University of California at Davis graduate veterinarian with 44 years of experience
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My dog is having diarrhea, which was totally under control

Customer Question

My dog is having diarrhea, which was totally under control with the medications prescribed by my vet. She has inflammation of the intestine disease. I was giving her diuretics and Prednisone prior ttaking her to MSU for a complete ultrasound. They prescribed a prescription dog food, another medication, and to cut down the diuretic to once a day instead of twice. Prior to the appointment they wanted her not to have any medication or food. I fed her the prescription dog food and missed two doses of prednisone and now I have diarrhea. How can I stop this? Thank you
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Submitted: 8 months ago.
Category: Dog Veterinary
Expert:  Dr. Michael Salkin replied 8 months ago.

Can you tell me, please, why a diuretic was prescribed initially? I can understand prednisone being prescribed in order to address inflammatory bowel disease (IBD) but a diuretic is usually prescribed in order to address cardiac insufficiency. Prednisone is usually contraindicated when cardiac insufficiency exists and in that case, the antiinflammatory antibiotic metronidazole or another immunosuppressant drug such as azathioprine or chlorambucil should be considered.

Customer: replied 8 months ago.
A diuretic was prescribed because she had fluid built up around her heart and stomach area. She now has very little fluid around the back of her stomach. Her heart appears strong according to MSU and my vet. What can I do to stop this diarrhea? Could it be her diet and medication dosage time was changed? Thank you
Expert:  Dr. Michael Salkin replied 8 months ago.

Thank you for the additional information. I would see how a loading dose of prednisone affects her. This can be 0.5 mg/lb once or twice daily until her diarrhea abates and then tapered to the lowest effective dose. If that weren't helpful, yes, an abrupt change from her old to the new diet should be incriminated but in time the gastrointestinal flora should adjust to the new diet and her diarrhea abate. The exception to that thinking is if she were intolerant to a protein in that new diet. That isn't possible if the new diet contains hydrolyzed protein but is possible if the new diet contains a novel protein such as kangaroo, venison, whitefish, etc. Please continue our conversation if you wish.

Customer: replied 8 months ago.
other than reducing the dosage of prednisone I just need to wait for the diarrhea to subside? Is there anything I can give her to stop the diarrhea such as Kaopectate or Pepto-Bismol? If so what dosage do you suggest?
Expert:  Dr. Michael Salkin replied 8 months ago.

No, I suggested increasing the dosage of prednisone to a loading dose temporarily. If that weren't effective then waiting for her to accommodate to the new diet is reasonable. Kaopectate and Pepto-Bismol both contain bismuth subsalicylate. As a gastrointestinal coating agent or acute diarrheas it's dosed at 0.1-1 mL/lb of the liquid 3-4 times daily. It can worsen some diarrheas in pets sensitive to the salicylate so you'd need to stop its administration in that case. Over the counter loperamide (Imodium) is another consideration and dosed at 0.05 - 0.1 mg/lb every 8-12 hours. I don't know if her type of inflammation will respond to loperamide, however. Before trying this drug it would be prudent to consult with her vet.

Expert:  Dr. Michael Salkin replied 8 months ago.
Hi,
I'm just following up on our conversation about your pet. How is everything going?
Dr. Michael Salkin

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