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Doc Sara
Doc Sara, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 952
Experience:  I am a dog and cat veterinarian with a lifetime of experience in our family veterinary hospital.
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My english mastiff has had diarrhea and soft stools (and sometimes

Customer Question

my english mastiff has had diarrhea and soft stools (and sometimes fatty/gel-like) for about two weeks. he has had a wormer to rule out worms/giardia, he eats grain-free food...we live in the country and he may have eaten coyote/deer feces. What can i do to help him? He has to go outside every two hours to try to go. He is gassy and uncomfortable, but his appetite and demeanor are as good as ever.
Submitted: 7 months ago.
Category: Dog Veterinary
Expert:  Doc Sara replied 7 months ago.
Hi there, I'm Dr. Sara. I'm a licensed veterinarian who works exclusively with dogs and cats. I'm sorry to hear that Rufus has been having diarrhea. I will do my best to help. Did the diarrhea seem to change or improve at all with any treatments your vet has tried so far? If so, which ones? Have you tried a diet change yet? I know that your vet has already done some of the things I'm about to suggest, but for completeness's sake, I'm going to show you my thought process on diarrhea cases from the beginning: Diarrhea can be caused by really simple things like bacterial infections or imbalances, viral infections, dietary intolerances, or intestinal parasites. If he's taking a monthly parasite preventive like Heartgard or Interceptor, this makes parasitism less likely but still not impossible - microscopic parasites like giardia and coccidia aren't covered by these preventives and sometimes can cause diarrhea. I know that your vet has hopefully covered these bases well already with a deworming medication like Drontal Plus or Panacur (Fenbendazole) and/or a course of a drug called metronidazole. I know that you've tried a bland diet for a few days, but it may be worthwhile to go a little longer with it. A bland diet consists of about 3 parts rice to 1 part boiled white chicken breasts. - I would continue this until things start to firm up or we move on to a diet trial. Another good idea would be to purchase a dog specific probiotic product like FortiFlora to help re-establish the right type of bacteria in the gut:http://www.amazon.com/Purina-Fortiflora-Canine-Nutritional-Supplement/dp/B001650NNW/ref=sr_1_1?s=pet-supplies&ie=UTF8&qid=1444322278&sr=1-1&keywords=fortiflora As the vet, I usually will start with a diarrhea case with a course of a medication called metronidazole which helps rebalance the gut and is also anti-inflammatory, a broad spectrum deworming, and the FortiFlora and bland diet. If that's not helping within a week or two, I usually will suggest running some blood work to make sure that everything is functioning OK inside. This may be where you are in the process. Sometimes we also need to send some blood out to the lab to check the pancreatic function and B12 levels, as problems with those can cause chronic diarrheas that won't respond to your typical treatment. I may also send out a fecal PCR test to check for a wider variety of infectious diseases. At this time, we will often try either a prescription food trial of a highly digestible food like Purina EN or a hypoallergenic food like a hydrolyzed protein source product like Hill's z/d Ultra - these are my usual choices but there are a wide variety of appropriate diets available, so your vet may choose something else. If all of the testing checks out normally and there's no improvement with a diet change, your next step would likely be an abdominal ultrasound or potentially GI biopsies. This is usually the best course of action to determine the underlying cause for the diarrhea. In a young dog, getting an appropriate diagnosis is really important, since treatment may require life long therapy with drugs that can have significant side effects. We typically do not want to embark on a long term course of medication in a young dog without first knowing exactly what we are treating. If further testing is out of the question, a course of prednisone is one of my last ditch efforts for pets with chronic diarrhea who haven't responded to anything else and have all the other testing come back normal. This is because inflammatory bowel disease or intestinal lymphoma can cause GI signs and it responds quite well to prednisone. The only down side there is that we don't know which disease we have initially, because they both respond well. The difference is that IBD can be managed for long periods of time, which lymphoma usually only responds for a few weeks to a couple of months. I hope that this info is helpful to you - please let me know if I can answer any other questions.~Dr. Sara ----------------------------------------------------------------------------------------------------------------------------My goal is to provide you with the most complete and accurate “five star” answer. If my answer isn’t what you were expecting, it’s incomplete, or you have more questions PLEASE REPLY to let me know what information you are looking for BEFORE giving me a negative rating! If my answer has been helpful to you, please show me by giving me a favorable rating. Thank you so much :)
Customer: replied 7 months ago.
my other issue is that my mastiff does not like other dogs and is fear aggressive with people, which makes getting him to the vet very difficult. i have tried everything you've suggested except metronidazole. the stools have varied between oatmeal and water, but have not been immediate responses to anything i've done (oatmeal consistency followed by water followed by oatmeal again). he also has gas/feces blowouts, with him not realizing that the gas was water feces and having accidents in the house. I did notice him eating something on one of our dog walks (i think coyote poop) and he's been having this issue since that time. nothing prior to that day. i can get metronidazole online, so i could try that. i could also extend the bland diet further.
what i wanted to avoid is scheduling an after hours trip to the vet (bcuz he will be aggressive to other pets), trying to protect the vet and vet techs from rufus being scared, just so they can do a bunch of tests that won't matter in the long run, and then I'll need to bring him back for more serious tests later. the more i bring him into the vet, the more unhappy and aggressive he will become. thus, i'm trying to determine what i can do at home to determine if this is serious enough for a vet trip for xray/ultrasound/etc...as that can be very dangerous/problematic.
Customer: replied 7 months ago.
oh, and this is an english mastiff, so, at 4 years old, he is no young dog. the life expectancy is 7-9 years.
Expert:  Doc Sara replied 7 months ago.
I understand your hesitation to take him to the veterinarian in order to spare him stress and endanger all involved. Your vet may be able to make some suggestions on diets (particularly the prescription diets I mentioned) and prescribe a course of anti-diarrhea medication and a full deworming. If he hasn't had a full course of fenbendazole or metronidazole then giardia is still a possibility. A very simple test run on stool sent to the lab can determine if giardia, hook worm, round worm, or whip worm is a potential despite your treatments so far. That's another thing that can be done without actually taking him in to the vet. The fecal PCR to look for infectious agents also would not require that he go in to the clinic. What other questions can I answer for you?~Dr. Sara
Customer: replied 7 months ago.
i did the full three days of fenbendazole to rule out worms/giardia. and i do have anti-diarrhea meds, but have ceased using them so that the stool can be evaluated.
i have recently moved and don't have a current vet. most vets say that they cant do any tests (fecal or otherwise) without an office visit (and other money-making efforts). he is in excellent health, always has been...just has this issue that started about two weeks ago. i don't want to go to a vet where they'll decide that i need $1200 in tests and xrays, only to find out that the problem would've righted itself over time. but i have done all else that you mentioned (food change, wormer, anti-diarrhea meds, probiotics, etc. i also read that a simple fecal test does not show giardia and will have to be done on three different occasions to even see a possibility of giardia. the SNAP giardia test is the only one that i read which will actually show giardia, whereas the typical giardia fecal test is a guess at best.
Customer: replied 7 months ago.
the fecal PCR test sounds like a good one, but i think they'll require an office visit, physical exam, assorted useless testing...and finally the PCR test that i want. but that will require a financial investment rather than simply running the tests that I need. if they could simply run all of the fecal exams without a visit and find nothing, then yes, i can see the need for coming into the office for a more thorough exam/blood work/etc, as new things would need to be checked. but i dont know that a vet can just accept a stool sample from me and do the tests that i want. can they?
Customer: replied 7 months ago.
also, i do have a microscope at home...would i be able to check a fecal swipe myself...or does the scope need to be of a particular magnitude? just curious.
Customer: replied 7 months ago.
i guess you had to go to work?
Expert:  Doc Sara replied 7 months ago.
You are quite right - I did have afternoon appointments and children to get fed bathed and to bed this evening. Thank you so much for your patience :) To answer your question - I doubt that it's likely that a vet will send out lab work on a pet that they have not examined, as they'll not be able to make any recommendations on treatment without establishing a valid veterinary client patient relationship, which legally requires that the vet do a physical exam (not a money making scheme, a law). We do run fecal flotations in our own lab sometimes at my hospital for non-clients with the understanding that if they want any interpretation or advice on the results they'd need to schedule an exam so that we can do so legally. The issue is less about the test and more about what happens after - why do I want to run a test if I can't legally interpret the test and make treatment recommendations? If a client requests a particularly expensive test (like the PCR, which is over $200 in my practice) then I suggest that they schedule the $40 office visit with me to discuss the issue and make sure that it's the correct test to be sending out. More often than not we come to the conclusion that there are other simpler things that need to be tried first (like the things I've mentioned in previous posts) and that the PCR is overkill. I don't want to waste my clients' money (by sending out an inappropriate test) any more than they do. You've been very thorough so far in you attempts to resolve the problem, however you are also right that this could pass on its own. I obviously cannot make that guarantee, though (even if I am able to do a physical exam). Giardia is notoriously difficult to locate in a fecal smear, which is why the ELISA snap test was developed. This is the test to which I was referring in my previous post. Some hospitals can do it in house, we send ours to the reference lab. The way fecals are read for hook, whip, and round worm requires preparation with a fecal flotation solution and a centrifuge, which is beyond the scope of what I feel that I can describe with proper justice in this venue. Thanks again for your patience in awaiting my reply. Let me know if I can handle any other questions for you.~Dr. Sara
Customer: replied 7 months ago.
I didn't mean to insult you with the "money making scheme" comment...it referred to the Banfield centers which are some of the only few vet clinics in my area. They are notorious for including unnecessary things just to pad the bill.
I guess my final question is this: how long should i wait for this to clear up on its own before I have to force the vet visit?
Expert:  Doc Sara replied 7 months ago.
I understand. Diarrhea that goes on for more than 3-4 days that doesn't respond to a bland diet is cause enough for me to seek veterinary care (whether it be by a phone call to a vet with whom you've got an established relationship or having an actual exam). Your circumstances of having recently moved are unfortunate for this situation, as most vets who have established a relationship with a patient already are willing to prescribe medication or run some tests without requiring an exam. The hitch here is that you haven't had the opportunity to establish that relationship yet, so you'll have to do so in order to get the basic level care. Perhaps your old vet would be willing to call in a prescription or make other recommendations if you describe your situation? They are likely familiar with how difficult your guy is to handle and might be willing to help out. I know I would if it were my patient.~Dr. Sara----------------------------------------------------------------------------------------------------------------------------My goal is to provide you with the most complete and accurate “five star” answer. If my answer isn’t what you were expecting, it’s incomplete, or you have more questions PLEASE REPLY to let me know what information you are looking for BEFORE giving me a negative rating! If my answer has been helpful to you, please show me by giving me a favorable rating. Thank you so much :)
Customer: replied 7 months ago.
and, say, he starts having regular formed stool for a few days and then it goes back to the same watery thing as before. is that more indicative of one problem over another? what if he was regular for a month and it returned?
Expert:  Doc Sara replied 7 months ago.
I've seen intestinal parasites have quite a cyclical nature of on and off diarrhea. This is because at any given time you can have parasites in different stages of maturity. Depending on the parasite you can have as long as a couple of months between the time of exposure and the time the parasite reaches the intestines and can cause issues. This is called a "pre-patent period". Deworming medications like fenbendazole are not systemically absorbed (they stay in the GI tract) so they don't kill any larva that are migrating in the body elsewhere. IBD can be cyclical especially if it's a dietary issue and the exposure to the offending antigens is intermittent. IBD that is not driven by diet can also wax and wane with no apparent rhyme or reason. Something cancerous like intestinal lymphoma is unlikely to abate, even with treatment. It's a bit early to be convinced it's something more serious yet since it's been only two weeks and he hasn't had any metronidazole yet. Most diarrheas end up being "idiopathic" in that we treat it symptomatically and it goes away - we do not know what caused it, and it doesn't matter as long as it responded to symptomatic care and the pet is back to normal.~Dr. Sara
Customer: replied 7 months ago.
while i realize that you cannot advise on this particular aspect, but...if it was you in this situation and you had access to metronidazole from a previous prescription that has not yet expired, would you give that to your dog to see if symptoms abate...or would you take the dog into the vet so that they can prescribe the same thing? i realize that the dosage is by weight of the dog.
Expert:  Doc Sara replied 7 months ago.
I have to legally suggest that you see your vet. I'm sorry - I can't risk my license and ability to continue to work as a vet and feed my family by advising you to medicate your pet. I hope that you can understand :)Thanks so much~Dr. SAra
Customer: replied 7 months ago.
i'm not asking for actual advice, i'm just asking that if you had two dogs, one of which had a recent prescription for metronidazole, would you use that on the second dog rather than leave it sitting in medicine cabinet? the dogs weights are different, so i would have to adjust, but i don't see why it would be a problem to use that, as i have it available. it's not as though i'm giving him morphine, it is just an antibiotic/anti-inflammatory. i realize that you can't give me the advice on medicating my animal, but you could provide a "what-if" as though it were your own animal (vets do this all the time...as do physician's--"if it were my kid, i would...". that's all i'm asking.
Customer: replied 7 months ago.
or how about a more pointed question: i have metronidazole that i have left over from my other dog earlier this year. i plan to dose my sick dog with this--adjusting for weight. do you think i will run into serious problems by doing so? i realize that you cannot prescribe this action, but can you tell me of any dangers i might run into if i decide to do it anyway?
Expert:  Doc Sara replied 7 months ago.
Friend, I do not think that I can comfortably give you any more information than I already have. If he were my dog, I would call a veterinarian with which I had a relationship (like my old vet) or have him examined by a new vet for further instruction. I'll opt out to allow another expert to enter the conversation if they wish. ~Dr. Sara
Customer: replied 7 months ago.
how about this question: how soon after giving my dog fenbendazole can i give him drontal plus?