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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 23838
Experience:  University of California at Davis graduate veterinarian with 44 years of experience
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My one year old Boxer seems to have a permanent loose stool.

Customer Question

My one year old Boxer seems to have a permanent loose stool.
What could the reasons for this be and how do I correct this
Submitted: 3 months ago.
Category: Dog Veterinary
Expert:  Dr. Michael Salkin replied 3 months ago.

Hamish, the following is how I approach chronic diarrhea in dogs:

Presumptively treat for gastrointestinal parasites with 7 consecutive days of fenbendazole. Fenbendazole is effective against all of the common nematodes (roundworms, hookworms, whipworms) as well as the protozoan Giardia. It's available over the counter in pet/feed stores as well as at his vet hospital. Routine fecal ova and parasite exams are too often falsely negative; hence, the need for presumptive treatment. If a positive change isn't seen...

2) Have a diagnostic panel of blood/urine tests performed. The panel should contain a specCPL blood test which is the most specific of the blood tests for identifying the presence of pancreatitis. It should also contain a TLI blood test which is the gold standard for detecting exocrine pancreatic insufficiency - a failure of the pancreas to produce enough digestive enzymes (maldigestion). To be very complete, serum vitamin B12 and folate levels should be performed as well. Malabsorption disorders (digested food isn't being absorbed properly) are suggested by lower than normal serum levels of these micronutrients. If nothing untoward is found...

3) Consider a food intolerance. Food intolerance/allergy is addressed with prescription hypoallergenic diets. These special foods contain just one novel (rabbit, duck, e.g.) animal protein or proteins that have been chemically altered (hydrolyzed) to the point that his immune system doesn't "see" anything to be allergic to. The over the counter hypoallergenic foods too often contain proteins not listed on the label - soy is a common one - and these proteins would confound our evaluation of the efficacy of the hypoallergenic diet. The prescription foods are available from her vet. There are many novel protein foods and a prototypical hydrolyzed protein food is Hill’s Prescription Diet z/d ultra (my preference because it avoids the possibility of her being intolerant to even a novel protein). A positive response is usually seen within a few weeks if we’ve eliminated the offending food allergen. Food intolerance can arise at any age and even after our patient has been eating the same food for quite some time. If such a dietary trial isn't helpful...

4) Abdominal ultrasound (which is particularly sensitive in evaluating the gastrointestinal tract itself) and/or scoping and biopsy of his gastrointestinal tract is indicated. We're looking for inflammatory bowel disease (IBD) or lymphangectasia - a protein-losing enteropathy - mainly. There's also a boxer granulomatous enteritis/colitis that needs to be considered. This is considered to be a variant of IBD in which a histiocytic ulcerative colitis is found. This is diagnosed by scoping and biopsy.

I understand that you're likely to be constrained by how much you can have done for him where you live. Please respond with further questions or concerns if you wish.

Expert:  Dr. Michael Salkin replied 3 months ago.
Hi Hamish,

I'm just following up on our conversation about James Watson. How is everything going?

Dr. Michael Salkin

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