Yes, I'm a licensed vet and I've been practicing for over 25 years:) I do have a few questions to ask about Xenia first:1. Is this an entirely new problem or has she had intermittently loose stools in the past?2. Any vomiting or disinterest in food? 3. Why was Prozac prescribed?4. What do you feed her?
There may be a slight delay after I receive your answers since I have to type up a response to you. Thanks for your patience. Deb
Thanks so much for the answers to my questions.I have several thoughts about the cause of her diarrhea based on the information provided and then I'll address your specific questions. When presented with a dog who's had loose stools for this duration of time and blood work is negative (ruling out a systemic disease), then my list of differentials is likely to include the following: 1. Internal parasites such as whipworms, hookworms, roundworms, or giardia even though stool samples are negative for the following reason: Stool samples are not always positive when these parasites are present since eggs are not shed in every sample. So, a positive is a positive but a negative is not necessarily a negative, if that makes sense.Studies have actually proven this to be the case even when multiple stool samples are examined. This is my professional experience as well.2. I agree with your vet that Inflammatory Bowel Disease (IBD) is a strong possibility. These reactions are usually triggered by the food that the dogs have eaten for a while and are usually the protein and/or the carbohydrate sources found in them. It would take a biopsy to diagnose this problem which many owners are understandably reluctant to have done. The signs can be intermittent but even well-controlled dogs will have flare-ups on occasion. I usually run a gastrointestinal panel on these dogs to rule out a folate or B-12 deficiency as well as issues with the pancreas. It sounds like this was probably done already. This condition is usually managed rather than cured but most dogs do very, very well once the right combination of food and drugs are found. My approach to this problem would be to1. Worm her with Panacur and Flagyl together for six days. This combination of drugs will kill all of the parasites that I mentioned.2. Start a probiotic such as Forti-flora.3. Change the diet. I'd feed a bland diet first, depending on the protein source in the Blue food (chicken is usually the most common ingredient in most dog foods). If that's the case, then I'd feed her boiled hamburg and rice (in a ratio of 1 to 4), small meals through the day. If I'm successful and a normal stool is obtained, then I'd recommend a food that has a totally different ingredient label. There are many, many options available in pet stores these days.To address your specific questions:1. I love Flagyl as a drug for diarrhea issues, especially IBD. If I highly suspect IBD or have it confirmed and Flagyl isn't working after using it for several weeks, then I'll try Tylosin or even Pred. Three months seems excessive to me. Most dogs tolerate this drug very well, but side effects can be seen.To quote The Veterinary Drug Handbook by Donald Plumb:Adverse effects reported in dogs include neurologic disorders, lethargy, weakness, neutropenias, hepatotoxicity, hematuria, anorexia, nausea, vomiting, and diarrhea. Neurologic toxicity in dogs may be manifested after acute high dosages or, more likely, with chronic moderate to high-dose therapy.
Three months could easily be interpreted as "chronic" although I have used low dose therapy intermittently for those dogs with IBD who respond to it and have an occasional flare-up.
2. We certainly can see stress diarrhea, usually colitis, especially in Shepherds but I'm not certain how much that may be playing a role here.I've dispensed Prozac for dogs for anxiety but it can take several weeks to be effective. 3. Flagyl is the same drug humans take. I typically dispense it to my patients but it can be purchased at a pharmacy with a prescription.I hope this helps. Deb
You're welcome. You'd probably need a prescription for Panacur (aka Fenbendazole) but it can be purchased online. (LINK) This site indicates that it's over the counter so you may be able to purchase it without one.The protocol for hookworms, round worms and whipworms is once a day for three days straight but when I treat for giardia as well, I worm six days straight in combination with Flagyl as I mentioned above. I also worm all dogs in the household.And since giardia oocysts can cling to the fur and cause recontamination, bathing is recommended as is regular clean-up of the stool in the yard, if possible.As far as side effects, some dogs will vomit or have nausea after deworming but it's not common. It's a very safe wormer.There's a huge range for Flagyl, depending on what's being treated. If Xenia weighs about 60-70 lbs, then 500 mg bid sounds about right for IBD or most "simple" enteritis cases. I tend to dose 25 mg/kg bid for giarida which makes it 750 mg although some vets dose even higher than this. Deb
You're more than welcome:) There seems to be some confusion over whether a prescription is needed for Panacur because I've seen some sites which require it when purchased online, but it would be worth trying to purchase it from the site I provided since they clearly state that it's OTC.
I wouldn't hesitate to worm her; there is no harm in doing so especially since I'd want to rule out parasites as a cause of her problem.
I hope you'll keep me posted about her. Even after you've rated (if you do, of course), we can still continue to communicate at no additional charge to you. Good luck:) Regards, Deb
Thanks for the rating and bonus; it's greatly appreciated.I'll look forward to an update about your girl when you have time. Deb