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Hello, my dog is a 7 month old golden retriever.
She's always having diarrhea problem ever since she is a puppy. At first my vet's thought she has parasites that causes the diarrhea, but later found out it's because the food. After change a few brand of dog food, she finally started to doing better with science diet (I also feed her probiotice and pumpkin with the food). Just about 2 weeks ago, she suddenly starts to eat very little and very slow amount, she doesn't finish the food I gave to her. I took her to the vet, the vet said she doesn't seems sick. The vet also give her a blood work, and the result says the same. Therefore I thought maybe she doesn't like the food. Yesterday, I start to change her diet to natural balance + pumpkin + old food. Just last night, she was having very bad diarrhea again, she cried in her crate all night, and I had took her out 4 times. She doesn't eat at all this morning, and she only had some water.
Hello, I'm Dr. Kara. I have over 20 years of experience as a veterinarian and I'd like to help with your concerns about Omi's chronic troubles with diarrhea and stomach upset.
I am very glad to hear that her blood tests look normal.
I do believe that she has food allergies and she may have a primary intestinal disease as well. I think that she may have developed a sensitivity to the food that she was eating successfully for a while and that led to stomach upset which decreased her appetite and now diarrhea.
It will be important to describe what sort of loose stools she has to try and localize the problem. Loose stools with mucous or bright red blood point more towards large bowel diarrhea or colitis, whereas just watery stools with no mucous point more toward small bowel disease.
Chronic diarrhea does cause changes in motility of the gut and can lead to reflux andvomiting. It can also lead to bacterial overgrowth in the gut. Probiotics such as Fortiflora or Benebac can help replace appropriate bacteria.
I know that she has had stool samples checked to make sure that parasitesaren't part of her problem in the past but have any been done recently? Have any other diagnostic tests been checked?
Has she had a fecal culture to check for abnormal bacteria such as clostridia?
Is she losing weight?
It is quite possible that she has a food allergy/sensitivity or inflammatory boweldisease and that she needs a different low residue, easy to digest food or ahypoallergenic food to be able to properly digest and absorb her food and not have loose stools. I highly recommend a trial of either Hills i/d or Purina Veterinary Diets EN. No treats, table food or edible chewies while she is on her food trial. If she does well she can eat these foods for life as they are balanced. Having had 2 dogs with inflammatory bowel disease I have a personal preference for Purina Veterinary Diets EN. Dogs with food allergies can benefit from Hills z/d or Purina Veterinary Diets HA.
Dogs with inflammatory bowel disease will worsen with stressful situations. Theremay be times when she will need medications too, such as metronidazole or evensteroids if that is her problem, but I have found that a consistent, easy to digest diet is very helpful for long term control.
There are other possibilities too.
Addison's disease, which is a poorly functioning adrenal gland, can lead to chronicdiarrhea and vomiting. These dogs cannot handle stress at all because their adrenal gland doesn't produce cortisone when stressed and their electrolytes can be off too if their adrenal gland isn't controlling that normally either.We see vomiting, diarrhea and sometimes physical collapse in severely affected dogs. Testing is an ACTH response test to check adrenal gland function and checking electrolyte levels. Treatment is steroid replacement therapy and electrolyte replacement.
Pancreatic insufficiency is another possibility. These dogs have a pancreas that produces a decreased amount of digestive enzymes, and the amount produced can wax and wane in some cases, especially early in the disease process. Testing is byrunning a blood test called a TLI which checks for digestive enzymes. Treatment is replacement of digestive enzymes at each meal. An easier to digest food would be expected to create less problems with digestion and as such less diarrhea.
Kidney and liver disease can cause diarrhea too, but I because her blood tests were normal I doubt either of these would be the problem.
Because this has been a chronic problem for Omi then more diagnostics need to be done. They can be as simple as fecal checks and cultures, or they can be more invasive such as biopsies of her gastrointestinal tract to look for inflammatory bowel disease (which would be likely) or infiltrative cancers such as lymphoma (not likely at her age).
To try and settle her stomach today you can try either:1) Pepcid-ac (famotidine) at one 10mg tablet per 20 to 40 pounds of body weightevery 12 hours.OR 2) Prilosec (omeprazole) at one 10mg tablet per 20 to 40 pounds of body weightevery 24 hours.These will reduce stomach acid and should help if this is related to simple nausea and gastrointestinal irritation.I would not feed her any food for 24 hours after the acid reducers are started. This should help stop gut spasms and restore normal gut motility. Small amounts of water or ice cubes given frequently are fine as he needs fluids after all that she has lost with diarrhea. You can give her pedialyte to replace electrolytes too but Gatorade is much too high in sugar which can make her intestinal irritation worse.
Today even with the fast you can start Kao-pectate at 1ml per pound or 1 tablespoon per 15 pounds of body weight every 6 to 8 hours. This is quite safe and will coat her irritated gi tract as well as absorbing bacterial toxins. You can use it for several days until her stools look normal. You can find kao-pectate at the drug store.If she has a tense painful abdomen, continues to have diarrhea after being on kao pectate for 24 to 48 hours, becomes very lethargic, begins vomiting or runs a fever greater than 103.5F then she really must be seen by a veterinarian as soon as possible. Make sure to take a fresh stool sample with you when you go.After her food fast start a bland diet of 1/3 boiled, lean hamburger (or white skinless chicken), all fats and juices drained off mixed with 2/3 boiled, plain white rice. Feed several small meals a day. You might wish to add 1 to 2 tablespoon(s) of canned pumpkin to each meal if you are seeing mucous in her stool as fiber helps soothe an irritated colon.Once she feels better (no diarrhea for 48 hours) start mixing in what will be herregular dog food very slowly, less bland more regular with each day. It should take a week or so to convert her back.
If Omi starts vomiting and feeling poorly though it would be best that she see a veterinarian now as anything you give her orally will just come back up worsening her dehydration.
Please let me know if you have any further questions.
Thank you for the rapid reply and very detailed. I do have a few additional questions that I hope to find the answers from you though.
Her first loose stool last night was a large bowl. After the first one, her stool became very watery-jelly like with mucous and small bowel afterwards, but no vomiting.
She is not losing weight. She jumped from 43 to 50lbs last time I weighted her. She is 7 months old female, is that a normal weight?
I fed her Hill's I/D for a very long time (she's being having diarrhea since I got her 8 weeks old) but vet told me I/D is not a long term solution since she is a growing puppy and need a lot of nutritions.
I just wondering what is the reason she start to eat less and slow thought? Some said it's because the weather, but I don't know. If she was doing good on science diet + fresh pumpkin, should I keep this diet? The reason I changed her diet was because she doesn't eat much, and puppy at her age should be eating like crazy isn't it?
I gave her some Kaopectate this morning, and I think the diarrhea have stopped. She is sleeping right now. The good new is that she just ate a little bit of her food sciences diet too. I still have a few cans of I/D. Should I switch back to I/D? or half I/D half sciences diet + pumpkin?
Last but not least, I know you have mentioned in your answer that she maybe has some inflammatory chronic bowel disease. I really want to know whether it's the disease or the food allergies cause her diarrhea or the both. What tests should I take her to run in order to find out?
Thank you for answering my questions.
Thank you for the additional questions. I'll answer them in order.
It sounds like she has a combination of what started as large bowel diarrhea (mucous) and small bowel diarrhea (watery) which happens when we have generalized bowel inflammation.
Although she isn't vomiting the fact that she isn't eating tells me that she has stomach irritation and upset as well.
It's difficult to say whether he weight is normal or not without looking at her but if she has a waist (tucked in behind her rib cage) and you can feel her ribs easily but not see them she is likely a good weight. 50 pounds sounds right for a 7 month Golden.
Your veterinarian is right in that i/d isn't ideal for growing puppies, they need more concentrated nutrition because they are growing, but if the pup is having severe diarrhea they aren't digesting and absorbing what they are taking in anyway so i/d is better at that point.
There can be several reasons that she began to eat less. One is by 7 months or so they are growing less rapidly and need less calories. Another may be that she may have become sensitive to a protein or carbohydrate in her food which led to stomach upset. If she wasn't having diarrhea and was maintaining weight on Science Diet then that may be the food for her.
At this point I would recommend i/d until her stools look normal and then gradually reintroducing Science diet and pumpkin, feeding a little less i/d and a little more Science diet at each meal. Done properly it should take a week or so to reintroduce her food. If however she is eating less, lethargic and starts losing weight and has diarrhea when on Science diet then I would switch to a different diet.
The only way to definitively diagnose inflammatory bowel disease is with biopsies of her bowel. The only way to diagnose food allergies is to get her on a hypoallergenic diet, clear symptoms and then introduce a food and look for a reaction. Both food allergies and IBD can cause diarrhea, vomiting, inflammation of the intestinal tract and weight loss. Food allergies can be a trigger that leads to IBD. By taking away triggers we can manage IBD better.
Let me know if you have any more questions.
Hello Dr Kara,
Omi is doing much better. After I gave her Kaopectate twice yesterday, her stool is back to the normal form, which is really good. I did what you said gave her I/D + old food + fresh pumpkin, and it works great.
Tho, she still doesn't eat much. She would eat a little bit and then go to sleep for a while and get up and eat some more, and just keep repeating it until all her "morning" food is gone, and then it's almost time for dinner.
She seems sleep a lot at home, but she is fine (by fine I meant she seems have good level energy) when outside. Outside is really hot tho, it's about 95 degree and inside it about 80.
I don't know if she doesn't eat has anything to do with the weather or something. But a friend also said she is in heat, I need to bring her to spayed quickly.
I do wish she can eat more and quicker, I'm worried because she is still growing.
Thank you for the update on Omi. I am glad to hear that she is getting better but I
understand your continued concern for her.
It's not uncommon for even sick dogs to get excited about being outdoors with all the exciting smells and sights, but I am glad to hear that she will play and gets energetic outside. That is certainly a positive sign. If you told me she was lethargic even outdoors I would be much more concerned.
With the higher temperatures where you are most dogs will be somewhat lethargic so that may be playing a part in her behavior too.
Is she maintaining her weight? If so then don't be too worried. Most of their rapid growth occurs in the first 6 months. Between 6 months and 2 years of age their growth rate slows down dramatically and thus so does their appetite. It is also true that heat cycles interfere with their appetite so that may be playing a part as well.
If she finishes her heat cycle, the temperatures go down and her appetite remains poor or she is losing weight then discuss using a more restrictive hypoallergenic diet (such as Hills z/d or Purina Veterinary Diets HA) with her veterinarian.
Of course intestinal biopsies would help to definitely diagnose her condition and thus help with a more comprehensive treatment plan because we would have a definitive diagnosis.
I know that you are worried but it sounds like she is feeling better. Let's give her a little more time and see how she does.