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Dr. Kara
Dr. Kara, Board Certified Veterinarian
Category: Veterinary
Satisfied Customers: 14883
Experience:  Over 20 years of experience as a veterinarian.
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My 7 yr. old mixed Terrier tends to have loose . I was wondering

Customer Question

My 7 yr. old mixed Terrier tends to have loose BM. I was wondering if I should try putting a little Cholestyramine in her food. Let me know what you think. Thanks...
My email is: *****@******.***
Perry James
Submitted: 1 year ago.
Category: Veterinary
Expert:  Dr. Kara replied 1 year ago.
Hello, my name is***** and I have over 20 years of experience as a veterinarian. I'd like to help with your concerns about Lucy's loose stools.
Cholestyramine is a bile acid sequestrant, which binds bile in the gastrointestinal tract to prevent its reabsorption thus it can be used to treat diarrhea resulting from bile acid malabsorption. This is not a common cause of diarrhea in dogs unless they have liver disease, so I don't believe that this will be helpful for Lucy. I do not recommend giving it to her.
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 and vomiting. It can also lead to bacterial overgrowth in the gut. Probiotics such as Fortiflora, Proviable, or Benebac can help replace appropriate bacteria. These are available over to counter and can be used as needed.
I assume that she has had stool samples checked to make sure that parasites aren't part of her problem. 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 bowel disease and that she needs a low residue, easy to digest food or a hypoallergenic 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 chronic loose stools may have inflammatory bowel disease, and that can be helped dietary changes and probiotics but will worsen with stressful situations. There may be times when she will need medications too, such as metronidazole or even steroids 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 for chronic loose stools too.
Addison's disease, which is a poorly functioning adrenal gland, can lead to chronic diarrhea 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 by running 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 would expect her to be sicker in general and diarrhea shouldn't improve with a change in diet.
In short if this has been a chronic problem for Lucy then more diagnostics can be done if she doesn't respond to probiotics and diet changes. They can be as simple as fecal checks and cultures, as well as a complete blood count and biochemistry profile to assess general health. Or they can be more invasive such as biopsies of her gastrointestinal tract to look for inflammatory bowel disease or infiltrative cancers such as lymphoma.
Please let me know if you have any further questions.