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I've got a 5 month old French Bulldog. She has had Diarrhea

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I've got a 5 month...
I've got a 5 month old French Bulldog. She has had Diarrhea since the day we got here (around 11 weeks old). The vet has checked the fecal for parasites and that is always negative. They have put her on two kinds of antibiotics (at different times). First was Albon Liquid and the other was Metraonidazole. Both were effective in stopping the diarrhea but ever time we stop it the Diarrhea comes back immediately and worsens the longer we are off of it. We have tried three types of food and also just plain white rice while off of it and no food changes seem to help. We are currently using a Salmon prescription food. She is currently on Albon, administering 7.5 ML at night. in the morning her BM is great but by 5:00 the next day it has already started to soften up. Our Vet doesn't have any other ideas and keeps doing the same thing, which is frustrating, does anyone have any ideas?
Submitted: 2 years ago.Category: Dog Veterinary
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Answered in 2 hours by:
11/14/2015
Dog Veterinarian: Dr. Michael Salkin, Veterinarian replied 2 years ago
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 31,784
Experience: University of California at Davis graduate veterinarian with 45 years of experience
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I'm sorry to hear of this with your Frenchie. Please note that fecal ova and parasite exams are too often falsely negative. It's prudent to presumptively treat with an anthelminthic (please see below). Albon (sulfadimethoxine) will address coccidia. Her response to that antibiotic suggests that coccidia was a problem at one time. It shouldn't be a problem at 5 months of age, however. The response to metronidazole suggests that a Clostridial infection or inflammatory bowel disease (IBD) was/is present. Metronidazole has nonspecific antibacterial, anti-inflammatory, and immunomodulary (suppresses the local GI immune system) properties and so its effect is difficult to evaluate in terms of just what it's treating. Here's my synopsis of how I address such a patient:

1) 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 your dog's vet's 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 her 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). 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) Scoping and biopsy of her gastrointestinal tract is indicated. We're looking for inflammatory bowel disease (IBD) or lymphangectasia - a protein-losing enteropathy - mainly. This invasive procedure isn't performed soon enough in too many patients.

Please respond with further questions or concerns if you wish.

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Dog Veterinarian: Dr. Michael Salkin, Veterinarian replied 2 years ago
Hi Brian,
I'm just following up on our conversation about your pet. How is everything going?
Dr. Michael Salkin
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Dr. Michael Salkin
Dr. Michael Salkin
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