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I have a 4 year old great dane who was presenting with

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I have a 4...
I have a 4 year old great dane who was presenting with vomiting and soft stools with mucous. He had lots of intestinal "gurgling" sounds and excessive gas as well. I took him to my vet and he was diagnosed with clostridium with many spores. Also sent a stool culture which was negative. No worms or giardia or coccidia either. Blood work was normal. We did a 10 day course of metronidazole but even while on the metronidazole his symptoms remained the same. After the course of metronidazole was finished his other symptoms (gas, gurgling, vomiting) returned as well. Repeat stool examination showed same overgrowth of clostridium. So we tried a 2 week course of amoxicillin. All symptoms abated within days. Also started adding pumpkin and more probiotics to his food. He completed the entire two week course of amoxicillin. Now he's 6 days out from finishing the amoxicillin and stool is soft and mucous again. Multiple small stools. Why can we not seem to clear up this clostridium? What is the next course of action?
Submitted: 2 years ago.Category: Dog Veterinary
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Answered in 2 hours by:
3/7/2016
Dog Veterinarian: Dr. B., Veterinarian replied 2 years ago
Dr. B.
Dr. B., Veterinarian
Category: Dog Veterinary
Satisfied Customers: 23,471
Experience: Hello, I am a small animal veterinarian and am happy to discuss any concerns & questions you have on any species.
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Hello & welcome, I am Dr. B, a licensed veterinarian and I would like to help you today. I do apologize that your question was not answered before. Different experts come online at various times; I just came online, read about your wee one’s situation, and wanted to help.

Now I am glad to see that your local vet has tested a stool sample and thus ruled out a lot of potential causes for Jones's signs. That said, if we are seeing a relapse after his most recent treatment, then we do need to consider a restest of the stool to definitely confirm that the Clostridium is still our active problem (especially since the use of antibiotics can be change the microflora such that other agents can rear their heads).

Otherwise, if this is confirmed, then we will likely need to plan a longer course of treatment. In fact, research on this type of Clostridium induced chronic diarrhea has found that extended courses of antibiotics were needed to get the bacteria cleared. In studies, Amoxicillin (22 mg/kg given every 12 hours) was used for at least 4 weeks. Though for more chronic cases, these tended to respond to the use of powdered Tylosin. As well, the use of dietary fiber like the pumpkin is indicated since it can help push clostridial spores from the gut and lower colonic pH, which prevents spore activation. And since some of these can linger for the long tem despite treatment, some dogs do benefit from long term treatment of Tylosin (given every other day) in conjunction with dietary fiber supplementation to prevent clinical recurrence.

So, with this all in mind, we may want to recheck the stool sample to see if this is still our trigger for Jones's signs but otherwise we will need him on a longer course +/- Tylosin to help settle this for him.

Please take care,

Dr. B.

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