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Hello my name s Dr. Emily Bemrose, and I am happy to try to help. I have been a small animal veterinarian for ten years, and also practice veterinary acupuncture. I'm sorry to hear about Kenji, diarrhea for four months is no fun for he or you! I just have a couple of questions for you. Firstly, what diet did you change him to, is he still currently on it? Have any of there therapies you have tried so far improved or eliminated his diarrhea while he was on them? And lastly has prednisone been tried at all yet? Getting this information will help me better advise you. Thanks!
If he had giardia, which i think is what your referring to, sometimes metronidazole is not effective at treating it, and the current recommendation is to treat with a medication called panacur instead. You would need to get this from your veterinarian. I would recommend that as the next step, if it hasn't already been done. The diagnostics to get intestinal biopsies are of course nice, because they tell us what we are treating precisely, but often times when my clients haven't been able to spend that kind of money I have treated based on what I think the most likely underlying cause is, and if they respond, I feel like thats the most important thing. If the panacur has been done, or doesn't help, it may be worth it to talk with your veterinarian about trying prednisone if they think it would be appropriate based on the the diagnostics that have been done so far. Prednisone is often effective in treating protein losing enteropathy, and also is useful in conditions such as inflammatory bowel disease which is another possibility for Kenji. As far as diet goes, if it is a protein losing enteropathy staying on the hydrolyzed diet is going to be important, even though it didn't do the trick by itself. This is also a good diet for food intolerances or inflammatory bowel disease so I would continue it regardless for a little while at least while you give some of these other therapies a try. From a holistic approach cooking a special diet for Kenji may be another option, and there may be some herbal remedies out there that can address his diarrhea. You would need to find a veterinarian that specializes in chinese herbal medicine to give these therapies a try. I hope this information helps!