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For nearly three months diarrhea. Tried three different

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For nearly three months...

For nearly three months diarrhea. Tried three different foods, three treatment of antibiotics, chalk, stool sample,probiotics and blood tests. She is active, downs her food quickly, no vomiting, slight blood when the strains. Bowel movements more frequent and wetter. Other than that she's happy, active, coat is glossy. 65 Lb, Black Lab,female, 8.5 yrs.

Veterinarian's Assistant: I'm sorry to hear that. Hopefully it didn't make a mess. Did the dog eat anything unusual?

Not that we're aware of.But her stool sample came back negative.....this has been going on since the first part of July. Vet stumped.

Veterinarian's Assistant: What is the dog's name?

Bootoo

Veterinarian's Assistant: Is there anything else the Veterinarian should be aware of about Bootoo?

I can't imagine what that could be,

Submitted: 11 months ago.Category: Dog Veterinary
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Answered in 4 hours by:
9/23/2017
Dog Veterinarian: Dr. Michael Salkin, Veterinarian replied 11 months ago
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 35,542
Experience: University of California at Davis graduate veterinarian with 45 years of experience
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You're speaking to Dr. Michael Salkin. Welcome to JustAnswer. I'm currently typing up my reply. Please be patient. This may take a few minutes.

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Dog Veterinarian: Dr. Michael Salkin, Veterinarian replied 11 months ago

I'm sorry to hear of this with Bootoo. This is how I address dogs such as she:

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 Bootoo's vet 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 BooToo's 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 because it avoids the possibility of her being intolerant to even a novel protein). 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) Abdominal ultrasound (which is particularly sensitive in evaluating the gastrointestinal tract itself) and/or scoping and biopsy of her gastrointestinal tract is indicated. We don’t perform scoping and biopsy soon enough in too many of these patients. We're mainly looking for inflammatory bowel disease (IBD) or lymphangectasia - a protein-losing enteropathy (intestinal disorder) but need to be concerned with infiltrative malignancy such as lymphoma and solid tumors such as gastrointestinal adenocarcinoma as well.

Please respond with further questions or concerns if you wish.

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Dog Veterinarian: Dr. Michael Salkin, Veterinarian replied 10 months ago
Hi,
I'm just following up on our conversation about your pet. How is everything going?
Dr. Michael Salkin
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Customer reply replied 10 months ago
We’re on the third dry food, currently Royal Canin Hydrolyzed Protein Adult HP, previously Hill's prescription diet, Digestive Care I/D low fat, can’t remember the first one. Drugs; (first)Metronidazole 500mg 14 days,(second) Enroflox 136 mg 1 daily 10 tablets, (third..but second iteration) Panacur (fenbendazole) 1.4 ml (powder)twice daily ( for the past four weeks) Early on, July RX Clay and RX Biotic. The condition continues to progress poorly. Started with soft stools now very wet/liquid 6 to 8 times a day. She’s lost some weight but still ravenous appetite 1 cup at breakfast and one at dinner….gone in less then 1 minute. Coat is beautiful eyes bright, active, jumps in circles at feeding time. We feel we’re losing her. She’s had the blood panel and stool sample.
Dog Veterinarian: Dr. Michael Salkin, Veterinarian replied 10 months ago

Thank you. You're at the point at which scoping and biopsy should be considered. You're likely to have your answer within 72 hours of that procedure.

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