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My 10 year old male neutered boxer has been diagnosed with

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Hi. My 10 year old...
Hi. My 10 year old male neutered boxer has been diagnosed with pancreatitus. First episode was last July, another milder episode in September, and the worst was 3 weeks ago. Since the first bout he has been on Royal canine id gastrointestinal wet and dry food. He has done very well on this. He gets NO table food, and never is not on a leash. His poops are always solid in the morning, but lately in the afternoon they are not formed and myshy.
Submitted: 2 years ago.Category: Dog
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6/3/2015
Dog Specialist: VetTechErin, Licensed Vet Tech replied 2 years ago
VetTechErin
VetTechErin, Licensed Vet Tech
Category: Dog
Satisfied Customers: 681
Experience: Published author in veterinary medical journals and on the Veterinary Information Network with a focus in toxicology
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Hi there!
My name is ***** ***** I would be happy to help you with your question about your dog. Sorry it has taken so long for someone to get back with you!
Pancreatitis can be a tough thing to beat, especially in an older dog with a prior history. Flare-ups tend to be far more common once they've had a bout as well.
Diarrhea is definitely one of the signs that we can see with pancreatitis, but when we start to see severe bouts (as you saw three weeks ago), we tend to see it coupled with vomiting, lack of appetite, and abdominal pain and discomfort. Since you're not seeing any of these signs, I would not start to worry quite yet, as we can see bouts of mild diarrhea from a bunch of different things, especially when they're recovering from a severe bout of tummy upset like he experienced three weeks ago.
You've already got him on a bland diet, which is great. This will help to settle his tummy upset, and as excessive fat tends to cause pancreatic flare-ups, it is good to help keep the pancreas issues at bay. If you feed treats, I would stop giving those and instead use pieces of bland kibble for rewards. Sometimes it is necessary to cut out everything but the bland food that works.
You can try adding a little bit of fiber to his diet to help promote healthy stools. Plain canned pumpkin puree (not pie filling with the spices) is a good source of fiber in dogs, and a lot of dogs love to eat it when it is mixed in with their food. Along the same lines, if your dog was recently treated with a lot of antibiotics, adding a puppy probiotic (which you can get at a local pet store or through your vet) can help restore natural bacteria to the GI tract, as antibiotics can cause diarrhea by killing off these intestinal bacteria. Giving a little bit of Greek Yogurt can have the same effect.
Some vets will use plain Pepcid AC/famotidine at 0.5 milligrams per pound of body weight (This is 5 milligrams per 10 pounds) to help reduce acid production in the stomach that can lead to nausea, vomiting, and diarrhea.
It is important that you give you vet a call and mention the diarrhea so they can at least make note of it in their records, especially considering his history. If at-home cares do not clear up the diarrhea in a couple of days, your vet may want to do further testing like checking a fecal sample, rechecking pancreatic enzymes, or getting him on some stronger tummy meds to help with the diarrhea.
If he starts to show any of the other signs associated with pancreatitis such as vomiting, inappetence, pain, etc., that's when you will want to get him in immediately for treatment. Otherwise, you are perfectly okay to wait until your regular vet is open to contact them.
If you have any further questions or concerns, please feel free to hit reply and continue the conversation. Otherwise good luck and I hope he starts to feel better soon!
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Customer reply replied 2 years ago
His stool was formed somewhat this morning but soft. No way I could pick it up. I did give him 1 dose of imodium last night at 11pm. Normal color, no blood. He wouldnt eat this morning, and he was having borborgymi.
Dog Specialist: VetTechErin, Licensed Vet Tech replied 2 years ago
In some very recent studies, loperamide/Imodium has been found to increase the secretion of pancreatic enzymes as an unintended side effect. While so far the number of reported cases of Imodium causing acute pancreatitis is rare, this may be due to the fact that there is no previously known association between the two. Because of this, Imodium may not be the best option for a pet who suffers from chronic pancreatitis. (If you are interested in learning more about this, here is one of the initial few case reports: http://www.hindawi.com/journals/crigm/2013/517414/#B10)
Since it seems like the diarrhea has progressed a little and you're hearing gurgling even on loperamide (which serves to slow down the gut motility in order to increase the absorption of moisture from the intestines) coupled with the fact that he is not eating, it is probably best to get him into the clinic today.
So soon after his last bout of pancreatitis, it is best to get it under control as quickly as possible to prevent it from increasing in severity. While it is entirely possibly he could be having diarrhea due to an unrelated issues (such as IBS, bacterial imbalance, parasites, having nibbled on something that didn't agree with his stomach, allergies to an ingredients in his food, etc), it's important to ensure that he doesn't start to go downhill swiftly as you may h ave experienced in the past. It may certainly be something they'll be able to get a handle on that will allow you to treat at home and potentially give you some alternative medications to address the diarrhea and appetite issue.
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Customer reply replied 2 years ago
What can cause diarrhea if he eats the same food everyday, no treats, no table food. Can stress be a factor
Dog Specialist: VetTechErin, Licensed Vet Tech replied 2 years ago
Stress can cause diarrhea, yes. But most typically, these are bouts of mild soft stools, and we do not frequently see that coupled with a lack of appetite (unless they're in a situation like at a boarding facility and experiencing constant anxiety).
Some dogs just have sensitive stomach or develop sensitive stomachs as they get older, so the foods they easily tolerated when they were younger may cause them to have soft stools off and on. Dogs can also develop "allergies" to ingredients in their food which can cause issues like vomiting and diarrhea.
As I said above, since he was recently treated for pancreatitis, many vets will give antibiotics along with other medications for treatment, and antibiotics kill off the normal bacteria in the stomach which helps with the digestive process. Simply being on antibiotics can cause diarrhea.
There is also parasites, dietary indiscretion (eating something they shouldn't, like grass outside), toxins, medications they're on, IBS, etc.
These are just some of the more common causes. Unfortunately, diarrhea (like vomiting) can be caused by almost any disease process, and can be extremely difficult to narrow down.
However, given your dog's history of pancreatitis, he is battling what we call "chronic" pancreatitis, which just means frequent bouts of relapse or recurring pancreatitis. The diarrhea that has developed in conjunction with his lack of appetite may be an indication of another bout developing, and it is far better to get a handle on it when the signs are mild than for it to develop into a more severe condition.
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Customer reply replied 2 years ago
Took him to vet to rule out parasites, guardia etc... they were all negative. He did test positive again for pancreatitis. His last bout was only 2 weeks ago. Ultrasound showed nothing out of ordinary. Why are these attacks coming on so close together
Dog Specialist: VetTechErin, Licensed Vet Tech replied 2 years ago
It is an unfortunate aspect of pancreatitis. When a pet has an episode of pancreatitis, it puts them at higher risk of developing it again. The more frequently the pancreas becomes inflamed and irritated, the more "damage" is done to the pancreas, or the less it functions normally. The more abnormalities a pancreas has, the more frequently a pet will get pancreatitis.
Older dogs just happen to be susceptible to the disease and flare ups than younger dogs. His bouts could be due to diet (perhaps he needs to switch to a different brand that's easier on his tummy), or it could be a personal sensitivity. If he is overweight, this could be a factor. Your vet may want to check some further blood work to rule out things like Cushing's disease, hypothyroidism, or diabetes, as they may cause more chronic flare-ups of pancreatitis.
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Dog Specialist: VetTechErin, Licensed Vet Tech replied 2 years ago
Hi,

I'm just following up on our conversation about your pet. How is everything going?

VetTechErin
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