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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog
Satisfied Customers: 28578
Experience:  University of California at Davis graduate veterinarian with 45 years of experience
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Constant diarrhea since 2/12. Went thru 2 different sets of

Customer Question

Constant diarrhea since 2/12. Went thru 2 different sets of Xrays, Metronazadole twice (started w/low dosage and then 2 a higher), 2 different sets of blood work; and thru it all has been on the bland diet of boiled chicken and rice; starting w/pumpkin added. Tomorrow off for an ultrasound. Thinking pancreatic issues, but the bloodwork never detected that. Meanwhile, the dog has lost a lot of weight and no doubt her butt hurts. Mentioned slippery elm to my Vet yesterday and he thinks it's worth a try. Looking at different applications (capsule, powder, liquid) and dosage for my dog, but her weight keeps dropping and quickly, and this will be tricky to introduce while they're still trying to figure out the cause.
JA: I'm sorry to hear that. What is the dog's name?
Customer: Davita
JA: Is there anything else important you think the Veterinarian should know about Davita?
Customer: She was a healthy, happy greyhound until this started on 2/12. She ate something on a walk, in the yard, who knows. Most times in the yard with a muzzle because of her having to eat everything, but noitt on the walks and it's always stopping to clear her mouth. We're ruling out an intestinal blockage based on the xrays.. Metronazadole should have cleared any infection if there was one.
JA: The Veterinarian will know if Davita will be able to digest that. OK. Got it. I'm sending you to a secure page on JustAnswer where you can place your fully refundable $5 deposit (plus $14 after the Veterinarian responds). While you're filling out that form, I'll tell the Veterinarian about your situation and connect you two.
Submitted: 1 year ago.
Category: Dog
Expert:  Dr. Michael Salkin replied 1 year ago.

I'm sorry that your question wasn't answered in a timely manner. It appears that there isn't much I can add. In most cases before I entertain any diagnostics I'll presumptively treat with fenbendazole for 7 consecutive days even if a fecal ova and parasite exam were negative for parasites. Fenbendazole is broad spectrum against all of the nematodes - roundworms, whipworms, hookworms - as well as the protozoan Giardia. If I don't see a positive response I'll perform diagnostics in the form of blood and urine tests including a specCPL blood test which is most sensitive for the presence of pancreatitis and serum folate and cobolamin (vitamin B12) levels which can help localize where a primary gastrointestinal disorder resides. A TLI blood test looking for exocrine pancreatic insufficiency would be elective. It's not something that presents as a peracute (sudden) onset disease.

If nothing untoward is found in such testing, a hypoallergenic food trial should be considered. Once again, this isn't something I would expect to arise peracutely. 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 (a hydrolyzed protein diet is 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 a food trial is to no avail I might see if she suffers from a dysbiosis - an imbalance in gastrointestinal flora. I would address this with a potent broad spectrum antibiotic such as enrofloxacin. Metronidazole is the antibiotic of choice for Clostridial and Campylobacter infections but isn't as broad spectrum as enrofloxacin. Should I not see a positive response to enrofloxacin, abdominal ultrasound or, preferably, scoping and biopsy of her GI tract would be my next diagnostic of choice.

Please respond with further questions or concerns if you wish.

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