(NN) I need your thinking caps - chronic diarrhea

[NewfMom]

This is about the boxer mix we adopted last fall (boxer with a long nose). He came to us about age 4, intact, a walking skeleton with stage 4 hearworm disease. He also has a very low pain threshhold and is a fearful, fear aggressive dog.

We clip his toenails when he is out for another procedure. He is at the point now where we can pet him along his whole back and look at his ears (although not yet clean them). His favored vet can now draw blood with a muzzle on and him grumbling but not actively struggling.

He is a dog who is happy and sweet when he is following the same routines with the same people in the same places. He still jumps if you pet his back while he is out going to the bathroom. He slinks instead of trotting if you are walking him and go to a different path than usual. He is more confident around my son who is "his person".

He is heartworm free now but we have been battling chronic diarrhea for many months now. We are having a very difficult time finding the cause.

He gets progressively worse until he is passing stools with the consistency of water with some blood mixed in and then will start throwing up even water.

His vitamin B ratios indicate the problem is somewhere in the small intestine. Addison's and EPI have been ruled out with blood tests.

Drugs he has been on while we've had him:

• Doxycycline
• Metronidazole
• Albon
• Prednisone - causes pee accidents
• Panacur - for a while this was most effective and he has taken it repeatedly but it is less effective now

We have been feeding him white rice and boiled chicken breasts along with occasional yogurt and probiotics for several months. Dropping back to just rice when it gets really bad.

When he gets bad the rice passes through unchanged or is returned unchanged hours later.

He is currently at the stage where his stools are like water when he goes outside but he is not yet having accidents in the house this go round.

He is usually very bouncy regardless of his diarrhea and always has a tremendous appetite whether he can keep the food down or not.

Last week he was on prednisone again and his urine had a very strong ammonia smell.

We have not been able to put a pattern on these bad spells except that they are getting more frequent and the panacur that used to help is getting less effective.

Things I have been wondering about trying are Metamucil cookies for fiber or valium.

The next test we could run is an endoscopy which is problematic on a dog so fearful with a low tolerance for pain.

I'm not seeing any allergy signs like bad ears or chewing his feet.

Any ideas?

 

[Jeannie]

I have to keep Adam on a low dose of Metronidazole all the time or he has loose stool too. Never did find out why, we just know what helps.

Have you tried allergy testing for food allergies?

 

[Angela]

Have you tried pumpkin?
About 2 years ago all my guys had rip roaring diarrhoea which was treated with Metronidazole. At that time I added pumpkin a tablespoon twice a day and have continued it ever since.
Hope you can get it under control, sounds like the poor guy has enough problems without that.

 

[DAWNMERIE]

I was gonna ask if you've tried oatmeal? Usually takes a few feedings. And I think that Dr. Becker recommends brown rice instead of the white, can't remember why? I'll see if I can find the video shortly. She's actually got a few new video's that are very interesting.

 

[NewfieMama]

He came to you intact - have you neutered him? Cooper had the WORST stomach till he was neutered, now he eats everything. And everything made him vomit/have diarrhea, even in small amounts, like a crust of bread or 2-3 pieces of plain penne...no idea if it's connected and that's not why we neutered him but it did coincide with his tummy troubles going away.

 

[nowhavethreebears]

White rice can speed up the digestive process...Long term I would go with pumpkin or brown rice...

 

[OodlesOfNoodles]

We used boiled sweet potato and turkey with great success when we had issues; I don't think the rice was sitting well with him.

 

[Ginny]

Since he's been on so many antibiotics, probiotics are probably in order. They should be given a few hours after the antibiotics in order for the good bacteria not to be killed. I use http://www.amazon.com/Vetri-Science...73419767&sr=8-1&keywords=vetri+mega+probiotic It has 7 strains of bacteria and is reasonably priced. Since it's so hot, I do express shipping so the temp. doesn't kill the bacteria.

How long did you keep him on the Panacur and was the dosage appropriate? Was he checked for Giardia? Snap Giardia tests are more reliable than the stool flotation screening.
http://www.amazon.com/Vetri-Science-Laboratories-0900714-120-Vetri-Mega-Probiotic/dp/B002GIVC4C/ref=sr_1_1?ie=UTF8&qid=1373419767&sr=8-1&keywords=vetri+mega+probiotic

 

[NewfMom]

Thanks for all the ideas. I'll run them by the vet. Maybe a food change will help.

He is still intact. He hasn't been healthy enough to do the surgery yet.

I have done a couple of kinds of probiotic with him. We have tested for Giardia repeatedly although I don't know which test they did. He has been on Panacur for 5 days at a time repeatedly.

 

[Lori]

Would a little bit of coconut oil be ok? It's got anti-viral/bacterial/fungal properties so maybe it could help somehow?

 

[Sound Bay Newfs]

Acidophiles is a great probiotic to try. But seriously consider the endoscopy. It is done under anesthesia and does not take long. It will show the vet what is going on in the esophagus/stomach and they can take tissue samples to check for infectious irritable bowel disease or other issues.

 

[jane]

Sounds a lot like what Roger went through. I couldn't do the endoscopy because both myself and the vet didn't want to put him under after his kidney failure.
Boxers do have digestive problems.
The fact that the food sometimes comes out undigested happened a lot with Roger.

I would definitely do the endoscopy. Add a good probiotic and a good digestive enzyme. Roger did best on a novel protein. He did great on venison. You can try rabbit, venison, bison etc....I would also stay away from grain. There are some good brands out there with protein sources like I mentioned and grain free.

Roger definitely had IBD. His lower intestines were the problem. He required B12 shots almost on a weekly basis.

I would also join a good boxer forum. Like newfie owners, these people know their breed. Since the breed has issues like this to begin with, you will come across people with the same problem.

 

[Sierra Newfs]

I suspect there may be a strong behavioral component to your boy's problems and maybe you do too since you mentioned you had been wondering about valium. From "Manual of Clinical Behavioral Medicine for Dogs and Cats" by Karen Overall, MA, VMD, PhD, DACVB, CAAB:

"Many dogs and cats with GAD [Generalized Anxiety Disorder] also exhibit conditions for which their people may have already sought help, for example, frequent vomiting, frequent diarrhea, "itchiness" and scratching, rashes, et cetera. Many animals diagnosed with chronic or intermittent diarrhea associated with irritable bowel syndrome (IBS) may also have some anxiety-related condition. Unless the veterinarian is accustomed to looking for behavioral conditions, she may not think to ask about anxieties, and so will miss the flag that IBS provides for early diagnosis of anxiety. You need to ensure that you know what normal is, and that you are persistent and forthright in reporting any and all behaviors that you find worrisome. Helping dogs and cats with behavioral problems requires a good dialog with your veterinarian and sometimes some gentle persistence from you if you veterinarian has had little or no training in behavioral medicine."

Dr. Overall also writes: "Inflammatory bowel disease/irritable bowel syndrome (IBD/IBS) is an often diagnosed but seldom verified condition. Any dog with IBD/IBS should undergo a complete behavioral history and evaluation. If IBD/IBS is not confirmed but the behavioral history is informative, the diarrhea may be a non-specific sign of heightened reactivity and autonomic arousal."

Dr. Overall's book is available on Amazon (amongst other places) if you'd like a very comprehensive text on behavior. The Kindle edition is a bargain. http://www.amazon.com/Manual-Clinic...=sr_1_3?s=books&ie=UTF8&qid=1374076472&sr=1-3

If you think this may be an issue for your dog, I'd discuss it with your vet soon. Most vets don't have a strong background in behavior and you may want to add a more experienced person to your dog's team.

Unfortunately there are no veterinary behaviorists in Washington. The nearest one to you is Dr. Pachel in Portland, OR. His website is: http://animalbehaviorclinic.net If you are unsure about traveling with your boy at this point and if your vet is up for a consultation, Dr. Pachel does offer this:

CONSULTATIONS DIRECT TO VETERINARIANS
Dr. Pachel also provides complementary phone consultations direct to veterinarians at no charge through Antech Diagnostics’ Professional Consultation service (1-888-VET-INFO, 1-888-838-4636) . These consultations are a valuable way to provide direction or perspective on cases but should not be considered the equivalent of an in-person assessment of the patient.

More information on veterinary behaviorists can be found at: http://www.dacvb.org

There are also three Certified Applied Animal Behaviorists (CAAB) in the Seattle-area. The biggest downside to a CAAB is if medication may be warranted they are unable to prescribe any directly, but may work in conjunction with your veterinarian to build a comprehensive treatment plan that includes medication, if needed. More information on CAABs can be found at: http://www.animalbehavior.org/ABSAppliedBehavior

I'd personally recommend Kathy Sdao and her information can be found at: http://www.kathysdao.com

While I have no firsthand experience, I have heard good things about Dr. Ha and his new partner Dr. Foster. Their information can be found at: http://www.adaptiveanimals.com/index.html

Whatever you decide, you have my best wishes for your boy.

 

[victoria1140]

Beau had similar issues and he had endescopes, biopsys, multiple tests and all clear. In fact in the end we knew more about what it wasn't than what it was and really annoying when all the specialist could tell us was he had irritated guts, well we could have told you that!!!

A couple of things as suggestions which helped are check his food , obviously for us Beau and Orijen was amazing but I understand not for every dog.

With merlin who has ibs I started off feeding him a tablespoon of food every hour so that his system had time to try and absorb it. I also gave him in between a probiotic along with a tablespoon of local honey and a slippery elm capsule to try and soothe his stomach.

All against the advice of my vets who just wanted me to give him hills z/d but after a week of feeding Merlin like that he wasn't so runny . In the end we went for a good grain free diet and we fed him like that for nearly a month slowly building up the amount his system could tolerate and then going slightly longer between feeds.
he still gets attacks even now and then we go back to smaller and more regular meals though his system has improved a lot.

May not work but definetly worth a try , have you had him allergy tested for food and environmental as maybe he cant tolerate rice

 

[NewfMom]

Thanks for the ideas. Our vet appreciated all the ideas. We have him back on the Albon for one more round. He is also continuing the probiotic. We added the Metamucil cookies for more fiber. For a few days this helped a lot.

We also decided to switch him off the rice and onto sweet potatoes instead. We are slicing these in thick slices and boiling them. He gets a bunch of those and a shredded boiled chicken breast at each meal.

He seems to do better for a few days whenever you change something and then it is back to having problems.

The next things the vet wants to try before scoping him is to finish moving him from rice to sweet potatoes and if that doesn't work, give him a week or two on the EPI enzymes even though the test was negative just in case.

Next she recommended do the endoscopy and seeing if he could be neutered at the same time.

I'm debating asking for either the allergy blood test and/or having her neuter him first in case it might make it easier to deal with him at the specialist.

I am concerned to make sure everyone stays safe if we take him to a new building, new people and try to do invasive procedures on him. I seriously considered trying to pay our vet to come on her day off to the specialist's and deal with knocking him out herself before the other vets had to deal with him.

I truly appreciate the ideas. I'll mention the behaviourist ideas to our vet. I know she has already consulted and internist about him.

I used a behaviourist for Kilrain and it was a big help (he didn't need the help, I couldn't make the adjustment from body language signals to audible ones for a blind dog without help LOL).