Diarrhea, Weight Loss, And Prednisone

[KellyandKris216]

Hi all,

 

I'm hoping someone can give me some insight and maybe some perspective on an issue I'm having with Renny (worrywart mom may be skewing my view on this). Sorry it's long-winded, I figured more info was better and there might be something I'm not thinking of.

 

Backstory: Renny is 3.5 and 80 lbs (as of 6/9). Since we brought him home 2 years ago, he's had a periodic but consistent cough/hack that doesn't seem to have any obvious cause, but also doesn't seem to bother him much. Zyrtec didn't seem to make it go away. When we brought him in for his annual exam on 6/9 I asked about it, and long story short we took some xrays that showed inflammation in the lungs/trachea. These were sent off to a radiologist who confirmed there was nothing sinister beyond the inflammation. The vet deemed it probably some kind of allergy, and to reduce the inflammation we started Renny on a course of Prednisone (2x/day for the first week, 1x/day for the second week (we are here), 1x/every other day for the third and fourth weeks). Course started on 6/12. Based on what I read on this board, I supplemented with Pepcid AC 2x/day as well.

 

Renny had what I understand is a normal greyhound reaction to the Pred: drinking and peeing like a race horse, not terribly interested in food (not unusual for him in the summer to begin with), panting, and looking like he feels rather "blah". We put Renny on some chicken and rice and reported the inappitence to our vet who recommended trying him on some different wet foods and cycling through until we found something he liked. Vet insisted that he should be ravenous due to the Pred, rather than skipping meals. We tried one type of wet food for 3 days mixed in with his regular kibble and another type for 2 days. He liked the wet food but not the kibble.

 

Problem: I think this started Tues afternoon, but Renny had some diarrhea in the house between his lunch pee break at 1pm and us getting home from work at 5pm. Stool was a very soft pile, not pure liquid. Wed he had another accident in the afternoon, went out 2x Wed night, and an accident around 5am Thurs morning because I missed the sound of him going downstairs. Thurs morning we switched back to straight chicken and rice, which he's since been only mildly interested in. Thurs at lunch my husband was greeted with 2 more soft piles of diarrhea on the kitchen floor. At this point I called the vet.

 

Vet thinks it was all the food changes that caused the diarrhea and recommended chicken, rice, pumpkin, and probiotics going forward until his stools firm up. A few hours after my call he had liquid poo and some bright red blood at the end. Called the vet back and left a message with the front desk; not entirely sure this made it to the vet because I never got a call back (I'd figure blood = call back). Having not heard back by 9pm, called SIL who is a vet in CA. Described his symptoms, she said the blood, since it was bright, was probably from his colon and a result of irritation from all the diarrhea. Keep up with chicken and rice and keep an eye on him.

 

We let Renny out 3x overnight between Thurs night and Fri morning. Fri morning, stool was still liquid and mucous-y, but no blood. Had to run to work between 9-11:30, came home to liquid poo in the kitchen. Called the vet and requested a tube of Proviable to stop the diarrhea. Renny got 2 doses of this on Friday. He's going out about every 3 hrs, including 3x overnight Friday night. Hubby may have given him another dose of Proviable at 4am, but he's still asleep so I don't know for sure.

 

This morning, he still has liquid, mucous-y poo, but no blood. In the past, the Proviable would have at least firmed up his stool a little after a couple of doses, not still be pure liquid. He's still on the boiled chicken and rice, pumpkin, Pepcid, and Pred.

 

Help needed: When I last talked to a tech on Thurs afternoon, she recommended staying the course until Monday. If he was still having diarrhea by then, bring him in for a check. They are open today (Sat) until noon though. I'm unsure if I should insist on bringing him in today for say a blood test, fecal, and fluids, or wait it out until Monday. Admittedly, I'm loath to spend another few hundred dollars if all they're going to tell me is more chicken and rice. He doesn't seem in imminent danger and diarrhea is messy but manageable. On the other hand, there's been no improvement despite a couple days of chicken, rice, and probiotics, and he looks downright emaciated. I wouldn't be surprised if he's lost 7-10 lbs since this started based on how he looks (I tried picking him up and standing on the bathroom scale, but it can't read the two of us). On the other, other hand, his looks could be what's causing my concern level to spike, when really he'll be fine to wait it out until Monday.

 

Any advice or perspective? Would you bring him in today or wait until Monday? Should I "sit down and stop touching the dog"?

 

Thanks a million! And sorry for the incredibly long-winded post.

 

 

[tbhounds]

Sounds like SIBO from the food change. Also, pred can play havoc with ghs-just melts muscle mass off of them. If he was my dog I would run a fecal, prophylactically de-worm him with a broad base de-wormer (need to rule out lung worm) and get him on a script gi food for the time being. W/D is a low fat (fat is hard to digest) and high fiber (the fiber will form the stools). Perhaps your vet will consider dropping the pred and try an antihistamine???

[MaryJane]

Talk to vet about dropping pred and instead using an allergy medicine and see if that helps the cough.

 

I would not use chicken - high incidence of contamination and heavy use of antibiotics plus, some dogs are allergic to it. Instead try using hamburger (90%) mixed with rice and maybe some mashed and cooked green beans. You might also want to put a few tablespoons of cooked oatmeal into the food as that provides fiber and can firm up the poop. A tablespoon or two of yogurt could help or could make it worse it they can't digest dairy.

 

The mucus poo indicates (my opinion) that GI tract is irritated and while a concern is not going to get better immediately.

 

It's hard to tell from your post - how long he has been having liquid diarrhea and whether he is eating and how much. Also, is he drinking water ?

[KellyandKris216]

After a morning of continued liquid diarrhea I called the vet and insisted on bringing him in for sub-q fluids to get him to Monday. When pulled, the skin on the back of his neck would stand upright instead of snapping back into place, so I was pretty worried that his dehydration was worse than I originally thought. We didn't get to see or talk with the vet, but a tech got him the fluids he needed. They told us he's lost 9 lb since his visit on 6/9. Within an hour of the fluids he perked up and looked better, and now he seems to have stabilized somewhat in that he hasn't needed a bathroom break in the last 5 hours.

 

Thanks for your replies and sorry I wasn't clearer in my word-barf! He's had pudding diarrhea since Tues and liquid since Thurs I think. He was only eating about a cup of chicken and rice for each meal since Wednesday before losing interest, and in hindsight, hubby and I don't think he's been drinking much the last couple days either. However, we offered him a meal of chicken, rice, and a bit of low fat cottage cheese when we got home from the vet this afternoon which he ate voraciously, and also separately drank about 2 cups of a mix of half chicken stock (no salt), half pedialyte. I'm hoping that means we've gotten him over a hump; we'll offer dinner in a few hours and see what he feels like.

 

The vet's original rationale for the Pred was the inflammation on the x-ray, combined with trying Zyrtec with no effect in the past. Another antihistamine might work better, but she wanted a course of Pred to try and knock out the inflammation cold. In hindsight I guess this wasn't the best idea. I understand Pred is one of those that can't be quit cold turkey, so I'm loath to stop it until I talk with the vet.

 

Hmm I didn't realize chicken isn't a great option, it just seemed like the blandest thing available. For what it's worth, his regular kibble is chicken (though he's been on other proteins in the distant past, but seemed to like this food best). Should I continue with the chicken for now to avoid upsetting his system by switching to the hamburger? Or is it a mild enough swap that it's unlikely to bother him? I'm unable to get the W/D diet until the vet opens on Monday, but I'll definitely discuss it with them then.

 

Tbhounds, I have a round of Drontal on hand. Would you recommend I give this to him now, or let his system calm down a little more? If I recall correctly you're a vet yourself, right?

[KellyandKris216]

Renny just went out for his first pee break since coming home, and didn't have any diarrhea (or any bowl movement for that matter). Hopefully that's progress in the poop department!

 

However, his pee stream was very thin and he spent probably 10 minutes trying to empty himself all over the yard. I'm going to guess this is because he's been so dehydrated and finally has enough fluids to spare to pee again? For what it's worth, I went inside and got a measuring cup to catch some urine (Renny looked highly offended but obliged me) and it looked a normal color, not overly dark or bloody.

[MaryJane]

Good to hear that you brought the dog in for fluids. Make sure that he stays hydrated - if he can do dairy, you can also give him yogurt if he is not interested in the water.

 

It sounds like, although not proven, that this is all coming from the pred initially and then going to a GI issue and because of that, not sure about giving dog a de-wormer because that could further complicate what is going on. Get him tested for worms on Monday and then treat if there are worms.

 

As to switching to hamburger, that can wait until you get a OK from the vet. Although, adding a few tablespoons of cooked oatmeal adds fiber (just like pumpkin) and could help. Also, some dogs do not tolerate pumpkin (diarrhea) but, will tolerate oatmeal.

 

I should have been clearer, I am not recommending that you stop the pred without discussing with your vet - since this all seems to have started with the pred, maybe it's best to get to a stable point again and then see whether there is a different way to handle it.

 

If blood shows up in poo along with vomiting, head to ER vet.

[KellyandKris216]

Thanks MaryJane! Apologies that I missed your oatmeal suggestion before, we have some handy so I'll add it to his breakfast in the morning. He had another full meal at dinner (~2+ cups of chicken, rice, pumpkin, cottage cheese, and water), and though he doesn't show much interest in plain water, he did like drinking the water we used to boil the chicken in.

 

I agree with your assessment, I'd just like to get and keep him stable until Monday and talk over new plans with the vet then. In hindsight I shouldn't have swapped his food all around; when the vet recommended trying different flavors, I figured maybe wet food was different. Should have listened to my gut; we'll live and learn and not do it next time. Poor pup.

 

Still no poop this evening, though he's still passing urine in thin streams. Crossing my fingers for a quiet night!

[Banjoman]

When my dogs have had tummy upsets I usually start them off on boiled rice then add fish rather than any form of meat. After that it’s scrambled egg then bring in the chicken.

[tbhounds]

Hi ya-Im a LVT. I would not administer any dewormers at this time until you see your

Vet Monday.

[KellyandKris216]

Never thought I'd be happy to see pudding poop at 3:45am, but it's better than liquid poop!

 

Renny ate another full bland-breakfast this morning. Still not much interest in regular water, but he drank some boiled chicken water.

 

He's passing fluids, though his urine stream is still very thin. If a normal stream is a super soaker, his stream is a $0.50 squirt gun. It's taking him about 10 min of going around the yard before he feels empty enough to come in. He's also having trouble with his "off valve" and has been dribbling all over the house. Nothing I can't keep up with with a towel, but he seems rather embarrassed by it. We started with a belly band, but since he seems to be laying in just a few spots in the house I've put down puppy pads instead (that way the moisture isn't being held against his body).