Recurring Diarrhea problem in older Greyhound

[JohnF]

GI problems seem to be an all too common theme on here; but this time It's hit my dog and I'm baffled. I wonder what I'm missing here? Peggy has been having cyclical gastro-intestinal issues these last few months. Her stool never firms up fully and can over a few days degenerate into explosive bloody diarrhea.  She has been to the vet several times, and had two stool samples taken, but no parasites or anything else remarkable have been reported. She actually gets very ill with these problems and ends up in the vets on a fluid drip. They treat the condition with Metronidazole and Synuclav, and indeed those two medications appear to control the problem and she goes back more or less to normal with her stool firming up to the consistency of ice cream. Sometimes I think the vomiting is due to something entirely unrelated to the ongoing diarrhea, like eating chicken which is possibly gone off.

These flare-ups are normally just diarrhoea related, but sometimes vomiting is involved. In the most recent event there appeared to be no blood in the in the vomit. The vet says that this time there was also a UTI probably from direct local contamination from faeces on her tail which locks down tight when she is worried. They confirmed this by checking the white cells in the urine sample. Nothing remarkable was found on a Bladder Ultrasound.

One of the worst aspects of this is the probable pain and certain distress which the dog suffers which sometimes makes it impossible for her to settle at night, getting up and down every half an hour then wanting to be put outdoors, and leaving me with no sleep. I've been giving Peggy Gabapentin for this but one can only give so much.

Peggy hates being given a bunch of tablets which take 2 or goes: Omeprazole, (Metronidazole, ½ a Synuclav, and 2 Gabapentin twice a day) and also a tiny Prednisolone tab which is the only one that doesn’t cause a problem. From what I can see, all these meds just antagonize an already distressed-stomach before they get to start working. Oh, and there’s also Pro-Kaolin Paste to administer.  I just wish manufacturers could come up with a less harmful treatment regime.

What puzzles me is the cyclical nature of the diarrhea becoming looser and eventually bloody. I thought it might be Giardia (I do know that smell) or Hookworms, but the vet says neither were found in the stool samples. He says Hookworm would be more often seen in kennel settings and as she has been with me since 2009, he doesn’t think there are any hooks, especially as spotting the eggs in stool is one of the first things vets learn. He therefore suspects IBS and is doing blood work to check vitamin B12 and folates.

Peggy will be 13 in September and has underlying kidney disease, about quarter way along the scale and still concentrating normal yellow urine, so one has to be careful with medications and food. She used to eat Turkey and Rice kibble, but went off it, and has been fed quality wet food that’s not too high in protein (like under 8% in wet) since. Maybe she has become allergic to chicken, but trying to find a GI diet without it seems impossible.

Does anybody have any idea what could be really causing this diarrhea, and hopefully what could be done about it?

[Dawnnziggy]

Right now I have 2 dogs with this problem.  Our new dog has been with us for 2 and a half months.  He has been struggling with hookworms.  It does include blood and explosive diarrhea.  He is very uncomfortable when being treated and needs to go out many times.  Our female grey is almost 10.  She has bouts with pancreatitis.  When she flares up, she is in a lot of pain and terrible diarrhea.  I feed her a low fat diet.  She eats Royal Canin Gastrointestinal food.  It is pricey, but it helps her out.  The 17 pound bag is $65.99 and the 28 pound bag is $89.99.  It is worth it!  It is very important to keep her away from human food.  I also put a teaspoon of Beneful on their food each night which just adds fiber.

Good luck!  I know how frustrating this is and how hard it is to watch your pup be miserable.  I felt really guilty about not knowing there was a reason Myrtle had such loose poops.

[zimsmom]

Have labs been done?  Liver Pancreas?  Maya who is 12 6/12 has diarrhea (although non bloody) since I adopted her at age 8.  I use Tylan powder for a few meals & it resolves.  Maybe ask for that.  

[JohnF]

2 hours ago, zimsmom said:

Have labs been done?  Liver Pancreas?  Maya who is 12 6/12 has diarrhea (although non bloody) since I adopted her at age 8.  I use Tylan powder for a few meals & it resolves.  Maybe ask for that.  

Yes, they have done all the normal metabolic tests, kidneys were the only ones elevated over last year's.   I still think it's probably some kind of parasite they just haven't found yet.

[MaryJane]

Why is she on Pred?  Also, have you tried a Probiotic?

[FiveRoooooers]

Having been down the same road of sensitive stomach/vomiting/diarrhea, what has worked for us has been either Tylan powder, which lately may be difficult to obtain, and/or Slippery Elm powder, which is available in either 400mg capsule form (so convenient) or powder that you boil up and refrigerate. 

Best thoughts for your old girl. 

[JohnF]

13 hours ago, MaryJane said:

Why is she on Pred?  Also, have you tried a Probiotic?

Pred 5mg to stimulate the urge to eat.   Yes tried Probiotics but maybe the strong meds 'kill' the beneficial bacteria?

[greysmom]

My first thought is pancreatitis.  Seniors stomachs are so touchy sometimes - human and canine! - and even small changes or additions can set them off.  A gastrointestinal food might be the best way to begin if the vet hasn't suggested it yet.  Something low, low fat and high fiber.  Or try just adding *insoluable* fiber to her food - Fiber tabs (check for artificial sweetners if you use a human brand), or beet pulp.  Limit all treats and add ins, too.

Second thought is that Pred is unhelpful except as a last resort.  It has *never* helped my dogs eat more, and only seems to cause problems.  She doesn't want to eat because she feels crappy, and even the thought of food makes her nauseaus.  If she has enough body condition, I would fast her at least 24 hours, then start with something new - either a RX diet or extremely low fat home-cooked.  Very small portions several times a day.

Third thought - not sure that gabapentin is an appropriate pain reliver in this instance.  Since it's mainly a nerve pain agent, it can't be helping too much in this case. 

And Metronidazol and Synuclav seem to both be antibiotics??  I haven't heard of Synuclav before though it seems to be like Clavamox here in the States.  And the metro is an antibiotic as well.  She may be getting an antibiotic overload, especially if she's sensitive to them after all this time taking them.  You don't seem to be adding any pre/probiotics back in to her, so you may want to start there.  FortiFlora is the gold standard of rxs for that here, and it may be a better place to begin than OTC or human add ins, like yogurt or buttermilk, as the dosage is very specific and consistent.

{{{hugs}}} for sweet Peggy.  I really hope you can figure this out for her.

[tbhounds]

May need to culture the stool.

[JohnF]

21 hours ago, greysmom said:

My first thought is pancreatitis.>>>

Yes, that was on my vet's mind too. But all the liver blood work came back fine, just a tiny little bit raised on one of the pancreatic factors. (Amylase I think) but he said it wasn't significant.

He also said there was also a diagnosis (other than idiopathic) for a disease caused by intolerance to antibiotics.

[JohnF]

3 hours ago, tbhounds said:

May need to culture the stool.

Thanks. Yes, I'll need to ask about that. They sent both samples off to a specialist lab and it took a few days, so maybe they already cultured it and found nothing remarkable? Apparently the kidney disease isn't as advanced as they initially thought either after the latest bloods and urine sample. I just wish they could get a handle on this condition; and I'm still not convinced it isn't Giardia because I know that smell.

[MaryJane]

Have you tired to feed a home-made diet? Maybe give turkey and rice with some veggies. 

[JohnF]

10 hours ago, MaryJane said:

Have you tired to feed a home-made diet? Maybe give turkey and rice with some veggies. 

Thanks Mary Ann. Yes, when she's feeling well enough, she will eat real Turkey and rice, and that's what her kibble was before she went off it.  She's improved over the last 3 days so is eating better and the stool is no longer liquid. The course of Metro. has come to an end  and but she's still getting 1 Pred. a day which, I think is stimulating appetite and (hopefully) getting some weight back on.  I'm getting some success with feeding "Chappie" dog food which someone suggested; I only hope she doesn't go off that too.