Recently the topic of diarrhea came up with a dear human friend. It’s not something folks typically discuss in polite company, unless you are a veterinarian. We veterinarians deal with the issue of diarrhea on a daily basis with our patients. Of course I teased my friend with the problem, “Did you get into the trash again?” Dietary indiscretion is far and away the most common cause of loose bowels for pets. Of course there are numerous other causes of diarrhea like stress colitis, parasites, food sensitivities, diet changes, a change in treats…. and more! This newsletter won’t focus so much on diagnosis but the immediate remedies that your vet may try in the urgent situation that is acute diarrhea. For the sake of your pet and your home, when your pet has diarrhea you want the situation resolved pronto!
Regardless of the cause of loose stool, I almost always send a probiotic. Probiotic has been shown to speed the resolution of diarrhea in pets. A lot of the information used to support probiotic use in pets is extrapolated from human literature, but probiotic use for dog diarrhea has been proven effective in speeding resolution. I typically send 7-10 days worth of probiotic for acute diarrhea, but I have several patients who are on probiotic long-term. Probiotic can come in capsules, powder, tablets and even liquid form. I use whichever formulation I think is most likely that an owner can get into a particular pet. More often than not I reach for Purina Fortiflora as it is supposedly palatable. I have not personally tasted it but have seen a pet readily lick it off the treatment table as I was trying to mix it into some canned food. That’s a good sign for palatability!
This is a medication that veterinarians use widely for diarrhea. Yes, it has specific treatment indications such as for giardiasis and other infectious agents, but it also helps with bacterial overgrowth from simple dietary indiscretions. We may also use it long term for patients with inflammatory bowel disease. I bet human doctors never ask their clients, “Did you eat something nasty out in the yard?”, but a good number of diarrhea cases are from indiscretions. Metronidazole has antibacterial and anti-inflammatory properties that set a good number of diarrhea cases back on track. I sometimes feel guilty that I may overuse metronidazole for my diarrhea patients, but it is so often effective in resolving the runs. Sometimes we have patients who respond to metronidazole when we can’t figure out why, even after running extensive fecal tests for pathogens and parasites. This of course makes conscientious vets worry that we are promoting bacterial resistance. That has been dubbed, “metronidazole responsive diarrhea”. The one problem with metronidazole is that it tastes nasty. Even when we try to hide the taste, the liquid compounded formulations for small pets is bitter. I find the best option is to hide the tablet form in a pill pockets and send it down the hatch.
When a pet has acute diarrhea, we often suggest bland food such as rice and a bit of lean meat. There are numerous prescription bland diets available. We are aiming for something easily digestible. After all, we don’t want to give your sweetie any more ammunition for more diarrhea! If diarrhea is chronic in nature we might opt for a high fiber diet or even a hypoallergenic diet, but for acute diarrhea we want something bland and easily digested.
Diagel is a homeopathic product that I’ve come to adore over the last few years. It’s a thick liquid and I think it smells good, kind of like pumpkin. Not all pets think it is tasty! I once gave it to a cat who drooled for half an hour after administration, so I’ll admit I now hesitate before I use it on felines. Most dogs accept it without much resentment. It does tend to stop them up! I find it a great product for situations of stress such as boarding or travel. I often send a dose with clients for travel if they are worried that their pet is sensitive and prone to stress diarrhea.
Over the Counter Remedies
Pepto bismol, kaopectate or loperamide are potentially acceptable options if your pet is feeling fine otherwise and is not vomiting and is eating well AND you are unable to get to your vet right away. Always communicate with your vet. Most vets prefer chatting with clients right away when such an issue arises. Of course, if the diarrhea is accompanied by vomiting you should seek veterinary care immediately.
If a pet has had repeat episodes of acute diarrhea, I sometimes send a broad spectrum dewormer such as Fenbendazole, even if repeat fecal tests come up negative. I especially use this “treat the treatable” approach if a pet was recently adopted or has had minimal veterinary care in the past.
This newsletter is focused on acute diarrhea. If it becomes a chronic situation, your vet has more diagnostic tests up his or her sleeve such as maldigestion panels or parasite antigen tests or diarrhea panels for specific infectious agents. If all that fails and the diarrhea persists, you might be headed to the internist for endoscopy and biopsy or imaging techniques.
If your pet is having frequent episodes of acute diarrhea, please cut out everything except the diet that you and your veterinarian choose. Three years ago one of my best clients had a problem. Her 4 otherwise healthy dogs kept getting intermittent acute diarrhea. We’d treat with many of the things listed above, run repeat fecals, fix the problem briefly then have recurrences. We were both getting frustrated until she realized it would came about after she would give them a particular treat. I didn’t even know she was giving this treat. Tell your vet what all you feed your pets. And while I’m on the topic always look to be sure the treats you give are made in the United States. Pets can get kidney disease from treats made out of the country, although the offending cause is still unknown. Until that mystery is solved, just be prudent and check that all the treats you give your pets are made right here in the good ole USA!
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NOTE: Consult your veterinarian first to make sure my recommendations fit your pets special health needs.