Puppy with diarrhoea

Re: Puppy with diarrhoea

Bob Russell — Sat, 18 Jan 2014 10:55:08 GMT

I do not count on the snap test being particularly reliable in itself but a +ve buys time to sort things out as owners are often not patient with a messy puppy! Fenbendazole sorts the majority out so worms/giardia would make sense.

As to testing normal poo I used to test in contacts. If asymptomatic cannot remember one +ve. I don't bother testing in contacts routinely now.

Still think the test is useful. Rarely seem to need metronidazole.

I suspect these are multifactorial but confirming a pathogen helps keep owners on your side and allows you to get patients on sensible diets!

Re: Puppy with diarrhoea

Martin Atkinson — Fri, 17 Jan 2014 15:08:35 GMT

[quote user="Bob Russell"]I have to admit I have never had a positive in a puppy with normal poo and plenty of positives with diarrhoea cases. I may be missing some other causes (perhaps Campylobacter cases in particular) but most of these seem to be self-limiting anyway. [/quote]

I think a SNAP test could be misleading, its not so much false +ve as false interpretation of a +ve and an assumption that if its there its got to be the cause. Same goes for campylobactor, it is present in enough normal samples to make its presence being the causative factor doubtful. In any case most of these things are self limiting with good diet and hygiene and so once again diet is probably the most important factor. I just wonder how many cases we send off with a sensitivity diet and tell the owners the patient must have that exclusively really comply or continue feeding titbits/Bakers etc because they're idiots and either don't trust us or think we won't know if they lie.

Metronidazole is a reasonable choice of treatment for suspected Giardia cases because it is immunomodulatory and will improve some cases which are just inflammatory due to dietary intolerance.

Re: Puppy with diarrhoea

Michael Woodhouse — Thu, 16 Jan 2014 22:53:11 GMT

[quote user="Bob Russell"]I have to admit I have never had a positive in a puppy with normal poo[/quote]

I have a confession. We bought a cocker spaniel puppy recently, and having seen a steady stream of puppies with various infections decided to test our asymptomatic pup's poo. Completely normal motions and tested positive for both campylobacter and giardia!

Dirty puppy.

Re: Puppy with diarrhoea

Gillian Mostyn — Thu, 16 Jan 2014 11:33:46 GMT

[quote user="Bob Russell"]I have to admit I have never had a positive in a puppy with normal poo and plenty of positives with diarrhoea cases. [/quote]

How often do you test normal poo?

Re: Puppy with diarrhoea

Clare Smith — Wed, 15 Jan 2014 15:04:18 GMT

[quote user="Anthony Todd"]

Not getting milk, by any chance??

[/quote]

Good point - I don't think so but its definitely something I'll need to double check with the owners.

Thanks for your reply's everyone - they have been very informative and useful!

Re: Puppy with diarrhoea

Bob Russell — Wed, 15 Jan 2014 12:15:42 GMT

[quote user="Anthony Todd"]

Not getting milk, by any chance??

[/quote]

Not a bad point!

Re: Puppy with diarrhoea

Anthony Todd — Wed, 15 Jan 2014 10:34:22 GMT

Not getting milk, by any chance??

Re: Puppy with diarrhoea

Bob Russell — Wed, 15 Jan 2014 09:00:53 GMT

The in house snap test is cheap and really useful for testing for Giardia. Owners get pretty pi**ed off, pretty quickly with puppies having constant diarrhoea around the house.

We get a high % of positives in these cases. Owners have some explanation and treatment for the condition. I explain we will retest until negative which gives some breathing space as I am sure some just sort themselves out!

I have to admit I have never had a positive in a puppy with normal poo and plenty of positives with diarrhoea cases. I may be missing some other causes (perhaps Campylobacter cases in particular) but most of these seem to be self-limiting anyway.

A good way to guide owners towards a better diet at the same time (puppy RC gastrointestinal for example). Seven days on fenbendazole and repeat each month until a negative test.

Very rarely use antibiotics in any puppy diarrhoea (unless blood present). I will even qualify a negative test by saying the test is not 100% all the time.

I am genuinely convinced that Giardia is more than an opportunist or secondary pathogen!

Re: Puppy with diarrhoea

Anthony Dennison — Wed, 15 Jan 2014 08:39:13 GMT

I've stopped bothering sending faecal samples of for puppies like this, they never seem to come back with anything except mixed faecal flora.

7-10 days on fenbendazole and metronidazole soon clears things up, with a pro-biotic to help soothe things

Re: Puppy with diarrhoea

Linda Filshie — Wed, 15 Jan 2014 00:50:46 GMT

I use fenbendazole first - cheap and cheerful, fewer side effects, and also going to get rid of any lurking rounds and tapes.

Re: Puppy with diarrhoea

Rob Loxley — Wed, 15 Jan 2014 00:17:50 GMT

[quote user="Martin Atkinson"] metronidazole rather than fenbendazole[/quote]

which do people reach for first? is their evidence for one over the other?

Re: Puppy with diarrhoea

Busybee — Tue, 14 Jan 2014 22:15:05 GMT

I have two very similar ongoing cases at the moment! Both about 3mo old, diagnosed with campylobacter, given treatment (erythromycin). One cleared the campy, one didn't and required a longer higher dose course of eyrthromycin. In both cases, we are concentrating on diet and in both cases it seems (fingers crossed) to be working! But is taking a long time. Keep on the probiotics, certainly try fenbendazole (cheap and easy and would be silly to miss it out) and if that fails, look hard at diet - be it chicken/rice, sensitive diets, hypoallergenic diets or chappie! Good luck!

Re: Puppy with diarrhoea

Miriam Lodewyks — Tue, 14 Jan 2014 20:19:01 GMT

They are frustrating, aren't they? Quite common, I raised a similar post a few months ago when I saw 2 puppies from the same household that had diarrhoea for weeks. Despite insurance and running every test I could think of, I struggled to keep the clients on board, and did have to resign to using Loperamide tablets intermittently for symptomatic relief. Worked OK and had no side effects, but would only use in extreme circumstances to keep clients on board...

Re: Puppy with diarrhoea

Michael Woodhouse — Tue, 14 Jan 2014 19:55:21 GMT

(a little bit of steroid can sometimes settle down, what I presume is residual inflammation). I'd treat concurrently with PBZ

Re: Puppy with diarrhoea

James Laidlaw — Tue, 14 Jan 2014 19:24:00 GMT

Fortiflora is quite good as a probiotic without the cost of prokolin. No clay but worked for me in a few cases quite well.

Re: Puppy with diarrhoea

Clare Smith — Tue, 14 Jan 2014 18:31:18 GMT

Thanks Gillian and I do agree and have tried to get them on a better food but to no avail at present but will keep trying! Puppy has been showng signs since 17th Dec so almost a month now. If fenbendazole makes no difference I will certainly be pushing them even harder for a diet change to something better quality rather than going for any further testing. I have already alluded to that in my phone call to them earlier so hopefully they are now well primed and I will eventually get through to them!

Re: Puppy with diarrhoea

Gillian Mostyn — Tue, 14 Jan 2014 18:11:29 GMT

I suspect diet is still the problem if the puppy is now on 'commercial puppy food' as they are likely to have bought the cheapest. A large bag of a good quality, easily digestible biscuit is going to be a lot cheaper than masses of further testing - I would certainly do that first! It can take ages for D++ to settle, even if it was caused by sudden change of diet in a puppy, and keep changing food, meds etc, in a happy, well puppy, may make the situation worse!

Re: Puppy with diarrhoea

Clare Smith — Tue, 14 Jan 2014 17:57:15 GMT

Gillian they originally put him on cooked chicken and rice when the problem first started and now have him on commercial puppy food- cost is also an issue so may struggle to get them on a diet any more specific than that!

Thanks for all the replies, just spoken to the owner and they are happy to try Fenbendazole so will see what difference that makes and will certainly keep him on the probiotics. I have both subtly (and not so subtly!) suggested that the diet may have set him up for the problem - not sure if it has sank in or not though and suspect when he is back to normal that they will go back to raw despite my best efforts!

Will let you know how we get on!

Re: Puppy with diarrhoea

Martin Atkinson — Tue, 14 Jan 2014 16:46:15 GMT

Given Giardia is excreted intermittently it may not be visible microscopically so immunochromatography or PCR may be useful and a course of metronidazole rather than fenbendazole. This is also immuno-modulatory which may help. A bit early for a food allergy/sensitivity although never say never but something like RCW Sensitivity Control may be useful along with 3 weeks of probiotics as it can take the intestines a while to recover.. If the owners are restless suggest TLI/B12/Folate and another faecal sample to look for viruses and crypto and subtly suggest it may be their diet that started in the first place. It could well be the campylobactor was not pathogenic and the antibiotics knocked out its natural gut flora so keep up the probiotics.

Re: Puppy with diarrhoea

Gillian Mostyn — Tue, 14 Jan 2014 16:06:29 GMT

what diet is it on now?

Re: Puppy with diarrhoea

Clare Smith — Tue, 14 Jan 2014 15:25:54 GMT

Thanks for the quick replies everyone! Giardia was top of my list too but just wanted to make sure wasn't missing anything else as they are slightly tricky clients to manage. Will get it on treatment and let you know how we get on

Re: Puppy with diarrhoea

Andrew Kent — Tue, 14 Jan 2014 15:11:55 GMT

Agree with Giardia - in a young dog like this then infection or diet high on my list.

I would probably treat with a week of fenbandazole initially and see what happens and then start a novel protein diet trial. You could also trial antibiotics as antibiotic responsive diarrhoea's sometimes appear in quite young dogs.

Andy

Re: Puppy with diarrhoea

Bob Russell — Tue, 14 Jan 2014 15:06:15 GMT

Giardia would be top of my list!