Chronic Diarrhea in Dogs
Dr. Bari Spielman
A complete medical history and physical examination
Veterinary care includes diagnostic tests to help determine the underlying cause of the diarrhea and to guide subsequent treatment recommendations. Some of the following tests may be necessary to diagnose the cause of chronic diarrhea:
Multiple fecal studies (flotation, smear and cytology, zinc sulfate test) to search for intestinal parasites, protozoal parasites, and bacteria
A complete blood count (CBC)
A biochemical profile
A urinalysis to help evaluate the kidneys and level of hydration
Abdominal radiographs (X-rays)
Thoracic (chest) radiographs, particularly in geriatric patients and animals who are suspected to have cancer
Bacterial fecal cultures
Tests for absorption and digestion problems, such as serum trypsin-like immunoreactivity (TLI), serum folate and cobalamin levels
Serologic tests for certain fungal diseases
Depending upon the clinical signs and the results of the above tests, your veterinarian may recommend further testing. These tests are chosen on a case-by-case basis:
An upper gastrointestinal (GI) barium series to help diagnose foreign bodies, partial obstructions, masses, thickening or displacement of bowel, etc.
Barium enema if colonic disease is suspected
Endoscopic examination and biopsy of the stomach, small intestine, and/or colon
Serum bile acids for suspected liver disease
A blood lead level test
Exploratory abdominal surgery (laparotomy) if other diagnostic tests are inconclusive, or if a disease is suspected that requires corrective surgery
Symptomatic or empirical treatment may be tried in some cases of chronic diarrhea, especially if initial diagnostic tests are inconclusive and the animal is feeling well and relatively stable. Empiric treatment does not replace the need to define the exact cause of the chronic diarrhea, it at all possible. Empirical treatment may include one or more of the following:
Deworming for whipworms, which may not show up on routine fecal tests
Short course of antibiotics for clostridial bacteria
Changing the diet to a high-fiber diet if large bowel diarrhea is present or to a hypoallergenic diet if small bowel diarrhea is present
Supportive therapy for ill, malnourished and unstable patients may involve hospitalization with intravenous fluids, supplemental nutrition and vitamins, intestinal protectants and adsorbents, etc.
Specific therapy of most cases of chronic diarrhea depends upon reaching a definitive diagnosis as to the cause, and then instituting therapy for that cause. Such therapy varies widely and can involve medications, dietary changes and surgery.
It is important to monitor your pet closely if he/she has chronic diarrhea. Pay particular attention to stool volume and character, the frequency of defecation, and any straining to defecate. Note the presence of any blood or mucus in the stool. Also monitor the dog's body weight, appetite and activity level. Administer all prescribed medications exactly as ordered by your veterinarian. Notify your veterinarian if you have any problems medicating your pet.