Chronic Diarrhea in Dogs
Dr. Bari Spielman
Deworming for whipworms, which may not show up on routine fecal tests
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. Empirical 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:
Short course of antibiotics for suspected 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, and supplemental nutrition and vitamins.
Plasma transfusions and infusion of other dense fluids may be required for animals with low protein levels.
Intestinal protectants, adsorbents, and antacids may be administered while results of diagnostic tests are pending, etc.
Motility modifiers (medications that effect the movement of food through the intestinal tract) may be tried in some cases.
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:
Deworming agents are required for intestinal parasites.
Products used for protozoal parasites include sulfa drugs for coccidiosis and metronidazole for giardiasis.
Antibiotics are administered for bacterial infections, small intestinal bacterial overgrowth, and some forms of colitis.
Antifungal drugs (e.g. ketoconazole, itraconazole) are given for fungal infections and may be tried for protothecosis.
Corticosteroids and dietary manipulation may be necessary for inflammatory bowel disease, lymphangiectasia, and other immune-mediated inflammatory disorders.
Dietary manipulation is helpful in cases of dietary intolerance, food allergy, colitis, short bowel syndrome, and irritable bowel syndrome.
Chemotherapy, radiation therapy or surgery may be helpful in certain cases of cancer.
Surgical exploratory is indicated to correct causes of chronic obstruction, intussusception, cecal inversion, remove foreign bodies, etc.
Intravenous fluid therapy and specific treatments for any liver and kidney disorders may be indicated.
Pancreatic enzyme replacement therapy is necessary in documented cases of exocrine pancreatic insufficiency.
Motility modifiers (medications that effect he movement of food through the intestinal tract) may be helpful in cases of irritable bowel syndrome.
Supplementation with cobalamin, folate and other vitamins is often required in the malabsorption/maldigestion diseases.
If lead poisoning is diagnosed antidotes may be started either orally or by injection.
Keep in mind that the resolution of chronic diarrhea is usually gradual with treatment. In a few cases, despite a correct diagnosis and proper therapy, diarrhea may not completely resolve or may worsen, especially in patients with cancer.
It is important to monitor your pet closely if he 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.
Repeated follow-up examinations, fecal tests and blood tests may be needed to bring the chronic diarrhea under control and prevent it from returning.