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Ask Dr. Michael Salkin Your Own Question

Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog
Satisfied Customers: 25233
Experience:  University of California at Davis graduate veterinarian with 44 years of experience.
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Hi my boy dog aged 4 has we have been told he has ibs ,he's

Customer Question

Hi my boy dog aged 4 has we have been told he has ibs ,he's on vitbie injections 1 a week ,pro fibre with meals but still has watery poos and wind his food it's hypoalligelic is there anything else I could try
Submitted: 2 years ago.
Category: Dog
Expert:  Dr. Michael Salkin replied 2 years ago.
Aloha! You're speaking to Dr. Michael Salkin
We need to clarify just what kind of gastrointestinal disorder Ollie suffers from. The three main considerations are IBS, a food intolerance, and malabsorption disorders and any combination of these considerations are possible concurrently. In addition, pancreatic exocrine insufficiency - a lack of digestive enzymes produced by the pancreas - needs to be ruled out by a blood test called the TLI.
IBS is usually addressed with an antiinflammatory drug such as the antiinflammatory antibiotic metronidazole or a glucocorticosteroid such as prednisone. Confirmation of IBS, however, is done by scoping and biopsy of the gastrointestinal tract.
Food intolerance/allergy is addressed with prescription hypoallergenic diets. These special foods contain just one novel (rabbit, duck, e.g.) animal protein or proteins that have been chemically altered (hydrolyzed) to the point that Ollie's immune system doesn't "see" anything to be allergic to. The over the counter hypoallergenic foods too often contain proteins not listed on the label - soy is a common one - and these proteins would confound our evaluation of the efficacy of the hypoallergenic diet. The prescription foods are available from his vet. There are many novel protein foods and a prototypical hydrolyzed protein food is Hill’s Prescription Diet z/d ultra (my preference). A positive response is usually seen within a few weeks if we’ve eliminated the offending food allergen. Food intolerance can arise at any age and even after our patient has been eating the same food for quite some time.
Malabsorption can occur secondary to any severe gastrointestinal disorder but is most often found concomitant with lymphangectasia - a disease of the lymph ducts in the gastrointestinal tract. It's often treated with prednisone and vitamin B12 injections. In fact, we can test for malabsorption by checking serum vitamin B12 and folate levels. Low levels suggest that our patient hasn't been able to absorb those nutrients.
Antibiotics such as tylosin and metronidazole may be helpful in cases of IBS and certain colitises. I'm not sure what oxy something is but I'd like to know.
Ollie's vet appears to be trying to treat everything at once but even if Ollie should improve, you wouldn't know which of the therapies is responsible. Ollie isn't improving, however, and so it would be prudent to outline a treatment plan that eliminates one disorder after another. For example, you might begin with a hydrolyzed protein diet as noted above and give it at least for a month to see if a positive change is seen. It can take 8-12 weeks in some dogs for such a diet to become effective, however. If the diet isn't helpful, you might initiate metronidazole, prednisone, or both to see if a presumptive IBS exists. If those drugs weren't helpful, you can test for malabsorption by measuring vitamin B12 and folate levels and if found to be low, scope and biopsy Ollie's GI tract looking for lymphangectasia or other pathology causing malabsorption.
All such dogs should be prophylactically wormed with fenbendazole for 5 consecutive days in case occult parasitism is present regardless of the results of a fecal ova and parasite exam - which is too often falsely negative. Fenbendazole is now available over the counter in many pet/feed stores. Antibiotics other than metronidazole should be avoided until the above search for an etiology has been completed.
Please respond with additional information and further questions or concerns if you wish.
Customer: replied 2 years ago.
Hi and thank you.
The tablets he was given were Oxycare 120mg.
Expert:  Dr. Michael Salkin replied 2 years ago.

You're quite welcome. Oxycare is oxytetracycline. I can't imagine an indication for that antibiotic in the gastrointestinal tract in a patient such as Ollie. Please continue our conversation if you wish.

I have to leave my computer for a few hours but promise to reply as soon as return if need be.

Dr. Michael Salkin, Veterinarian
Category: Dog
Satisfied Customers: 25233
Experience: University of California at Davis graduate veterinarian with 44 years of experience.
Dr. Michael Salkin and 2 other Dog Specialists are ready to help you
Customer: replied 2 years ago.
Hi sorry what you think I should first take him off the tablets and try him on the hills zl food
Expert:  Dr. Michael Salkin replied 2 years ago.
Yes, that's a reasonable first approach. The oxytetracycline - like all the tetracyclines - is likely to cause worse diarrhea.
Thank you for your kind accept. I appreciate it.
Please continue our conversation if you wish.

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