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Dr. Kara
Dr. Kara, Veterinarian
Category: Dog
Satisfied Customers: 17271
Experience:  Over 20 years of experience as a veterinarian.
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My 5yr old pug has chronic diarrhoea and has been receiving

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My 5yr old pug has chronic diarrhoea and has been receiving treatment past two months including a range of antibiotics and stool thickening tablets which have had no affect, he's on a gastro and intestinal specialised food but is still loosing weight rapidly. He's had 3 days hospitalisation which include a full organ blood test and ultra scan of abdomin (which all came back clear). What can I do or is there a specialist vet in Northern Ireland who I can go to? I'm desperate please help
Submitted: 2 years ago.
Category: Dog
Expert:  Dr. Kara replied 2 years ago.
, my name is***** and I have over 20 years of experience as a veterinarian. I am sorry to hear that your pup is suffering from chronic diarrhea which is leading to weight loss, and that has not improved with antibiotic therapy.
I understand that he has had some screening blood tests, as well as an ultrasound, which were not diagnostic. I assume that the blood tests were a complete blood count and biochemistry panel. I also recommend measuring folate and cobamalin levels to try and determine if he has primary intestinal disease and if so where his intestinal disease may be located.
It will be important to describe what sort of loose stools he has to try and localize the problem too.
Frequent, small, loose stools with mucous or bright red blood point more towards large bowel diarrhea or colitis.
Normal frequency, with normal or increased amounts of watery stools with no mucous point more toward small bowel disease. Weight loss usually indicates an inability to digest or absorb the food he is taking in, and thus is more commonly seen with small intestinal diarrhea.
Of course sometimes we see a combination of changes if both small and large bowel are affected.
Chronic diarrhea does cause changes in motility of the gut and can lead to reflux and vomiting. It can also lead to bacterial overgrowth in the gut. Probiotics such as Fortiflora or Benebac can help replace appropriate bacteria.
I assume that he has had stool samples checked to make sure that parasites aren't part of his problem. Have any other fecal diagnostic tests been checked?
Has he had a fecal culture to check bacteria such as clostridia?
It is quite possible that he has a food allergy/sensitivity or inflammatory bowel disease and that he needs a different low residue, easy to digest food or a hypoallergenic food to be able to properly digest and absorb his food and not have loose stools. I highly recommend a trial of either Hills i/d or Purina Veterinary Diets EN. No treats, table food or edible chewies while he is on his food trial. If he does well he can eat these foods as they are balanced. Having had 2 dogs with inflammatory bowel disease I have a personal preference Veterinary Diets EN. Dogs with food allergies can benefit from Hills z/d or Purina Veterinary Diets HA.
Dogs with inflammatory bowel disease will worsen with stressful situations. There may be times when he will need medications too, such as metronidazole or even steroids if that is his problem, but I have found that a consistent, easy to digest diet is very helpful term control.
There are other possibilities diarrhea too.
Addison's disease, which is a poorly functioning adrenal gland, can lead to chronic diarrhea and vomiting. These dogs cannot handle stress at all because their adrenal gland doesn't produce cortisone when stressed and their electrolytes can be off too if their adrenal gland isn't controlling that normally either. We see vomiting, diarrhea and sometimes physical collapse in severely affected dogs. Testing is an ACTH response test to check adrenal gland function and checking electrolyte levels. Treatment is steroid replacement therapy and electrolyte replacement.
Pancreatic insufficiency is another possibility. These dogs have a pancreas that produces a decreased amount of digestive enzymes, and the amount produced can wax and wane in some cases, especially early in the disease process. Testing is by running a blood test called a TLI which checks enzymes. Treatment is replacement of digestive enzymes at each meal. An easier to digest food would be expected to create less problems with digestion and as such less diarrhea.
Diabetes, kidney and liver disease can cause diarrhea and weight loss too, but I would expect that those would have been picked up with a screening blood test.
In short since this has been a chronic problem then more diagnostics need to be done. They can be as simple as fecal checks and cultures, as well as blood testing 's or pancreatic insufficiency. Or they can be more invasive such as biopsies of his gastrointestinal tract to look bowel disease or infiltrative cancers such as lymphoma.
If you are interested in a referral to a specialist then you would want to see a veterinary internal medicine specialist. Below is a list of three in Ireland. If they aren't close to you perhaps your veterinarian could consult with them about Bob and get some recommendations.
Dr Carmel T. Mooney
University College Dublin
School of Veterinary Medicine
UCD Veterinary Hospital
Dublin 4
Ireland ***@******.***
Specialty: Internal Medicine since 1998-01-01
Status: Active
Dr Sheila Brennan
Small Animal Clinical Studies
University Veterinary Hospital
University College Dublin
Dublin 4
Ireland ***@******.***
Specialty: Internal Medicine since 2006-09-15
Status: Active
Emma O'Neill
University College Dublin
Faculty of Veterinary Medicine
Department of Small Animal Studies
Dublin 4
Ireland ***@******.***
Specialty: Internal Medicine since 2004-09-15
Status: Active
Please let me know if you have any further questions.
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