Hello Claire, I'm Dr. Deb. The other expert with whom you were chatting on the 31st of March isn't online at this time but I can help if you'd like.If that's acceptable, I have a few questions I'd like to ask first about Chaos if you don't mind:1. I read the exchange between you and Dr. Peter where you indicated that he was wormed. Has he been wormed more than the one time?2. What was used to worm him?3. Has a stool sample been checked for parasites?
There may be a slight delay after I receive your answers since I have to type up a response to you. Thanks for your patience. Deb
Claire: Thanks so much for the additional information.I agree with Dr. Peter that the most common cause of diarrhea with blood is going to be internal parasites if the patient is other wise acting fine. For those pups who are lethargic and not eating, then parvo is always a concern in these situations. But the fact that Chaos is not otherwise acting ill is a very, very good thing:) First, let me reassure you that while blood can be alarming when seen, it doesn't necessarily have to be concerning unless there are profuse amounts of it. It usually simply indicates intestinal inflammation which I believe Dr. Peter previously mentioned.When presented with a pup this age who develops bloody diarrhea (intermittent or continuous) but is otherwise healthy, then the most common causes are going to be internal parasites of one sort or another. I have to admit I'm a little surprised that your vet didn't run a stool sample when he was seen, but the possible parasites which could cause his symptoms include:1. Coccidia which is a protozoal organism. Here in the States, Albon is the most commonly used drug to treat this infection; however, this drug does't actually kill the organism but just prevents it from reproducing. This LINK discusses this organism in some detail.Albon may be available over the counter in the UK and it may be worth starting him on this drug if you can find it. Even if he doesn't have Coccidia, it won't be harmful to give him this drug.2. Hook worms can be seen in pups this age and cause bloody, loose stools. Drontal is a good wormer for this particular parasite but I advise that it be given every two weeks for three doses. In some cases, it takes the complete worming cycle to be given before the parasites are killed and the stools return to normal.3. Giardia can also cause bloody, loose stools. Drontal would not be my first choice for this problem. I usually worm with both Panacur and Metronidazole together for 5-6 days. Panacur may be available over the counter in the UK but Metronidazole is a prescription drug whicih you'd have to get from your vet. For now, I'd continue the bland diet and the pro kolin but I'd also get him on a good probiotic such as Forti Flora which may be available at local pet or grain stores. I know you can purchase it online but you may not want to wait for it to be shipped to you. However, if internal parasites are the cause of this problem, then you're not going to see improvement until this problem is addressed, unfortuantely.And, I should mention the problem with diagnosing parasites with fecal samples: false negatives are always possible since eggs/oocysts are not shed in every sample which is evaluated. A positive is a positive but a negative doesn't necessarily rule them out, if this makes sense.If this were my case,I'd run a fecal sampleI'd continue the Drontal wormer on TuesdayI'd worm with Albon (even if a stool sample is negative)I'd continue the bland dietI'd start probiotics.Consider Panacur and Metronidazole together if no improvement is seen.I hope this helps. Deb