Metronidazole, probiotics and poop

[ks-man]

Yes, the title was intended to get Karen's attention ;)  Thought it was better to do a thread rather than PM in case others have similar questions. 

Cannoli had giardia 6 weeks ago and was put on Panacur, metronidazole and Proviable DC.  We continued the Proviable (and a little pumpkin) for 18 days after he finished the metronidazole.  Within a day or two of stopping the proviable his stool got very soft and eventually diarrhea.  

Our vet put him on a bland diet of wet RX canned food which firmed up the stool.  We gradually weaned him off the RX food back to his kibble but the day he had all kibble the stool started getting soft again. 

The vet recommended that we give him a quarter can of the RX food with every meal or 2 tablespoons of pumpkin with every meal for the foreseeable future to get him some extra fiber.

I'm now wondering if either instead of or in addition to the extra fiber if he should go back on a probiotic.  His stool is firmer then it was but he still has some soft stools here and there.

Also, this morning was the second time that he has thrown up in his crate at around 5am.  He usually gets up between 6:30-7am.  I took him out and he pooped a ton.  I think the throw up was simply a reaction to waking up or else because he had to poop and didn't want to go in his crate.  He didn't whine or cry to get out first, just heard him gag.

So two main questions, would you recommend I get him back on Proviable for a while and any reason I should be concerned with him throwing up in his crate (previous time was about a week ago).

Thanks!

[ks-man]

Thanks Karen, I'm not going to change anything until we have a fecal sample done.  A reason I am thinking food is b/c I had read a few things online about stool color and Cannoli's has almost always been a yellowish brown and a few sources mentioned food intolerance.  Here is one example, not sure if these are to be believed or not.  Even when his stools were firmer they often are light in color.  I spend more time researching his poop then I ever did with my two kids...

https://www.caninejournal.com/dog-poop-color/

[Karen, Jasper and Jackdoodle]

Yeah, this is not the most scientifically accurate site I've seen on this topic. Actually, yellowish poop can indicate a number of things, including liver disease. It can also just be caused by ingesting foods that are in the yellow-orange family. 

But, in all cases, it's a change in the color of the poop that can indicate a problem. If Cannoli's had always been a dark brown, a sudden change to a lighter color, or yellowish might signal a concern. But if it's always been that color, there's less of a concern. 

And the simple fact is that dogs can't be born with a food intolerance. It's something that develops with time, and a lot longer period than a couple of months. So you can pretty much rule out a food intolerance.

On the other hand, a sensitive stomach is always a possibility.

BUT....when a young puppy has had giardia, or any intestinal parasites, and been treated with metronidazole, you can always, always, always expect tummy troubles down the road. And it makes sense to consider that the most likely cause of Cannoli's issues. 

There's an old saying that I learned from a member here who is an MD: "When you hear hoofbeats, look for horses, not zebras." 
Sometimes, it might turn out that what you hear is in fact zebras. But 99 times out of 100, it's going to be the most likely, common scenario. :)

[Karen, Jasper and Jackdoodle]

My labradoodle had a sensitive stomach. I adopted him at 14 months, so I don't know his food/parasite/antibiotic history. But from the beginning, he did not tolerate certain kinds of kibbles, particularly formulas with grains. 

So if Cannoli does have a food issue, or if you simply want to switch foods to see if things improve, it would make the most sense to switch to a grain-free LID food with a simpler formula (meaning fewer ingredients).

Whatever you do, do not let your vet talk you into Rx junk food. :)

[ks-man]

So, the sleuthing continues.  Yesterday evening we were outside in my back yard for a bbq.  Cannoli went behind a shed for a little bit and we caught him drinking some filthy water that had piled on a garbage can lid.  My wife then told me that he was out back for a while with my daughter on Thursday afternoon (the diarrhea started Friday afternoon).  I'm guessing drinking some filthy water might have been the cause of his stomach issue and wasn't food related at all.

I know he can get giardia from drinking outdoor dirty water but doubt giardia would show itself that quickly as I think I remember there is a lengthy dormant period.  The good news is that he didn't wake me up last night (though he was running a ton and up late so he was exhausted) and this morning his stool was formed and fairly firm.  

I'm going to keep him on the fiber for another day or two and if his stool is normal I'm guessing it was either the water or something else that he got to in the backyard.  If the diarrhea comes back I'll get a fecal sample done and if it is negative consider switching foods.

Thanks for the help.

[Karen, Jasper and Jackdoodle]

Drinking standing water outside is definitely the main way dogs get giardia besides getting it from contact with fecal matter from infected dogs & other animals. It's true that the incubation period is 10-14 days, so it wouldn;t show up yet in a fecal test. On the other hand, if the water did NOT contain any parasites, drinking dirty water in itself doesn't usually cause ongoing diarrhea. (At least not if you judge by my Jasper, lol). Maybe one loose stool.

However, I agree with you that this is most likely not food related. I think your plan in your last paragraph above makes sense. 

Please keep us posted. :)

[Doodle & Hound]

My pup was treated twice for Giardia.. right after we brought him home. It's not unusual per vet for two treatments, sometimes the cysts Don't show up in first stool sample. He was on probiotics for 3 months

[Karen, Jasper and Jackdoodle]

It helps a lot if the vet prescribes Panacur instead of metronidazole (Flagyl). 

[ks-man]

I decided I wanted to try and get Cannoli (7 months old) off the probiotic which he's been taking for 2-3 months.  He's been off the psyllium for over a month.  His stool had been well formed and firm for the last few weeks.  About 1-2 days after I stopped giving him the probiotic he stool started softening and yesterday (3-4 days after stopping) it was very soft and mushy.  Today he had some diarrhea.  

I'm pretty confident that this is due to stopping the probiotic since the timing perfectly coincides and he's been on it so long.  Do you think this is just his stomach adjusting to being off it and just needs a few days until his stools should start firming up again or do you think that his stomach seems to need the probiotic at this stage of his life?  

Thanks!

[Karen, Jasper and Jackdoodle]

I think he still needs the good bacteria in the probiotic to help with proper stool formation. I would not discontinue it. There are dogs (and people) who eat yogurt or take probiotics every day forever, to help with having regular, well-formed stools. 

If you want to try discontinuing the probiotics again (and there is really no reason to do so, except for the cost), start giving him 2-3 tablespoons of plain unflavored non-fat yogurt every day for several days beforehand. You can make it fancy by adding a few blueberries or dried cranberries to it, or you can just serve it plain. You can add it to a meal, or give it to him in the evening as "dessert". That's what we do with Jasper. They love it and it's good for them. I buy Fage Total 0%, but any plain unflavored non-fat yogurt is fine.The good bacteria in the yogurt will help replace those in the probiotics. 

[ks-man]

Ugh, wish I saw your response yesterday which you seemed to post right after my question.  For some reason it didn't show up on my phone.  Last night was an awful night with two cases of diarrhea on our carpet and me putting him back in his crate (he's been out of for weeks at night) which made him quite unhappy.  I decided I was going to put him back on the probiotic and hope that it kicks in quickly.  Then I saw your response...

Guess as soon as I saw his stool softening I should have started it back up.  Oh well, lesson learned.  

[Magda and Bear pup]

Slippery elm bark is a herb alternative that cures all sorts of digestive and intestinal problems in dogs. I’m using it currently. You could either sprinkle the powder on their food or you could make a syrup which can be given 30 min before eating or at bedtime to settle their tummies. It acts like similar with the Pepto Bismol for humans! 

https://pethelpful.com/dogs/Slippery-Elm-Bark-for-Dog-Diarrhea-and-...

[Karen, Jasper and Jackdoodle]

In this case, it's a lack of good gut bacteria causing the problem, and slippery elm won't do a thing for that. 

I'm personally not a big fan of "holistic" and herbal remedies with little to no clinical research behind them.