Puppy with Giardia and Lots of Itchiness

[Beau]

Hi everyone,

I have an 11 wk old goldendoodle puppy named Beau. Three days after picking him up, he had diarrhea and vomiting. His fecal sample was initially negative. After a stint at the animal hospital (the vet initially thought he may have parvo but luckily that wasn't it), where they couldn't find the cause of his GI upset but were able to normalize his symptoms, he was released with a round of metronidazole and fenbendazole, as well as Proviable-forte, just in case he had giardia. They also put him on Science Diet i/d. I had his stool retested a week or so later, specifically looking for giardia, and he tested positive for giardia, so his vet recommended another dose of the metro and fenbendazole three weeks after he completed his first round. We should be starting that next week.

Luckily, Beau hasn't had a recurrence of diarrhea or vomiting, but his stool is still very soft and smells AWFUL, and he sometimes has smelly gas. When he was on the meds and prescription diet, his stool firmed up and smelled WAY more normal. He is also ridiculously itchy (and has been since we got him; doesn't have fleas) and occasionally sneezes. The vet sent him some prescription shampoo to help with the itch, but that obviously doesn't solve the underlying problem.

My husband and I are on the fence about whether to try switching his diet (currently on Life's Abundance puppy, which is what the breeder had him on) to a limited protein diet. We're not sure if the smelly and loose stool is due to the giardia (unclear whether the meds or the change in diet led to the positive change). If it is the giardia, we still don't have an explanation for the insane itchiness. We have thus far held out from switching because we don't want to add confusion to any potential giardia symptoms, but we hate the thought of him being on something that his body doesn't tolerate.

Any thoughts about how best to approach the situation? And if you all do recommend a switch, what food should I switch him to and how do we proceed from that point forward to figure out what's bothering him? We're open to pretty much anything.

Thanks so much,

Beau and Family

[Karen, Jasper and Jackdoodle]

Marion Nestle, PhD Professor Emeritus of Nutrition and the leading authority on commercial foods for both humans and pets, says there IS no difference...it's all marketing. 

[Beau]

This is all really helpful. Trying to find good information online is a nightmare. I guess if the giardia goes away and fixes his stool, I can just switch to a more complex puppy food or ALS food? If it still smells and is loose after the giardia is gone, then I focus on finding LID because it could mean he has some some of intolerance to something in the L.A.?

I really like the idea of only doing Panacur for this next round. The only thing that gives me pause is that the combination of the two didn't work the first time around. I guess it can't hurt to try just the Panacur though. Worst case, if it doesn't work, we just go back to adding in the metronidazole.

[Karen, Jasper and Jackdoodle]

Honestly, poop stinks. The nicest, firmest poop still stinks, regardless of what you feed them. It's never going to smell nice, even when the giardia is completely gone and it's firmed up. 
I can promise you he doesn;t have an intolerance to something in the food. But when the digestive tract is irritated or inflamed, or there is a parasite or bacterial imbalance, it's not possible for normal digestion to take place and for normal stool to be formed. You see all those commercials on TV for human probiotics? It's the same thing in dogs. We all need a good colony of healthy gut flora to have a healthy digestive function and nice firm regular stools. 

When the digestive tract is not in tip-top shape, it can't handle anything besides plain, simple, bland diets. When children have an upset tummy, we give them tea, rice, applesauce...we don't feed them pizza, lol. It's the same with dogs. 

Puppies who have had giardia from a young age and have been treated with medications, especially metronidazole, are going to have wonky digestive systems until you can get a strong colony of good gut bacteria established. Some people switch them to a homemade chicken and rice or chicken & sweet potato diet rather than the vet's Rx garbage...same idea. Bland, simple food with a lot of fiber. The reason I hate suggesting that for people in your shoes is that it can be almost impossible to switch them back to kibble after that. But it is a LOT easier for them to digest.
I would say, stay with the current food, use the probiotics religiously, and talk to the vet about another course of Panacur alone. I agree that it can't hurt, you can always add metronidazole if it doesn;t get rid of the giardia. Getting rid of the parasite doesn;t do much good if the dog's GI tract is going to be permanently sensitive because of a bacterial imbalance caused by the meds. It's going to be weeks before I would think about switching kibbles. Let's see how it goes.
If you haven't yet read that link I gave you at the beginning of this discussion, you really should. It's an eye opener, and something all dog parents need to know. 
Here it is again: https://doodlekisses.com/group/thefoodgroup/forum/topics/an-update-...

[Beau]

I read the link, and that sounds awful. My husband picked up a 45 day supply of Proviable-forte today, so we'll start him back on that tonight. And we've decided to try a round of just the Panacur. Crossing our fingers that it work this time around. Thank you again for your feedback!

[Karen, Jasper and Jackdoodle]

Please keep us posted. I hope things get better. 

[Beau]

I definitely will, and I do too!

[Karen, Jasper and Jackdoodle]

Just saw this timely article from Texas A & M about the importance of maintaining a healthy gut microbiome, and it includes the same warning about using antibiotics when not absolutely necessary:
https://thebark.com/content/dogs-benefit-balanced-microbiome?utm_so...

[Beau]

Totally unrelated to Beau's giardia (started the Panacur yesterday btw *fingers crossed*), but figured I'd ask here since you all have been so helpful. Beau's vet gave him Interceptor Plus and Nexgard. I went down a google rabbit hole earlier and saw that the FDA has issued an alert for Nexgard. Any thoughts about using these two meds, or better alternatives if these are a no-no? Thanks!!

[Karen, Jasper and Jackdoodle]

We've had many discussions here about this, some of them quite recently. 

Here's a link to a recent comprehensive discussion about this: 
https://doodlekisses.com/forum/topics/flea-prevention-and-breeder-w...

And here's a link to my search on the topic, you can browse through these many discussions and comments at your leisure. https://doodlekisses.com/forum/topic/search?q=Nexgard+FDA

I don't think there should be any further discussion of flea/tick prevents here in this particular current discussion. :)

[Beau]

Perfect thank you!

[Beau]

Beau took his last dose of Panacur yesterday. Hoping that this round worked. If it didn't, my husband and I are considering just letting Beau's body eventually get rid of the giardia instead of continuing to load his system with antibiotics repeatedly (unless he gets diarrhea again, at which point we'd probably try out another round of Panacur). Is that insane?

On another note, I'm trying to figure out which food to have lined up to switch him to once we balance out his system. I know we had discussed LID options, but do you think I should do that, or just switch him to a normal formula? Also, I've gone through a lot of the threads in the group and it seems like everyone is fine with grain-free food, but is there a benefit to feeding them grain-free vs grain (or vice versa)? I see both options on the approved list. 

[Karen, Jasper and Jackdoodle]

Giardia is never going to go away on its own, and since the giardia cysts will continue to be shed in his stool, he will likely keep reinfecting himself. Panacur is relatively benign (much more so than metronidazole) and another course shouldn't hurt if he still tests positive after this, provided you continue to give the probiotics for a good long time. 

Some dogs do better with grain free foods. Grain-free foods often (but not always)  have higher protein content and lower carbohydrate content, which is beneficial to many if not most dogs; it often results in more nutrients being absorbed and utilized, and lower stool volume. Grain-free foods also usually (but not always) have a better Omega 3 content and a lower Omega 6:3 ratio, which is also beneficial, especially for dogs with dry and/or itchy skin. And for those dogs who have atopic dermatitis (also known as environmental, seasonal, or inhalant allergies), which is common in Labs and Goldens, grain-free food can help because it contains less particulate matter. Storage mites, which a common and particularly noxious allergen, live in cereal type foods with high particulate matter. 
However, many dogs do perfectly well with foods that contain healthy grains. If a dog has always eaten a diet that contains grains, has no skin or allergy issues, and has good digestive health, there would be no reason to switch to a grain free formula. 
Your pup doesn;t fall into that category, unfortunately. While it is possible that he might do perfectly fine with a diet containing grains once the giardia is gone and his gut microbiome is healthy, at this point, a grain-free diet would most likely be a better option.