Is Metronidazole safe?

[Diane, Hurley and Sidney]

Hurley has loose stoles. I took a sample into the vet. Nothing discovered. Thinks he just ate something. Prescribed Metronidazole. Is that medicine acceptable? I am feeding him white rice, chicken, chicken broth, either sweet potato or banana in his food. There has been no change in his diet.

[Karen, Jasper and Jackdoodle]

I personally would never give any dog metronidazole without a good reason. Diarrhea in itself is not a good reason to give antibiotics unless there is a confirmed infection that needs to be treated. If the vet thinks that the diarrhea was caused by Hurley eating something he shouldn't, why would he prescribe drugs for that? 

I am so frustrated with vets prescribing this drug for every case of diarrhea regardless of cause. It can have serious side effects, especially when used frequently or long term.

I'd skip the chicken broth, and if Hurley normally eats a grain-free diet, I'd skip the rice, too. I'd feed a 50/50 mix of plain boiled white meat chicken and sweet potatoes with maybe a little plain fat-free yogurt. You'll need to feed about twice as much of the homemade diet as you normally feed kibble, as it's much lower in calories. If it doesn't resolve in a couple of days, or if it gets worse, you may want to bring in another stool sample, as giardia doesn't show up in every sample. 

[Diane, Hurley and Sidney]

Thank you all for your thoughts and suggestions. Hurley does not get dirrehea except on rare occasions and then I can usually trace it back to something he probably ate. He does on occasion throw-up, also. That tends to be something he found in a trash can in the bathroom (Kleenex or such). PS I am still training my husband to be careful what he puts in the trash can and am back to trying to catch Hurley at it so he can be disciplined.

Anyway, I am going to start with the sweet potato end chicken diet and am giving him yogurt also. If it clears up and does not come back than it will be clear it was something he picked up. Challenging for me to figure out where or when. My brother claims Hurley and the other two doodles are not allowed to eat anything on their walks but.....

If the dirrehea comes back I'll take another sample in and ask for a giardia test. And will give Hurley the meds. I don't like to take meds myself so I did not want to rush into giving anything to Hurley until I had addressed it with people such as yourselves.

I put a lot of faith in what I read and learn on doodle kisses and have gained a lot of valuable knowledge. Plus hearing about what other doodle owners are experiencing. And best of all is enjoying the pictures of the doodles and the comraderie.

[Karen, Jasper and Jackdoodle]

Diane, if he does come up positive for giardia, you want Panacur. Studies have shown that it is more effective than metronidazole for clearing up giardia, and it has far fewer side-effects.  http://www.vetmed.wisc.edu/pbs/zoonoses/GIk9fel/giardia.html

From the article: 

Treatment of Giardia infections in dogs and cats:

• Metronidazole (e.g., Flagyl) can be used in both dogs and cats (not in pregnant animals).
• Albendazole (e.g., Valbazen) was recently found to be quite effective in dogs, and may be more efficacious than metronidazole in stopping the shedding of cysts. However, both metronidazole and albendazole have been associated with significant adverse reactions in dogs and cats:
  • Albendazole: leukopenia +/- anemia and thrombocytopenia; anorexia, lethargy; CNS signs; vomiting and diarrhea; salivation; elevated hepatic and pancreatic enzyme levels; abortion and teratogenicity
  • Metronidazole: vomiting; CNS signs
• Fenbendazole (e.g., Panacur® or Drontal-Plus®) now appears to be the drug of choice. Used in dogs and cats at 50 mg/kg for 3 (-5) days, fenbendazole has been shown to be completely effective in eliminating experimental Giardia infections, and with only mild vomiting/diarrhea as potential side effects.

[Diane, Hurley and Sidney]

Thank you, Karen. I am printing your recommendations off to have with me if I need to go back to the vets.

I am going to be very puzzled as to how he picked it since the only other dogs he is around are his two doodle buds and he is the only other dog they are around.

[Shari Becker]

Sounds like you have already solved this problem, but in February, while on vacation, Lexi was hospitalized for what we believe was food poisoning. She snagged something from a spilled trash can, and was violently ill within 24 hours. At the hospital, they were insistent that we had to give Metronidazole, saying it would bring down her inflammation. (There was even blood in her stool) We called our vet at home, and she was totally opposed to it as a first tactic. She said that if they found an infection or parasite that it was one thing, but that it so clearly seemed to be food poisoning and there were other approaches to try first. She suggested we take the prescription and hang on to it in case more natural approaches didn't work.

We used Slippery Elm, probiotics, pumpkin, sweet potatoes and boiled meat. It did take Lexi a full week to be completely back to herself, but she was so much better within 24 hours and then even 'more' better in 48 hours...

Ironically, we were at the vet yesterday for another reason (Puppy herpes UGH), and she was saying that she wishes more vets and pet owners understood that sometimes viruses and bugs just need to run their course. She said Metronidazole is a great drug when used properly, but that is becoming a magic bullet for some practices every time a dog has an upset stomach.

[Karen, Jasper and Jackdoodle]

Apparently, the American College of Veterinary Internal Medicine agrees with your vet, Shari:

http://www.vetcontact.com/en/art.php?a=572

From the article: 

Metronidazole, a `classic` drug in canine medicine, is currently very popular to treat a variety of diseases: giardiasis, various inflammatory processes in the gastrointestinal tract, hepatic encephalopathy etc. The potential myelosuppressive side effects of this drug are well known, but neurological problems seem to be more common and less known, as the excellent summary of the American College of Veterinary Internal Medicine shows.

Metronidazole is a synthetic nitroimidazole compound used with increasing frequency in small animal practice. It is commonly prescribed in the treatment of inflammatory bowel disease, gastritis associated with helicobacter, giardiasis and empirical treatment of diarhea. 

Metronidazole has also been used successfully to alter intestinal flora in dogs with hepatic encephalopathy and exocrine pancreatic insufficiency. Use of this antibacterial has been advocated in the treatment of osteomyelitis and periodontal diseases.The mechanism of action for these effects are a matter of controversy. It is believed that the drug disrupts DNA and nucleic acid synthesis in bacteria. Its antiprotozoal activity is not adequately explained. 

Adverse effects in dogs and cats include neurologic disorders, lethargy, weakness, neutropenia, hepatotoxicity, hematuria, anorexia, nausea, vomiting and diarrhea. 

Neurotoxic effects include encephalopathy, cerebellovestibular signs and periopheral neuropathy. 

Neurotoxicity following prolonged therapy is most often related to cumulative dose and duration of treatment. 

Most canines who develop neurologic signs secondary to metronidazole administration have received weeks to months of therapy, but toxicity after short-term therapy at relatively low dosages (<60 mg/kg/day) has been reported. 

 

[Diane, Hurley and Sidney]

Hurley's stool this morning is just about back to normal. I gave him sweet potato, chicken, rice and banana last night and this morning. I'll go back to his regular grain free food as soon as his stools are completely firm. If they turn soft and very loose again I go to next steps.

What I hearing from all the replies is to be sure he has an infection before taking Metro or any other medication which would mean a stool specimen to the vet asking for further testing for specific conditions.

You have no idea how helpful you have all been.

I am always impressed with the wealth of knowledge, experience, understanding, compassion, etc so many have for others. H's issue is small compared to what some of you have gone through with your pups.

[Karen, Jasper and Jackdoodle]

I'm glad that Hurley's digestion seems to be getting back to normal. Dogs do get occasional stomach bugs, just like people, that usually resolve in a couple of days with a bland diet, and I hope that's the case with Hurley. Please keep us posted.