What's going on with my pup?

[Monica And Cooper]

Hi everyone. So Cooper is 10 months old now and other than puppy craziness and some stuff when he first came home all has been smooth. About 2 weeks ago he started having diarreah. He even pooped and peed in the house which is unheard of for him. He went to the vet and his fecal ttested negative for everything. We always play ball in the backyard and at times he gets into cat poop (we have strays in the neighborhood) he is never unattended but manages to find it and he's quick. So the doc said he thought it was from that. Gave him a shot sent home 3 cans of ID food (I think that's what it was called) and put him on a med called sulfasalazine. After a few days I slowly transitioned back to his regular food. He was great within a few days. Fast forward 6 days and here we are again. He started yesterday with diarreah again and pooped all over his bed this morning. Vet said to start him on rice and I may have to bring him in.

No vomitting
Absolutely no change in diet, no new snacks.... Nothing
He is still on Origen puppy
Has been watched like a hawk in the yard and to my knowledge has not gotten into any cat poop.
His disposition is good. He is is happy and goofy self.

I'm at a loss. Can't figure out the culprit. Any feedback greatly appreciated.

[Karen, Jasper and Jackdoodle]

Well, it would help to know what kind of shot the vet gave him, but the "culprit" is likely the sulfasalazine. That's a very powerful antibiotic/aspirin combination that's normally only used for severe digestive diseases like Inflammatory Bowel Disease or Colitis. I have to say that I think your pup was way over-medicated, especially in light of the fact that there was no infection found, and the vet suspected the diarrhea was from eating cat poop. Why give a powerful antibiotic/antinflammatory for that? In fact, I have never heard of a dog being given sulfasalazine for one bout of diarrhea. 

Any time a dog is on antibiotics, and especially the strong ones that work mainly on the GI tract, you must also give probiotics, and you need to continue them for a couple of weeks after the antibiotics are discontinued. The reason is that the antibiotics kill the good bacteria necessary for proper stool formation along with the bad bacteria, and once the meds are discontinued, diarrhea often returns and can even be worse. 

Order Proviable today. You can only get it from the vet or online. In the meantime, start giving him 2 tablespoons of plain unflavored nonfat yogurt 2-3 times a day. 

Now on to diet. Forget the rice. Your dog is on a grain free diet, the last thing he needs is rice. Also forget the Hill's i/d, which is nothing more than a poor quality "bland diet" consisting mostly of corn and chemicals.

The best "bland diet" to feed when a dog has tummy troubles is a homemade mixture of 50% plain cooked white meat chicken and 50% mashed sweet potatoes. You can bake the sweet potatoes in the microwave very quickly, and the peel comes off with your fingers. The homemade bland diet contains less than half the calories of the Orijen, so you will need to feed about twice as much. Keep him on that diet and the probiotics until the stool firms up, then gradually reintroduce the kibble. If the diarrhea persists, ask the vet to do an Xray, to be sure that he hasn't ingested something that is indigestible and is sitting there in the gut. I've had people here tell me they are absolutely positive that their dog didn;t eat anything like that, and after weeks of meds, diet changes, hair-tearing-out, etc., it turned out there was a sock or part of a rope toy sitting in there. 

I hope this helps.

[Monica And Cooper]

Well I'm so happy I read this now. I was literally on my way back to the vet for the ID and they wanted to do another round of the sulfasalazine!!!! Pulled over at a gas station to read. will start with all your suggestions today.
So should I continue to feed him this new diet on his regular schedule (2xper day)?
Also I'm sorry to be so literal but exactly how much chick/potato should he be getting at a feeding? I will order the probiotic today.
How long should it usually take for he to respond to the new diet and stools to harden? I just want to know when it's time to start getting really concerned. A foreign item sitting in his gut sounds scary.
As always Karen thank you for your wisdom and suggestions. You never disappoint! :)

[Karen, Jasper and Jackdoodle]

One cup of the homemade mixture contains only about 200 calories; the Orijen Puppy has about 480. So if you're feeding 2 cups a day of Orijen, feed 4 cups a day of the homemade food. 3 cups Orijen = 6 cups homemade food. 1.5 cups of Orijen = 3 cups homemade food. You get the idea. 

The most important thing is to get that Proviable. He needs some good gut flora. Start the yogurt in the meantime. And you'll need to give the probiotics for several weeks, even after things are back to normal. 

A foreign item sitting in the gut is scary. It can lead to an immune response, which in turn can be the beginnings of IBD, and I wouldn't wish that on my worst enemy. 

But we have to think, what caused the diarrhea to start with? The most common cause is giardia, or some other parasitic infection. You might consider having another fecal done. Giardia doesn;t always show up in every stool sample. But you are going to need to be strong about the i/d and the sulfasalazine. The diet part is pretty easy, you can simply say you would prefer to feed him a homemade bland diet that is grain-free rather than corn, brewer's rice, and cellulose (here are the ingredients in Hill's i/d to back you up: http://www.hillspet.com/en/us/products/pd-canine-id-dry Whole Grain Corn, Chicken Meal, Brewers Rice, Egg Product, Corn Gluten Meal, Whole Grain Sorghum, Pork Fat, Chicken Liver Flavor, Powdered Cellulose, Lactic Acid, Soybean Oil, Pork Liver Flavor, Potassium Chloride, Iodized Salt, Dried Beet Pulp, Calcium Carbonate, Dicalcium Phosphate, vitamins (Vitamin E Supplement, L-Ascorbyl-2-Polyphosphate (source of Vitamin C), Niacin Supplement, Thiamine Mononitrate, Vitamin A Supplement, Calcium Pantothenate, Vitamin B12 Supplement, Pyridoxine Hydrochloride, Riboflavin Supplement, Biotin, Folic Acid, Vitamin D3 Supplement), Choline Chloride, minerals (Ferrous Sulfate, Zinc Oxide, Copper Sulfate, Manganous Oxide, Calcium Iodate, Sodium Selenite), L-Tryptophan, Taurine, Mixed Tocopherols for freshness, Natural Flavors, Beta-carotene)

With the meds, I personally would say that I am not comfortable giving antibiotics without knowing the cause of the diarrhea, and without a diagnosed infection present. 

If the vet insisted that he needed something, I'd ask for Tylan (tylosin). It's a very mild antibiotic used to treat all kinds of digestive issues, and it has virtually no side effects. 

[Karen, Jasper and Jackdoodle]

Oh, and if you do run another fecal and he does test positive for giardia, ask for Panacur. Insist on it. Not metronidazole (flagyl). 

Assuming that the cause is just a stomach bug, the stool should firm up with the bland diet and the Proviable within a week. 

[Laura and Angus]

I was gonna mention the Giardia too! We had a bout of this with our pup recently from daycare and they get that from eating stool...ugh! 

[Karen, Jasper and Jackdoodle]

Monica, I was looking back at your past discussions and saw that Cooper has had some health issues in the past. I see that at one point, he got a B12 shot. If he has any issues related to absorption of B12, that could be related to the diarrhea. I'd ask for a B12 shot, it's harmless and might help. 

Another thing I wanted to mention regarding sulfasalazine: When my Jack was first diagnosed with IBD a few years ago, I was exploring different drug options hoping to avoid the long-term use of prednisone, and I came across sulfasalazine. It was not recommended for Jack because it can cause a disease of the eye called keratoconjunctivitis sicca or KCS. In some breeds, KCS is genetic, and Poodles are one of the breeds affected, particularly Miniature Poodles. With Cooper being an F1B mini, I'm assuming that there are Miniature Poodles on both sides of his genetics, which is another reason you really want to avoid sulfasalazine when not absolutely necessary. 

[Monica And Cooper]

Karen when he was a pup they had given him tablets for the b12 deficiency, just like a little supplement. Vet is closed until Monday. Should I give him those tablets or not add anything new?

[Karen, Jasper and Jackdoodle]

The thing about B12 supplements is that if there is some reason the dog (or person) isn't absorbing B12 from their food, they aren't going to absorb it from oral supplements, either. There's a glycoprotein called intrinsic factor that is produced in the stomach, and which is necessary for B12 absorption. When there is some damage or problem with the lining of the digestive tract, that can interfere with the production of the intrinsic factor and therefore with the absorption of B12, which is why dogs with IBD so often have B12 deficiencies. This is also why B12 is usually given as a shot. There are oral B12 supplements that contain intrinsic factor, but they aren't common, and not all of them are effective. I'm sure it wouldn't hurt to give him the B12 pills, though, and it might help a bit.   

[Monica And Cooper]

Ok thank you!!!