An update on Woody & possible long term effects of metronidazole

[Jill, Woody & Maxi]

I am one of the many owners whose puppy (now 3 years old!) came home from the breeder at 8 weeks with loose stools, diarrhea, pudding poop, whichever you would like to call it.  After weeks of negative fecals, we finally received a positive fecal for giardia.  Our first vet prescribed a course of metro, which temporarily cleared it up, then, back again to diarrhea. Course after course of metro, hills I/D food, a prescription of clay (what was I thinking?!?!) 2 vet changes, more metro, (finally) Panacur..and then my breeder told me about Doodlekisses.  By this point, Woody was 5 months old, so this treatment has been going on for 3 months, with no resolve.  To make a long story short, after DK, and the help of Karen and friends I learned about the importance of a quality dog food, and the importance of treatment for giardia.  Throughout those 3 months, never once did I (or was I told by a vet) to give a probiotic..so Woody had 3 months of metro kill the bad bacteria in Woodys intestines…along with the good bacteria.  We tried all quality foods, and nothing would work..until The Honest Kitchen, Embark..and even then things still weren't perfect…we were finding pieces of undigested food in his stools.  After a bout of acute pancreatitis (from adding ground lean turkey to his Embark) We finally decided we need to take this further than our regular vet.  

We made an appointment at Cornell University Animal Hospital, where we found out Woody has an inflammatory bowel condition of his digestive tract that was causing diarrhea and preventing complete digestion of his food. In inflammatory bowel disease, the body's immune system attacks either proteins from the diet or self antigens or normal bacterial flora in the GI tract. The bowel wall becomes inflitrated with inflammatory cells and the result is destruction of villi and thickening of the bowel wall. This prevents normal uptake and digestion of food and leads often to diarrhea and weight loss. 

Inflammatory bowel disease can be grouped into three catagories: food responsive, antibiotic responsive, and steroid responsive. We are lucky enough, that Woody has fallen into the category of food responsive.  We have been home cooking for him full-time for well over a year now. I have a system where I buy in bulk, take one 4 hour period out of one day of the week, and prepare about 7-10 days worth of food, which I freeze, then take out during the week.  It is simple, now that I have a system.  This will now be a life long commitment, which I am more than happy to do..being that he is responding so well to it (we just had our follow up appointment, and all of his labs came back great!)

My point of this discussion is that you have to be your own advocate.  If I had the knowledge that I learned here on DK…who knows? Maybe this could have all been avoided.  Please, don't ever let your vet give you medicine without a good reason, and KNOW the side effects, and what you can do to avoid them..in the case of Woody, maybe taking a probiotic from the beginning would've helped?

So a BIG THANK YOU to all that have helped along the way..and please, if anyone has any questions, feel free to ask!

[c zoomer]

You have shared some very important information. My thanks to you. I hope all of the newbies find this so they are forewarned. Dinah was given meds for her uti and probiotics were also given. When I questioned the vet, she said dogs didn't have a backlash from killing bacteria (and getting a yeast infection like people). I dunno, but I'm glad she was given the probiotics!

[Dolly Dykhouse]

I am so grateful to this group I cannot begin to thank all of you members enough for sharing all of your education whether through research or hard fought experience.

I brought Henry home 3 weeks ago today and he has had soft stools/runs ever since. I brought him for his first puppy check up the next day and a stool sample which tested negative for Giardia and other parasites. The vet wanted to put him on Metro and a bland diet for 5 days. The bland diet was met with even worse runny stools so I put him back on his kibble. I added yogurt and pumpkin and Proviable DC which he has been on ever since. The stools firmed up and then would go back to soft. He has always been a double pooper, first would be fairly firm and second fairly soft. He would eat every kibble at each meal and was happy and energenic and has gained over 7#. I took him in for his 2nd round of puppy shots on Thursday and it has been non stop soft pudding poop ever since. He has 6-7 or more stools a day, even waking at 2am to go out and have a loose stool. I thought maybe its time to change to a better food so I bought Earthgrains Holistic Puppy Vantage and mixed 1/4 C in with each 3/4 C for each meal two nights ago. Last night he only ate half his dinner and again this morning only half. I tried giving him some of his original kibble to see if that was it, nope. I gave him a 1/4 C of the new kibble to see if he liked it better, nope. I thought okay, maybe he just doesn't like it and I'll try something else like Wellness Core or Fromm. I just don't want to willy nilly be changing foods on him especially with the ongoing soft stools. Last night he had one slightly firmer stool and it looked to have some blood in it. I am now beside myself! Of course the vet is closed today for Easter Sunday so tomorrow is the earliest I can get him in and bring yet another stool sample. I am so tempted to buy the Panacur and treat him even though he has tested negative but I don't want to treat him unnecessarily. I am feeling a bit lost, thank goodness for this group and the similarities you have all shared.

Any advice is welcome...Karen a big thank you to you for your original comments on the Puppy Madness thread. I can use all the help I can get.

[Karen, Jasper and Jackdoodle]

It's a mistake to start switching foods at a time when a puppy has diarrhea; it just confuses the issue. 

It does sound like he may have giardia, which does not show up in every stool sample, and also has a 10-14 day incubation period; so he very well may have had it when you brought him home, and it was just too soon for the giardia cysts to show up in a fecal float test. I would bring several samples in to the vet for testing, as the cysts will not be present in every one, and I would ask for Panacur whether he tests positive or not. Insist on it. 

Panacur is a very benign drug with virtually no side effects. I would not be concerned about using it, even if he doesn't have parasites. 

There is no reason to ever feed any dog an Rx "bland diet"; it's absolute garbage and contains no medicinal or therapeutic ingredients whatsoever. If needed, you can feed your own "bland diet" consisting of 50% plain white rice (or cooked sweet potatoes, for dogs on grain free diets) and 50% boiled white meat chicken diced very fine, or very lean (90% or better) cooked ground beef with all fat drained off. You will need to feed about twice as much of the homemade diet as you typically feed kibble, as it contains only about half the calories. 

When looking for a new food for a dog with digestive issues, you want to look for a grain free food that contains a single protein source and very few other ingredients, what we call an LID or limited ingredient diet. Wellness Simple Solutions and Zignature are two brands to consider. These are not "puppy" foods, but they are fine for puppies. 

You also want to use only 100% pure protein treats like Pure Bites, or small pieces of plain boiled white meat chicken if you give treats, and be sure to carefully supervise the pup outdoors to be sure he isn;t ingesting anything he shouldn;t.

If all else fails, pick up a bottle of VSL#3 probiotic capsules (human probiotic sold in drugstores, must be refrigerated) and give one capsule per day instead of the Proviable. Probiotics must always be given at least 2 hours apart from any antibiotics.

I hope this helps. 

[Dolly Dykhouse]

You're right, I blew it on introducing a new food right now. I had hoped (naively) that a change to a better quality food might help. It looks like we will wait until we get his bowels to a normal state before attempting that again and we'll try Wellness or Zignature.

The bland diet he recommended was actually the homemade variety with boiled chicken breast and rice and some canned organic pumpkin. I used my pressure cooker and cooked the breast in water with sweet potatoes. I gave him the cooked chicken with the plain rice and sweet potato and the runs seemed to get worse not better so I went back to the kibble. 

I agree that I need to bring a couple of samples tomorrow and no matter what he is going on Panacur. If it's a relatively benign drug it certainly won't hurt him and as many have said, there are false negatives in testing for Giardia so I am going to insist we do something that might help him in the long run. 

It's been decades since I had a puppy and my youngest is 26 so I had forgotten what it is like to feel so vulnerable when your helpless child (furry or otherwise) is not quite right and you feel like you are grasping for straws to make it better. Thanks for your wisdom Karen, it's greatly appreciated.

[Karen, Jasper and Jackdoodle]

I've never used a pressure cooker, but there's an easier way to cook sweet potatoes and chicken, at least to me, and I like to cook them separately so that I can be sure of the proportions of 50 % protein to 50% carbs. You can bake a large sweet potato in the microwave in 7 minutes, and it will retain more of the nutrients than using water. Then you can easily peel them and mash with a fork. I boil boneless skinless chicken breasts for about 20 minutes, and then cool in ice water. I wouldn't use both rice and sweet potaoes, use just one or the other. If you use sweet potatoes, no pumpkin is necessary, as the sweet potatoes have more than enough fiber, which is one reason I prefer using them over rice. The combination might also have contributed to the runs getting worse, especially if you also gave pumpkin. Higher carbs/less protein can cause loose stools for some dogs.  

I once had a foster here with raging giardia, and although i was very careful about cleaning up after him, I was concerned about JD getting it. My vet ran a fecal, and even though Jackdoodle tested negative, the vet suggested that I give him 3 days worth of Panacur just to be safe. JD has several health issues, and I know my vet would not recommend giving him any kind of drug unnecessarily if there was any risk to it. Panacur really is very safe. 

[Haley, Yeti, and Phin]

How does a dog contract giardia? Just wondering for future reference!

[Karen, Jasper and Jackdoodle]

The giardia cysts have to be ingested, which usually happens in one of two ways; from standing water outdoors, including puddles, or from fecal matter from an infected animal. Anything that gets on their feet and then they lick their paws, or they drink from a puddle, or they pick up a tennis ball that's been sitting outside bathed in spring runoff, or...

Public dog runs are a hazard, so are communal water bowls at dog parks. But it's also very common for puppies to come home with it, especially if there was more than one litter at the breeder and/or the puppies are allowed outdoors in the same spaces that adult dogs and/or wild animals go to the bathroom, or even in the same indoor spaces if the adult dogs are tracking things in from outside. 

[Dolly Dykhouse]

Well that certainly applies to Henry. His breeder co-bred her sire with another breeders dam; Henry was at his dams breeder until 3 days before I picked him up. There were two other litters, one a week younger and one a week older at the sires breeder for a total of a dozen or more pups in the puppy run. We took Henry out for a walk on her property so she could show me how she "personality tests" each puppy. Of course he did his business while we were walking as I am sure multiple puppies from other litters have done before him. 

I wish I had found this site before getting Henry, but man I am so glad I have found it now!

[Haley, Yeti, and Phin]

Thanks so much Karen! We are getting puppy number 2 (not anytime soon) and I just wanted to make sure I knew how to prevent it incase puppy number 2 comes home with it! :)

[Karen, Jasper and Jackdoodle]

If there are a large number of cysts present in an area, such as a public dog run, they can even get it from sniffing the cysts from contaminated ground:

https://vcahospitals.com/know-your-pet/giardia-in-dogs

[Dolly Dykhouse]

Okay, I removed the pumpkin and just gave him the sweet potato. He gets 1 cup of kibble (12 weeks and 20# so recommended amount of his chicken soup for the dog lovers kibble is 2-3 1/4 C per day) and for the last 3 feedings he is not finishing his bowl like he always has and I'm thinking it might be too much kibble plus the 1/4C of sweet potato? Should I decrease the kibble a bit and give a bit more sweet potato? I also give him a good tablespoon of plain yogurt with his kibble at lunchtime along with his daily dose of Proviable. I really want to switch him over to Wellness Core because even though the chicken soup for the dog lover puppy is a recommended food it does have grain in it and I think that might be a contributing factor. Should I hold off on this until he has had the 3 doses of Panacur and see how his stools are doing?

I'm taking his stool samples from yesterday to the vet today, I ordered the Panacur yesterday on Amazon and gave him his first dose with his dinner; so grateful to Amazon Prime same day delivery let me tell you! I'm really hoping this does the trick, I can't stand thinking that he is suffering in any way. I can tell when he's uncomfortable, he is restless and flopping around in his crate some nights and I know we will be getting up in the middle of the night with his need to poop. The pudding poop with signs of blood sent me over the edge yesterday with worry.

[Karen, Jasper and Jackdoodle]

Yes, blood in the stool is never a good sign. 

I would hold off on making any changes in his kibble until the stool improves. You can eliminate the kibble and just feed the homemade bland diet, but i would not introduce a new kibble for awhile. 

I think it might have been better to hold off on the Panacur until you see the vet and get a recommendation for dosage and length of treatment. He may need 5 days of treatment. But I don't think it will hurt that you've already started it. 

And again, you must not give the Panacur and the Proviable within 2 hours of each other, and longer is better.