Choosing a food

[Paul]

Thanks Karen and Jackdoodle for the suggestion of posting again, in case there are new more recent thoughts on this.

Abby is 22 months old, 50lbs and an energetic, happy, healthy golden doodle. However about eighteen months ago, one night she had an episode of vomiting (after eating a raw bone). A few months later she had another episode out of the blue of vomiting and diarrhea. She became dehydrated and didn't eat for a few days, requiring IV fluids. At that point she had an ultrasound and a couple of xrays and was put on Metronidazole. Stool came back negative for anything, and after a few days, she recovered.

We stopped raw bones at this point, which we had given her occasionally as it kept her occupied a whole evening.

Since then she has had another three episodes. She wakes us in the night, has diarrhea, and vomiting. She has had several courses of Metronidazole. Stool sample most recently showed Clostridium Perfringens Toxin. She is again on Flagyl and we have been advised to give her only the Hill'Diigestive Care I/D cans, which she eats with relish. She is on Probiotics.

We now want to find a way of feeding her that is healthy and gentle on the gut and I am convinced by this site that the Rx cans are not good for her.

The vet keeps returning to Flagyl .and Probiotics, but this is not sustainable

Any suggestions would be very appreciated.

[Karen, Jasper and Jackdoodle]

Hi Paul, I agree with you that the Hill's i/d food is not a good choice for Abby. There are some cases of digestive disease in which an Rx food is your only option, but even in those cases, Hill's i/d is still not a good choice for any dog, for any reason. There is nothing therapeutic or medicinal in Hill's i/d, and the inbgredients are among the cheapest and worst on the market. In cases where a dog needs an Rx food, the best brand is Royal Canin, and your best choice is usually a hydrolyzed protein food like Royal Canin's HP. 

One thing to take away from this if nothing else is to never, ever let a vet give your dog metronidazole without a good reason, and never repeated courses of it. This alone can lead to severe bacterial imbalances in the gut, and even Inflammatory Bowel Disease. A "good reason" is a verifiable infection in the gut, and even then, there are are other drugs that are both more effective and more benign than metronidazole. 

What probiotic did your vet give you? Many vets sell you Purina's Fortiflora, which is not a good choice. Proviable DC is a better choice, and for cases of continuing digestive issues such as Abby is experiencing, your absolute best bet is a human probiotic called VSL#3, which has been studied in dogs with serious digestive disease and has been a miracle for many of us here. It is pricey, but no more so than endless rounds of junky Rx food & probiotics. 

Also, you must give probiotics at least two hours apart from antibiotics, and longer is better. 

I would suggest getting the VSL#3 (I buy it at CVS; you want the capsules, not the powder. They keep it behind the pharmacy counter as it MUST be kept refrigerated.) and start Abby on 2 capsules once a day. 
She needs to be on a single protein, limited ingredient food, preferably one that contains a protein she has not eaten in the past. Look at Zignature, any formula other than Zssentials. Also look at the Wellness Simple Solutions line. A third option would be Acana's Singles line. 

Do not give any treats other than plain pure protein treats like Pure Bites, and try to stick with the same protein as the food. For chews, try elk antlers (supervise her closely) or Nylabone DuraChews :https://www.chewy.com/nylabone-durachew-peanut-butter-/dp/108523
If she still has symptoms after 2-3 weeks, I would ask your vet to run a GI blood panel. Specify GI panel. This is diiferent from what GP vets run in house; it measures only three things: cobalamin, folate, and something called a TLi ratio. It must be sent out to TAMU and takes about 5-7 days to get results. If the GI panel shows any abnormalities at all, my next step would be a veterinary internal medicine specialist. 

[Paul]

Thank you so much for this information. I know this about myself as a human patient, that I have to be my own advocate, but I am realizing that I need to be Abby's too. I am worried about the repetitive use of Flagyl. So I will definitely follow your suggestions and see how it goes.

I really appreciate your detailed input.

[Karen, Jasper and Jackdoodle]

The following discussion about another member's experiences with repeat courses of metronidazole will interest you, and hopefully serve as a cautionary tale: 

http://www.doodlekisses.com/group/thefoodgroup/forum/topics/an-upda...

[Karen, Jasper and Jackdoodle]

I would also stop the metronidazole and ask your vet for tylosin (brand name Tylan). This is a much more benign drug than metronidazole, with none of the side-effects. Many of us whose dogs have been diagnosed with digestive disease are on Tylan with no ill effects. 

And it's possible that Abby doesn;t need any drugs at all, since 80% of all dogs test positive for Clostridium Perfringens, whether they have symptoms or not. Here is some reliable info on that: http://www.marvistavet.com/clostridium-perfringens.pml

I hate to say it, but maybe you need a new vet? 

[Paul]

Dear Karen And Jackdoodle
We stopped the Flagyl and transitioned Abby to the zignature duck... We also started the VSL 3 twice daily.
Abby has been so well. She has her old energy back and seems so happy. Her poops are normal with no blood or mucus..
I am so grateful to you for the guidance. Thank you.
Do you think we should keep her on the VSL 3 twice daily indefinitely?
Also she does poop several times a day - more than before - but always solid, formed with no mucus or blood. Is that normal? Is the frequency of bowel movement an issue? she does about four per day.
I so.appreciate this forum Thanksu again.

[Karen, Jasper and Jackdoodle]

I'm so glad Abby is doing well! Thanks so much for the update.

You can cut back to giving the VSL#3 once a day. I would continue it for at least a month; there is no harm in giving it indefinitely, even forever lol, but I know that can get pricey. 

As long as her poop is solid and well-formed, I wouldn't worry about the frequency. 4 times a day does sound like a lot, but every dog is different, and the volume may decrease as she adjusts to her new diet. It often takes a month or two for their digestive systems to completely adjust after a major dietary change. 

I hope Abby continues to do well.