Puppy with Diarrhea

[Mcct]

Hi all. I'm looking for advice about my 5 month old australian labradoodle (she's 35 lbs, will get to be about 45, I'm guessing). She has had several bouts of bad diarrhea that I'm trying to figure out. Fecal samples are clear. The 1st time, the vet gave her metronidazole but I have said no to it since then after learning more about it. Recently, puppy has been eating LA All Stages Grain Free food (after switching her from the LA puppy food after lots of diarrhea). I've been giving her proviable DC probiotics for a few months now, along with Optagest digestive enzyme and a teaspoon of pumpkin with her kibble. She was great for about a month on the new all stages food (LA), but now has terrible diarrhea again. I'm cooking her plain chicken and white potato for now (should I switch to sweet potato or is that too much fiber?) and am continuing with the probiotic and the enzyme. I realize from reading other comments on this board that I should be feeding her more of the homemade food, as it's not equal in nutrition to the kibble. As she comes out of this bout of diarrhea, I'd like to transition her off of LA brand food. Once she normalizes on the home-cooked food and I'm ready to slowly re-introduce kibble, do you think I should just re-introduce a new brand, or go back to her LA food for the transition, then later transition away from the LA food? Any good suggestions of a new kibble for her would be appreciated. Vet mentioned Canidae grain-free, Oso Pure and Natural Balance as some options but I'm not sure what to go with. My pup seems super sensitive so I don't want to play around with her food excessively. What would you do if she was your pup? Thanks so much - I truly appreciate your wisdom and this board. 

[Mcct]

I've also limited treats for the last few months to really limited ingredients. Mostly just dehydrated chicken treats. No bully sticks, etc. 

[Karen, Jasper and Jackdoodle]

There is an ALD breeder in your area who has a strain of antibiotic resistant giardia rampant in her puppies. How many fecals have been done and when was the last one?
I would stop the digestive enzymes; they are worthless and can actually make matters worse. I would use sweet potatoes rather than white potatoes for the homemade food, in a 50/50 mix of white meat finely cut chicken and sweet potato, and you need to be feeding twice as much of that as you normally would feed kibble. You do not need the pumpkin if you switch to sweet potatoes.
The best LID food I have found for dogs with digestive issues is Wellness Simple Solutions, either the salmon or the turkey formula.
You might also consider switching probiotics to VSL#3. We've talked about this a lot here, hopefully you have seen some of the posts. VSL#3 is a human probiotic which has been studied extensivelty in dogs, and it has worked wonders for those of us whose dogs have chronic diarrhea or digestive issues. You can do a search here for more info. In either case, you will need to continue with the probiotics for several weeks even after the stool improves. 

[Haley, Yeti, and Phin]

I switched my pups to Wellness Simple Solutions and I am very happy with it! My older guy has a sensitive tummy with diarrhea issues similar to your own while he was a puppy. Karen have you ever heard of perfect form from honest kitchen? Would it be worth a shot for her?

[Mcct]

I have heard that's a good one too. I wonder what Karen will say about it....

[Karen, Jasper and Jackdoodle]

Perfect Form is okay, but a good probiotic would do a lot more.

[Haley, Yeti, and Phin]

I am glad to hear that! The boys had relentless diarrhea from Thanksgiving into January with multiple fecal tests from different vets coming back negative. Every time I tried to wean back onto kibble it would come back. I was giving VSL #3 and read about perfect form so I decided to give it a shot. After about a week the diarrhea subsided and I was able to successfully wean them back onto kibble. Only problem was they didn't want their kibble after having chicken and pumpkin for 2 months straight (which was so expensive! I  have no idea how people can afford to feed homemade) hahahaha.

[Mcct]

Thank you, Karen! The last fecal sample was at least a month ago. I should get another one. Our breeder says she hasn't seen this issue. I will follow your advice on feeding. When I transition my pup off the homemade food and back to kibble, do you think I should go directly to the new food (I'll try the Wellness LID) or transition her back to the LA kibble, then transition to the Wellness at a later time? Is it OK to feed a 5 month old pup this Adult Wellness food? I've been on VSL #3 before - my family all has gut issues. It's expensive but I agree that it may be what will help her get the good gut flora built back after her early exposure to the metronidazole.  Would you give 1 capsule of VSL #3 a day or a different dose? Thanks again - this is super helpful. 

[Mcct]

One more thing - once she balances out, do you have any treats you'd recommend? Is there something basic and grain-free that you've seen work well for sensitive pups?

[Karen, Jasper and Jackdoodle]

Oh, and treats: Pure Bites Chicken is your best bet. Just 100% plain freeze-dried white meat chicken. 

[Karen, Jasper and Jackdoodle]

Re " Our breeder says she hasn't seen this issue", that's what I hear from every person whose puppy or dog has had any kind of health issue. They will not admit it. Nothing you can do about that, except not buy from her again or recommend her to others. 
When you transition from the homemade food, I'd go straight to the Wellness Simple Solutions. It is fine to feed it to a puppy, you will just have to calculate feeding amounts as the label won't give that info for puppies. Your vet can help you with that. I can help too.
If you do try the VSL#3, give her one capsule a day. I found that buying it at CVS if you have a CVS frequent buyer card is the cheapest way to go. You get a 30-40% off coupon every month, and you can buy it then; saves a ton. And CVS's price is already about $10 below the manufacturer's retail. 

[Mcct]

Thanks again. I didn't realize CVS carries VSL, good to know.

The vet is suggesting giving her immodium (1/2 tab) and I have held off, as it seems that's not getting to the root of the issue. Or is it helpful to reset the diarrhea process? I have seen a bit of blood in her stool the last few days so I called in to report that and haven't heard back.

The other food that has been recommended to me a lot lately is Osopure (Artemis) LID turkey and garbanzo bean (or duck + garbanzo) kibble. It is only available in my area though. Several local pet boutiques say they've seen it to be great for sensitive dogs. 

[Karen, Jasper and Jackdoodle]

Not every CVS branch carries VSL#3 capsules so call around. If your local store doesn;t have it, they will usually order it for you.
Wellness Simple is nutritionally superior to the Osopure. Simple contains 26% protein as opposed to only 24% in the Osopure. Fat is 12% in the Wellness food vs 14% in the Osopure. (you always want more protein and less fat with digestive issues.) The BIG difference is in the Omega 6:3 fatty acid ratio. Simple's ratio is less than 3 to 1 in the turkey and less than 2 to 1 in the Salmon vs 6 to 1 in the Osopure Duck, and Omega 3 fatty acids make a big difference in digestive health as in everything else, so much so that dogs with serious digestive disease are given Omega 3 fatty acid supplements.  Finally, the Simple formulas are much more calorie dense than the Osopure: 446 kcal per cup in the Salmon and 430 kcal/cup in the Turkey vs only 335 in the Osopure duck, so you would need to feed a lot more if you go with the Osopure. To me, there is no contest, lol.