Persistent diarrhea in young ALD (7 mos) in PNW

[Megan + Willow & Hazel doodles]

First post but have had our older Goldendoodle girl for over 11 years. This is about our new girl- 7 month old Australian Labradoodle Hazel. She's had a touchy stomach since an initial giardia diagnosis in January (a few weeks after we got her). We are in the PNW and while she is not from the breeder with the antiobitic-resistant giardia we were in a puppy group with a puppy from that breeder and that is very likely the giardia she got. Positive giardia in January and  a round of antibiotics (Panacur and Metronidazole) and her next fecal was clear. She's had ongoing bouts with diarrhea however and I thought it was bully sticks or food and we've tried raw, and a few different kibbles. She was spayed mid-May and a week later horrible diarrhea (uncontrollable) and giardia fecal came back positive. Another round of Panacur and Metronidazole. Her fecal in early June came back clear and another last week came back clear (under microscope) but her stool has never firmed up. Conflicting suggestions from our vet and her breeder. Vet is recommending an "exotic" protein like kangaroo. Breeder suggests not switching food right now and using "Firm it Up" (we started today) and a probitoic. We started the vet-recommended probiotic-- Proviable-- five days ago. Current food is Farmina Natural and Delicious codfish (she's been on that approx 2 months).

The diarrhea is continuing and I am open to ANY suggestions. Does she still have giardia and it's just not showing up? Do we need to change food or try a different probiotic? I am incredibly grateful for the expertise of this group.

[Karen, Jasper and Jackdoodle]

The problem is that you weren't giving a probiotic until now. Repeated courses of metronidazole will always result in chronic diarrhea unless you are giving a good probiotic right from the start, and continue it long after the meds are discontinued. This is because the metronidazole destroys all of the good gut bacteria necessary for proper digestion and stool formation, and you end up with a bacterial imbalance in the gut, too much bad bacteria and not enough good. 
Proviable is a very good probiotic; I recommend it all the time. However, at this point, you need the Mother of All Probiotics, VSL#3. It's a human probiotic that has been extensively studied in dogs; if your vet has questions about it, refer him to the studies done by Albert Jergens at Iowa State. https://vetmed.iastate.edu/users/ajergens
VSL#3 has been close to a miracle for many of us here whose dogs have suffered from both short and long term digestive diseases and problems. You can get it at several different drugstores, I found CVS to have the best prices. I've heard you can get it at some Costcos. Many places will order it for you. Be careful where you get it, as it MUST be kept refrigerated. Plan to give one capsule a day and continue it for at least a month.
While I agree that changing food may complicate the issue, it would probably help if you got her on a good LID food. Wellness Simple Solutions is the best one I have found for these types of issues. The Farmina is not a bad food, but it does contain grains and those can be a problem for dogs with digestive issues. It also has too many different ingredients, which can also be a problem for sensitive digestive systems. I'd try the Wellness Simple Solutions Salmon & Potato formula. Keep treats very plain, pure protein treats like Pure Bites. 
Firm Up is just pumpkin & apple fiber. Some plain mashed sweet potatoes would be just as good and a lot cheaper. With all due respect to your breeder, I have yet to meet one who really had any reliable knowledge about nutrition, and that includes my own, who I adore. (Vets are not much better in this respect, lol.)
Hope this helps. 

[Megan + Willow & Hazel doodles]

Karen- I feel so fortunate for your time and input helping us. I feel like I'm corresponding with a celebrity after reading all your incredible posts. ;-) Thank you. We are following your advice to the letter. I found VSL#3 at the very fancy "integrated pharmacy" (the CVS in my area is at Target and they didn't have it). The pharmarcy had it and it was in the fridge and they confirmed it was kept refrigerated at all times, so we've started that today. The Petcos here did a "pet food reset" (their words) recently and aren't carrying the Wellness Simple Solutions in-store in my area. So I ordered it and it will arrive on Monday and we'll start transitioning. I'l keep you posted! Again, incredibly grateful for your help, Karen.

[Karen, Jasper and Jackdoodle]

Thank you for the kind words, Megan.

I had that problem with finding the Simple Solutions formula in the size I wanted at my local pet supply stores, too. They started ordering it for me. 

It took about two weeks on VSL#3 for me to see a major improvement with Jack; others have seen improvement sooner, and I hope that will be the case for you. Please keep us posted on how the food transition goes, I hope it goes well. 

 

[Nancy, Ned, Clancy, and Charlie]

I don't know the correctness of my method of administration, but after reading how many capsules in a day human might take of VSL#3, when Charlie has one of his bouts of diarrhea, I give him 3-4 capsules spread out over the day for a several days, then I give him two per day for several more, and once I see that he  seems to be responding, I cut down to one per day.  Explosive diarrhea is not my friend.....

Again - perhaps not recommended, but when Charlie has one of these bouts, I have to change his kibble to an LID formula also.  I do this switch cold turkey - transitioning does not help his tummy. However when I go back to his regular kibble, I very carefully transition him - if I go back too soon, we have a relapse.

[Karen, Jasper and Jackdoodle]

Jack took two capsules once a day, for years. But he was an 80 lb adult. While VSL#3 is not a drug and there's very little likelihood of getting "too much", I thought one capsule would be appropriate for a 7 mo old ALD. Human dosage is 2-7 capsules per day I think.

[Nancy, Ned, Clancy, and Charlie]

I totally agree with you, Karen, especially about puppies.  The dosage on our VSL#3 says 1 - 16 which is why I tried Charlie with a higher dose at the beginning of one of his bouts. It was an experiment I was willing to try on a 4 year old dog - never on a puppy.

[Megan + Willow & Hazel doodles]

Thank you!

[Karen, Jasper and Jackdoodle]

And good point about not transitioning when switching to the LID food! That needs to be done cold turkey. 

[Megan + Willow & Hazel doodles]

Appreciate it- would not have thought to go cold turkey. Will stick with the 1 VSL#3 a day. Thank you again.

[Megan + Willow & Hazel doodles]

Brief update but we've seen a significant improvement after just a few days. We started the food yesterday and VSL#3 on Saturday and I'd say things look 65% better already. Incredible- thank you!

[Karen, Jasper and Jackdoodle]

I'm so glad! Thanks for letting us know! 

[Nancy, Ned, Clancy, and Charlie]

Thanks so much for the update. I hope the improvement continues. This combo helps so much with Charlie.