Puppy with Giardia and Lots of Itchiness

[Beau]

Hi everyone,

I have an 11 wk old goldendoodle puppy named Beau. Three days after picking him up, he had diarrhea and vomiting. His fecal sample was initially negative. After a stint at the animal hospital (the vet initially thought he may have parvo but luckily that wasn't it), where they couldn't find the cause of his GI upset but were able to normalize his symptoms, he was released with a round of metronidazole and fenbendazole, as well as Proviable-forte, just in case he had giardia. They also put him on Science Diet i/d. I had his stool retested a week or so later, specifically looking for giardia, and he tested positive for giardia, so his vet recommended another dose of the metro and fenbendazole three weeks after he completed his first round. We should be starting that next week.

Luckily, Beau hasn't had a recurrence of diarrhea or vomiting, but his stool is still very soft and smells AWFUL, and he sometimes has smelly gas. When he was on the meds and prescription diet, his stool firmed up and smelled WAY more normal. He is also ridiculously itchy (and has been since we got him; doesn't have fleas) and occasionally sneezes. The vet sent him some prescription shampoo to help with the itch, but that obviously doesn't solve the underlying problem.

My husband and I are on the fence about whether to try switching his diet (currently on Life's Abundance puppy, which is what the breeder had him on) to a limited protein diet. We're not sure if the smelly and loose stool is due to the giardia (unclear whether the meds or the change in diet led to the positive change). If it is the giardia, we still don't have an explanation for the insane itchiness. We have thus far held out from switching because we don't want to add confusion to any potential giardia symptoms, but we hate the thought of him being on something that his body doesn't tolerate.

Any thoughts about how best to approach the situation? And if you all do recommend a switch, what food should I switch him to and how do we proceed from that point forward to figure out what's bothering him? We're open to pretty much anything.

Thanks so much,

Beau and Family

[Marlena and Henry]

So, the same thing happened to our 14 week old goldendoodle.  Tested positive for Giardia & needed 2 rounds of metronidazole & fenbendazole to completely knock out the giardia.  Henry also had really smelly gas until I stopped the Life's Abundance puppy food...it definitely was not agreeing with him.  The Life's Abundance was also making him very itchy.  

Once the Giardia was gone, I put him on Holistic Select Salmon, Sardine & Anchovy Puppy formula.  All his gas & smelly stools went away and everything has been great for 3 months.  I also continue to give him 1 Proviable daily sprinkled on his kibble.  His itchiness went away, too.  I believe the ingredients in the Life's Abundance was causing his itchy skin & smelly gas.

[Karen, Jasper and Jackdoodle]

Okay, so:
The itchiness is absolutely unrelated to the food. 100%. It is close to impossible for any dog under the age of 6 mos to have an allergic response to any food, simply because they have not been eating anything long enough for a food allergy to develop. It takes months to years for that to happen, and even then, it's rare. 1% of all dogs have an allergy to any food. Trust me, this is not a case of his body not tolerating the food. It's not a very good food, and we will help you switch to something better once the digestive issues are resolved, but don't worry that his body can't tolerate it. That's not it, I promise you. 
The Rx food is pure garbage, and it contains no therapeutic or medicinal ingredients, but what it does contain is a whole lot of insoluble fiber, in the form of cellulose, and that's what helped with the stool. 

You are absolutely right that changing his food now would complicate matters, and you don't need that; things are complicated enough.
The itchiness may be due to dry skin, and that can be alleviated with Omega 3 fatty acid supplements, but I really strongly suggest you don't start those until the digestive issues are resolved. There is also a very good shampoo called Douxo Calm that you can order online that helps a LOT with dry itchy skin, and I'd bet it's better for this than what the vet sold you, and probably cheaper to boot.

There's also the chance that your puppy has mites. Mites can't be seen with the naked eye, your vet needs to do a skin scraping and look at that under a microscope. (It's painless). I'd have that done if I were you, considering the overall condition in which this pup was sent home. 
It is a huge, huge mistake to put a young puppy on repeated courses of metronidazole. It's very likely to lead to ongoing digestive issues, maybe for life. Metronidazole has known side effects and is not as effective as Panacur (fenbendazole) anyway. Sometimes, in cases of severe digestive illness, you do need the metronidazole. But I would urge you to consider just repeating the Panacur for the next round. Please read this discussion to understand why: https://doodlekisses.com/group/thefoodgroup/forum/topics/an-update-...

Any time a dog is on metronidazole (and to a lesser extent, any antibiotic) you need to give the probiotics for at least several weeks after the meds are discontinued. The metronidazole destroys all of the good gut bacteria and then when it's discontinued, the bad bacteria proliferates and the diarrhea comes roaring back. You have to establish a good strong colony of the good gut fauna which is needed for proper stool formation. So if you have stopped the Proviable, please start it again, and keep him on it for a month at the lest. Also: you must give probiotics at least two hours apart from the antibiotics, and longer is better. If you were giving them closer together than that, the probiotics were basically useless. 
Bake a sweet potato in your microwave, mash it, and keep it in your fridge. Try adding a tablespoon to his meals.
That and the probiotic should help. Try to only use pure protein treats like Pure Bites if you are using training treats. 
The smelly loose stool is definitely due to the giardia. I wouldn't wait til next week, I'd ask the vet for another round of Panacur NOW. Unlike Metronidazole, there's no need to wait between courses. As long as he still has giardia, nothing is going to improve. And restart the Proviable. 
I hope this helps.

[Beau]

Thank you both so much for your prompt responses! It is very much appreciated and very, very helpful. A few follow-up questions:

1. Should I just use the Douxo shampoo or also their other products (mousse, spray, gel, etc.)?
2. Any Omega 3 supplement you recommend for future use?
3. I know the metronidazole sucks. I've had it myself and it's quite unpleasant and has an awful list of side effects. Is the Panacur enough to make the giardia go away? Is there a heightened dosage that they need to give him if not combining with the metronidazole? 
4. The vet told me that the reason they were waiting 3 weeks between rounds had to do with the giardia parasites' life-cycle (or something along those lines). Is that total bologna? It didn't make sense to me that they were making us wait for so long to continue treatment but didn't want to overload him with drugs either. 
5. Anything else I should be doing to help the giardia go away (other than cloroxing my apt and disinfecting his toys/bedding)?
6. Do I continue on the Proviable forte? Or do I switch to Proviable DC?
7. I have been giving him canned pumpkin when his stool gets softer to bulk it back up. I'm guessing this is the same concept as the sweet potato. Any benefits of the sweet potato over the pumpkin?
8. When we do get the giardia resolved, what food do you recommended switching to? I saw the approved list on the forum, but there are so many options!

Thank you again!!

[Karen, Jasper and Jackdoodle]

1.Just the shampoo for now. And brush him every day.

2. You want the Omega 3 fatty acids DHA and EPA, which are only found in fish. There are a lot of good products out there, but I don't have any specific brand recommendations. You want plain fish oil, nothing else. Wild salmon oil is always a good bet. Some dogs get loose stool from fish oil, so don;t start it now. Evening primrose oil softgels (human) are also a good substitute for fish oil, but since they can lower the seizure threshold in dogs prone to seizure disorders, I would not give them to a young puppy. Foods with high fish content and a good Omega 6:3 ratio also help, such as the food Marlena is feeding. But not yet.

3. According to every study i've seen Panacur is more effective than metronidazole at getting rid of giardia. There are resistant strains, but in those cases, even metronidazole doesn;t work; you have to go to other drugs. (Hopefully, your pup did not come from the Pacific NW, many doodles from there have had these kinds of cases.) Five days is the longest course of Panacur I know of, but I'm not sure. It is a very safe drug. 

4. I know that they wait between courses of metronidazole because of the drug's side effects. They usually wait 2-4 weeks to retest bewteen courses of meds. But since your guy is still showing positive, I don;t see the reason for waiting. Sometimes giardia doesn;t show up in a test, so you wait to test & then retreat if necessary. But in this case, it's showing up, it never went away. I'd ask if there is any reason not to start just Panacur now. 

5. You must of course pick up poop the instant it's deposited outdoors, and keep your guy on leash and supervised outdoors constantly. Don't ever let him come in contact with (or drink!) any standing water out there. I used a spray of 10 parts water 1 part bleach on all the outdoor areas that poop had touched when I had a foster here with giardia. And yes, it did kill the grass. Use baby wipes on his butt after he goes, too. 
6. I'd stick with the Proviable Forte, it's got more live cultures.

7. Sweet potato is cheaper, lol. Some dogs also like it better than pumpkin, it's thicker and sweeter.

8. I'd go with a fished based limited ingredient formula like Wellness LID Salmon & Potato. Many dogs here with digestive issues have done great with it:
https://www.wellnesspetfood.com/natural-dog-food/product-catalog/si...
And no, he doesn't need a "puppy" formula. An ALS formula (all life stages) is fine for most puppies.

[Marlena and Henry]

Beau,

FYI, The Wellness that Karen recommends is not an ALS formula...it is an adult food.  I was told by our holistic vet that puppies need a food with a higher fat content so you may want to research some other options that are in fact a fish based, puppy formula.  Also, I bought a bag of the Wellness & the kibble pieces are huge...too big for our 14 week old.

Also, Henry was on 2 rounds of Panacur first before we started Metronidazole.  The Panacur did not work for him.  The first round of Metro also wasn't effective, which is why he went on a 2nd round of Metro.  Sometimes, Giardia just doesn't respond to Panacur & you have no choice than to give the antibiotics.

[Karen, Jasper and Jackdoodle]

I would respectfully disagree with your holistic vet regarding the Wellness Food. Many puppies here have done just fine on it. Puppies do need more calories per lb of body weight than adult dogs, but those calories do not have to come from high fat foods. 
Regarding the size of the kibble, I happen to have a photo of it from when my guy was eating it. The dish shown is only 10 inches long, so it's obvious the pieces of kibble are not huge, lol. 
It's true that sometimes, Panacur alone doesn't eradicate giardia. But in your case, you tried two rounds before going to metronidazole. And that's my point. Metronidazole might be needed, but why start with it? Why not try the safer drug first? 

[Adina P]

WHAT?  (referring to the PNW comment)  You'll have to tell me more separately.  Is it more on the west side?

[Karen, Jasper and Jackdoodle]

One well-known very large scale ALD breeder in particular. It's been discussed here in their group as well as in TFG and Health Group. I have no idea if she's west, east, whatever. Where have YOU been, lol? 

[Beau]

Eek I hope that's not the case with my little guy. :( He came from Utah, which I don't think is technically the PNW? *fingers crossed*

[Karen, Jasper and Jackdoodle]

No, it's not Utah and it's not goldendoodles. ALD = Australian Labradoodle. And I'm pretty sure Utah has a much drier cliate than the PNW, which does make a big difference when it comes to giardia and parasites. 

[Karen, Jasper and Jackdoodle]

The problem is that there are not many (any?) LID foods made specifically for puppies. It's possible that your pup doesn't need an LID formula; his issues may be strictly due to the giardia & meds, and once all that has resolved, he might be fine with a more complex formula. Typically, I look at the current food and then try to find something comparable to the macronutrient profile, so that the transition isn't too radical. But that's hard to do with L.A., because there is very little info online about the exact ingredients and nutritional profile of their foods. 
I like Fromm's formulas, both the puppy foods and the ALS formulas, but none are LID. I like Nature's Variety and Canidae's LID foods, but again, they are not for puppies. Zignature makes single protein ALS formulas that work well for most dogs, but they are not really LID. Acana Singles are good ALS and LID formulas, so perhaps one of those would work for you. But we are currently not recommending that people start with a Champion product because of speculation that the company may soon be sold.
I have never yet had one dog of any age who did not do well with the Wellness Limited Ingredient foods, which is why I recommend them for digestive issues. 

[J and Riley (and Luna)]

I mean... how different can puppy and adult kibble possibly be?  Food is food.   Baby mammals generally eat the same thing as adults, they just eat more calories relative to their size and have slightly different needs for minerals etc.  Sure puppy food might have more fat but I would actually argue that it's the adult food that has LESS fat (so our adult dogs don't get overweight), not that the puppy food intentionally has a lot of fat, if that makes sense.