Diarrhea - When should you be concerned?

Diarrhea. This should be a fun post! I think we all have horror stories about diarrhea. Whether our 5 month old baby had loose poop that exploded out of the diaper and somehow made it all the way up to her neck (been there!), or maybe our adult dog had a particularly rough night and left us numerous diarrhea puddles to find in the morning. So, what are the causes, when should we be concerned, and what can be done about it?

Let’s start with puppies and kittens. Did you know that many puppies and kittens are born with intestinal parasites? It’s true. Roundworms and hookworms can travel through the placenta from mom to baby in dogs and cats. This is why we Veterinarians recommend deworming pregnant female dogs and cats, and also recommend deworming new kittens and puppies every few weeks until they are 16 weeks of age.

Source: Clinician's Brief

Some parasitic infections can be easy to treat, but others require numerous treatments. Other parasites, including Giardia, Coccidia, Tapeworms (often from fleas), and Whipworms can also cause significant issues in young pets. So, please bring a stool sample with you to your first Veterinary visit! Usually you cannot see worms in their stool; we look for the eggs under the microscope. We like to get on top of these infections quickly because not only are most of them Zoonotic (YOU can get them from your pets), but once they are in your yard, they can be difficult to get rid of, leading to re-infection.

Another VERY important cause of diarrhea in puppies is PARVO. See my corresponding post on the Core Vaccines Your Dog Needs. Parvo is caused by a virus in the stool and is deadly in many puppies. It is so important to not only get those vaccines on board as soon as possible, but to also limit where you take your dog until he/she is fully vaccinated.

Puppies need a total of 3 boosters of the DHPP (includes Parvo) vaccine. They can still contract Parvo if exposed to infected stool with one or two boosters of this vaccine on board. Do the whole series of 3 vaccines and limit your trips to dog parks, etc, until they are fully immune! The younger a puppy is when they contract Parvo, the less likely the treatment will be successful. Symptoms of Parvo included lethargy, not wanting to eat, vomiting, and diarrhea. This diarrhea will be bloody and have a HORRIBLE smell. Diarrhea is usually not the first symptom seen at home, so we Veterinarians will often do a Parvo test on a young puppy that just doesn’t seem right to catch this as early as possible.

A puppy with Parvo requires INTENSIVE hospitalization in ISOLATION because of how extremely contagious this virus is. We wear gowns, double glove, and walk through a bleach bath for our feet before going into Isolation with these puppies and after treating these puppies. All supplies (catheters, gloves, blankets, thermometers, etc) stay in Isolation and are not used on any other patients. These puppies are almost always on IV fluids, IV antibiotics, anti-nausea meds, and require treatment MANY times per day to survive. Hospitalization is typically a week or more, and costs thousands of dollars. Very scary stuff. There was one summer where I saw 6 or 7 Parvo puppies in a row. It seemed that as soon as I sent one home and cleaned Isolation, the next one would show up. All of them survived, but what a summer. The local dog park was where most of them contracted the disease. I love dog parks, but only after dogs are fully vaccinated.

Next in our talk about diarrhea is a special note about German Shepherds. This breed is more prone to Exocrine Pancreatic Insufficiency (EPI) than other breeds. When the Pancreas (digestive organ) doesn’t produce the needed enzymes to break down the food, these dogs fail to gain weight and will have very gray and runny stools. If you suspect this may be happening with your Shepherd, your Veterinarian can run a blood test to diagnose this disease. Treatment usually consists of adding these pancreatic enzymes on the food in a powder form.

Okay, let’s shift our focus to some of the reasons why your adult dog or cat may have developed diarrhea. The first and most obvious reason may be a change in diet. This might be our fault or theirs. If we humans change our dog or cat’s food abruptly they may develop diarrhea. Imagine eating the same thing morning and night for months or years at a time, to then suddenly eat something completely different. The body just does not handle that well.

Any diet changes for our pets should be gradual. This means mixing the old and new food together in the bowl, and slowly decreasing the amount of old food and increasing the amount of new food until they are completely on the new food after 10-14 days. But, there are also the cases where the dog or cat finds something inside or outside and decides to eat it. Whether this is the pork roast sitting on the counter, the entire loaf of bread, the decaying animal carcass found in the spring as the snow melts, etc, they all lead to diarrhea. Well, unless you are the Weimaraner I saw that ate 16 brats and 3lbs of Salmon and never had a day of diarrhea…..guts of steel everyone!

This diarrhea typically lasts for a few days, but can cause considerable stress for not only your pet, but for you as well. Always call your Veterinarian first to see if they feel an exam and medication is necessary; pets can become dehydrated very quickly from this amount of fluid loss. Pancreatitis is nothing to play around with. These animals often require hospitalization until the vomiting and diarrhea cease and they are able to eat again. One thing I often recommend in practice is a Bland Diet for a couple days to rest the intestines. This consists of BOILED hamburger and rice, BOILED chicken and rice, or cottage cheese and rice. Feed two parts rice to one part hamb/chicken/cottage cheese. Notice I capitalized the word boiled. You want this to be as low fat as possible, so we don’t want to fry this in oil or butter prior to feeding it to our pets. Drain all excess grease before mixing with the rice. After about 3 days we need to start adding the dog food back in with our mix in small quantities. Our homemade mixture lacks many of the necessary vitamins and minerals dogs need daily.  If your Veterinarian decides that more needs to be done for the diarrhea, often an intestinal parasite dewormer, an intestinal antibiotic (Metronidazole), and/or a Probiotic may be sent home with your pet.

Intestinal parasites affect adult dogs and cats as well. If your dog is eating feces outside (yuck, but they commonly do), this is a huge cause. But, it can also be as simple as walking through stool outside on the ground and coming back inside and licking their paws. Parasites are typically spread by the fecal/oral route. Another big cause of intestinal parasites is FLEAS. Fleas carry tapeworm eggs, and as your pet is chewing on their skin due to irritation from flea bites, they are swallowing fleas in the process. Tapeworm segments look like little grains of rice on your pet’s fur near their behind.  Some Tapeworm infections cause diarrhea, others do not, and the pet may still have solid stool.  Parasitic infections require a trip to see your Veterinarian to diagnose the type of intestinal parasite and get the correct treatment for it. Please bring a stool sample!

Other causes of diarrhea to briefly touch on include food allergies, Irritable Bowel Disease (IBD), certain kinds of cancer, and other diseases.   Once your Veterinarian has ruled out the more common causes of diarrhea, they may recommend a hypoallergenic diet trial, abdominal x-rays, or other testing to look for a more difficult to diagnose cause. Our goal is to get both you and your pet sleeping through the night again!