While having a dog with diarrhea is certainly not your choice, telling a veterinary professional your companion dog has diarrhea is a common but non-specific complaint.
Think about all of the potential causes, such as: bacterial infection (what bacterium?), fungal infection (what fungus?), viral infection (what virus?), blockage in the gastrointestinal tract, cancer, food sensitivity or intolerance (food intolerance to what food or foods?), cancer, adulterated dog food, overeating, food change, eating something toxic, sneaking food off the kitchen countertop, exocrine pancreatic insufficiency (EPI), colonopathy, intestinal parasites, inflammatory bowel disease, enteropathy, liver disease, medications, or kidney disease.
On top of all of that, we need to figure out if the diarrhea is acute or chronic. Additionally, if it is coming from the small intestine or the large intestine.
Acute or chronic?
Fortunately, parameters have been established to determine if the diarrhea is acute or chronic.
Acute – One or more episodes of diarrhea lasting less than 14 days.
Chronic – Lasting more than 14 days or intermittent over 3-4 weeks.
Small intestine or large intestine?
Diarrhea tells a story about the part of the intestinal tract that is affected.
Large intestine diarrhea — urgency to defecate, increased frequency, small stool volumes, mucus covered stool, and straining to defecate.
Small intestine diarrhea — no urgency to defecate, possible vomiting, large stools produced at normal frequency, fatty and frothy stool, and no straining.
Next, we discuss treatment options.
Antibiotics
Oftentimes while we are whittling down the potential causes, origin, and status of the diarrhea, antibiotics are immediately prescribed as a stopgap measure. Antibiotics are anti all biotics and cause a continued gut imbalance after the symptoms have stopped.
Indeed, a recent study suggested that prescription antibiotics at first presentation of uncomplicated diarrhea in dogs causes no difference in clinical resolution of these cases.
So, what are some other options out there for companion dog parents to try?
Treatment Option: Wait and See
A good option for acute diarrhea, if your dog is not showing any other symptoms except for possibly a little fatigue, you can decide to withhold food for 24 hours and restrict water to small drinks every few hours.
After that, you can try boiled or baked, skinless turkey, and white or well-cooked brown rice. You can also help alleviate the diarrhea by providing the leftover rice water, which also encourages drinking and hydration.
Other foods you can try are baked or sautéed white-colored fish (cod, trout, tilapia, mahi mahi), hard-boiled or scrambled eggs, skinless and boiled or mashed potatoes, pumpkin, and plain goat yogurt.
Of course, if your companion dog has a food intolerance according to NutriScan Food Sensitivity and Intolerance Test, then you should avoid any of the identified reactive foods, as they can make the diarrhea continue and worsen.
Treatment Option: The EPI4Dogs Method
Dogs with EPI have a secondary condition called small intestinal dysbiosis (SID). Dysbiosis means a disruption of the normal microflora in the gut, and is the newer name for small intestinal bacterial overgrowth (SIBO). The clinical signs of SID are intermittent bouts of diarrhea, malabsorption of nutrients, and possible weight loss.
SID is not exclusive to dogs with EPI. Other dogs can have it too and it is often a chronic condition (enteropathy).
First, let’s explain EPI. The pancreas produces and then secretes digestive enzymes (juices that help digest food) into the small intestine. They aid in the digestion of proteins, fats and carbohydrates. In EPI, the pancreatic acinar (cluster of) cells are “atrophied” (meaning they are wasting away or are possibly already destroyed), and cannot properly manufacture digestive enzymes. So, the fecal output is often voluminous yellowish or grayish soft “cow patty” stools.
Thus, dysbiosis not only encompasses a possible microbial overgrowth, but also current research indicates that there is a lack of bacterial diversity or impaired microbiota in the small intestine.
After ruling EPI in or out with the Trypsin-Like Immunoreactivity (TLI) test, dogs that have positive results start taking digestive enzymes (usually porcine-sourced) along with vitamin B12.
But, why do some dogs with EPI that already are taking digestive enzymes have SID? Managing EPI is a delicate balance that not only includes digestive enzymes and vitamin B12, but also diet.
The non-profit, EPI4Dogs, is an amazing organization that combines clinical research and the daily experience of EPI4Dogs parents. They have a protocol for managing SID in dogs with EPI that may be beneficial for other dogs.
They suggest trying the list below in this order:
- Prebiotics (They prefer slippery elm bark powder, a soluble + insoluble fiber. You can also try licorice.)
- Synbiotics (prebiotics + probiotics)
- Antibiotics (Tylosin Tartrate/Tylan)
- Fecal (Microbiome) Transplant
Epi4Dogs did a mini-study with Texas A & M University’s Gastrointestinal Laboratory with slippery elm and dogs with EPI in an effort to hopefully understand why it appears to work with so many of their dogs, although not with every single case. The researchers suspect that slippery elm functions as an excellent mucilage by inhibiting bad metabolites from seeping in through the gut.
Even though it sometimes takes longer to control SID with prebiotics, good results are sustained longer with prebiotics than antibiotics.
If you must resort to antibiotics, EPI4Dogs suggests adding a synbiotic approximately halfway through the antibiotic regimen.
Once the SID is under control, a companion pet parent may need to consider switching to a different source of enzymes or diet. Now, NutriScan comes into play because if your pet has a food sensitivity to pork (porcine), you are really not getting ahead of EPI since the small intestine is battling the offending food. In this case, you can opt for pancreatic enzymes from bovine (cow), sheep or lamb if your pet did not show sensitivities to these proteins. If NutriScan showed your pet to have a true classical leaky gut concurrent with EPI, you may need to use plant-based enzymes.
Treatment Option: Probiotics
Trying probiotics to manage diarrhea also can be beneficial. However, you need to make sure they contain the right blend of probiotics for canine diarrhea. Indeed, EPI4Dogs prefers synbiotics (prebiotics with probiotics), as probiotics feed off prebiotics, which help them flourish in the gut.
Treatment Option: Large Intestine
If your companion dog has mucus in the poop, it may indicate a large intestinal issue. You can certainly try psyllium (a prebiotic) or a synbiotic. Psyllium soaks up a significant amount of water in the digestive tract, making stool firmer and slower to pass through.
Conclusion
These are simple alternative options to hopefully avoid and bypass antibiotics. Please be sure to discuss these options with your veterinarian.