My dog has chronic diarrhea. Vet wants ultrasound. What's next?

With a normal stool sample and blood panel, the next steps are experimenting with diet - specifically a hypoallergenic prescription diet (such as Royal Canin Ultamino, which is definitely the most expensive option, but also the one that seems to work best in diagnosing food allergies. It takes eating ONLY the prescription food for about a month to see if it helps, and then if it does help you can certainly experiment with less expensive foods. If you she would having signs of food allergy you'd need to do a full 3 months, but for intestinal issues, you should see a response in just a couple weeks) OR a high fiber/easily digestible diet (such as Hills Fiber Response EN). Some dogs need continual probiotics to keep normal stool. Treating any underlying anxiety (if present) can also help. Finally, a gut biopsy, which is much more invasive and costly can be done. Since she isn't yet spayed, I would consider doing a gut biopsy when/if she is spayed because that would be minimal additional expense or trauma for her while she's already have an abdominal surgery. I hope that helps! Wishing you the best with this difficult issue - It can take a long long time to get to the bottom of things

There are several things I try for diarrhea that is not responding to typical treatments - sometimes I give the medications for a longer duration, sometimes I'll try a different antibiotic, and sometimes I'll try a different diet (which it sounds like your vet is attempting with the EN). Your vet might also want to retest a stool sample - sometimes with diarrhea there just isn't enough actual feces to get a positive results. Chronic diarrhea can also be caused by inflammatory bowel disease which is a more severe form of IBS and ultrasound and special blood testing can help diagnose this. Corticosteroid medications and B12 injections are often the recommended treatments for IBD.

If you have not done a good trial already, I would recommend a diet such as Royal Canin Ultamino and feed this for at least 4 weeks and see if this makes a differencr. If after the diet trial there is no difference, I would recommend adding in a probiotic such as Purina fortiflora which can be found online or at your local pet store. If the diarrhea is still there, I would recommend an abdominal ultrasound. If this is inflammatory bowel disease, Bonnie may need to be on drugs such as Budesonide and Azathioprine. I hope this helps guide you in the right direction. Please let me know if you have any other questions or concerns and I would be more than happy to help you further.

Hi, thanks for using Petco Pet Education Center, formerly Petcoach! Poor Kai! It may be best to sign up for a consult and show us the blood work and ultrasound reports. The tests that are pending also may be helpful so we will just have to patiently wait for those results. I would be sure she has been dewormed even if the stool tests were negative, have a B12, folate, TLI and PLI blood test done, have her tested for Addison's disease, try her on a prescription hydrolyzed diet like Royal Canin HP or Purina HA and then I would consider taking her to surgery or getting endoscopic biospies of her stomach and intestines to rule out IBD, lympangectasia and lymphoma. Tylosin and a probiotic is worth a try too. I think there are many other things to do before euthanasia. I hope this helps and I wish Kai the best of luck!

Thank you for submitting your question regarding Patsy. Has she had an abdominal ultrasound yet? I will typically recommend this as well as a gastrointestinal specific blood panel prior to biopsies. I assess cobalamin and folate levels as well pancreatic values such as TLI and PLI. These results can help to guide treatment. I hope this information helps!

Thank you for submitting your question regarding Bellamie. If the pain medications are not helping her situation, then I worry about a primary gastrointestinal tract disease. I recommend a full blood panel. Values such as cholesterol and albumin can be affected by chronic gastrointestinal disease. I would also do a GI specific blood panel that measures cobalamin, folate, TLI and PLI levels. These are vitamins involved in digestion and pancreatic values. From there, an abdominal ultrasound by a veterinary radiologist may be needed. A prescription diet trial could be beneficial as well. I hope this information helps!

Thank you for submitting your question regarding Harrison. Your veterinarian ruling out parasites and instituting a diet change were great first steps. This will give an answer or resolve the diarrhea in 75% of cases. Unfortunately, it seems that Harrison is still suffering from intermittent diarrhea. I would recommend bloodwork next. Low cholesterol and/or low albumin levels can indicate serious GI disease. In this case, I typically perform an abdominal ultrasound (by a board certified radiologist) and run blood to check pancreatic function as well as cobalamin and folate levels (vitamins used in digestion). This will guide my treatment protocol as far as diet (I may consider a hydrolyzed diet which can have anti-inflammatory properties), medications (chronic antibiotics, steroids or other immunosuppressive drugs) and supplements (probiotics, vitamin B12, etc). There are lots of options to resolve his diarrhea, but will take a further work up since he has not fully responded to the common causes and treatment. I hope this information helps and I am available for a consultation if you want to discuss Harrison further. Good luck!