My dog's chronic diarrhea worsened with steroids. What should I do?

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.

I'm so sorry that you are dealing with this with Cosita. Thank you for including a picture. She is adorable. I am attaching a link below to a handout on IBD. https://www.veterinarypartner.com/Content.plx?P=A&S=0&C=0&A=598 The end of that handout specifically addresses your concern. The problem with doing steroids is that it decreases the inflammation in the intestines and will likely make Cosita feel better, but if her disease is due to cancer (lymphoma), putting her on prednisone will make it harder to diagnose and treat her cancer later. "Lymphoma is temporarily responsive to prednisone but better responses can be obtained from stronger chemotherapy agents. Exposure to prednisone will make the lymphoma much more difficult to diagnose should biopsies be obtained later. Plus, exposure to prednisone can lead to resistance to other medications. (This is less of a problem for cats, but in dogs even a few days of prednisone can make a lasting remission impossible to achieve.)" There is nothing wrong with starting her on steroids, but you have to understand that it will limit your treatment and diagnostic options in the future if the steroids do not help. Good luck! I hope that was helpful and answers your questions. Thanks for using PetCoach.

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.

I am sorry to hear about Lady! The next steps in diagnostics would include abdominal ultrasound and surgical biopsy to look for possible inflammatory bowel disease or cancer. This is likely why your vet has started steroids (these diseases will sometimes respond to steroids). If this is inflammatory bowel disease a trial of a hydrolyzed protein diet may also be of benefit.

Poor guy. Steroids can cause abnormal stools, so this is likely the culprit. Also his body is stressed, so loose stool is commonly seen. You can try giving him a bland diet of boiled plain chicken and rice or cottage cheese for a few days, then slowly transition him back to his normal diet once his stools do return to normal. 1-2 tsp of canned pumpkin (not the pie filling) can also be added to his food daily to help solidify his stools. If he still has loose stools after 48 hrs, then a repeat vet visit is likely needed to get him on something stronger. You should continue to give the Benadryl as instructed by your vet. I hope that your puppy feels better soon and that his stools return to normal on a consistent basis. Best wishes and take care.

Thank you for submitting your question regarding Remi. In the bloodwork that was run, did it include GI specific testing such as cobalamin, folate, PLI and TLI levels. These are values that will give information such as the location of GI disease (small intestine vs pancreas) and treatment options. I typically do this planel in conjunction with an abdominal ultrasound. This information with the ultrasound can give insight into conditions such as inflammatory bowel disease, pancreatitis, exocrine pancreatic insufficiency, food sensitivities or as you mentioned cancer. The anti-inflammatory properties of the antibiotic she was on could help even with a tumor in GI tract, but there are so many other causes of diarrhea that would respond as well. I think it is worth pursuing further bloodwork and the ultrasound. If you can get a diagnosis, then a treatment plan can be developed. I hope this information helps!

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