My dog's diarrhea keeps returning. Is long-term Flagyl safe?

Related Answers from Veterinarians

• Answered By Anna M., DVM

  Veterinarian

  Sorry to hear about Amber's diarrhea struggles! Sounds like your vet has done a pretty good workup so far. Have they discussed an abdominal ultrasound with you? That would be my next step with a dog with chronic diarrhea that responds to metronidazole (flagyl) but gets worse off the meds, if bloodwork and a fecal test have already been done. I would be thinking about the possibility of IBD (inflammatory bowel disease) or a food sensitivity. GI lymphoma would be another concern in an older dog, but would be quite unlikely in Amber given her age.
  
  To answer your question - yes, I do have some patients who stay on flagyl permanently as part of their treatment therapy, and in Amber's case it may be appropriate to do so...but I would recommend considering an ultrasound for a little more information as to what's causing Amber's diarrhea, and/or discuss with your vet a prescription food trial to see if her system tolerates that better. I hope that helps!

  

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• Answered By Lauren Jones VMD

  Veterinarian

  I'm sorry to hear that Amber has been having such frequent diarrhea! Flagyl (metronidazole) is an antibiotic and antiparasitic medication that can be useful to kill overgrowth of bacteria in the gastrointestinal tract. It can be useful in modulating the cell immunity in cases of inflammatory bowel disease, in which case it is often used for the long term. However, if the cause of Amber's diarrhea is unknown still, it would not be recommended for long term use at this point in time. It may be worth looking into additional diagnostic tests to evaluate the ability of her intestines to absorb vitamins (B12, folate, TLI levels), as well as an abdominal ultrasound to determine if there are signs of chronic inflammation in her intestines. From there, it may be worthwhile to consider hypoallergenic or novel protein diets (it can take 2-3 months to see a full effect from a diet change). Amber's vet should be able to discuss further diagnostic testing and treatment options, but you can always consider a specialist in internal medicine, if needed. I hope that all goes well for Amber!

  

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• Answered By Stacey Anstaett, DVM

  Veterinarian

  Published on June 5th, 2018

  Hello! I would follow your veterinarian’s recommendation for medications at this time but if the diarrhea is not improving, some diagnostic tests will need to be performed to help guide treatment. Talk to your vet about blood work and an abdominal ultrasound (a sonogram of the belly). Diarrhea that becomes chronic (ongoing for weeks) can be due to inflammatory bowel disease, cancer in the GI tract, or even inflammation in the pancreas or liver.
  
  I am so glad to hear he is eating and acting normally... it is not an emergency to have further testing done but if it is not resolving, seek additional tests. Ultimately this may even include obtaining biopsies of the intestine via endocscopy or surgery— however blood work and an ultrasound will give some insight as to the best options moving forward.
  
  Best of luck with him, I hope he improves!

  

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