PetMeds® Chronic Diarrhea treatment options
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Many of the questions I get in the clinic and online are what treatment or diagnostic options are available for those pets that have had chronic diarrhea and/or have been on multiple courses of drugs, dietary trials, wormings, etc. My definition of chronic diarrhea includes a pet who has had diarrhea for more than a few weeks, or one who has had more than two or three episodes in a given year.
While each episode must be looked at separately, due to the possibility of multiple causative factors, many pets with chronic diarrhea typically have the history of being prescribed therapeutic trials of prescription antibiotics such as Metronidazole, Enrofloxacin (i.e Baytril), Tylosin, as well as wormed for hidden parasites with broad acting wormers such as Panacur C, even if stool samples are negative. many pets will often be tried on different types of diets by veterinarians. These usually vary from the novel odd protein diets that a pet has not been exposed to before, such as duck, rabbit, or venison, to lower molecular weight enzymatically broken down proteins (known as hydrolyzed diets) often carried by prescription at local veterinary offices.
While some pets will do well on these for a while, in most cases many often relapse. In my practice I always include a good probiotic such as fast Balance, NaturVet Enzymes & Probiotics or Mitomax by Imagilin for long term use in any pet with chronic diarrhea. We are just starting to see published studies documenting the effects of prebiotic and probiotic use in animals with chronic diarrhea.
I also find that the supplement L-glutamine from health food stores also helps restore the intestinal lining and reduce inflammation. Inspite of all of these interventions, there are still pets who suffer relapsing chronic diarrhea. If a full blood work and several stool sample analyses fail to yield a diagnosis, then some vets will put pets on a trial of cortisone, “assuming” the pet has a disease called inflammatory bowel disease. and while many pets will improve on cortisone for chronic diarrhea, it is important for both animal guardians and veterinarians to realize that they are presumptively treating and there is still a risk with such a shotgun treatment.
There is a population of pets who have chronic diarrhea who may actually have an impaction, or cancer of the digestive tract. That’s why any pet with chronic diarrhea who fails dietary trials should have a proper diagnosis by imaging the digestive tract with ultrasound, laparascopic or endoscopic exam and biopsy before simply assuming Prednisone is the answer
In some occasions, full thickness surgical biopsies are needed. The benefits of this is that if a diagnosis of impaction or cancer/lymphoma is delayed and/or is masked by the use of Prednisone, then such diseases become much harder to treat with the appropriate medical therapies, had the diagnosis been made earlier on.
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