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Chronic Diarrhea in Dogs

What is Chronic Diarrhea in Dogs?

Chronic diarrhea in dogs is a prevalent concern among pet owners, often prompting visits to the veterinarian. Diarrhea manifests as an increase in stool frequency and/or looseness, indicating an underlying issue rather than a standalone ailment. It accelerates the passage of food through the digestive system, hindering the absorption of essential nutrients, electrolytes, and water. This can result in urgent instances where dogs are unable to control bowel movements, leading to accidents indoors. Alternatively, they may maintain control but produce loose or liquid stool instead of the usual firm consistency during outdoor bowel movements.

Diarrhea frequently resolves without intervention, but persistent cases can result in dehydration, lethargy, and vomiting. In dogs, two primary types of diarrhea exist:

  • Acute diarrhea emerges suddenly and typically resolves spontaneously or with medical intervention.
  • Chronic diarrhea, or chronic enteropathy (CE), occurs when dogs fail to respond to standard diarrhea treatments. Alternatively, they may initially respond to treatment but experience recurrent episodes. Chronic diarrhea is diagnosed when symptoms persist for more than two weeks.

Is Chronic Diarrhea an Emergency?

Chronic diarrhea is typically not an immediate emergency; however, it can escalate to severe dehydration and malnutrition if left untreated. These complications may advance to systemic illness, organ failure, and potentially fatal outcomes. If your dog experiences frequent vomiting, struggles to retain food, or displays signs of lethargy, weakness, or depression, it could indicate an emergency situation that requires prompt veterinary attention.

Causes

Causes of chronic diarrhea in dogs can be perplexing for pet owners and uncomfortable for the affected pets. Various factors contribute to its occurrence, including inadequate nutrient absorption, intestinal inflammation, increased secretions, leaky intestinal walls, or impaired intestinal muscle function.

Common culprits behind chronic diarrhea include:

  • Parasites
  • Food sensitivity or allergy
  • Inflammatory bowel disease (IBD), characterized by intestinal inflammation, possibly stemming from autoimmune conditions.
  • Exocrine pancreatic insufficiency, where the body lacks enzymes to digest fats, proteins, or carbohydrates properly.
  • Other underlying diseases.

Diarrhea is often categorized as either small intestinal or large intestinal, depending on its origin. Food ingested by dogs traverses from the mouth, down the esophagus, into the stomach, then through the small intestine before reaching the large intestine and ultimately being expelled as stool.

Both small and large intestinal issues can lead to acute or chronic diarrhea. In cases of small intestinal diarrhea, stool volume tends to be substantial, with occasional vomiting and weight loss. On the other hand, large intestinal diarrhea manifests in smaller, more frequent bowel movements, often accompanied by bright red blood.

Sometimes, diarrhea results from conditions unrelated to the intestinal tract, such as pancreatitis (inflammation of the pancreas), liver, or kidney failure.

Certain breeds, like Soft Coated Wheaten Terriers and Yorkshire Terriers, have a genetic predisposition to protein-losing enteropathy. Meanwhile, breeds like Boston Terriers and Boxers may develop intestinal lymphangiectasia and/or ulcerative colitis, leading to protein loss in the stool. These conditions often exhibit symptoms akin to chronic diarrhea and typically require additional diagnostic testing for confirmation.

Diagnosis

To diagnose chronic diarrhea in dogs, veterinarians consider cases where standard diarrhea treatments fail to yield results for over two weeks or when recurrent diarrhea persists without resolution.

The diagnostic process involves ruling out underlying conditions. A comprehensive physical examination is conducted, followed by tests to investigate potential causes:

  • Parasites: Fecal float tests are employed to detect parasites, common triggers for both small and large intestinal diarrhea. Hookworms in the small intestines may lead to anemia, while whipworms in the large intestines cause chronic, watery diarrhea by depleting nutrients. Certain parasites, such as giardia, can be challenging to detect through fecal tests. Veterinarians often treat for parasites as a precaution, as many heartworm preventatives also target intestinal parasites.
  • Diet: After physical exams, fecal tests, and deworming, veterinarians explore dietary therapies to pinpoint sensitivities to specific food ingredients. Various diet options include bland formulations with added prebiotics and probiotics or hypoallergenic diets. Novel protein sources or hydrolyzed proteins are common in hypoallergenic diets to minimize allergic reactions. Proper adherence to diet trials is crucial if recommended by the veterinarian, who may also suggest allergy testing.
  • Underlying diseases: If deworming or dietary adjustments fail to alleviate chronic diarrhea, further diagnostics are pursued to rule out systemic illnesses. Baseline assessments involve blood work, urinalysis, and abdominal x-rays. Abnormal protein levels may prompt investigations into causes of protein loss in dogs.
  • Chronic Enteropathy: Irritable Bowel Disease (IBD) involves chronic inflammation of the gastrointestinal tract, affecting the small or large intestine, or both. Symptoms may include vomiting, decreased appetite, and weight loss. Additional blood work and tests may be outsourced to external laboratories to confirm IBD.
  • Infectious diseases: Bacterial and viral pathogens can trigger chronic diarrhea. Fecal PCR panels help screen for common offenders like clostridium. Bacterial overgrowth in the intestines may respond to prolonged low-dose antibiotic therapy.
  • Refractory diarrhea: Some cases of chronic diarrhea defy treatment and diagnostic tests, necessitating further imaging like ultrasonography and potentially intestinal biopsies. Gastrointestinal cancers, though rare, can also provoke chronic diarrhea.

The diagnostic process aims to pinpoint the precise cause of chronic diarrhea in dogs, facilitating tailored treatment plans for optimal outcomes.

Living and Management

When a dog experiences acute diarrhea, it’s often advisable to transition to a bland diet to ease symptoms. Additionally, incorporating probiotics such as Purina Fortiflora or Nutramax Proviable can help restore healthy bacterial balance in the gut, promoting normal digestion.

Monitoring your dog’s bowel movements closely is essential. Any changes in frequency or consistency should be promptly communicated to your veterinarian. Establishing a trusting relationship with your vet is crucial for uncovering the underlying cause of chronic diarrhea in your dog. It’s important to acknowledge that the recovery process may take longer than anticipated, requiring patience and understanding.

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