# 6 month old puppy with chronic diarrhea, all tests neagative



## Megora (Jun 7, 2010)

Does he get any dairy products? Cheese, etc? What about the treats you give him? 

One thing to be aware of is that with some dogs they start out with a reaction to something like food (colitis), and over time it becomes a chronic issue, particularly if there is scarring in the colon/intestines.


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## lovecooper (Apr 21, 2013)

Since he started with this early, we have kept him off treats. No dairy. We use his kibble as treats and occasionally he would get a dentastick or nylabone healthy edible, but very few because of the stomach issue.


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## Drea0119 (Jan 25, 2013)

Love copper, I had this same problem with my golden pup, she was also put on metro after test came back okay, so they put her on a prescription dog food called Iams intestinal plus, it did wonders this is the only food that haven't gave her diarrhea, it is very expensive, but anything to make our little girl feel better, you should give it a try 


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## Drea0119 (Jan 25, 2013)

And Callie only gets kibble and we just noticed she does ok with cheese so we use slice cheese for training


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## lovecooper (Apr 21, 2013)

Thanks so much, Can you tell me what the main ingredient is? We noticed that all the foods we have tried has chicken (including the nylabone treats) so we were wondering if he has a chicken intolerance.


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## lovecooper (Apr 21, 2013)

Has anyone ever heard of the nutriscan test for food intolerances?


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## Manna777 (Jun 20, 2012)

Hi we had problems with Ernie put of the blue in Feb we had 3 lots of colitis which cleared with metro and started when he came off. We we advised to changed the protein source so we tried fish and sweet potato but it still had maize so that was dose 3. We are on Lamb and veg grain and hypo plus herbs by a company in the UK CSJ heal and resist so far we seem ok but it is early days. 

Fingers crossed you managed to sort the tummy troubles


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## CITIgolden (Mar 9, 2013)

It is curious that antibiotics would stop it and yet there's nothing showing up on her tests.

Has your vet checked for adrenal function or bile acids? They can also test for malabsorption. While rare, sometimes, vitamin b12 deficiency can cause a condition that would result in diarrhea.

Have you tried switching her to rice and low fat chicken breast diet for a while? You can boil chicken breast with rice to make it more flavorful. The same goes with other kinds of meats. I'd stay away from hamburger mixes or ground meat just because you never know what's in it, but if you suspect chicken intolerance perhaps some lean beef will do.

Also, start adding probiotics supplements with food, especially after treating with antibiotics. You may also want to supplement the diet with some general vitamin mix. Your puppy is growing fast at this time and will need all the nutrients it can get.


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## tippykayak (Oct 27, 2008)

I don't know why this hasn't been suggested yet: giardia or coccidia. They're famous for showing false negatives on fecal tests, and they cause exactly the kind of cyclical diarrhea you describe. They're also a lot more likely than exotic food intolerances. Ask you vet about a longer prescription for the metronidazole, or an on/off prescription where you try to catch the parasites in their active stage.

It also helps to clean the puppy daily so he can't reinfect himself.


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## Tahnee GR (Aug 26, 2006)

I agree with Tippy- my first thought was coccidia and then giardia. Both are hard to diagnose and both will clear up and then recur, especially if not treated for a long enough time or if reexport.


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## lovecooper (Apr 21, 2013)

Thanks for all the replies, A bile acid test was performed also a GI fast panel PCR and Superchem CBC and UA (don't know what those are). All negative. Also stool sample were tested on 3 different occasions, all negative for giardia and coccidia, do you think there could be a false negative 3 times? We have him on metronidazole right now for 2 weeks instead of 1, vet said sometimes they just need more time on the metro to get the tummies back on track. 

He has been on probiotics for a while and they worked great for about 4 - 6 weeks then all of a sudden diarrhea starts again. I am crossing my fingers that this ound of metro along with probiotics will do the trick but my gut (no pun intended) says the diarrhea will come back.


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## CITIgolden (Mar 9, 2013)

True, i agree with the previous two posts, given good response to antibiotics you would think it's something that actually responds to antibiotics - either a parasite or bacteria. 
Ask your vet if they do in-house giardia testing or send it out to labs like Antech or Idexx? In-house tests have been proven to be less than 30% effective unless done consecutively for days or more. 

If they've tested for parasites more than once over a few weeks and turned out negative, ask for an ELISA fecal test, it's a different method and will discover parasitic antigens.


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## drofen (Feb 2, 2013)

Because of the life cycles of the organisms we're talking about it is very likely you could have 3 false negatives, especially if they have been evenly spaced out.

There is no magic additive in Flagyl that would make the stools firm up while the dog is taking it. It has to be a reduction in parasitic or bacterial load.


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## CITIgolden (Mar 9, 2013)

3 tests are unlikely to come up negative if they send out to labs especially...

Maybe try changing the antibiotic? There are examples of resistance to antibiotics.

If after this treatment she's still have problems and you tried the plain diet, perhaps move on to checking enzymatic deficiency.


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## CITIgolden (Mar 9, 2013)

One thing to also keep in mind with both Gia.and cocc.is that they usually progress fast in such a young dog, so her symptoms would be getting worse after a while if the infection was present, including tarry/bloody stool, loss of weight, vomiting etc...


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## Dallas Gold (Dec 22, 2007)

I'm sorry you are going through this. 

I also suspect something like coccidia or giardia. 

I unfortunately have lots of experience with a dog that does have digestive enzyme deficiencies and chronic soft stools, currently age 9. I think the chances of your puppy having this type of issue so soon is small, but it could happen. We had a TLI/PLI fasting blood test done initially and discovered he was severely cobalamin and folate deficient. Those levels came up with carefully timed and measured cobalamin injections and a daily folic acid supplement, in a dose the veterinarian prescribed (40 mcg). 

We discovered sometimes probiotics made my dog's issues much worse. Particularly Purina Forti Flora, which is often a veterinarian's first option. We tried a few others with disastrous results. Finally a vet suggested Prostora, which helped him a bit. 

We ended up eliminating all but his prescription kibble from his diet, including treats. He is doing very well right now on a new Hills dry ID formula- not the regular ID but a new formulation. Even so, with one non kibble treat or stealing a morsel or two of the puppy's food, the soft stool came back. 

This year we went on a trial of Tylan Powder. It's off label use but it's the solution for us right now. It's worked even better than Flagyl for us. 

I just think it's much too early for your puppy to have IBD or digestive enzyme deficiency issues, and suspect a parasitic or bacterial infection like the others.


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## mylissyk (Feb 25, 2007)

What brand of food are you feeding him? I ask because if you are using Blue Buffalo it is known to cause diarrhea or soft stools in a lot of dogs. also, how much are you feeding him a day? sometimes too much food can be the cause.

But I agree with others that there is a chance it could still be giarrdia or cocicidia. either of those require much longer courses of antibiotics than is generally given, more like a month of two months rather than a 10 or 14 day run.


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## lovecooper (Apr 21, 2013)

Thanks again everyone, this forum keeps me sane and gives me great ideas. 

Cooper is on Royal Canin HE GI health, Hills id and natural balance before that. He is eating 2 1/2 cups per day, the bag recommends 2 1/3 per day. 

If it is gia or cocc would there be other symptoms besides diarrhea? He is otherwise very happy, energetic, eating and gaining weight. I will mention it to the vet to see if there is a more specific or reliable test for gia or cocc.


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## Tahnee GR (Aug 26, 2006)

CITIgolden said:


> One thing to also keep in mind with both Gia.and cocc.is that they usually progress fast in such a young dog, so her symptoms would be getting worse after a while if the infection was present, including tarry/bloody stool, loss of weight, vomiting etc...
> 
> 
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Not so much in a dog this age, in my experience, especially when the drugs are enough to knock it back for awhile but not get rid of it entirely. I know that coccidia can be devasting to very young puppies who are not being properly cared for, but I have more often seen it evidenced in a litter as diarrhea and small size for their age.


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## Mirinde (Jun 8, 2011)

In my personal experience, giardia can run a massive spectrum of symptoms. In our case, our dog went from being happy/normal/active/hungry one day, to lethargic the next, to literally incapacitated with pain the day after that (this is NOT common in an older puppy/dog). He didn't even get diarrhea until after we started treatment...our symptom was vomiting. We only caught it because it showed up on a stool sample (pretty unusual). So for giardia, yeah, there can be a whole host of other symptoms. Excessive gas, super foul smelling or yellow tinted stool, stomach pain, vomiting, sleepiness, rejecting food, and general restlessness/panting/discomfort are all symptoms we experienced at varying times throughout our Great Battle Against Giardia and at varying points of treatment.


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## tippykayak (Oct 27, 2008)

Tahnee GR said:


> Not so much in a dog this age, in my experience, especially when the drugs are enough to knock it back for awhile but not get rid of it entirely. I know that coccidia can be devasting to very young puppies who are not being properly cared for, but I have more often seen it evidenced in a litter as diarrhea and small size for their age.


My experience goes along with yours, especially with giardia. Chronic, non-acute giardiasis seems to come and go in cycles, with or without treatment. It _can_ flare into a dangerous state if the puppy is very young and/or becomes dehydrated, but just as often, it seems to come and go chronically.


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## lovecooper (Apr 21, 2013)

My vet did the GI Fast panel PCR (a more specific fecal test), would this see gia and cocc? BTW it came back normal. 

Also did a bile acid, superchem cbc and UA, all normal

At this point vet seems to think its a dietary issue or maybe just an immature GI system that he might grow out of.

He's on metro now, if diarrhea comes back again vet will change food again.


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## tippykayak (Oct 27, 2008)

lovecooper said:


> If it is gia or cocc would there be other symptoms besides diarrhea? He is otherwise very happy, energetic, eating and gaining weight. I will mention it to the vet to see if there is a more specific or reliable test for gia or cocc.


My dog about a decade ago who had chronic giardiasis showed no symptoms other than severe diarrhea that came and went in cycles. A round of metronidazole would put him right for a week or two, and then boom. He was happy, healthy, incredibly active, and had good appetite the entire time.

There simply isn't going to be a great test for a cyclical parasite like giardia or coccidia. The shedding stage needs to be going on when the sample is collected or it'll show negative. The fancier tests can trigger on a smaller amount (as opposed to the old-school test where you actually look for cysts under a microscope), but the parasite needs to be in a particular phase of its life cycle to test positive.

Usually the response to treatment is the most helpful diagnostic element. If the dog gets better on metronidazole and then worse again after the drug is stopped, especially a couple of times in a row, that's sort of a classic giardia diagnosis in and of itself. I don't see any reason I'd pay for more tests if the flagyl was alleviating symptoms while it was being given.


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## tippykayak (Oct 27, 2008)

lovecooper said:


> My vet did the GI Fast panel PCR (a more specific fecal test), would this see gia and cocc? BTW it came back normal.
> 
> Also did a bile acid, superchem cbc and UA, all normal
> 
> ...


If this were my dog and he were better on metro, that would be enough for me, and I'd pursue a longer metro treatment and/or a staggered one (there are some protocols for staggered treatment your vet can look up, but the basic idea is that you hit the parasite with metro for 7-10 days, then take a week off, then hit it again for 7-10 days). The parasites appear to be totally resistant to drugs when they're in a cyst stage, so the dog gets better, but then they break out of their cysts and sicken the dog again. The staggering is intended to catch them when they hatch back out. Don't mess around with this on your own, but you can certainly ask your vet about it.

One thing I wouldn't do is switch foods over and over or pay for expensive and/or invasive testing. If he's getting better on metro, that would tell me everything I needed to know, at least for the short term. That's what I'd do for my dog, though let me be crystal clear that I'm not a vet nor anything close to one.


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## Dallas Gold (Dec 22, 2007)

tippykayak said:


> If this were my dog and he were better on metro, that would be enough for me, and I'd pursue a longer metro treatment and/or a staggered one (there are some protocols for staggered treatment your vet can look up, but the basic idea is that you hit the parasite with metro for 7-10 days, then take a week off, then hit it again for 7-10 days). The parasites appear to be totally resistant to drugs when they're in a cyst stage, so the dog gets better, but then they break out of their cysts and sicken the dog again. The staggering is intended to catch them when they hatch back out. Don't mess around with this on your own, but you can certainly ask your vet about it.
> 
> *One thing I wouldn't do is switch foods over and over *or pay for expensive and/or invasive testing. If he's getting better on metro, that would tell me everything I needed to know, at least for the short term. That's what I'd do for my dog, though let me be crystal clear that I'm not a vet nor anything close to one.


and that brings up another point- a sudden switch in food, without transitioning, often brings on diarrhea and soft stools.


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## lovecooper (Apr 21, 2013)

All the stool samples were tested during his bouts of diarrhea, would that time be a good time to see the giardia? Or is that too late? 

If it is gia or cocc, how long should he be on metro? I saw someone say a few months. I also don't want to medicate unnecessarily. Of course I would rather be safe than sorry.


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## lovecooper (Apr 21, 2013)

you're right, I don't want to switch foods again we've been on 3 different foods and neither were better or worse, so it does seem to lean toward a gia or cocc. I'll mention to the vet about staggering metro.


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## CITIgolden (Mar 9, 2013)

I have to disagree that there's no test to giardia no matter what stage. There is, we use it with humans and the same one is done on dogs, endoscopic testing, even blood tests...but ELISA testing will discover antigens of the parasite - which may give a false positive because the parasite or the earlier stage cyst has already been killed but at least you would know if there was a parasite or is. Sounds like your vet has done some more advanced testing and 3 negatives would be a fairly safe bet.

Don't switch food, you can try simple bland foods - rice, boiled chicken,for a week. Interestingly enough enzymatic issues are more common than allergies in dogs and yet we're much more common to go searching for allergies.

You should finish the course of antibiotics, keep on plain foods, and then retest again after 10 days or so after antibiotics. 

If nothing in her blood test points that there's an active immune response (I.e.infection), and there are still problems then you should look for other causes. 

You want to avoid repeating antibiotics Sao many times with a young puppy and that can severely compromise her immunity.


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## tobyzmom (Aug 14, 2011)

Our Toby gave us a run for our money with the vet that first year too with the loose stools. When we finally switched him off Chicken based kibble to Lamb and Rice he's been fine ever since, no more runny's. Even chicken based treats will start him getting runny again. So no chicken for him. Hope it can turn out to be as simple as that for you also. Best of luck and hope Cooper is on the mend soon.


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## Ohiomom9977 (Jul 27, 2012)

Charlie went through loose stool issues as well. As a precaution we treated for giardia & whipworms. We switched to a limited ingredient lamb & rice kibble which helped. Then he tested positive for cocidia in November. Our vet treated this with Marquis (a paste actually made for treating horses). This was very effective & only 3 days of treatment. Also, his cocidia poops were loose & VERY foul smelling. We still get loose stool here& there. Too much food also gives him looser stool & we have to really be careful to not overfeed. 


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## Mirinde (Jun 8, 2011)

Also, has your vet considered Panacur in addition to/instead of/in cycle with the metro?


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## Summer's Mom (Oct 20, 2010)

2 weeks of metronidazole probably wont clear giardia if it is there. We had similar issues with Summer when she was a puppy except hers went on to full blown colitis with mucous and blood in the stools. We decided to treat for giardia even tho all tests were negative and she did very well on the metronidazole. Like your pup, the diarrhea recurred whenever we stopped. (even after high dose for 2 + 1 weeks to clear giardia)

Vet was beginning to think of autoimmune colitis which is a different ball game with long term management. In the end she did well on long term (like 60 days at a time) very low dose metronidazole, and a homecooked diet. We managed to escape steroids.

She was free from problems for more than 2 years and only recently had a few days of bloody and mucousy stools, while I was away and she was staying with family. Vet thinks maybe stress of me leaving brought on an episode of colitis. She's doing fine after a course of metronidazole and simple diet. We're back on kibble! 

Consider trying low dose metronidazole for a longer time? It apparently is not only an antibiotic but has anti-inflammatory properties in the gut, which is why it helps even when its not an infective cause


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## CITIgolden (Mar 9, 2013)

Again, your vet will have the best idea what to do. PcR tests he's done are pretty accurate. No medicine has been officially approved to treat giardia in dogs, so a wide variety of human antibiotics are and can be prescribed. The prepatent period of giardia is 3-10 days, so if you'd repeated your tests within that period at least once in the three times you tested her you would get a positive result. 

Metronidazole is among the antibiotics that have been shown to have more adverse reactions, it's been heavily overused and you should try to minimize it as much as possible. Lower than recommended dose is just feeding the bacteria and parasite and making them more resistant, while killing the good bacteria and hurting your dog's immunity. It is also about 65% effective against giardia. Many vets use Fenbendazole instead, a short therapy has proved much more effective with fewer side effects.

Do yourself a favor and talk with your vet, every vet knows that they can test your dog, even if endoscopic ally, if they reallysuspect giardia and need to diagnose it...too many, good intentioned people, give too many antibiotics to dogs and we have started seeing adverse reactions to plenty meds when they are really needed for more serious conditions, food allergies are on the rise in part thanks to immunosuppressants. Over 70% of antibiotics given in the US are for animals, granted mostly in agriculture, but pets are in those stats too.

Yes, giardia, like common cold or anything else can show one or more symptoms, but with a 9mo old puppy and the timeframes you described there would likely be more symptoms....




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## Tahnee GR (Aug 26, 2006)

Coccidia is still more on my mind than giardia, but that is based on my experience. I have yet to see giardia in my puppies, but have frequently seen coccidia. It is hard to diagnose and can be hard to treat.


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## tippykayak (Oct 27, 2008)

CITIgolden said:


> Again, your vet will have the best idea what to do. PcR tests he's done are pretty accurate. No medicine has been officially approved to treat giardia in dogs, so a wide variety of human antibiotics are and can be prescribed. The prepatent period of giardia is 3-10 days, so if you'd repeated your tests within that period at least once in the three times you tested her you would get a positive result.


This really isn't true. Your claim ignores the fact that giardia has a poorly understood life cycle, and it is not easily detected during several phases of the cycle. A PCR test is a great thing, but it only works if there are some actual protozoa in the sample. PCR testing is also relatively expensive.



CITIgolden said:


> Metronidazole is among the antibiotics that have been shown to have more adverse reactions, it's been heavily overused and you should try to minimize it as much as possible. Lower than recommended dose is just feeding the bacteria and parasite and making them more resistant, while killing the good bacteria and hurting your dog's immunity. It is also about 65% effective against giardia. Many vets use Fenbendazole instead, a short therapy has proved much more effective with fewer side effects.


Fenbendazole may be a good choice here, and that's something the OP should discuss with a vet, but "hurting your dog's immunity" is a sort of nebulous, undefined problem, whereas giardiasis is a serious illness and should take priority over theoretical immunity issues. Do you have any research you're referring to specifically here that shows that metronidazole or similar class antibiotics have some long-term effect on the immune system?



CITIgolden said:


> ...good intentioned people, give too many antibiotics to dogs and we have started seeing adverse reactions to plenty meds when they are really needed for more serious conditions, food allergies are on the rise in part thanks to immunosuppressants.


Whahuh? Food allergies are on the rise because people give antibiotics to dogs when they are sick? Can you back that up, like, at all? With research of any kind?



CITIgolden said:


> Over 70% of antibiotics given in the US are for animals, granted mostly in agriculture, but pets are in those stats too.


Let's not blur the difference between prophylactic antibiotics in industrial farming with the prescription of antibiotics to a dog with the symptoms of an intestinal parasite. Antibiotics for symptomatic dogs are not a significant contribution to the problems we're having drug-resistant bacteria.



CITIgolden said:


> Yes, giardia, like common cold or anything else can show one or more symptoms, but with a 9mo old puppy and the timeframes you described there would likely be more symptoms....


I think the vets on the forum and those of us who have had dogs with chronic giardiasis would disagree strongly with you there. Chronic, cyclical diarrhea with no other symptoms is probably the most common thing that's posted about on the forum when it comes to giardia. Some dogs, particularly very young puppies, show up with more serious symptoms, but they seem to be the exception around here, not the rule.


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## lovecooper (Apr 21, 2013)

I have heard on this site many people talk about gia and cocc poop having a distinct smell and consistency (mucus & blood). The diarrhea we're dealing with is just plain old soft stool sometimes liquidy without blood or mucus and never smells out of the ordinary, just normal smelling poop. 

It's making me a little nervous that we could be missing the gia or cocc, I will keep all of this info in mind when talking to my vet.


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## Ohiomom9977 (Jul 27, 2012)

When Charlie has coccidia I could smell it from the deck when he was in the yard, & that smell lingered strong. That was just my personal experience. Fortaflora also seemed to make his loose stools worse instead of better. Charlie is almost 11 months old so we dealt with this mainly from 3-7 months old


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## lovecooper (Apr 21, 2013)

Hi Mirinde, My vet did have him on panacur for 5 days at one point, then we went to probiotics (prostora). Was working great for a while then something set him off again.


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## CITIgolden (Mar 9, 2013)

tippykayak said:


> This really isn't true. Your claim ignores the fact that giardia has a poorly understood life cycle, and it is not easily detected during several phases of the cycle. A PCR test is a great thing, but it only works if there are some actual protozoa in the sample. PCR testing is also relatively expensive.
> 
> 
> 
> ...



I'm merely trying to help and offer an alternative opinion to a concerned dog owner. I would encourage a refresher on giardia lifecycle and its diagnosis. As someone who has the benefit of seeing aggregation of information from hospitals and clinics, including veterinary, I feel very confident to say that misdiagnosis is largely due to a human error not following of the prescribed protocols - i.e. vets testing in-house with the kinds of tests owners could buy as well, not properly storing samples, freezing samples instead of refrigerating or refrigerating at inappropriate temperatures for longer than prescribed times, or purely not sending them to the labs in an appropriate fashion. Judging by the fact that this particular vet has already done PCR tests, I would rule that out. So what qualifies us to judge that particular professional for incompetence?! 

If you back up and read, you will see that the vet has already done PCR testing so let's not throw in red herrings in terms of costs...

Giardia happens to be "fairly" common in small children, and I don't see many kids out there have chronic giardiasis....

There is plenty of research documenting everything in my post(s) but I don't intend to waste time arguing with someone who has their mind set one way. The purpose of my post here is to try to help the lady/gentleman who was asking for additional opinions, I thought I was fairly clear to discuss options / ask questions with their vet based on potentially hearing anything new on here. 

We can start new threads if you want to debate the science...behind antibiotics, giardia testing, lifecycle, treatment etc. 

Kind regards


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## lovecooper (Apr 21, 2013)

:wave: I appreciate all your responses CITIgolden. I like to get ideas from as many people as possible because it arms me with more knowledge to ask the right questions of my vet. I'm taking everything into consideration but of course I also understand that every dog and situation is different and I would never diagnose my own pet. All the responses have been great and I have a lot of things to go over with the vet, some things I never would have thought to consider without using this forum. So thanks again, and keep on posting!!!!!


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## tippykayak (Oct 27, 2008)

CITIgolden said:


> I would encourage a refresher on giardia lifecycle and its diagnosis.


Would you direct me towards something of this sort? I was working off the CDC, which I thought was a pretty comprehensive, reliable resource on the subject. Perhaps I am incorrect and should read what you are reading, which apparently contradicts what the CDC has to say. I direct you to the bottom of the page I linked, which states "While animals are infected with Giardia, their importance as a reservoir is unclear." Also, on the CDC diagnosis page, it specifies that "Giardia cysts can be excreted intermittently."



CITIgolden said:


> As someone who has the benefit of seeing aggregation of information from hospitals and clinics, including veterinary, I feel very confident to say that misdiagnosis is largely due to a human error not following of the prescribed protocols - i.e. vets testing in-house with the kinds of tests owners could buy as well, not properly storing samples, freezing samples instead of refrigerating or refrigerating at inappropriate temperatures for longer than prescribed times, or purely not sending them to the labs in an appropriate fashion. Judging by the fact that this particular vet has already done PCR tests, I would rule that out. So what qualifies us to judge that particular professional for incompetence?!


It's not an issue of incompetence on the part of the professional, and I would not accuse the OP or the vet of mishandling a sample. It's part of the nature of the disease that it is not present in every sample. My point was simply that a PCR negative would not rule out the disease because of this basic fact. If there's no giardia in that particular sample, the test will show negative, no matter how sensitive.



CITIgolden said:


> If you back up and read, you will see that the vet has already done PCR testing so let's not throw in red herrings in terms of costs...


I did read, which is why I was talking about PCR testing in the first place. It's not a red herring as if it is, in fact, giardia or coccidia, I didn't think the OP should bother re-testing with potentially expensive PCR tests that are not 100% reliable because, while they are >99% accurate _when there are cysts or trophozoites in the sample_, that may not have been the case with the tested samples and may be the case in any future tests.



CITIgolden said:


> Giardia happens to be "fairly" common in small children, and I don't see many kids out there have chronic giardiasis....


To be a bit explicit about the difference between kids and dogs, dogs lick their own butts far more than children do and may have other behavioral or physiological differences that explain why giardiasis isn't typically chronic in children but is frequently chronic in puppies. One has only to search GRF to find many, many examples of threads about chronic giardia.

There is also scholarly research on the subject of life cycle, reinfection, asymptomatic or diarrhea-only cases, chronic cases in humans and dogs, and other ways that giardiasis can be hard to test for and/or persistent, starting with the CDC entry I linked earlier that specifically states that cysts may not be present in a given sample, as well as others:

Comparison of 4 Giardia Diagnostic Tests in Diagnosis of Naturally Acquired Canine Chronic Subclinical Giardiasis. "However, shedding is intermittent, even in chronically infected individuals..."

The Biology of _Giardia_ spp. (old, but thorough)

The public health and clinical significance of Giardia and Cryptosporidium in domestic animals (analysis of epidemiology)



CITIgolden said:


> There is plenty of research documenting everything in my post(s) but I don't intend to waste time arguing with someone who has their mind set one way. The purpose of my post here is to try to help the lady/gentleman who was asking for additional opinions, I thought I was fairly clear to discuss options / ask questions with their vet based on potentially hearing anything new on here.
> 
> We can start new threads if you want to debate the science...behind antibiotics, giardia testing, lifecycle, treatment etc.
> 
> Kind regards


My mind is certainly not set one way or the other on any of these issues. I'm sorry if I gave that impression. I was just offering a disgustingly-acquired wealth of personal experience with these diseases. I think some of your posts were incorrect on the facts, specifically on the reliability of PCR testing and the incidence of chronic giardiasis in dogs, and I attempted to dispute those issues politely. If you think I am incorrect, I always appreciate the inclusion of source material so I can learn more. If you feel I'm not worth the time, I completely understand.


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## Leslie B (Mar 17, 2011)

Not to muddy the issue here - I do agree that the primary cause of the diarrhea is coccidia or giardia (although it could be a host of lesser known parasites) but has the vet run a comprehensive panel on the stool? I have seen dogs that were on a host of antibiotics and ended up with NO bacteria in their intestines. That can be just as bad since the good bacteria are needed to properly digest food. Guess what the primary symptom is for a lack of bacteria? Diarrhea.

Instead of prescribing more/new/different antibiotics it could be beneficial to do more testing first.


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## CITIgolden (Mar 9, 2013)

tippykayak said:


> Would you direct me towards something of this sort? I was working off the CDC, which I thought was a pretty comprehensive, reliable resource on the subject. Perhaps I am incorrect and should read what you are reading, which apparently contradicts what the CDC has to say. I direct you to the bottom of the page I linked, which states "While animals are infected with Giardia, their importance as a reservoir is unclear." Also, on the CDC diagnosis page, it specifies that "Giardia cysts can be excreted intermittently."
> 
> 
> 
> ...


The Brazilian sourced study you cite, sort of refutes everything you've said in your post, which is why I don't like picking apart scientific peer-reviewed journals, as every scientist can and will share an opinion and subject this and that to his/her own interpretation. Tests are actually much better at ruling out giardia and other diseases than diagnosing them as counterintuitive as that may seem, the study you cite concludes that...as well as with any human condition, we don't rush to diagnose anything without correlating one diagnostic with another. 

Nevertheless, these debates are great for science, but not all that useful for a forum like this. Moreover, the authors' CI vs. sensitivity would be acceptable to FDA even for human diagnosis. I also don't want to hijack this thread, but just read the conclusion of the article (again, I hope). To sum up, this PARTICULAR study which is by no means THE GOLDEN STANDARD OF ABSOLUTE, states that a negative is likely to be more correct under low prevalence, especially when correlated with multiple tests than a positive is to be a positive (if you read one of my summarily judged "inaccurate" posts I did warn about false positive - due to possible presence of antigens following treatment) - I happen to be very very familiar with this trend and was suggesting running an alternative test instead of showing antibiotics down the dog's throat just because of someone's hunch (and with all due respect, all of us here can offer our best guess, some based on more or less experience and knowledge, but nevertheless limited experience without seeing the patient). 

EVERY single disease vector "sheds" intermittently including human bacteria and viruses, therefore we repeat tests, correlate with other symptoms etc.. Much of the blood test results for people have CIs that would make everyone paranoid. 

Giardia cycle lasts about 3-10 days to infection (or be present in the analyzed assay). Three negative tests over a period of before and after treatment should be pretty accurate. I'm sorry you've had problems with Giardia, it's a pesky and resistant little thing, but thankfully far from being impossible to diagnose. 

Here's the excerpt from the study you referenced...and I quoted above:

"However, when we used
the FAB coproscopy results as the gold standard (assuming
100% accuracy), and examined the effect of different
prevalence rates—representative of juvenile (50%) and
healthy adult dog (1 or 10%) populations—the PPV remained
reasonable for most methods at 50% prevalence,
but became poor at prevalence rates of 10% or less. Conversely,
the NPV generally was poor at 50% prevalence
rate, but improved almost to 100% at 1% prevalence
rates. This means that at low prevalence rates (or low
prior probability of infection), a positive result is substantially
more likely to be a false positive than a true
positive, *whereas a negative result is almost certainly a
true negative.* *Thus, the tests can help rule out Giardia
infection in low probability situations, but cannot rule it
in.* As such, these tests are of little value as screening
tests, because many dogs without giardiasis will be incorrectly
diagnosed and improperly treated."

I disagree with the dose of absolutism that they dismiss the value of testing, I'm sure a number of other scientists would disagree, the usage of WILL BE INCORRECTLY DIAGNOSED is a bit too strong on a such a small sample study. But then again this is just one paper, and I'm sure if you look at the responses to this in medical journals others have come up with different results. 

Also, you are talking apples and oranges when saying that a giardia cycle is something we don't understand vs. the potential for intermittence in the assay. 

The point about kids not running around with chronic cases of giardiasis is that we can diagnose it and treat, and do that, not the difference in what kids do vs. dogs. 

Lastly, here are some studies linking the use of antibiotics with allergies in children - before you dismiss this by saying dogs are different than children know that most diagnostic screenings, reference ranges, treatments, and dosing of treatments we use on dogs are based on results from studies and reactions done on children. There's been very little money invested in animal medical research until recent times...particularly pet health. (I prefer citing non-scientific articles, but do have access to actual studies for all examples).

Antibiotic Exposure in Infancy Linked to Food Allergies | Nutri-Link Ltd - Clinical Education
MCH Research Program > Funded Projects > (SDAS) Antibiotics Received in the First Year of Life and Odds of Food Allergy in Children


And then more broadly on antibiotics and allergies:

Antibiotics May Increase Allergies, Asthma
Prevalence of Allergies and Asthma | AAAAI


Again, I apologize to the lady who started this post and is concerned about her dog, because we've gone way off topic here. I hope your puppy recovers soon and you find out what was wrong.

And to Tippykayak, I do understand you are trying to help, and I think all of us here are, so in the interest of this puppy's health you may opt not to spend time responding to me again, as I don't think the discussion is productive and won't engage further.


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## CITIgolden (Mar 9, 2013)

Leslie B said:


> Not to muddy the issue here - I do agree that the primary cause of the diarrhea is coccidia or giardia (although it could be a host of lesser known parasites) but has the vet run a comprehensive panel on the stool? I have seen dogs that were on a host of antibiotics and ended up with NO bacteria in their intestines. That can be just as bad since the good bacteria are needed to properly digest food. Guess what the primary symptom is for a lack of bacteria? Diarrhea.
> 
> Instead of prescribing more/new/different antibiotics it could be beneficial to do more testing first.


Thank you for the succinct and common sense post and suggestion!


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## lovecooper (Apr 21, 2013)

what other test could the vet run, they've run a lot already. any suggestions you have would be appreciated.


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## lovecooper (Apr 21, 2013)

a gi fast panel pcr was run which I understand is a pretty thorough test. a host of other test were done as well


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## CITIgolden (Mar 9, 2013)

lovecooper said:


> a gi fast panel pcr was run which I understand is a pretty thorough test. a host of other test were done as well


Is she still having diarrhea? Have you tried the bland cooked diet? And what is your vet recommending you do? Does she have a healthy appetite and no weight loss?

If he's ok now, try the bland food for a week (cooked rice and boiled chicken breast). Add some probiotics, I currently use Vetri-Science Vetri-Probiotic Everyday Dog Chews

KC has stopped having loose stool since I've put him on probiotics. Human ones work too, but dogs usually don't like the capsules and powdery are a bit of a pain to mix in. I'm sure you can find other brands as well. It's also good to alternate probiotics every once in a while. Keep refrigerated after opening.


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## lovecooper (Apr 21, 2013)

he is on probiotics, they helped for a while. have not tried the bland diet yet, vet wants to stay on royal canin or switch to something else if diarrhea returns. I will bring up the bland diet with the vet.


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## CITIgolden (Mar 9, 2013)

lovecooper said:


> he is on probiotics, they helped for a while. have not tried the bland diet yet, vet wants to stay on royal canin or switch to something else if diarrhea returns. I will bring up the bland diet with the vet.


Well then, don't worry much about it. See how it works out, your vet seems to know what s/he is doing. Don't change the diet as that may upset his stomach more. Just check if Royal Canin was in a recent recall mess...I can't remember anymore, but I don't think so.


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## tippykayak (Oct 27, 2008)

CITIgolden said:


> Tests are actually much better at ruling out giardia and other diseases than diagnosing them as counterintuitive as that may seem, the study you cite concludes that...as well as with any human condition, we don't rush to diagnose anything without correlating one diagnostic with another.


I think you are misreading the study, as the paragraph you quote assumes a 100% prevalence rate, since they infected all of the subject dogs. They then measure the other tests against the FAB coproscopy in order to measure their relative accuracy. The actual rate of positive tests, despite the fact that every dog was infected with the disease, was no more than 90%, leaving a 10% window, even on their "gold standard," which is a florescence test, not a PCR test. I refer you to table 1.

That statement you quoted contains its own context, so I'm not sure why you missed it, but the authors' comment was that the *NPV was generally poor* except in the context of "low probability situations." So it seems to confirm what I've been saying about the probability of multiple false negatives.

They even had a dog who was clear for a while and then got reinfected by itself!



CITIgolden said:


> Nevertheless, these debates are great for science, but not all that useful for a forum like this. Moreover, the authors' CI vs. sensitivity would be acceptable to FDA even for human diagnosis. I also don't want to hijack this thread, but just read the conclusion of the article (again, I hope). To sum up, this PARTICULAR study which is by no means THE GOLDEN STANDARD OF ABSOLUTE, states that a negative is likely to be more correct under low prevalence, especially when correlated with multiple tests than a positive is to be a positive (if you read one of my summarily judged "inaccurate" posts I did warn about false positive - due to possible presence of antigens following treatment) - I happen to be very very familiar with this trend and was suggesting running an alternative test instead of showing antibiotics down the dog's throat just because of someone's hunch (and with all due respect, all of us here can offer our best guess, some based on more or less experience and knowledge, but nevertheless limited experience without seeing the patient).


In terms of my reading the conclusion, here are some highlights:
"Cyst shedding is variable in chronically infected individuals, and therefore, if we assume 100% prevalence in our study population, this resulted in <100% sensitivity of even the most sensitive method." Frankly, it looks like it was never better than 90% with any method.

Furthermore, "it is likely that some dogs spontaneously cleared their infections and then became reinfected (as evidenced by Dog #19, where all diagnostic tests were negative for a substantial period of the study), and FAB coproscopy accurately reflected the infectious state of those dogs at most, if not each, time point."

Lastly, "Our study underscores the difficulty in correctly identifying dogs chronically infected with Giardia by both cyst detection and fecal antigen detection..."



CITIgolden said:


> Giardia cycle lasts about 3-10 days to infection (or be present in the analyzed assay). Three negative tests over a period of before and after treatment should be pretty accurate. I'm sorry you've had problems with Giardia, it's a pesky and resistant little thing, but thankfully far from being impossible to diagnose.


Not impossible, but three false negatives, even in a 90% accurate test, are not a particularly crazy coincidence. Given that 90% was the highest the study ever got, and those dogs weren't treated, it's probably well over 1/100 chance in this case.



CITIgolden said:


> Also, you are talking apples and oranges when saying that a giardia cycle is something we don't understand vs. the potential for intermittence in the assay.


Not at all. We don't know how frequently they shed under different conditions. For that reason and many others, we don't know the false negative rate. The study we've picked apart should underscore that more than anything else.



CITIgolden said:


> The point about kids not running around with chronic cases of giardiasis is that we can diagnose it and treat, and do that, not the difference in what kids do vs. dogs.


The difference in the potential for a dog to reinfect himself is pretty huge relative to a child, which would help explain why the dog in question improves on a course of metro and then becomes symptomatic again once it's over. I have yet to hear you offer a plausible explanation for that.



CITIgolden said:


> Lastly, here are some studies linking the use of antibiotics with allergies in children - before you dismiss this by saying dogs are different than children know that most diagnostic screenings, reference ranges, treatments, and dosing of treatments we use on dogs are based on results from studies and reactions done on children.


As actions like licking the ground and one's butt are not likely to influence allergic reactions like they do with reinfection of intestinal parasites, I agree that research on allergies and kids should be relatively applicable to dogs.



CITIgolden said:


> Antibiotic Exposure in Infancy Linked to Food Allergies | Nutri-Link Ltd - Clinical Education


Conclusion: correlation observed, no causation proven. There are a huge number of explanations for the correlation that don't boil down to the idea that antibiotics cause allergies.



CITIgolden said:


> MCH Research Program > Funded Projects > (SDAS) Antibiotics Received in the First Year of Life and Odds of Food Allergy in Children


Now it's my turn to accuse you of not reading. This isn't a study. It's a proposal for a study.



CITIgolden said:


> And then more broadly on antibiotics and allergies:
> 
> Antibiotics May Increase Allergies, Asthma
> Prevalence of Allergies and Asthma | AAAAI


Again, more theories and correlations, but no causality. I'm not rejecting the possibility of a connection between allergies and antibiotic usage, but nothing you've listed comes remotely close to demonstrating anything other than correlation. It's worth exploring and research, but it's not worth skipping antibiotics on a sick puppy, especially one who already improved on a course of the medicine.



CITIgolden said:


> Again, I apologize to the lady who started this post and is concerned about her dog, because we've gone way off topic here. I hope your puppy recovers soon and you find out what was wrong.
> 
> And to Tippykayak, I do understand you are trying to help, and I think all of us here are, so in the interest of this puppy's health you may opt not to spend time responding to me again, as I don't think the discussion is productive and won't engage further.


The OP seems perfectly capable of reading what she pleases and skipping what she pleases. In the interest of this puppy's health, I hope she strongly considers the possibility of using the medicine that has helped the puppy before rather than heading off onto theoretical ground about far less likely causes. Remember that if it is giardia or coccidia, the chronic irritation and diarrhea could do more long term damage to the puppy than a theoretical link between antibiotics and allergies.

I think that the most likely scenario here is that the dog was either cured by the course of medicine and was reinfected or has had subclinical levels of the parasite at times. I think your well-informed disagreement provides her with a different perspective. She's ultimately responsible for her dog and can choose the course she finds more persuasive. I don't see how bowing out helps the dog.

I'm sorry you are finding this conversation less edifying than I am. I will certainly not hold it against you if you stick to your statement and ignore me.


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## CITIgolden (Mar 9, 2013)

My advice to lovecooper, and that's the best I can do based on the situation described and my limited knowledge, is to wait and see, considering the puppy is clinically showing no symptoms, all tests were negative and he had just completed a treatment with antibiotics (which btw are broad-spectrum antibiotics so could have been one of many conditions that can be easily gone by now - in the event of recurrence I'd recommend talking to the vet about a different antibiotic). And start looking for other causes, such as among other enzymatic issues (can react to antibiotics' anti-inflamatory properties...), and which to Dallas Gold's point earlier do tend to culminate with older dogs but can start earlier. Nutriscan, a bit pricey, is a good way to test for food sensitivities without doing the trial and error approach. 

Obviously, nobody is preventing the owner to keep testing and retesting for g&c and giving potentially useless treatment...If you are absolutely convinced it is talk to your vet about more invasive methods like endoscopic tissue sampling which yield certainty, but quite frankly should be the absolute last resort.


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## tippykayak (Oct 27, 2008)

CITIgolden said:


> My advice to lovecooper, and that's the best I can do based on the situation described and my limited knowledge, is to wait and see, considering the puppy is clinically showing no symptoms, all tests were negative and he had just completed a treatment with antibiotics (which btw are broad-spectrum antibiotics so could have been one of many conditions that can be easily gone by now - in the event of recurrence I'd recommend talking to the vet about a different antibiotic). And start looking for other causes, such as among other enzymatic issues (can react to antibiotics' anti-inflamatory properties...), and which to Dallas Gold's point earlier do tend to culminate with older dogs but can start earlier. Nutriscan, a bit pricey, is a good way to test for food sensitivities without doing the trial and error approach.


After all of our back and forth, our advice is really similar! As long as the puppy has no symptoms, I certainly wouldn't restart antibiotics. I would, however, go straight there if there were a flareup. And I'd definitely talk to the vet about the benefits of switching to fenbendazole for the next round. The only thing I wouldn't worry about is food sensitivity at this point.



CITIgolden said:


> Obviously, nobody is preventing the owner to keep testing and retesting for g&c and giving potentially useless treatment...If you are absolutely convinced it is talk to your vet about more invasive methods like endoscopic tissue sampling which yield certainty, but quite frankly should be the absolute last resort.


I definitely would not give medicine unless symptoms flare up again. And I wouldn't bother retesting if they did.


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## lovecooper (Apr 21, 2013)

I'm curious as to why nobody thinks this might be a simple food intolerance or sensitivity, since all other tests have come back normal. I know the metro is an antibiotic, but it also has anti-inflammatory properties. Maybe the metro is relieving the inflammation caused by a food intolerance. I would hate to continue with medications unnecessarily if a simple food change or supplement could help. Remember, the one thing that did seem to help for a while was probiotics.


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## tippykayak (Oct 27, 2008)

lovecooper said:


> I'm curious as to why nobody thinks this might be a simple food intolerance or sensitivity, since all other tests have come back normal. I know the metro is an antibiotic, but it also has anti-inflammatory properties. Maybe the metro is relieving the inflammation caused by a food intolerance. I would hate to continue with medications unnecessarily if a simple food change or supplement could help. Remember, the one thing that did seem to help for a while was probiotics.


I can't speak for everybody else, but my guess is parasites over intolerance because parasites are so incredibly common relative to food intolerances. A cyclical parasite is the simplest explanation and therefore probably the accurate one.


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## Tahnee GR (Aug 26, 2006)

I agree with Tippy-if you hear hoofbeats, do you think horses or zebras? Parasites/bacteria are so common whereas true allergies are not as common, especially when looking at young puppies.

I truly believe that many people think their dog has allergies or sensitivities when what they had was something like coccidia, and their dogs immune system has finally reached the point where it can handle the issue.

Not saying that allergies/sensitivities don't exist, but that they are less common than many people think.


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## Goldens R Great (Aug 19, 2010)

lovecooper said:


> I'm curious as to why nobody thinks this might be a simple food intolerance or sensitivity, since all other tests have come back normal. I know the metro is an antibiotic, but it also has anti-inflammatory properties. Maybe the metro is relieving the inflammation caused by a food intolerance. I would hate to continue with medications unnecessarily if a simple food change or supplement could help. Remember, the one thing that did seem to help for a while was probiotics.


 I’m sorry to read about your pup. I know how frustrating digestive issues can be because I’ve gone through it with Finn.

Could this be coccidia or giardia? It sure could and I wouldn’t rule it out at all. The bottom line though is this is your little pup and if you want to spend money and do the NutriScan test with Dr. Dodds, I say go for it. 

Finn had digestive issues from the very beginning (October 2011) – terrible gas, soft/mushy stools, etc. He had numerous fecals done which were all negative. I was about at my wits' end trying to get a nice firm stool from him. He progressively got worse and by last September it was basically bloody diarrhea. He was on a variety of different meds (Metronidazole, Cerenia, Pepcid and Imodium), I gave him probiotics and pumpkin, he was tested for an exocrine pancreatic insufficiency which was negative, and had a diarrhea panel that tested for campylobacter, parvo, clostridium, cryptosporidium, giardia and salmonella. He was negative for all of that. He had also been wormed with Panacur three times - nine to ten days each time. I had him x-rayed and everything was fine. The vet put him on z/d prescription food which he ended up having an allergic reaction to. Nothing helped.

I finally decided to do the NutriScan test with Dr. Dodds because I wanted to rule out a food intolerance issue. I did both panels and he had an intermediate reaction to White Fish and I was told to avoid it. 

The bloody diarrhea continued so out of desperation I had the vet do an Endoscopy. The first report we received back from the lab was that Finn either had a parasite or he had Inflammatory Bowel Disease. They did think he was a little young to have IBD. My vet decided to get a second opinion and the lab said Finn had some lesions in his duodenum which were consistent with Schistosomiasis due to probable Heterobilharzia Americana. I asked the vet to repeat that three times!  It's a parasite found in standing water, but it's typically found in the southern Atlantic and Gulf Coast states. The only water Finn had access to was my mom and dad's pond. The only thing I can think of is possibly the parasite was transported by cranes and Canadian geese that come to the pond every spring/summer. 

All that being said (sorry to write a book ), the earliest Finn could have gotten this parasite was when he went swimming a year ago in March for the first time. *So I truly believe his issues when I first got him were due to the Fish intolerance. Every food he had been on contained White Fish. I also believe the bloody diarrhea was caused by the odd little parasite. *

When we found out about the Schistosomiasis we wormed him again on Panacur for ten days and I also switched him to Acana Limited Ingredient food – Duck and Pear – which doesn’t contain White Fish. Now that the parasite has been eradicated and Finn isn't eating food with White Fish, his stools look great.

So as I said at the beginning of this novel , if you don’t mind spending the money and want a little bit more information on your little guy and you want to rule out a food intolerance issue, I would do the NutriScan saliva test.

I wish you all the best with your little man. Please keep us posted!


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## BeccaJ (Nov 25, 2012)

*My Tucker has the same issue*

I was searching through the forum for some help with our 5 month old Tucker. He has had diarrhea Metronidazole, a number of worming treatments, numerous tests and yet everything comes back negative. While he is on the Metro, the diarrhea goes away. Within two days of getting off of it, the diarrhea comes back. Our vet is advising to go on a round of treatment with Tyleson but this would be for 9 months. I want to rule out everything before taking this step. Can you tell me what happened with Cooper and how you resolved his issue?


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## Momo retriever (Jun 10, 2015)

*Was this problem solved?*

Did you ever solve the problem?


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## Sri (Mar 24, 2021)

lovecooper said:


> Hi everyone, this is my first post. We got our first Golden (Cooper) 4 months ago and he is wonderful. He started with soft stools at 9 - 10 weeks. We have tested for everything, blood work, stool samples, allergy tests etc. everything comes back OK. He went on metronidazole which firms up the stool but softens up again a few days after metro stops. Tried prescription foods (Hills ID and Royal Canin GI Health), same result, soft stools. We tried probiotics which seemed to be the answer, they really helped him for about 4 - 6 weeks, but then all of a sudden, soft stool/ diarrhea back again. He is a very happy, playful puppy and he loves to eat so we are not worried about anything serious. We think there may be a food intolerance or vet thinks he may just grow out of it. We don't know what else to do. I feel so bad for him, sometimes during these bouts of diarrhea he can't make it through the night. Does anyone know if there is a test for food intolerances and if they are reliable? I have heard of something called Nutriscan, anyone have any thought on that? Also if anyone can give some advice on good dog foods for sensitive stomachs. My breeder uses Natural balance which we started Cooper on originally, maybe we just have to try a different flavor. Any help would be greatly appreciated.


My wife and I are exactly in this boat with our 7 month golden male 'Karma' . We have had all these tests come out negative , have tried 2 different vets, metro, tylan powder all helping only on an interim basis. We are simply not making any progress and that is quite frustrating frankly. Any workable solutions in this regard 'crowd sourced' is highly appreciate. Promise to send you a bottle of wine and a post card of Karma, should we see light at the end of this dark tunnel

Sri


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## smart15179 (1 mo ago)

I have a four month old, golden retriever, currently experiencing the same exact thing. She's had diarrhea ever since we've gotten her and we've been to multiple vet and ER clinic. she was positive for Giardia originally, and was placed on metronidazole and Panicker, which firmed up stool for a little bit and then After some time, the diarrhea came back with mucus. Therefore we dropped off another stool sample which came back negative, and the samples are sent out to Antec. Although the store was negative we were advised to place her back on panic, her and metronidazole and another stool sample was dropped off again, which came back negative but the Elisa Giardia was positive meaning that she at one point was infected with giardia. We were advised that this may be a sensitivity to food so nonetheless we've been trying different foods including I/D by hills science diet and then we tried hydrolyzed protein, the prescription food by Purina neither worked , and then we were advised by another vet that feeding raw kibble such as Stella and chewies would be the best way to go. Unfortunately, we're still experiencing diarrhea and then we finally went to get another professional consultation and we had placed our dog on Tylan, which is another antibiotic. She seems to be responding well although she does have periods of diarrhea I'm just worried that when we finish this course of 14 days, the diarrhea will come back. We have a G.I. consult coming up in December. If anyone else has any other recommendations, please let me know.


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## breannadanielle2 (1 mo ago)

Megora said:


> Does he get any dairy products? Cheese, etc? What about the treats you give him? One thing to be aware of is that with some dogs they start out with a reaction to something like food (colitis), and over time it becomes a chronic issue, particularly if there is scarring in the colon/intestines.


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## smart15179 (1 mo ago)

She gets no treats, solely stella and chewies + royal canine with Tylan for now. Were on day 7 and were seeing some progress but still periods of diarrhea. She's tried I/D and purina vetinarian prescribed diet. I'm fearful to make any changes now during the coarse of this abx


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