Chronic diarrhea.

Dr. Marie replied:

What a frustrating problem! It sounds like your vet is doing all of the same things I would do for chronic diarrhea - food change, metronidazole, probiotics and diarrhea panel. I have had a few cases like this that I just can't figure out.

While I may not have the answer for you, I'll give you my thoughts on Kaja's case.

I would likely try treatment with a broad spectrum dewormer such as fenbendazole (also known as panacur). I would do this even if fecal exams are negative. There are some parasites that can go through stages where they are hard to detect.

One of the other reasons for trying fenbendazole is that dogs with hookworm can have chronic diarrhea along with skin issues. However, the ones that I have seen usually have skin problems on their feet rather than backs. But still, it is worthwhile to try.

The other thing that would tie together skin issues and diarrhea would be an allergy. However, food changes and prednisone really should have helped.

Another thing that I usually do for dogs with chronic diarrhea is a couple of weeks of an antibiotic called tylosin. I have had several cases where we couldn't find an answer but the dogs did well with tylosin. Some of these dogs need a course of tylan whenever they have an outbreak of diarrhea and other dogs need a tiny amount daily to keep them having solid stools.

Here's something else you can ask your vet about - Addison's disease. Addison's can sometimes be difficult to pick up. It can cause chronic GI issues. If this were my case I would likely do a baseline cortisol blood level. It's a relatively inexpensive test to do. If she has Addison's then this is treatable, but it is a lifelong disease. If left untreated it can be very serious.

If none of these things are working then the next step is to have intestinal biopsies done. This can be expensive, but it is our best chance at getting a diagnosis.

I hope things look up soon!

Dr. Marie.

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Dr. Marie replied:

There are a number of autoimmune conditions that can cause skin conditions. However, if the skin problem cleared up with Cephalexin this sounds more like a bacterial issue. While an autoimmune problem is possible for the diarrhea, it is really unlikely.

Panacur is much better than Revolution when it comes to intestinal parasites.

With Addison's the symptoms can be really vague. We can sometimes see episodes of weakness. But, often off and on gastrointestinal issues (i.e. diarrhea) can be the only issue.

Feel free to take this list to your vet. Ultimately, they can advise you better than I can as to what steps to take next though!