Falling between stools

Dear Dogs Today,

We are the proud owners of a three-year-old (four in June) Tamaskan bitch and an eight-year-old collie cross bitch. Our problem lies with Willow, the Tamaskan. As is common with Arctic breeds she has a very sensitive digestive system and when she was a young adult she was fed Burns Venison and Brown Rice with very little disruption to her digestion. Unfortunately a couple of years ago we had difficulty sourcing that particular type and slowly introduced her onto Burns Chicken and Brown Rice. She had the occasional upset if she happened to scavenge but, within a couple of days, back to her usual self.

Early January this year she had a bout of chronic diarrhoea with liquid faeces evacuated under pressure! A campylobacter infection was positive from stool sample and treated with antibiotics. She was on Royal Canin Chicken and Rice sensitive for the duration. Three consecutive days stool samples after the antibiotics were clear.

Now, however, she has had diarrhoea for almost four weeks. She also came into season at the same time and the first couple of weeks she had very loose stools progressing to liquid (as described above). Her season has been slightly different too in that at no point has it become copious as previous but more just drips.

We initially fed her Royal Canin Chicken and Rice with the vet prescribing Pro-kolin with no improvement. If anything it became slightly worse with what looked like undigested fat among the liquid. A blood sample to check her pancreatic function came back normal. By now we had progressed onto boiled rice and chicken which we prepared ourselves, again with no improvement to the consistency. She eventually took a dislike to the boiled rice and would pick the chicken out. She has lost about a kilo of weight in a week on top of the weight she had already lost. She is currently about 19.6kg.

Vet is now thinking about a small bowel biopsy for a definitive diagnosis but a further blood test for biochemical levels showed that her blood protein and albumin levels as very low but there is no infection present. Quite rightly the vet does not want to biopsy her while her bloods are like this. Started on Prednisolone (5mg three tablets, twice daily) five days ago and feeding her, on the vet's advice, on boiled chicken and some Burns Chicken and Brown Rice. After the first 24 hours she produced her first solid poo in almost a month. The elation was short-lived however and we then went from cow pat consistency to liquid again today. Follow up appointment with vet in two days.

We are really very worried and she is very subdued and depressed. She has never lost her appetite although she would leave the boiled rice. We would be extremely grateful to hear from anyone whose had a dog with similar symptoms and what did they do? Should we change her diet completely (obviously would have to be introduced over time). Could she have developed an allergy to chicken? That seems to have been the only constant through all of this

The collie cross throughout this has been on her usual diet of Burns Chicken and Brown Rice and has no problems. She was tested for campylobacter during the first episode and she was clear.

Kind regards,

Andrina Robertson, by email

Issues of consistency

I have a five-month-old Labradoodle who is vaccinated and wormed. I feed him a complete puppy food - one feed in the morning and another in the early evening. When he goes to toilet in the morning his stools are normal. However, when he toilets for the rest of the day they are much lighter in colour and runnier (the consistency of runny ice-cream). I also have an adult collie-GSD cross that I feed a complete meaty food and her stools are normal. Why do his stools change throughout the day and what can I do to get them normal?

Kim Farthing, by email

Would a definite diagnosis make a difference?

We have a beautiful male Whippet named Alfie who will be three years old in February. Ever since he was about four months old he has suffered intermittent gastrointestinal problems with vomiting and diarrhoea. (He tested positive for giardia when he was seven months old and was treated with panacur.) As well as the gastro problems, Alfie suffers from a more serious health problem, that seems to follow a bout of vomitting and/or diarrhoea. It first occured when he was 10 months; he presented with a high temperature, general lethargy and discomfort with movement such as lying down or getting up. He did not respond to treatment with antibiotics. Eventually the vet prescribed steroids following Alfie's obvious discomfort when his neck was examined, and a noncommittal diagnosis of steroid-responsive meningitis was put forward. I did not want to go down the road of having a spinal tap carried out to confirm the diagnosis.
This condition has recurred another four times during the past two years, each time being treated with steroids - which bring about an almost miraculous recovery within 24 hours. He has been kept in overnight at the vet's on a drip on at least three occasions to ensure he does not dehydrate due to his high temperature.
He has just finished his most recent course of steroids and the vet is suggesting that we refer him to a neurologist if the condition recurs again, in order to get a definitive answer. This would mean a ferry ride and car drive (we live in the Channel Islands) when he is ill to the nearest specialist in the south of England. Alfie is insured so cost is not an issue, but the thought of the journey with the high temperature and obvious discomfort he shows really worries me. Would a definite diagnosis make a difference to his treatment? He responds to steroids so I wonder if a diagnosis, which could be inconclusive, would make any significant difference to his health management. I don't want him to be reliant on steroids forever, but if this works then is long-term treatment a realistic option?
I have to say when he is well you would never think he'd had an ill day in his life - he is energetic, loving and playful.
We would appreciate others' thoughts especially if you have been through something similar.
Jo Lamb, Guernsey

Steroid-responsive meningitis is often a condition diagnosed by excluding other causes for the clinical signs the patient is showing, and by response to treatment with corticosteroids. It is also a condition liable to flare up, such that long-term therapy with low-dose corticosteroids is not unusual.
It is because of this recurrent nature of steroid-responsive meningitis that your vet will have advised referral for a definitive diagnosis. If it was confirmed as the cause of your dog's bouts of illness, then all your questions and concerns about his treatment and long-term outlook could be addressed with a far greater degree of certainty. Long-term treatment with corticosteroids is not without its concerns but if needed for medical reasons then the benefits should outweigh any disadvantages.
It is however always your decision and I can quite appreciate your worries about referral, not least in your situation where travel involves a considerable journey including a ferry ride, and when Alfie is very unwell. On that basis, then a response to corticosteroid treatment when a flare-up occurs can be acceptable, provided there is full recovery with treatment. Compromise is not necessarily the wrong route to take.
I particularly remember a Border Collie who presented on an August Saturday with such acute neck pain that she had become stuck in the passenger footwell of her owner's car. I did refer her because I was worried about a slipped inter-vertebral disc in her neck, but she was diagnosed as having steroid-responsive meningitis and responded very well to methylprednisolone. When we began reducing the dose, she did have flare-ups, which settled once the dose went back up an increment. She has now been off treatment for three years.
Alison Logan, vet