Monday, March 19, 2012

Monday Pet Tip: Diarrhea and Your Pet

What is diarrhea?
Diarrhea is the passage of feces as unformed or loose stools, usually in increased volume and frequency of passage. It is a result of increased speed of passage of fecal material through the intestine combined with decreased absorption of water, nutrients and electrolytes. There are many causes of diarrhea. Diarrhea may occur as the only sign or in combination with other signs of more widespread disease, or with symptoms that result from prolonged or severe diarrhea.

What causes diarrhea?
Diarrhea is not a disease in itself but a clinical sign that may reflect one or more of many different problems. Most involve some degree of inflammation of one or more sections of the alimentary or gastro-intestinal (GI) tract. The GI tract is the continuous tube that carries food from mouth to anus. Inflammation can be caused by infectious agents such as bacteria, viruses, coccidia, and intestinal worms, or by non-infectious irritants such as chemical toxins, poisonous plants, and so on. Allergies to certain specific components of a diet may be responsible for diarrhea. Changes in diet can lead to temporary changes in the stool. If frequent liquid or semi-liquid stools persist for more than two days, you should consult your veterinarian. Diarrhea may occur as a sole symptom or as one of several symptoms of a more generalized disease problem. Many mild cases of diarrhea can be resolved quickly with simple treatments. Others are the result of serious or life-threatening illnesses such as cancer. Even diarrhea caused by mild illnesses may become fatal if treatment is not begun early enough to prevent severe fluid and nutrient losses.

When should I bring my pet to the vet?
Your veterinarian will attempt to determine how sick your pet has become as a consequence of the diarrhea. If your pet has experienced diarrhea for two or more days or any of the following symptoms are experienced in conjunction with the diarrhea, it is important to schedule an appointment with a veterinarian:
  • Vomiting
  • Dehydration
  • Loss of appetite
  • Abdominal pain
  • Fever
  • Lethargy
  • Bloody and/or watery diarrhea

What types of tests are performed to find the cause of my pet’s diarrhea?
If diarrhea is associated with several of the above signs, your veterinarian will perform a series of tests in order to make a diagnosis. This permits specific disease treatment. Diagnostic tests may include microscopic fecal evaluation, abdominal radiography (x-rays) with or without barium, blood tests, fecal cultures, biopsies of the intestinal tract, video endoscopy, ultrasound and exploratory abdominal surgery. Once the diagnosis is known, treatment may include special medications, diets, or surgery.

If your pet does not appear systemically ill from diarrhea, the cause may be less serious. Some of the minor causes of diarrhea include stomach or intestinal viruses, intestinal parasites, and dietary indiscretions (such as a change in diet or eating garbage or other offensive or irritating materials). A minimum number of tests are performed to rule out certain parasites and infections. These cases may be treated with drugs to control the motility of the intestinal tract, drugs that relieve inflammation in the intestinal tract, and, often, a special diet for a few days. This approach allows the body's healing mechanisms to correct the problem. If your pet is not improving within two to four days, a change in medication or further tests may be necessary.  It is important to keep your veterinary clinic updated about your pet’s progress to optimize its recovery.

 How is the cause of diarrhea determined?
It is important to provide your veterinarian with a detailed medical history. Ideally you should write this out in chronological order before you go to the clinic. Be as detailed as possible on the date you first noticed a problem, even in retrospect. Also report the progression of the clinical signs. Note any changes in the normal routine of your pet or your household. How frequent are the stools? What is the color, consistency, and smell of the feces? Is your pet showing any other signs such as vomiting, loss of appetite, lethargy, or loss of weight? We have a checklist to help you put this history together.

Besides a thorough clinical exam, your veterinarian may recommend additional diagnostic tests. These tests may be deferred in mild cases of diarrhea unless initial treatment fails or the condition worsens. Tests may include blood work, stool and rectal swab samples for parasite examination and culture, radiographs, and endoscope exam.

How is diarrhea treated?
Initially, and often in advance of in-depth work-up, a non-specific approach may be adopted. It is a good idea to withhold food for twenty-four hours and encourage water consumption. Gradually reintroduce small quantities of a light, easily digestible diet. Boiled rice or other pasta with some boiled skinless chicken may be given if a special veterinary diet is not available. Anti-diarrheal medication may be used to help speed your pet’s recovery. Many cases of diarrhea will respond quite readily to simple treatment, without the initial cause ever being established. As the stools return to normal, your pet’s regular diet can be gradually reintroduced, mixed initially with the bland rice-chicken or similar diet.

If there is little or no improvement over two or three days, if your pet is not taking any water or if the pet’s health worsens, then your veterinarian should be notified at once. Treatment may be more aggressive based on the results of an in-depth clinical work-up as outlined above. Loss of fluid is one of the most serious aspects of severe or prolonged diarrhea, and if vomiting is present, dehydration can rapidly escalate. Correcting the dehydration may require intravenous or subcutaneous fluids.

Can I use anti-diarrheal medications from the human pharmacy?
Some of the preparations recommended for people are very dangerous for pets so never use a medication without consulting your veterinarian first. Products containing ASA or acetaminophen are extremely toxic in cats and can be harmful to dogs as well.

My pet has chronic diarrhea. Will it get better?
Chronic diarrhea that has been present for two to three weeks or longer may prove more difficult to diagnose and to treat effectively. Even extensive work-up does not always provide a definitive answer to the problem. But in many cases a thorough clinical work-up, including food trials, can result in a successful outcome.
In order for us to narrow down the cause of diarrhea in your pet, please answer the following questions as accurately as possible and bring this information with you to your pet's appointment. If you are not certain about the answer please indicate “approximately” or “not sure”.

  • How long has the diarrhea been present?
  • Is the diarrhea more severe now than a few days ago?
Frequency and Nature of Stool
  • Watery stool
  • Stool is the thickness of pancake batter
  • Very bloody stool
  • Only sporadic blood present
  • Blood not present in stool
  • Bright red blood present
  • Dark, tarry blood present
  • Entire stool is soft or watery
  • Only portions of the stool are soft or watery
  • Diarrhea with each bowel movement
  • Diarrhea is sporadic (some bowel movements are normal)
  • Only 1 or 2 bowel movements per day
  • More than 4 bowel movements per day
  • Increased, large amount of stool
  • Decreased or normal, small amounts of stool
  • Stool is dark brown in color
  • Stool is very pale in color
  • Stool is black and tarry in appearance
  • Thick mucus or pieces of tissue present in stool
  • Loss of bowel control (defecates in the house on the floor)
  • Severe straining when having a bowel movement
  • How powerful is the smell?
  • What is your pet's normal diet?
  • Is your pet's appetite normal? If not, are they eating at all?
  • What have you been feeding your pet during the last week? Include dog or cat foods, treats, table foods, milk, and anything else that you have fed your pet. Also state what percentage of the diet is each item or category.
  • Does your pet have access to foods other than what you feed them? If so, what?
  • Has there been a diet change in the last few weeks? If so, does that correspond with the onset of the diarrhea?
  • Has the diet changed within the past two months?
  • Do you feed your cat milk?
  • Did you feed your pet table scraps within the past two weeks? If so, what?
  • Has your pet gotten into any off-limits food recently?
  • Does your cat hunt and eat prey?
General health
  • When was your pet last vaccinated?
  • Are there any other signs of illness?
  • Is your pet as active as normal?
  • Describe any change in water consumption (increased or decreased).
  • When did you first notice any other signs of illness?
  • Has there been any weight loss? If so, over what period?
  • Have you seen any vomiting? If so, how frequently and for how long?
  • Does your pet go outside your house?
  • Does your pet go outside your yard?
  • Does your pet have access to garbage cans, either within your house or yard or outside your yard?
  • Does your pet have toys that it plays with that it could have swallowed?
  • Does your pet have access to sewing materials, such as thread or needles, rubber bands, or string?
  • Do you have other dogs or cats that live with this one? If so, does the other pet have diarrhea?
  • Do any other animals in your house currently have a diarrhea problem?

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