The Ins and Outs of Diarrhoea in Dogs!

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Diarrhoea is a common complaint dealt with at Hollybank veterinary centre and it can come in all shapes and sizes-literally! The faeces can range from ‘looser than normal’ to very watery and many of the cases we see contain fresh blood and mucous too. Sometimes we may also get the complaint of straining to defecate; more often than not the animal is not constipated, they just have the sensation that they need to defecate. (This straining is usually responsible for the fresh blood seen.)

Although diarroea can present on its own, it is often seen with other gastrointestinal signs such as vomiting and a reduced or absent appetite. This information coupled with a thorough history and physical examination help us to decide what we think is the most likely underlying reason.

Diarrhoea is classified into two broad categories:

  1. Primary gastrointestinal disease (GIT); something directly affecting the GIT.
    1. Dietary indiscretion/scavenging
    2. Dietary sensitivity/intolerance
    3. Parasite burden
    4. Viral/Bacterial/Fungal infections
    5. Inflammatory disorders such as inflammatory bowel disease
    6. foreign bodies or obstructive conditions such as cancerous masses.
  2. Secondary GIT; something elsewhere in the body having an effect on the GIT.
    1. This can include disorders with the pancreas
    2. Liver disease
    3. Kidney disease
    4. Toxicities
    5. Endocrine diseases

What next?

This is dependent on what we think the underlying reason for your dogs diarrhoea is. If we are concerned of underlying diseases (secondary GIT) then blood tests are indicated to rule in or out some of these concerns. We will then often do symptomatic treatment until we have more information, at which point we will adjust our treatment plan according to our findings.

If we are concerned about a primary gastrointestinal disease then our management is based on what we think is highest up our list. For example, if we feel infectious or dietary reasons are most likely we will often start with symptomatic treatment whereas if we are suspicious about the presence of a foreign body then imaging the gastrointestinal tract is required. This involves a combination of ultrasound and x-rays.

Symptomatic treatment involves a sensitive and palatable diet, probiotics and for cases of vomiting and poor appetite we will elect to give an anti-sickness injection too. This, time and TLC is often all that is needed.  In some cases however, the fluid losses and poor intake of food and water can lead to dehydration and  we need to extend our symptomatic treatment to intravenous fluid therapy and monitoring in the hospital. This is also why it is important for us to re-examine your pet if they have failed to improve with initial management.

To give antibiotics or not?

In veterinary medicine it is really important to practice safe and responsible antibiotics use. Generally, diarrhoea does NOT require antibiotic courses and there is scientific evidence to support this. A large proportion of cases will resolve with the management mentioned above and only in a few cases do we even consider their use. 

Brave Pet of the Month…Scooby!

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Scooby is the most well behaved and tolerant little Schnauzer we have ever met! He came to us late one evening with an injury. Prior to that evening he had been a very well and happy boy.

On exam, Scooby had two large wounds underneath his right front leg. The wounds were deep creating two pockets of space and the the tissue underneath the skin had been torn at different angles. Although Scooby was extremely brave and allowed us to examine the wound he required sedation to clip, clean and fully assess the extent of the damage. Luckily, the rest of his clinical exam was fine.

The surrounding hair was clipped and the wound was flushed copiously with sterile water. This is to ensure any debris was washed out of the wound. The injury was the result of a dog bite so would automatically be classified as ‘contaminated’. As you can see, the holes created space within the tissues and there were different layers of damage but luckily no other important structures were damaged.

Next, we had to make some decisions about how we were going to manage this wound. This had to be done taking into account some potential risks and complications:

  1. Closing a contaminated wound via surgery can close dirt and bacteria inside. If surgery is performed some drainage must be provided. A special drainage tube can be placed at the time of surgery or part of the wound can be left open.
  2. Wound healing relies on the tissue being kept as still as possible. Too much movement will delay the healing process. Unfortunately, Scooby’s wound was in a place that would be very difficult to immobilize.
  3. Wound healing relies on minimal tension on the wound. If there are abnormal forces or pulls on the tissue then this again will delay healing. Given the location and the directions the tissues were torn in, this wound could definitely be at risk of tension under surgical closure.

In cases where we have such worries it is better not to rush into a surgery. Instead, the wound can be managed ‘open’ for a couple of days. This allows for re-assessment and ensures we make the best decision for that particular injury.  It involves leaving the wound exactly as it is but providing pain relief, antibiotics, strict rest and a buster collar to prevent patient interference! Wounds can in fact be managed completely in this way. 

This is not to say surgical closure was not an option. However, inappropriate closure could ultimately result in breakdown of the wound resulting in a wound even more difficult to close. Additional surgeries could be required or open wound management may then be the only option.  This not only increases the time it takes for full healing but also increases costs too.  In which case, open wound management can play a really important role in early wound management. With any luck, Scooby might not need a surgery at all, but if he did, at least it would be a smaller surgery with a more predictable outcome.

When we leave a wound open the body starts the natural healing process. The wound edges themselves contract  and the space left by the injury will eventually close down as the tissues all knit back together.  New tissue growth then starts from the sides inwards and bottom upwards. Wounds can heal completely in this way but as you can appreciate this takes time. Within the first week or so Scooby’s wound started to contract and improve.

img_4040We elected to persevere with our open management. However, before the tissues contracted too much we wanted to try to oppose the tissues back together slightly; by closing the gap this would reduce some of the space to be filled and in turn help speed up healing time. We did this by placing four very loose stitches. As this was still a ‘contaminated’ wound we still left a small hole for drainage. We also started applying barrier cream around the wound to prevent painful ulcerated skin around the drainage hole.

 Given more time and TLC the wound began to completely heal. We stopped the pain relief and antibiotics after a couple of weeks and in just less than 8 weeks the wound had completely filled in and his hair was growing back! We couldn’t have asked for a better behaved patient and he definitely deserves our ‘Brave pet of the month’ for coping with this wound!

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Hollybank Blood Donor List

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As with humans, dogs sometimes require blood transfusions. We have a National Pet Blood Bank which can provide us with lots of different blood products but sometimes a transfusion directly from a donor is most appropriate for our patients. Donor lists are dogs that meet certain criteria that we know we can call on if we require an emergency transfusion.  They can provide us with products that the Pet Blood Bank cannot –such as platelets that are essential to help the blood clot.  The added benefit to our patients of having donor blood is that it is available immediately, without having to wait for it to be delivered from the blood bank.

Donor dogs need to have a relaxed, friendly temperament and be happy to sit still for a period of time.   We only ask dogs who are over 25kg in weight and between one and eight years old.  Donor dogs must never have travelled and must not be on any medication.  We also require them to be vaccinated up to date.  We perform a thorough clinical exam and run a full blood screen on all dogs prior to them donating to ensure that they are in good health. There are no costs involved when you put your pet on our blood donor list.

We clip fur from the neck and place a needle into the jugular vein to collect the blood. Most dogs happily lie comfortably on their side whilst this is being done. We collect blood into a bag that is lined with a special substance to stop it clotting.  The whole procedure only takes about ten minutes and afterwards the dogs receive the equivalent of our tea and biscuits – a bowl of water and some food!  As well as a big fuss too!

Dog blood donors really do save lives and we are incredibly grateful to our donors and their owners.  By the very nature of blood donation we often need to call on our donors at short notice.  We understand you may not always be available to bring them down but if you would be happy to be placed on our donation list we would be very appreciative.

If you think your dog might be a suitable donor, would like to discuss it further or would like to be placed on our list then please contact Helen at the surgery on 01606 880890.