I began my veterinary career with emergency consultations in Vincennes, on the outskirts of Paris. Those nights on call are etched in my memory, particularly for the numerous cases of diarrhea in puppies that I encountered. Most pet owners arrived at the clinic with expectations—understandably seeking a swift, medical solution, a magic bullet, to relieve their puppy’s distress. However, the field of veterinary medicine has seen significant evolution over the years, especially in the treatment of this common issue. This shift in treatment strategies might come as a surprise to many, moving away from the quick fixes many anticipate. In this blog, we’ll explore the modern recommendations for managing puppy diarrhea, highlighting the advancements that are transforming puppy care in veterinary practices.
- What’s Behind Puppy Diarrhea?
- What’s on the Menu for a Puppy with Diarrhea?
- When Is It Time for The Vet?
What’s Behind Puppy Diarrhea?
Unraveling the Causes
A myriad of factors can trigger diarrhea in dogs. However, it’s rare to encounter cases stemming from liver failure, acute kidney failure, or cancer in puppies.
Predominantly, we zero in on three principal culprits:
– viruses (aka viral enteritis – and let me tell you: MANY viruses can cause diarrhea in puppies!),
– digestive parasites; when we think of parasites in puppies, our minds often jump to digestive worms, but in reality, tiny single-celled organisms called protozoa take the lead as the most prevalent culprits!
– and nutritional issues.
These are the focal points during a consultation for a puppy presenting with diarrhea. Identifying the root cause is crucial, as it steers the course of treatment.
| Viruses | – Parvovirus Infection: A highly contagious viral illness in puppies, characterized by severe vomiting, diarrhea, and immune suppression. – Distemper Virus: A serious viral disease affecting puppies, leading to symptoms like fever, nasal discharge, coughing, lethargy, and neurological complications. It can also lead to diarrhea. Contrary to popular belief, this is not a relic of a bygone era! – Rotavirus: A common virus in puppies causing gastrointestinal symptoms such as diarrhea and vomiting, often leading to dehydration. – Norovirus: Although more commonly associated with humans, norovirus can infect puppies, causing gastroenteritis with symptoms like vomiting and diarrhea. – Astrovirus: A virus that can infect puppies, leading to mild to moderate gastrointestinal symptoms, including diarrhea and vomiting. – Kobuvirus: A less commonly known virus that can affect puppies, potentially leading to gastrointestinal disturbances like diarrhea. – Circovirus: A virus known to infect puppies, associated with symptoms such as vomiting, diarrhea, and in severe cases, systemic illness. … |
| Digestive Parasites | – Giardia: A microscopic parasite that causes diarrhea and gastrointestinal upset in puppies. – Coccidia: Tiny, single-celled parasites that infect the intestinal tract of puppies, leading to severe diarrhea and dehydration. – Roundworms: Common intestinal worms in puppies, often transmitted from the mother, causing pot-bellied appearance, vomiting, and diarrhea. – Hookworms: Small, blood-feeding intestinal worms that can cause severe anemia, weakness, and diarrhea in puppies. – Whipworms: Parasitic worms that live in the large intestine of puppies, leading to bloody diarrhea, weight loss, and dehydration. … |
| Nutrition | – Abrupt diet change: Sudden changes in a puppy’s diet without gradual introduction can disrupt the digestive system, leading to diarrhea. – Overfeeding: Giving a puppy too much food can overwhelm their digestive system, resulting in loose stools or diarrhea. – Foreign Body: Ingestion of indigestible objects by curious puppies can obstruct the gastrointestinal tract, causing diarrhea among other symptoms. – Dietary Indiscretion: Puppies eating inappropriate items, such as garbage or toxic substances, can experience gastrointestinal upset and diarrhea. |
For a deeper dive into the diagnostic process, I recommend revisiting a previous blog where I elaborate on this critical first step:
Why Does My Puppy Have Diarrhea? Health Guide & Expert Insights
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Assessing the Severity
The intensity of diarrhea can vary widely, and tools like fecal score charts tailored for puppies are invaluable for evaluation. It’s important to remember that these charts differ from those used for adult dogs and vary according to the puppy’s size.
Factors such as the stool’s colour, smell, and accompanying clinical signs play a significant role in assessing the situation’s gravity.
For a comprehensive understanding of these assessments, refer to my earlier blog on the subject:
Why Does My Puppy Have Diarrhea? Health Guide & Expert Insights
As a general guideline, if you’re concerned about your puppy’s condition, it’s best to consult your veterinarian promptly. Puppies can deteriorate rapidly, and in matters of health, it’s always better to err on the side of caution in my opinion.
What’s on the Menu for a Puppy with Diarrhea?
The Role of Nutrition
So, what to do when your puppy is suffering from diarrhea?
I think it’s essential to recognize that leveraging optimal nutrition should be the cornerstone of your initial strategy in those situations.
This approach is particularly pertinent in cases of mild diarrhea…
If you’re facing what appears to be a severe case, or if uncertainty clouds your judgment, remember the advice previously mentioned: consulting with your veterinarian is paramount to gain the necessary clarity.
Recently, I tuned into a webinar focused on canine diarrhea and was struck by a remarkable statistic: a whopping 84% of diarrhea cases presented to veterinarians are classified as mild.
Although this figure encompasses dogs of all ages, not just puppies, it highlights that mild diarrhea constitutes the overwhelming majority of cases encountered in veterinary clinics.
As I’ve consistently emphasized in my blogs, adopting a systematic approach to nutrition is vital for puppies (and in all dogs actually!). This involves addressing three fundamental questions: What to feed? How to feed? And how much to feed?
Here, I’ll provide you with my insights on navigating these questions to ensure your puppy’s swift recovery and well-being.
What To Feed: Understanding Bland Diets
When one mentions a bland diet, images of boiled chicken and rice often come to mind.
This is probably because this simple dietary adjustment is widely recommended in veterinary clinics for puppies (and dogs) experiencing diarrhea.
The reason boiled chicken and rice have become synonymous with a bland diet lies in one term: their high digestibility (=how easily food can be broken down and absorbed by the body).
This concept has been so widely embraced that countless blogs and articles have been dedicated to exploring its applications and benefits… but is it enough here?
It is a good start – but we can do so much better today here I think.
Sure, crafting a homemade bland diet offers flexibility.
It’s however crucial to recognize that these diets can miss important nutrients for growth, like minerals and vitamins; and those are vital for puppies.
And something which is also crucial: nutritional consistency.
Puppies’ digestive systems struggle with frequent changes in their food’s nutritional makeup, and that’s a challenge often faced with homemade bland diets actually.
This is why in cases of mild diarrhea I lean towards specialized commercial diets typically.
Some are indeed highly digestible and also specifically designed to ensure digestive health in puppies.
I strongly suggest verifying if the diet you pick has a claim for digestive health, as they’re more reliable indicators than just the ingredients list.
Moreover, consider therapeutic GI puppy diets prescribed by veterinarians, which can be an excellent choice for puppies.
Remember, the primary focus should always be on digestibility when addressing mild diarrhea in puppies, to support their health and growth effectively.
What To Feed: Supplements?
When a puppy suffers from diarrhea, the instinct to reach for supplements is strong… yet caution is warranted.
Remember, the key to effective nutrition is balance—not excess.
Overloading on supplements, even with good intentions, can backfire, exacerbating the very issues you’re aiming to alleviate.
Pumpkin, for example, is a common go-to for its gastrointestinal benefits…
Pumpkin is rich in what we call soluble fibres – which are beneficial for dogs with diarrhea because they absorb water and form a gel-like substance in the digestive system. This helps to slow down digestion, allowing for better absorption of nutrients, and can also firm up loose stools, providing relief from diarrhea.
It’s commonly suggested in various sources to give pumpkin to a puppy experiencing mild diarrhea… yet it’s important to understand that it’s not a universal remedy.
I’ve witnessed cases where puppies were supplemented with pumpkin… while they were already fed with a therapeutic GI diet AND other supplements with digestive benefits – like psyllium seeds. All of that only to see the diarrhea persist.
The issue? Potentially, “too much of a good thing” disrupting the delicate balance needed for recovery.
This is why, unless your veterinarian advises otherwise, I advocate starting with a diet specifically formulated for digestive health, sidelining supplements in the initial approach to mild cases.
This method ensures a focused, balanced approach to restoring your puppy’s digestive harmony.
What To Feed: Probiotics?
What about Probiotics?
Those supplements are often hailed for their gut-balancing powers indeed. They are live beneficial bacteria that support the health of the microbiome of the digestive tract.
Think of the microbiome as a bustling city within the gut, teeming with beneficial bacteria that are so integral to our pets’ health that many experts liken it to an organ in its own right. This microscopic metropolis is not just a digestive aid; it’s a cornerstone for immune system development, a sculptor of behaviour, and a key player in weight regulation.
There is this new realm of veterinary science called DOHAD—Developmental Origins of Health and Disease; and it suggests that digestive disturbances in the tender phases of puppyhood might pave the way for persistent gastrointestinal woes in adulthood.
Given the microbiome’s monumental role, preserving its harmony is paramount, especially when our furry companions face digestive upsets like diarrhea.
In these delicate moments, nurturing the microbiome becomes a top priority. And probiotics often emerge as a highly advocated solution in this regard.
If you want to find out more about other strategies to optimize the puppy’s digestive microbiome, check my previous blog on this topic:
Puppy Gut Health: Starting Right to Ensure Lifelong Wellness
However, it’s crucial to proceed with informed caution again here.
Navigating the world of probiotics can be like walking through a maze – not every path leads to the desired destination.
Research has illuminated a critical truth: the efficacy of probiotics varies widely.
Some hold the promise of benefits, backed by solid scientific evidence, while others fall short, offering little more than hope without results. This underscores the necessity of selecting probiotics with a foundation in science.
I watched a great webinar recently on treatment recommendations in cases of diarrhea in veterinary medicine; in it, a nuanced perspective on probiotics was shared.
The discussion brought to light intriguing findings: the speaker showed results of studies demonstrating that, in the face of acute diarrhea, the expected benefits of probiotics often dissolve into the shadows. Contrary to popular belief probiotics may not wield the power to conquer mild diarrhea in puppies with the efficiency many assume.
Such insights serve as a potent reminder of the value of professional guidance in my opinion.
Before embarking on a probiotic regimen, especially in delicate cases of puppy diarrhea, the wisdom of a veterinarian becomes indispensable.
It’s a call to action: consult with those who understand the intricacies of canine health, ensuring that our choices are informed, effective, and, above all, safe for our cherished companions.
What To Feed: Mixed Feeding?
And when managing mild diarrhea in puppies, I find that mixed feeding emerges as a harmonious step worth considering.
This approach, which artfully blends feeding both dry and wet food, offers a gentle reprieve for the troubled digestive tracts of our furry friends.
The rationale behind this method is rooted in the workings of the digestive system, particularly in a region known as the border brush. This area, adorned with enzymes adept at breaking down carbohydrates, plays a pivotal role in digestion. However, when the shadow of diarrhea looms, this area can become compromised, leading to a decrease in the efficiency of these crucial enzymes.
Wet food, characteristically lower in carbohydrates than its dry counterpart, steps in as a gentle ally in these times of need.
By integrating wet food into the diet, we lighten the carbohydrate load, thereby easing the burden on the compromised digestive system. This thoughtful adjustment can significantly enhance the digestibility of the diet, offering a soothing balm to the digestive tract.
I often recommend mixed feeding as a temporary measure during episodes of diarrhea in puppies. Transitioning to a blend of wet and dry food for a week or two provides the much-needed respite for the border brush cells to recuperate.
This period of recovery is crucial, paving the way for a return to optimal digestive function and the restoration of stool quality. And once the digestive landscape has healed, a gradual shift back to a primarily dry diet can be made.
How To Feed: Digestive Rest?
I’ve laid out comprehensive puppy feeding strategies in a previous blog, which I highly recommend for a deeper dive into nurturing your puppy’s health from the bowl up.
However, there’s a pivotal piece of advice that merits a spotlight in this discussion.
The traditional approach of prescribing a period of digestive rest—a 12-24 hour fast accompanied by water but devoid of food—has long been advocated in numerous texts and blogs as a remedy for diarrhea.
This method, aimed at allowing the digestive system a moment of respite to ‘reset,’ is now under scrutiny. The tide of veterinary opinion is shifting, with a growing chorus of experts advocating for a different course of action: feeding through the episode.
The argument against the old-school fast (nil per os or NPO) and in favour of continued feeding hinges on the belief that maintaining a flow of highly digestible nutrients can actually expedite recovery.
Obviously, it calls for a thoughtful selection of highly digestible diets that support the healing digestive tract, as discussed before. And this approach is particularly paramount when it comes to puppies in my opinion.
These burgeoning bundles of energy are not only battling the discomfort of diarrhea but are also in the throes of growth, making their need for consistent and quality nutrition non-negotiable.
The decision to continue feeding amidst digestive distress is more than a mere feeding strategy—it’s a commitment to supporting their delicate developmental journey.
How Much To Feed: Something NOT to Overlook!
When navigating feeding a puppy, particularly in the throes of mild diarrhea, the quantity of food becomes a linchpin in their health and recovery.
This critical factor is often overshadowed by what and when to feed, yet it holds the power to tip the scales between wellness and further digestive distress.
Overfeeding, a common oversight in puppy care, can inadvertently induce what’s known as osmotic diarrhea—a condition where excessive food intake overburdens the young digestive system, pulling water into the intestines and resulting in diarrhea. This starkly illustrates why precision in portioning is paramount, especially in these sensitive cases.
Adhering to the feeding guidelines provided on your puppy’s food packaging is an excellent starting point.
These recommendations are crafted to align with the nutritional needs of growing puppies, offering a solid foundation for their diet. And with the advent of pediatric growth charts for puppies, we’re now equipped to refine these amounts even further, tailoring the portions to the individual needs of each pup with unprecedented precision.
Despite the simplicity of measuring cups, their reliability for gauging food portions falls short, often veering towards overfeeding—a fact underscored by multiple studies.
In contrast, a kitchen scale emerges as a champion of accuracy, ensuring that the food your puppy receives is measured to the gram, eliminating guesswork and fostering optimal health.
The notion that using a scale is too time-consuming is a myth worth debunking. Investing a mere 30 seconds to weigh your puppy’s meal can drastically enhance their dietary balance, making every second count towards their long-term well-being.
Embracing this practice is an atomic habit with monumental benefits.
When Is It Time for The Vet?
For the vast majority of mild puppy diarrhea cases that walk through the doors of veterinary clinics, nutrition stands at the forefront of treatment strategies.
Yet, the spectrum of treatments extends beyond dietary interventions, branching into various medical therapies tailored to the root causes of the ailment.
When a puppy’s diarrhea escalates beyond the mild, transient episodes, a veterinary diagnosis becomes indispensable.
As described earlier, the cause of the discomfort could range from parasitic infections, where a dewormer like fenbendazole becomes the weapon of choice against culprits like Giardia, to more complex conditions that necessitate intravenous fluid therapy to combat dehydration in severe cases.
The arsenal of treatments at a veterinarian’s disposal is vast, with each medication or therapy meticulously chosen based on the puppy’s specific symptoms and the underlying diagnosis.
However, amidst the diverse options for medical intervention, one topic remains notably absent from our discussion so far: antibiotics.
And this omission is deliberate, as the use of antibiotics in treating puppy diarrhea warrants a thoughtful conversation.
Antibiotics: A Double-Edged Sword?
Reflecting on my years in emergency consultations some 15 years ago, the prescription of antibiotics for any puppy presenting with diarrhea was almost a reflex, ingrained in our veterinary training.
The rationale was straightforward: diarrhea was often attributed to harmful bacteria wreaking havoc in the delicate ecosystem of the puppy’s digestive tract, and antibiotics were the cavalry called in to restore order.
This was the conventional wisdom of the time, a well-intentioned strategy aimed at quick recovery.
However, the landscape of veterinary medicine has undergone a seismic shift since then, particularly in our understanding of the gut microbiome’s complexity and its pivotal role in overall health.
A landmark study on the effects of metronidazole, a go-to antibiotic for gastrointestinal issues in dogs, cast a long shadow on our previous practices.
The findings were stark, revealing that such antibiotic treatments could significantly disrupt the microbiome’s balance, leaving a lasting impact that, in some cases, might never fully recover.
This revelation was a wake-up call, highlighting the potential for dysbiosis—a state where the natural balance of the microbiome is thrown into chaos, potentially setting the stage for chronic health issues down the line.
The implications of DOHAD (Developmental Origins of Health and Disease) became impossible to ignore, underscoring how interventions in puppyhood could echo throughout a dog’s life.
In light of these insights, the approach to using antibiotics in cases of diarrhea has been recalibrated.
The American Veterinary Medical Association (AVMA) now advises against the use of antibiotics in mild cases of diarrhea, and for those cases as mentioned before many authors are now advocating instead for a nutrition-centered approach.
The criteria for antibiotic intervention have become more stringent, reserved for severe and complicated cases of diarrhea—situations characterized by additional complicating factors like systemic illness which suggest a more profound infection may be at play.
Moreover, when antibiotics are deemed necessary, the methodology has evolved.
The preference now leans towards intravenous administration, specifically targeting bacterial septicemia—where bacteria have entered the bloodstream—without further disrupting the gut’s microbial community.
This targeted approach, coupled with recommendations for shorter treatment durations, reflects a more nuanced understanding of antibiotics’ impact on the microbiome.
This paradigm shift serves as a crucial reminder in the ongoing discussion of “What Do You Give a Puppy for Diarrhea.”
Despite lingering perceptions among pet owners, antibiotics are not a panacea for diarrhea and are often unnecessary for recovery.
Observations from clinical practice suggest that the natural resolution of diarrhea, typically within about five days, is frequently independent of antibiotic use.
This challenges the misconception that antibiotics are a direct catalyst for improvement, emphasizing the importance of judicious use and aligning with the latest veterinary guidelines to safeguard the long-term health of our puppies.
Fecal Transplant: Harnessing the Power of Microbes
During a recent deep dive into a webinar focused on antibiotic recommendations for dogs experiencing diarrhea, a fascinating concept caught my attention: the “Dysbiosis Index.”
This innovative test, unheard of in veterinary practices 15 years ago and still not commonplace in many clinics, offers a groundbreaking way to gauge the health of a puppy’s gut microbiome.
Unlike in the past, where we relied heavily on observational assessments and educated guesses, we now have access to specialized laboratories capable of providing this insightful analysis, allowing us to quantify the level of microbial imbalance—or dysbiosis—within the digestive tract.
The allure of the Dysbiosis Index lies in its ability to transform the abstract into the measurable.
Rather than navigating the murky waters of post-antibiotic recovery with uncertainty, veterinarians can now pinpoint the extent of microbiome disruption and strategize effective interventions.
Among the most promising of these interventions is the fecal transplant, a procedure that involves transferring fecal matter from a healthy donor into the gastrointestinal tract of the affected puppy.
This direct infusion of beneficial microbes serves to reseed and rebalance the gut flora, fostering a return to digestive harmony.
The potential of fecal transplants extends beyond the theoretical, with an increasing body of research underscoring its practical benefits.
One study that particularly stands out explored the application of fecal transplants in newborn puppies, suggesting a possible role in enhancing neonatal survival rates.
Another compelling piece of research demonstrated a remarkable improvement in puppies afflicted with parvovirus, where those treated with fecal transplants showed a rapid resolution of diarrhea within the first 48 hours of hospitalization—a testament to the procedure’s efficacy.
As we continue to explore and refine the use of fecal transplants, their place in the veterinary toolkit for managing chronic diarrhea and other gastrointestinal disorders is becoming increasingly significant.
This evolving area of veterinary medicine holds the promise of revolutionizing our approach to digestive health issues in puppies, shifting the paradigm from traditional treatments to more holistic, microbiome-centred therapies.
Since my early days in veterinary practice 15 years ago, the evolution in managing puppy diarrhea has been nothing short of revolutionary. Nutrition now anchors our therapeutic strategies for mild cases, underscoring a profound shift towards nurturing the delicate ecosystem of the digestive microbiome. Our arsenal has expanded beyond mere symptom management to embrace interventions that foster microbial harmony and recovery. This significant progress represents a leap forward in canine health, illuminating the pivotal truth that the events of puppyhood cast long shadows over a dog’s life. Armed with this knowledge, we stand better equipped to shepherd our puppies through their formative stages, ensuring their journey is marked by vigour and vitality.
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