Soren is 4 1/2 months old and it seems like he's had more than his fair share of tummy problems.  We'd only had him about 2 weeks when he had his first bout of vomiting and diarrhea.  The vet x-rayed him, and there were no obstructions, but the vet noted that Soren had a lot of gas in his intestines.  The vet gave him fluids and flagyl and suggested chicken and rice until he was well.  Soren got better in 4 or 5 days.  Two weeks later, he had vomiting and diarrhea again.  This time it wasn't a complete shock, so I just made sure he was keeping water down and started feeding him chicken and rice.  He was better in a few days.

 

About 10 days ago, Soren had another bout of vomiting and diarrhea.  It persisted, so I called the vet.  We did another round of flagyl and chicken and rice.  He got better and he was eating kibble again, although he spit up again last night.

 

During the time we've had him, he's spit up occasionally (when he didn't otherwise seem sick) and had a fair number of loose stools.  From time to time, there's been a small amount of blood in his stool as well.

 

The vets (I've consulted with 2 different vets) identified a number of possible causes, but neither seemed overly concerned because Soren's been gaining weight and growing and he's never been lethargic (except when he's actually vomiting).  Our normal vet said it could be 1) dietary indiscretions (he is really good at grabbing stuff off the ground) 2) allergies 3) a sensitive stomach/not having enough good bacteria in his tummy.

 

She recommended putting a muzzle on him when we go on walks so we could rule out the first one.  I HATE to do that, but maybe it would be best for the time being.  She also recommended that I start giving him a probiotic (possibly fortiflora) to build up the good bacteria in his stomach.  I did switch from Wellness kibble to California Natural Kibble.  It didn't seem to make a difference.

 

Soren is my first puppy, so I'm not really sure what's normal or what's worrisome.  Has anyone had a dog with these problems?  Any suggestions?  Are there any tests I should be asking the vet to perform?

 

 

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Was he tested for giardia and coccidia? Has he been thoroughly wormed for everything?

I don't usually worry about loose stool as long as the puppy is very happy, but I DO worry about diarrhea (watery stool, urgency, inability to hold it, frequent bouts) and I worry about vomiting if it's more than the normal watery/yellowy/foamy stuff that just means an empty stomach.
He has been thoroughly wormed, but he hasn't been tested for giardia and coccidia. Neither of the vets seemed to think it was necessary. And, I really couldn't tell from what I read about giardia and coccidia on the internet whether it was really likely.

He almost always seems very happy. :)
Giardia and coccidia are two of the most common reasons dogs have diarrhea and vomiting. And since they're part of a normal fecal float, testing is cheap and easy and should be a first response to any recurrent digestive issues. So I would *definitely* do that, and consider treating for them even if the exam is negative because the meds to address them are easy on the dogs and a good "just in case" kind of response in case the vet missed a few cysts. Coccidia is treated with Albon, which is a sulfa drug, and giardia is effectively treated with fenbendazole (Panacur or SafeGuard).

Once you've addressed those possibilities, I agree that probiotics and digestive enzymes may help.
Since this is a baby puppy who has had the symptoms since he was newly home, IBD would definitely not be my first guess. If everything else is ruled out, a specialist may be the right choice (leading to a definitive diagnosis, not a vet guess of IBD) but it's not normally a disease of tiny puppyhood.
As Joanna stated, Giardia would be my first guess (or possibly coccidia). It makes sense given the history too. He gets better when you give him Flagyl, which is one of the treatments for Giardia. The super bad thing about Giardia is that it is REALLY easy to reinfect yourself (or in this case the puppy) again and again and again since it transfers in shed hairs. (Note, there is a vaccine for Giardia, it is ineffective, don't get it) Your best bet is to sanitize and vacuum like a mad person!

Ask the vet to do a Giardia snap test of a fecal sample. This should be a FRESH sample, preferably drawn by the vet. The vet will tell you to bring one in, don't. Giardia is very hard to detect and will usually only show up during an active infection and on a fresh sample. So the next time he starts showing symptoms take him in and have a Snap test done. Also, I would recommend treating with Panacur rather than the Flagyl. In my opinion, it works better and has less side effects.

Oh, and one more thing. Be giving him some probiotics. You can order some from a company like Nzymes, buy some from your vet, or probably even your local feed store. He's been on a lot of Flagyl lately which is very, very hard on that little puppy systems. I would put him on probiotics for about a week. to try to build his natural immunities back up. Anytime he is on an antibiotic (like Flagyl) be giving him probiotics at the same time.

I don't always agree with everything this lady says, but she has some good information on Giardia.

Hang in there! If it is Giardia, it can be frustrating. My boy picked it up from a kennel on his flight home to me (got stuck in the airport) and has gotten reinfected 4 times! I finally took a homeopathic approach to treatment and that seemed to help. He hasn't come down with it again, knock on wood!
I'm leaning towards option 1, I am guilty of it, I have to keep my leash really short on garbage days here in the city. Also option 3, my Mocha have a sensitive stomach, you don't need to go buy probiotics from a store, just grow your own, its cheap and you can google tons of recipe, it's even easier than making ramen noodle and I'm a guy :)
This is just like my Lilo; all started when he was a puppy. I switched food a couple of times and he got better until about 2 months ago he had terrible vomiting, diahrea and loose, bloody stools. I was so worried that I took him to the vet (ours is wonderful) and we mulled it all over for about 2 weeks while he was on the chicken and rice diet. After numerous expensive and extensive testing, the best money we spent was on the food allergy test. It was about $175, and for that you get a complete comprehensive list of allergens for your pet with a list of foods, brands and flavors, that are safe. It turns out, the little guy is allergic to just about everything in dog food, haha. For now, we've settled on DVP's Natural Balance Lamb and Rice. So far, he has been SOOOO much better. So, food for thought, you may consider the allergy panel. IMO, was well worth it!
Noodles has a very sensitive stomach and he has been tested for just about everything. Our jogs consist of me staring at the ground making sure he doesn't see something before me (and he is almost 5). He is getting better in that he only has this problem one time a year, but at the beginning, it seemed like every 3 months he was having problems. I had to take him to the ER vet last year because he had been throwing up for 3 days, still drinking water, but couldn't keep anything down. Poor little guy was given a shot to stop throwing up and then hooked up to some fluids. He ended up throwing up in the car on the way home and I was really worried that this was something more serious than just an upset tummy. Both the ER doctor's and Noodles doctor called me the following day and Noodles was already feeling much better. He kept staring at me because he thought I was starving him to death, but after a week on medicine and bland food, he was back to his normal self. Please knock on wood because it has now been a year and no trips to the ER or emergency trips to the vet for his tummy. :) I have noticed a difference now that he is on a different dry food and I'm mixing green beans in with it. Maybe his tummy didn't agree with the other food, who knows...
A friend of mine has a dog with gut issues that took a lot of time and aggravation trying to figure out. The only dog food or dog treats he could eat without getting sick or having diarrhea was Canidae brand. The vet came to the conclusion that it is the Lactobacillus Acidophilus* in the Canidae that helped him. If Soren's stomach is that sensitive you may want to give it a try. It is a great dog food. It made all the difference in the world with my friends dog. Here is a link: http://www.canidae.com/ Hope this helps :)
Most yoghurt already have Lactobacillus Acidophilus, it is heat sensitive, that's why it needs to be in the fridge. Look for the LAC seal, it means 100 million culture per gram. Yes, there are freeze dried Lactobacilus Acidophilus used in dog food, however it can be destroyed due to the high heat protrusion process, I'm not sure if Canidae "sprayed" it on after the kibble cools down, if you look at their label, it claims to have 100 million culture per POURD (1 pound = 453 grams),you'll get the best bang for your buck by buying yoghurt separately or growing your own.

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