Question:
Our dog has had bloody diarrhea for the past six days. She is a large mixed breed dog. It came on suddenly.and she has never had diarrhea, nor blood in her stool before.
When the problem began, we took her to our regular Vet, who prescribed
sulcralfate and metronidazole. She was tested for parasites, and the tests
were negative. She has had no change in appetite, but she does seem quite
lethargic. Her weight is stable, and she has been vomiting intermittently,
but I have not been able to see any blood in her vomit. Since taking the
two prescribed meds, the blood has not abated, nor has the diarrhea. But
the blood has changed from bright red to very dark, almost black. She is on
Heartguard, and had never missed a dose. The only other med that she is on
is soloxine, for a thyroid condition.
Please advise as to what should be our next step, as our regular Vet does
not have the equipment to perform any specialized tests. I am very concerned because despite the medication given, her stool has not firmed up and the blood is still present, just very dark, almost black, in color. If there are any vets or vet techs reading this, I would appreciate your opinions on what tests would be necessary to definitively diagnose what is wrong with her, since she does not have parasites. I'm very worried. Thanks so much for reading this and thanking those who respond, in advance.. Cookie's Mom

Answer:
Have they done radiographs to see if there is a foreign object?

Also have they done bloodwork? Any chance the dog could've gotten into something toxic?

Answer:
Originally Posted by doggirl
Have they done radiographs to see if there is a foreign object?

Also have they done bloodwork? Any chance the dog could've gotten into something toxic?

Yes, radiographs were done and no foreign object. CBC done and slight anemia. No other tests done, and I am very worried as she has been somewhat of a chronic vomiter, but this diarrhea is acute, severe, and with the blood, I am very concerned, especially since it has persisted for nearly a week with no improvement. Thanks for replying. Any other suggestions, and might I be so bold as to ask, are you by chance a vet or tech since you seem knowledgeable.

Answer:
Is the diarrhea odd smelling? I would test for parvo then if negative, test for leptospirosis. Unfortunately, leptospirosis takes two weeks to get results back. If you can keep her hydrated, that is half the battle. Also ask your vet about tomaflu and if they can get some. It helps greatly in case it is parvo or leptospirosis.

Answer:
Originally Posted by BMDLuver
Is the diarrhea odd smelling? I would test for parvo then if negative, test for leptospirosis. Unfortunately, leptospirosis takes two weeks to get results back. If you can keep her hydrated, that is half the battle. Also ask your vet about tomaflu and if they can get some. It helps greatly in case it is parvo or leptospirosis.

No, no odd smell at all. Just very runny and now black. I am worried that she may have a gastric ulcer since our Vet put her on sucralfate. She has been vaccinated for parvo, I think, but not even sure what leptospirosis is. Could you please explain? And she is eating and drinking just fine, but she is lethargic, which is not like her at all. Usually wants to play and be where we are, now content to eat, drink, and sleep. Not her norm.

Answer:
Was that the only abnormal result on the blood test? Do you have the results, and do you know how to read them?

My first reaction is bacterial infection (Campylobacter or C. perfringens?). Very puzzling that the blood in stool is becoming darker. Either something is moving up the GI backwards, it's occuring at different places in the GI tract, or possibly the two sources of blood in the stool are unrelated (eg upper GI bleed caused by meds as you mentioned).

Is the dog appearing to have pain? Can you palpate the abdomen? Does it sound fluid-filled when you tap it? How is your dog's hydration?

Could this dog have drank water from a source outside that you didn't see, or could she have gotten into something else? Do you live in the country?

Answer:
Originally Posted by doggirl
Was that the only abnormal result on the blood test? Do you have the results, and do you know how to read them?

My first reaction is bacterial infection (Campylobacter or C. perfringens?). Very puzzling that the blood in stool is becoming darker. Either something is moving up the GI backwards, it's occuring at different places in the GI tract, or possibly the two sources of blood in the stool are unrelated (eg upper GI bleed caused by meds as you mentioned).

Is the dog appearing to have pain? Can you palpate the abdomen? Does it sound fluid-filled when you tap it? How is your dog's hydration?

Could this dog have drank water from a source outside that you didn't see, or could she have gotten into something else? Do you live in the country?

Yes, I have the results and I will type then here. We live in the city, and she does not have access to any water other than what we give her indoors. She is an indoor dog and shares our home with three cats, none of whom are ill. She does not appear to have pain upon abdominal palpation. Also, I forgot that an ultrasound was done of her abdomen and it was negative, too. Here are her blood test results as follows:
Hemoglobin 9.8 (low)
Hematocrit 28.6 (low)
WBC 16.5 (high)
RBC 3.90 (Low)
MCH 25.1
Platelet 172 (on the low end of normal, norm. 170-400)
neutrophils 13860 (high, 84%, norm range 2060-10600
bands 0
lymphocytes 1155
moncytes 1485 (high, norm range 0-840)
eosinophiols 0
basophils 0

Can you please comment on this, because to the layperson, it seems as though it's serious and the fact that she is anemic, plus the fact that she has elevated WBC would lead me to believe that she is bleeding internally and should have some kind of more definitive test, perhaps endocsopy???? Thanks.

Answer:
I'm with you - I think I would go to your closest vet college, depending on your financial situation. I may be a worrywart but there is too much of a chance of something serious. My suspicions are a bacterial infection, poisoning, or tumour(s).

Personally I'd choose to take this case to a vet college because they have specialists who are really amazing at diagnostics, and they have the most up-to-date knowledge and equipment. Hopefully it's not something serious but the CBC results and the symptoms are troubling. Quick diagnosis could certainly help.

Good luck, I will definitely post if I come up with any other ideas.

Answer:
Originally Posted by doggirl
I'm with you - I think I would go to your closest vet college, depending on your financial situation. I may be a worrywart but there is too much of a chance of something serious. My suspicions are a bacterial infection, poisoning, or tumour(s).

Personally I'd choose to take this case to a vet college because they have specialists who are really amazing at diagnostics, and they have the most up-to-date knowledge and equipment. Hopefully it's not something serious but the CBC results and the symptoms are troubling. Quick diagnosis could certainly help.

Good luck, I will definitely post if I come up with any other ideas.

Thanks for your input. Just a couple of things that occured to me. If she were poisoned, why would her appetite still be good and why would she still be drinking normally? And wouldn't she be exhibiting signs of severe abdominal pain??? Since there was no evidence of a tumor in either the radiographs or the ultrasound, I am wondering if she could indeed have a bleeding ulcer. (i.e. our vet prescribed sucalfate, so she must have thought it a possiblity, too) And IF she has an ulcer, could it cause a bacterial infection in her stomach? Also, an overgrowth of clostridium (?sp) was noted, but no parasites in her stool, even under microscope. Any other ideas? Thanks for replying.

Answer:
the high WBC, neutrophills and monocytes screams infection to me. Everything else are just signs of the bleeding. Sorry can't help beyond that. But best wishes! Let us know how it turns out

Answer:
Originally Posted by Puppyluv
the high WBC, neutrophills and monocytes screams infection to me. Everything else are just signs of the bleeding. Sorry can't help beyond that. But best wishes! Let us know how it turns out

I am very upset. The only tests done by the specialist were an abdominal and chest x-ray, and some more bloodwork. No abnormalites seen on the x-rays and she's still anemic and WBC still elevated. They're keeping her on the two medications prescribed by our regular vet and adding a dewormer (panacur) and metamucil to firm up her stool. We took her there with the idea of having her scoped, but we can't do it ourselves, nor can we make them do it. Any other ideas?

Answer:
Yes, a tumour(s) or serious bacterial infection.

You said Clostridium was noted; this is something I'd follow up on - this is one of the things I suspected initially - bacterial infection, specifically Campylobacter or Clostridium perfringens.

Personally I'd take her to a vet college where they have way better diagnostics. It sounds like your vet is not particularly proactive. Whereabouts are you exactly?

Answer:
Cookie's Mom, I see you are in Florida. If you are south of Orlando contact the Florida Vet Specialty Hospital in Tampa/St. Pete area, I have heard they have an extension in Maitland too, just north of Orlando.
The Universty of Florida Vet college in Gainesville is your best bet...352/392-4700. Open all the time and the best...you may need a referral but that is not hard to obtain...

Answer:
Karin, that you for the information. You are obviously a very caring person as well as a great animal lover. Thanks. CM

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