At wit's end with chronic diarrhea
This is my first post here, although I've been lurking for a while. I have a neutered 2 year-old GSD x Border Collie that has been suffering with chronic diarrhea now for months. I know that GSDs can be particularly susceptible to GI issues and I've read through many of the "chronic diarrhea" posts on the forum, but have noticed that most threads seem to taper off without any resolution. I'm curious as to whether anyone has experienced this type of saga with their own GSDs and if so, what was the most successful approach in resolving it?
Rigby has always been an apathetic eater, with relatively frequent two-ish day bouts of anorexia. I rescued him at apx. 12 months old, and about seven months later (in November of last year) I noted he'd lost a bit of weight, although his stools were normal. I chalked it up to the stress of moving around a bit, did satin balls for a while, and started adding canned food to his dry (Kirkland Brand Salmon and Sweet Potato), and he gained the weight back, although he was still skinny.
In the spring of this year I was becoming concerned with his weight again, but many people suggested that it's not uncommon for young GSDs to be really skinny, and that he would fill out around 3 years old. Then... the diarrhea started.
At first it was just occasional loose stools. He'd have a normal BM in the morning, but in the evening he would go two or three times back to back, with the second and third rounds increasingly sloppy. This went on for a while, and then it started increasing in frequency, to where he was going three times a day. He then had a bout of liquid diarrhea. I fasted him and put him on white rice and boiled chicken before slowly reintroducing his kibble, and he seemed to bounce back, but his stools were still unformed and soft. He also seemed to be very uncomfortable after eating, curling up in a ball, moaning when lying down or when repositioning, and stretching (downward dog/upward dog, or Halloween cat) a lot more than usual.
Off to the vet. Fecal test for parasites, including an ELISA test for giardia, all negative. Did a one-week course of metronidazole just in case, but it didn't help the diarrhea at all. Back to the vet. Tested him for EPI. cTLI, cobalamin, and folate levels were all normal. His GP started him on prednisone for anti-inflammatory effects and probiotics, as well as a feeding trial-- Natural Balance Limited Ingredient Diet Sweet Potato and Venison (a novel protein for him). We saw immediate improvement on the steroids-- his stools became formed again, although they were still too soft. He had bad side effects on the pred, panting, polydipsia, and his moaning and stretching had not abated, so the next week we were back to his general practitioner. She seemed to think he was doing much better and attributed the discomfort to the steroids, so switched him to medrol.
One week later and no improvement. His stools were still formed but very soft, no change in his apparent discomfort (stretching and moaning). GP added metronidazole back in with the medrol, and took abdominal x-rays, which showed no apparent torsion/blockage/swelling/etc, and bloodwork-- thyroid was a little low (consistent with him not feeling well), but otherwise his blood cell count and blood chemistry were unremarkable.
We then went to an internal medicine specialist, who suscpected a bacterial infection and/or SIBO. Did a fecal test for major types of bacteria (coccidia, campylobacter, etc.), all negative. She switched him from metronidazole to doxycycline, and continued with the medrol. The doxy seemed to help firm up his stool a bit more. Specialist then started him on a fiber trial, with psyllium fiber added to his food. This also seemed to help a bit, although he was still pooping, large volume, three or four times a day, still moaning/seeming uncomfortable. He had gained a bit of the weight back.
After about two weeks he began refusing his food if fiber were added to it. I dropped the fiber and it didn't seem to make a difference one way or another in terms of his stool. A little over a week and a half after that his full-fledged diarrhea came back, sloppy, wet, and mucousy, for three or four days. I'd be watching him very closely and I'm pretty sure he hadn't gotten into anything or eaten anything other than his kibble. It took four or five days for him to get back to the "formed but soft stage." Then he began refusing his kibble... Hand feeding worked for a while, but then he outright refused it regardless of what I'd try. He'd also been losing weight again, and started eating grass.
He had a five-day course of Panacur, and we took him in to have an ultrasound, which didn't show anything abnormal, and more bloodwork and an ACTH test, which all came back normal/negative. The specialist suggested I do whatever it took to get him to eat, so I switched him to white rice and boiled beef. She also wanted me to double up his antibiotics and double his dose of steroids. We live in a pretty remote area, so it can be hard to get meds. We'll have to wait until next week when more medrol is delivered to increase the dose.
Recently, several folks have suggested I try raw, so yesterday I switched him to BARF model raw, which he has been eating. He hasn't yet had a BM, so I guess I'll have to wait and see what that's like, but he has still be uncomfortable (moaning/streching, especially early morning~ 3:00/4:00 AM), and maybe a bit gassy (although I have a really bad sense of smell and have a hard time telling), and has also continued to eat grass. I don't expect miracles on raw, but I did hope that maybe he wouldn't seem so uncomfortable after eating it. But perhaps the transition will just take the time and he'll improve in a week or so...?
So this is where we are: He's had diarrhea now off and on since March or April and continuously since late May/early June. He's been tested for EPI, Addison's, bacterial infections, and parasites, all negative. He's had Panacur, been on a fiber trial and a feeding trial, had abdominal x-rays and an ultrasound and bloodwork twice, all normal. He's currently getting metronidazole and doxycycline twice daily (morning/evening), probiotics (FortiFlora) midday, and medrol in the morning (to be increased to twice daily next week).
His energy has been more or less fine. He's skinnier than he should be (probably needs four or five extra pounds- can see his ribs, spine, hips). And he's experiencing some kind of discomfort or pain after eating, whether that be gas pains/bloating, or something else, as well as in the early morning. Because of the nature of his diarrhea and the fact that he hasn't vomited at all, the specialist suspects something intestinal.
Has anyone experienced ANYTHING like this? In the end, what did the diagnosis end up being? Or what was tried that ended up helping? I love this dog like nothing else. For a two year-old, this shouldn't be happening. I'll do whatever it takes, but I'm running out of funds for meds and testing and consults, and patience. I've been worried sick over him being sick.
Thank you all for reading through this novel of a post, and I would really appreciate any insight or advice.