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Puppy Diarrhea: Best Practices in Preventing and Managing Puppy Loose Stool

Why is my puppy pooping diarrhea? Give yourself the tools to understand, prevent and treat diarrhea in puppies. This webinar with Dr. Marty Greer, Revival’s Director of Veterinary Services, gives tips on how to help with puppy diarrhea and she will help you be prepared and properly care for a puppy with loose stool and how to stop a newborn puppy from having diarrhea in the first place. If you have more questions on what to do if your puppy has diarrhea, call us at 800.786.4751.

Managing & Preventing Puppy Diarrhea

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Why Does My Puppy Have Diarrhea?

There are many causes of diarrhea in dogs. Parasites are the ones that we think of most commonly. We’ve been well trained to think about internal parasites, roundworms, hookworms, coccidia and giardia. We see bacterial infections as well. We can see salmonella, we can see Clostridium. Those can be primary causes. Sometimes Clostridium is secondary to some other GI upset. Campylobacter is almost always secondary. So something else that caused a GI upset, whether it’s a water change or a diet change or a parasite, well, that campylobacter and sometimes Clostridium move into the GI tract and cause problems that don’t go away quickly. E-coli is the kind of bacteria that we should normally see in the GI tract of dogs, but there are some that are a little bit more virulent than others. So sometimes we’ll see the dogs on E-coli create issues. Sometimes puppy diarrhea is related to using antibiotics inappropriately. So if you willy nilly use antibiotics on your puppies or your other dogs frequently will see diarrhea associated with that. It’s important to keep that in mind that antibiotics are not without their risks.

Viral infections, of course, are a really common cause of diarrhea in young puppies. Parvo, we typically see between ten and 14 weeks of age. It doesn’t happen in itty bitty newborn puppies. There’s a parvo one that can cause a viral infection in really young puppies. But it’s a different virus than the parvo two, which is the most common one that we see. There is a canine coronavirus that causes GI disease in the dog. It is not the same coronavirus that we experience with COVID. Dogs have their own coronavirus. It causes a respiratory disease, and they have a coronavirus that can cause GI disease.  The fourth is small intestinal bacterial overgrowth or SIBO for short. That’s when the wrong bacteria set up housekeeping in the GI tract. So it’s not really an infection, but it’s certainly an overgrowth of bacteria that shouldn’t be in the intestines.

Commonly, we see a diet change as a cause. Water changes, inappropriate food intakes, overeating, food sensitivities or allergies can cause problems. If you do see an associated change with something different in the dog’s diet, that’s something to make note of and report to your veterinarian or keep track of in your records.

Of course, there are toxins. Cancer is not common, especially in young puppies, but it is a possible cause of diarrhea in the dog. Then we have inflammatory bowel disease and malabsorption, which can be sort of cousins to each other, inflammatory bowel disease means that the wrong kind of inflammation, inflammatory cells are living in that wall of the intestine that can then interfere with the absorption of certain nutrients. We can see problems of that. We can see metabolic disease such as liver disease and pancreatic disease, diabetes. Any metabolic disease that upsets the dog’s system can cause it. And then there’s probably another thousand reasons that dogs can get diarrhea, but there’s so many that we cannot possibly cover them all.

When to Take Dog to Vet for Diarrhea

While it’s tempting at times to treat symptomatically what’s going on, sometimes having a specific diagnosis from a veterinarian, can be a more cost-effective way to handle your puppy or your dog’s diarrhea.

In the process of trying to treat it, you might actually make the diarrhea worse with certain medications, including antibiotics. Do keep in mind that just willy nilly pulling something out of the cupboard that was prescribed by your veterinarian from another dog’s disease may not really solve your problem. Be really careful what you’re thinking about doing. You may want to call your veterinarian first and ask about medications before you start administering them.

What Will a Vet Do For a Dog With Diarrhea?

What do most of us want to do first, as a breeder, or as a family dog owner? What do we usually try to do? First of all, we usually try not to go to the vet, right? Because we know that’s going to cost us some money. But there are important things that we need to make sure of that we cover with the veterinarian if we do end up needing to go in for veterinary care. The first thing that your veterinary technician or receptionist or a veterinarian is going to ask you about is going to be the dog’s history. Was there a diet change? Was there something different in the dog’s food? Did they get into the garbage can? Did you change bags of food even if it’s the same brand? Sometimes just the bag of food is different. They’re going to ask about the stool character. What color is it? Is it yellow? Is a green? Is it orange? Is it runny? Is it hard? Are there small amounts frequently? Are there large amounts infrequently? Is there straining? What other kind of symptoms are going on with this? Next is going to be the physical exam. We’re going to take the dog’s temperature, feel their abdomen, check their lymph nodes, just do a comprehensive physical exam, feel the abdomen, see if there’s something in the abdomen that we could see or feel that’s not supposed to be there. Dogs will eat almost anything and those can cause some serious problems with the GI tract.

The third and most common thing that we’re going to do is going to be the fecal flotation, which is where a stool sample is taken to the veterinarian. It’s mixed with a special solution and looked at under the microscope, looking for parasites and parasite eggs. That’s a really commonly done test many veterinary clinics to those in house. We have now gotten to the point that we send most of ours out to the diagnostic lab for a couple of reasons, one of which is the diagnostic lab has technicians that can identify the difference between certain types of coccidia or certain other kinds of parasites. We’ll get a report back that says this is a coccidia parasite, but this is not a dog parasite. This is just something passing through the dog’s GI tract. So in other words, they went out and ate deer feces or rabbit droppings, and that parasite is showing up on the stool sample, but it’s really not taking up residence and it’s really not the source of the problem.

Rather than treating the wrong disease, the fecal flotation done at the diagnostic lab with a trained technician can be more specific in the parasite that they’re seeing. There’s also the fecal ELISA test, and that’s where they look for the protein of the parasite. That’s going to allow us to see parasites at a much smaller number, especially things like giardia, but sometimes roundworm, sometimes hookworms. They will pick up smaller and smaller amounts of evidence that there’s a parasite there that we don’t even know about, because we can’t see the eggs under the microscope. It’s a really great test to have if you’re having an ongoing problem with chronic diarrhea or recurrent diarrhea in your dog or in your kennel in a situation that you’re just not eliminating it.

You can talk to your veterinarian about whether that test is an effective test that could be included for your dog. The fifth is a direct smear, and this is the least accurate test that we can do. And that’s where we just take a smear of bacteria and fecal material, put it under the microscope and look at it just with magnification. And that’s not going to be very effective because it’s only going to be a very small amount of stool. So when we do fecal floatation and fecal ELISA tests, we use a teaspoon or so of stool, a direct smear is just the amount that would stick to a Q-Tip and then go on to a microscope slide. It’s not as effective. But sometimes that’s all we get. Fecal cultures, again, are another way that we can test. If the dog has an ongoing problem with diarrhea and we’re not resolving it, that’s where they actually look to grow the bacteria that are in the stool. Another thing that we can do in-house frequently, or if not in-house, done at the diagnostic lab is a parvo snap test. That’s an ELISA tested again looks for that protein of the parvovirus. So in-house in under 30 minutes. Your veterinarian can take a look at that stool and assess whether the puppy has parvo. Now, sometimes parvo snap tests will be positive if there was a recent vaccination for parvo, but most of the time, if it’s positive, it really means that the dog has parvovirus.

The seventh test is going to be the TLI/PLI/cobalamin/folate panel that is run typically at Texas A&M, and that tests for pancreatic insufficiency where the pancreas doesn’t produce enough enzymes and causes diarrhea. It tests for pancreatitis, which is an active inflammation of the pancreas. And it also checks for cobalamin and folate, which are two of the B vitamins that are absorbed through the GI tract. And if dogs have chronic diarrhea, some of those will end up with deficiencies of those B vitamins, which then turn around that we can substitute to replace those when the dog’s not absorbing them adequately.

If we’re still not getting an answer and we are kind of plodding along through this and your dog or your kennel is having chronic diarrhea problems, you’re probably not going to ultrasound, if only if you have a whole kennel full of dogs with the same thing. But if you only have one dog with diarrhea, that dog may have inflammatory bowel disease, and an ultrasound can be a pretty effective tool in diagnosing that without going to surgery. Ultrasound would be appropriate for a single dog that’s got chronic diarrhea, but not a group of dogs.

And then intestinal biopsies are the final thing that we would do. And that, again, is an invasive procedure either done with an endoscope or with surgery. And those are reserved for really significant situations with an individual dog. We rarely have to go to that level. But I do want you to know that if you have a dog with chronic diarrhea that would be a test that at some point your veterinarian might discuss doing with you.

Puppy Vomiting and Diarrhea

So what are the symptoms that we see associated with puppy diarrhea other than diarrhea? Frequently the dogs with diarrhea also have vomiting. Vomiting with diarrhea is usually a sign that the dog is sicker than diarrhea alone. I worry more if vomiting started before diarrhea started. I worry less if the dog had diarrhea and then starts to vomit because that’s less likely to be an intestinal foreign body or blockage.

Dog Loss of Appetite and Diarrhea

We also can see appetite loss with the dog with diarrhea. They just don’t feel good. They have a bellyache. If they’ve had diarrhea for long enough, they’re going to start to lose weight, or in the case of a puppy, not gain weight. We may see abdominal pain so that when you put any pressure on the abdomen, the job is uncomfortable or painful.

You may see frequency and urgency of defecation. So the dog may be asking to go out 20 or 30 times a day instead of two or three times a day, urgency being that they can’t wait.

Dog Diarrhea Mucus and Blood

Stool character can change. The color can change. We can see blood. We can see mucus. Those are both signs of large intestinal disease. Greasy stools are more a sign of small intestinal disease. Your veterinarian may ask you about the number of stools if the dog is straining, what the color is, what the blood or mucus is. Those are all keys to whether we’re looking at small intestinal diarrhea, large intestinal diarrhea or both. It may not seem important to you, but it is important to the veterinarian that is trying to make a diagnosis and come up with a specific treatment for your dog’s diarrhea.

Dog Straining to Poop But Has Diarrhea

We can also see a dog straining to poop, which is where the dog stands and squats and squats and squats. Sometimes people think that means the dog is constipated. But in reality it may also mean that it has such bad diarrhea that it’s just got so much inflammation in the intestine that the dog feels like it still has to go, even if something is no longer there.

Dog Fever and Diarrhea

We can also see a dog with a fever and we can see dehydration from passing so much fluid out and not being able to keep enough fluid down by drinking enough or vomiting too much that we end up with a dehydrated patient. So those are all really important keys that your veterinarian is going to want to discuss with you.

Antibiotics for Dog Diarrhea

What do most of us want to do? We want to just reach for an antibiotic, right? A dog has diarrhea, I’ll give them this pill. It should all be fine. Right? Well, antibiotics sometimes can be the right thing to do, but they sometimes can be the wrong thing to do. If you are already experiencing an episode in the GI tract where the bacteria aren’t the right ones, their antibiotics can actually make it worse. Just reaching for an antibiotic every time your dog has a little bit of loose stool is not appropriate. Don’t just think an antibiotic is your solution for everything, because actually you can make that worse in some cases.

Dog Diarrhea Worms

Since parasites are such a common concern in dogs, I want to make sure that we don’t under-emphasize those. The most common parasites we see are going to be roundworms, and somewhere around 90% of puppies that are born without their mother being on an appropriate dewormer are going to end up with roundworms from the time that they’re developing in the uterus all the way through the time that they’re born, through weaning and through their new homing. Roundworms are the most common. They’re the ones that look like spaghetti. They’re the long, round, skinny ones with tapered ends. Then we see hookworms. That’s another common parasite. Those are nastier than roundworms. They sort of hang on to the lining of the intestine and suck blood from the puppy. We can see this in puppies, especially in the southern states where it’s warm all year. Hookworms can cause severe anemia in puppies and to the point that puppies can die from their anemia. We see less of it in the northern states, but it’s certainly not something the northern states are exempt from. You can’t usually see hookworms in the stool sample like you can roundworms. Whipworms are even more difficult to see in stools, but they can be there. Those tend to live in the cecum, which is a little pouch of the large intestine, and they’re harder to diagnose because they don’t show up. Their eggs don’t show up in every single stool sample the way that roundworm and hookworm eggs do, so they can be a little bit sneakier and a little bit harder to diagnose as a chronic cause of diarrhea.

Coccidia and Giardia in Puppies

We see Giardia and Coccidia in puppies. Giardia is a one celled parasite. Coccidia is a little bit different. Coccidia doesn’t have a tail on it. Giardia does. They look different under the microscope and there’s different tests for them. But almost every breeder at this point is going to have Coccidia and/or Giardia in their breeding kennel, every rescue organization, every foster, every humane society. Coccidia and giardia are really difficult to get rid of once they’re in your facility. These parasites live in the soil, they lives in the environment, and they’re very, very hard to get rid of. Almost every puppy born into those facilities or transferred through those facilities ends up at some point with Coccidia and/or Giardia.

Do Tapeworms Give Dogs Diarrhea?

Then there are tapeworms, which again are less common. Those are the ones that you can see the segments of either on the outside of the stool or the rectum. They’ll look like a grain of rice in dog’s poop. Dogs can get tapeworms from fleas; they can get them from other places. Most dewormers will get rid of all of these parasites except for Coccidia.

Cryptosporidium in Puppies

And then we have cryptosporidium. We can see it in dogs. It’s just not that common, and it’s not frequently seen as a cause of diarrhea. But just be aware if you’re having a problem, it might be there.

How to Prevent Diarrhea in Dogs

So what are the things that we can do to prevent diarrhea in our dogs? Because first and foremost, rather than having to treat diarrhea, wouldn’t it be great to just avoid it in the first place and not ever have to deal with it? The first question is weaning. At the time that a puppy is weaning off of its mother and going on to solid food, commonly that’s a change in the diet when we can see associated diarrhea. Making sure that the transition is gradual is your best bet. I tend to use Royal Canin Starter Mousse as my weaning diet, but the fewer diet changes you have during the process of weaning, the better. If you can take mom’s food, it should be a puppy diet that she’s on or a diet like Purina 3020 Sport. You can start softening her food with warm water and transitioning so that very gradually, instead of just saying, okay, the puppies are four weeks old today, we’re weaning you can start introducing the food to the puppies that is Mom’s diet started about three weeks of age. I always wet the food down so that it’s not dry kibble that they can choke on, put it in a low flat dish, let the puppy start to nibble on mom’s food, and then gradually they’re going to transition under that food. There’s no sudden diet change. That’s probably the best way that you can avoid diarrhea at weaning.

Puppy Diarrhea New Food

Number two is when new homes and new foods become an issue. At the time that a puppy leaves your facility and goes to the new home, it’s common for people to send along a bag of food or suggest that the people that are buying the new puppy already have the same food that Mom’s been eating, and the puppies have been eating so that you don’t have a diet change at that transition because you’re stressing them during a household change. You’re stressing them with new water, stressing them with new home, new food. That’s a lot of stress and that will initiate a lot of diarrhea, especially if the puppies are kind of on the cusp anyway because of a parasite like Giardia or Coccidia. We don’t want those all to combine into a real mess. Because the first thing you want to do is have a puppy that moves into its new home and is happy and healthy and things are great, and its stools are formed and nobody’s losing their mind because the puppies having diarrhea 16 times a day. So make sure there’s as few diet changes during that transition as possible.

Do Puppies Get Diarrhea When You Change Their Food?

Garbage is a really common cause of diet change or other kind of dietary indiscretion. You leave your plate on the coffee table and you run to answer the phone and the puppy eats a piece of pizza, or you have friends over and you have a brat fry in the backyard and that somebody ends up feeding a brat to the puppy. That’s going to cause diarrhea because there’s so much of a diet change with that.

Try to avoid any kind of garbage diet change, table scraps, any of those things are going to help reduce the chances that puppies have diarrhea. Stick to their food. Stick to the treats that you want to give them for training, and just try to avoid anything else in the diet.

Foreign objects can also cause diarrhea. Sometimes they cause blockages, sometimes they cause diarrhea. Be very vigilant that the puppies are in an area that’s puppy proofed and the puppies cannot be eating socks, underwear, TV remotes, pens, sugarless gum. You name it, if you leave it someplace that the puppy can get to it, they’re going to chew it up.

Can Certain Water Cause Diarrhea in Dogs?

The second thing we want to do for puppies during a transition is to avoid a water change. I suggest that the people who are coming to pick up the puppy bring an empty jug to put water in from your facility so that they can take water home and not have a dietary or water change at the same time.

How to Treat Puppy Diarrhea

If the moms were not on pyrantel during their pregnancy and lactation, we’re going to deworm the puppies starting at two, four, six and eight weeks of age.

If they are on pyrantel, which is Nemex, at two for six and eight weeks, you’ll eliminate roundworms and hookworms. And then when you get to eight weeks to ten weeks of age, they can switch over to the heartworm preventatives like Heartgard Plus, Sentinel, Interceptor, Tri-Heart. All those have intestinal parasite control products in them as well, so then that picks up where the every-two-week transition takes off.

Albon Liquid for Puppies

Albon is an anti-bacterial. It’s an antibiotic that comes in a liquid form. It comes in tablets as well, but liquid is easier to use for puppies. The recommendation from one of the infectious disease specialists at one of the pharmaceutical companies is to put the puppies on Albon for six days. The last three days they’re at the breeder’s house through the first three days of the new home. Six consecutive days, not three days, and then off a few days and then back on, so six days in a row. And what that seems to do is stabilize the intestinal bacteria in the GI tract and in doing that, you reduce the risk that they’re going to pick up parvovirus. It doesn’t kill parvo, but because you have a stable GI tract, the puppies are less likely to end up with parvovirus. It’s a pretty cool trick. I want to make it clear that you’re not selling to people a sick dog, a dog that’s going into their home that needs an antibiotic, but rather you’re doing this to stabilize the gut and that you’re doing this out of the best interest of that puppy so that they are less likely to end up with diarrhea and therefore parvo in the transition into a new home.

Puppy Stress Diarrhea

Stress, of course, can be very upsetting to dogs, any kind of a lifestyle change. So when they’re put in a crate and taken to a new home, that could be stressful. The ThunderEase collars can really reduce stresses in those puppies. That would be a great tool to use, especially if you have dogs that stress easily. Think about your dog, your breed, how they tolerate those transitions and think about preempting that with a collar or a spray of the pheromones. Then probiotics, of course, are the most important new darling of veterinary discussions. The last two or three years, we’ve heard about probiotics to reduce mastitis, to reduce metritis, which is an infection in the uterus and to make the gut healthier.

Probiotics for Puppies With Diarrhea

Doc Roy’s® GI Synbiotics™ is a dog probiotic that comes in a tube. Breeder’s Edge Nurture Flora is another probiotic that is specifically formulated for puppies from birth to three months of age. You can start this gel on the puppies when they’re first born so that you can start establishing the correct bacteria in their GI tract and not just taking it to chance that they’re going to get the right bacteria. This is a great tool to get the puppies gut populated with the right thing. It’s different than what yogurt is at the grocery store. Stick to the dog stuff because dogs have their own bacterial flora, it’s different than humans. I give probiotics either daily or every couple days, depending on whether you have diarrhea or not, just to stabilize the gut and make sure that the right bacteria are there. You can’t really overdose on a probiotic. It’s better to err on the side of being too generous than not generous enough.

Motility modifiers are kind of an interesting topic. I have a lot of people that have read online that Imodium is good to use for diarrhea, and then they call me because their dogs are vomiting. I’m not sure what the relationship is if those dogs were going to vomit anyway, or if the Imodium somehow just takes a dog that’s on the verge of thinking about vomiting because they already have an upset GI tract, and it pushes them over the edge. But in my hands, Imodium has not been wildly successful. I tend to use kaolin pectin for animals, not the human stuff. The human stuff is different. It metabolizes into aspirin. It’s different than dog and cattle kaopectate. So stick to the kaolin and pectin products and not to the motility modifiers, Imodium.

How Do You Rehydrate a Puppy With Diarrhea?

If we have a dog that has diarrhea we want to make sure that they don’t dehydrate. You can have subQ fluids at home or you can have them given by the veterinarian. Use electrolyte products like Breeder’s Edge® Puppy Lyte. The puppies really like the chicken flavor and will drink this pretty readily. This can prevent diarrhea with a subsequent dehydration. Intravenous fluids can be given if the dogs are sick enough, they need to be in the hospital.

Test New Dogs for Parasites and Bacterial Infections

It’s important to isolate new dogs in your kennel. You want to screen those dogs before you introduce them into the kennel, that they have a fecal, they have a brucellosis test. You’re not bringing in a new dog into the kennel or the facility where they might bring a parasite or a bacterial infection with them.

It’s best to just have those dogs isolated in a part of the kennel that they’re not going to have cross-contamination. You get a stool sample done and a brucellosis test if they’re going to be in a breeding facility and have that done.

When you’re cleaning kennels, always clean the sick dogs’ last; clean the healthy dogs’ kennels first. Make sure your airflow goes correctly through, so it goes from healthy dog to sick dog, not the other way around. And make sure that you’re not tracking in from a sick dog facility into the healthy puppy room, where you don’t want to introduce new organisms that can cause diarrhea.

Racoon Latrines

We can’t overlook the importance of raccoon latrines. The Center for Disease Control has information about finding raccoon latrines and disinfecting them. Raccoon latrines can have parvovirus, can have Baylisascaris as a parasite. They can have leptospirosis. Many times we have people that are living in rural areas with their dog kennels along the tree line, fence line deck, any of those areas where raccoons set up a latrine. They travel for a long distance to urinate and defecate in those areas. It takes just one dog in your kennel to run over there, check it out because it smells really fascinating, then run back to the kennel. They’ve got it on their feet, on their hair, on their skin. They may have eaten something over there and then they’ll bring it into the rest of the kennel.

If you have parvo, if you have lepto, if you have other diseases, you can’t explain, take a look and see if a raccoon latrine is the source of your problem. The dogs need to be kept away from it. If they get into that area, they need to be bathed. If they are exposed, you can use boiling water, not on the dog, but you can use boiling water in the areas to disinfect those raccoon latrines. And a propane torch, but only if that raccoon latrine is found to be outdoors, not if it’s in an outbuilding like a barn.

Best Worm Treatment for Dogs

Probably the most effective website that we have is the CAPC website. It’s the Companion Animal Parasite Council Quick Product Reference Guide and it lists by dog and by cat, all the parasites and all the parasiticide products that are on the market right now in the United States. It’s written by veterinarians, pediatricians, lawyers.

Best Food For Puppy With Diarrhea

When it comes to how we treat general diarrhea in puppies and dogs, the first thing most people want to do as a dietary management, you can use a prescription diet, or you can use a homemade diet. Prescription diets actually work very well. They will cause a resolution of diarrhea three days faster than a homemade, bland diet. If your veterinarian offers you a prescription diet, don’t squirm and say, “No, I don’t want to spend the money on it.” Reach in and say, “Yes, please send me a prescription diet.” There’s only one GI puppy diet on the market. All the other gastrointestinal diets like Hills i/d and Purina EN, Royal Canin has a number of different GI diets, but they do actually make a GI diet for puppies at Royal Canin. This can be used as a maintenance diet if you’re a transitioning puppies or you’re always having diarrhea at weaning, this would be a good diet to wean onto to prevent diarrhea. It’s a really good diet to reach for if you’re having problems. The homemade diets that a lot of people make are either going to be ground beef that’s boiled or chicken that’s boiled, mixed with boiled rice and they are bland diets. They’re nice, but they don’t get rid of diarrhea as quickly as the prescription diets.

Sometimes fiber can help. You’ll hear people talk about canned pumpkin. The reason that they do that is for the insoluble fiber in that. It helps to bulk up the stool and cut down on the amount of fluid that’s just loose in the stool, making it runny. There are also insoluble and soluble fibers on the market that you can purchase over the counter. Miralax is a soluble fiber. The Metamucil or the psyllium are the insoluble fibers, and both of these can be useful. As far as helping with diarrhea, obviously, you don’t want to give too much or you end up with more diarrhea, but sometimes the bulking up of the stool with the soluble and insoluble fibers can make a resolution of that diarrhea more rapid.

How to Help a Puppy With Diarrhea

The second thing we want to talk about for treating diarrhea in puppies are medications. The medications include wormers, antibiotics, anti-coccidial drugs. The most common parasiticide that we use for roundworms and hookworms is going to be Nemex, which is pyrantel pamoate. Those are available in many, many forms, usually in liquid form. Very good tasting, easy to give to puppies even as early as two weeks of age.

Should I Deworm My Dog if it Has Diarrhea?

Other deworming options for dogs with diarrhea are Panacur or Safeguard. Fenbendazole is the active ingredient in those. Not as good tasting, but more of a broad spectrum dewormer for dogs. Nemex will do roundworms and hookworms. Panacur and fenbendazole do roundworms, hookworms, giardia, one kind of tapeworm and whipworms as well. If you’re having diarrhea and you’re not able to resolve it, fenbendazole would be an appropriate thing to reach for. Pyrantel is given once every two weeks. Fenbendazole is given for 3 to 5 days in a row, up to five days if you’re dealing with giardia. Other common dewormers that we see on the market are going to be Advantage, Albon, Centragard, Cestex which does tapeworms, Drontal and Droncit which do tapeworms, Heartgard Plus which is heartworm and roundworms and hookworms, Interceptor which is heartworms, roundworms, hookworms and whipworms Iverhart, which is roundworms and hookworms. Iverhart Max, will include tapeworms as well. These are commonly seen dewormers that are used at veterinary clinics. Others include Panacur, Praziquantel, Profender Topical, Proheart Injectable, Quad Dewormer, Revolution, which is a topical not an oral, Sentinel, Sentry Worm X and Simparica Trio. Simpatico Trio is an interesting drug. It does roundworms and hookworms it does heartworm, and it does flea and tick, however, it is not labeled for use in breeding dogs. If you have a young dog that may be coming up in a breeding program, do not use products that are not labeled for use in male or female dogs being intended in a breeding program.

Tri-Heart Plus is similar to Iverhart. Trifexis, his again is broad spectrum, but not labeled for use in breeding dogs, so be really careful with what you’re doing. Read the labels. If you have a question, the Pet Care Pros at Revival have a list of all these medications and whether they’re safe in breeding dogs or not. Before you reach for any of these or your veterinary prescribes them, if you can’t find the label online, call Revival and get some help with that.

When to Worm a Pregnant Dog

There are two ways to deworm a pregnant dog. There’s the deworming protocol that we can use during pregnancy and lactation for the moms, or we can wait until the puppies are born and then get rid of their parasites. But if we do the pregnancy and lactation and we put the mom on this during the last three weeks of her pregnancy in the first two weeks of lactation, we have puppies born without worms. Instead of waiting for your puppies to be born and then get worms, you can preemptively deworm them with this protocol.

Here is the protocol: Panacur 10%. It comes as a liquid. It comes as a granule. I try not to use the paste because I think it’s more difficult to dose correctly. The liquid medication is given at one cc per 4 lb. of body weight. Use her pre-pregnant weight because her intestinal tract is still the same size that it was before. So just because she’s pregnant doesn’t mean her GI tract got bigger. If she weighed 80 lbs., you give 20 ccs. If she’s 90 or 100 lbs., when she delivers the litter, you still give 20 ccs. The day that we ultrasound and give that weight and confirm a pregnancy is the weight that I use as my dosing, not the extra 20 lbs. that she put on during the pregnancy. Give the Panacur every single day for five weeks. The label says three days. This is an off-label use and I understand that. But it is safe for dogs in this format, and we’ve been using this for a long time and it is well known in the group of veterinarians that do reproduction that this will prevent the development of parasites in puppies even before they’re born.

Roundworms will migrate through the placenta and into the puppies’ circulation and into their intestines before they’re born if you don’t preemptively do this and if the mom had roundworms when she was a young dog. So the bottom line is, unless you do the Panacur protocol, all puppies should be dewormed at two, four, six and eight weeks and you should worm their mother those same days unless she was on the fenbendazole protocol.

The alternative to this is to do Pyrantel at two and four weeks, but by six weeks then start to switch over to fenbendazole, which like I said earlier, is a little broader spectrum. It’ll get Giardia as well. It won’t get coccidia, but it will get giardia, roundworms and hookworms.

Why is My Dog Still Sick After Deworming?

Sometimes there is an apparent treatment failure. It looks like the deworming isn’t working because they still have parasites. But the giardia tests can stay positive for an unknown period of time even if the giardia is gone, the test may still say positive, so it may look like it failed. Sometimes we’re not giving the right dose, so you absolutely, positively need to weigh those puppies and the mom to know how much dewormer to give them. Don’t just pick up a puppy in your hand and go, “Well, I think it’s about 2 lb.” That’s not weighing the puppy. You need a scale that weighs in pounds and weighs in grams. Put the puppy on the scale, weigh it, record it, and make sure you’re giving the right dose of dewormer.

When you get a new bottle of medication, whether it’s Panacur or an Nemex or Albon, all those that are suspensions that tend to settle out, the best thing to do is to shake it really well when you first get it and then pour it into smaller bottles so that the whole thing is easier to shake up and you can get a more even mixture if it sits in that same bottle for the whole several months that you’re using it. What happens is many times the beginning of the bottle is too dilute the bottom of the bottle is too concentrated. So be aware that dividing into aliquots can really help a lot.

Antibiotics for Dog Diarrhea

Albon is an antibiotic. It does a great job for dog diarrhea. It does a great job for puppies with coccidia. We also use Metronidazole frequently. Metronidazole is not only antibacterial, so it will help straighten out any bacterial upset in the GI tract, but it’s also anti-flagellate meaning giardia, and it seems to have an anti-inflammatory effect in the intestinal tract. If we have a puppy that has diarrhea, even if it doesn’t have a bacterial overgrowth or a coccidia or giardia problem, many times the anti-inflammatory effect of Metronidazole will work. Metronidazole should not be used during pregnancy and must be used with great care, but not until the puppies are at least eight weeks old because it can cause a toxicity in very young puppies. Don’t be using it on really small, really young puppies. Make sure Metronidazole is dosed accurately because it’s got a narrow safety margin, meaning that a little too much of it will cause seizures and other kinds of neurologic disease. So be really careful with metronidazole. Tylosin is another antibiotic that we see frequently used for diarrhea. I don’t use it first line, but if we’re having problems and not able to clear things up, it is a poultry product made to be a water additive for chickens and turkeys. But it does a nice job managing diarrhea in puppies. It is not absorbed from the intestinal tract, so it’s different than all these other drugs. It has a better safety margin for young dogs.

Then we have the anti-coccidia drugs. I use Albon period, end of discussion. I use Albon. There are lots of people that are using Toltrazuril. It is not approved in the United States for any species, not in dogs, not in cows, not in horses, not in chickens, not in turkeys, not in cats. It is not labeled for use in the United States. I avoid this drug. I don’t want to use a drug that we don’t have FDA approval for. The same with Ponazuril. It is approved, but only for horses in the United States. The adverse effects that we can see are blisters in the mouth, loose stools when we are trying to treat diarrhea, and then you get loose stools from it, a rash on the skin, loss of appetite, dry eye. It’s really not a safe drug as you may have been led to believe by all the people that are posting on Facebook and online and talking about Ponazuril. I just flat out don’t use it in dogs because Albon is still a really good drug for coccidia.

Puppy Wormer Dosage

Why shouldn’t we use these other drugs? Well, many times they’re meant to be used in large animals, so it’s very hard to get a dose for a 2 pound puppy when you have a tube of medication in your hand that’s supposed to treat a 1,000 pound animal. These drugs are not FDA approved. I stick to drugs with dogs on the label. If you run into an adverse event, you don’t have the company standing behind that drug to say, I will help you deal with what just happened. If you lose puppies to it, if you lose business to it, those companies are not going to stand behind their product. If you stick to something like Albon and you have an adverse event, the company will stand up and help you with those adverse events. So please stick to drugs that are labeled for use in dogs. Errors in dosing are really easy to have happen when you’ve got this big giant tube of medication and trying to dose a 2 lb. or a 3 lb. or a 4 lb. puppy. You’re going to make a mistake on the dosing. I’ve seen too many people give ten times the dose, not realizing it because they miscalculated the dose. Just don’t do it.

It’s way too easy to have a compounding error. It’s way too easy for something like this to go wrong when you’re trying to calculate doses yourself. I would just say to you, don’t do it. Stick to drugs we know we’re safe for dogs, that are labeled for dogs, that are the right dose for dogs. And you’re going to be in a much safer place.

Puppy Eating Poop

Is the dog or puppy eating stool and is that making them have diarrhea or are they eating stools because they have a malabsorption syndrome and they’re not adequately absorbing the nutrients in their stool? Make sure that you’ve had a stool sample check to make sure there’s not a parasite. You may also want to do the TLI/PLI/cobalamin/folate test. There has to be a 12 hour fasting. It’s a blood test. It goes from your veterinarian. And then, sometimes dog stool eating is just a really nasty habit.

Coprophagia, is the technical term for poop eating. A lot of dogs will do poop eating after they’ve had a litter. The females will start to eat the stool as they should when they have young puppies and they just perpetuate that once the puppies are gone, they continue to be stool eaters. Doc Roy’s FeCease is a stool eating deterrent supplement for dogs that can help to interrupt that. Sometimes it works, sometimes it doesn’t, but always make sure there’s not an underlying medical condition first.

If you have more questions on how to treat puppy diarrhea, call a Pet Care Pro at 800.786.4751.

Written by: Marty Greer, DVM

Director of Veterinary Services

Marty Greer, Doctor of Veterinary Medicine, has 40+ years’ experience in veterinary medicine, with special interests in canine reproduction and pediatrics. She received her Doctor of Veterinary Medicine from Iowa State University in 1981. She’s served as Revival’s Director of Veterinary Services since 2019. In 2023, Dr. Greer was named the Westminster Kennel Club Veterinarian of the Year.

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