By Ines Di Giacomo DVM
Gastrointestinal disorders are some of the most common problems in dogs, and puppies have a higher risk of diarrhea than adults. In fact, about 10 to 25 percent of puppies have a tendency to develop digestive problems during their first year of life. Diarrhea reduces the growth rate of puppies and increases their risk of mortality. In fact, gastrointestinal problems are the main cause of death in dogs under one year of age. It is therefore essential to treat quickly and effectively all puppies that have a digestive problem.
A Critical Stage for Puppies
Weaning is a critical stage for puppies. The switch from breast milk to solid food implies changes to the intestinal mucosa, changes of the nutrient transport, and changes in the activity of digestive enzymes and intestinal flora.
At the same time, the puppies go through a phase of immunity gap. Because of the persistence of maternal antibodies, puppies are refractory to vaccinations (maternal antibodies present in the puppy’s bloodstream block the effectiveness of vaccines), but they are already susceptible to infection.
In addition, the separation of the puppy from the mother and siblings, as it sometimes happens when puppies are entrusted to new families when they are not yet fully weaned, causes a lot of stress that affects the metabolism, immune system and intestinal functions of the puppy. These phenomena may explain the higher frequency of diarrhea in puppies than adults.
Digestive disorders may also represent a risk to the health of people living with the sick puppy! Some infectious agents excreted in diarrhea are potentially zoonotic,(transmitted from animals to people) such as Giardia duodenalis and Toxocara canis.
The Fecal Score in Puppies
It is essential to define what is meant by “abnormal feces.” The quality of feces can be assessed by using the “fecal score of the puppy“, a visual scale encompassing 13 points where 1 equals liquid feces; and 13 equals feces that are formed and very dry. This scale is different from that used for adults.
It is important to keep into consideration several physiological changes in order to define an abnormal fecal score. In fact, large breed puppies (over 25 kg as adults) produce softer feces than those produced by smaller breed puppies and younger puppies (4 to 5 weeks old) produce softer feces than older puppies.
The threshold score which defines abnormal feces varies with the size and age of the animal and corresponds to a fecal score under 5 for puppies of large breeds, under 6 for puppies of small breeds at 4-5 weeks of age, and under 7 for puppies of small breeds at 6-8 weeks of age.
A Variety of Pathogens
Diarrhea in weaning puppies is a complex phenomenon. Puppies are often infected by different pathogens but the presence of an enteropathogenic organism (an organism producing disease in the intestinal tract) is not always associated with gastrointestinal symptoms. In fact, 18 to 54 percent of dogs can eliminate parasites or virus without showing any symptoms.
In addition, each enteropathogenic organism does not cause the same clinical signs in all the puppies. The pathogenicity of an infectious agent and its clinical manifestations depends on the enteropathogenic organism but also on the age and immune status of the puppy. Finally, there are frequent co-infections and interactions between enteropathogenic organisms.
Evaluating the Problem
Weaning diarrhea in puppies requires a systemic approach and is influenced by three factors:, the host (the age, genetics, local and systemic immunity of the puppy), the pathogen (virulence, type, dose) and the environment (population density, stress, hygiene, temperature and humidity).
It is important to assess the environment in which the puppy sick lives, especially if lives in a herd. Consider the type of farming, animal shelters, the food provided, the management of animals and general health conditions.
It is important to assess the quality of the food given to puppies (some cases of diarrhea are related to the consumption of raw meat contaminated with Salmonella enterica); the number of daily meals (dividing the food ration in 3-4 meals helps reduce the risk of diarrhea in puppies); the amount of food provided (avoid overeating!).
It is important to evaluate which and how many enteropathogenic organisms are eliminated with feces by the puppy. The two most simple and rapid methods to identify enteropathogenic organisms involved are:
- The observation of a feces sample under a microscope (analyzing at least three feces samples taken on three consecutive days, considering that the elimination of pathogens may be intermittent).
- The ELISA test (there are commercial kits available to identify some parasites such as Giardia spp. These are cheap and rapid tests and based on the same principle of pregnancy tests for women).
In cases of diarrhea or sudden death in weaning puppies you should always suspect the CPV (Canine Parvo Virus)
Treating the Diarrhea
Management of the diarrhea of weaning requires a comprehensive approach. Some authors recommend not to feed the sick puppies for 24 to 48 hours and then gradually give small amounts of food in the following days. However, it has been shown that enteral feeding (delivery of a nutritionally complete food directly into the gastrointestinal tract) during an acute diarrheal episode helps maintain the integrity of the digestive tract.
If the diarrhea is not accompanied by other clinical signs, it is not essential to provide antibiotic therapy. This is instead carried out if there is presence of blood in the feces (which is suggestive of severe damage to the intestinal mucosa) and in the presence of fever (suggestive of a systemic inflammatory reaction).
In case of severe and profuse diarrhea, the puppy must be hospitalized because the risks for dehydration and hypovolemia (decreased volume of blood) are very high and it is necessary to provide intravenous fluid therapy.
Medical treatment of weaning diarrhea in puppies includes the administration of de-worming products. The antiparasitic treatment depends on the microscopic evaluation of fecal samples and the choice of the active principle is mostly based on its spectrum of action. In any case, it is advisable regular worming against Toxocara canis (roundworms) because it has a high prevalence.
While it is good practice to clean and disinfect areas where the puppy lives , it’s important to use disinfectants only after you have cleaned and rinsed all surfaces, because most of the disinfectants are inactivated by organic materials.
The prevention of weaning diarrhea starts by careful dietary control. Administer very digestible and rehydratable food and divide them into 3-4 portions to facilitate digestion. Also, remember to regularly worm your dogs, puppies and adults. For any other doubts or questions, consult your veterinarian.
Grellet Aurélien (2016) Veterinary Focus, 26 (1), 14-21.
About the Author
Ines Di Giacomo DVM graduated from the Faculty of Veterinary of the University of Teramo, in Abruzzo Italy. She’s interested in ultrasound diagnostics so decided to follow a specialist so to learn more about this topic.
In the meanwhile, she has been attending a veterinary clinic to put into practice what she has learned during her years of study. Since her graduation, Ines has attended numerous seminars to improve her knowledge in different areas of veterinary medicine such as radiology, ultrasound, reproduction, dermatology.
Ines would love to expand her knowledge in parasitology, anethesiology, and surgery but the road is still long. She says “Although the university is over, you never stop learning!“