Revised December 2011.
Intussusception — In very young pups (and other animals including humans) the intestine can invaginate (one part slips inside another). The condition, also referred to as “telescoping intestines,” also occurs in adults, but not as frequently. Most common immediate causes include worms and other parasites, and obstruction by indigestible materials, garbage, or toxic substances. The German Shepherd Dog seems to experience a relatively high incidence of this disorder and I believe there is a genetic propensity, a familial trait, in certain bloodlines.
Diarrhea and soft stool — Diarrhea can be a symptom of any number of disorders from cancer to overeating, but is most often associated with disease or parasitism of the small intestine. Diarrhea or loose stool is quite common in the German Shepherd Dog, even when no physiological disease has been identified. However, since this is not a normal condition, the owner should make a sincere attempt to find and attack the cause. Some of the causative factors in true diarrhea are: pancreatic insufficiency, chemical or mechanical irritation of intestinal linings, parasites, microorganisms, and a psychosomatic condition related to the “high-strung,” emotional make-up of the German Shepherd Dog. Foods that can cause loose stool include milk (if suddenly introduced into the diet), excessive liver or fats, and those with a high fiber content. However, simple overeating is perhaps the most frequent culprit. Most people overfeed their dogs.
Soft to runny stools may be an indication of a general inflammation of the stomach and intestines known as eosinophilic gastroenteritis. It is treated symptomatically with something to coat the lining, plus perhaps a steroid and Kaopectate, until the dog “heals itself.” Many veterinarians and owners administer Pepto-Bismol, also. In the case of very young puppies with watery stool or repeated diarrhea, rush to your veterinary clinic with the pup and/or the stool samples. Most of the time the cause of diarrhea in a young puppy is serious, such as parvo or coccidiosis, perhaps with hookworm as well. The Campylobacter bacteria cause some cases of acute or chronic diarrhea, and most labs would have no trouble identifying this infection. Generally, watery diarrhea is not an indicator of “campy,” but more often has a different cause. Erythromycin antibiotic is 90% effective against that organism, although resistant strains may be evolving.
Giardia — Even giardia can be quite dangerous if the pup is young and has been exposed to other challenges, such as being wormy, stressed, or otherwise weakened. Giardiasis is marked by watery diarrhea with a uniquely acrid “bloody” odor, that experienced breeders can identify quite easily even before a stool sample is analyzed. Giardia is a protozoan disease; i.e., it is caused by a single-celled “animal” flagellate parasite, so-called because it is highly motile, having a tail. The Merck Veterinary Manual describes it: “Transmission occurs in the cyst stage by the fecal-oral route. Incubation and pre-patent periods are generally 5 to 14 days. Giardia cysts survive in the environment and thus are a source of infection and reinfection for animals, particularly those in crowded conditions… prompt removal of feces from cages, runs, and yards will limit environmental contamination. Cysts contaminating the hair of dogs and cats may be a source of reinfection.” Regarding treatment, the manual says, “Flagyl ™ (metronidazole) is about 65% effective” (in removing cysts from feces) and if administered “for 3 days, effectively removes giardia cysts from feces of dogs; no side effects are reported.” By the way, these oocysts are much smaller than worm eggs, and require much higher magnification to find them; still, they are not shed every day, so it may be wise to start treatment and then wait for a three-to-five-day combined stool sample to be checked by your vet. Despite the “low” rate or ridding the body of cysts, many vets prefer Flagyl. The success rate is reportedly declining as giardia is now demonstrating resistance to the drug. In addition, it may be a little hard on young puppies, with some neurological side effects. I prefer the use of Albon™ to control concomitant bacterial infections in weakened pups, with or without Flagyl for the protozoa, as mentioned below. With any of these, I give a second dose 7 to 10 days after the first, to be sure.
Panacur (fenbendazole) is relatively pricey and seems to be sold only in large-volume jars from the usual vet supply catalogs. For giardia, Panacur is considered a static drug, 100% effective in clearing cysts from feces in 3 days (the cysts are the infective part), with no side effects reported, and is safe for pregnant and lactating animals. In the lab, giardia did not develop resistance to fenbendazole. It does not have a repelling taste. A field representative for Intervet, the company that manufactures Panacur, admitted that Flagyl may be preferable for the occasional dog that has general stomach distress. With either one, a 5-day dose has been reported by some to be effective when the 3-day regime was not.
I would also recommend that you ask your vet about Albon™ (sulfamethoxine) which is very effective, although for a different reason, and should be given for 15 to 21 days. The sulfa drugs do nothing to the Giardia organism itself, but they do combat the secondary bacterial infections that are probably the real killers of puppies. Such an approach allows the pup to regain enough health to withstand the protozoan, even though it may be retained in the body for a while. It is more readily available, probably lower in cost, and in widespread use. A disadvantage in any sulfa drug is a number of adverse side-effects, but I have not had any problems, probably because I do not keep dogs on the medication longer than recommended, and have genetically strong breeding stock.
There are a few less-often used: Valbazen (albendazole) is about 90% effective in removing cysts but has been implicated in birth defects, suppression of the immune system, and destruction of red blood cells. Atabrine (quinacrine) also has unpleasant side effects. Some have recommended a Giardia Lamblia vaccine for dogs with persistent or repeated cases.
Toxic gut syndrome (TGS) — This disorder has been identified as a specific syndrome, with some similarities to other disorders such as intestinal volvulus, which may have been blamed for death when TGS was the real villain. Dr. Chuck Kruger, a Corgi and GSD breeder in Washington State, has been an intensive observer of this syndrome. Chronic intestinal disease, called overgrowth of intestinal bacteria in the UK, and probably the same thing that Kruger dubbed “toxic gut syndrome,” is also being studied in Britain, and has been found to be a particular problem in younger dogs. Treatment with high dosage of antibiotics over a long term has been claimed to have a good success rate there. Kruger pioneered much work in the problem because of so much found in certain American GSD lines. See http:\\www.dockruger.com
The German Shepherd Dog has a higher packed cell volume (number of blood cells per unit of blood) than do most other breeds, with 50 to 60 percent “solids” compared with 40 to 45 percent. When such a dog becomes dehydrated, thickened and/or lessened blood supply to the small intestine apparently increases growth of bacteria that are always present there. These Clostridium and E. coli bacteria produce such quantities of toxins that the dog is unable to get rid of them fast enough, and death by poisoning occurs. By the time owners see symptoms such as discomfort when the abdomen is touched, attempts to vomit, and excessive salivation, it is probably too late. Prevention may be accomplished through dietary means (feeding Lactobacillus acidophilus, live-culture yogurt, or cultured buttermilk), or by the same toxoid vaccine that is given to lambs to prevent Clostridium perfringens types C and D. As research is done on this recently defined syndrome, more will become known as to the best treatment.
Vomiting and gastritis — Vomiting comes easily to dogs. Grass eating and subsequent vomiting give rise to all sorts of explanations, the most popular being that the dog was sick and ate the grass to help him throw up. Actually, excess grass is more likely the reason for the reflex action. Dogs mostly eat certain types of grass because they like the taste, just as with the case of garbage, but it does appear that individuals learn that too much can cause vomiting, so the intentional eating of grass to induce vomiting seems to come after experience. Gastritis, an inflammation of the stomach lining, can be caused by the ingestion of too much grass, garbage, or indigestible materials. It can also be caused by viral or bacterial invasion, but much more common, especially in pups, is the presence of endoparasites: tapeworms, roundworms, hookworms, whipworms, and coccidia. Actually, tapeworms or roundworms can fill up the belly to the extent that they back up and cause vomiting from sheer bulk. The initial treatment for gastritis or vomiting may be the withholding of food and administration of Kaopectate™ every four hours.
Ulcers — Ulcers have been diagnosed all too frequently in German Shepherds and may be related to pancreatic problems or other causes: it’s difficult to tell, when several conditions exist at once, whether one is the cause or effect of another. Necrotic bowel syndrome, a disorder of unknown cause, is diagnosed usually on autopsy, when part of the intestine is found to be dead and rotting away. This condition may be synonymous with or overlap intussusception or other diseases. It takes a small toll, mostly among heavily linebred German Shepherd Dogs with “American lines.” Eosinophilic ulcerative colitis syndrome is most common in Cocker Spaniels and German Shepherd Dogs. If your pup or adult has intermittent to constant diarrhea, with or without blood, and does not respond to treatments for the more common disorders, this disease may be the cause. Initial treatment may include corticosteroids, antibiotics, and antispasmodics to see if the symptoms can be halted.
Irritable colon — Also known as spastic colon, this disorder with mucus in or on the surface of soft or frequent stools may be the result of stress. The best “cure” is prevention — breed stable temperaments and build confidence in puppies.
Polyps — Rectal polyps are little round or teardrop-shaped, red to purplish, blood-filled balls hanging on the lining of the rectum. Sometimes they are clustered like tiny grapes, and are found very close to the anal opening or further inside the rectum. They should be surgically removed, since they rupture easily and are a potential site for infection. A drop of bright red blood recurring on the end of stools is a sign that you should have the dog examined for polyps. They are similar to hemorrhoids in humans in that respect.
End of 3-part series on common disorders of the digestive tract