Thursday, September 12, 2013

Dude, You Are Stressing Me OUT!



I say this word frequently during my routine veterinary day. 

Every time I do I have to take pause and explain. 

Stress in medical terms is something that causes an upset or disturbance.

For people when we say the word "stress" and we think "bad," but a disturbance isn't always a bad thing. So I start throwing out examples, like, "remember when you got married, or you moved, or got excited for your birthday? Well, those weren't necessarily bad things but they got your body worked up. And you might have had cramps, diarrhea, or not been able to eat because you were nervous? Well, that was stress and your body reacted to it."

Cooper is a 4 month old effervescent dynamo puppy. He came to see me last week because he had had diarrhea for the last two or three days and his mom was worried. 

I listened to her tell me about Coopers routine and what changes had occurred over the last few days to weeks. She told me that Cooper was normally a very happy energetic puppy. He loved to play, he had a huge assortment of toys, he had been kept current on his vaccines, was on heartworm and flea & tick preventatives and except for the 2 or 3 daily episodes of abnormal loose stool was acting just fine. 

There are a few key points to Cooper's moms statement. In an effort to help educate you all I am going to take a moment to review them.
  1. Cooper is acting normally. Always listen to your patient before anyone or anything else.
  2. Cooper is current on heartworm medication prescribed by his vet. Dogs kept on heartworm medication are less likely to have intestinal worms. 
  3. He was an acute case of diarrhea (clinical signs lasting less than 72 hours). It is so important to seek help inside of this window.
I asked Cooper's mom about his activities and home environment. Specifically I wanted to know if he was being given table food, or snacks, and what type they were, if he tended to eat things he shouldn't like garbage, things outside, etc., and if there had been any changes in his home life.

Here's why I asked. Many healthy young puppies (dogs under 1 year old) have episodes of acute diarrhea because of one of two things; they got into something that they shouldn't have (think garbage can raid or the delicacies of wild animal poop), or they got stressed about something.

In veterinary medicine we call the latter item "stress colitis."

Stress colitis causes large bowel diarrhea which is an increased frequency of having to defecate, straining to defecate (many people incorrectly think their dog is constipated because they are straining), soft to watery stool, sometimes with blood visible in it, and is most often affecting young dogs.

For all young dogs with diarrhea it is important to examine a fecal sample. Intestinal parasites are a common cause of diarrhea in dogs and can cause significant weight loss, anemia, and even death. 

For Cooper his stressor was re-visiting crate training.

Cooper, like many young, newly adopted puppies had been started on crate training when he first arrived at his new home. But over the last few weeks he was left out for longer and longer periods of time.

Then his mom had to go back to work and his daily routine changed from having not been in his cage for any measurable period of time, to in the cage for a work shift.

His mom said that she felt terrible leaving him alone all day. But she wanted him to be safe (CRUCIALLY IMPORTANT!!), so she was taking him for walks in the morning before she left and playing with him when she got back home. She wasn't sure that my presumption about Cooper being stressed in his cage so I recommended that she try to leave a video camera on him when she leaves to monitor him. 

She also had a few other clues that made me suspect that Cooper was having a hard time getting all of his needs met.

Cooper was a young very energetic puppy in a household with a couple who were past retirement age but still working. His mom admitted that she was having a very hard time keeping up with him and was unable to play with him to the point if him being tired. So Cooper was being put in a cage with extra energy left over and being left alone all day. His needs for exercise and social interaction were not being met fully.

Cooper is 4 months old and he is stressed already. Worse is that he doesn't have a clear way to start having his unmet needs resolved.

Coopers treatment plan was five fold.
  1. Check a fecal and address any intestinal parasites. Remember some intestinal worms are what we call "intermittent shedders" so I will not declare a pet parasite free until we have three consecutive negative fecals.
  2. A bland gi diet. This can be either boiled boneless, skinless chicken, or boiled ground beef and rice, OR a commercially available prescription food like Science Diets I/D for 5 to 7 days. A bland diet is designed to not only be easy to digest but also to not over work a body system that is trying to recover. This is done by offering small amounts of the bland diet with an increased frequency. So, instead of feeding a large meal twice a day feed four small meals every 6 hours.
  3. Probiotics to help replace the good gut flora that aids in the bodies ability to remove excess water from the feces.
  4. A plan to address his future stress.
  5. A monitoring protocol to insure that his acute colitis did not evolve into the more difficult to treat and resolve chronic diarrhea.

My advice; Get Cooper a puppy, or something he can exhaust and that will in turn exhaust him.

If you have any questions about this, or any other pet related item, you can ask me at, or find me on Twitter @pawbly, or FreePetAdvice, or Google+ +Krista Magnifico.

Thanks for reading!
And remember Always Be Kind.

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