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    Bloody diarrhoea in dogs: is an oral electrolyte solution sufficient?

    Gastrointestinal disorders in dogs manifest with signs such as diarrhoea, which, if severe, can cause significant dehydration in the patient. While intravenous therapy is required for more severe cases, oral rehydration therapy may be safe and effective in less severe examples. Here we look at the study that has proven this point.

    Fluid loss: the cause of dehydration

    GI disorders feature an increased frequency of bowel movements of reduced volume, while mucus and fresh blood in the faeces are often observed. There is not usually any weight loss, except for in chronic disorders.

    Once acute diarrhoea has been ruled out following a standard treatment for 2–4 weeks, it is worth spending the time and money to obtain a specific diagnosis to guide management of the problem, after receiving the owner’s approval. 

    Therapeutic approach: a common denominator

    Treatment depends on the type of diarrhoea and an appropriate diet is especially important. When the underlying cause is chronic, diarrhoea is more complicated and will not resolve by itself. A protocol must be followed to progressively rule out possible causes. As such the following should be eliminated: parasites, bacterial infection, systemic diseases (renal, hepatic, pancreatic), diffuse lymphoma, neoplasms, lymphangiectasia, fibre-responsive colitis (AVD Diabetes Colitis).

    Once ruled out, there are two options: empirical treatment or an intestinal biopsy, which may be normal or present signs of mild or severe inflammation. In general, special hypoallergenic diets rich in fibre are required for chronic colitis, as well as immunosuppressants, antibiotics, probiotics, etc. Antibiotic therapy may be applicable in some cases.

    With respect to treatment in acute phases, support treatment including rehydration is commonly used for all cases of bloody diarrhoea in dogs. Although the treatment of choice commonly implemented in dogs with worrying signs is traditionally intravenous, here we present a study into the management with oral rehydration solutions in cases of bloody diarrhoea in dogs with mild to moderate dehydration1. It is also advisable to avoid solid foods for 24–48 hours.

    Is oral rehydration solution sufficient?

    The aim of this study, as explained above, was to determine the efficacy and safety of an oral electrolyte solution (OES). To this end, a sample of 20 dogs with bloody diarrhoea and fewer than three episodes of vomiting was selected and offered an OES. (The relevant diagnostic tests were also performed and treatment given for vomiting.)

    Animals that refused to take the OES or had signs of severe dehydration, determined through various analytical parameters, were administered intravenous crystalloid fluids. Thirteen dogs (65%) voluntarily consumed OES soon after their admission.

    In under 24 hours, the dogs’ haematocrit, total serum protein and urea concentrations were significantly lower than at admission, while no significant changes were observed in other parameters such as blood pH, base excess and sodium, potassium, chloride, calcium, magnesium and lactate concentrations. Secondly, the authors found the treatment to be cost-effective, costing significantly less for the OES group than for the group treated with intravenous fluids.

    They concluded, therefore, that rehydration therapy with OES was safe and effective and that the potential benefits of the therapeutic approach, compared with traditional intravenous fluid administration, involve less time for the clinical staff administering treatment and lower veterinary costs for owners.                         

    Reineke EL, Walton K, Otto CM Evaluación de una solución de electrolitos de administración oral para el tratamiento de una deshidratación leve a moderada en perros con diarrea hemorrágica J Am Vet Med Assoc 2013;243: 851-857.