I'm putting this in the main forum rather than in the Food group or Health group because it is so important for dog owners and especially new puppy owners to know this. Not all vets keep up with continuing education and new developments/research. It's up to us to educate ourselves. I've seen way too many doodle puppies who were unnecessarily given metronidazole go on to develop chronic digestive issues. Learn to speak up and question your vet, and say no to metronidazole! 

Think metronidazole works? Maybe not so much

https://www.veterinarypracticenews.com/metronidazole-november-2019/?fbclid=IwAR0xwjYpyr6CxxM6OBxHiD8ZA1AqHqKnMj4e9rBHe6TiX_ZfBKEyJTlZt-o

From the article: 

"Conclusion:
There has never been strong evidence to support the use of metronidazole to treat acute idiopathic diarrhea for dogs, and the results of the first clinical trial evaluating this practice indicate it is probably not effective. This information should discourage the use of metronidazole as a treatment for acute diarrhea."

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  • Interesting article but I wouldn't want to throw the baby out with the bath water. I'm sure there are appropriate situations  for administering metronizadole. I agree that it is over-prescribed and it's not a universal cure all.  I'm glad they caviated the use of probiotics. For most dogs or humans a daily probiotic isn't needed for gut health, but there are people and situations where a quality probiotic is helpful so one could assume the same might be for dogs. As for joint supplements, the jury is very much still out but they certainly don't hurt. 
     I realize that the article wasn't intended to go any further than it did but I'd really have liked to know suggested alternatives for diarrhea treatments if it doesn't resolve naturally. 

    • I agree that there are appropriate uses for metronidazole, but it simply should not be used right off the bat for every case of diarrhea, particularly when the cause is unknown. And it certainly should never be used as the first line of treatment for giardia. It's been known for at least 10 years that Panacur is not only more affective against giardia, it has a shorter course of treatment and far fewer side effects. Yet time after time, we hear about doodle puppies who are immediately given metronidazole for giardia. 
      For diarrhea that is not caused by giardia, there are all kinds of treatments that don't involve antibiotics or anti-protozoans, just like there are for humans. Years ago, I remember giving a dog Pepto-Bismol or something similar. And often, no treatment other than a few days of bland diet and perhaps some probiotics may be needed.

      I was told by a veterinary physical rehab specialist that joint supplements like glucosamine seem to work better for dogs than humans, so i agree that the jury is out on that. But as you correctly point out, they don't cause any harm, even if they don't help. The same cannot be said for metronidazole.

      I was particularly interested in the part of the article that said that metronidazole was ineffective when used with prednisone for IBD. I remember Jack's IMS wanting to get him off the metronidazole very early on after he was diagnosed. And VSL#3 probiotics were what helped us eliminate the metronidazole. I'm still a huge fan of medical grade probiotics. 

      • We are using Visbiome right now for Ned and Charlie. Ned IS on prednisone too so that part was a concern because we have both boys on metronizadole right now. Charlie's diarrhea cause is unknown but it was very, very severe and, for me it was a last resort choice.! Along  with home cooking, a slow transition to LID kibble and human probiotics we are seeing lots improvement. When charlie gets these bouts it takes a month to resolve. ( I have always suspected that Charlie came with one of those medication resistant Giardia infection that was treated with overuse of metronizadole.)

        Ned's situation is very different and I resisted metronizadole but he needed a respite from his runny poo. If there was an alternative we'd be very open to it. 

        • I can't remember if we know what breeder Charlie came from. There is an ALD breeder in the Pacific NW whose puppies carry an antibiotic- resistant form of giardia, and who also breeds a lot of brown & white parti puppies. 

          • And that is the exact area he was imported from.  We were never able to track down the specific breeder, but with the knowledge we do have, it's a good bet. (some of the other breeders we checked with felt he looked like a dog from that breeder and they'd probably know).  He's also most likely a 'victim' of the early spay/neuter orthopedic problems. 

      • is there any evidence that links metronidazole as a causative agent for ibd or other conditions?  i tried to research this and only found articles about human use.  these articles said there was a relationship between use of metronidazole and ibd but that there was a question whether the metronidazole use was a causative factor or whether precursor symptoms of ibd had caused the metronidazole use.

        • The human studies are good enough for me. And there are numerous studies showing the use of metronidazole to be a precursor for new onset cases of IBD and Crohn's disease in humans. 

          • i felt the human studies were ok too, but my problem was that i didn't find any that said that the use was causative for sure.  they said they were linked but inconclusive on which was the chicken and which the egg. the oncologist for my granddog who is taking palladia has also included metronidazole (only when he has loose stools) as part of his treatment regimen.  he also takes a probiotic daily along with various other drugs and supplements.   he took his first dose of the metronidazole yesterday.  he has been on this treatment regimen for 10 months and has been doing very well so far.  i didn't find the studies you mentioned when i did my search, probably not the exactly right search terms, but wanted to read them and also share with my daughter so she could discuss with oncologist.  this sweet boy has always had a sensitive tummy and we do not want to do anything to create extra problems for him.we would really appreciate any help guiding us to these studies  

            • When we are talking about cancer, or any other serious disease, I trust the specialist in charge of the treatment plan to know how to use metronidazole or any other drug judiciously...although I do always ask the purpose of any drug. (I'm astounded by the number of people who don;t even know the names of the drugs their dogs are taking, or what they are taking them for.) As I said above, I agree that there are appropriate uses for metronidazole, but it simply should not be used right off the bat for every case of diarrhea. 
              This post is simply meant to inform owners, because we are constantly seeing young puppies given metronidazole for giardia, and that causes ongoing problems. 
              When my Jackdoodle was first diagnosed with IBD, metronidazole was part of his treatment plan. It was necessary due to the amount of inflammation of his intestinal lining. Our goal was to get him off of it as quickly as possible, because it does cause neurological problems when used long term. (THAT is a well-known fact easily found on any drug site.) 
              In using any drug, the issue is always benefit versus risk. For a dog with cancer, the benefits may well outweigh the risks. But not for a 10 week old puppy with a parasite, lol. 

            • Here is one study on the link between metronidazole and IBD in humans.
              I will look for more once I'm reassured that our democracy is not being destroyed today, lol. 
              https://www.mdedge.com/gihepnews/article/79651/gastroenterology/met....

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