Species: Dog Breed: German Shepherd Age: 3-6 months
Long story short my little over 3 month old puppy has Giardia.
Sidenote: she goes to Daycare at my vets office 3 days a week. I love them but they also frustrate me. They are great but they are a business and businesses need to make money.
anyway,
She had diarrhea, anorexia somewhat etc..
She was tested for Parvo and a slew of things and Giardia was positive.
She was first prescribed Metronidazole (sp?) but it didn't work.
during the time she took it I cleaned and disinfected the whole house especially her bedding and toys and food stuff. I changed her pee pads every time she went to the bathroom and wiped her privates to clean off any cysts. I didn't let her lick. Because she is pee pad trained for now we didn't let her out back for fear that she got it out there.
I did clean everything I could think of that the cysts might cling to she would not re-infect as she was going through the medicine.
I don't think they were as diligent at the daycare; they didn't even know what I was talking about when I explained the cysts and re-infection (staff at daycare; not vet).
Well we thought it was working but then the diarrhea started back etc and she also vomited this time once... so they wanted to do an X-ray. This place upsales a lot (I have had many dogs there, one that I put through chemo; and she still died 3 months and $5000 later) so I would not let them at this point.
I asked why would we jump to that when she is being treated for Giardia. I explained that her vomiting could be side effects of the medicine. They said no it is blockage. I would not allow it assuming she does not have blockage and that this all started with the Giardia.
(We have already in the month she has been there for this and other things spent $100s on various things; I just don't want to jump in with more money going out)
So after a lot of them, trying and succeeding in making me feel guilty they said they would talk to the Vet and see if he insists on xrays.
He said the med is not 100% effective so he put her on Albendazole. 2 times a day for 2 days.
Which finally leads to my question.
I didn't know when she was put on it but I now know that this med is very strong and it has been tested and known to get the cysts ect... when other meds fail but... the side effects are horrible.
The first day she ate all her food but was lethargic and had diarrhea. The second day she ate very little and did vomit once. Today is her first day on no meds...she is playful and happy but tires easy. She is still eating but not a lot. She is drinking. She has not vomited yet. She did have diarreah this morning (last dose was at 8pm the night before) and vomited once at 4am.
I see you know about this drug and the side effects.
Do you know how long after the last dose the side effects will start to go away? Like half life ect...
Thanks so much,
Barbara
Dr. Marie replied:
I'm sorry to hear that you are dealing with this frustrating problem. Diarrhea in puppies can often be very difficult to deal with.
Usually, if Giardia is the cause of the diarrhea, then we see significant improvement within 24-48 hours of starting the medication. This makes me wonder if there is something else going on in conjunction with the Giardia.
Are you sure it was Albendazole that your vet prescribed and not Albon? Albon is commonly used to treat a parasite called coccidia in dogs. Often, if a puppy has Giardia they will have coccidia too and we don't always diagnose it on the fecal exam so we will treat for it just in case. Albendazole, however, is not commonly prescribed.
If this were my case and I had treated with these meds and the puppy still had diarrhea then I would be giving you a few options. I might consider testing for parvo virus. However, if your puppy has had all of the proper vaccinations and at the proper times then this is unlikely. If there was vomiting along with the diarrhea then I most definitely would be recommending an xray. Puppies are notorious for eating things that they should not. *If* there is a partial obstruction then it needs to be dealt with as soon as possible. The odds are that the xrays will not show any obvious obstruction, but again, if there was one it could be life threatening, especially if not dealt with right away.
It sounds like she is slowly improving and this is a good thing. I would say that from all that you have written, it is unlikely that it is the medication that is making her sick. But, the frustrating thing with pets is that in many cases we never find out what the culprit is. One of the things I dislike the most about practicing veterinary medicine is that every time I want to run a test or prescribe something it is costing my clients money. I really do believe that it is rare that a vet would prescribe a test or a treatment just to make more money. But, sometimes it can seem that way when it looks like we are just shooting in the dark.
It sounds like your vets are doing the right things.
I hope things look up soon!
Dr. Marie
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Customer reply:
Thanks so much for your quick reply. Actually they did give her Albendazole.
She was actually tested for Parvo first and was negative.
Then they tested her for Giardia and it was positive.
They started with Metronidzole but it didn't work (she may have licked or something and re-infected... so they gave her the Albendazole (I am reading and writing exactly what is on the label). It is a liquid that we gave her 4 times over 2 days. We got strict on cleaning all surroundings and cleaning her as well.
I have been told Albendazole can have severe side effects especially in puppies so I was hoping you may know how long those last after the last dose.
Today she is finally getting some appetite back and knock on wood, has not vomited. She is still weak but playful and happy when we engage her.
If she does vomit again; now that she has completed all the meds... then I will take her for Xrays. I just wanted to finish the treatment first and let her get over the side effects before jumping into that.
I guess I just felt like they didn't even realize that vomiting could be a side effect. We are in the middle of treating for Giardia (even the Metronidzole has been known to have side effects); she vomits and they wanted to do X rays. I just wanted to wait to make sure this treatment was done and then see what happens.
That is why I wrote. I was hoping you may know how long after the last dose the side effects would start to pass.
I love my vets office very much. I agree I don't think they would prescribe things just for money. But I also didn't want to jump right to the next thing until we completed this.
I think I was hurt by the "guilt" comments like... "that is what you need to do when you take on the responsibility of a puppy, etc..." that the front desk said to me. Those comments make me feel like they push things on me.
So far she has not vomited again and looks to be improving. Now that she is off the Albendazole if she vomits just once I will take her right in... if they are closed I will take her to the ER.
Thanks again so much. Not just for helping me but for your web site.
Dr. Marie replied:
I did some research for you and apparently albendazole is occasionally used by vets to treat giardia that is not responding to metronidazole. But, from what I can see it is not common. Here is a quote from Plumb's which is a veterinary drug handbook that is commonly used:
"It (Albendazole) has been used for treating Giardia infections in small animals, but concerns about bone marrow toxicity have diminished enthusiasm for the drug's use."
It's not a bad idea to confirm that albendazole is indeed what you were supposed to be prescribed. It's possible that a mistake was made. But, I am always very reluctant to contradict a vet's orders as there may be other factors in the case that I am not aware of. For example, it's possible that in your area the vets have been dealing with giardia that is resistant to regular treatments and maybe they have found that albendazole is the most effective treatment.
Albendazole can commonly cause appetite depression. The textbooks say that it can cause something serious called aplastic anemia. This is a problem with the red blood cells. However, it appears that this is quite rare and would be much more common if a significant overdose were given or if it was given for a long period of time. I think that it is quite unlikely that any lasting harm is done.
I think that it's possible that the vomiting was a side effect of the medication. But, if it continues I think that it would be correct to go looking for other causes of vomiting in puppies such as a foreign object.
I hope that helps and hope that things are completely better soon!
Dr. Marie
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