As mentioned in previous posts, Cosmo requires a special diet because he tends to form calcium oxalate bladder stones. In addition, he developed hyperlipidemia last year, which necessitated a low-fat diet. We started his low-oxalate, low-fat diet early in 2018, and eliminated two fiber-rich treats (banana chips and pita chips) to reduce the fat in his diet. This reduced the fiber content from about 4.5% (dry matter) to 3.8%. Then in September, I eliminated green peas from his diet, thinking that it would improve an intestinal gas problem he was having. That brought the fiber content down to 2.8%.
Cosmo has a history of occasional bouts of diarrhea dating back to 2011. At that time the problem was diagnosed as being caused by an overgrowth of Clostridium bacteria in his gut. This is not unusual in dogs and can be triggered by many factors, including stress. It can usually be treated successfully with a few doses of the antibiotic metronidazole. In Cosmo’s case, if he were not treated with metronidazole when mucus appeared in his soft stools, diarrhea would soon develop, and on occasion, vomiting. This problem was typically a yearly or semiannual event. However, since he has been on a diet with relatively low fiber, the problem has been much more frequent, as can be seen from this calendar, which I started for our Arizona vet.
Soft stool calendar
The problem came to a head in September just before we left for our annual trip from Anacortes, WA, to our Arizona home. In addition to the stress he may have felt regarding our move, he also had impacted anal glands, which prompted a visit to his Washington vet on September 15. Anal glands are naturally expressed during defecation, but with the soft stools he was producing, this was not happening. When the glands become impacted, they cause discomfort or even pain for the dog (i.e., more stress). After the vet expressed the glands, that problem was addressed, but he continued to have bouts of very soft stool. If the stool appeared to contain mucus, I treated with metronidazole until the problem passed.
After we arrived in Tucson in late September, we took him to his Arizona vet (Dr. Joshua Fender) for another consultation. He reviewed his diet and noted that Cosmo’s fiber content should be at least 5% of dry matter (it was then 2.8%) and suggested adding Metamucil to his diet. I did that by adding 1/2 level teaspoonful to each of his twice-daily meals (about 1.7g per meal). The addition of the Metamucil and the reintroduction of green peas in his diet brought the total fiber to 5.1%. The increase in fiber had an immediate positive effect! The stools became much more formed and solid enough to pick up without leaving residue. The amount of intestinal gas also decreased significantly. Cosmo hates to “fart” and almost always turns around to see what just escaped from his anus. So it is easy to see when he has gas. I have tried larger amounts of Metamucil (up to 3/4 level teaspoonful per meal), but it does not seem to be more effective and makes his food too sticky. I add the Metamucil just before giving him the food (well mixed).
I may have caused some of his problems by not paying attention to the fiber level in his diet. Pet Diet Designer doesn’t show fiber content on the main “balance screen” and only shows it on the Nutrient Report, which I don’t always review. So it was easy to lose track of the fiber amount in his diet. I will check fiber from now on! But even if the fiber amount was displayed more prominently, I might not have thought to increase the fiber in his diet for loose stools. I think of fiber, like Metamucil, as a laxative! Also, many references I have seen online recommend 2.5 to 5% (DM) as the minimum fiber in dog food. Most commercial dog food contains a fair amount of insoluble fiber in the form of plant-derived cellulose derivatives (e.g., beet pulp). I have yet to find many good sources of insoluble fiber since most contain oxalate or are high in fat. Both of these are contraindicated in Cosmo’s diet. However, about 73% of the fiber in green peas is insoluble (reference). Metamucil is mainly soluble fiber, which absorbs water and forms a gel in the gut. This may help move food residue through the digestive tract. It is also possible that gut bacteria metabolize the soluble fiber in Metamucil into compounds such as short-chain fatty acids, which alter the intestinal environment and may change what is causing the soft stools/diarrhea (reference). Here is another good reference to this topic.
Some research indicates Metamucil can be useful in treating diarrhea in dogs (reference here). There is also one anecdotal claim for its usefulness in treating soft stools in a dog. It was effective for at least three years.
Whatever the effect, adding Metamucil fiber to his diet seems to be helping Cosmo. So far, he has had normal stools for 16 days without any metronidazole. I have also been giving him a dose of ForteFlora (probiotic) every three days. We have used this probiotic for years, and although it has not prevented his loose stools, it might encourage a healthier gut flora while he is on Metamucil. Time will tell if the combination of Metamucil and ForteFlora solves this problem. Stay tuned.
Update 11/13/18: Cosmo has had normal stools for 27 days without metronidazole. Today he had his anal glands checked by our vet tech, and they were empty. Great news. They must be secreting normally with each bowel movement. I am amazed that a bit of fiber (about 1.7 grams of Metamucil twice daily) seems to have solved his soft stool problem.Â
