Diarrhea-Non-Life Threatening

[hanksmom]

Hello!! I have a 3 1/2 year old gray male. Got him when he was about 4 weeks, fell out of a tree. Did soft release ( he was healthy) lived in and out for about a year and one day decided he liked the life inside, lol. He was a singleton and I guess he prefers to stick with his mom (me). Anyways. He has been in for about 2 years, no issues, healthy and has a balanced diet of greens, squash, cucumber, avocado, in moderation 2 Henry blocks a day, and free feed mauzari blocks. No nuts, or seeds, besides a pecan maybe once every three months if that. Active, living his best life. For about 3- 4 weeks we have been dealing with diarrhea. When it started like 4 weeks ago, I noticed it after he had his piece of avocado, two days later it was very soft and splattered, stopped avocado, and it got better. Then roll around to the next week and I gave him some avocado again and it happened again....took the avocado away and he has not had any in about 2 weeks, but we are fighting this diarrhea every day. Now, his first poops in the morning are normal, as the day goes on here comes the soft, squishy, watery diarrhea. No blood, brownish to light brown, not losing weight (585 grams), and still active as all get out!!! The poop smells as well. I have been working with a rehabber and we have tried, no food, only Henry's and Mauzari with maybe a slice of squash and cucumber. We have tried Imodium, with no luck. I have bought Dia-Stat and give him that through a syringe, he hates it, but we manage about 6-9 CC's. He has been on .25 (point 25) of metronidazole, tomorrow will be the 7th day. I bought some Bene-bac and got it today, and started that today. I am at a loss and not sure what to do for him anymore. Any thoughts?

[SamtheSquirrel2018]

Hi HanksMom and thank you for finding The Squirrel Board!
I'm sorry that you have not yet had a response to your post. I was just on TSB and noticed it but I am at work and had to return to work responsibilities and will need to do so again now but I will return probably in a couple of hours. Others may notice your thread a my response with "bump" you post back in view! For my information when I am able to return or for others; I have some questions; 1) what is your Squirrel's name? 2) What fluids and how much of these is your Squirrel getting in addition to Dia-stat. Is he getting plain water! It is easy for a Squirrel to become dehydrated with diarrhea and they must have plain water. They can NOT be given just Pedialyte or dia-stat as their electrolytes (sodium chloride, etc) will become highly concentrated and this can cause very serious problems! 3) Are you giving the Metronidazole simply in response to the diarrhea or are you presumptively treating Giardia or Coccidia? 4) Do you have any Bactrim (trimethoprim-Sulfamethoxazole)? Do you have any Ponazuril or Totrazuril? These have been used successfully for treating Coccida as have some of the sulfa drugs. 4) Do you have access to a Squirrel-friendly Veterinarian!

I must return to work duties but will get back with you!
Regards,
SamtheSquirrel

[hanksmom]

Thank you for your response!! To answer your questions
1. His name is Hank
2. He is still eating and drinking fine (just water) along with his Dia-Stat. He hasn’t lost his appetite at all and is still spunky as ever. His mood hasn’t changed at all in the 3 weeks we’ve been dealing with this.
3. We tried pancur first and that didn’t help, then the metronidazole (today is the 7th day) and it was started to control the diarrhea and the possibility of the Coccidea or the other. But, still hasn’t helped. We are continuing those meds for 10-14 days at .25 (point 25) twice a day.
4. I just started .3 (point 3) of SMZ today to maybe see if that helps. The smell makes me really believe we’ve been fighting Coccidea.
5. Not a squirrel friendly area at all sadly!
6. He hadn’t been losing weight at all until these past 4 days. He was 583 grams and now about 575 grams when I check this morning. Still has his blocks and veggies, eats them up.

[SamtheSquirrel2018]

Thank you for your response!! To answer your questions
1. His name is Hank
2. He is still eating and drinking fine (just water) along with his Dia-Stat. He hasn’t lost his appetite at all and is still spunky as ever. His mood hasn’t changed at all in the 3 weeks we’ve been dealing with this.
3. We tried pancur first and that didn’t help, then the metronidazole (today is the 7th day) and it was started to control the diarrhea and the possibility of the Coccidea or the other. But, still hasn’t helped. We are continuing those meds for 10-14 days at .25 (point 25) twice a day.
4. I just started .3 (point 3) of SMZ today to maybe see if that helps. The smell makes me really believe we’ve been fighting Coccidea.
5. Not a squirrel friendly area at all sadly!
6. He hadn’t been losing weight at all until these past 4 days. He was 583 grams and now about 575 grams when I check this morning. Still has his blocks and veggies, eats them up.

Thank you HanksMom and hello Hank-Squirrel!

The facts that Hank is active, eating normally, not experiencing excessive weight loss (Hank's weight should continue to be regularly monitored, however!), and drinking both water and some extra electrolytes via Dia-Stat are all good signs. By the way, please do NOT mix Hank's plain water source with Dia-stat or anything else for that matter! His water should be pure water!

Are you or the Rehabber who is helping you familiar with and able to perform a Fecal Flotation Test? This test is relatively simple to perform if you have the necessary supplies and equipment and familiarity with what you might see under the microscope. There are also easily available published charts with photomicrographs of oocysts (parasite eggs) and intestinal parasites that can be used by novices and those very experienced with Fecal Flotation Tests as well! If Coccidia, you are most likely to see the the oocysts rather than the actual parasite as the Coccidia themselves are obligate intracellular parasites (the actual parasite lives inside the intestinal cells and not in the lumen which is the actual passageway inside the intestines). The Fecal Flotation Test is potentially very valuable in evaluating an animal with diarrhea! If you may not be familiar with the Fecal Flotation Test or able to perform it yourselves; there may be a local Veterinarian who would be willing to perform a Fecal Flotation Test for you even though there may be no Squirrel-friendly Vet in you area! By the way, a negative Fecal Flotation Test does NOT rule out the presence of parasites and submitting additional specimens following a possible negative test is worth considering! When you state that you are using ".3" of the SMZ/TMP; it is not clear if you mean means 0.3 milliliters of a particular concentration of the drug or 0.3mg of the drug itself!

As far as the doses of the medication are concerned; if you would like comments or suggestions regarding drug dosing and mixing; we do this by Private Messaging on The Squirrel Board (TSB) and not on the Open Board. This restriction is done for several important reasons. If you would like some comments about the mixing and dosing of the medications you are already using or are considering; please mention this and post the specific medication and its formulation (tablet, capsule, etc) along with its strength (such as 100mg) and one of us will send a PM to you with the mixing and dosing "specifics!" or if you just want some comments on this, we will give you those as well! We will need to know more than what you have provided for us to know how Hank's medications are being dosed currently, however! One very important and necessary variable in formulating a dosing plan is Hank's weight and you have provided that! BUT the other information needs to be clarified in that the particular formulation (tablet, capsule, powder, etc) will need to be known and the particular strength as well. For instance, Metronidazole is available for human use in 250mg and 500mg tablets. The other necessary variables to be supplied is how you may have diluted or mixed the medication (the concentration of the drug such as JUST FOR EXAMPLE, 10mg per milliliter).

Please keep on with updates on Hank!

Regards,
SamtheSquirrel

[island rehabber]

Hanksmom, coccidia is what comes to my mind as well. Toltrazuril and Ponazuril are very effective and easy to order online. I strongly recommend. The very fact that he is otherwise healthy really sounds like cox, which won't be cured by SMZ or metro.

[hanksmom]

Thank you for responding!! He is drinking plain water from his bowl in his cave, and I mix the dia stat as directed by Henry’s. He didn’t get it yesterday, I feel like I’m stressing him out more when I have to hold him down and use the syringe, he will usually take anywhere from 6-9 cc’s. I am using the 3 ml/cc syringes. I dont have access to a microscope but have thought about purchasing one from amazon if you have recommendations! The rehabber lives further away from me and has been helping me through calls and messages. They have been amazing! This is the dosing they told me to do for him on the two meds below

Crush a 250mg metronidazole and add 2.5ml water (or a total of 2.5ml karo syrup and water to make it taste better).
Dose .25 (point two five) twice daily for ten days.

Crush one smz 400/80 to powder and add 10ml water. Dose .3 (point three) twice daily for seven days.
You can give both meds at the same time twice daily.

Bene-Bac, two hours before or after current meds are given.

If you can tell me where to by the other meds that are easily available I will order those as well!!

[SamtheSquirrel2018]

Hanksmom, coccidia is what comes to my mind as well. Toltrazuril and Ponazuril are very effective and easy to order online. I strongly recommend. The very fact that he is otherwise healthy really sounds like cox, which won't be cured by SMZ or metro.

Just a few comments on this;

I too, would strongly recommend use of Toltrazuril or Ponazuril BUT a number of the sulfa drugs including SMZ/TMP are effective for treating coccidia! In fact the only medication that is actually "approved" for Veterinary treatment of coccidia is s sulfa drug called Albon (sulfadimethoxine)!

Toltrazuril or Ponazuril actually kill the coccidia and are called coccidiocides. SMZ/TMP and the other sulfa drugs do NOT kill the coccidia directly but interfere with one or more of their vital functions and this "weakens" the coccidia this results in the animal's own immune system being more effective at killing the coccidia! Medications that function this manner for treating coccidia are called coccidiostats. Treatment of coccidia with most sulfa drugs requires far more days of treatment and far more doses of the the medication than would be necessary if utilizing Toltrazuril or Ponazuril! HanksMom, if you have or can obtain either Toltrazuril or Ponazuril; there would be decided advantages to stopping the SMZ/TMP and starting Toltrazuril or Ponazuril! By changing therapy to utilizing Toltrazuril or Ponazuril; you would still save yourself (and Hank!) time and number dosing preparations as again, to optimize its effectiveness, the SMZ/TMP will need to be dosed for at least 14 days and preferably for 21 days!
Regards,
SamtheSquirrel

[SamtheSquirrel2018]

Are you or the Rehabber who is helping you familiar with and able to perform a Fecal Flotation Test? This test is relatively simple to perform if you have the necessary supplies and equipment and familiarity with what you might see under the microscope. There are also easily available published charts with photomicrographs of oocysts (parasite eggs) and intestinal parasites that can be used by novices and those very experienced with Fecal Flotation Tests as well! If Coccidia, you are most likely to see the the oocysts rather than the actual parasite as the Coccidia themselves are obligate intracellular parasites (the actual parasite lives inside the intestinal cells and not in the lumen which is the actual passageway inside the intestines). The Fecal Flotation Test is potentially very valuable in evaluating an animal with diarrhea! If you may not be familiar with the Fecal Flotation Test or able to perform it yourselves; there may be a local Veterinarian who would be willing to perform a Fecal Flotation Test for you even though there may be no Squirrel-friendly Vet in you area! By the way, a negative Fecal Flotation Test does NOT rule out the presence of parasites and submitting additional specimens following a possible negative test is worth considering!

Hello again HanksMom:
I just wanted make certain that you saw my suggestion for having at least one Fecal Flotation Test performed (and several more if the first does not reveal anything definitively diagnostic). This relatively simple test is considered by most Veterinarians (and Rehabbers) to be an essential component in evaluating cases of diarrhea! Again, as I mentioned; even if there is no "Squirrel-Vet" to see Hank; a local Veterinarian may nevertheless, be willing to perform the Fecal Flotation Test for you without actually examining Hank! You would just need to bring a stool specimen to the Vet's office.

Please keep on with updates about Hank!
When are you expecting the Toltrazuril? I will be glad to provide dosing recommendations for you (and will let you know the well accepted Exotic Animal Formulary from which I base my dosing protocol) or others here will be able to provide dosing instructions for you. A repeat weight just prior to initiating the Totrazuril would also be be ideal!
Regards,
SamtheSquirrel

[hanksmom]

Hello again HanksMom:
I just wanted make certain that you saw my suggestion for having at least one Fecal Flotation Test performed (and several more if the first does not reveal anything definitively diagnostic). This relatively simple test is considered by most Veterinarians (and Rehabbers) to be an essential component in evaluating cases of diarrhea! Again, as I mentioned; even if there is no "Squirrel-Vet" to see Hank; a local Veterinarian may nevertheless, be willing to perform the Fecal Flotation Test for you without actually examining Hank! You would just need to bring a stool specimen to the Vet's office.

Please keep on with updates about Hank!
When are you expecting the Toltrazuril? I will be glad to provide dosing recommendations for you (and will let you know the well accepted Exotic Animal Formulary from which I base my dosing protocol) or others here will be able to provide dosing instructions for you. A repeat weight just prior to initiating the Totrazuril would also be be ideal!
Regards,
SamtheSquirrel

I guess I can call some vets and see if they would preform a frack if I bring it in, they will ask questions and this is not a squirrel friendly state sadly. I’ve been wanting to get things needed to do my own at home if someone could direct me to that as well. The Toltrazuril I ordered yesterday so hopefully Tuesday or Wednesday