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

[island rehabber]

My personal opinion is based solely on my experience rehabbing squirrels with coccidia. Thankfully it has only hit my house twice, but I will tell you that NOTHING worked except Toltrazuril.

[hanksmom]

We have been dealing with this for about 3-4 weeks now! His morning poops are like they should be, firm, round, but still smell. As the day progresses it turns to watery diarrhea. I have stated multiple times to others that the smell really has me believing it’s Coccidea, but I assume they want to continue to use other treatments first. I stress him out more by constantly giving him syringes of meds and dia stat and feel that makes the issue worse 🥴 He loves his mom, but he’s getting to where he’s like “umm nah lady, you have meds” lol
If you can send me links for the meds, I’m more than happy to purchase them and get them here. I want to end this for him. Especially since I’ve stated to multiple people the smell is strong. I know we have to go through every step, but I’m also going back to my vet tech days of if all the signs are there, let’s knock it out before it gets worse. The rehabber did say they would look to see if they had Albon and send it when the snow clears but bless him 4 weeks of this has been rough. Trying everything under the sun and not even touching it .

[SamtheSquirrel2018]

We have been dealing with this for about 3-4 weeks now! His morning poops are like they should be, firm, round, but still smell. As the day progresses it turns to watery diarrhea. I have stated multiple times to others that the smell really has me believing it’s Coccidea, but I assume they want to continue to use other treatments first. I stress him out more by constantly giving him syringes of meds and dia stat and feel that makes the issue worse 🥴 He loves his mom, but he’s getting to where he’s like “umm nah lady, you have meds” lol
If you can send me links for the meds, I’m more than happy to purchase them and get them here. I want to end this for him. Especially since I’ve stated to multiple people the smell is strong. I know we have to go through every step, but I’m also going back to my vet tech days of if all the signs are there, let’s knock it out before it gets worse. The rehabber did say they would look to see if they had Albon and send it when the snow clears but bless him 4 weeks of this has been rough. Trying everything under the sun and not even touching it .

Hello again HanksMom:
First off, as I mentioned in my last post; Albon is a Brand name for sulfadimethoxizine which is a sulfa drug in the same family as the SMZ/TMP you are now using! It is NOT in the same family of medications as Toltrazuril or Ponazuril! Also, as I mentioned; if you are considering a change in medication with the focus on the likely culprit for Hank's diarrhea being Coccidia; I would suggest either abandoning the Sulfa Drugs and change to Toltrazuril or Ponazuril and of those two, I would opt for Toltrazuril 5%!
There is also a 2.5% formulation of Toltrazuril but I read somewhere that the 2.5% solution was originally formulated for pigeons and can be irritating to Cat's mucus membranes so I don't use it for Squirrels either! NOTE: I have never verified this because since reading this, I have only purchased the 5% solution and this is fine with me! The 5% solution has 50mg of Toltrazuril contained in each 1ml of the solution. We can help you with dosing by Private Message! A few sources that I have used in the past are listed in order of my recency of purchases;

https://toltrazurilshop.com/products...quid-solution/

https://horseprerace.com/toltrazuril-5-240ml/

https://www.allthingsbunnies.com/Tol...s-p/med132.htm

Regards,
SamtheSquirrel

[hanksmom]

Thank you so much for the information! So even if they send the Albon, it’s the same as what we are doing now basically?
I will Order the other so it can be heading this way. The smell of his poop to me is the main reason I believe it to be cox. It’s stout and smells horrible. He also ate dried up dirt from my husbands boots around the time this started which is another reason I believe it’s cox. Maybe he got something from it. I weighed him this morning and we are at 574 grams. Still spunky and eating and drinking.

[hanksmom]

Hello again HanksMom:
First off, as I mentioned in my last post; Albon is a Brand name for sulfadimethoxizine which is a sulfa drug in the same family as the SMZ/TMP you are now using! It is NOT in the same family of medications as Toltrazuril or Ponazuril! Also, as I mentioned; if you are considering a change in medication with the focus on the likely culprit for Hank's diarrhea being Coccidia; I would suggest either abandoning the Sulfa Drugs and change to Toltrazuril or Ponazuril and of those two, I would opt for Toltrazuril 5%!
There is also a 2.5% formulation of Toltrazuril but I read somewhere that the 2.5% solution was originally formulated for pigeons and can be irritating to Cat's mucus membranes so I don't use it for Squirrels either! NOTE: I have never verified this because since reading this, I have only purchased the 5% solution and this is fine with me! The 5% solution has 50mg of Toltrazuril contained in each 1ml of the solution. We can help you with dosing by Private Message! A few sources that I have used in the past are listed in order of my recency of purchases;

https://toltrazurilshop.com/products...quid-solution/

https://horseprerace.com/toltrazuril-5-240ml/

https://www.allthingsbunnies.com/Tol...s-p/med132.htm

Regards,
SamtheSquirrel

I just purchased this from the first link you sent!
Toltrazuril Liquid Solution - 4oz - 120mL, 5% × 1
size:
4oz - 120mL
Strength:
5%

[Milo's Mom]

Albon, Toltrazuril, and Ponazuril are now the gold standards in squirrels for coccidia, with the latter being preferred.
Smz-tmp and metro combo is generally not used anymore when treating squirrels.
Sam is right, they treat differently...some kill some prevent multiplication and allow immune system to manage.
Also need to look at length of time and cleanliness of entire area squirrel is in...otherwise reinfecting is likely. Then theres dehydration and malnutrition and it snowballs from there.
At my clinic we use ponazuril, but it can be hard to obtain without a vet. Baycox (toltrzuril) would be easier to obtain and is next best IMHO. Then Albon.
They all work well, but I would suggest staying away from the smz-tmp/metro combo...you're just going to irritate the squirrel and frustrate yourself.

[hanksmom]

Albon, Toltrazuril, and Ponazuril are now the gold standards in squirrels for coccidia, with the latter being preferred.
Smz-tmp and metro combo is generally not used anymore when treating squirrels.
Sam is right, they treat differently...some kill some prevent multiplication and allow immune system to manage.
Also need to look at length of time and cleanliness of entire area squirrel is in...otherwise reinfecting is likely. Then theres dehydration and malnutrition and it snowballs from there.
At my clinic we use ponazuril, but it can be hard to obtain without a vet. Baycox (toltrzuril) would be easier to obtain and is next best IMHO. Then Albon.
They all work well, but I would suggest staying away from the smz-tmp/metro combo...you're just going to irritate the squirrel and frustrate yourself.

Yeah he and I are both irritated at this point! His cage is cleaned once a day and recently twice a day if he messes in it before his bedtime. Most of the time he’s out and I’m cleaning behind him. It’s been 4 weeks of this and I think we are both done with it. I did just place the order for the Toltrazuril. So it will be here hopefully in the next few days. Thankfully he’s been his crazy self, eats and drinks water. I haven’t given him anymore dia-stat bc he’s just getting frustrated with me and the syringe. It’s been too much of holding him down giving him this or that to eliminate other possibilities. He’s always been healthy even when he decided to live outside (he would come in and out) and this is the first issue we’ve ever had. I just feel in my heart it’s Coccidea bc of the awful smell. It was so bad the other night after I cleaned his cage, he went back in, was playing and all of a sudden I smelled it 🥴 But I’ve told everyone about the smell for 4 weeks. 😫

[hanksmom]

Just to show what we have been dealing with, morning poops are usually normal and then throughout the day it turns to the diarrhea

[Milo's Mom]

How old? Adults don't usually present with diarrhea with coccidia. However, with giardia they do.
Explain the odor please...sickingly sweet, death, what are some common descriptors?
Other than SMZ what other abx have you used?
When you follow him and clean please make sure you're using ammonia...its the only thing other than heat that kills coccidia. Bleach, lysol, chlorhex...they don't kill it.

[hanksmom]

How old? Adults don't usually present with diarrhea with coccidia. However, with giardia they do.
Explain the odor please...sickingly sweet, death, what are some common descriptors?
Other than SMZ what other abx have you used?
When you follow him and clean please make sure you're using ammonia...its the only thing other than heat that kills coccidia. Bleach, lysol, chlorhex...they don't kill it.

He is 3 1/2 years old. He did eat some dried mud that was on my husbands boots (he works in the log woods) at first, I thought it was the avocado, but he has not had that in over 3 1/2 weeks. I have been using Clorox wipes, But I will look into the ammonia. Do I need to dilute it with water or anything?

[hanksmom]

Also, we have tried
1. Pancur- 4days didn’t help
2. Metro- yesterday was day 7, didn’t work
3. Added SMZ yesterday along with metro.
I bought dia stat and that hasn’t helped.its just started stressing him out a lot more since I have to do the syringe. Got him bene bac as well and give him that every two hours after his medication and he started that about 2 days ago.
Before the diarrhea really started we thought we smelled a dead mouse but we did not have one, the smell was around his cage. The smell is stout, not sweet, I’d say more like decaying something, but not as strong as death smelling of that makes sense

[island rehabber]

"Coccidia smells sweet, Giardia smells like death." That's what I was taught when I started rehabbing. I wonder if giardia is what we are dealing with here.

[hanksmom]

"Coccidia smells sweet, Giardia smells like death." That's what I was taught when I started rehabbing. I wonder if giardia is what we are dealing with here.

Definitely not sweet, it’s a very stout smell. His morning poop is normal and then we head into the diarrhea throughout the day. I have Toltra 5% coming. We tried the pancur for 4 days too