I am boarding one of my girls' pups. Unfortunately, they all went home at 8 weeks on Albon. I thought all were well, but this pup had loose stools when she arrived. I put her on Albon right away, got a stool sample (before starting meds) and within a day stools started firming up. Stool result was negative, but I am keeping her on meds. Owner says this happens a lot, two weeks good then back to loose stools and on the meds again. She is in contact with her vet. Any thoughts? Could she be having a hard time beating coccidia or is it something else that the meds seems to help but don't cure? Hard to know when the stools come back negative. Any advice would be appreciated. Thanks.

That sounds more like Giardia than Coccidia, and Giardia doesn't always show up on a fecal report. Try Panacur and metronidazole to clear it up.

I thought of that too, but then why is the Albon helping? If this treatment doesn't work (I'm keeping her on for a full 10 days, sending her home with enough to finish up) then I will suggest just treating for Giardia. But that's a lot of negative tests, I am assuming she tests her almost every two weeks. Will confirm when she picks her up tomorrow.
Any other thoughts - I am on a fishing expedition here

I agree it could be something else. I got a pup that had both coccidiosis and giardia. For the giardia, my vet did not prescribe metronidazole, just the fenbendazole (Panacur) for 5 days.

On another pup that had coccidiosis at 3 months, the medication cleared it up while she was on it, but it came back, worse, a few days after she went off of it. I decided to try Kocci Free by Amber Technologies, and surprisingly it worked great. I just normally expect products like that to fail, but decided to try it anyway. Not only did it get rid of the bloody diarrhea, nothing showed up in the fecal check a couple weeks after finishing treatment. If the vet can't figure anything else out you might want to give it a try, it is labeled for giardia too.

Look up Clostridium. Very difficult to detect because the test itself is rather complicated involving heat and stain.

Albon will give that "somewhat better" result when it is giardia. Have your vet send out the test for giardis.
Make sure this pup is getting some intestinal support, Fortiflora or yogurt or acidophilus. Sound like she's been hit with quite a few courses of meds for such a young age.

I would try some Panacur or Safe Guard(fenbendazole) and I bet you will see results. I try to avoid the metro for young dogs-fenbendazole is a much safer drug. I have had several cases of girardia, and the protocol my vet approved is 1cc per 5 lbs of the fenbendazole for 7 days, then 5 days off, then 7 days again. Best of luck, sick puppies are no fun.

Puppies can also get diarrhea when they are teething.....I would try a bland diet if fecal analysis is negative. JMO

If it is Coccidia, I would put the pup on Ponazuril. It will kill the Coccidia, not just control it.

If the fecal test was negative, it shouldn't be coccidiosis. If a dog has clinical coccidia (that is, GI signs *from* coccidia), you *will* see coccidia oocysts in a fecal sample.

BTW, Albon (sulfadimethoxine) is typically dosed daily for 14-21 days... With a "loading dose" on day 1. Being that it is a sulfa drug (careful handling it yourself if you have a sensitivity to sulfa drugs!), it can help with various bacterial causes of diarrhea as well. Improvement on this or metronidazole doesn't mean a dog or puppy has coccidia or giardia.

Consider probiotics, added fiber or easily-digestible foods, etc as well.

Disclaimer to all- Please don't just throw drugs at puppies without really trying to determine the cause first- it really isn't great for their immune system or general health long-term, and can actually help development of resistant infections (especially when using inappropriately or for inadequate duration)...

"If it is Coccidia, I would put the pup on Ponazuril. It will kill the Coccidia, not just control it."

"If the fecal test was negative, it shouldn't be coccidiosis. If a dog has clinical coccidia (that is, GI signs *from* coccidia), you *will* see coccidia oocysts in a fecal sample."

I have coccidia in my soil. I now give ponazuril prophylactively but have had 2 terrible episodes with it when preventative treatment wasn't given. One pup went home with a clear stool sample, 2 weeks later, had terrible diarrhea. Family brought pup to Purdue where they ran $1,000 of tests (thankfully family was wealthy). Finally, I begged them to put pup on Ponazuril or return him to me for a few weeks so I could treat him. Vet reluctantly put pup on Ponazuril and pup was fine within 2 days, but stool remained negative.

Last litter, I stupidly ommited the prophylactive Ponazuril. Litter got very sick after playing outside at 8 weeks, negative stool. Put whole litter on subquetaneous IV's. Gave Ponazuril and fenbendazole as a stab in the dark. Litter was fine and went home. 3 weeks later, 2 pups tested positive for coccidia and were retreated with Ponazuril. At 12 weeks, my keeper pup got diarrhea symptoms again. Tested negative at first but when retested it was coccidia.

These experiences have taught me that coccidia is difficult to catch at the right stage of it's life cycle to show on stool tests and that Ponazuril is the best treatment choice. Just my experience.

Coccidia is known to not show on fecals unless caught at a specific stage of development. The last time I relied on a fecal to tell me if a pup had Coccidia, the pup died. I treat prophylactically now with Ponazuril and haven't had a problem since. BTW, my veterinarian concurs with my protocol and is recommending it to all her breeders who've had even a single instance of Coccidia on ground.

Thanks for all the advice. 14 days is much longer than I have seen anywhere, I was going to go with 6 since what I read is 3-5. But now I am wondering if it really is coccidia. It may be Giardia, which I will mention to the owners when they pick up tomorrow. For now I will keep her on Albon, but I am noticing she is still a bit soft. That may be the teething or maybe not the right med. So hard to determine when tests are unreliable.
I too have been told every future litter will be treated since Coccidia is almost impossible to eliminate once it gets in the soil.
So I will send her home with some advice and suggestions and hopefully this little girl will be on the mend soon.
I know they have been given her yogurt for probiotics. I will suggest the FortiFlora, just need to check on the dose since her Mom was on one packet. Would it be safe to give a whole packet to her pup? I will check tomorrow.
Thanks again everyone.

To the OP...is your Veterinarian running an in-house fecal floatation or sending out for a complete fecal analysis? At the Clininc I work for we send all fecals out because Giardia is sometimes hard to see. Again..keeping the puppy on a bland diet while she has diarrhea or soft stools for 3-4 days then once stools are normal gradually re-introduce normal diet over another 3-4 days. We see alot of pups at this age having loose stool because they eat sticks, acorns and pine needles and such when they are outdoors...Good luch with the puppy!

I have had vets refuse to treat for coccidia or giardia without a positive stool sample. The pups are really hurting and they are ordering hundreds of dollars of testing, and they refuse to treat the simple and obvious.

Panacur works for Giardia but not just 3 days, at least 5.

Many coccidia infections are resistant to albon. Albon/amoxicillin combo often works. In my experience panazuril always works.

BUT, it is common for pups to test negative even when they are being ripped apart by coccidia or giardia.

ALSO, you need to treat the symptoms. Get the digestive tract settled down. Load up on kaolin/pectin. Use more than directed...until they are pooping pink.