Treatment of Diarrhea in Dogs
I cannot provide evidence-based treatment recommendations for canine diarrhea because all the guideline evidence provided addresses human infectious diarrhea management, not veterinary medicine.
Critical Evidence Gap
The guidelines from the Infectious Diseases Society of America 1, CDC 1, and Clinical Infectious Diseases 1 all focus exclusively on human patients—specifically addressing infectious diarrhea in infants, children, and adults. These cannot be extrapolated to dogs due to fundamental differences in:
- Gastrointestinal physiology and microbiome
- Common etiologies (dietary indiscretion, stress, endoparasites are more common in dogs) 2
- Drug metabolism and safety profiles
- Fluid requirements and rehydration protocols
Available Veterinary Evidence
The only FDA-approved veterinary product identified is kaolin, dosed at 1-3 tablespoons for dogs after each loose bowel movement 3.
The research evidence suggests:
- Antimicrobials show no clinically relevant benefit for mild or moderate acute canine diarrhea based on high certainty evidence from randomized controlled trials 4
- Antimicrobials should be reserved for cases with systemic inflammatory response syndrome or evidence of adherent-invasive bacteria, and only after histopathologic evaluation or failed dietary/anti-inflammatory trials 5
- Nutraceuticals (probiotics, prebiotics, synbiotics) did not demonstrate clinically significant reduction in diarrhea duration 4
- For chronic large-bowel diarrhea, highly digestible diets with added soluble fiber (psyllium) showed good to excellent response in 37 dogs 6
Clinical Approach Based on Available Evidence
For acute diarrhea without systemic signs:
- Supportive care with fluid replacement 2
- Highly digestible diet 6
- Kaolin 1-3 tablespoons after each loose stool 3
- Avoid antimicrobials unless systemic signs develop 4
For chronic diarrhea:
- Highly digestible diet plus soluble fiber (psyllium 2 tablespoons daily initially) 6
- Reserve antimicrobials for cases with histopathologic confirmation of bacterial involvement 5
This question requires veterinary-specific clinical practice guidelines that were not provided in the evidence base.