From Habit to Evidence: The Shift in Antibiotic Use for Canine Acute Diarrhea

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Metronidazole has been the reflex prescription for canine acute diarrhea for years and that habit is hard to break. We sit down with Dr. Erin Fry to unpack what the data actually says about outcomes in mild to moderate acute diarrhea, including cases with bloody stool, and why supportive care often matches antibiotics for speed of recovery. Along the way, we get honest about the real reasons “we know better” doesn’t always translate into “we do it” when a worried client is sitting in front of us.

We walk through what uncomplicated acute diarrhea looks like in practice and what supportive care really means: hydration plans, a highly digestible diet, smart fiber use, and when probiotics may fit. Erin also explains why the gut microbiome is now central to the conversation, and how antibiotic-associated dysbiosis can linger for weeks to months, with special concern for puppies and kittens. If you’ve ever prescribed “just in case” because you feared missing something, this conversation gives you a clearer risk-benefit frame grounded in randomized controlled trials and day-to-day clinical reality.

Then we zoom out to the culture of prescribing. Peer expectations inside a hospital, mixed standards between clinics, client demand for instant gratification, and the challenges faced by newer grads or relief doctors all shape decisions. Erin shares practical tools for behavior change, including practice-wide talking points, team alignment from front desk to exam room, and a concrete starting point using the AVMA antimicrobial stewardship checklist.

If you want a clearer, evidence-based approach to treating canine acute diarrhea without unnecessary antibiotics, listen now, share this with a colleague, and leave us a rating and review on Apple Podcasts or wherever you listen.

JAVMA article: https://doi.org/10.2460/javma.25.10.0686

AVMA veterinary checklist for antimicrobial stewardship: Veterinary-Checklist-Antimicrobial-Stewardship.pdf

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