greyhead

Thinking of you and hoping you get some clarity. Try to get some rest. It's hard to focus when you're as tired as you must be.

Hookworms have the ability to encyst themselves, both in the soil and in the body, and emerge when they feel like it. So a year later is not a stretch for them. Hope it's not that. We had it happen that both our dogs started refusing food from a 3/4-used bag of kibble that had been fine up until then. Got a new bag of the same kind and they were fine with that. We figured the first bag wasn't fresh enough to last until it was used up. Maybe a new bag is in order?

Glad that ultrasound is coming up. All fingers and paws crossed here for Billy and for you.

Yeah, Wendy, that sounds right up my alley! I'm impressed with your research skills!

It just occurs to me to mention that prednisone is not your only option. We're starting Spencer on budesonide, a different immunosuppressant, the action of which is confined to the GI tract and without the potentially long list of side effects that pred has (e.g., excessive hunger, thirst, elimination; and those are the more benign side effects). It's costing around $35 for a month's supply, so it's more expensive. Worth it to us because in addition to those considerations, Spencer didn't improve on pred and dropped a lot of weight fast. Pred works for some dogs, so I'm not suggesting you not use it. But wanted you to know there are alternatives so you can think about it and ask your vet. ETA: Ditto what Batmom said about Pepcid. There's nothing like excess stomach acid to spoil an appetite!

This is your prior post that I was remembering: It's confusing -- for me as well as you, I'm sure! So they found bacterial overgrowth somewhere somehow, but the specific bacterium didn't show up when the stool sample was cultured. Maybe you could ask the vet how they tested for bacterial overgrowth and why there might be such a discrepancy between that and the poop culture. (If need be, tell her I AM crazy to know! ) It just seems in that gap of information is an answer you're going to need. Prayers and hugs, Mary

I'm so sorry this is happening. It seems beyond awful to have what's good for his tummy be bad for his lupus. Pepcid and similar things (Costco's version of Zantac) help Spencer's tummy a lot, and all three vets that have dealt with Spencer recommend them. I wasn't giving it religiously until I realized how much less gurgling occurs when he takes it! So he gets it twice a day, with his meal or a few minutes beforehand. I do recall that some kinds of medicines for acid reflux, which I used to have, significantly reduce B12 over time. Maybe that's what your vet was concerned about. I'm thinking you should flat-out ask him at this point! Meanwhile, I'll do a little internet research to refresh my memory about this and I'll get back to you. ETA: Okay, looked it up, and B12 requires stomach acid to be used, so that's an issue if you reduce the stomach acid. I don't worry about it since Spencer is getting B12 shots. So I'd say this: 1) give Pepcid or Zantac when Soul is having troubles (i.e., gurgling, loss of appetite) because there is probably excess acid occurring then, and you won't get a lot of B12 depletion if you don't give it twice a day for a long time; and 2) a bottle of B-12 and some syringes are very cheap, and the shots are very easy to give at home, then you don't have to worry about it. And I'd say any dog with significant GI trouble, not to mention bleeding, probably is low on B-12 and could use the shots anyway. I'd be happy to coach you about the process, and your vet tech can demonstrate and supervise you until you're comfortable with it. So PM me for more info and encouragement if you like. Spencer sends kisses to you and Soul! I do too, for that matter!

I'm so very sorry...

When did he last get some B-12? That affects appetite and everything to do with the nervous system, like mood and activity too. I've always fears that Tylan wasn't strong enough for him. You never said which germ it was, but you did say he had "way, way, way" too many of them, as I remember. Tylan is a very weak antibiotic. If your vet didn't use the C&S to determine which antibiotics that particular germ was sensitive to (susceptible to being killed by), and instead just threw tylosin at it because that's where many people start, it might have helped briefly because it was better than nothing. But if the medicine doesn't really fit the germ, all the germs aren't going to die. Which bacterium was it? And if the germ infection doesn't go away, you can easily wind up with IBD, which is a very big deal. I could be way off here, but you seem lost, and that's what I think, for whatever it's worth.

The vet and I both get that. But we feel that what may be ideal for getting an ironclad diagnosis is not best for Spencer and that the evidence we already have is far, far more than merely suggestive. In any case, there are other specialists if we need them and perhaps one of them is a bit less rigid. Thank you! We're hopeful. I feel really good about starting with budesonide. Yes, I can imagine that every dog with diarrhea could wind up being a topic of conversation if they didn't have some narrowing principle. I'll see if I'm permitted to read the posts even if I can't join. Thanks for the suggestion! Beau still doing great, I take it. Gained all his weight back. That's so cool!

We did talk about fiber at my urging. I was wondering if I should add beet pulp at least to his food. But the vet doesn't want to mess with that right now and is just saying give him calcium citrate in the absence of bones/necks. Since we're adding budesonide, she wants to watch his reaction to that and be able to surmise that any reaction he has is to that and not some other change. But I'm sure we'll get back to the fiber issue in a couple of weeks! Just got back from Costco where, emboldened by our tax refund, I bought steak for a change! But it's just a temporary treat! Fortunately, we like tortillas and cheese!

The internist is off the team. Her choice. No biopsy = no IBD diagnosis on her planet. So she won't play. (I understand most specialists would agree with her.) She wanted to do endoscopy if not surgery, but endoscopy can't get to the parts of the small intestine that the ultrasound demonstrated, structurally, to be problems. Well, it could get to the jejunum, but that's all. So the vet did put him back on Flagyl after we talked today, dosage reduced from 2000 mg/day to 1,000. Another C&S will show the bacterial status of things, so that'll be good. He starts budesonide, 2mg/day, on Monday when it gets here. And she's fine with sticking to raw venison. I don't know if she's that big a fan of raw, but he's doing well enough that she doesn't want to change anything beyond the meds at this point. (We may add Forti-Flora soon.) While venison isn't cheap, and DH and I have been getting by on tortillas and cheese , we did just get our tax refund, so for now it's all good. Vet said she had been guardedly optimistic. But now that she has read more stories of successful IBD treatment, she's "a step closer to plain optimistic." I love our vet! (She did say she'd read that budesonide may have two downsides: shedding and "goofy behavior." Thanks everybody for the PM's and posts, the support, and answering my endless questions. Spencer's a gentleman hound and would be mortified if I didn't express his gratitude as well.

Gosh, Robin, be careful of that pseudomonas! I'm sure you've looked it up by now. "Yikes" is right. Can't even imagine what it must be like to have strep along with it. Does Loca have a fever?

Played phone tag with the vet today; I was at a mandatory event so loud that I couldn't even hear my cell ring! But her message said her researches have led her to budesonide. Seems to her like people start with other things like pred but very often wind up at budesonide anyway. This is good because I'd reached the same conclusion! She didn't mention Flagyl, but I made an appointment for 8:30 tomorrow to discuss that with her; I think he is going to need it, but I'll take in a poop sample for another C&S to recheck the Clostridium. Two more are included in the fee, so I'm thinking Helicobacter, and I don't know what the third should be. They already ruled out Salmonella and E. coli last time. Her message said the internist recommends a low-fat food, and perhaps something by Royal Canin in particular. He's been on low-to-no fat for months anyhow on his raw diet. I'll discuss kibble, but if it's not no-grain/low carb, I don't think we're going to do it. And we're definitely not doing poultry either, so that probably lets most prescription diets out. I'll cook the venison if that'll make everybody happy! I've read Tigger's posts about Stevie's IBD treatment, especially from last Nov. 7. Their good vet recommended probiotics, glutamine, denamarin (SAMe & milk thistle) for liver support, and fish oil for Omega-3's, among other things. We've had complications with probiotics, but maybe keeping it simple, like with acidophilus, would be worth a try. Tigger, if you're reading this, I can't thank you enough for sharing Stevie's story. So that's how it stands, and I'm tentatively optimistic. As always, I welcome your thoughts. I'll post again tomorrow after actually talking to the vet about the food and Flagyl. Many thanks for your support. It sustains me and, therefore, Spencer. ETA: Vet's message said internist still wants to biopsy but, since I'm not going there now, she's consulting with my vet anyhow, I guess.

Yup, that's how I feel! Spencer had been doing very well, I thought: dark brown poop, starting to get texture even without any bone in his diet for a week, enthusiasm for walks and stuffies. Then DH took both dogs on two walks on Sunday, each of about 2 miles! (He knows walks make Spencer happy, and he wanted to make him very happy before he left for a week in Texas!) Problem being that Spencer then lost a couple pounds, visibly! And he became less vigorous about everything, less sure-footed, etc. So I've spent all week trying to increase his food intake a little and give him short walks. He's responding well, but his poop is going back from brown to yellow/orange and softening. So I'm hoping that getting him back on Flagyl will straighten that out. ETA: He has been less gassy and gurgly since he was switched from cooked chicken to raw venison. He would like to eat more than the 2 lbs a day I've been feeding him. If we can keep him on it, I've found I can get a better price on 5-lb buckets than on the 2-lb chubbs I've been getting. Thanks for the vote on the surgery. I would have felt better about doing it if Spencer hadn't lost 2 lbs just from walking 4 miles! I guess the internist isn't going to help with the treatment plan if we're not going to do the biopsy. So it'll be up to the regular vet and us, with help from GTers, to fashion a treatment plan if we don't biopsy.

Finally got a message from the vet at 4:00. (Didn't get to speak with her. We'll do that tomorrow, hopefully.) Expected to hear something last Monday, but she didn't hear back from the internist until today. Short course: The internist doesn't think we have a diagnosis because IBD can only be truly diagnosed through biopsy. Given the location of Spencer's problems, it would have to be surgical. The vet knows, on the other hand, that we're reluctant to put him through that. The ultrasound showed thickening of the small intestinal wall and parts of the stomach lining, lymphangiectasia of the lymph structures and dilated lacteals. So all that surgical biopsy would add, if I understand this at all, is identification of the particular type(s) of inflammatory cell(s) involved. This might or might not lead to better (i.e., more focused) choice of medicine? So our vet's message said that she's been reading and reading and reading to come up with a plan and that she has one. It doesn't include surgery. I don't know what it does include, but I'll find out tomorrow. I'm probably going to reject any prescription diet that relies heavily on carbs, as Spencer has not seemed to handle them at all for a long time. He's doing pretty well on raw venison which, since it doesn't contain bone, I can also cook if that seems like a better idea. And I'm leaning toward the budesonide/Flagyl/single novel protein solution that tbhounds suggested. (Venison was novel to him as of a week ago, and I'd just as soon stick with it.) Spencer dropped 10 pounds fast when he was briefly on prednisone, and I'm not eager to repeat that if we don't have to. Since he has been off Flagyl for a week, I'll take in poop tomorrow for retesting for his SIBO problems. So I'll post more tomorrow after speaking with the vet. Anybody have any thoughts relative to the questions I've posed or anything else? Particularly whether surgical biopsy is required? Thanks for all your help! I try to stay calm and clear for Spencer's sake, but JEEZ the waiting/worrying has been hard! Especially with Spencer being on no medicine whatsoever the last week.

Be as strong as you can manage, hon. We're all here for you.

I'm so sorry for your loss. You were lucky to have each other, yes?

Thinking of you and Zoe.

I'm so VERY sorry! Sending hugs and prayers.

Thanks, Robin. I'm so glad Beau has done so well for his sake and yours. And it encourages me that Spencer will get through it too. But I confess I'm more than slightly nervous about getting the food and medicine choices right!

Does anyone know what causes IBD? Would SIBO precede it or follow it usually? I'm guessing this might be a chicken-and-egg problem that could happen either way. But I'd love to know whatever y'all know. Yup, you're right, Terrified Yet Brave One, no kibble for months! Just got back from food-acquisition expedition. No, the ground venison does not have any bone included. A local pet store, Mud Bay (are they national or just regional here?), has deer antlers in plastic bags. The gal said the inside is soft. But the outside bony part seems like it would be really hard and dangerous to teeth! And it's the bone he needs rather than the marrow anyway, right? Still going to check with Bravo just for future reference. And I'll put feelers out for local hunters and raw feeders.

QUOTE(ahicks51 @ Apr 23 2009, 07:35 PM) 3967598[/snapback]As for which probiotics- that's an interesting question, and it happens with humans as well. I reacted very well the first time I took VSL#3, but so badly the second time I never took it again. I am leaving all bifidobacterial species out of my diet; the author of the diet I'm on never said why. About 6 months ago, I found a paper on bifidobacteria and pullulanase; turns out some bifidobacteria put out pullulanase. The bacteria I am combatting ALSO puts out pullulanase (the reason I avoid it) to "debranch" polymeric carbohydrates- the "branched" form of starch. So- that's how certain bugs can cause certain problems: molecular mimicry. Which probiotic did you use? The Purina one? Back to this question, the probiotic we used is called PB8 by Nutrition Now, Inc. It has 6 Lactobacillus strains and 2 Bifodobacterium strains: L. acidophilus, plantarum, rhamosus, casei, paracasei, and salivarius; and B. bifidum and longum. How do I find out if Clostridium (he has two strains) pulls out pullulanase? And whatever else I need to know about this kind of thing? You ARE really smart! And you're a treasure! As are the other H&M mavens and the non-mavens that nonetheless are brave enough to read H&M stuff and offer help and support! Thanks to all of you on behalf of all of us.