greyhead

Very glad to hear that!

I agree with the above. And if our experience is at all typical, and I fear that it is, the problem is made worse by vets who don't take these problems seriously to start with, don't do appropriate testing and treatment, and then things escalate from small problems to big problems. So to the above list I'd add vets who think they know about greyhounds but don't know enough, don't understand the implications of coming from tracks/kennels, don't quite register that coming from other states means exposure to problems not native to the current state (e.g., types of worms, TBDs), don't tell owners that negative fecal tests don't mean absence of worms, and don't suggest fecal cultures instead of fecal tests in response to indications of bacterial infection or overgrowth.

The reason for starting budesonide, as I understand what I've been told, is that the oncologist says the pred isn't doing any good at all. Jordan PM'd me some very helpful info. I'm thinking I'll tell my friend she might as well go ahead with the oncologist's plan but have meds on hand for severe pain and a plan for the end.

These special dogs have a distinct presence, and we feel it when it's gone. I'm so sorry she had to leave. But you did her proud throughout. Godspeed, Phaedra.

I'm so sorry, Judy. Thanks so much for saying this, as hard as it must be. I'll make sure my friend hears it, and I'm sure she'll take it to heart.

Right, I forgot she's a blood donor! I wouldn't go for PCR either.

I didn't think so, Tracy. They used pred exclusively. Then he had a flare much later, and then they may have tried budesonide. Thanks for the input, Kathy and Jey. I wasn't comfortable relying on the human Crohn's experience, but it would be a relief if this doesn't have to be handled like NSAIDs. On the other hand, I don't think there's a lot of experience with these meds in greyhounds. The only thing is, I distinctly recall a hound passing away from IBD last spring when both pred and budesonide were given at the same time. That poor dog was in bad shape before the budesonide was added, but a couple people here said they shouldn't be given simultaneously. One was Burpdog, but she hasn't responded to me on this. ETA: Thanks Meghan. You posted while I was writing. I share your concern about the spine. And I guess human experience is what she might have to go on.

Actually, Jen, what I've wondered about with Violet is whether she has an underlying TBD. Has she been tested? I say that because Shane has two, always tended to overheat, and the overheating went away after treatment -- until lately. And apparently you don't really "cure" a TBD, you just get it into remission, from which it can later reemerge.

Okay, just got an email from S. that she sent 30 minutes ago. I'll just copy it here: "The doctor came back with direction for switching the meds. "She said to decrease predonizone 20mg/day to 10mg/day starting from today for 5 days, the predonizone will be stopped, but get him on Budesonide 2.8mg/day starting right away at the same time. "I thought they never should be given at the same time, and told her I'm not comfortable with it. Then she became pretty aggressive and telling me its my choice following her instruction or to my friend (which is you), such & such that I really felt uncomfortable. "Telling her that I'm not even trying to argue with you, and why she has to be aggressive. I think she was offended, but what can I do except being honest and tell my feeling to it. "Anyways, she said it's okay if to reduce predonizone for 10mg/day for 5days, and not starting the Budesonide till after 5days stopping with predonizone, if that will make me feel better. "Do you think it's better waiting for 5days instead of start given at the same time, like how I feel??" I said I'd start decreasing the pred, as instructed, but wait at least a couple days before starting the budesonide, just to give herself time to think (and for me to ask your reactions)! It's so weird because when we talked earlier, she sounded so relieved because the vet had sounded so on-the-same-page (as in never, ever give those two meds at the same time)! So, any thoughts about what she should choose?

Texted S. to inquire about the cancer, and she said it's small-cell lymphoma in the intestine. She added: "But there's also sign of cancer with spine just found out also, can be lymphoma or another kind." I know the intestines were biopsied, but the spinal thing is brand new. I hope the "sign" is really something else!

Yes, Jen, I do think that's possible. Much depends, I think, on how much hookworm they have when they're treated. If it's a brief and recent infection, so the number is small, then briefer treatment will probably do the trick. But if they are a lot of them and they've been there a while, have to treat much more aggressively. As to dormancy specifically, I don't think we know what motivates it. Just speculating, anything that makes their environment less than ideal for them could lead to dormancy; that would include the number of worms (e.g., increased competition for resources). It might also include Flagyl, since that seems to knock them back a bit but only temporarily. Elizabeth, glad to hear there's an extensive treatment program planned! The only difference between Drontal and Drontal Plus, IIRC, is that the latter also treats tapeworm and is more expensive. I'll just add that Spencer never had diarrhea from hooks, and the pudding poop appeared cyclically. I was interested to note that the fecal picked up hooks at a time when his poop was in good form! (Of course, it was also found on equipment superior to what had been used for the fecals previous to that. But still, it may be worth noting that egg shedding doesn't necessarily occur when the poop looks the worst.) We'll cross our fingers and paws along with you! Please let us know how things work out.

Thanks, Tracy. I don't know what kind of cancer it is, but I know what you mean and I had the same question. (My friend's English is somewhat limited, so I try to just deal with whatever concern she presents me. She knows I have no cancer experience, so we've never gotten into the specifics of that, especially since I'm not sure that even she knows.) It appears that maybe this cancer is the kind that morphs from IBD and then spread, but I'm guessing. My friend just called -- we'll call her S. here -- and the conversation with the vet went well. Turns out the vet isn't intending to just switch abruptly or to give them both at once. She intends to taper the pred. Now that she realizes how upset, uncertain, and overwhelmed S. is, the vet is going to call several other oncologists and ask their advice about how to best make the switch. The reason for the switch, in the vet's mind, is that the pred has done no good whatsoever, as far as she can tell, and there's nothing to lose at this point in trying another approach. (Why do they always wait until the 11th hour to try budesonide?!) She did say that the dog doesn't have much time left. So the vet has ordered the budesonide, it will arrive at her house from the pharmacy tomorrow, but S. doesn't know what dose is ordered. I told her it should probably not be more than 3 mg., and 2 might be better to start with, but whatever. I told her about Spencer's tongue swelling alarmingly the one time we tried 4 mg. for a flare early on, so she'll be on the lookout. The vet will let her know ASAP what her other oncologist friends have to say. Thanks so much for the help, Kathy and Tracy. S. loves this dog more than life and is beyond grateful for any and all help.

I'm very sorry for your loss, Mary.

I'm so very sorry for the loss of your beloved Manero.

The TOTW food sounds pretty rich for an older dog. If you want to keep feeding 3 cups, perhaps you'd consider switching to a Natural Balance formula like venison and sweet potato. It's yummy but nice and simple.

Friend is at the oncology office now but doesn't know how soon she'll be seen. The dog will get chemo. She asked if she could have the oncologist call me, if only so I can help my friend understand what the vet is saying. I said sure. Yikes.

Thanks, Kathy. IIRC, you don't just stop pred all of a sudden, you always taper it, right? So if the oncologist is proposing to start budesonide immediately, the dog has to continue on the pred while tapering, yes? (The budesonide has already been ordered and is arriving today.)

Just ran across this and thought of you, Colleen. http://www.petmd.com/blogs/fullyvetted/2013/may/new-treatment-options-for-inflammatory-bowel-disease#.UjDiP1jn9kA

A Japanese friend has an older grey with intestinal cancer that has spread to the spine. He's going in for chemo in an hour or so. The oncologist has finally consented to try budesonide, which I'd recommended when it looked like he had IBD. Since budesonide targets the GI tract, maybe that's not a bad idea, even though it's now cancer. But he has been on prednisone for a long time, and this oncologist is proposing to start the budesonide right away. I'd heard here that a two-week wash out period would be required between the two meds. My friend mentioned this to the vet, but the vet said that she hasn't seen anything in the literature to that effect. My Japanese friend loves her dog dearly. She even came back here from Japan to get better treatment for her dog than he was getting there! But she's very polite, not at all argumentative, and isn't sure how to get the oncologist to back off. The dog has lost a lot of weight and now can't even get up without assistance, I think. So perhaps being off pred for two weeks and without anything else is not a good idea, which I told my friend. But she's afraid that she can't explain to the vet why she no longer wants to switch from pred to budesonide. So can any of you point me to anything, anecdotal or otherwise, that my friend can use to support her position? She's desperate, and I'm desperate to help her. Many thanks, and please hurry, Mary

There have been stories like this on GT -- from me! And I started reading on GT about problems around hook diagnosis and treatment in 2006, when we got the diagnosis. It's true that vets in many states don't expect hookworm, can't identify hook eggs in a fecal, don't have the best equipment for finding worm eggs (and don't send the sample to a lab that does have it), and treat by standard labeled instructions rather than aggressively. Back in 2006 I did an archive search here and found several people whose dogs had been bedeviled by hooks; they all recounted the aggressive treatment that had been required, including using Panacur, for instance, for 5 to 7 straight days instead of the recommended 3. They also spoke of needing to follow up with Drontal, as hooks not already killed would tend to have become resistant to Panacur. The dormancy problem is what's responsible for the permanent hookworm cases, including Spencer's. The meds can't kill the dormant hooks since they're encased in impervious cysts. They hatch when who-knows-what motivates them to do so. Stress, anesthesia and, apparently, whelping are things of which I've heard that seem to persuade hooks to emerge from dormancy. The lifecycle of hooks is three weeks. Thus, an internist told us to administer the Interceptor we used every three weeks instead of every four as recommended on the label. She said she had one dog (a terrier, I think) she directed to take it daily (for some period of time), but that that was highly unusual, under supervision, and shouldn't usually be done! As most folks on GT know, Spencer wound up with a raging Clostridium perfringens infection (SIBO) after a dental. It got that bad -- indicators were soft-serve poop that was first orange, then yellow, and eventually smelled totally vile -- because it took months before they did the right test to find it. They'd given a low dose of Tylan and, when that didn't clear it up, assumed that it was not the SIBO it actually turned out to be. And whenever I'd asked them to test the poop, they'd tested only for worms, not bacteria. I finally just *told* them to culture the poop, by which time he'd lost 20 lbs. I mention this because poop cultures are another thing that seem to be rarely performed. And, most importantly, when we find one thing wrong, like hookworm, we and the vets tend to assume that we've found *the* problem. So I really want to urge people to keep looking for additional issues if worming doesn't clear all the symptoms. Spencer didn't have PLE or PEI despite the orange/yellow poop. He had orange poop because the undiagnosed Clostridium was wreaking havoc on his whole GI tract, ending in IBD. It's also true that we learned to recognize a hookworm resurgence more reliably by symptoms than by fecal testing, due to the problem with timing the fecals. (You'd have to test three or four weeks in a row to be sure you tested during the egg-shedding stage.) In Spencer's case symptoms including inappetance in the morning; jumping as if being bitten by something (hooks do bite); and repeated throat clearing followed immediately by swallowing (they'd migrated to his lungs), which is easily mistaken for a backward sneeze. I think that whatever worming schedule the kennels at the track follow when the dogs are racing may not carry over to the adoption kennels, or at least didn't back in 2005 when we started adopting. There may not be a budget for it? Anyhow, that might be an area to look into if we want to figure out why newly adopted racers turn up with worms.

As well as the touching beauty of your feelings and memories, what strikes me is how well-matched you and Wink were. That was an enormous gift for you both.

Welcome from Seattle! What a happy family!

Amitriptyline has "dry mouth" among its SE's. If stress happens, having a dry mouth can get ugly. Nortriptyline is better in this regard and has fewer anticholingeric SE's in general, but it's the same class of drug, so...

We've noticed that Shane's episodes are preceded by car rides too, and we have a couple theories about how that happened. In any case, we've decided to start taking him for car rides in a different car than the one we've been using and for short durations initially, gradually extending the time. We're also not going to stop anywhere in particular, as ending in an unpleasant or ambiguous place is part of the problem. In short, we'll be going for "pointless" rides. For what it's worth, we think everything with Shane is complicated by ongoing pain (LSS, arthritis, etc.). So we'll see if having him back on daily Tramadol helps too. Good luck with Violet.

How is Atticus doing now? The green color can be due to a bile issue, which may or may not be a big deal. It may be that he's getting more than an optimal amount of tuna, which can be too rich for frequent consumption. If the green and smelliness persist, there may be a problem that a vet should consider. Analyzing the poop for bacterial overgrowth may also be a good idea.