Flagyl Instructions -- Empty Stomach?

[greyhead]

Spencer is still being treated for Clostridium-based SIBO. Two weeks of Simplicef, then two weeks on clindamycin, and much improvement but not done. Another week of Simplicef and no improvement.

 

So today we're to start Flagyl. Months ago we used 500 mg twice a day, now we're using 1000x2. Vet's instructions are give two pills, fast for 24 hours, then bland food. So second dose will occur during the 24-hour fast, but printed standard-instruction sheet says give with food (and standard practice with antibiotics).

 

Should I give him a mouthful or two of food with the second dose. Or at least follow it with a chicken neck to kill the taste in his throat? (He pretty much hates Flagyl!)

 

As to bland diet, he eats cooked chicken, and that's bland enough. But he eats about half ground raw food and turkey necks. The raw food is meat only, no carbs and low fat. Commercial bland diets aren't an option, as he can't handle veggies or grains. So do you think the raw meat is simple enough to qualify as bland? (We're using beef/tripe, buffalo, and sometimes venison for the raw.)

 

Can't believe this isn't over yet! And just FYI, we're doing abdominal ultrasound next Tuesday to see what's going on with his gall bladder (white/light poop) and whatever else looks interesting. We suspect gall stones.

 

Many thanks for any ideas/experience you can share!

Edited April 18, 2009 by greyhead

[Batmom]

Wouldn't give him raw anything until he's recovered. Cook it (no bones of course).

 

I would give him a slice of bread or similar with the meds.

 

 

[RobinM]

Wow, I am sorry you are still going through this. I would be surprised if it's stones, uncommom for a greyhound, but certainly not impossible.

 

Flagyl can be iffy on the stomach. I would also give the bread if he will eat it UNLESS he is grain intolerant???

[Guest SoulsMom]

When I needed to fast Soul, but also give him his Flagyl I gave his pills to him in a very small amount of the I/D diet.

 

Soul is not supposed to have grains either b/c of his Discoid Lupus, but in his case it was the lesser of the two evils. The bland I/D diet prevents the gastrointestional bleeding he would have, yet it causes his Lupus to flare up. I'd rather him have a bloody nose from the lupus than bleeding out internally like he was . . .

[Batmom]

Bread was just an example. Anything @ that size would do -- good slice of cooked chicken breast, hamburger patty, hardboiled egg, whatever he can tolerate.

[ahicks51]

Flagyl is awful. It tastes the same way a tire fire smells. No exaggeration- I've tried both. I prefer tire fires.

 

My solution was to cover the pill in peanut butter, and swallow it whole. If you can stuff it inside something that'll be swallowed and not chewed, good for you. I really have no idea why they can't put some sort of coating on it that prevents the taste from hitting the tongue before swallowing. It's absolutely dreadful.

[greyhead]

THANK you, everyone! Those are all good suggestions. This afternoon I just shoved the two pills, one at a time, to the back of his throat, and then I gave him a small chicken neck to get the saliva going to wash down any taste. Will probably do that again but also give some cooked chicken or peanut butter or whatever to protect his tummy.

 

Yup, still dealing with this! Good thing we love this guy so much!

[Blaidd49]

There is a product called Forti-Flora which you can get from your vet which [iMHO] is a must have when treating with Flagyl or Doxy

The difference is amazing [regardless of whether you are feeding raw or commercial]

Pam

 

THANK you, everyone! Those are all good suggestions. This afternoon I just shoved the two pills, one at a time, to the back of his throat, and then I gave him a small chicken neck to get the saliva going to wash down any taste. Will probably do that again but also give some cooked chicken or peanut butter or whatever to protect his tummy.

 

Yup, still dealing with this! Good thing we love this guy so much!

 

[ahicks51]

Tell you what- try coating the pills in butter. Even if the stuff so much as touches the tongue, the taste lingers for a long time; he may eventually wise up to your tricks!

[Guest PiagetsMom]

When I needed to fast Soul, but also give him his Flagyl I gave his pills to him in a very small amount of the I/D diet.

 

I did the same with Mirage.....made a little "meatball" with the I/D and put the Flagyl inside.....he took it with no problems, but then he's a food hound.

Edited April 18, 2009 by PiagetsMom

[greyhead]

Good idea with the butter!

 

Anyplace one can get Forti-Flora besides the vet? Just curious, as she may not have it, and I can't even ask until Monday.

 

Shane sends regards to his half-brother Piaget!

 

Spencer was going nuts earlier, wanting DINNER! Poor Shane is going to fast with him, for solidarity and because he can always stand to drop an ounce or 16. They both seem to have settled down and resigned themselves to...starvation!

Edited April 18, 2009 by greyhead

[Burpdog]

That is a very high dose. Watch for seizures.

 

It will tear up the stomach so with food is preferable.

[greyhead]

That is a very high dose. Watch for seizures.

 

It will tear up the stomach so with food is preferable.

 

Is it rare to give a dose that high? It does make me nervous. Would going for a 30-minute walk have any effect, for good or ill, on the likelihood of seizure? Maybe there's no proven correlation, but does anyone's experience suggest anything?

 

Tried the butter coating this a.m., and it was a total fight. He spit the pills out four times. I gave up on those as they were disintegrating and went with two new dry ones. Still a fight but got it done. So what IS the deal with these not being coated with something, as AJ suggested?! How hard would that be! This is going to drive me crazy.

 

The only thing about peanut butter is I'm afraid the stickiness will make him try to chew it. But I'll give it a try.

 

 

 

 

[Burpdog]

Have you tried canned meat balls? Tripe is good.

 

How much does he weigh?

[greyhead]

Have you tried canned meat balls? Tripe is good.

 

How much does he weigh?

 

He weighs around 80, down from his high of 89 thanks to SIBO!

 

I've never seen canned meatballs! And where does one get tripe? (I can try getting tripe from local raw-feeders who buy it in bulk, if I can track them down.)

Edited April 18, 2009 by greyhead

[ahicks51]

You can often get tripe-in-a-can from "botique" dog food stores. I dunno about Petco and PetSmart and those places.

 

You can get boiled tripe (fit for human consumption because it's boiled white, removing many of the nutrients that otherwise endears it as pet food) at some supermarket stores.

[Guest mandm]

How about getting some extra large size empty gel caps and stuffing the flagyl inside of those?

 

I wouldn't give A/B on an empty stomach, human or canine, especially when the problem is a bad stomach. Does the vet think the A/B will be more effective that way?

 

Yikes that's a high dose! Have you rechecked his cobalamin/folate levels to see if there has been improvement?

 

How does Spencer do when he gets no A/B? Has he had a break from his meds since you started treating him for the clostridium?

 

My greyhound had a bad case of SIBO and while his gut seemed to improve almost immediately after finding a diet that was right for him, his SIBO did not immediately improve. It took a while. And it takes a good amount of time for the gut to heal.

 

Probiotics seem like a good idea, but they made my SIBO hound worse. But I was treating my greyhound with very mild A/B, Tylan -- don't know if that makes a difference or not.

[greyhead]

How about getting some extra large size empty gel caps and stuffing the flagyl inside of those?

 

I wouldn't give A/B on an empty stomach, human or canine, especially when the problem is a bad stomach. Does the vet think the A/B will be more effective that way?

 

Yikes that's a high dose! Have you rechecked his cobalamin/folate levels to see if there has been improvement?

 

How does Spencer do when he gets no A/B? Has he had a break from his meds since you started treating him for the clostridium?

 

My greyhound had a bad case of SIBO and while his gut seemed to improve almost immediately after finding a diet that was right for him, his SIBO did not immediately improve. It took a while. And it takes a good amount of time for the gut to heal.

 

Probiotics seem like a good idea, but they made my SIBO hound worse. But I was treating my greyhound with very mild A/B, Tylan -- don't know if that makes a difference or not.

 

Hi Wendy! Yeah, I had the same thought about the gel caps. Don't know if mine are large enough, but I'll check. But if they're going in a gelcap, is there any reason I can't cut them so the pieces will fit? I didn't get to talk to the vet, but I think she wanted a 24-hour fast to rest the intestine and stop the diarrhea. But it probably would have made sense to hold off on starting the Flagyl until after the fast! In any case, he's eating now and seems none the worse for wear. (I gave him his pills followed by small amounts of food just to buffer.)

 

He hasn't had his cobalamin/folate rechecked, nor has he had a break from A/B. (He still does better after he gets his cobalamin shots, so i guess he still needs them. Actually, I was told he'd need them for life, though retesting was anticipated anyhow.)

 

Finished the Simplicef and could tell by texture and smell that he wasn't quite done, though much improved. Vet put him on clindamycin and he improved immediately but then slid back to D and smelliness. So when that round was done, she put him back on Simplicef. After a week of that I told her it wasn't working, and that's when she started the Flagyl on Friday. I'm not sure but I think Flagyl might have been the A/B that the lab microbiologist thought the Clostridium most susceptible to. When it had been tried at a lower dose weeks before that, there wasn't much improvement, and then he started refusing food. (I used to tuck it into some food, and he might have bit into a pill, tasted something worse than tires burning, and didn't trust food anymore!) So now I'm trying to just shove the pills far enough back to get them swallowed, without trying to hide in food. The gelcap approach is probably the most promising. Having him refuse food again is one of my biggest fears.

 

Probiotics also seem to make Spencer a bit worse. Sometimes he'll eat yogurt, sometimes not.

 

Hugs to you and scritches to Milt.

 

[Batmom]

FWIW, I pill most of the dogs by ratcheting open mouth and stuffing pill waaaaaaaaaaaaaaaaaaaaaay down their throat, then immediately offering a blob of peanutbutter for them to lick so they swallow. No coating needed, there's little/no chance to taste 'em.

[greyhead]

FWIW, I pill most of the dogs by ratcheting open mouth and stuffing pill waaaaaaaaaaaaaaaaaaaaaay down their throat, then immediately offering a blob of peanutbutter for them to lick so they swallow. No coating needed, there's little/no chance to taste 'em.

Good idea and one I'll keep in mind! But then again, Spencer has never gone for peanut butter, now that I think of it. Weird!

 

Tonight I fit the pills in gelcaps, which I notice did tend to stick at the back of his throat. (Gelcaps are NOT slippery.) But I immediately handed him his dinner, so the chicken chased the pills right down.

 

And just to update, we still had D on his walk, but it was brown instead of yellow, and it didn't smell vile! Not seeing any negative side effects from the med, but we'll keep watch. I imagine seizure risk increases the longer you give this stuff.

 

Thanks!

[Guest mandm]

I wouldn't think there would be any harm in cutting the tabs in order to stuff them inside gel caps. I think precaution against cutting pills is mainly for time-released meds. But I'm not sure. You could call a pharmacy and ask.

 

Metronidazole that I have given has always been vet supplied and are white uncoated tabs. But I looked up human flagyl and saw that they are film coated tabs. I bet the human version would go down easier. But they probably cost a lot more.

 

When treating my greyhound's SIBO, I used a different strategy than yours. I tried to keep it real simple and avoid all meds or anything that might upset my dog's stomach. My strategy worked, but it took real long. Maybe I could have cleaned him up quicker had I tried more meds. Your strategy seems to be working, and that's great. I hate to suggest another pill, it goes against my methods. But if I remember correctly, your greyhound was deficient in both B9 & B12, folate & cobalamin, is that correct? Mine was also deficient in both. And since you say the B12 shots seem to help a lot, have you thought of supplementing his folate with folic acid? That's a real easy pill to give.

 

Like Batmom, I cram pills so far back that my poor greyhound has no choice but to swallow. I've tried every way to hide them, even the fancy pill hider stuff that comes in a tube like toothpaste, but nothing works. He peels off the good stuff and spits out the pill like a cherry pit.

Edited April 19, 2009 by mandm

[Guest Energy11]

Spencer is still being treated for Clostridium-based SIBO. Two weeks of Simplicef, then two weeks on clindamycin, and much improvement but not done. Another week of Simplicef and no improvement.

 

So today we're to start Flagyl. Months ago we used 500 mg twice a day, now we're using 1000x2. Vet's instructions are give two pills, fast for 24 hours, then bland food. So second dose will occur during the 24-hour fast, but printed standard-instruction sheet says give with food (and standard practice with antibiotics).

 

Should I give him a mouthful or two of food with the second dose. Or at least follow it with a chicken neck to kill the taste in his throat? (He pretty much hates Flagyl!)

 

As to bland diet, he eats cooked chicken, and that's bland enough. But he eats about half ground raw food and turkey necks. The raw food is meat only, no carbs and low fat. Commercial bland diets aren't an option, as he can't handle veggies or grains. So do you think the raw meat is simple enough to qualify as bland? (We're using beef/tripe, buffalo, and sometimes venison for the raw.)

 

Can't believe this isn't over yet! And just FYI, we're doing abdominal ultrasound next Tuesday to see what's going on with his gall bladder (white/light poop) and whatever else looks interesting. We suspect gall stones.

 

Many thanks for any ideas/experience you can share!

 

 

I have had to use Flagyl for GI infections in some of my greys. I am a retired Paramedic, and worked for a vet for four years.

 

You could grind up the Flagyl and put in a piece of meat, cheese, or yogert. Those pills are HUGE, and I understand how hard it is to give them. MINE would eat ANYTHING in a piece of cheese or peanut butter :-)) I would try mashing them up and putting in anything you know your grey will eat.

 

Hope he gets better soon!