Ibd But Prednisone Not Helping

[Guest SusanP]

Following an ultrasound on Tuesday, Wizard began taking prednisone and metronidizole for presumed inflammatory bowel disease. Given his history etc, we and the vet believe this is the most likely diagnosis,and we are not willing to put him through a biopsy to rule out the less-likely intestinal lymphoma, given what he's been through, his age, and the prognosis should he have it. The vet did say that even if it's cancer we'd see some initial improvement on the prednisone.

 

But he's been on the meds since noon on Tuesday, and it's Friday morning now, and there is no improvement. In fact, I've been up since 1 a.m. with him taking him in and out and in and out. He's restless, as he is when he needs to poop these days. He did a little at 1 a.m. and has been peeing each time since then. Now it's 6 a.m. and he's restless but is no longer interested in going out to pee, either. Thinking the prednisone was finally making him hungry, I offered him a little canned Iams Low Residue, which he ate, but he didn't want a lot. He took his meds with cheese at 5;30, no problem. But I'm scared--It's like the prednisone isn't doing anything at all except making him slightly thirstier.

 

I'm calling the vet this morning, but does anyone have any ideas?

 

ETA: He's on 20 mg of the prednisone a.m. and 10 mg p.m. The vet he's seeing for this is a board certified internal medicine vet at a specialty and emergency center in a nearby city, the best clinic in the area. Her specialties are ultrasound, chemo, endoscopy, endocrinology and gastrointestinal diseases. Our own vet recommended her.

Edited April 16, 2010 by SusanP

[Batmom]

What are the prednisone and metronidazole doses?

 

Pred can make a dog restless, and you usually do need several days before it has a beneficial impact.

[Burpdog]

From what I understand, pred should not be used in greyhounds for IBD. Email Marilyn at Greyhound Adoptions of Florida.

[Guest SusanP]

I can't find any contact info for a Marilyn in sites related to Greyhound Adoptions. Do you have her email? I may try emailing OSU. I don't see anything about not using prednisone online. But I think he needs help pretty fast.

[RobinM]

From what I understand, pred should not be used in greyhounds for IBD. Email Marilyn at Greyhound Adoptions of Florida.

]

I'm sorry, but I strongly disagree.

 

Dr. Couto and my vet both reccommended to start at 40mg BUT it wasn't until we added in the 50 mg of imuran and upped the pred to 50mg that we started to see some changes.

 

Susan, reread my original answer to your previous thread and feel free to PM. I can you you with info.

[Guest SusanP]

Prednisone 20 mg a.m. and 10 mg p.m.

Metronidazole 500 mg 2x day

[Guest kydie]

I know how you feel, have lived with this for 7 years, these meds take a long time to help, my pup was on the for a least 2 weeks before i noticed a difference and was on them for 3 months, but he was also put on regalan, and some type of an antibiotic, wish I could remeber what it was, I keep pred, and regalan in my house at all times, so I can start it ASAP before I get to the vet Good Luck

[RobinM]

Prednisone 20 mg a.m. and 10 mg p.m.

Metronidazole 500 mg 2x day

 

We started on 40mg of pred too, but the flagyl made Beau sicker. After 3 weeks we added in imuran and upped the pred to 50. We were able to lower pred slowly after 3 weeks on the 50 of pred.

 

How was your pup diagnosed? How do you know it's IBD?

 

ETA- you need to not give him cheese. If he has IBD, he needs to be one one food. There is so much reading on this subject. One of the best places to get all the info in one place is http://pets.groups.yahoo.com/group/IBDogs/

Edited April 16, 2010 by RobinM

[Guest multigrey]

Many greyhounds can't tolerate high doses of pred for long periods of time. It really does a number on them. Adding imuran and a few other drugs seems to work much better over the long run.

 

When you have to do something quickly, you don't always have a lot of choices....hopefully he can tolerate the pred till you see enough improvement to go on and add/take away some of the meds.

 

IBD can be nasty and no two dogs seem to respond the same way to the many, many different combinations of drugs. It's exactly the same as with food....what keeps one dog alive can just destroy the gut of another dog.

 

Wishing you speedy, positive results.

[Guest SusanP]

It's the vet's day off, but the clinic is going to try to reach her at home and help us. I'll ask about both imuran and regalan.

[RobinM]

One more thought. If you know for sure that he can not tolerate the pred, there is always budesonide which most vets don't use. Including mine and they treat mega #s of greyhounds.

 

We switched Beau to budesonide after 1 year 1 month on pred. Big difference in his personality.

 

But before you start switching, you need to stabilize.

[Guest jskelton]

Cher, diagnosed via endoscopy, started out with 40 mg Prednisone twice daily, 500 mg Metronidazole (Flagyl) twice daily, 1 50 mg Azathioprine (immunosuppressor)daily. This really nipped it in the bud. Now she's on 10 mg Prednisone and 50gm Azathioprine every three days.

 

Arwen had IBD like symptoms but it was Intestinal Lymphoma. She was diagnosed 5 weeks ago. Without going for the ultrasound and getting a proper diagnosis, she'd be gone by now.

[Guest Stripeyfan]

No advice to add to what's already here, but really hope you start seeing some improvement soon.

[greyhead]

Spencer's IBD was diagnosed with ultrasound and symptoms too. Before the IBD dx, he had a very, very bad case of SIBO caused by Clostridium perfringens. We gave him prednisone, not knowing what he had, just that it ws intestinal, and he immediately went downhill. Dx'd the SIBO, gave three different antibiotics, serially, and then dx'd the IBD and started budesonide. A year later, he's doing great.

 

I had to INSIST finally that they test his poop for germs, and it was I who suggested C. perfringens be included (after reading an Internet article by a vet). I don't know why vets don't routinely do this, but they dont'.

 

Someone on GT had encouraged me, after the SIBO dx, to get serious about the then-possible IBD. She said, "SIBO won't kill your dog. IBD will." Well, I only found out this month that that's incorrect. One of the strains of C. perfringens (that Spencer had) leads to gangrene if not stopped, and that leads to death.

 

It stands to reason that any immunosuppressant, prednisone or otherwise, would not be doing any favor to a dog with a bacterial infection! So please, please, insist that they test the poop. Just because he has IBD doesn't mean he doesn't have something else too.

 

Please feel free to contact me if there's anything you want to talk about. (Email access through Profile page.)

 

All the hugs in the world,

Mary

Edited April 17, 2010 by greyhead

[Guest SusanP]

You know, I was wondering about a fecal test, and I was going to ask the vet about it next. Now I know I should push for it. Neither dr. even mentioned doing one at any time. But what is SIBO?

[ahicks51]

But what is SIBO?

 

Small intestinal bacterial overgrowth. The gut of carnivores is necrotic, versus fermentative (in vegetarians). Feed a carnivore too much vegetable matter for too long, and bacterial growth is the result. Sufficient bacterial growth can cause things to go seriously out of whack, and make it difficult to re-establish a healthy flora.

[greyhead]

Yes, AND Clostridium also lives in dirt and can be picked up that way, so I imagine some of the other nasty germs can too.

 

I'll try to dig up my articles to give you some backup with your vet. I'll even contribute my vet's phone number if he has any questions! ( But DH is returning from airport imminently, and I'm looking for my lost wedding ring, so give me until tomorrow for the articles, okay? Or let me know if you really need them sooner.)

[Guest jurishound]

As far as I know, IBD can only be confirmed by endoscopy. Is your dog on a limited antigen diet? If it truly is IBD, no drug in the world will help until the protein that is cauing the inflammation is eliminated from the diet. We are treating at Angell Memorial in Boston, with pred 30 mg for 7 days, 20 mg for 30 days, 10 mg for 30 days, then 5 mg every other day; 63 mg azathioprine daily; metronizadole (flagyl) 500 mg for 14 days, 250 mg for 30 days, 250 mg every other day; and fortiflora. Royal Canin RX venison and potato limited antigen diet. NOTHING else, not even a lick.

[greyhead]

Susan, here is a link to a recent thread where in my reply to it I gave a link to a good vet article on SIBO. I'm so sorry I can't be of more help right now. Still have sick dog and lost wedding ring. I'll keep checking back in though.

 

How is your pup today?

 

ETA: Okay, found the ring and my life is my own again! I see your other thread now too. Sounds like he's doing well enough this a.m.

 

ETA: I fotgot to past the link before! It's post #8. http://forum.greytalk.com/index.php/topic/251196-diagnosis-for-kelly/page__p__4464262__hl__Clostridium%20__fromsearch__1&?do=findComment&comment=4464262

Edited April 18, 2010 by greyhead

[greyhead]

Susan, see Stripeyfan's thread about Prednisone in H&M today. There's also a possibility of SIBO in that case, and there's mention (by me) of why you should test the poop with a C&S (culture and sensitivity) rather than with a standard fecal in the vet's office.

[Guest Hazel]

Following an ultrasound on Tuesday, Wizard began taking prednisone and metronidizole for presumed inflammatory bowel disease. Given his history etc, we and the vet believe this is the most likely diagnosis,and we are not willing to put him through a biopsy to rule out the less-likely intestinal lymphoma, given what he's been through, his age, and the prognosis should he have it. The vet did say that even if it's cancer we'd see some initial improvement on the prednisone.

 

But he's been on the meds since noon on Tuesday, and it's Friday morning now, and there is no improvement. In fact, I've been up since 1 a.m. with him taking him in and out and in and out. He's restless, as he is when he needs to poop these days. He did a little at 1 a.m. and has been peeing each time since then. Now it's 6 a.m. and he's restless but is no longer interested in going out to pee, either. Thinking the prednisone was finally making him hungry, I offered him a little canned Iams Low Residue, which he ate, but he didn't want a lot. He took his meds with cheese at 5;30, no problem. But I'm scared--It's like the prednisone isn't doing anything at all except making him slightly thirstier.

 

I'm calling the vet this morning, but does anyone have any ideas?

 

ETA: He's on 20 mg of the prednisone a.m. and 10 mg p.m. The vet he's seeing for this is a board certified internal medicine vet at a specialty and emergency center in a nearby city, the best clinic in the area. Her specialties are ultrasound, chemo, endoscopy, endocrinology and gastrointestinal diseases. Our own vet recommended her.

[Guest Hazel]

Hi, I also have a dog with IBD her breath was so bad that was my vets first give-away. We put her on 10mg pred and each meal 1 tbl of pepto. worked like a charm. I will say with just the 10 mg of pred I did not like the way my girl was acting, very figgity, not relaxed and she would dribble out pee at random times. you could see she was not liking it.

my vet told me to go to 5mg and its been perect ever since. HOWEVER my dog is home feed.NO rice, corn,oatmeal, wheat ect af ANY sort. chicken, turkey, mackeral, spin, beets and sweet pot for the carb. THIS IS IT it has helped her sooooo much. dog food was poison to her, i do add an enzymn to help digest food.

her snack is another cup of sweet pot. i give 1 1/4 meat 1/2 veg 1 1/4 pot twice a day.

hope you can take something from my book I just wrote

[Guest SusanP]

Thanks for all the information you've all given me. I will finally be able to discuss this with the vet tomorrow--It's been a long weekend.

[Guest MZH]

Entocort often works when all else fails. So might Tylosin powder. These are my last resort things.

 

I'm on Entocort on a very low maintenance dose. It lets me leave the house without having to wear a pad of some sort. That plus going gluten-free has changed my life. It sounds dramatic but it really is to me.

 

Edited because my brain sometime works faster than my fingers.

Edited April 19, 2010 by MZH

[Guest SusanP]

I will finally be able to discuss all this with the vet today. Or DH will call her early this morning from work-I'll be teaching a class all morning and won't be able to phone. One thing that frightened me yesterday is that several times, Wizard's scalp began either visibly jumping or I could feel it vibrating with my hand. His jaw, too, and he clacked his teeth together repeatedly in a slow, rhythmic way. I don't know what it means, but I don't feel like it's good. Does anyone know?

He ate less yesterday, too. But he did opt to go down the stairs and out in the yard with the other dogs and walk around, and he's no longer having accidents in the house.

 

I"m counting the hours til we can get some answers and shift gears here. I'm just not sure how much more I should put my boy through.

 

We got off to a slow start diagnosing and treating this because his symptoms were so atypical--weightloss has been minimal, no vomiting or diarrhea. Just a variety of symptoms associated with huge amounts of gas in his poor intestines. I wish this would all move faster to bring him some relief.

 

Thank you all for the ideas you have given us. Susan