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Merlin Had A Relapse


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Merlin went back to the vet today to have his Lipase levels checked. Some of you may remember that he had haemorrhagic gastro-enteritis back in March and was pooping vast quantities of blood. We're still trying to figure out what's causing it, even though my vet is pretty sure it's IBD.

 

His lipase levels are still very high, by the way. But he's been ok on I/D and Flagyl.

 

About 45 minutes ago his stomach started to make loud noises and it's still bad. We are bracing for a relapse. My question is this: I have some emergency Sucralfate (Carafate) at home, which the vet let me have in the event of a flare-up (Sucralfate is what made him get better the last two times). When should I give it to him? Should I wait until I see for sure that he is pooping blood again, or can I just give it to him to calm his stomach a bit if he is exceedingly gassy, arching his back and pacing, etc? Also, I know it's supposed to be taken about an hour before a meal, but could I give him some hours away from a meal to see if it helps?

 

Any advice would be greatly appreciated... thanks.

 

:(

Edited by MerlinsMum

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Kerry with Lupin in beautiful coastal Maine. Missing Pippin, my best friend and sweet little heart-healer :brokenheart 2013-2023 :brokenheart 
Also missing the best wizard in the world, Merlin, and my sweet 80lb limpet, Sagan, every single day. 

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Kerry, give it NOW. Don't wait. It will not hurt him to have it "off schedule". At least get it started.

Will be praying for the best outcome, we don't want our Merlin going through that again.

 

sue

 

just checked my med book and humans take it before meals and at bedtime

Edited by dex95lucy
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I too would likely give it now. You know your dog. Doesn't have to be given before a meal; just, if you're feeding a meal, you need to leave that time in between.

 

Hope you can stave off any relapses.

Star aka Starz Ovation (Ronco x Oneco Maggie*, litter #48538), Coco aka Low Key (Kiowa Mon Manny x Party Hardy, litter # 59881), and mom in Illinois
We miss Reko Batman (Trouper Zeke x Marque Louisiana), 11/15/95-6/29/06, Rocco the thistledown whippet, 04/29/93-10/14/08, Reko Zema (Mo Kick x Reko Princess), 8/16/98-4/18/10, the most beautiful girl in the whole USA, my good egg Joseph aka Won by a Nose (Oneco Cufflink x Buy Back), 09/22/2003-03/01/2013, and our gentle sweet Gidget (Digitizer, Dodgem by Design x Sobe Mulberry), 1/29/2006-11/22/2014, gone much too soon. Never forgetting CJC's Buckshot, 1/2/07-10/25/10.

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I'm not a Vet and I don't play one on TV, but it is my impression that the two hour window before meals or meds is to allow the drug to work as intended: form a "paste" to coat the stomach in order to protect against ulcers.

 

Hope the Wizard feels better soon.

Linda, Mom to Fuzz, Barkley, and the felines Miss Kitty, Simon and Joseph.Waiting at The Bridge: Alex, Josh, Harley, Nikki, Beemer, Anna, Frank, Rachel, my heart & soul, Suze and the best boy ever, Dalton.<p>

:candle ....for all those hounds that are sick, hurt, lost or waiting for their forever homes. SENIORS ROCK :rivethead

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Carafate really is just a tummy coater-- it works for the upper gi. If you have any flagyl (metronidazole) left I would start him on that too. High lipase values usually indicate a pancreatic issue. How high was the amylase? Did your vet ever run a spec cpl test?

Edited to add- carafate should be given one hour prior to other meds as it will stop proper absorbtion of the other medications.

Edited by tbhounds
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Thank you so much. That's what I thought too.

 

Carafate really is just a tummy coater-- it works for the upper gi. If you have any flagyl (metronidazole) left I would start him on that too. High lipase values usually indicate a pancreatic issue. How high was the amylase? Did your vet ever run a spec cpl test?

Edited to add- carafate should be given one hour prior to other meds as it will stop proper absorbtion of the other medications.

 

Yes, that's the other reason I was asking... I am expecting to see bloody stools at this point (soon - he just pooped and it was fine, but clearly digested before his tummy issues started again), but if I give him Carafate now, hopefully it will help calm him stomach and the bloody stools won't last as long.

 

He is already on 500mg Metronidazole and has been on and off (give or take three weeks) since he had his first flare-up at the end of March. He is also on I/D.

 

I know that high lipase levels are consistent with pancreatitis... I actually don't think Merlin has IBD as such, I think he gets stomach ulcers and that's what causes this, but I am not a vet or even a vet tech, so I have no proof. Just a suspicion, I guess. Or it could be pancreatitis, and my vet did consider it for a while but thought IBD was more likely.

 

Thanks so much for this advice.

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Kerry with Lupin in beautiful coastal Maine. Missing Pippin, my best friend and sweet little heart-healer :brokenheart 2013-2023 :brokenheart 
Also missing the best wizard in the world, Merlin, and my sweet 80lb limpet, Sagan, every single day. 

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He's in a bad way :cry1 Please keep him in your thoughts.

large.sig-2024.jpg.80c0d3c049975de29abb0

Kerry with Lupin in beautiful coastal Maine. Missing Pippin, my best friend and sweet little heart-healer :brokenheart 2013-2023 :brokenheart 
Also missing the best wizard in the world, Merlin, and my sweet 80lb limpet, Sagan, every single day. 

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Sending prayers and light for a calm night with your sweet boy. :hope:candle

Jeanne with Remington & Scooter the cat
....and Beloved Bridge Angels Sandee, Shari, Wells, Derby, Phoenix, Jerry Lee and Finnian.....
If tears could build a stairway, and memories a lane, I'd walk right up to heaven
and bring you home again.

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Thanks everyone... Our night was less eventful than I feared, which is good... He did get some sleep. His stomach is still gurgling, although not as loudly as last night, when it was really alarmingly loud; and he is no longer pacing.

 

I will be feeding breakfast around 7am and will be giving him another dose of Carafate shortly, to give the meds time to coat his stomach before receiving food. However, I am in two minds as to whether I should also give him Pepcid. Currently he is taking Pepcid in the evening (20mg) ahead of his dinner, then 500 mg Metronidazole (Flagyl) after his meal. DH thinks I should leave the meds situation as it is and NOT increase the dosage until I have spoken to the vet. I am not so sure - the current low dosage he is on is to keep things on an even keel, but it's not high enough to manage a flare-up. I don't want to rush and increase his meds willy nilly, but I also don't want to extend the length of a flare-up for longer than I need to...

 

Any advice?

Edited by MerlinsMum

large.sig-2024.jpg.80c0d3c049975de29abb0

Kerry with Lupin in beautiful coastal Maine. Missing Pippin, my best friend and sweet little heart-healer :brokenheart 2013-2023 :brokenheart 
Also missing the best wizard in the world, Merlin, and my sweet 80lb limpet, Sagan, every single day. 

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Guest Stripeyfan

Hope Merlin is feeling better today! FWIW Kelly is going to be on a low dose of ABs (500mg/day) for the rest of his life for his IBD, but despite this he still flares up sometimes. I've found the best way to stop a flare-up is to fast him for 12-24 hrs (depending on the severity of the flare-up), then feed little and often for a couple of days, working back up to his normal amount of food. This way I don't have to adjust the meds. I also give slippery elm which really helps.

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Guest greytkidsmom

Thinking of you and your sweet Merlin this morning.

Kebo had a bout of stress colitis and his dose of pepcid was 15mg twice daily if that helps. He weighs about 76 pounds.

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Good thoughts for Merlin! I hope he feels better today.

Kyle with Stewie ('Super C Ledoux, Super C Sampson x Sing It Blondie) and forever missing my three angels, Jack ('Roy Jack', Greys Flambeau x Miss Cobblepot) and Charlie ('CTR Midas Touch', Leo's Midas x Hallo Argentina) and Shelby ('Shari's Hooty', Flying Viper x Shari Carusi) running free across the bridge.

Gus an coinnich sinn a'rithist my boys and little girl.

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Thanks! I was hoping you'd comment here, given your experience with Kelly. Merlin seems okay now - he didn't have any bloody diarrhea this morning, thank goodness. And last night was nowhere like the last few times. We slept downstairs in case Merlin needed to go out in the night, but he didn't ask to. He didn't try to eat grass or anything.

 

I don't know whether to continue with the Sucralfate until I can talk to the vet. And what about meds? Should I keep him on his usual dose until I've spoken to my vet?

large.sig-2024.jpg.80c0d3c049975de29abb0

Kerry with Lupin in beautiful coastal Maine. Missing Pippin, my best friend and sweet little heart-healer :brokenheart 2013-2023 :brokenheart 
Also missing the best wizard in the world, Merlin, and my sweet 80lb limpet, Sagan, every single day. 

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The biggest issue with IBD is maintaining a very steady routine about everything - food, meds, behavior. Their body needs that iron-clad schedule to keep on track. If it was me, I wouldn't change anything. You know this bout was probably because of th vet visit. That stress is over, so he needs to be back on his routine.

 

:kiss2 for Merlin (and Sagan if you can sneak one in without Merlin seeing it!) and :grouphug for you!

Chris - Mom to: Felicity (DeLand), and Andi (Braska Pandora)

52592535884_69debcd9b4.jpgsiggy by Chris Harper, on Flickr

Angels: Libby (Everlast), Dorie (Dog Gone Holly), Dude (TNJ VooDoo), Copper (Kid's Copper), Cash (GSI Payncash), Toni (LPH Cry Baby), Whiskey (KT's Phys Ed), Atom, Lilly

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Kerry, I'm just seeing this. I'm so glad he did well last night. Poor boy (and you, too). Is this something that will ever be "cured" and go away? Do they know what causes this? I hope your sweet Wizard's over the worst of it.

Sunsands Doodles: Doodles aka Claire, Bella Run Softly: Softy aka Bowie (the Diamond Dog)

Missing my beautiful boy Sunsands Carl 2.25.2003 - 4.1.2014

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I would not stop the carafate-- it's not going to hurt to continue--at least until you can speak to your vet on Monday.

Edited to add- you can give an average sized GH 1gr three times a day.

Edited by tbhounds
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