Metronidazole

[greyhead]

When Spencer was acting like this, isolating himself in the guest room and being nervous, it was before we found the intestinal malabsorption (through Texas A&M), which I assume is the diagnosis you also received. He even started having trouble getting up, and he showed cognitive confusion. The B-12 shots took care of all that. But we gave them twice a week for several weeks, longer than the standard protocol. Even now he gets them every two weeks when the protocol says every four, because he just does so much better with more frequent shots.

 

We opted not to do the intestinal biopsy, which it sounds like your vet is proposing to do. My vet mentioned doing it too, but she added that the results wouldn't really change the treatment! Since Spencer was already so depleted, we opted not to set him back further by such drastic surgery. And I have never regretted that decision for a minute. We did learn a lot by doing an ultrasound of his stomach, intestines, and other major organs. It showed structural changes consistent with IBD, as were his symptoms. So I'd go for an ultrasound done by a really good/experienced radiologist so you can be sure they understand what they're seeing.

 

Hope you can hang in there. We're here for you. It was kind of a tough fight getting Spencer properly diagnosed and treated for all his intestinal issues, but three years later now I'm thrilled to have a reasonably healthy and entirely wonderful senior boy!

[JJNg]

I feel like we don't have all the information here... Is Huck eating and drinking ok? Is he producing stools? Any fever? If he is truly having "extreme pain in his stomach" persistently, that may be grounds to do an abdominal exploratory surgery. But ultrasound would be a less invasive test to do first, before going straight to surgery.

 

What are the signs Huck is showing that indicate abdominal pain? Panting, pacing, and avoiding interaction can be behavioral signs as well as side effects of medication, as Batmom mentioned. A dog with severe abdominal pain will often walk or stand in a hunched position. They will tense up or cry out (or turn around and try to bite) when you palpate or even gently press on the belly area. And this is should be a consistent, repeatable finding.

 

Several years ago, my mixed breed Corey started vomiting a little (just once or twice a day) and acting like his belly hurt. He would walk around hunched up, and you could tell he didn't feel good. Bloodwork, x-rays, and even a barium series were completely normal. Of course, this started a couple days before a holiday weekend, and I was going out of town with all the dogs to go lure coursing.

 

Long story short, his abdominal pain became extreme late Sunday night/early Monday morning (around 3 am) on Memorial Day while I was in Georgia. He woke me up crying in pain and gasping with every breath (I could tell it wasn't respiratory distress, he was in pain). So I rushed him to the UGA vet school where they called in the radiology resident to do an emergency ultrasound. The ultrasound showed signs of infection in his abdomen (septic peritonitis) and they did an exploratory surgery to find a tumor on his cecum (appendix) that had ruptured. They were able to remove the tumor and he's doing great now, although he had to have another surgery for a recurrence 2 years later, and is now on Palladia.

 

Anyway, bottom line of the story is that severe abdominal pain that warrants surgery is pretty obvious. If Huck is eating and drinking and not showing such obvious signs of persistent abdominal pain, I wouldn't do the surgery. Even if he is, it would better to start with an ultrasound. Best of luck, and I hope Huck is feeling better soon!

[Walliered]

I have canceled the surgery and am asking for an ultra sound. While he is out for that I have asked to do a dental on him. Also am asking for a consult with OSU and to recheck his blood for malabsorption of his food (I guess that will be done at Texas A&M again?) Thanks for the encouraging words. I love my greys very much, but once they are gone I can promise you I will never have another one. Their health issues have been very stressful for them and for me. I cannot afford the constant vet bills nor the over the top worry. Thanks for e-mailing me.

[JJNg]

I have canceled the surgery and am asking for an ultra sound. While he is out for that I have asked to do a dental on him.

Will they be sedating/anesthetizing him for the ultrasound? That shouldn't be necessary.

[Walliered]

Oh, I just assumed they would put him under,but I have no idea as we have never done one. That is why I thought she could go ahead an do a dental. He had one a year ago when she had to pull an upper molar that was cracked in half to the bone. That is the way he came to me from Augusta.

[Batmom]

Unless he's a total fruitcake, they shouldn't need to anaesthetize for the ultrasound .

[Walliered]

Huck is eating all of his food every meal. His poop ranges from normal to very, very soft..like you cannot get it out of the grass. He has only panted a little today. He has been asleep for the last 5 hours (after his dinner). For the last week he has been confused, panting and pacing. He stays way back in the house all by himself and is spooked at the slightest thing. The 5 gallon bucket and the mop handle nearly put him over the top. She only pushed on his stomach once and he screamed. I have not tried it at home, because I am not going to hurt him. He does not have a fever and has not had one that I know of. He is not walking in a hunched position. But he does stand around and act like he does not know what to do. He will stand in one place for a very long time. If I go up to him he will follow me to his crate and get in, but may not lay down for several minutes. He does not act like it hurts him to lay down or get up.

[Batmom]

I really would try taking him off the meds (metronidazole and tramadol) and see how he is after a few days.

 

Joseph acted so bizarre and distressed the first time* I gave him tramadol, I was a whisker away from taking him to the e-vet. Panting, pacing, standing rooted to one spot and staring at nothing, unresponsive .... I haven't seen serious neuro side effects from metronidazole but I have seen lethargy, "leave me the heck alone" crabbiness, and reactions similar to tho somewhat milder than those from tramadol.

 

 

 

*I have given him tramadol once since then, long story but had no other good options. He does OK with it if I give a very small dose first, then add on a second dose an hour or two later (the 2 doses making one low-normal dose for a dog his size).

[Walliered]

He was doing the constant panting, pacing and all the other stuff about 4-5 days before she put him on Metronidazole. It did not change anything until today (I am not sure the meds changed anything). So, since I obviously do not know what I am doing, what would you suggest he go on to ease these symptoms? She thinks his immune system is shot. I know my Mother was on Pred for so long that it became her immune system and she could not live without it. I do not want to put him on this med long term. The reason she did not put him on any meds is because it was Labor Day weekend when he started all of this. I have not given him Tramadol since yesterday.

[Batmom]

Impossible to know what meds to give until you know what's wrong. If a dog is vomiting, you can safely give Pepcid (10mg famotidine) 99% of the time. If a dog has nonhemorrhagic liquid diarrhea and you're unsure of the response to metronidazole, your best bet is a 24-hour fast followed by whatever bland, easily digestible food your dog can tolerate (for us, that's usually overcooked rice and partly defatted, cooked beef). In either case, you want to watch for dehydration.

 

As tbhounds I think suggested, he should have bloodwork, and probably a urinalysis and fecal exam, as well as the ultrasound.

 

I'm not sure what would lead a vet to say a dog's "immune system is shot"?

 

Have you considered a second opinion? You can get a review of his tests and records for free from OSU's Greyhound Health & Wellness Program.

Edited September 11, 2011 by Batmom

[tbhounds]

True ibd is an immune mediated disease-- perhaps that is what your vet is referring to. When my ibd boy had a flair he too would stand in the corner and not want to lay down-- he hurt. Ibd is a pita disease but, can be controlled once properly diagnosed. As I mentioned before there are certain blood tests that should be done -TLI, bile acids and a chemistry checking his protein levels etc. A skilled Dr performing the ultrasound should give you some answers but, an endoscopy may be reccomended. Of course sometimes abdominal surgery may be necessary. Going to surgery will allow the Dr to get true cut (full thickness) biopsies. However, as I mentioned before I feel diagnosing ibd is a step by step procedure and jumping to surgery would not be how I would approach this.

Most often Ibd can be controlled with medications some of those being antibotics, pain control and yes, perhaphs a corticosteroid (pred or budesonide) and a novel food.

I understand your frustration-many of us that have or had dogs with ibd will understand what you are going through. Please no flaming here as I'm not suggesting you don't love your hound but, have you considered talking to your adoption rep about possibly re-homing him? I only suggest this because I do understand that we all have limited funds and not everyone can emotionally handle a long-term disease such as ibd. Only a thought.as I sensed your frustration in your last post.

[Walliered]

The adoption agency where the grey came from is no longer in business. So, he will not be going anywhere. Besides, I really do not believe anyone would adopt a dog with these problems.

 

Anyway, he ate all his food and we walked for about an hour (60 degrees) here. He wanted to keep walking, but I stopped. He immediately went into his crate in the back part of the house and that is where he is now. There is no panting and no pacing and no acting confused.

[Batmom]

Hoping very much that you can get to the bottom of things.

 

Can understand how worried and "what next????!" you must feel.

 

Hugs to yourself and scritchies to your good boy. If only they could talk, eh?

[Walliered]

Results of last blood test done on 4-11-11 Texas A & M Cobalamin Fasting 179 ng/L Control Base 251-908 Interpretation: Consistent with distal small intestinal disease, EPI or small intestinal bacterial overgrowth. Check canine TLI to rule out EPI. Consider cobalamin

supplementation

 

TLI Fasting 6.8 ug/L Control Base 5.7-45.2 Within normal range

 

Folate Fasting 8.4 ug/L Control Base 7.7-24.4 Within normal range

 

Pancreatic Lipase Immunoreactivity Fasting 59 ug/L Control Range 0-200 Within normal range

 

They sent me a really long list of the blood test results. The only one out of range was Creatinine and it was 1.7 with a range of .05-1.6 mg/dL

[Walliered]

Thanks Batmon. Yep, I am pretty worried. He is only 5 years old and I think he has hurt with one thing or the other since I adopted him...but he came with the cracked molar. I was told he broke his upper jaw at the race track and the lasting result of it was the tooth..She pulled it about 1 week after I adopted him. What was so sad was when the adoption vet did his dental he noted the tooth was "damaged" to the bone and needed to be watched. Why didn't he pull it while the dog was under? Didn't think much of the vet's decision. Thanks

t