Need Help Diagnosing Problem

[Guest tore140]

Also, did that Sucralfate Liquid cost you an arm and a leg? I needed it but my vet told me it was pretty expensive, so instead we took the 1 gram pill, pounded it into a powder, and mixed with with water in a syringe.

[XTRAWLD]

Also, did that Sucralfate Liquid cost you an arm and a leg? I needed it but my vet told me it was pretty expensive, so instead we took the 1 gram pill, pounded it into a powder, and mixed with with water in a syringe.

 

Umm, she said it's not cheap but it wasn't expensive either and looks like the invoice says $37.50 for 120 ml.

 

I asked her why she chose Pepcid over Zantac for example and she said chose pepcid out of familiarity because she used a lot of it in the IV formulation at the intensive care unit. She said I could actually use either one, but I'll go for the Pepcid. She was actually also surprised that a vet didn't give us an antacid for use with prednisone because pred can cause GI ulceration. Reducing the acid in the stomach will help to reduce the risk of ulcers. This makes total sense, but I never discussed this with any vet for the past years Kasey has been on it.

 

Oh gosh, what underlying damage could there be do you think? He's been on low dose pred since 2008 (like 10 mg once a week). Would Pepcid take care of the ulcer itself if he had one as well as the acid reflux?

[Guest tore140]

Also, did that Sucralfate Liquid cost you an arm and a leg? I needed it but my vet told me it was pretty expensive, so instead we took the 1 gram pill, pounded it into a powder, and mixed with with water in a syringe.

 

Umm, she said it's not cheap but it wasn't expensive either and looks like the invoice says $37.50 for 120 ml.

 

I asked her why she chose Pepcid over Zantac for example and she said chose pepcid out of familiarity because she used a lot of it in the IV formulation at the intensive care unit. She said I could actually use either one, but I'll go for the Pepcid. She was actually also surprised that a vet didn't give us an antacid for use with prednisone because pred can cause GI ulceration. Reducing the acid in the stomach will help to reduce the risk of ulcers. This makes total sense, but I never discussed this with any vet for the past years Kasey has been on it.

 

Oh gosh, what underlying damage could there be do you think? He's been on low dose pred since 2008 (like 10 mg once a week). Would Pepcid take care of the ulcer itself if he had one as well as the acid reflux?

 

 

Glad the sucralfate wasn't much, that's affordable from the price I gathered from my vet. My understanding of sucralfate is that it actually helps the body heal from an ulcer by coating the irritated tissue and protecting it so it can heal. So if you do have some ulceration going on from the prednisone, the sucralfate will help it heal. The pepcid will help with the acidity in the stomach, so the ulcer will not get irritated from it. I imagine the sucralfate is only temporary until your ulcer and/or irritated esophagus heals, but the pepcid might be a maintenance for him to be comfortable.

[TheFullHouse]

Heard back from the vet this morning - "From what I've been reading through the vet lit so far, it sounds like esophagitis, which is essentially what we're treating him for now. I'd also like to start him on another drug that you can pick up from the drug store...it's an antacid called Pepcid (you may have heard of it) and will help with esophagitis as well."

 

Look at you GT'ers...helping to diagnose this. Thank you all very much. I'm truly grateful for your help. Looks like great minds think alike!

 

You can get the generic of Pepcid AC at Costco a lot cheaper. It comes 3 boxes to a package. I use it because I have acid reflux and it works great. The problem with acid reflux is once the acid gets into the throat it burns like crazy and makes you have a sore throat for a few days which may account for the licking. Laying down after eating also makes it worse because the acid travels to the throat. How to keep a greyhound up on it's feet for a while after eating might be a challenge though. Eating small meals during the day helps. It's the large meals that give you trouble. I'm assuming it's the same for dogs as people. You can also take Pepcid twice a day instead of once.

Edited January 4, 2012 by JillysFullHouse

[JJNg]

I asked her why she chose Pepcid over Zantac for example and she said chose pepcid out of familiarity because she used a lot of it in the IV formulation at the intensive care unit.

For oral dosing, Pepcid is also easier to dose with the tablet sizes available, especially for small dogs. For example, the Zantac dose range for a 66 lb dog would be 15-60 mg twice daily. Zantac comes in 75 mg tablets, some of which are irregularly shaped and difficult to split accurately.

[XTRAWLD]

I asked her why she chose Pepcid over Zantac for example and she said chose pepcid out of familiarity because she used a lot of it in the IV formulation at the intensive care unit.

For oral dosing, Pepcid is also easier to dose with the tablet sizes available, especially for small dogs. For example, the Zantac dose range for a 66 lb dog would be 15-60 mg twice daily. Zantac comes in 75 mg tablets, some of which are irregularly shaped and difficult to split accurately.

 

Yes I discovered that when I was at the store yesterday. I found 10mg pepcid after searching the shelves after only being able to find 20mg. They also had chewable versions, which I almost got instead, but it had added calcium and something else and because the vet said make sure it only has famotidine so here we sit. Would giving the chewables be ok too?

 

So far I think he's doing better. No major episode, but he did struggle a bit last night when eating for the first time since starting this. He also seems a little more spunky this morning and we didn't hear his stomach gurgling last night like we usually tend to hear.

 

Hubby sais last night he would like to try to get Kasey off pred to see if he'll be any better....I'm hesitant because when he goes for longer than a week without pred he really makes a mess of himself scratching at his ears. I dont want to see him constantly scratching and being bloody again. - he just suffers. But all the carpet is removed from our house and we have a good handle on his food intake not containing his allergens. Just not sure about it all.

[XTRAWLD]

To update on Kasey - our vet communicated with her circle of grey friends and basically here is a short synopsis I have compiled based on responses from 4 other vets.

 

Symptoms: Same as Kasey

Diagnosis: Esophagitis

Solution: Pepcid (no response to treatment. Switched to Ranitidine)

 

Symptoms: GI rumbling and discomfort.

Solution: Z/D trial, which resulted in significant improvement, then added in famotidiine

 

Symptoms: Same as Kasey

Solution: Hypoallergenic food trial & Metoclopramide. Pursue rads and some baseline bloodwork

 

Symptoms: Same as Kasey

Diagnosis: Postprandial regurgitation, caused by delayed gastric emptying due to some sort of inflammatory bowel disease. Lymphocytic plasmacytic enteritis common in greys.

Solution: Limited Ingredient Diet

 

While he currently is not on a Limited Ingredient Diet, he is on a food that fits his allergy requirements. We will be switching food on the weekend and are continuing treatment with Pepcid (famotidine) and the Sucra syrup. We will also be cutting out the Green Lipped Mussel additive for joint wellness (perhaps he does after all have a reaction to shellfish), and also eliminating the fish oil entirely.

 

I hear less belly grumblings, but maybe that's because I'm more aware. He seems to be happier, so in the very least he is experiencing some relief.

 

Thoughts to some of the diagnosis and solutions of similar symptoms?

Edited January 6, 2012 by XTRAWLD