Merlin's Continuing Health Issues

[MerlinsMum]

I meant to post a nice, positive an update on Merlin's IBD issues a while ago, but it's been crazy at work. Then, a week ago, DH asked the dogs to get up so he could take them out into the yard for their last pee before bedtime, and when Merlin got off the couch he could barely stand. He started swaying, acting drunk, panting, and had no balance at all. We immediately thought that we were seeing a reaction caused by chronic use of Metronidazole (Flagyl). As some of you know, he's been on Metronidazole since April of last year for IBD, and long-term use of Metro has been known to cause neurological problems. We kept him on it because the dose he's been getting has just worked so well in keeping his IBD flare-ups in check. However, we have monitored him constantly to make sure he was not developing any neurological issues.

 

So that night we put his harness on him and tried to take him out on a leash. He seemed excessively alert, interested in food, very disoriented. We decided to take him to the e-vet. We went to a new place that was recommended to me by my vet, also because we knew that one of their vets specializes in neurology. However, it was incredibly quiet, it took me at least 10-15 minutes to even find someone to speak to, and it turns out that there was only one (albeit very nice) vet on call, and three critical cases, including that of a dog who had swallowed rat poison (thankfully, he made it). So they did a brief exam, determined that his condition was not life-threatening, and then told us it would be at least an hour before they could see us. In the meantime, Merlin's symptoms appeared to be subsiding and he seemed to be getting more antsy about his unfamiliar surroundings, the fact that the place was really overheated, etc. etc. . So we decided to take him home, and call our regular vet first thing in the morning.

 

He slept soundly through the night and by the next morning he was able to lift his leg again to pee, his appetite was very good, he seemed happy and playful and loving.

 

I called the vet and she suggested keeping him on Metro in the morning (500mg) and switching to Tylan powder (Tylosan) in the evening, and monitor. The first few days were fine. But two days ago things went downhill fast and he's had terrible diarrhea since then. I should mention that I've been introducing a new food, too, as he is so fed up with I/D - Purina EN gastro-enteric formula, which the vet told me is the same as I/D but a different brand. I introduced it slowly and in any event Dr. Katie told me that if his stools got bad again it is very unlikely that it would be because of the new food, as this formula is meant specifically for dogs with GI issues.

 

Well, he did very well for a few days... but two days ago things degenerated quickly, and although I haven't yet seem blood in his stools, he's had very bad diarrhea, and usually that means a flare-up is just around the corner So I calledmy vet again today and she suggested I switch him back to his old dose of Metro right away, and that we monitor him and call her at once if he has another episode or generally experiences balance issues and disorientation. I am worried but I was thinking along the same lines too - that I should put him back on Metro twice a day and take our chances.

 

Has anyone had a dog experience similar issues from chronic use of Metronidazole and NOT seen a recurrence? If he has an episode again, is it going to just get worse? Is it likely to be temporary, like the last time? I don't know what to expect.

 

Thanks for any advice you have to offer.

Edited January 26, 2012 by MerlinsMum

[Trihounds]

Hey Kerry - I wish I had some sage words of wisdom for you, but I do not. I didn't know there was a potential neuro impact from Metro but whenever I read about neuro symptoms, I do think back to Bumper's situation where an autoimmune reaction caused swelling in his spine for no known reason. That swelling caused neuro issues in his hind end as it impacted his spinal cord. Not suggesting that's da Wizard's issue just that something non-obvious or un-related should not be ruled out, even though it may be unlikely.

 

Hoping for some improvement in your man.

[XTRAWLD]

I hate when things are in control (seemingly) and then are not. Stay strong. I have no experience but offer my praise and thoughts.

[45MPHK9]

No advice, Kerry. I just wanted you to know that we will be thinking good thoughts for Merlin.

[Moneypenny]

Kerry,

 

I haven't read all of the prior info on Merlin's condition so I apologize if my suggestion has already been tried. My very first greyhound Shadow had the same problems you are describing as far as the IBD. This was in 1999. We tried many things, including the metro, we even did predinsone to reduce inflammation. I don't think my vet called it IBD, it was just horrible diarrhea. Long story short, what finally worked and firmed up his stools was a fish and potato dry food and only homemade treats with no corn. We battled this for months, Shadow also had low protein and albumin levels, so my vet suggested giving him cooked eggs with his food. I would hard boil a bunch and just slice one on his food each meal. He did stay on the metro for a while after things improved, but he also had the neurological episode you are talking about, totally freaked me out I thought I was going to lose him, but then I learned also that neuro issues are a side effect of the metro. He never had another episode once we cut the dosage back a little. Once I got him on a very restricted diet, he was fine for over a year and we stopped the metro, he did great until he got osteo

 

I can't remember the brand of food at the time, but I had to order it because at that time you couldn't buy fish/potato food at the pet store.

 

I don't know if this helps any, but I know how you feel, give Merlin a

[greysmom]

 

Is he on the lowest effective dose of Flagyl or the same dose you started with? He might be able to handle a lower dose twice a day?

 

Also, I would talk with your vet about the suggestion above for his diet. Seems to me that IBD doesn't necessarily need a "special" diet, just one his system can tolerate. A fish and potato kibble could be just as easy to digest as the I/D or the EN, an offer some additional benefits like more fiber and protein.

 

We'll be thinking about you!

[Guest verthib]

Maybe try keeping him on the Flagyl while switching his food? Maybe it was too many changes at the same time (new food and new med).

[greyhead]

When Spencer had similar neuro issues, it was before the IBD was even diagnosed. He had it, just not diagnosed yet. Intestinal Malabsorption was the diagnosis after the neuro issues, and B-12 shots put a stop to them. He still gets them every two weeks because that's the frequency that works best for him. At the beginning it was twice a week. But, yes, he had a lot of trouble getting up, he'd about fall over when lifting a leg to pee, and he got confused about where he was and what he had wanted to do when he got there! That cleared up immediately with the B-12. It's such a simple but neurologically critical thing.

 

He started Flagyl in early '09 and was on it continuously for two years. But we got the dose down to 250 mg. twice a day, then once a day, and for the last year or so only give it for a day or two at a time when he has a flare. We do give him 1/8 tsp of tylosin twice a day, and for the most part that does the trick.

 

We also have all this time used budesonide as an immunosuppressant, starting at 3 mg/day and working our way down to what it has been for the last 9 months or so, 1/2 mg. every third day.

 

Not only did we need a novel protein for meat, but we had to eliminate all carbs except sweet potato. So we use Natural Balance kibble, along with Wellness canned, and he has never used a prescription food at all. That's because the prescription foods seem to be heavy on rice, or corn, or both, neither of which he can handle at all. (He could have anything but white rice before the IBD, but no grains at all since then.) Talking with AJ Hicks and others here on GT gave us the idea that many of these IBD dogs need foods that minimize carbs, and that approach has worked very well for us.

 

I'm so sorry Merlin is having this trouble, and I know how hard it is on you too. We'll keep you in our thoughts and hope you can turn this around.

Edited January 26, 2012 by greyhead

[sabrina]

Merlin we are thinking of you wizard & wish the big D would go away for good

[Batmom]

What would happen if you kept him on the food that his gut best tolerates and stopped the metronidazole?

[GreyPoopon]

A couple of things I've learned the hard way during the last 10 years: 1. It's best not to change more than one thing at once, and 2. Even if the foods seem to be the same, they may not be tolerated in the same way. I also agree with greysmom's comment that it's not necessary that the food be a prescription diet, only that it be tolerated.

 

I don't have experience with the neurological issues (at least, not the ones you're facing), but I'd be inclined to revert to the previous diet and meds until he's stable, then try altering (reducing or exchanging) the metronidazole. If you can keep him stable, then you might try switching his food.

 

[rschultz]

(((hugs))) for merlin and u..lexie would always get worse on the metro. The tylan powder daily in both feedings always helped. None of the prescription food ever worked for Lexie. We switched to precision chiken recommended by Rocket's parents. I mix that with natural balance and venison. Hope he gets better soon.

[PrairieProf]

Oh crap(!), I'm so sorry that the problems you mentioned have continued.

 

No advice, but I've looked at the EN ingredients in the past and they are a fair bit different than the I/D, even though the foods are designed for the same purpose.

 

He didn't have problems on the I/D from what you said, just stopped wanting to eat it, right? Do you think that was just pickiness or was his stomach starting to bother him? (As you know I'm a believer in I/D, Beth is on it and does so well, though she doesn't have IBD per se.)

[FiveRoooooers]

Can't add much, Kerry, except good thoughts for figuring out what's going on with the Wizard. You know that we are big fans here of Tylan, twice daily if necessary, and we have had instances of needing both Flagyl and Tylan together for a while. Thinking of you guys.

[kudzu]

Yes, I have had a dog go through something similar & it was indeed the metronidazole. He had previously taken the drug & tolerated it relatively well. Many months later when put back on it for a different reason he went down within days of starting. Stopped it immediately & he quickly began to recover. However, you need to know that this dog already had a polyneuropathy of peripheral nerves & peripheral neuropathy is a rare side effect of metronidazole. Talk about bad timing though. Just when you are switching foods he develops something that may precipitate a switch in meds? Ugh!

 

I want to reiterate a few things folks have already mentioned. The dog I mentioned above had an extremely compromised GI tract. We worked to keep him on a low residue diet. Tylan worked well for him though he had a combo of poor GI motility & SIBO not IBD. He also require B12 injections. Fish & potato food was all that he could eat for quite a while.

 

I have found with my Greys that they do best with lower carbs. Foods higher in meat content & with no grains seems best. My girl went through multiple bouts of colitis before we made that switch. After going no grain she's not had a repeat.

 

Am hoping your wizard is feeling magical again very soon.

[4My2Greys]

Hoping you get things resolved and Merlin starts improving.

Edited January 28, 2012 by 4My2Greys

[mychip1]

Thinking of you and Merlin......

[JenniferS]

I'm not sure about the long-term effects of the metro, but I know before Ducky was diagnosed with IBD & PLE, the Metro didn't control the diarrhea, so we had to try other things, including a strict diet & other meds. The Natural Balance LID Venison worked well for him for a while. When that stopped working we went to Science Diet d/d vension & z/d allergen foods. He also got B12 shots. It is a very frustrating disease and takes a lot of trial & error. There is another forum I found helpful while we were going through it:Canine Lymphangiectasia Support

Good luck!

[BatterseaBrindl]

that Merlin is feeling better today

 

for Kerry

[racindog]

Oh no! Poor Merlin. We just can't have our Wizard under the weather like this. I am praying praying praying for your fast recovery. We all LOVE you guy. Sending lots of love and healing energy.

[Guest SoulsMom]

Maybe try keeping him on the Flagyl while switching his food? Maybe it was too many changes at the same time (new food and new med).

 

That could very well be it . . . I know when Soul 'flares' I just have to get back to basics to get it under control. Hope Merlin can find his 'new normal' again soon

[Guest BrianRke]

Hugs and good thoughts to you and Merlin

[phall]

My boy, Star, has colitis and has been on metronidizol for the last year or so with no problems. It seems to work very well for him. Initially he was taking it 3 times a day (along with sulfasazine), but we've been able to wean him down to once a day on the metro and no sulfasazine at all. (I tried to go every other day with the metro, but he started having flare-ups so for now once a day will continue.)

 

When we first got Star before he was diagnosed with colitis, we tried EN. He did not do well on that. He's been on I/D canned food and W/D kibble now for almost a year and he does very well with it. I add cooked chicken and cooked pasta to his food. It's a balancing act, for sure. Star is a big boy - 82 pounds and he's thin. He eats a lot! It amazed me when we brought him home - he eats 7-8 cups of food a day and is still thin!

 

I hope Merlin is feeling better.

 

Pat

[Charlies_Dad]

Kerry, no advice but just wanted to send along good thoughts for your beautiful boy Merlin.

[Guest patgam]

Thinking of you and Merlin....and hoping that he gets back to his 'wizardly' self.

Hugs