Help! Ibd

[tbhounds]

The weight loss is most likely due to the use of pred- it just melts the muscle off of our hounds. The lovely thing about using Budesonide is it reduces the systemic side effects seen with pred.

Have you been referred to an internal medicine Dr yet??

[DesiRayMom]

Another vote for Budesonide. Desi lost 10 lb in 2 weeks on pred.

[greyhead]

Harley was DX with IBD via endoscopy on February 18 and lost a whopping 20 lbs during his 5 day stay in the CCU. He hasn't gained any weight since then (has actually lost a couple - I am waiting for someone to call the local SPCA, he looks so thin) and still has chronic diarrhea. He is on prednisone, azathioprine, flagyl, zeniquen, pepcid, and sotolol (for tachycardia). We have tried Royal Canin rabbit and bison (he was exposed to venison when Talca was DX with IBD) and he is now on Hills Z/D (hydrolyzed protein) and cooked lamb. He won't eat the Z/D without the lamb "supplement" but wolfs it down when lamb is added. I am not sure what else to try that he will be willing to eat and am starting to panic!

 

How is sweet Harley doing now? I keep hoping for an update. Still holding you both in our thoughts and prayers!

[Guest jurishound]

Thank you, everyone, for your replies. We have tried many things, but Harley is still unable to gain any weight (he is down to 55 lbs) and continues to have soupy poop. I am so worried that this is actually alimentary lymphoma that was missed on the endoscopy. Chlorambucil, which apparently treats both lymphoma and IBD, is next.

 

I am cooking turkey and potato for him which he has been eating along with Z/D, until recently. The nutritionist recommended a diet of bison and tapioca. Sounds dreadful to me, but I will give it a try. We have run out of novel proteins at this point, with the exception of kangaroo (shudder).

 

We are seeing a board certified internist at Angell Memorial, a teaching hospital here in Boston.

 

He needs to go out every 3 hours at night, which is taking a bit of a toll. I asked about switching to budesonide from the pred, and the vet does not recommend it. Not sure what to do with that.

 

He is such a good boy. My heart is breaking.

[MaryJane]

Proteins like chicken and turkey are just fed so many "antibiotics" on the farm and IMO, that might be a contributing factors to issues like IBD.

 

Have you tried fish like Tilapia - someone else on the site had an IBD dog that they used this fish and it seemed to work. They also made dehydrated treats from the fish.

 

I'm sorry that you are going through this - it's tough but hopefully he will stabilize and then start to gain weight.

[sweetdogs]

 

We are seeing a board certified internist at Angell Memorial, a teaching hospital here in Boston.

 

He needs to go out every 3 hours at night, which is taking a bit of a toll. I asked about switching to budesonide from the pred, and the vet does not recommend it. Not sure what to do with that.

 

Why not? What you're doing now isn't working. It's a similar drug with fewer side effects that could be helpful for him. I'd want to try that before a chemo drug.

 

My very best wishes for your boy - I'm sorry he's struggling so.

[greyhead]

We are seeing a board certified internist at Angell Memorial, a teaching hospital here in Boston.

 

He needs to go out every 3 hours at night, which is taking a bit of a toll. I asked about switching to budesonide from the pred, and the vet does not recommend it. Not sure what to do with that.

 

Why not? What you're doing now isn't working. It's a similar drug with fewer side effects that could be helpful for him. I'd want to try that before a chemo drug.

 

My very best wishes for your boy - I'm sorry he's struggling so.

Here's a link to a 2008 article discussing budesonide use in the context of other IBD treatment: budesonide Notice the description of how it was relatively new for this purpose back then and usually given after poor response to other, traditional remedies like prednisone. Unfortunately, vets are still following this progression of starting with prednisone just because that's what they've always done. But budesonide has been around a while now, and it works very well for greyhounds in particular, at about half the dose given to other dogs, I gather. The 3 mg dose we started with is readily available; when dose reduction becomes appropriate later, it is easily compounded by Roadrunner Pharmacy in Arizona, for instance, and several of us on GT here have the contact info if and when you want it.

 

I found that by Googling "budesonide for canine IBD," and there were quite a few articles. If you wanted to use Google Scholar, you might get even more. (Let me know if I can help.) You will probably have to be your dog's advocate in this and, as tired as I know you are (because I've been there), being well-informed about this will make it a lot easier for you to do that. I'd go as far as to say our Spencer would have been quickly lost on prednisone; the few days he took it, the weight just melted off of him. And we are not alone in that experience. So I would urge you as your dog's advocate to not let any vets, even the internist at Angell, get away with just doing what is usually done. This is a greyhound.

 

ETA: Our internist called today about our IBD dog for other reasons. I took the opportunity to ask her what is the reluctance to use budesonide. She replied that for her, it's the cost, especially since many dogs do fine on a short course of prednisone.

Edited March 29, 2012 by greyhead

[JenniferS]

My vet at Tufts also did not want to go the Budesonide route without first trying the pred. Unfortunately Ducky did not live long enough for us to try I feel like it is one of those things that no matter how smart/seasoned the vet is, they are not always willing to try new things. Angell & Tufts are the best in the area, yet some vets stick to very traditional medicine only. My suggestion would be to perhaps print out this thread to show him/her what so many other gh owners have experienced with Budesonide.

Sending many good thoughts to you & Harley.

Edited March 30, 2012 by JenniferS

[Batmom]

Tapioca is used in some commercial dog foods. Think of it as just another starch.

 

Re pred vs budesonide: I think sometimes you have to say to your vet, "What harm would come from trying it?" KWIM?

 

Sending best wishes to OP and all the others dealing with same .

[4My2Greys]

Not sure if your looking at single ingredient foods re the bison and tapioca, but here is a kibble made with buffalo and tapioca.

 

http/www.thewholedog.org/rubicon.html

 

Rubicon Great Life

Buffalo (Organics Inside / USDA Approved Ingredients ) Raw Food portion: Freeze dried buffalo, freeze dried buffalo liver, freeze dried ground buffalo bone, inulin, green tripe, mixed baby sprouts, sprouted chia, yumberry, goji berries, acai berries. full spectrum chelated minerals, coral calcium + 74 trace minerals, vitamins, 7 billion active probiotics enclosed in salmon oil.

 

Wholistic Kibble portion: Buffalo Meat, Tapioca, Jicama, Yams, Pumpkin, Kelp, Flaxseed, Egg, Sweet Potatoes, Cranberries, Blueberries, Suncured Alfalfa Meal, Peas, Parsley, Garlic, Artichoke, Fennel, Rosemary

 

KCal/cup 421 Protein (min) 22%, Fat (min)14%, Fiber(max) 4%, Moisture (max) 10%, Ca. 1.4 Raw Food : Moisture <3% Calcium-1.49, Phosphorus-.97, (Buffalo is a very clean, leaner, meat source with no known health problems. It is a good food for dogs with allergies.)

[Guest jurishound]

Thanks for all of your helpful replies. On the issue of budesonide v. prednisone, the vet is willing to try it. She has been reluctant to use it because of her belief that the site of absorption of the non-enteric coated compounded form can be "variable." The enteric coated capsule form is apparently used to treat Crohn's disease in humans and consequently, is not absorbed (in humans) until it reaches the colon (Harley's disease is largely in the small intestine, I believe). We have an appointment with her tomorrow to discuss this and decide. In the meantime, Harley is on a diet of cottage cheese and white rice. I am fairly certain that frequent changes to his diet can't be good, but I am desperate for him to eat.

 

The buffalo/tapioca kibble looks interesting - thank you!

Edited March 30, 2012 by jurishound

[tbhounds]

Regarding the Budesonide--my IBD dog had small bowel disease too-- Budesonide worked very well for him- in fact it truly saved his life!

[RobinM]

How much pred? It wasn't until beau had 60 mgs of pred AND 50mg of immuran that the turnaround came. Within a month we started lowering the pred. I would o the z/d0nly with a mild fish. We did tilapia. Z/d cookies too. We've Been there done that. beau has come a long way.

[Walliered]

Vet just took Huck off of the AZ drug as it was ruining his liver. The Budesonide drug is $500.00 per month. Vet is trying to get Trupanion to cover it.

 

Oh, forgot to post.. He absolutely stopped eating ZD Vet put him on DD which he is eating. But, his stool is like water coming from the garden hose.

[tbhounds]

Vet just took Huck off of the AZ drug as it was ruining his liver. The Budesonide drug is $500.00 per month. Vet is trying to get Trupanion to cover it.

 

Oh, forgot to post.. He absolutely stopped eating ZD Vet put him on DD which he is eating. But, his stool is like water coming from the garden hose.

$500/month?? Not sure where you were quoted that but, I didn't pay any where near that and I purchased it at a higher end local compounding pharmacy. The op needs to seek quotes from various pharmacys-- wedgewood and roadrunner are two I can recommend.

[greyhead]

Vet just took Huck off of the AZ drug as it was ruining his liver. The Budesonide drug is $500.00 per month. Vet is trying to get Trupanion to cover it.

 

Oh, forgot to post.. He absolutely stopped eating ZD Vet put him on DD which he is eating. But, his stool is like water coming from the garden hose.

No way is Budesonide $500 a month! I'll look at my records later, but the 3 mg was more like $50 IIRC.

 

Jurishound, Spencer's main site of inflammation was also the small intestine, and the capsules worked fine. Just tell your vet to trust us. (I wish our wink emoti didn't look so smirky!)

.

Edited March 31, 2012 by greyhead

[Walliered]

Dr. Angela Holcombe quoted me the $500.00 per month. This was quoted to her by her vet rep. I will inform her what was said here on Greytalk. Thanks.

[Walliered]

Sorry, drug rep.

[greyhead]

Sorry, drug rep.

I'm guessing that drug rep doesn't represent budesonide.

 

ETA: Wanted to add that Roadrunner Pharmacy sends the first prescription by free overnight delivery. (They also send a toy, but it's not usually big enough for a greyhound.) And come to think of it, I think we got all our budesonide from Roadrunner from the beginning because the vet didn't carry it.

Edited March 31, 2012 by greyhead

[Guest jurishound]

We ordered budesonide, but it won't arrive until Tuesday - the pharmacy couldn't do overnight on a Saturday or Sunday. And he isn't eating anything at all today.

Edited April 1, 2012 by jurishound

[4My2Greys]

If you have a health food store nearby see if they have Manuka honey. It was shown in clinical trials to reduce colonic inflammation due to IBD. It has helped Nadir to eat many times when he has had flare ups. With him it also seems to act as an appetite stimulant in that if he's not feeling well and walks away from his food he will start eating almost immediately after being given just a teaspoon.

It is awful when they go through this. I hope he's on the mend soon.

[greyhead]

We ordered budesonide, but it won't arrive until Tuesday - the pharmacy couldn't do overnight on a Saturday or Sunday. And he isn't eating anything at all today.

I'm so sorry. You might try a scrambled egg. If he doesn't currently have bad diarrhea, you could try a third of a bottle of vanilla Ensure, the regular formula, not the Plus or anything else. If that goes okay, do it again tomorrow. He may be interested in eating something a while after that (say, 15 minutes to an hour later). You can also try cooking him something, and steaming worked well for us; I can't suggest what because I don't recall what his eating history has been. We used boneless, skinless chicken breasts; later he couldn't have chicken in any form, but it got him through the crisis until we got the meds and put him on venison, which was then a novel protein for him.

 

I hope others will chime in with their suggestions. Whatever you do, go slow and simple. Hopefully, he'll keep drinking water.

 

I'd even consider getting the vet to phone in a prescription locally today if you can get ahold of him/her, or get an e-vet to do it. Have you been given any instructions about stopping the pred? (We did it so far in advance of the budesonide that it wasn't an issue, so I have no advice to offer.)

 

You and your boy will be in my thoughts and prayers, fervently, so please keep us updated.

[Guest jurishound]

He just ate a little lamb. I emailed the vet and she suggested starting the chlorambucil. Other than that, her plan is to start the budesonide along with his current dose of pred (50 mg)(??). The hospital pharmacy doesn't carry budesonide and I think only the enteric coated form is available at "people" pharmacies?

[greyhead]

He just ate a little lamb. I emailed the vet and she suggested starting the chlorambucil. Other than that, her plan is to start the budesonide along with his current dose of pred (50 mg)(??). The hospital pharmacy doesn't carry budesonide and I think only the enteric coated form is available at "people" pharmacies?

Thank goodness he ate some!

 

I Googled chlorambucil, as I knew nothing about it and have never heard of it being used for any IBD hounds. It sounds seriously harsh, with side effects that include vomiting and things that I wouldn't want to induce in someone whose GI tract is already a mess. But that's just my opinion, and you'll have to follow your own best instincts. I did PM tbhounds and ask her to check in here and see if she could help, which I'm sure she will if she gets the message.

 

We did get some human-grade budesonide through a GT friend who had extra. She had gotten it from Canada faster and cheaper at the time than she could get it otherwise. And the medicine was in capsule form, not enteric coated. So that enteric business may be incorrect info, or maybe it's one optional form of the medicine.

 

I'll keep up with the prayers, in case they're working, and you keep updating so I know how I'm doing. And stay strong. That's beyond important.

[Walliered]

I guess everyone knows my hound, Huck, has IBD. We do not have a holistic vet anywhere near here and my vet has not ordered the budesonide. So, I made the decision to start him on slippery elm and yogurt today. I also bought raw hamburger meat (made for dogs) and a product called Sojos (veg and fruit) that I am soaking with water in the ref. I will start him on a little of that tomorrow. I feel that he is going to die if we keep on the same course that he has been on the last year. I will keep the pred. up for a few more days then will taper. I will wait a few days and call the vet and tell her what I am doing.

 

Oh, I forgot to say: I am still giving him the probiotic even though the vet said to stop. I may stop now that I am giving him yogurt.