Ibd Questions

[Guest mameyer]

I've been lurking on here for several months now and I promise I'll post a better intro with the required pictures soon, but for now I just have a couple questions for those experienced with IBD dogs.

 

I've had my 2 1/2 y/o boy Ari for 9 months now. The past 6 months we've been tweaking meds/diet/etc to get his gut under control. He hasn't had a biopsy yet, so we haven't tried steroids, but I feel like that's coming. The past month and a half he's been really well controlled on Iams, daily tylan, probiotic and twice daily pepcid. The past several days he started with anorexia and very loose stools. Yesterday I tried a dose of slippery elm and today he put out 3 small bloody stools and was vomiting this morning. He has had bloody stools in the past with other flare ups, but none with this one. Is the slippery elm just coincidental or could that make him worse? We didn't give any today.

 

He's had negative fecals in the past few months and we've dosed with Panacur just to be safe. Sulfasalazine and flagyl actually made him worse. Our vet would rather manage him more conservatively if we can given his age. We both hate the thought of throwing him on steroids at 2.

 

Any other suggestions?

[greyhead]

Spencer has had IBD for 3-1/2 years and is now 11-1/2. For the first 2-1/2 years he was on budesonide, which several of us on Greytalk have used successfully instead of prednisone. It is an immunosuppressant that targets the GI tract and has almost no side effects, mostly just fur loss. I'm one that swears by budesonide for greyhounds, especially greys "of a certain age," and strongly advises against prednisone. (I don't personally know of any greys as young as yours with IBD, and I don't know what the implications of immunosuppression may be for them.) The weight just melts off most of these IBD dogs when prednisone is used, and then we lose precious time when they have to be slowly weaned from it before they can be given anything else.

 

Have you done fecal cultures to rule out infection, not just worms? I ask because Spencer started his IBD woes with a small-intestinal bacterial infection that took three months and three antibiotics to get rid of. Only then did we start the budesonide. (Of course one wouldn't want to give any immunosuppressant to a dog with an infection until it is cleared up.) We also gave tylosin and metronidazole for most of this time. Now he gets tylosin daily but the others only when he has a flare.

 

Recently we discovered that sucralfate is vastly superior to Pepcid or Zantac in calming his digestive tract. Tried slippery elm capsules briefly but he didn't seem to do well, and probiotics made him worse. (Probiotics seem to work for some IBD dogs and to work against others.) L-glutamine is an amino acid that his internist recommended and seems to help him a lot, though we don't give it every single day.

 

What are you feeding Ari? There are various approaches to food, and I'm just wondering what yours has been. Hopefully, others will chime in, tomorrow if not tonight. It's good you've joined us. We can wait for the pictures, surely, until things settle down. You don't have enough posts to send or receive PM's, so I'll keep an eye on your thread to see if you need anything.

 

Mary

Edited June 12, 2012 by greyhead

[Guest mameyer]

Thanks so much Mary!

 

I'm actually a bone marrow transplant nurse, so I'm quite familiar with budesonide in my practice. Long-term immunosuppression makes me nervous, though I suppose if we exhaust all other options it may come to that.

 

I don't think that they ever did a stool culture; I'll add that to the list. When they ran a fecal initially I recall the vet mentioning that there were a significant number of bacteria present. He started metronidazole because of that, and Ari developed increased abdominal pain and bloody stools within a few days.

 

Do you give a sucralfate slurry or the tabs?

 

When I first brought him home I had him on Kirkland Chicken and Rice. His stools were always soft, so it was suggested I switch to lamb and rice. Stools were better on lamb, and his coat improved significantly. When he later developed diarrhea and gastritis symptoms, we switched to a grain-free salmon and sweet potato. Still runny. At that point we tried boiled chicken and rice and progressed to Hills ID. That got us to cow pies/pudding. He was eating well, no GI distress whatsoever, but still had loose stools so we put him on Iams lamb and that was the best he'd ever been. Its a little overwhelming sifting through all the food/nutrition posts. Never sure which is the best route to go!

 

Tummy troubles aside, he's been fantastic! I don't think I could have picked a better addiction to develop!

[tbhounds]

Have you tried a novel food diet? Another thought would be to try different fiber diets-- high fiber like Hills W/D or Low Residue Diets (like raw).

[GreyPoopon]

For what it's worth, my IBD dog (Minnie, a poodle) has been well controlled for years on a suitable diet. The initial bouts of HGE, which occurred before she was three, were so bad I almost lost her, and she was scoped (two types of severe IBD related at least in part to food allergies) and put on a slew of meds, including the maximum dosage of pred. She was also given a limited-ingredient novel diet. We were able, in time, to eliminate the meds. Now that she's 13, she's gotten a bit more fragile, and is back on misoprostal.

 

Some years after Minnie was scoped, we tried food allergy testing. Although it has a bad reputation, it has been very helpful for Minnie and others (one suspected colitis, some prone to soft stool) here at GITroublesRUs.

[greyhead]

Meghan, we use the sucralfate tabs.

 

Be careful about switching foods among protein sources. What we found happens is that each new protein initially brings a good response, only to deteriorate within a week or two as the IBD dog develops an inflammatory response to that new protein. The wonderful thing about immunosuppression is that it prevents that from happening! So you find a novel protein as you start the budesonide, and life gets good again. Because we hadn't known this and Spencer had a history of GI distress from hookworms and the SIBO, we had switched foods many times over the years and there wasn't much left that was novel to him. Fortunately, there was still venison. Oddly, many would say, he also did and does well on raw food! (We get commercially prepared Primal Pets venison nuggets.) Experience shows, though, that he needs precisely one-third of his intake to be raw; anything more or less leads to trouble. Even his internist is on board with it because it works for him. So that's one more thing to add to your bag of potential tricks.

 

ETA: It seems that not many vets have much experience with budesonide, so you may have to educate yours. It's also important than greyhounds get half the dosage appropriate to other breeds, so a starting dose of 3 mg/day for our then 70-lb Spencer. (I think we just gave it once a day, but I'll have to check to make sure it wasn't 2 mg twice a day at the very very beginning. Fortunately, our vet had her own IBD dog and handled this well.)

Edited June 12, 2012 by greyhead

[MaryJane]

Have you ever tried just hamburger and rice - some greyhounds have food sensitivities and I've found that chicken is high on the list of problem foods. One of my current greyhounds cannot have chicken at all and if he does, liquid poo. He does great on beef like hamburger of roasts.

[Guest LindsaySF]

I would culture the stool to check for bacterial infection.

 

When you did Panacur, how many days did you give it for? How many treatments did you do? I would do a 7-day course.

[phall]

Hi Meghan,

 

My boy, Star, has colitis and was diagnosed when he was just under two years of age. We tried probiotics with him and they didn't help at all. After much trial and error, under the guidance of an internal medicine specialist, we found that what works best for Star is a diet of W/D dry food, mixed with some canned I/D (the W/D wasn't filling him up - he was always hungry on it when he had just the W/D), with cooked chicken and pasta added. He gets metronidizal daily. He does get occasional flare-ups which we treat with pepcid and reglan. He's three and a half now - so young for dealing with this.

 

Good luck with Ari.

 

Pat

[greyhead]

I would culture the stool to check for bacterial infection.

 

When you did Panacur, how many days did you give it for? How many treatments did you do? I would do a 7-day course.

Yeah, I'd underscore this too. You won't get anywhere good, with food or other meds, if either infection or worms are involved. And if there's infection, you definitely don't want to start immunosuppression.