Addendum To Pjay And Ibd

[Guest greytsmom]

Abdominal ultrsound inconclusive for non responsive treatment of IBD. Very slight increase in size of right adrenal gland, positive for enlarged mesentaric lymph nodes (bx sent off to pathologist...will be a week before results are known). Initially thought UTI was still unresolved, but now I am wonder if iatrogenic cushings isn't at play. We finished weaning him from Prednisone 3 days ago. He seemed to return to normal drinking and peeing over the weekend. Monday I noticed a slight increse in both, this morning, he drank copiously and had a pee accident over night. Question on this is, how long (or will) till his system returns to "normal" after prednisone weaning, if indeed this is iatrogenic cushings?

 

Second, I need help with an alternative to Hill's Z/D. We took him off his kibble for 2 days, added Slippery Elm Bark to rest his tummy as recommended by Mom2Shiloh. It worked beautifully! "Normal stools", although they were quite large as compared to what he ever had. He actually acted like he was feeling a bit better and NO stomach gurgling. We are gradually re introducing his kibble. He had a bit more kibble his morning then he had yesterday and what did I hear about 45 minutes after he ate? His stomach gurgling. And, I am expecting a change for the worse in his next stool. Our vet assures me he cannot be allergic to Z/D, BUT can develop sensitivites to it. Well now, what am I suppose to do with that information and what do I feed him. I sure don't want to stir up his colon by feeding him anything that will turn the little progress we made upside down. I do not want to ever put him back on PRED. Budesonide is not available through our vet. She would have to order it from the east coast. She mentioned it once and hasn't since.

 

Does anyone have a simple homemade lo fat diet for IBD dogs I can start out with and what supplements would I need. He is 12 years old and I just want to make what ever time he has left, comfortable. By the way he has lost 14 # as of last Friday. I will be taking him in tomorrow just to see where he is at weight wise. We live in a small rural community without access to specialists. Thank you for your help and wisdom.

[MaryJane]

You can do a diet of hamburger (lean 90%), rice and veggies. DO NOT use chicken - chicken are fed so much antibiotics that some doctors think it causes IBD in people because it removes the "good bacteria" in the system and leaves the harder to kill "bad bacteria". Cattle are fed antibiotics but, less than chickens. The Economist magazine just had a great article about the "bacteria in the gut".

 

For my dogs - they get about 2 cups of rice, between 1/3 to 1/2 cup of cooked hamburger, and 1/4-1/2 cup of cooked veggies for dinner. They get about 1 to 1/2 cup of oatmeal, 1/4 cup of grits, and 1/3-1/2 cup of hamburger for breakfast. They also get some snacks during the day (toast/peanut butter and applesauce/yogurt). You can also give them cheerios (unsweetened). Sometimes I add a touch of molasses to the cereal.

 

For supplements - they each get 1 multivitamin a day - regular one not a man's or women's. the larger boys get 4 calcium pills (500 each) a day - the girl gets 3 calcium a day (NO vitamin D added), and 1 fish oil supplement for each one daily.

 

You want to think about getting a probiotic and maybe giving some yogurt daily.

 

I used Dr. Remaillard to get the basic recipe for home-feeding - she now has her own web site. You can give more hamburger but, you want to do kidney/urine tests to make sure that he can handle it. I've had dogs with kidney issues and because of that, had to keep protein levels low.

[Guest greytsmom]

Thank you... Didn't know chicken was worse then beef! We (humans) here eat a lot of chicken.

 

I am going to see how his colon responds to being back on the kibble. If st the slightest hint of a degrading stool, I will put him back on potato diet for a few more days, then try this lo fat diet you shared. We have spent $1,000 dollars in office visits, meds, and tests to no avail and now because of pred, may have created another problem. We have been trying to achieve a positive outcome to this latest flare up for 3 months. I must honestly say I am weary.

[MaryJane]

I might suggest that you eat organic chicken - no antibiotics. Beef has more fat than chicken which is why most people think chicken is better. Cows also get antibiotics but it seems better regulated than the antibiotics chickens get.

 

Do a google search "antibiotics in beef" and "antibiotics in chicken"

[JJNg]

now I am wonder if iatrogenic cushings isn't at play. We finished weaning him from Prednisone 3 days ago. He seemed to return to normal drinking and peeing over the weekend. Monday I noticed a slight increse in both, this morning, he drank copiously and had a pee accident over night. Question on this is, how long (or will) till his system returns to "normal" after prednisone weaning, if indeed this is iatrogenic cushings?

 

Iatrogenic Cushing's is directly caused by the prednisone (or other steroid) while it is being administered. So the immediate signs like increased drinking and urination usually resolve within days of stopping the steroid. More chronic effects, like a pot-bellied appearance due to weakening of the abdominal wall muscles, or skin and coat changes, will take weeks to months to resolve. However, we usually see iatrogenic Cushing's in dogs who have been on steroids for years. I believe Pjay was only on a full dose of pred for about 2 weeks before you started weaning down, so it's highly unlikely this is iatrogenic Cushing's. And if he's completely off pred now and his drinking/urination had returned to normal, this recent return of those signs is not related to the pred.

 

I do not want to ever put him back on PRED. Budesonide is not available through our vet. She would have to order it from the east coast. She mentioned it once and hasn't since.

 

Budesonide is available through human pharmacies, as well as mail order and compounding pharmacies. No reason your vet should need to order it. The brand name is very expensive though, and I believe most people use the compounded form. Hopefully others with experience with chime in.

 

Does anyone have a simple homemade lo fat diet for IBD dogs I can start out with and what supplements would I need.

 

Please check with your vet before you change Pjay's diet. IBD can be aggravated by food allergies or food intolerance/sensitivity, and the most common proteins that dogs are sensitive to are beef and chicken. An alternative to a hydrolyzed protein diet like z/d is to go with a novel protein/hypoallergenic diet. There are commercial diets like the Royal Canin Hypoallergenic line (Potato combined with Duck, Venison, Rabbit, or Fish). Or if you prefer to home cook and want to try a novel protein diet, you can use meat sources like turkey or fish, which are usually more available than meats like venison or rabbit.

 

There are also other hydrolyzed protein diets available, and trying a different brand than Hill's z/d may get better results. Purina HA and Royal Canin's Hydrolyzed Protein formula are other options.

[Guest greytsmom]

Thank you, and honestly I would prefer not to do home cooked, but if that is only solution I will. I just came back from vets for weight check and he is down another 1# since last Friday. At least he is not losing as fast and I attribute that to the few days of potato diet he ate. We have been gradually introducing his kibble back and he was ok with a few, but the more he ate over the last couple of days, the more he started to turn up his nose at it until this morning he refused to eat. And his stools have become soft again. They are still formed, but cannot completely pick up. I have c/o to my vet about the Z/D (twice) and she did not offer an alternative. I feel like I am on my own here... Thank you for the info regarding Cushings. PJay had been on Pred for about 5 weeks, the last 2 at the 40 mg dose. He was much better about drinking and peeing Saturday and Sunday, but had an accident during the night. Then Monday and Tuesday, he was drinking and peeing more then normal for him. Today, he seems back to normal with the drinking and peeing. I am going to give the vet a call now to see if I can try one of the other commercial hypoallergenic foods.

[Guest greytsmom]

now I am wonder if iatrogenic cushings isn't at play. We finished weaning him from Prednisone 3 days ago. He seemed to return to normal drinking and peeing over the weekend. Monday I noticed a slight increse in both, this morning, he drank copiously and had a pee accident over night. Question on this is, how long (or will) till his system returns to "normal" after prednisone weaning, if indeed this is iatrogenic cushings?

 

Iatrogenic Cushing's is directly caused by the prednisone (or other steroid) while it is being administered. So the immediate signs like increased drinking and urination usually resolve within days of stopping the steroid. More chronic effects, like a pot-bellied appearance due to weakening of the abdominal wall muscles, or skin and coat changes, will take weeks to months to resolve. However, we usually see iatrogenic Cushing's in dogs who have been on steroids for years. I believe Pjay was only on a full dose of pred for about 2 weeks before you started weaning down, so it's highly unlikely this is iatrogenic Cushing's. And if he's completely off pred now and his drinking/urination had returned to normal, this recent return of those signs is not related to the pred.

 

I do not want to ever put him back on PRED. Budesonide is not available through our vet. She would have to order it from the east coast. She mentioned it once and hasn't since.

 

Budesonide is available through human pharmacies, as well as mail order and compounding pharmacies. No reason your vet should need to order it. The brand name is very expensive though, and I believe most people use the compounded form. Hopefully others with experience with chime in.

 

Does anyone have a simple homemade lo fat diet for IBD dogs I can start out with and what supplements would I need.

 

Please check with your vet before you change Pjay's diet. IBD can be aggravated by food allergies or food intolerance/sensitivity, and the most common proteins that dogs are sensitive to are beef and chicken. An alternative to a hydrolyzed protein diet like z/d is to go with a novel protein/hypoallergenic diet. There are commercial diets like the Royal Canin Hypoallergenic line (Potato combined with Duck, Venison, Rabbit, or Fish). Or if you prefer to home cook and want to try a novel protein diet, you can use meat sources like turkey or fish, which are usually more available than meats like venison or rabbit.

 

There are also other hydrolyzed protein diets available, and trying a different brand than Hill's z/d may get better results. Purina HA and Royal Canin's Hydrolyzed Protein formula are other options.

 

Yes, Budesonide is available here at local pharmacies in capsule form and not in the dosage she wanted him to have.

[Guest greytsmom]

OK we have the bx report back and it really is good news all the around. No cancer! He has intestinal lymphangiectasia as a result of his IBD. The good news for me is it can be managed; the bad is, there may be flare ups. I sure would like to hear from others who are or have dealt with this componnet of chronic intestinal disease.And thank you all who selflessly gave me encouragment and ddiet advice.

[Burpdog]

Jodie had IBD, a pancreatic insufficiency and gluten intolerance. She ate the following for around 18 months and had the best coat of the bunch:

 

5# boiled potatos with skin, mashed

2# green beans, put in processor

3# or so of boiled meat, beef or chicken

2C of rice made with 4C of water

 

I added fish oil and sterlized calcium to each feeding.

 

Isaac had problems for 2 years before I finally did allergy tests on him. He is allergic to peas, turkey & lamb in the food area. Of course, I had been feeding him turkey and not chicken..... He started NB duck & potato and did very well on it.

[greyhead]

Those of us who use budesonide for our grey's IBD usually have it compounded into the desired dosage. We started at 3 or 4 mg per day and ended at .05 mg per day. We use Roadrunner Pharmacy in Phoenix, a compounding pharmacy with which our vet was familiar. They used to overnight the first batch of medicine for free. All their contact info, including toll-free #, is available at www.roadrunnerpharmacy.com Your vet can phone or fax a prescription to them, and they get right on it. Thereafter, you can call in yourself for refills.

 

Many hugs,

Mary

 

PS: We went the novel-protein route, using venison. We used other things before that; but until we started the budesonide, he developed inflammation within a week or two of starting each new food. So the medicine and the novel protein work together! (Or at least they had to in our case.) Happily, there are venison kibbles and canned foods out there, such as Natural Balance kibble witih sweet potato, and Wellness makes a canned too. I'll be happy to help more when I don't have to rush off as I must now. I'll check back in here on Sunday.

 

ETA: You can see Spencer, our IBD dog, on the left in my siggie. He lost about 20 lbs. before we turned him around. He gained 10 back, and he has been fine with that for the last three years. He'll be 12 in November.

Edited August 25, 2012 by greyhead

[Guest greytsmom]

Those of us who use budesonide for our grey's IBD usually have it compounded into the desired dosage. We started at 3 or 4 mg per day and ended at .05 mg per day. We use Roadrunner Pharmacy in Phoenix, a compounding pharmacy with which our vet was familiar. They used to overnight the first batch of medicine for free. All their contact info, including toll-free #, is available at www.roadrunnerpharmacy.com Your vet can phone or fax a prescription to them, and they get right on it. Thereafter, you can call in yourself for refills.

 

Many hugs,

Mary

 

PS: We went the novel-protein route, using venison. We used other things before that; but until we started the budesonide, he developed inflammation within a week or two of starting each new food. So the medicine and the novel protein work together! (Or at least they had to in our case.) Happily, there are venison kibbles and canned foods out there, such as Natural Balance kibble witih sweet potato, and Wellness makes a canned too. I'll be happy to help more when I don't have to rush off as I must now. I'll check back in here on Sunday.

 

ETA: You can see Spencer, our IBD dog, on the left in my siggie. He lost about 20 lbs. before we turned him around. He gained 10 back, and he has been fine with that for the last three years. He'll be 12 in November.

 

Your Spencer's picture looks a bit like our PJay now. He was up to 72# from a racing weight of 68#. he is now at 60-61 #. We have him on a boiled turkey, sweet/whitepotato combo/peas. I started him out on just the sweet/white potato combo as a suggestion from another greytalker here. I was hoping my vet would make a suggestion, but she did not as I think she was waiting on ultrasound report. When PJay quit eating altogether, I felt I had to do something and it was the w/e and couldn't consult with our vet. His loose stools subsided almost immediately. His appetite was waning, but he did it some. I then added the turkey and lastly the peas. So far so good and his appetitie is seemingly back to his normal. He is eating once again with gusto!! I know we both feel better... My next task is to gradually attempt to switch to a dry hypoallergenic kibble with the same ingredients as he is eating home cooked. I am really not wanting to do home cooked, but in the end I may have no choice. Want I want to know is, what is the recommended percentage of fat for lymphie dogs?

[greyhead]

I'm sorry, greystmom, that I don't know the recommended fat percentage you're looking for. Just sharing our experience, we didn't go the hypoallergenic food route since those foods had so many ingredients (e.g., corn, rice) that Spencer had already shown sensitivity to, and we didn't trust those foods. (Our vets didn't recommend them either.) We went with a simple-ingredients food from Natural Balance for kibble, and the fat % in that is 10%. We've used three kinds of canned venison, currently Wysong at 7% fat (previously Wellness and Natural Balance). We recently switched away from the Wellness canned because it produced a batch with excess flaxseed and provoked a flare in Spencer, the second time that has happened.

 

In short, we've found that although fat content is an issue for us, the other possible ingredients in the foods are also an issue. Spencer can handle small amounts of additional carb-type or other ingredients. But when the foods start adding blueberries, and spinich, and kelp, and flaxseed, etc. etc., or produce an odd batch with something in excess, that's as big a problem as the fat is.

 

Perhaps others will be able to give you more authoritative figures on fat content, but I hope our experience will help you in the meantime.

 

ETA: Although this isn't your question, I need to tell you this. If you go the compounded budesonide route, which I highly recommend, greyhounds should receive half the dose recommended for other dogs. It doesn't sound like your vet is experienced with budesonide, so I thought it worth mentioning. (Spencer also has lymphangiectasia with his IBD and responded very well to budesonide. It helped that our vet had an IBD dog of her own and was willing to research alternatives to pred, knowing that our dog had no more weight to lose!)

Edited August 26, 2012 by greyhead

[RedHead]

I am not sure on the fat content but just wanted to let you know (from experience) that the ingredients your dog tolerates in fresh or cooked form may not be tolerated in a processed kibble form. From what I have found, the cooked rice or potato that always seems to firm up stools does not produce the same results in many rice based or potato based kibbles. It can go the other way as well. People think their dog is intolerant to an ingredient in a kibble (e.g. chicken) but when they give fresh chicken their dog is just fine. This is not always the case of course, but I have seen it happen several times. If you cannot find a kibble that works, sometimes adding in smaller amounts of the cooked ingredients that work now can keep things on track. I did this successfully with an old dog I had with pancreaitis and digestive problems and it worked wonders. Every ibd case is different though so advice from what worked on one dog may not work on another. Good luck!

[Guest greytsmom]

I'm sorry, greystmom, that I don't know the recommended fat percentage you're looking for. Just sharing our experience, we didn't go the hypoallergenic food route since those foods had so many ingredients (e.g., corn, rice) that Spencer had already shown sensitivity to, and we didn't trust those foods. (Our vets didn't recommend them either.) We went with a simple-ingredients food from Natural Balance for kibble, and the fat % in that is 10%. We've used three kinds of canned venison, currently Wysong at 7% fat (previously Wellness and Natural Balance). We recently switched away from the Wellness canned because it produced a batch with excess flaxseed and provoked a flare in Spencer, the second time that has happened.

 

In short, we've found that although fat content is an issue for us, the other possible ingredients in the foods are also an issue. Spencer can handle small amounts of additional carb-type or other ingredients. But when the foods start adding blueberries, and spinich, and kelp, and flaxseed, etc. etc., or produce an odd batch with something in excess, that's as big a problem as the fat is.

 

Perhaps others will be able to give you more authoritative figures on fat content, but I hope our experience will help you in the meantime.

 

ETA: Although this isn't your question, I need to tell you this. If you go the compounded budesonide route, which I highly recommend, greyhounds should receive half the dose recommended for other dogs. It doesn't sound like your vet is experienced with budesonide, so I thought it worth mentioning. (Spencer also has lymphangiectasia with his IBD and responded very well to budesonide. It helped that our vet had an IBD dog of her own and was willing to research alternatives to pred, knowing that our dog had no more weight to lose!)

Question on your experience with budesonide...Will that work on a grey who had no response to prednisone?

[Guest greytsmom]

Greyhead and and Redhead thank you for your wisdom. I admit to being a bit overwhelmed with what lays ahead as far a finding a diet with the proper requirements. Truthfully, right now, I am winging it. I am feeding home cooked as I mentioned in a previous post, but I am not sure I am given the corrrect proportions. And as a supplement, I have read where some give a regular adult vitamin. I have started that, but I honestly am uncomfortable doing that not knowing if it is the correct thing to do. My vet knows I am feeding home cooked and hasn't mentioned supplements. I am retired and money is a concern. I honestly never dreamed this kind of complicated illness would occur long term with any dog. And I have had dogs all of my life. I was not prepared... Redhead, thank you about the warning in regards to switching from home cooked to commercial I was not surprised to read that, but a bit dismayed, that I may need to start from scratch if he should not tolerate the dry food. I, however, was planning on keeping the cooked potatoes that seem to be the stool binder. :-)

 

Greyhead, thank you for sharing the info abound the compounded medication and the roadrunner pharmacy. I am going to pass this information along to my vet.

 

I am sure I will have more questions in the not so distant future.

[greyhead]

Question on your experience with budesonide...Will that work on a grey who had no response to prednisone?

 

That's a question best put to a vet who has experience with both meds. Our Spencer responded to budesonide but not to prednisone. However, when he was given pred, he had an undiagnosed case of SIBO, and it's not surprising he did badly on pred at that time. He was only on it briefly, like a week, before an internist we were consulting pulled him off of it; he hadn't yet been diagnosed with IBD either, just GI distress of unknown origins. You don't want to give an immunosuppressant to a dog with a GI infection, or it will just get worse! We didn't start budesonide until after we'd done a poop culture & sensitivity, found the exact bacterial strains, and cured them.

 

That being said, there have been greyhounds with IBD who did poorly on pred but well on budesonide. It's also worth noting, though, that Spencer didn't recover on budesonide alone. His ultrasound-based IBD diagnosis was deemed "moderate to severe," for what it's worth. He needed both metronidazole and tylosin along with the budesonide treatment in order to stop stomach gurgling/gas, digest well and gain weight, and have reasonable poop consistency. And the food component was critical too. In the end, we feed 1/3 raw venison (commercially prepared) to 2/3 venison kibble and canned -- because that's what works best for him, not for any theoretical reason. He also does poorly on probiotics, nor can he have any fish oil pills or anything of that nature. He also can't handle vitamin pills. However, he does require B-12 injections for intestinal malabsorption, as a lot of these IBD dogs do. They are easy to give at home subcutaneously and cheap too. I think you're instincts about avoiding supplements until you get the basic treatment plan in place are good. The general rule with these dogs is: simple is best. (Of course, "simple" is a relative term.)

[Guest greytsmom]

I do not remember PJay losing so much muscle mass from his thighs with his inital illness brfore dx. however it seems as if he has lost so much from his hp bones that not only do they protrude from the top of the hips, but can easily be descerned from the side of his thigh, when he lays down. Perhaps it is me, but he seems to have some difficulty getting back up from a lying position... We do have an egg crate type bedding for him, but he doesn't always lay on it. I can see red pressure marks after he lays down awhile.I am wondering about how long it will take to gain his weight back.He did gain 0.4# in 5 days. Doesn't seem like much at alll, but I am grateful, he didn't lose anymore. I hope this new dry kibble doesn't set him back, This flare up has taken a lot out of him and i would hate to lose any ground we have gained. I can tell he doesn't feel well, even though he is eating and his stools are "normal". He still has more bad days then good.

Edited August 27, 2012 by greytsmom

[greyhead]

I suggest you get a bottle of B-12 from your vet (or wherever) right away, some syringes with 25-gauge needles, and give 1cc subcutaneously. I'll look back and see what Spencer's dose was -- or maybe JJNG will pop in and enlighten us, because it's standard -- but it's something like two or three shots the first week or two, then once a week for a month, then every other week for another month, and then monthly thereafter. As I say, that's approximately what we did with Spencer. He also had trouble getting up and was becoming mentally confused. Lack of B-12 does those things.

 

IBD can involve Intestinal Malabsorption, and when it does the B-12 is low. You can test for it, but that takes time. Since B-12 is water-soluble and doesn't do any harm, it won't hurt to go ahead and just try it. Several of us have had near-miraculous results with it. It has to be an injection and not a pill, if IM is the cause, because there's something called Intrinsic Factor that's missing in the gut and that's required to process it in the gut. The injection bypasses the gut, of course, and it's very very easy to give. A vet tech can show you how if you've never done it before.

 

Sometimes in looking for the big things, like cancer, we and our vets overlook the small things like B-12 deficiency. But addressing this "little thing" gives a really big bang for the buck. Not addressing it is a very bad idea, as it results in a very weak dog who can't remember why he should even want to get up anyhow. We're pulling for you and Pjay! You can do this!

[JJNg]

Injectable B12 is usually given once weekly for 4-6 weeks, then once monthly. If the underlying disease is well controlled, the B12 injections can be stopped.

[Guest greytsmom]

Called vet and waiting for return call. He is reluctant to do 3 deck steps. Normally leaped over those. And he has been drinking much more and peeing more... This also reported to vet. Thanks for the encouragement greyhead. Doing all I can, but not gaining ground. :-(

[Guest greytsmom]

Sounds suspicious for Cushing's... After reading about progression of symptoms and his behavior I am almost certain on top of his IBD and lymphangectasis, he now has Cushing's and had had it for awhile. I am to call her tomorrow. I am sure more tests will be expected to confirm clinical signs. What then.... Sure hope it isn't.

[Guest 2dogs4cats]

I have Daisy now on homecooked food for her diabetes. It's lowfat, low sugar and digests slowly, so maybe it will help you. It's chicken, brown rice, mashed green beans and egg. The brown rice is MUCH better than white. I also add a doggy vitamin. My vet didn't suggest a human vitamin although I know some people use them. I "ferment" it overnight, so that it smells all like chicken and Daisy loves it! It's much better than commercial food for her and it's not expensive to make.

 

Hope your pup feel better soon!

[Guest greytsmom]

PJay deteriorated rapidly Tuesday and Wednesday. As of 3-4 weeks ago, I suggested Cushing's and was told no he would be eating voraciously and wanting more. By this time he wasn't eating as well as he had and through out the next month, had days where he ate well and others, not so much. He was in such distress on Wednesday, I could barely take it... As the vet walked out of the door, she turned and said, from the looks of him (he was panting heavily), she said he probably has Cushings that came on like a vengance. Personally, I think he has had it for awhile. All of this is moot at this point. At least he is no longer suffering. I did my best and there was absolutely no improvement over a 3 month period. I want to thank you all for your help and suggestions. The only good thing I accomplished for him, was to see that he didn't loose any more weight. I am so sad. I feel like I failed him in the end., but I try to remember he had 8 great years with us and we had the joy of loving this goofy, endearing, happy go lucky boy. Thank you PJay and we will rest you beside your "partner in crime", Molly. Edited August 31, 2012 by greytsmom

[greyhead]

I'm so very sorry, hon. Of course you feel awful, but you did all you could. He did have all those great years with you, and he is not suffering at all.

[Guest greytsmom]

I'm so very sorry, hon. Of course you feel awful, but you did all you could. He did have all those great years with you, and he is not suffering at all.

Thank you so much greyhead...you helped me through this with your great suggestions, which I did pass on to my vet. This website has been such a great help and comfort to me for the 8 years PJay was with us. There are so many knowledgable and kind people here.