Sam Has An Ulcer

[KF_in_Georgia]

Dark, tarry poop, so we went straight to the vet. (They had an opening an hour after I called.)

 

Now he's on twice daily carafate, wait an hour, bland meal, wait two hours, the rest of his meds (famotidine, metronidazole, methocarbamol, gapabentin, tramadol, and thyroxine) for the next five days. No more Doxipin until his poop stabilizes. (Doxipin is not likely to be the problem, but it's the newest addition to his pills.)

 

And no more meloxicam for his arthritis. Ever.

Edited January 31, 2013 by KF_in_Georgia

[JohnF]

That's scary. My last dog was on Metacam or Meloxicam for many years but, due to the bleed risk, I only gave the full recommended dose on days when her arthritic shoulder was acute.

 

There is a kaolin plus probitoic medication you can give that helps too.

[KF_in_Georgia]

He's been getting a little less than the full dose since November or so. Before that, he only got it occasionally. (Full dose = one half of a 7.5mg tablet. I've been halving the tablet with the pill splitter, then snipping off the corners to whittle the dose down a little in case the pill splitter didn't split it evenly.) Sam's also been getting a probiotic capsule in the evening.

 

He's eating well, no vomiting, no fever, so we probably caught this in time to prevent complications. Happily, he loves chicken and rice, so the bland diet won't be a problem.

 

At least I'm working from home these days. That'll make 3-hour meals twice a day a little easier to handle.

[TwiggysMom]

Yep, Twiggy got ulcers from Metacam, too. A course of carafate cleared everything up quickly, and she's right as rain now.

 

No more Metacam for her anymore!

[tbhounds]

Ok-absolutely not judging here-not my intention, however, I couldn't help but to notice you were using the human meloxicam. This is one of the dangers with this form of med--I know you can develop GI ulcers from the veterinary product too just doesn't seem to be as prevalent. This is why I always sound like a broken record when folks here ask about dosing with the vet formula vs human.

The carafate should help pretty quickly. You know you can melt the tablet in a oral syringe with warm water right? Sometimes giving the liquid is a bit easier. Did the vet recommend giving priolsec too??

[KF_in_Georgia]

The vet didn't mention prilosec.

 

Sam always got the pill form of meloxicam on top of two cups of kibble (plus pepcid), so we thought he'd be okay. Isn't the liquid/vet formula expensive? (Sam's been taking seven prescriptions, plus heartworm/flea/tick, pepcid, and probiotics.

 

He gets pills inside a piece of sliced turkey. These days, I glue the pill(s) in the turkey with a dab of peanut butter. He can't figure out how to spit out the pills without losing the peanut butter, so he'll swallow the whole thing.

[tbhounds]

I would ask if they thought if Prilosec (omeprazole) would be of benefit---and sady, there is a big cost difference between the human meloxicam vs the vet formula. I'm sure that's what makes the tablets more attractive to owners. Believe me-I get it-I'm all for saving a buck when I can-I'm just not convinced that dosing with the human meloxicam is the safest route to do so.

Hope he improves quickly!!

[IndyandHollyluv]

Oh poor Sam. Just fyi - a few years ago, my (angel) Holly, 12-1/2, was dx'd with protein losing nephropathy (PLN) and an angry duodenal ulcer (she had a one-time only awful vomiting incident). Took her to ER. Long weekend but ultrasound revealed an ulcer which the vets thought was related to the PLN.

 

Anyway, ER vet prescribed antibiotics, Carafate, Prilosec, Tramadol -- but Holly, as I expected, by Day 3 refused all meds no matter how I disguised them. I think she got a taste of a nasty Tramadol so she rejected ALL meds -- guilt by association. She was a very (emotionally) sensitive girl and forcing her to take meds seemed to violate her trust in me. So I let Holly do it her way.

 

After reading several posts on GT and the Internet ... I purchased some Manuka Honey - and that Holly was okay with (like a teaspoon give or take). Manuka Honey has anti-bacterial and anti-inflammatory properties. I purchased jar at a local health food store for about $17 - or you can order online.

 

I want to mention that I also gave Holly some Metacam (not a ton) for back issues during her senior years. That could have been a contributing factor so I have nixed that med for my puppers - at least on any regular basis.

 

Holly had no further vomiting incidents. I eventually lost her to kidney issues but I believe the ulcer was under control once I started her on the honey.

 

Oh, you may want to reconsider the rice. Not all doggies do well with rice. Mine all seemed to suffer GI upset or diarrhea, mushy stools whenever rice product was on the menu.

 

For mild to moderate pain, etc., instead of Metacam, my vet recommended the Chinese herb "Body Sore," which all of my seniors have been on. No problem, no ill effects. I purchase the powder form which comes in a jar (and which you store in the fridge).

 

Good luck to you and Sam. Hope he feels better soon.

Edited February 1, 2013 by IndyandHollyluv

[KF_in_Georgia]

Sam generally does okay on rice--except that he makes an awful mess with it. I'll probably pick up some potatoes tomorrow. And I have some manuka honey I can give him.

[JJNg]

Ok-absolutely not judging here-not my intention, however, I couldn't help but to notice you were using the human meloxicam. This is one of the dangers with this form of med--I know you can develop GI ulcers from the veterinary product too just doesn't seem to be as prevalent.

 

I agree. And I suspect that part of the reason we see more ulcers with the human generic meloxicam is that many vets round up on the dose. Half of a 7.5 mg tablet would be an appropriate, full dose for an 80-lb dog. For any dog smaller than that, you're rounding up on the dose, unless you're giving 1/3 of a tablet, which IMO is hard to do accurately. Unfortunately, Pepcid won't prevent ulcers caused by NSAIDS, just treat mild ones as they develop.

 

Sending good thoughts that Sam is back to normal quickly!

[KF_in_Georgia]

He's worse this morning. Or, at least, just as bad, and he's been on the carafate a day and a half. Vet appointment in an hour-plus. He seems to feel fine, but that poop is scary-looking. We'll head for the vet's early and hope they have a cancellation. Besides, he hates the car ride so much, and getting there early will give him a chance to calm down.

 

(How good does he feel? He stole a loaf of stale bread out of the kitchen trash while I was drying my hair and couldn't see/hear what he was up to. I caught him just as he was getting through the plastic wrapper. Curses! Foiled again!)

 

ETA: He's had a bit of manuka honey--but not today. And I'll ask about Prilosec.

Edited February 2, 2013 by KF_in_Georgia

[greytpups]

Poor Sam, hope he gets better soon

[Remolacha]

Poor Sam

[KF_in_Georgia]

Home from the vet. Vet gave us more carafate and authorized Prilosec in place of the Pepcid. (He said 2.5mg a day on the Prilosec. Does that sound right?) Also okayed the manuka honey.

 

The vet said the thing to worry about was vomiting and/or loss of appetite. That would mean the ER. So I got Sam in the house when we got home, and he promptly vomited breakfast.

 

There's no blood in what he vomited, so I'm thinking this is Sam being carsick, which is not unheard of. I called the vet's office, but they'd already closed. Gums and tongue are an okay color (the vet said they weren't as pink as usual, but nothing to worry about).

 

RIght now, Sam is sacked out on his bed, looking like a dog who's had too much riding in the car and hanging out at the vet's.

[KF_in_Georgia]

Clearly, my vet is not used to prescribing Prilosec. It comes in 20mg tablets or capsules, so getting a 2.5mg dose per day doesn't seem feasible.

 

I bought a 14-count package of the 20mg tablets. But for now, I'm giving Sam the 20mg famotidine that we were going to stop in favor of Prilosec. But can one of you vet-types tell me the recommended dosage for a 66-pound greyhound?

 

As I was leaving the vet's office today, I told him that if there was a problem, I'd be checking in with you guys on GreyTalk. He actually nodded agreement; he hasn't disagreed with any of your recommendations so far.

 

ETA: I checked the forums and found a thread where one vet recommended 25mg. I'm thinking my vet just misplaced a decimal point. At any rate, the recommendation from you guys was for 20mg. Since I've already given Sam a dose of Pepcid, I'll wait until tonight's series of pills and give him the 20mg Prilosec then--unless I hear otherwise from you guys.

Edited February 2, 2013 by KF_in_Georgia

[tbhounds]

Its 20mgs of Prilosec once daily :-)

[KF_in_Georgia]

Thanks. I'm convinced that his vomiting this morning was definitely car-sickness. He's already made two trips to the kitchen to look for something to get into.

[Guest grey_dreams]

Thanks. I'm convinced that his vomiting this morning was definitely car-sickness. He's already made two trips to the kitchen to look for something to get into.

 

Yay for naughtiness He must be feeling better! Hope he continues to improve!

[KF_in_Georgia]

Four hours after he ate breakfast, I got back the breakfast and his meds (and lots of bile--but no blood). So we've paid a visit to the ER for him to get Anzemet and Metronidazole injections--the first for the nausea, the second because that's the most critical of the meds he upchucked.

 

He's able to keep down water, so he didn't need fluids. In a bit, we're going to start the dinner routine and see what happens.

[Batmom]

 

Fingers crossed that dinner stays down!

[KF_in_Georgia]

As I was leaving, they said that if I need to bring him back in within 12 hours, they'll waive the $104 exam fee. That's nice to know, but I'm hoping I won't need that.

 

Sam adores vets and vet techs, especially male ones. The tech brought Sam out to me, turned to go, and Sam tried to follow the tech out of the room.

[Batmom]

Sam

 

Can be embarrassing when it's your own dog, eh?

[KF_in_Georgia]

Yeah. He cheered up the folks in the waiting room with that one. Then he circled through the room to get petted by everyone.

 

He's done this before (leaving me so he could follow a tech) when his regular tech brought him to me after a dental. But this tech was a total stranger.

[KF_in_Georgia]

After less than four hours after the Anzemet shot, Sam was fighting to hold down his dinner and meds. He managed, mostly because I kept urging him to lie down and get petted. He'd nap for an hour or so, then get up, wander around looking distressed, drooling and licking his lips, and swallowing hard, until I could get him to lie down again. We're now 8 hours past dinner, 6 hours past his meds, and he's sleeping peacefully.

 

We'll be up early to try again for breakfast. (He's lost breakfast two days in a row.)

 

Fingers crossed.

[4My2Greys]

Hoping breakfast goes well this morning for Sam.