Sam Has An Ulcer

[tbhounds]

Are you sure that you are still dealing with an ulcer?? Should have been improving by now, not digressing. Might be time for further diagnostics to be run ie: images, scope.....

[KF_in_Georgia]

If this is an ulcer, would amicar help with the bleeding?

 

He's not really worse. He's just not better. He's been taking the carafate for three days now. Breakfast was two hours ago, and he's been asleep since then, so he hasn't gotten sick again. But the morning poop wasn't good. It's time for the morning meds (metronidazole and his pain pills), but I'm inclined to wait a bit and let him sleep as long as he wants to.

 

ETA: Okay. Maybe not with the amicar. First source I found online said "Side effects can include vomiting and diarrhea."

Edited February 4, 2013 by KF_in_Georgia

[tbhounds]

How was the ulcer diagnosed?? I think I remember you saying you're giving the carafate twice daily?? I have always given it every 8 hours. Give 1 hour prior to meds & food (least that's what OSU had me do with my girl). Also, are you feeding a bland diet like I/D??

[IndyandHollyluv]

I'm sorry to read Sam is not really improving. Per my post on page 1 -- and forgive me if I missed this -- but has Sam had an abdominal ultrasound? My vet referred me to an ER vet/internal medicine specialist who saw Holly's ulcer on the ultrasound - so there was no guessing. She was dx'd one day after her intense vomiting incident.

 

While an ultrasound may not be inexpensive, neither will be the sum total of all the meds, vet visits, etc., should Sam not improve.

 

Perhaps there could be something else brewing?? I would recommend an ultrasound. Hugs to you and Sam.

Edited February 4, 2013 by IndyandHollyluv

[KF_in_Georgia]

The vet just diagnosed from visible symptoms and from knowing what meds Sam was on. Attention focused immediately on the meloxicam. No scoping was done. Sam's nearly 13 and doesn't handle anesthesia particularly well. He also has some very raspy breathing that might be early stage laryngeal paralysis (Sam didn't cooperate with that exam; his lungs sound pretty good, but his breathing when stressed is very noisy). His poop hasn't been completely liquid (lord knows, I've seen worse from him), but the color has been alarming. No bright red, fresh blood, but redder than Silver's poop, and they're eating the same food. He's now been seen by three vets over this--two at the regular practice and one at the ER. He's drinking plenty, peeing well, and shows no signs of dehydration. (His poop isn't watery enough or frequent enough to cause worries on that score.)

 

The vet just said carafate (1gm tablet) twice daily, food an hour later, other meds (pain meds and 500mg metronidazole in the morning; pain meds and Prilosec in the evening) two hours after the food. He's getting chicken (it's canned breast meat packed in water) and something extra: either rice, potatoes, or oatmeal. (He's thrown up once on the rice, once on the potatoes. He's kept down two rice meals, one potato, two oatmeal meals.) He's gotten some manuka honey either licked straight from the spoon or mixed in the oatmeal (it's unflavored instant oatmeal). The acute nausea usually hits about three to four hours after he's taken the carafate. The two times he threw up were right after he took the additional meds, but I think he already was so nauseated that the pills were just the last straw. He gets his pills wrapped in a slice of turkey, glued there with a dab of peanut butter.

 

His pain meds right now are methocarbamol, tramadol, and gabapentin. He also takes soloxine morning and night. He had been taking Doxepin for a month (usually given 3 hours away from meals), but the vet said to discontinue it until Sam's poop got back to normal, so he hasn't had it since Wednesday night. He had been on a maintenance dose of metronidazole--250mg every other day--since diarrhea would break out every time we stopped it. For now, he's getting 500mg daily. (Tylan doesn't work on him.) The vet at the ER yesterday gave him a shot of metronidazole since he'd just thrown up his morning meds.

 

It's been more than 5 hours since the morning carafate, and he doesn't appear nauseated. Maybe he slept through today's episode.

 

ETA: His first vomiting incident was Saturday morning; second was Sunday morning.

Edited February 4, 2013 by KF_in_Georgia

[TwiggysMom]

I'm glad to hear Sam kept his breakfast down! I hope dinner stays down as well!

 

You mentioned giving the carafate tablet. Do they have you crushing it and giving it as a slurry?

 

When Twiggy went through her ulcer, I was supposed to give the carafate as a slurry - it is supposed to be more effective that way. I cheated and mixed it with chicken broth and let her lap it up instead of mixing it with water and squirting it down her throat because I felt she was going through enough already, but it worked really quickly.

 

Sorry if that is what you're already doing, but thought I'd mention it if it might help Sam a little more quickly.

[KF_in_Georgia]

They didn't mention crushing the carafate. I just gave him his first one of the day, but I'll remember that for later.

 

But he's doing better. Kept down both meals yesterday, and didn't have trouble with them. Poop's not back to normal, but we're making progress. I might feel safe enough leaving him for a while to go grocery shopping. I'm out of oatmeal.

[KF_in_Georgia]

Just for fun:

 

 

Sam on Saturday, waiting for his vet to appear.

 

He seems to be feeling much better. I'll keep him on bland food at least until his poop is back to normal (the consistency is fine, the color is off). I think we have five more days of carafate, and he and Silver are enjoying the special meals. (I got more oatmeal at the store today.)

 

The Prilosec can be used for 14 straight days, and that might be a good idea.

[Batmom]

So glad to hear he is feeling better! Got some awfully cute ears there, too .

[tbhounds]

Just an FYI-you can use the Prilosec much, much longer if needed. My girl was on it daily for 9 months. Glad to hear of improvement!