Orange, Muscous-Y Poop

[greyhead]

UGH!

 

James is back on Simplicef for another staph infection. The vet thinks it's related to the issue that's causing his mucousy, loose poops but basically said to just pick another food and try again. Terrific.

 

Spencer had a brief staph infection with his SIBO (orange poops), but I can't seem to locate his thread. Here's another where I mentioned it at post 12. http://forum.greytalk.com/index.php/topic/287149-mystery-illness-for-almost-6-months/?hl=%2Bstaph%2C+%2Bspencer&do=findComment&comment=5261277 Meanwhile, I'll see if I can find anything about a possible connection between the two out on the web.

 

ETA: www.med.upenn.edu/gastro/.../Gastroenterologybacterialovergrowth.pdf This is a very technical scholarly article addressing the question of whether SIBO infections (in humans) unleash bacterial infections in other systems and places in the body, including the skin. The answer is yes, though the mechanism(s) is(are) uncertain. But it may be as simple as chronic diarrhea itself spreading germs to the skin or as complex as the immune system becoming compromised and failing to do its job vis-à-vis protecting entire systems and organs. See the page with the section heading Bacterial Translocation and Sepsis, second column, for the most pertinent statement for your situation. (sorry, I couldn't see any page numbers in the pdf file.) And maybe your vet should read this?

 

It's important to note that the bacterium involved in the SIBO is not necessarily the bacterium that shows up as a problem elsewhere. Spencer's SIBO, for instance, was due to overgrowth of Clostridium perfringens, while his skin infection was likely staph-based. (We got the skin lesion cured before needing to culture it.) To the extent you can tolerate reading it, this article should also convince one not to let a case of SIBO go undiagnosed or casually treated.

Edited October 5, 2013 by greyhead

[Guest RMarie]

Spencer had a brief staph infection with his SIBO (orange poops), but I can't seem to locate his thread. Here's another where I mentioned it at post 12. http://forum.greytalk.com/index.php/topic/287149-mystery-illness-for-almost-6-months/?hl=%2Bstaph%2C+%2Bspencer&do=findComment&comment=5261277 Meanwhile, I'll see if I can find anything about a possible connection between the two out on the web.

 

ETA: www.med.upenn.edu/gastro/.../Gastroenterologybacterialovergrowth.pdf This is a very technical scholarly article addressing the question of whether SIBO infections (in humans) unleash bacterial infections in other systems and places in the body, including the skin. The answer is yes, though the mechanism(s) is(are) uncertain. But it may be as simple as chronic diarrhea itself spreading germs to the skin or as complex as the immune system becoming compromised and failing to do its job vis-à-vis protecting entire systems and organs. See the page with the section heading Bacterial Translocation and Sepsis, second column, for the most pertinent statement for your situation. (sorry, I couldn't see any page numbers in the pdf file.) And maybe your vet should read this?

 

It's important to note that the bacterium involved in the SIBO is not necessarily the bacterium that shows up as a problem elsewhere. Spencer's SIBO, for instance, was due to overgrowth of Clostridium perfringens, while his skin infection was likely staph-based. (We got the skin lesion cured before needing to culture it.) To the extent you can tolerate reading it, this article should also convince one not to let a case of SIBO go undiagnosed or casually treated.

 

Thanks, Mary. I'm on vacation so I will read the article either on the return trip tomorrow or when I'm back home. I am 100% convinced the 2 are related, but just not sure how entirely. I don't know if it makes a difference that James isn't having diarrhea, just soft poops for no apprent reason. I started a thread on the Health forum about it the other week if you're bored and want to read more about his problems. The topic is entitled "starting to think this isn't a coincidence." Thanks for your help.

[greyhead]

I did find and read through that thread, Rachel, which is why I decided to dig a little deeper on the subject. FWIW, I don't think it has to be diarrhea. Spencer rarely had diarrhea per se, just the orange soft-serve that smelled increasingly vile (because C. perfringens is an anaerobic bacterium). He started having some diarrhea when he moved into the IBD realm shortly thereafter. Wishing you the best luck figuring this out!

[Guest AngelPup]

UGH!

 

James is back on Simplicef for another staph infection. The vet thinks it's related to the issue that's causing his mucousy, loose poops but basically said to just pick another food and try again. Terrific.

 

Wow, very frustrating. Good luck getting to the bottom of it. I wish I could be of more help, but I'm new to grey poop issues...

[Guest RMarie]

Mary, that pdf article was a dead link. But, I did read through the prior posts you sent me. I'm going to see how James does with this 3 week dose of Simplicef. If he isn't better or if he relapses, I'll definitely proceed from a standpoint of SIBO. It just makes sense at this point. If he were only having loose poop, I would just pick a new food and be done. But, to be ok for a bit and then start having mucousy poops tells me something else is going on. Add to that his staph infections...

 

Is the cobalamin/folate test something we should do prior to poop culturing?

[greyhead]

That's the standard approach, Rachel, I think -- to do the cobalamin/folate first. And that's what we did. At that time (2008), the c/f test was only being done at Texas A&M. I don't know if there are now more labs doing it. Sure hope the Simplicef takes care of things!

 

Here's the Google entry for the link, which isn't dead but isn't coming up when the URL with the ellipses is used. At least you can access it by the title if nothing else.

Small Intestinal Bacterial Overgrowth: Roles of Antibiotics, Prebiotics ...

www.med.upenn.edu/gastro/.../Gastroenterologybacterialovergrowth.pdf‎

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smithii.29 –31 However, in support of a role for bacterial overgrowth in symptom pathogenesis, studies have re- ported a parallel improvement in gastrointestinal ...

 

 

 

Edited October 8, 2013 by greyhead

[Guest RMarie]

Thanks, Mary. I read (most) of the article. I agree with you, I found the Bacterial Translocation and Sepsis section interesting. What is really weird is that this time James' staph infection cropped up on the base of his tail; all the other times were either groin pustules or the hard crusty lesions on his back between his shoulders. Coincidence? I'm not so sure.

[Guest AngelPup]

 

It's important to note that the bacterium involved in the SIBO is not necessarily the bacterium that shows up as a problem elsewhere. Spencer's SIBO, for instance, was due to overgrowth of Clostridium perfringens, while his skin infection was likely staph-based. (We got the skin lesion cured before needing to culture it.) To the extent you can tolerate reading it, this article should also convince one not to let a case of SIBO go undiagnosed or casually treated.

 

Mary, thank you for posting this article. It is very scientific but from what I did understand, it was pretty interesting as far as how SIBO can interfere with nutritional absorption and cause other illnesses and is a result of the intestines not working properly for whatever reason. I'm assuming Brady has SIBO since he has relatively normal stools as long as I give him a 1/2 Flagyl pill every other day, but if I go more than three days, he goes back to light pudding poop (or worse). I saw that you mentioned your dog had been cured of SIBO--how did you do that? Brady has a yearly exam coming up next week and I have a list going on what I want to ask the vet, so this is very timely. She suspects that Brady has colitis or some other IBD that is causing diarrhea, but we haven't done any further testing to confirm that since she said that the treatment would most likely be the same.

 

I'm going to ask her about SIBO and whether we should test to see what exactly is causing it, Vitamin B12/folate deficiency, etc. Anything else I should ask about?

[Guest RMarie]

One of the two turds in James' poo this morning was firm and bouncy!

[Guest AngelPup]

One of the two turds in James' poo this morning was firm and bouncy!

 

Isn't that a BEAUTIFUL thing?! LOL!

[Guest RMarie]

 

Isn't that a BEAUTIFUL thing?! LOL!

[Guest RMarie]

We're going back to the vet this coming Saturday. James has been having soft poops for a few weeks (after having amazing poops not that long ago) and this weekend we found a nasty pustule that looks like the ones he had before that were previously diagnosed as staph. Ugh! Mostly likely proceeding with the cobalamin/folate testing and possibly even a skin culturing.

[Hubcitypam]

...so I'm currently, slowly, transitioning to Blue Buffalo Basics turkey and potato. It's a sensitive stomach formula and has 7% fiber (green bag only has 5%), which surprised me since it's grain free.

If you think fiber is the key look into "light" and "senior" formulas. Poodle eats Natural Balance Ultra Light which is 8%.

 

Rex had chronic colitis and had runny mucousy and sometimes bloody poop. We wormed and fecaled him within an inch of his life and he had a standing prescription for Flagyl. I tried at least 6 foods but it was the Iams that fixed him. Just depends on the dog.

[Guest RMarie]

I thought fiber was the issue before, which is why I switched him to a Blue Buffalo line that has 7% fiber. His poops were great for a bit, then went mushy for no reason....or so we thought. When we found the pustule the other day, we knew we were back to some sort of infection. Which came first....who knows. It seems that every wound he gets develops into some sort of infection, and he's had 2 wounds in the last month. His immune system is compromised. I just don't know from what.

[Guest AngelPup]

We're going back to the vet this coming Saturday. James has been having soft poops for a few weeks (after having amazing poops not that long ago) and this weekend we found a nasty pustule that looks like the ones he had before that were previously diagnosed as staph. Ugh! Mostly likely proceeding with the cobalamin/folate testing and possibly even a skin culturing.

 

I'm sorry to hear that you are once again going through this. Very frustrating! Hopefully you and your vet will be able to get to the bottom of it!

[Guest RMarie]

James went to the vet this past weekend. He's lost about 6lbs after having soft poops over the last few weeks . He had bloodwork done. We did a mal-absorption test and a CBC. The CBC was normal, but the mal-absorption test showed elevated TLI and slightly decreased B12 and folate. He's currently on a 10-day regimen of sulfasalazine, which instantly helped calm his gut and firm up his poops (they're also smaller, which I'm hoping means he's actually now absorbing some of the nutrients from the food rather than just pooping them back out).

 

The next step would be to do a biopsy to diagnose IBD. I really don't want to put him through that, though. Is that a bad decision on my part?

[Guest Celestrina]

No. It is an expensive test where he will need to be sedated. All symptoms and other tests point in that direction.

[greyhead]

No, that's a good decision, not a bad one!

 

After the same test you had showed malabsorption, we elected to look at the gut by ultrasound. My vet and a radiologist did it together and agreed that the findings, which were described to me in detail, strongly suggested moderate to severe IBD. A biopsy was not going to change the treatment at all, and it would have put him at great risk as sick as he already was. So in consult with our vet we declined to do a biopsy and treated him successfully for IBD for four more years. The official, textbook, internists' stance is that you don't have a diagnosis of IBD unless you have a biopsy. But you don't really need an internist to treat it anyhow, just a vet who's willing to do some research.

 

Let me jump in now and suggest that if and when your team decides it's appropriate to treat for IBD, please, in the name of all the greyhound angels and saints, try budesonide instead of prednisone. You can get more info on that from tbhounds, Burpdog, and myself. But one mustn't treat with either of those unless and until any bacterial infection has been knocked out! Because those steroids are intended to get the immune system to back off, which would be bad during an infection.

Edited November 27, 2013 by greyhead

[Guest RMarie]

I guess my question is when do we treat him for IBD? When his poops get soft?

 

To rewind his current food situation, he was on Iams months ago but we cut that out after unexplained soft poops. We switched him to Blue Basics grain free turkey and potato (sensitive stomach food). We was doing great on that. When we had Moneypenny for the 2 weeks before returning her, his poops were soft from stress, no doubt. As soon as we returned her, his poops were awesome...the best ever! All 3 poops during the day were fantastic, firm and bouncy. Then, they got soft again a few weeks ago. He's back on a 10-day regimen of sulfasalazine, though given his test results the vet isn't sure 10 days will be enough.

 

If his poops improve, do we just wait to use steroids? Do we use steroids even if his poops are good?

As far as bacteria, the vet said there was no evidence of bacterial overgrowth to indicate SIBO. I guess you can tell that from blood work because we did not culture his poops?

[Guest AngelPup]

Good luck with everything RMarie! Our vet said that if it comes to it, we can have Brady officially diagnosed with IBD (or rule out other issues) by taking him to an EV down the road from them since they apparently have a radiologist who specializes in that, so a biopsy might not be necessary. Our vet did say that if we go the biopsy route, it would mean sedation and taking several biopsies in different areas of his intestinal tract to confirm. But she also said that the treatment would be the same anyway. Brady is still on Iams, although the output isn't as great as in the beginning and we're still trying to wean him off the Flagyl. Seems that every time I get down to 1/2 pill daily or every other day, he goes back to pudding poop.

 

As far as the number of poops, the vet said that the more grains/fiber, the more frequency/larger size stool. She said we could try a grain free or limited ingredient as long as it says easily digested and/or sensitive stomach on the bag, but I haven't tried anything else yet. We recently adopted another dog who does great on Iams (they actually look TOO hard) and I don't want to mess with anything until she's settled and we're sure she doesn't have worms or another parisite.

[GreytNut]

After lots of Flagyl, other antibiotics, and anti-IBD meds, we had this same trouble. The internist recommended giving L-glutamine (500 mg/day). It was amazingly effective at making for coherent poop! It both heals intestine/stomach walls that have been inflamed AND discourages bad germs from multiplying. It's pricey but worth it. And we used the TwinLabs brand effectively, while the SolaRay (sp) brand didn't help.

 

Thank you! Just ordered some of that for Riley. He's coming off a course of antibiotics and he's had terrible diarrhea. Probiotics seem to be helping but they are slow to kick in and we still don't have totally firm poops yet. I suspect the L-glutamine will help to soothe his tummy.

 

To the OP and to RMarie, I hope you find out what it ailing your pups. Have you tried adding human probiotics like Culturelle and/or plain lowfat or nonfat Greek yogurt to their food? If your vet gives it the green light, it might help. It's not a quick fix because the good bugs need time to build up their population.

Edited November 28, 2013 by GreytNut

[greyhead]

I guess my question is when do we treat him for IBD? When his poops get soft?

 

To rewind his current food situation, he was on Iams months ago but we cut that out after unexplained soft poops. We switched him to Blue Basics grain free turkey and potato (sensitive stomach food). We was doing great on that. When we had Moneypenny for the 2 weeks before returning her, his poops were soft from stress, no doubt. As soon as we returned her, his poops were awesome...the best ever! All 3 poops during the day were fantastic, firm and bouncy. Then, they got soft again a few weeks ago. He's back on a 10-day regimen of sulfasalazine, though given his test results the vet isn't sure 10 days will be enough.

 

If his poops improve, do we just wait to use steroids? Do we use steroids even if his poops are good?

As far as bacteria, the vet said there was no evidence of bacterial overgrowth to indicate SIBO. I guess you can tell that from blood work because we did not culture his poops?

 

All I can share is what happened to Spencer, plus whatever I've picked up from other GTers who have had this problem. Spencer's blood work didn't reveal SIBO, although on the TLI test the cobalamin being low and the folate normal meant he had malabsorption, which is a possible indication of SIBO. (The vet treated briefly with a very low dose of Tylan and, when he didn't improve, wrongly concluded that it wasn't a case of SIBO.) I had to push, push, push for a poop culture and even tell them what three bacteria I wanted them to test for! They rolled their eyes, but they did it. Came back WAY positive for the bacterium I most suspected. And knowing the bacterium involved allows the lab to test which meds will best kill it.

 

If I were you and the sulfasalazine doesn't work, I'd have an ultrasound of his GI tract done, stomach and intestines and nearby organs. If there is inflammation and thickening of the intestinal walls, for instance, the US should show that and pinpoint the location(s) where the problems are. If the dog has lost a lot of weight and isn't really young, I'd resist biopsy, especially because the information gleaned doesn't really change the treatment. If the US indicated IBD, I'd treat for IBD. That's what we did. (Where we live, an ultrasound runs around $300, plus or minus $100 depending on where it's done.)

[Guest RMarie]

Thanks Mary. It was looking like the sulfasalazine was working, but his poop has started getting soft again these past few days. I'll call the vet Monday and let her know and inquire about doing an ultrasound. I'm starting to wonder if his pancreas isn't the root cause.

[Guest RMarie]

We're re-starting sulfasalazine again tonight and James will be getting an ultrasound on Tuesday, Dec. 17th.

[Burpdog]

If he has an absorbtion problem, why not put him on enzymes? I don't understand.