Sarge's Ultrasound Results

[claudiav]

Can someone in the medical field translate these findings for me? My vet said she thinks the campylobacter infection is still embedded in the intestinal tract, and we are treating him with Baytril (since a month of Tylan didn't kill it) but I wish I could understand all the terminology...

 

[fliggie]

I can't decipher it all, but it appears as though they are looking at a bacterial infection, as you noted, and issues with renal disease/kidney disease. They want to scope his GI tract.

 

I'm sure someone else will chime in and edit/correct, but that seems like the low down.

[kudzu]

This is my layman's take on the report. Spleen is larger than average for dogs in general but normal for a Greyhound. For bowels you should rule out bacterial infection or something diet related. The walls are thicker than average. That's diffusely, meaning basically all over in the bowels not just one spot. Lymph nodes in that area were somewhat enlarged. That could all be from infection. Not sure what's meant by the layering comment. For kidneys you should rule out chronic renal disease. Reduced architecture can happen as dogs age. If bloodwork & U/A don't look suspicious then I would not worry but would speak to the vet for more details. They recommend upper GI endoscopy. Would guess part of the reason would be to get samples for further testing. FISH=Fluorescent In-Situ Hybridization It can be used to check for bacterial infection. It says if the owner chooses not to pursue that then you can try antibiotics to see if that helps. It also adds that you, the owner, have chosen to try the antibiotics first.

 

ETA: Found some FAQ on FISH testing from Cornell. https://ahdc.vet.cornell.edu/sects/Refer/fish_faqs.cfm

Edited September 24, 2013 by kudzu

[claudiav]

Thank you Kudzu! yes, CBC, U/A, stool sample, testing for Addison's disease, testing for Malabsorption vs Maldigestion, and FISH testing have been done prior to ultrasound. Stool sample a month ago revealed campylobacter infection in the large and small intestine, and the malabsorbtion due to the kidneys having been put under the stress of severe dehydration (he has had diarrhea for 8 weeks now). He was on Tylan powder for a month, but it seems it didn't kill the campylobacter infection, which she said is very resistant to many ABs. So we are now on Baytrill and hoping those do the trick. I was concerned there was a tumor that was causing him pain, and that's why he has not been eating.... he went on a four day hunger strike... we gave him inappetance and anti-nausea pills.... I have even fed him by syringe b/c he wouldn't eat and I will not let him waste away.... i'm hopeful that she doesn't see what typically would look like cancer, but more likely the infection that has not been killed off.... of course, if Baytril doesn't work in 14 days' time, it may be time for that biopsy (upper GI endoscopy) which I swore not to put him thru... and if his appetite doesn't improve, he will need to go on some sort of steroid, but I am so worried about it as he is already a bag of bones, and I don't want it attacking any other organs in the process... this boy raced @ 78 lbs and he was down to 64 yesterday.... the Baytril needs to kick that infections' ass and my boy needs to gain weight!!!

[kudzu]

The following is just guessing based on my experience with a cat who had gi lymphoma. Would think that if cancer was a high suspicion then they would go for a biopsy via abdominal surgery not endoscope. Endoscope would give a look around that area & rather small samples of a limited area so may be used when trying to get different samples for better check on bacteria.

 

Totally understand wanting to avoid the biopsy, even endoscopy rather than surgery. Also understand wanting to avoid the steroids. Been there; done that, with mixed results. Hope very much the Baytril does the trick.

 

Can't remember. I know you've posted about this issue before & have tried LOTS of things. Have you tried B-12 injections? That wouldn't be a solution to a bacterial infection but is often very helpful nonetheless when GI issues contribute to malabsorption. The injections can be done sub-q at home. Really easy, can give appetite a little boost & also help the dog feel a bit better while you continue treatment & diagnostics.

[krissn333]

I'd go longer than 14 days on antibiotics since the vet said this is a tough one to kill off. Might need to go with 21 days of Zeniquin.

[tbhounds]

Just want to add-if it becomes evident that a corticosteroid is needed I would suggest you use budesonide rather than pred. Budesonide stays, for the most part, in the GI tract -pred is more systemic (with all the side effects).

The u/s report really isn't so bad-most everything is pointing to IBD or a bacterial infection. They did mention chronic kidney disease-assuming the renal values where normal did you say you ran a urinalysis-checking for concentration and protein??

[claudiav]

I changed Sarge's diet abruptly when i adopted him, and likely caused the whole problem. Though, I'm still confused why it took 4 days for the diarrhea to start. However, when it started, it was AWFUL! It exploded out of him, he couldn't control it, he was having accidents in the house, yet his appetite was ON! I waited too long to bring him in b/c I wanted him to see my regular vet, who was not in for 4 days. By then, she took one look at him and said he needs to be admitted, he is severely dehydrated. I freaked out and blamed myself, but I didn't know these diarrhea episodes can be so dangerous with greys, and they can lose them if severe enough. I learned my lesson, that's for sure: no more abrupt food changes, and no waiting over 24-48 hrs of diarrhea starting.

 

As a result of that severe dehydration, two months ago, his kidney values dropped drastically, and we have been monitoring them to make sure they slowly come back up. I am giving him weekly B-12 sub-q injections. Thankfully, we are not in the kidney disease stage... but he did have some damage b/c I waited too long and he was so badly dehydrated. It must be at this point that he picked up the infection and it has been HELL to get rid of it. We are now on Zeniquin, and within 2 days I have already seen an improvement in his poops... we had our first non-diarrhea, slightly formed poops and I swear I did a celebratory dance. He loves this Iams low residue vet food, and he's eating it with gusto. I can't remember the last time he ate the same food three times a day --- much less, with gusto! So I think we're on the right track. My vet agrees and I can't be any happier.

 

God, it's been a long, rocky road, but I am hopeful we are turning the corner.... and I am so elated it's not cancer!!! he wasn't responding to Tylan and his appetite was not improving... like I said, he even went on a four day hunger strike, and I had to feed him by syringe... I thought he was dying....

 

now we gotta fatten up my gorgeous bag of bones

Edited September 25, 2013 by claudiav

[greyhead]

Claudia, food changes don't cause bacterial overgrowth. That is not your fault!

 

Further, my vet never ever recognized the possibility that our dog's SIBO was SIBO! I had to finally just *order* them to do a culture & sensitivity on the poop. This is not your fault, and I'm glad you have a much sharper vet than we did. (Well, like my vet, yours went after it first with Tylan, which is too mild.) Repeat: Food changes don't cause SIBO (unless the food is contaminated, and that's a different issue entirely).

[claudiav]

Claudia, food changes don't cause bacterial overgrowth. That is not your fault!

 

Further, my vet never ever recognized the possibility that our dog's SIBO was SIBO! I had to finally just *order* them to do a culture & sensitivity on the poop. This is not your fault, and I'm glad you have a much sharper vet than we did. (Well, like my vet, yours went after it first with Tylan, which is too mild.) Repeat: Food changes don't cause SIBO (unless the food is contaminated, and that's a different issue entirely).

 

Sorry to sound ignorant.... I've learned so many abbreviations here... What is SIBO?

[greyhead]

SIBO stands for Small Intestine Bacterial Overgrowth. Bacteria that are normally found in the intestines sometimes over-grow or multiple beyond the level at which they are supposed to occur for normal balance of the various intestinal bacteria. Campylobacter is one of those normally-occurring bacteria that can over-grow under certain circumstances. The circumstances leading to a case of SIBO are not perfectly understood, but in our family it happened after administration of an antibiotic (clindamycin) after a dental cleaning. In the end, clindamycin was one of the three anti-b's it took to get rid of the SIBO (which in our case was Clostridium-based).

 

Sorry for the abbreviation without explanation. My fault entirely. We all come here in ignorance, whenever we need help, no matter how many thousands of posts we've made previously. So no apologies are necessary for that. Ever.