Budesonide Vs Pred For Ibd

[Guest elizabeth7418]

My Addy was unofficially "diagnosed" with IBS/IBD this past July. We haven't gone through with an ultrasound/biopsy because, at the time, our vet didn't feel it necessary.

 

Quick background on my bub: she was positive for hookworm from March-November of 2013 (we adopted her in January of 2013), and tested positive again in July of 2014. She's on monthly heartworm preventative (was Heartgard, now Sentinel). She's always had relatively soft stools and gone through periods of food picky-ness (usually about once a month she'd go on a hunger strike). She was kenneled for 10 days in June while we were on vacation, and had really bad diarrhea when we picked her up. She was treated with Flagyl, Centrine, and Forti-flora, and nothing seemed to make a difference. Took her to the vet in July for unrelated concerns, which was when she tested positive for hookworm again. After explaining her history to the vet (we have a vet here in Illinois, but I was visiting my parents in PA, so we took her to my mom's very grey-savvy vet), the vet suggested that she could have IBS or IBD, probably caused by prolonged hookworm infestation. She put Addy on Sulfasalazine, and we immediately saw improvement in both her stools and the frequency of her "hunger strikes." We also tried Olewo carrots, which did wonders for her poop, but she had a likely allergic reaction to them that caused her back feet to get bright red and itchy. The skin condition went away as soon as we stopped using the carrots.

 

Fast forward to today, and her poop is really bad again (not quite liquid, but definitely on the soft-serve end of the spectrum). Her hunger strikes are also becoming more frequent. My vet had said that prednisone would be the next step if the sulfasalazine stopped working, but, from what I've seen on here, Budesonide is much preferred to pred. My mom has a grey on pred (and also used to work at a vets office), and hasn't heard of budesonide, so I'm seeking your advice. I have an upcoming appointment with the vet, and I'd like to suggest trying her on budesonide, but I want to go into the appointment prepared. What are the big differences between the two? Benefits to budesonide vs pred?

 

Thanks so much in advance!

 

Also, here's my bubby (I posted this on the Greytalk facebook page this morning, so you may have seen it already).

 

[MaryJane]

Have you tried a diet change yet? My Lucy, who has IBD, is on a white fish diet - it gets added to rice, veggies and oatmeal. She also gets a probiotic and vit B12 shots. Have they checked the VitB12 and Folate levels?

 

Lucy is a seizure dog and is already on 3 meds for the seizures and because of this, additional meds for the IBD will likely be our last course of action.

[greyhead]

We used budesonide instead of pred for Spencer, our IBD dog. He had already lost 20 lbs and had no more to lose. Budesonide targets the gut and avoids the wider-ranging side effects of pred, so no weight loss at all. The only side effect we saw was fur loss on the legs and chest over time (three years).

 

He also had a permanent case of hookworm that did a lot of damage before it was caught. But before the IBD he got a long case of SIBO, in his case a vast overgrowth of two strains of Clostridium perfringens. That tends to kill intestinal tissue and leads to intestinal malabsorption. It can be fatal. So I don't really advise going to an immunosuppressant of any kind, whether budesonide or pred, until you've had a fecal *culture* (culture and sensitivity) to rule out bacterial overgrowth. Otherwise, you're just giving the bacteria a helping hand, you know? (Vets don't seem to do fecal cultures readily, partly because they expect to find many bacteria occurring naturally. It's the *number* of specific bacteria that's important to find out, that determine an overgrowth. We finally had to just order our vet to send it to the lab and get it done!) It took three antibiotics to clear the SIBO. By that time he had developed IBD, and we treated him for that.

 

Good luck. Let me know if I can be of any help.

Edited November 24, 2014 by greyhead

[Guest lsanta]

Hi, everybody. I'm new. My 11-month old boy, Manolo, has been diagnosed with SIBO. I need some opinions. What causes SIBO? The vet began with Flagyl, but it didn't help him. Now he's on Tetracycline and Ketoconazole?. How long should I wait to see results, if any? I'm really desperate and hate to see him poop so badly! Please help me. Thank you. His folate levels are 14.1, he said that it's not EPI. What to do???

[Houndtime]

I am just copying and pasting were I responded to another post. I don't want to be negative about vets, because I really trust and believe in them, but, I have had two greys diagnosed with IBD, who eventually, did not have it.

 

 

We went through this last year with Fuzzy. We spent $1300 on tests and meds in about 12 days. Next was a stomach scope and biopsy and I just took a breath and said hold it.

He did terrible on prednisone. We had him on it for three days and it took 10 days to get him off. I did the veterinarian's potato diet and then put him on a single protein diet. I chose Dick Van Patten's Duck and Potato and kept him on it for about a month. I bought kibble, canned and treats all the same.

Look up the potato diet and give it a shot. Fuzzy was better in about 12 hours. He had lost 11 lbs. Also, make a slurry with slippery elm bark (health food store), pumpkin, probiotics, oatmeal, and yogurt can help too. Just, not all at once. Good luck with your pup.

Edited by Houndtime, Today, 09:00 PM.

[NeylasMom]

What did you actually do to treat the hookworms? What medication(s), what dosage, dates (or what frequency)?

[greysmom]

Our Lilly is also dealing with much the same issue.

 

She had hooks very bad for a small, 11 week old puppy when we got her and it took several months of treatments (I've forgotten exactly what, but it was 2 or 3 different meds). She has *always* been an extremely picky eater, and also gets violently car sick.

 

In September she began to have a long bout of whatever-it-is - diarrhea ranging from liquid squirts to soft serve to fairly good poops, nausea which makes her not want to eat, horrible tummy noises - all in a cycle which seems to be repeating about 2 weeks long. We thought her stomach was getting too empty so we adujusted her eating schedule to include a snack before bedtime. This evolved over time to her refusing to eat in the mornings at all, so for the last two months, she has only been eating food at dinner and before bed. We also tried an elimination diet and changed her over to a salmon and potato limited ingredient diet. Both of these changes worked for a little while - good poops, eating relatively normally (for her), no stomach noises in the morning.

 

If you try an elimination diet, chicken is a good place to start. Unfortunately, there is chicken in EVERYTHING so you have to read labels like mad and eliminate ALL sources. Even Pill Pockets have the first ingredient listed as chicken, so it's not just food or treats.

 

But we are now back to square one and waiting for the results of a consult with an internal medicine specialist to see what to do next. By coincidence, an xray of her abdomen for something else, clearly showed the walls of her intestines and they were quite thickened (the vet estimated approx 5mm), so we're pretty sure we are dealing with some sort of IBD. I, too, mentioned budesonide to my vet, and she was not all that excited about it. She knows greys so I expected her to be more knowledgable about using budesonide. I'll be watching to see if there are more answers to your question.

 

But you do need to rule out hookworm (and other worms), SIBO, and even food allergies. The only way to definitively diagnose IBD is an intestinal biopsy, so you want to be sure you will get a result that means something if you put your dog under for surgery.

 

 

 

Isanta - SIBO is a bacterial overgrowth in the intestinal tract. It can be caused by several things though I've usually seen it after a long course of antibiotics that kill off all the good gut bacteria - which can happen if you are treating for stubborn infestations of worms. If you don't have the right kind of antibiotic, it won't kill off the bugs you want it to, so it needs to be targeted. Flagyl is relatively low key as antibiotics go, so you would need a stronger one, too. It can take several weeks of treatments to clear a SIBO infestation. At the same time you should be giving him a good pre and pro biotc like Forti Flora from the vet to re-culture the intestines with good bugs. I have also heard that they use high fat buttermilk in the racing kennels for this purpose. If he has bad diarrhea, make sure he stays hydrated by drinking water, broth, Pedialyte, etc.

[phall]

So sorry you are going through this. My boy, Star, has and continues to be treated for colitis/IBD. We believe it, too, started with a prolonged and severe hookworm infestation. After trying many, many over the counter foods including several that are listed above, and probiotics, none worked for Star. Unfortunately the only food he handles is prescription W/D kibble with canned I/D, with some cooked pasta and chicken. We went through a couple of years with Star on metronidazole, sulfasalazine, Pepcid, and another prescription (can't remember the name and I don't have it with me right now). Even through that, he had flare ups sometimes caused by stress and sometimes for no reason we could figure out. Fast forward to today - about 3.5 years since we brought him home and we realized his problem - Star continues to be on the same diet. He is on a maintenance dose of metronidazole and Pepcid, but does not need the other meds unless he has a flare up. He hasn't had a flare up in about a year. I tell you all this because I know it can be so hard to go through this with your greyhound. Hang in there.

[Guest elizabeth7418]

Thank you all so much for the responses! I forgot to mention that she's been on Tylan powder since July with no real improvement.

 

As far as treating hookworm, we've used drontal plus (didn't work), drontal plus with panacur (didn't work), pyrantel (finally kicked it...this was last year from March-November), and then panacur again in July which took care of that infestation. I don't remember dosages except that they pyrantel was given over a period of 8 weeks.

 

She currently eats (and has eaten since September 2013) Castor & Pollux grain free chicken kibble with boiled chicken as an add-in. During that time period, we've tried switching her food to fish-based kibble (two different ones, I don't remember the first, but the second was Pure Balance grain-free salmon) as well as game-based (Pure Balance bison maybe?), and she absolutely would not touch any other kibble. I have a feeling that chicken is the issue, but it's so, so hard to watch my 9-year-old baby absolutely refuse to eat anything, when she will eat the chicken.

 

We're heading to my parents' for Thanksgiving this Wednesday-Sunday, and she definitely eats consistently there (they have two greyhounds, so she knows that she has to eat or they'll eat her food). I believe my mom feeds grain-free salmon, so I may try gradually changing her over to that while we're there to see how that goes. I will also have a fecal culture done to rule out (or diagnose) SIBO.

[inugrey]

I highly recommend you join a Yahoo group called IBD dogs. It was very helpful.

Good luck finding your right cocktail.

[tbhounds]

First my sympathies-true IBD is a horrible disease but, luckily many times it can be managed. I do think you may be jumping the gun in starting a corticosteroid -idk, perhaps you have run other tests already? Of course it's hard for one to chime in without knowing all the history--prior tests runs, blood work..... Some tests that I would rec are a bile acids test, TLI also, many labs offer pretty comprehensive diarrhea panels that you may want to discuss with your veterinarian.

I would definetly start by offering a novel protein, novel carb diet. Other food options would be to offer a hydrolyzed diet. Other factors are to determine if your hound may be fiber or low residue responsive. One also needs to rule out IBD versus food sensitivity. Of course the recommended diagnostic test is to get what they call true cut biopsies of different sections of the gut and stomach. Often this test is balked at because the fear of surgery but to be honest it is the only way to receive a definitive diagnosis.

IBD is a complicated disease requiring strict management. If it's determined that your hound has IBD and a corticosteroid is recommended I do prefer budesonide over pred for many reasons. Sadly, many clinicans are not familiar with its use in veterinary medicine and for that fact I would recomend you seek out an Internal Medicine Vet. Budesonide is a very strong corticosteroid but, the majority of the drug stays within the GI tract and therefore has less systemic side effects. It is also not inexpensive :-(

Hope this helps--keep us posted.