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3 year old has Ascites and we are not sure how to proceed


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Hello,

My 3 year old boy Enzo developed Ascites about 1 month ago out of nowhere a few days after his yearly checkup. His swollen belly was initially accompanied by diarrhea, excessive drinking of water, and some vomiting which made us think he was sick. A few days later, his belly went back to a normal size and his eating/pooping/peeing habits went back to normal as well. About 1 week later his swollen belly came back. As soon as we noticed his swollen belly, we took him to the vet where they took a sample of the fluid and his blood. Blood tests came back mostly normal, but his Total Protein was at 5.5 (which seems to be in the normal range for greyhounds?) and his Albumin was at 2.0. The fluid was clear and did not indicate any inflammation. The vet recommended an ultrasound and to add boiled boneless skinless chicken to his meals. The results of the ultrasound came back normal. His liver was within normal limits for size, shape, and echogenicity and the rest of his organs (including his heart) were within normal limits. The vet started him on a course of Denamarin (to rule out liver disease), doxycycline (to rule out an infection), and a diuretic (to help manage the fluid). We just finished the course of Denamarin and Doxycycline and his Ascites has remained the same as it was when it first started. We have now scheduled a CT scan to see if something can be picked up that the ultrasound missed (blood clot perhaps?). I have been scouring the internet looking for another case of a greyhound owner who has experienced something similar and my search brought me here where I found a few threads talking about PLE which was a symptom of IBD. The ultrasound of his small intestine showed mild increased fluid within a few intestinal loops, but the wall layering and thickness throughout it was otherwise normal. We are scratching our heads over here trying to figure out the underlying cause of his Ascites and I would appreciate any responses from people who have experienced something similar or could give me advice. Thank you!

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Update: After going to the Internal Medicine Vet, she ordered a host of new tests done which included a liver function test, urinalysis, fecal analysis, x-rays of his heart, and assessment of his GI health. The results of the tests show that his total protein level has dropped from 5.5 to 3.9 and albumin has dropped from 2.0 to 1.5. The urinalysis shows that he's losing protein through his pee and the bile acid test shows that he's not properly absorbing protein from his food, so she isn't sure what the underlying cause of the protein loss is since the ultrasound showed that his kidneys and liver looked normal. GI tract is actually healthier than 1 month ago. IM specialist decided it's possible that he's experiencing inflammation at a cellular level that has not yet resulted in a change to the structure of his organs and she is going to start him on a high dose of prednisolone for 2 weeks (I know budesonide seems to be the preferred steroid due to less side-effects, but she wants to start with pred) and she will drain half of his fluid today since he is not comfortable walking/laying down. Trying to stay positive about this seeing as a lot of the similar types of cases I've found on the greytalk forums haven't ended up with good outcomes. I'm glad that he's still acting like his normal self and that he's still a young boy, so I have hope that his body can handle/overcome this. 

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This sounds like classic symptoms of PLE as the result of IBD (been down that road).  Like you we started with pred and eventually switched to Budesonide.  My boy stayed stable for 3 years before the inflammation eventually morphed into cancer.  IBD is a daily struggle but, if you stay diligent to medication and food protocols it is manageable.  Has the internal med Dr recommended a hypoallergenic food for you yet?  What finally worked for my boy was rabbit.

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6 hours ago, tbhounds said:

This sounds like classic symptoms of PLE as the result of IBD (been down that road).  Like you we started with pred and eventually switched to Budesonide.  My boy stayed stable for 3 years before the inflammation eventually morphed into cancer.  IBD is a daily struggle but, if you stay diligent to medication and food protocols it is manageable.  Has the internal med Dr recommended a hypoallergenic food for you yet?  What finally worked for my boy was rabbit.

Thanks for your response! The Dr hasn't recommended a hypoallergenic food yet, but I will ask about this. We will be going back in 2 weeks to get bloodwork done to check his protein and albumin levels to see if he's responding to the prednisolone. I'm glad they drained half of his fluid (4 liters came out!) because now he seems much more comfortable/lively on our walks. 

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On 1/13/2022 at 4:50 AM, tbhounds said:

This sounds like classic symptoms of PLE as the result of IBD (been down that road).  Like you we started with pred and eventually switched to Budesonide.  My boy stayed stable for 3 years before the inflammation eventually morphed into cancer.  IBD is a daily struggle but, if you stay diligent to medication and food protocols it is manageable.  Has the internal med Dr recommended a hypoallergenic food for you yet?  What finally worked for my boy was rabbit.

Question for you: Did your boy have ascites when you started him on pred? If he did, how long did it take to see any change in the ascites? He's now had 6 doses of the pred, but we haven't really noticed any of the side effects yet besides slightly higher water intake. 

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On 1/18/2022 at 5:58 PM, brindlehound91 said:

Question for you: Did your boy have ascites when you started him on pred? If he did, how long did it take to see any change in the ascites? He's now had 6 doses of the pred, but we haven't really noticed any of the side effects yet besides slightly higher water intake. 

No ascites but his blood proteins were very low so, either it went undiagnosed or we got him on the corticosteroids in time.  I don’t think just 6 doses of pred one would see a difference just yet.

Edited by tbhounds
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We had to put Enzo down this evening :( Last night, he started panting (which we thought was a side effect of the pred) but then he also started shaking and could not sleep at all. We took him to the emergency vet this morning and the internal med vet said he had a fever and that his white blood cell count was VERY low which meant that either he had gotten some type of infection, or that he had an underlying infection that his suppressed immune system could not fight. We were going to start giving him an antibiotic, but by the time we went to pick him up, he had become unresponsive. The vet said we would have to take him somewhere for overnight IV treatment, but that there was a low chance he would bounce back from this. There is a huge hole in my heart right now, but I'm so happy that I was able to give him an amazing life for the past 2 years and I wouldn't have changed a thing. Thank you so much for all of your well wishes and advice. 

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:grouphug I am so very sorry. 

Old Dogs are the Best Dogs. :heartThank you, campers. Current enrollees:  Punkin. AnnIE Oooh M

Angels: Pal :heart. Segugio. Sorella (TPGIT). LadyBug. Zeke-aroni. MiMi Sizzle Pants. Gracie. Seamie :heart:brokenheart. (Foster)Sweet. Andy. PaddyALVIN!Mayhem. Bosco. Bruno. Dottie B. Trevor Double-Heart. Bea. Cletus, KLTO. Aiden 1-4.

:paw Upon reflection, our lives are often referenced in parts defined by the all-too-short lives of our dogs.

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I am so sorry that Enzo had to leave you. You tried so hard to help him. I will add Enzo's name to the list of Bridge Angels here on GT.  :grouphug

 

Freshy (Droopys Fresh), NoAh the podenco orito, Howie the portuguese podengo maneto
Angels: Rita the podenco maneta, Lila, the podenco, Mr X aka Denali, Lulu the podenco andaluz, Hada the podenco maneta, Georgie Girl (UMR Cordella),  Charlie the iggy,  Mazy (CBR Crazy Girl), Potato, my mystery ibizan girl, Allen (M's Pretty Boy), Percy (Fast But True), Mikey (Doray's Patuti), Pudge le mutt, Tessa the iggy, Possum (Apostle), Gracie (Dusty Lady), Harold (Slatex Harold), "Cousin" Simon our step-iggy, Little Dude the iggy ,Bandit (Bb Blue Jay), Niña the galgo, Wally (Allen Hogg), Thane (Pog Mo Thoine), Oliver (JJ Special Agent), Comet, & Rosie our original mutt.

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oh no :( I am so very sorry :(  he was much too young :grouphug

Kim and Bruce - with Rick (Rick Roufus 6/30/16) and missing my sweet greyhound Angels Rainey (LG's Rainey 10/4/2000 - 3/8/2011), Anubis (RJ's Saint Nick 12/25/2001 - 9/12/12) and Zeke (Hey Who Whiz It 4/6/2009 - 7/20/2020) and Larry (PTL Laroach 2/24/2007 - 8/2/2020) -- and Chester (Lab) (8/31/1990 - 5/3/2005), Captain (Schipperke) (10/12/1992 - 6/13/2005) and Remy (GSP) (?/?/1998 - 1/6/2005) at the bridge
"Always do sober what you said you'd do drunk. That will teach you to keep your mouth shut." -- Ernest Hemmingway

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Thank you all so much for the support, it is really helping our grieving process to know that there is such a great community of greyhound/sighthound owners out there. We would like to start the process of looking for another greyhound to fill this hole in our lives and hearts in the next 6 months. Our time with Enzo was much too short and we are absolutely prepared to pour all of our love into another beautiful greyhound in Enzo's honor. 

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5 hours ago, brindlehound91 said:

Thank you all so much for the support, it is really helping our grieving process to know that there is such a great community of greyhound/sighthound owners out there. We would like to start the process of looking for another greyhound to fill this hole in our lives and hearts in the next 6 months. Our time with Enzo was much too short and we are absolutely prepared to pour all of our love into another beautiful greyhound in Enzo's honor. 

Enzo would approve.  He'll probably send you your new one.

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I am so very sorry.  Enzo, may your spirit run with the wind.  

It is often said that there is no better memorial for a wonderful dog than to give a home to another.  :grouphug

 

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Ellen, with brindle Milo and the blonde ballerina, Gelsey

remembering Eve, Baz, Scout, Romie, Nutmeg, and Jeter

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