As you know Max has been having issues with vomiting and soft stools.
9 Days ago the specialist put him on sulcrate, tylosin, meclomide (?) a motility drug.
He's not vomited at all.
3 days into it his stools became hard and perfect. Then last Monday, I fed him a lot of his usual hypoallergenic treats (Medical, hydrolized chicken). Since Tuesday his stools have been hard/soft.
The vet says the next step is to biopsy to confirm a suspected eosphillic colitis.
Before we go to that invasive and expensive step, is there anything else we should reasonably consider?
Dr. Marie replied:
I definitely agree that the biopsy is the next step. Your vets have really done everything else that could be done to try to get to a diagnosis.
Thanks for sending me the report from the referral vet. They have been very thorough! It really is looking like inflammatory bowel disease is possible. And, as you know, the only way to diagnose IBD is with biopsies.
Endoscopy really isn't terribly invasive. Max will have an anesthetic but really shouldn't have any pain afterwards.
I'm trying to rack my brain to think of other options, but can't at this point.
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Is that hiber... bacteria not an option.
If it is IBD... I've read that in a young pup it can usually be controlled by medicines (pred, azath) and strict diet. Usually you can gradually diminish the meds and control it by diet alone.
Has this been your experience?
Is this IBD common in a dog Max's age? It all began when I tried to change foods!
I'm concerned because my last dog developped it at 12 yrs (biopsied) and was on hamburger and rice diet, aza and pred... and never saw a normal stool for the rest of his life and kept losing weight. Was this a different type?
Unrelated - is there a way to diminish the possibility of bloat? I've made sure Max is kept very quiet for 1 hr following meals.
Dr. Marie replied:
I'm so sorry for the delay Jay. I had some technical issues that kept me from getting my notifications last night.
The word that you're thinking of is helicobacter. This type of infection can definitely cause intermittent vomiting. However, soft stools and diarrhea are not normally a part of helicobacter.
I find that most of my cases of IBD are controlled quite well with small doses of pred. There are different degrees of IBD though and some dogs can require stronger medicines. Sometimes it can be hard to tell the difference between IBD and some types of intestinal cancers. I don't think at all that Max has cancer, but it's possible that your previous dog did.
I'm not aware of a connection between IBD and bloat. While bloat can happen to any dog, it's not terribly common in Golden Retrievers. The only way that we know of to prevent bloat is to do a surgery to tack the stomach in place. I will do this for dogs that are prone to bloat such as Great Danes, but not often.
I just had one other thought. You may consider asking your vet about the possibility of Clostridium Perfringens. This is a bacteria that can cause chronic diarrhea. (However, it doesn't directly cause vomiting, so it doesn't fit completely). You can sometimes diagnose Clostridium with a DNA test but it's debatable sometimes how accurate the test is. The tylosin that he is on will usually treat Clostridium. So, one option would be to keep him on tylosin for several weeks and see if this clears the problem up. If so, some dogs with Clostridium need to stay on Tylosin for the rest of their life. If this happens there are no negative effects that I am aware of.
The initial suspicion was eosophilic colitis which I believe is related to an allergic reaction. The specialist said the prognosis for that was good.
However, yesturday I was using lots of Z/D Ultra for training purposes and today he has a bit of diahrea. Does that mean it's not likely to be eosophilic colitis? Does that necessarily mean a worse prognosis?
On Rice 7 Hamburger he does pretty well. Hard or near Hard stools consistently.
His scoping is Wednesday.
Dr. Marie replied:
I'm not sure that I know the answer to your question Jay. Any answer I would give here would be merely speculation. It's likely best to wait until we get the scoping results and then go from there.
Max had the biopsies of upper and lower GI yesturday at 2 pm. Since then he's finished maybe 25% of his meals each time.
Though tonite he is active and alert to about 90% of normal.
Tonight he also started drinking normally.
When will he eat normally? Is it an issue 30 hours later?
Dr. Marie replied:
Unfortunately I don't know the answer to that question. The fact that he is bright and alert is good. I would imagine there could be some intestinal discomfort for a few days.
As long as things are getting better rather than worse I would consider that a good sign.
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Dr. Marie is a veterinarian who practices in a busy animal hospital in Ottawa, Ontario. She created Ask A Vet Question as a resource for good, accurate veterinary advice online. Dr. Marie treats dogs, cats, hamsters, guinea pigs, and rats. She has been a vet since 1999.
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