Biopsy?

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.

I hope you get some answers after the tests!

Dr. Marie.


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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.

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.

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.