My Annie, 15 1/2 pheochromocytoma - Annie is now an angel running free [Archive] - Page 2 - Canine Cushing's Information and Support Forums

frijole

06-15-2010, 10:39 PM

Hi Sue - thanks! We are hanging. I have been experimenting with the reglan (sp?) drug. It immediately helped her appetite and things looked great so after a couple days and her appearing to be "normal" I cut it from 2 pills a day to 1. The next day she didn't eat. So I immediately went back to 2 pills. Have been doing OK up until a couple days ago. I noticed Sunday night that her tummy was really growling. (and it hasn't in the past - not even when loading) So I started back on the pepcid ac.

I make sure to wait 20 mins before feeding (after giving pepcid and the reglan) and this a.m. she walked away from kibble. I threw some canned on it and she ate some of it. I just left it out and it was gone when I got home. Tonight same thing - canned food (this stuff is 100% natural so it has chunks of carrots, fish, etc in it) and she ate about 1/3 and left the rest.

Took her to a softball game where she was very chipper. Just got home and she ate the rest. So I conclude there is something wrong with her stomach/digestion.

I read the pages and pages on pancreatitus and it could well be. So that test will happen before long. I know I need to fast her. I suppose I should call ahead of time to make sure they have the ability to do the exact test from Idex that I want done.

There is a flowchart on one of the articles that clearly tells vets what tests to do first, second, etc so I will bring that to help my vet along. It gets old and I just feel like I have the weight of the world on me trying to look out for my girl.

Sorry if I haven't been active around here - still care and peeking in... I just don't have alot to give right now... my brain is so tired.

We went off on the eating tangent with Annie but nothing yet explains why the lysodren numbers went up after an increase in dosage. Part of me suspects the test was faulty. The other part of me is afraid to risk putting her back on it only to have a repeat. But I do think I will have to do another acth before making that decision.

She is still drinking less than 1 cup a day of water. No more accidents in the house. Her back legs are getting weaker and weaker so it is only a matter of time before I will have to do something. Sorry to ramble... as you can see I don't have a definitive plan yet.

BestBuddy

06-15-2010, 10:55 PM

Hanging is good!

I think the idea of a "grand plan" is somewhat overrated. I love to be organized and have everything in place but our dogs just don't seem to understand this.

Having a petite plan is what I would suggest, only one step at a time and then the next and so on. Your plan will change many time each day so it's not as disappointing if only the one thing doesn't work and you can try the next rather than have it all mapped out and have to completely rethink things.

I know it's all rather useless info but you know I am cheering you on.

Jenny

frijole

06-16-2010, 08:57 PM

I think Haley sent me an angel today.

The company I work for does business via catalog, the internet and we have a few retail stores. There is a retail store attached to our offices and we have a new employee who is a sweetheart and loves animals. She asked yesterday about my dogs and so I told her about Haley's passing and Annie's illness.

That's when I found out she is also a vet tech! She said we have to find out who in this state knows how to treat cushing's. (duh) Anyway she made some calls and get this...

this weekend, right here in my town the Nebraska Vet Med Association is meeting! AND.... there is a speaker from Idexx coming to talk about cushings amongst other things...

Here is the agenda I found online and his bio!

Sponsored by Idexx Laboratories
8:00 a.m.
Challenges in the diagnosis and treatment of Canine
Hyperadrenocorticism
10:00 a.m.
Break
10:30 a.m.
Progress in the diagnosis and treatment of Canine Hypothyroidism
Progress in the diagnosis and treatment of Feline Hyperthyrodism
12:00 Noon
Business Meeting & Lunch
1:30 p.m.
Treating Diabetes Mellitus 2010
3:00 p.m.
Break
3:30 p.m.
Addison’s Disease: Diagnosis and management
Hyperparathyroidism in the dog

Dr. Kintzer received his DVM from Cornell University. Following an internship at the Animal Medical Center in New York City and an internal medicine residency at Tufts University School of Veterinary Medicine, he was a staff clinician at Tufts for 5 years. For next several years, he was the internist at Boston Road Animal Hospital in Springfield, Massachusetts. He is currently with the Animal Medical Center of New England in Nashua, New Hampshire. He has written
many articles and chapters on canine and feline endocrinology and lectured nationally and inter-nationally on endocrine disorders. Dr. Kintzer is a past president of the Society for Comparative
Endocrinology.

SHOULD I STALK HIM??!!!

zoesmom

06-16-2010, 09:59 PM

You have to ask??????????????? I say YES!!

frijole

06-16-2010, 10:00 PM

I have never stalked before. LOL. Guess I should try to email him and beg for help?! Any suggestions? Anyone know this guy? Or about him?

Harley PoMMom

06-16-2010, 10:13 PM

Lynne (Clydetheboosmom) takes Clyde to Tufts, I wonder if she knows Dr. Kintzer?

frijole

06-16-2010, 10:34 PM

He now practices in Nashua, NH - great town... used to travel there for work. And I just emailed the office - no direct email but info@ with a major plea for help.

Keep your fingers crossed.

Carol G

06-16-2010, 11:23 PM

frijole

06-16-2010, 11:28 PM

Kim,

That sounds like a wonderful possibility.

If you don't hear back from Dr. Kintzer tomorrow morning, you might want to call his office and explain how important it is that he see the email you sent. He may not even see the email and you could need someone to bring it to his attention.

Fingers and kitty cat toes crossed here.

Carol & Atty CatThanks. I will do that. I made the email headline read "Dr Kintzer - Nebraska - HELP! Also sent it high priority.

All of the vets use the same email address which is just info@ etc. so someone must pick up their emails for them.

frijole

06-16-2010, 11:31 PM

Just spoke with my stepdad who came over today at noon to let Annie out since the neighbor boy is on vacation. He told me he came in and she was lying on the floor in plain sight and never even acknowledged him. He said he sat at the table, read my paper for 15 mins before she even tried to get up. She couldn't. He picked her up and carried her outside to potty. She was out for a while and didn't attempt to go up the 2 steps to the deck. She waited for him to lift her and carry her inside.

Meanwhile I come home at 5:30 to a happy perky dog who ate her food.

Like I said before - the leg issues went away with the lysodren - even if she was at a 19. :(

AlisonandMia

06-17-2010, 12:29 AM

Kim, I wonder if she couldn't be suffering from intermittent low BG. Is there any way you can get hold of a glucometer?

I certainly hope it isn't this because the most likely cause would be a insulinoma - which isn't a good thing. This link will take you to the page where symptoms are mentioned: http://www.petplace.com/dogs/insulinoma/page3.aspx Anne does however lack one important symptom and that is seizures (due to low BG).

I really hate to bring this up and it probably isn't what is going on - but I know that you'd want to know about it if it is what is happening...

Alison

frijole

06-17-2010, 01:10 AM

Thanks Alison. It was painful to read but you are right... I would rather know the possibilities than not.

I know nothing about insolinomas - never heard of it til just now. You are right - no seizures. Also she has not gained weight - she has lost. She is less than 14.5 lbs and her normal wt was 16-17. I don't know when she lost it - with her round cush tummy I didn't notice weight loss.

That article also mentioned that non pancreatic tumors can cause low blood sugar concentration. Well, we learned from the ultrasound that she does have a small tumor on her liver and they said it was benign.

No - I don't have access to a glucometer.

So what do I do? I currently have her scheduled to go in on Friday for the spec cpl (sp?) test for pancreatitus.

According to this article I should do a complete blood panel and a urinanalysis

I can hear her stomach growling from here... she is about 20 ft from me lying on the carpet.

This sounds like something I should deal with tomorrow and not the next day.

So after all this - do you think she even has cushing's?

AlisonandMia

06-17-2010, 01:19 AM

The thing that really makes me think that it is Cushing's is that her LDDS test was so classic for PDH. You'd think that if it was a false positive that she wouldn't have suppressed so very well at the 4 hour mark. And her ACTH stim was pretty high wasn't it? And the big tummy and muscle wasting.

I do think the insulinoma is unlikely - as you said she hasn't gained weight and you haven't seen any really spectacular crashes. But maybe something to keep in the back of your mind.

I think pancreatitis or some other sort of GI upset is more likely - maybe she just feels really off sometimes - that is exactly how I behave if I'm feeling nauseated, I can tell you!

Is she still on the Pepcid?

Alison

frijole

06-17-2010, 01:26 AM

Yes she is on the pepcid. Thing that has me concerned is the tummy growling just started within the last few days. So it never happened while loading. It wasn't there when she refused to eat. She's been on the reglan for a week and NOW we have the tummy growling. ???

Trying to decide about tomorrow... they already told me they couldn't do the test til afternoon and I didn't want her to fast til evening so I elected Friday instead. Guess if I am concerned in the a.m. I will take her in.

AlisonandMia

06-17-2010, 01:34 AM

One of the things that Reglan does is to enhance gastric emptying - so that could result in tummy rumbling I'd think. It is said that being able to hear the gut rumbling away is caused by normal gut sounds being amplified by a more or less empty stomach which acts as a sounding chamber - which is why some people's stomachs seem to rumble when they are hungry.

Alison

PS: Reglan can zonk you out.

frijole

06-17-2010, 01:37 AM

Thanks for telling me it can zonk you out... that might explain some of what happened today. I don't remember reading that but I probably wasn't looking for it at the time.

Speaking of zonked... I am going to try to get some sleep now. Thanks for the help Alison! As always, great talking with ya. Hugs from across the pond from both Annie and I. Kim

frijole

06-17-2010, 11:09 AM

FYI I called. Emails go to the head of marketing to distribute. ha.

I spoke w/Dr Kintzers tech and she said that she doubted he could actually see my dog due to licensing issues but that he could consult with my vet if my vet were to approach him. So I guess I get to make a call to my vet making sure he is going to the conference and asking him to ask for help?! Fun.

Next stop is Iowa State or K State - closest IMS specialists. Wish I knew of a success story and a name. I just know that not all IMS are created equal and I need a good one and I need him/her NOW.

marie adams

06-17-2010, 11:55 AM

Hi Kim,

My motto has always been if you don't ask...you will never know the answer to the question. I have always told my daughter this even when she was small. :D:D

I hope Annie is eating better today!!

Good Luck!!! And yes, Haley did send you and Annie an angel!!!;)

SasAndYunah

06-17-2010, 12:14 PM

Hello Kim,

I certainly don't want to add to the confusion but was Annie ever tested for babesiosis (or another tickborn disease)? Nausea, lack of apppetite, joint pain, weigthloss, depressed, lethargic...all symptoms that could point to babesiosis. Just a thought...

Wishing you and Annie nothing but the best!

Saskia and Yunah :)

Carol G

06-17-2010, 12:54 PM

Kim,

I hope your vet will consult with Dr. Kintzer -- if your vet is willing to do that (and do it right), I think that could work very well.

On trying to find a K-State or Iowa State IM, I am thinking it might be helpful to ask Dr. Oliver and Dr. Kintzer (or ask him through his tech) if they have recommendations -- as well as asking any other vet anyone might be able to think of with a lot of expertise relative to Cushings.

Still have the fingers and kitty toes crossed for you two.

Carol & Atty Cat

frijole

06-17-2010, 02:34 PM

What is amazing to me is the amount of support and research on this single thread is greater than the effort given (at least that I am aware of) by my caregiver. I can not thank you enough.

Interesting on the babesiosis. Never heard of it - makes sense given the time of year. I will have a list of tests a mile long.

I know my vet is willing to refer me because we talked about - my problem is he hasn't actively said - I would like to refer you to Dr X because I feel he is an expert blah blah.

Again, thanks. And she ate fine again today. The problems come AFTER she eats and I think that is why she sometimes is not eating.

frijole

06-17-2010, 08:27 PM

What a day. OK - so the vet tech of the IMS told me my vet would need to approach him. I never did hear anything from my email. Don't know if he even got the message.

So same thing today at noon - Annie could not get up and stepdad took her out to pee.

I cried about 15 times at work.

Annie was out of the reglan and I decided to leave work early and to go pick some more up, return the metacam and speak with my vet in person about tomorrow's conference.

Sigh.

He was the only vet in the office (there are 3 and one is on vacation) I waited a long time and there were still 2 people ahead of me and I just told them to have him call me.

Just hung up. I updated him on the fact that the meds aren't working like they were, the cause and effect of eating and what appears to be pain, the hind leg issue that has developed.

I told him I was glad we are doing the spec cpl tomorrow. He got real quiet. He told me he was concerned we wouldn't learn anything new and mentioned the test we had just done (lypsase and amalyse) and he didn't feel this would be any different. I told him I had an 18 page article from Idexx that I would be happy to share that told specific reasons why the test he did was not sufficient and the difference between the two.

At that point he said, but what are we going to do if it is pancreatitus? I said - treat it? He said she isn't eating, she's already on a low fat diet, and the drugs they recommend are reglan, baytril and other drugs that have cortisol which he said she should have a sufficient amount of in her system.

I then said - look, I am not trying to tell you what to do - but I am trying to save my dog. I don't know what else to do but try to eliminate things other than get into my car and drive straight to Iowa State University (IMS there).

He said that is an option and he felt it was probably more of a digestive issue and said he wanted to phone Idexx. He said they a "Senior Panel" which includes the CPL as well as bloodwork that would be broader than the panels they do. I told him that would be great.

He just called me back as I typed this with an update. He spoke to Idexx (which btw the tech at the IMS office told me is a great resource) and they didn't think cpl either. They thought the senior panel, which includes it would be good as well as a test for the GI (v/b?12 and folate) and an xray to see if there is gas in the small intestine.

The Idexx guy told him they have seen cush dogs that suffer from gas and successfully treat it with Gas X. I told him there hadn't been any flatulence with Annie and thats when he brought up his concern is if the gas is in the small intestine.

He then proceeded to tell me that is alot of testing/money and I told him again I don't care that I want to at least eliminate. I am supposed to let him know in the a.m. what I want to do.

I'm here for an hour and then Annie and I are going to a Tball game and will check in later. Appreciate any thoughts, feedback. ITs ok to throw things - I did. Kim

AlisonandMia

06-17-2010, 09:17 PM

What time is she getting the Reglan? That she's doing this at the same time each day suggests very strongly, I think, that it could be medication-related - like the dose could possibly be peaking in its effects at that time.

She is an oldster so maybe she actually needs a smaller-than-typical dose.

Alison

frijole

06-17-2010, 09:33 PM

He told me to give it to her 2 to 4 times a day and I'm giving 1/2 of a 5 mg pill. Recommended dose is .1 to .2 per POUND given every 6 to 8 hrs. That puts her at the upper range of recommended BUT I am only giving it every 12 hours.

Noon would be approximately 6 hrs into it. Given their recommended dosing... do you think it is actually because it has worn off and she needs more? In the evening she gets it at 5:30 and by 10:30 she seems pretty drowsy. Course we sleep thru the night so ???

Alison - I need your brain. :D:confused::D Too much or not enough?

I am off to watch 4 and 6 yr old T ball teams. BBL

zoesmom

06-17-2010, 10:25 PM

They thought the senior panel, which includes it would be good as well as a test for the GI (v/b?12 and folate) and an xray to see if there is gas in the small intestine.

Kim, Sorry I have no advice on the reglan and dosing. :confused:

I can tell you that the above test is the one Zo had which led to her diagnosis of SIBO (small intestinal bacterial overgrowth). It tests two B vitamins (B12 and folate). Only one of those was out of range for Zo-think the folate. And that dx was what led us to start the tylan (after trying Forte first - yuck, pig digest) As you know, it had multiple beneficial effects on Zoe, beyond her intestinal tract. But it's main use in the canine population is for dogs with intestinal issues like diarrhea/chronic soft stools/bad gas (that, and the tear staining that some of the small breeds are prone to.) Doesn't sound like Annie's had any of those kind of tummy problems.

Zo was also given a/b's by her vet in So Cal for mild pancreatitis. Has your vet given you any a/b's recently? Wonder if that would help if there's something subclinical going on - anywhere. I think some vets like to 'try' a/b's in certain cases of pancreatitis but not all do. Also wonder if 4 smaller meals / day would help . . . whether or not she's got pancreatitis. I'm sure that wouldn't be easy, with you at work.

On the legs, I have a sneakin' suspicion it's probably due to her cortisol creeping up again. Just a guess. Hope you and she enjoy your evening at t-ball. And I hope you get some answers soooooon. Sue

frijole

06-17-2010, 10:33 PM

Sue,

a/b? sorry...don't know what it is so guess we haven't had one recently. :)

Yep, the legs is cortisol creep even though my vet vehemently disagrees with me that it is a sign of cushings. He believes the only thing to treat is excess water. Just shoot me.

frijole

06-17-2010, 10:41 PM

OK... so I realised that I forgot to relate the part of the story about the conference and the IMS!!

My vet is NOT going to attend. One vet is on vacation and the other is moving tomorrow. So he is the only one there. I mentioned the IMS being in town and speaking at 8 am regarding how to diagnose and treat cushings .... he informed me that he is attending a 4 hr session in October.

So I have an IMS w/knowledge staying a few miles from my house the next few nights and can't get to him. I even asked the vet tec at work if she knows any tecs going to it that could get a message to him.

I looked up the Senior Panel on the Idexx site and don't see that it includes the CPL test as I was told. I even asked again to confirm it.

I am on a mission... I am going to find a quote from our resource section from an expert regarding the symptoms of cushings to prove to my vet that it is about way more than treating excess thirst. I am so pissed I could just scream. I treated Haley for four years and her symptoms were the appetite, panting, belly and the hind leg shakes.

I think he and the vet in Omaha read that article we just posted about not treating because the dog doesn't live any longer because he has mentioned that line about five times in the last two phone conversations.

Am I out of line to expect that my dog should be able to get up from a sitting position and go up steps? Sorry -

zoesmom

06-17-2010, 11:12 PM

Sue,

a/b? sorry...don't know what it is .

Sorry, a/b . . . .my favorite abbreviation for antibiotics. Zoe was once given amoxicillin for a mild flare-up of pancreatitis. And, No, we can't possibly shoot you. Annie needs you all in one piece!!! :p

Is there any chance you could go sit outside the meeting room at the place where the conference is taking place this weekend and try to catch Kinzer as he comes out for lunch or something. Look miserable and say you're desperate for some advice on your cush dog. Ironic how you have so few choices in your town and yet there's the big state vet conference, being held right there!:rolleyes::rolleyes:

OK, this would really be getting brash. But is the conference based at one particular large hotel/motel. Maybe you could write out a message and go to the front desk and leave it for him. And also beg and plead the front desk person to see that he gets it.

Carol G

06-17-2010, 11:22 PM

Oh Kim, I'm so feeling your pain now. That is so stupid -- you are just suppose to sit and wait patiently until October?

How can your vet not know the Cushing symptoms besides thirst?

I'm with Sue, go to the place where the conference is and hang out.

All I can tell you is that for treating my guys the world changed when we started seeing our IM.

Carol

BestBuddy

06-17-2010, 11:27 PM

I would stalk him for sure.

Hang around the conference to try and catch him and like Sue said maybe if you can find out where he is staying leave an envelope at the hotel desk. I would make the envelope look important, so he thinks it is something he needs to read and then hit him with the plea to help inside.

Jen

frijole

06-17-2010, 11:34 PM

Would you stalk him if his tech told you he probably couldn't help because he isn't licensed in NE?

Dollydog

06-17-2010, 11:45 PM

Kim, he may not be able to treat Annie but he might have another useful suggestion for you....or even the name of someone who could help you. It can't hurt to ask!

BestBuddy

06-18-2010, 12:14 AM

I guess if he isn't licensed then he can't take Annie on as a client but I'm sure he can still talk to you about his views and give you some suggestions and even a referral to someone who could help.

Dr Bruyette gave me some suggestions when I asked him about Anipryl and Phoebe's senior issues and I'm sure he isn't licensed in Australia and Dr Oliver gives advice far and wide.

Jenny

Casey's Mom

06-18-2010, 01:29 AM

Stalk the guy!! He would probably gladly give you some advice and be interested in Annie's story.

Love and hugs,

Franklin'sMum

06-19-2010, 11:39 AM

Stalk the guy!! He would probably gladly give you some advice and be interested in Annie's story.

Love and hugs,

I'm with Ellen and everybody else :), you'll never know unless you try

Big hugs,
Jane, Franklin and Bailey xxx

frijole

06-21-2010, 08:30 PM

Well, I did reach out to Dr. Kintzner but never got a call or email. :(

Annie was perky on Friday but she fasted for the testing so that explained that. It is after eating that she is so lethargic you think she is dead or dying. I did note there was bile on an area rug - no sign of any vomit anywhere. This is 2nd time I have seen bile.

Rest of weekend was up and down depending on food intake. Water intake increased to almost 1 1/2 cups on Friday but then Sunday it was a little over 1/2 cup!?

Meanwhile on to the results from Friday's tests. I just got these over the phone so haven't had time to research and I do NOT have hardcopies yet.

Liver enzymes: Alk Phos was 726 (her last read 1-2 mos ago was 433), ALT remains normal (always was) and AST was normal. Note my vet keeps saying we don't worry about Alk Phos til it hits 900. :confused:

She scored a 1.7 on the thyroid part of the panel (assume t4) so he says that is normal (Note she takes thyroxine 2 x a day for last 2 yrs)

Urine - normal

Triglicerides - HIGH at 323 normal is 20-150

B12 and Folates were both HIGH (sorry, didn't get nos) and he said this rules out IBD but suggests bacteria in the digestive system.

Spec CL = 114 so normal, pancreatitus ruled out.

He prescribed 125 mg clavamox 2 x a day (said it is a dose for a 20 lb dog and Annie is 14.5 or less by now)

I brought up the triglicerides and said I had read something about that being very common in schnauzers and there is a disease associated with it and he brushed over it and said... the problem is we cannot treat that because she is already skinny and underweight and on a low fat diet.

So I got off the phone and googled schnauzer and triglicerides and confirmed that the disease I was thinking of is hyperlpidemia... more at link:

http://www.weir.net/~lglass/canine-hyperlipidemia.htm

First off - I'm not giving clavamox until I hear back from you that it is safe to give. I did a search on the forum and there are tons of hits and I read about upset stomachs, seizures and drowsiness.... does anyone have an educated opinion on this drug given Annie's condition?

Second - does anyone remember any cases of treating a cush dog with hyperlipidemia? I will research in a bit.

Third - given the fact that the lysodren reduced the cortisol but only to a normal dog's level... and with a possible dx of hyperlipidemia... do you think that there is something ELSE caused the cortisol to rise? I know I am beating this dead horse but at some point I have to decide whether I can treat this or not and I want to make sure we got the dang dx right.

Thanks - Kim

AlisonandMia

06-21-2010, 09:13 PM

I don't know much about the subject but I thought that gut bacteria overgrowth problems where better treated with Tylan. As far as I know Clavamox is more likely to cause a gut-flora imbalance than cure one. (I've had the human equivalent of Clavamox, Augmentin, do some pretty nasty things to my insides!) It would all depend on the offending bug(s) but from what I've seen Tylan is usually the preferred antibiotic in this sort of situation.

Hopefully Sue will be along in a while.

From what she posted the other day on another thread Tylan does not require a prescription.

Alison

StarDeb55

06-21-2010, 09:24 PM

Alison has hit the target. I'm not sure whose thread Sue was posting on in the past several days, but I know she said that an elevated B12 & folate signals intestinal bacterial overgrowth(?) which is what her Zoe was given Tylan which said did miracles. I am also certain that Munchie has hyperlipidemia, but I do not remember what Louise was doing for it, other than diet. Since there are so many other sources for alk phos besides the liver, this may be coming from somewhere else, & not Cushing's related since Annie's other liver function tests are normal. Let me think on this some more & if I come up with anything else, I'll be back.

Debbie

frijole

06-21-2010, 09:26 PM

Alison, I can get Tylan from work! We sell it. But I just recently started reading about it. I read where it helped with IBD and with diarrhea but not this issue and so I wasn't sure.

I would prefer something that wasn't harsh... it says 10% of dogs vomit on it. I just hate to do that to her if I don't have to. Guess I need to google some more on Tylan. :)

AlisonandMia

06-21-2010, 09:30 PM

Here's some info on SIBO: http://www.epi4dogs.com/sibo.htm

Includes dosing info for Tylan.

Alison

frijole

06-21-2010, 10:11 PM

Alison, I think you are onto something... is this saying that Clavamax could make things worse? Just double checking...

Potential Side Effects of Clavamox® in Canine and Feline Patients
The most common side effects seen with Clavamox® are gastrointestinal symptoms and include vomiting, diarrhea and lack of appetite. In these cases, feeding the dog or cat prior to administering the antibiotic may alleviate the symptoms.

Overgrowth of pathogenic bacteria in the gastrointestinal tract can also occur in canine and feline patients receiving Clavamox®. This change from the normal bacterial population within the intestinal tract can lead to antibiotic-associated diarrhea.

Read more at Suite101: Clavamox, An Antibiotic Used in Dogs and Cats: Uses and Side Effects of Clavamox in Canine and Feline Patients http://webcache.googleusercontent.com/search?q=cache:7l74Qv8Zvc4J:petproducts.suite101.c om/article.cfm/clavamox-an-antibiotic-used-in-dogs-and-cats+small+intestinal+bacterial+overgrowth+in+dogs +clavamox&cd=1&hl=en&ct=clnk&gl=us#ixzz0rXWyoLGP

AlisonandMia

06-21-2010, 10:52 PM

Yep, I'm pretty sure that that is what it is saying.... Depends on the organisms involved or course - there could be cases where Clavamox could help a gut upset but I don't think this is what it is usually used for - more skin, respiratory and urinary tract stuff I think. Clavamox is very broad spectrum so wipes out a lot of the "goodies" as well as baddies. I gather that Tylan and the other recommended antibiotics (Flagyl and tetracycline according to the article) are not so board spectrum and happen to target the problem bugs and leave the good guys alone, more or less.

Clavamox (Augmentin) did some nasty things to both my husband and I - and neither of us is very "delicate" in this regard either. We both needed to take probiotics for a while after.

Alison

SasAndYunah

06-21-2010, 10:55 PM

Hi Kim :)

It's the middle of the night in The Netherlands and I can't sleep and so I came to the CC board and saw your post. I was wondering...was there ever a fecal exam done on Annie? Just to rule out the more "obvious" causes like internal parasites and pancreatic enzymes insufficiency and to do a bacterial type and count for example? If it were me, I would rather start there then admit anti biotics without knowing what exactly is going on. Does Annie have bad (smelly) gas, diarrea? That's what is usually seen in SIBO and I can't remember reading about either one... If there's some intestinal issue going on, anti biotics may (seem to) help for a little while but are likely to make things worse in the long run (more "damage" to the intestinal flora, more sensitivity to intestinal infections, etc) Instead you could try some probiotics to help her intestinal flora become "healthier"...if that is the cause. Just some 4 'o clock in the morning thoughts from me...for whatever they are worth ;)

Saskia and Yunah :)

frijole

06-21-2010, 11:20 PM

No gas and no diarrhea. She is on metoclopramide to help her eat (anti nausea pill) and it makes her constipated so her poo is quite hard. But even when loading with lysodren she had no gas which I thought was interesting.

I am also concerned with the high triglicerides - hyperlipidemia which could be caused by untreated cushings. They say treat the disease - cushings - to prevent hyperlipidemia... but until her stomach is settled I can't treat the cushings.

I did just read an article where fish oil and oatmeal in the food dramatically helped and that is easy enough to do. I suppose I could add some probiotics and yoghurt to the mix.

frijole

06-21-2010, 11:21 PM

StarDeb55

06-22-2010, 12:49 AM

frijole

06-22-2010, 01:19 AM

Kim, in that link that Alison posted, it mentions a serum cobalamine measurement along with the B12/folate as being the most significant test for SIBO. If Annie's latest round of bloodwork was only at the end of last week, I would think that the lab should still have sample that this test could be added on. I wouldn't delay to long as most labs don't keep samples much more than 5-7 days.

Debbie

Thanks Deb - I have to admit that was written for the medically astute so I had a hard time understanding some of it. :confused: So I could have my vet contact the lab and ask them to take the blood and do a serum cobalamine measurement. What will this tell me? Sorry. I am over my head.

StarDeb55

06-22-2010, 01:50 AM

If pancreatic function is normal (i.e., serum TLI is normal) then finding a decreased serum cobalamin concentration or increased serum folate is supportive of SIBO. If both of these are found together, SIBO is extremely likely; however, this combination occurs infrequently.

Kim, the above is the pertinent information from the link. Assuming there is sample left from last week's blood draw & it hasn't been pitched yet, your vet should be able to call the lab & add the cobalamine. With an already elevated folate, you've got one out of 2, cobalamine comes back low, & I think you have found the answer. Refresh my memory, pancreas issues have been ruled out?

Debbie

frijole

06-22-2010, 08:02 AM

Kim, the above is the pertinent information from the link. Assuming there is sample left from last week's blood draw & it hasn't been pitched yet, your vet should be able to call the lab & add the cobalamine. With an already elevated folate, you've got one out of 2, cobalamine comes back low, & I think you have found the answer. Refresh my memory, pancreas issues have been ruled out?

Debbie

Yes spec cl test results were part of yesterdays tests and came in within normal range.

So you are saying try to get this done to confirm what the doc says (bacteria overgrowth) is the case. I am asking because I want to make sure I understand before I make another argument with his dx. Thanks

zoesmom

06-22-2010, 11:07 AM

B12 and Folates were both HIGH (sorry, didn't get nos) and he said this rules out IBD but suggests bacteria in the digestive system.

He prescribed 125 mg clavamox 2 x a day (said it is a dose for a 20 lb dog and Annie is 14.5 or less by now)

Thanks - Kim

Don't know much about the hyperlipidemia, Kim. But the above B12/folate test is the one I've talked about Zoe having - that led to the SIBO dx and the tylan. Thinnk the IMS also did the test for EPI at the same time (exocrine pancreatic insufficiency?) Isn't that the TLI test? I forget. Think that becomes a possibility when a dog has had chronic pancreatits for some time. And looks like that was also included in Annie's panel. But in all of those tests, the only thing that came back 'off' in Zo was her folate (it was high). Her B12 was in range but don't remember if it was close to borderline or not. Would have to look up. Given Zo's digestive miseries, our IMS thought we should go ahead and treat for SIBO. And so did I.

Ok, stretching my memory now (will have to go check her records later) but this is how I remember we proceeded. IMS put her on antibiotics first - forget which and for how long and the exact reason. I, too, thoughth that was odd. I want to say she prescribed baytril but it could have been clavamox. Zoe did take clavamox OFTEN over the years for uti's. (Clav, baytril and simplicef were the 3 that I knew wouldn't upset Zo's tummy. I think clavamox is a brand name of amoxicillin or some form of it.) BUT each dog can be different with the a/b's.

Then the next step was to put her onto that Forte Flora stuff. Nasty smelling gross powder made from pig digest. Either it didn't work or I couldn't stand it so that's when the vet said 'let's try tylan.' We did and it worked. I researched it then and found many glowing reports for it online (lots from owners.)

Are you sure the vet said that both of Annie's #'s on that test were high. Because I think B12 (same as cobalamin) is usually low and the folate usually high with SIBO. But our vet still felt trying the tx would be worthwhile, even with just her folate being high. So maybe some dogs can have symptoms with just one number out of range. The usual signs are chronic soft stools (or chronic diarrhea) and the gas. But maybe in some dogs it could manifest as a fickle appetite 'cause I don't recall you mentioning these other symptoms. Zo was - more often than not - a picky eater (before and after cush dx). Only occasionally, she would vomit bile.

OK, here's where I have a theory about tylan and the other benefits Zoe got from it (beyond the SIBO). I have a gut suspicion that one of the reasons all of Zo's other 'problems' began to fall into line on the tylan was because it allowed her to absorb her various medicines more efficiently and consistently. The gas stopped, think her appetite even improved a bit, the stools firmed up . . . but ALSO her PD/PU/uti's came to a screeching halt, her thyroid levels finally stabilized and stayed that way until the very end, and her trilo dose and cortisol levels also did the same. Now I'm sure you don't remember ALL of the ups and downs we went thru with those last two things (her frequent dose changes and fluctuating test results.) But they were ever-changing until the tylan, sometimes worse than other times. And IMO, it may have been that her upper gut was so screwed up from the SIBO that her body was getting a varying amount of her thyroxine and her trilo. Which brings us to Annie's resistance to the lysodren. Maybe that could be a sign of something similar. Maybe she's not absorbing it all that well. It's a theory. Why it helped Zo's lifelong PD/PU/utis' is another question altogether, tho'. Perhaps it corrected some ongoing condition in her urinary tract (bacterial or otherwise) that had existed because of all those years of a/b treatments.

So really, Annie's had the test for SIBO . . . as the folate/B12 (cobalamin) was that test. Sue

PS - the tylan powder is very bitter tasting (I tested a dab once). Hence, you couldn't just sprinkle on their food - they wouldn't eat it then. I even would wipe off the outside of the capsules when filling them because Zo would avoid them like the plague if there was any hint of powder on the capsule. I had also been in the habit of following up any course of a/b's with probiotics and/or yogurt but that apparently made no difference for the SIBO. Had done that for years and continued to do so, whenever Zo would finish up a course of regular a/b's since it does restore the lower intestine to the proper balance. And whenever she was prescribed another a/b, I would hold up on the tylan until those were done.

StarDeb55

06-22-2010, 12:18 PM

Sue, thanks for clearing up the B12(cobalamine) thing. In all my years in the lab, I have never heard B12 called cobalamine, so I have learned something new. Sorry for the confusion, Kim.

Debbie

zoesmom

06-22-2010, 01:00 PM

Just googling and found a link about folate and B12 in humans - and it does say that b12 can also be elevated as opposed to low in cases of SIBO. (I think that's what it's saying?) That's not what I understood as I'm sure our IMS was looking for a low b12 in Zo. (But it's been awhile and I coud be mistaken!)

The article talks about b12 overload and malabsorption, gastric inflammation, with some patients not having many symptoms. Also mentions some have bloating and occasional abdominal cramps. Again, this is for humans and a rather technical article. I just browsed quickly.:rolleyes: Sue

http://www.yourhealthbase.com/vitamin_B12.html#overload
It's a long page and I clicked on the b12 overload link near the top and was taken to the bottom. I skipped all the stuff about the other B vitamins.

zoesmom

06-22-2010, 01:30 PM

Found this (cut and pasted) ..... forgot to copy the link but it was a Virginia school.

Though Annie hasn’t had diarrhea, it can apparently affect appetite, too. You did say she was bloated (so maybe that’s not only from the cushings):

EFFECTS OF SYMPTOMS OF SIBO
ON FOOD INTAKE
The impact of SIBO on malabsorption and maldigestion
extends beyond the direct effects noted above. Post-prandial
symptoms commonly seen in the context of SIBO
discourage food intake, providing a further barrier to
good nutrition. The nearly ubiquitous symptom of postprandial
bloating is often reported by SIBO patients as
the reason for their decreased oral intake. Bloating occurs
as a result of bacterial fermentation when increased numbers
of bacteria come into contact with food in the small
intestine. Abnormal products of bacterial fermentation,
maldigestion, and malabsorption all contribute to the gastrointestinal
symptoms of bloating, diarrhea, cramping,
abdominal pain, boborygmi and nausea that are associated
with the carbohydrate intolerance in SIBO. Bacteria
normally derive energy from carbohydrate fermentation,

Also talks about breath testing in humans (guess not an option in dogs) and fecal testing apparently not very accurate.

While direct culture is considered “gold standard”
for bacterial disorders, culturing is not an appropriate
gold standard for bacterial overgrowth since the intestinal
bacterial flora may be out of reach of available instrumentation.
It is important to recognize that bacterial overgrowth
may involve only the more distal portions of the
small intestine. Culturing for bacterial overgrowth is
characterized by its high false-negative rate and
it is poorly reproducible.

frijole

06-22-2010, 02:01 PM

I am relieved to learn that the test was already done because I have already disagreed w/the vet 3 or 4 times this week and I have to spread it out until I have another solution in that department. ;)

I am purchasing the Tylan today at work - but we only sell the powder so I will have to hide it in food until I can get the capsules. Did you buy one of those capsule machines Sue? (amazon.com has them both)

Thanks so much Deb and Sue. I guarantee you Annie will appreciate it.

zoesmom

06-22-2010, 02:18 PM

Kim - I think it will be impossible to hide it in food. I bought empty gel caps from the Whole Foods Market (any health food store should sell them, tho.) They come in two sizes and I used both, but the ones I bought said on the package how many mg. of powder/herbs/etc. one would hold. Our vet didn't act like it was big deal to get the precise amount. I'd have to look but think Zoe's orignal rx from the vet was 375 mg. Let me go check what (if any) I still have on hand and see what the capsules say. Sue

OK, I had bought '0' and '00' size caps. Only have the '00' left and am pretty sure they are the bigger ones. It says they hold 700-800 mg and when I used them, I only filled them maybe half full to 2/3 full. I wish I could remember how much Zo's dose was, but didn't somebody post a link for you earlier to tylan dosing. I'd have to go dig out her massive file and it's buried in a box now. :(:(:(

Anniie's so much smaller that the '0' caps should hold enough for her. I think they held something like 300-400 mg, and for Zo, I'd try to get as much powder in as possible. But for Annie, depending on her appropriate dose, you might only need to fill them to half ....or less. While I was googling earlier, I did see another mention of treating them with a/b's first, as Zoe's IMS did for her. In case there's an underlying cause, I guess. Still doesn't make a lot of sense to me. It's a very complicated disease process apparently, with the possible factors being the migration of bacteria from the large colon into the smaller colon but also something about the b12 being a by-product of improper food digestion????? (Never ever quote me on that.;):p)) I've read this stuff about SIBO before, when Zo had it, and I still don't understand it that well!!!!!

gpgscott

06-22-2010, 07:05 PM

Kim,

I can't possibly add to the information given.

I can say that I think about you and Annie and care for you both.

Scott

k9diabetes

06-22-2010, 09:38 PM

Not as fast as a local purchase but I bought empty gelatin capsules at www.capsuline.com (http://www.capsuline.com).

They were really affordable and I didn't even have to pay shipping. I bought 500 small ones for something like $17.

Natalie

frijole

06-22-2010, 10:16 PM

Thanks Scott, Sue, Deb and Natalie. I really appreciate your input. You guys are my sole support in this. No one else understands all this nor would they go to this length to save a dog.....so I sit here and stew and fret...and I can't tell you how much I appreciate everyone's help as I figure this out.

Sue and Nat - did you buy the capsule machine thing or did you do it by hand? Seems tedious as hell. ha. How do you convert 1/16 tsp into mgs? (I know... google it)

I bought the tylan today at work so tonight I gave her first dose. I put it in pill pockets... not real good because the grains are so fine they stick to the outside of the pocket.. and I did rinse it off when I was done to hide the smell. Actually I couldn't smell anything BUTTTTTT, I washed my hands afterwards but some must have got stuck under my nails... I was eating dinner and licked a finger and about DIEEEEEDDDD. Putrid! Awful taste that lingers too.

Was talking to a guy at work who has used it with pigs. He said the taste is so bad that they often mix it with KOOLAID to feed the piglets! Laughed at the thought of little pigs drinking koolaid. ha.

I have to say Annie is the perkiest today that I have seen her in a month or more. She is smiling, barking, smelling things outside....

This issue was there, no not as great, PRIOR to my loading because I had noticed it every 6 mos around time to get her teeth cleaned... so I thought it was painful to eat. Anyway...during loading I switched from the Solid Gold kibble with a bit of canned in it to strictly canned (Solid Gold) thinking that would make her more likely to eat as she loves it.

I am thinking that might have something to do with her triglicerides? I need to find that website where you can check the actual fat content of all pet foods (not what is on bag or can). Anyway, over the weekend I went back to the smaller amount of canned and that might be helping as well.

She is restless at night but then again she has cushings and is hypothyroid. (She was never restless until a few weeks ago)

Anyway... I am hoping that I can get her tummy under control and that her legs hold out in the meantime. And then I can start thinking about the cushings.

Fingers, toes and eyes crossed...

addy

06-23-2010, 09:38 AM

SavingSimon

06-23-2010, 11:15 AM

zoesmom

06-23-2010, 11:32 AM

Kim -

I did not use a capsule machine. It is a little tedious to fill them by hand but I'd sit down every 3 weeks or so and do them until I got tired of it. The powder is very 'clingy' and like you, I'd get it under my nails sometimes. YUUUUUCKKKK. Guess you could wear gloves but I never did. I'd pour some of the powder into a small kid-sized bowl and work over a paper plate to catch any powder mess I made. And then I'd just run the bigger side of the capsule thru the powder to scoop it up. When done, you can pour the 'droppings' on the paper plate back into the jar. It would take me about 30-45 minutes at a sitting. (Sit in front of a TV to avoid boredom!!!:p)

Restless at night. Zoe had spells of that off and on - to the nth degree, sometimes. One time, it was apparently because her thyroxine was too high. Never did figure out why it happened the other times - and it was AFTER she went on trilostane.

I was just looking back on the first page of Annie's thread (curious about when things started) and saw that your vet was suggesting dental work for Annie last July. Did you ever go ahead and get it done??? Because I was always suspicious of bad teeth when Zo's appetite was off. Hope Annie's behavior this morning is a sign that things will start to improve so you can get back to dealing with the cushings and the lysodren. I noticed a change overnight when Zo began the tylan. Sue

zoesmom

06-23-2010, 11:47 AM

B12 and Folates were both HIGH (sorry, didn't get nos) and he said this rules out IBD but suggests bacteria in the digestive system.
Kim

Just wanted to add a note about this. Dogs can have both IBD and SIBO. So I 'm not sure that this particular test rules out IBD. In fact, I don't think it tells you anything about IBD.

Zoe's IBD was confirmed by her previous ultrasounds, long before we found out about the SIBO. And I get the impression that there is not yet a proven connection between the two conditions . . . other than SIBO is rather rare and that a good % of the dogs who are dx'd with SIBO also have IBD. (But NOT the other way around , i.e. most IBD dogs will not develop SIBO). It may well be two different mechanisms are at work, in the two conditions.

I wrote that I thought Zoe's repeated treatments with a/b's might have triggered hers, but after reading more yesterday, I saw nothing about that. I did see alot, however, on the migration of bacteria from the large to small intestine because of inadequate 'motility' in the intestinal tract, also on diet - possibly related to too many carbs - and on poor digestion and malabsorption issues. It's definitely complicated as most of the articles were talking about stuff that was way over my head. Sounds like they are still not certain of the exact cause. Sue

frijole

06-23-2010, 02:43 PM

Re the SIBO vs IBD - interesting... if my memory is right he said that Annie's B12 and Folate levels were HIGH and so that ruled out IBD because they are usually LOW in that case. LOL So how can anyone ever have both if that is true? Rhetorical question Sue. ;)

frijole

06-23-2010, 02:44 PM

i read the tyon has anti-inflammatory properties as well as being an antibiotic so may help with any inflamation as well.

I ,too, will switch to it if the metronidazole doesn't help my Zoe's loose stools.

Addy
Zoe and Koko's Mom

Addy, in my research I can tell you that I frequently saw where someone went from the metro to tylan. Good luck with Zoe!

AlisonandMia

06-23-2010, 07:57 PM

Re medication getting under fingernails (yuck!) - a toothbrush is really good for cleaning under your nails. Much better than a so-called nail brush. I used to clean my nails that way after messing about with Mia's Lysodren - just to be on the safe side.

Alison

BestBuddy

06-23-2010, 11:34 PM

Kim,

Wishing you the best of luck with the Tylan. I noticed in Addy's thread you mentioned you could lick this problem, seems like you already did.:D Lick your fingers I mean, sorry couldn't help the bad joke.

Jenny

frijole

06-23-2010, 11:47 PM

Oh Jen you are so funny and if you really want to get grossed out I will send you some. :)

Alison - this stuff is so "magnetic" it just clings to stuff. I am going to try to find some capsules locally this weekend and if not will buy them on line.... meanwhile I am putting it into the large pill pockets.

Tonight I about died because she had chewed it and spit it out. I assumed she would not eat it... but luckily the cushings appetite for the beefy treat won out and she did eat it. Whew.

So far no changes in poops. She is eating but I haven't weaned her off the anti nausea drug yet either. S L O W L Y. I am just glad to have figured out why she wasn't eating.

She and Jessie go to the groomers tomorrow so they are having a doggie sleepover tonight. Plus I get to keep my insulin skills polished and give Jessie her shot in the a.m. Fingers crossed on the tylan.

Carol G

06-24-2010, 12:10 AM

Kim,

I needed some smaller capsules than what they sell at the health food stores around here and I was able to get them from a pharmacy. I talked the pharmacist into giving me a few to get me by until he could special order a container of them for me. They cost more than what I could get them for on line but I needed them then so I was willing to spend a little more. (Use them for Atty Cat's pred which is also foul tasting).

So, that might be a possible source if you can't find them anywhere else. This was a pharmacy in a medical complex.

Carol

apollo6

06-24-2010, 01:18 AM

You can get capsules at Henry's , Whole food, not sure on size.

frijole

06-30-2010, 09:04 AM

Just a quick update. So far, knock on wood, the Tylan seems to be working and the appetite is almost back to normal. I will start weaning her off of the anti nausea pills to see. Fingers crossed. Kim

Harley PoMMom

06-30-2010, 09:16 AM

Fingers crossed. Kim

Everything crossed here.

Love and hugs,
Lori

Squirt's Mom

06-30-2010, 11:29 AM

Hanging, praying, and hoping with you and everyone else, Kim!

Big hugs!
Leslie and the girls - always

littleone1

06-30-2010, 11:39 AM

Keeping everything crossed here.

Roxee's Dad

06-30-2010, 12:24 PM

Found some real wood to knock on..fingers and paws crossed and keeping you both in my thoughts and prayers.

addy

06-30-2010, 02:30 PM

Oh, that is good news!!! :)

I am so very glad,

Addy

frijole

07-03-2010, 07:53 PM

The results from the last series of tests were mailed to me and I just got them. They include a Senior CBC, Folate/B12, Spec cPL

I am posting all items that were high as there were a few that the vet did not mention on the phone.

Cobalamin B12 >2000 (284-836 ng/L) HIGH
Folate 23.2 (4.8-10 ug/L) HIGH

(consistent with small intestine bacterial overgrowth)

Senior Screen with Spec cPL Chemistry Panel:

Alk Phos 726 (10-150 u/l) HIGH
AST NORMAL at 93
ALT NORMAL at 33
CK 341 (10-200 u/l) HIGH
Triglyceride 323 (10-150 mg/dL) HIGH

Hemolysis Index ++++ (Index of ++++ may increase AST and CPK by 25-50% and decrease ALP and GGT values by >50%) ????

MCH was 25.5 (with 26 being highest normal range)
MCHC was 34.6 (with 36 being highest normal range)

Neutrophil SEG 83 (60-77%) HIGH
Monocytes 0 (3-10%) LOW

Remarks: RBC morphology appears normal, no parasites, lipemia observed may artifactually increase HGB, MCH and MCHC. Reactive lymphycytes present, platelets clumped

Absolute Monocyte 0 (150-1350 uL) LOW
Absolute Netrophil SEG Normal 11039 (11500 highest normal)

Urinalysis

1.023 specific gravigy
PH 7.0 Protein 2+ (200-300 mg/dl) negative trace

-------------

Deb - if you could explain the abnormalities I'd appreciate it. He only mentioned the b12/folate, triglicerides and alk phos to me. Not familiar with this other stuff.

THANKS. I'll try to google it as well but I have much greater faith in you. ;):p:D

StarDeb55

07-03-2010, 10:03 PM

Kim, before I really get into this, I need to know the total WBC count before I can comment on the neutrophils & monocytes.

Debbie

frijole

07-03-2010, 11:18 PM

Kim, before I really get into this, I need to know the total WBC count before I can comment on the neutrophils & monocytes.

Debbie

WBC was 13.3 (5.7-16.3 THOUS/uL)

Let me know if you need anything else and I really appreciate it.

frijole

07-04-2010, 12:46 PM

Deb, I did as much as reading as a layman can and alot of points to infection but the monocyte reading makes no sense to me as elevated can be a sign of infections, elevated cortisol if I read it right, amongst other things.

Meanwhile - she hasn't eaten today yet. :(

I started reducing the anti nausea pill to 1/2 dose 5 days ago. On day 3 and 4 she didn't eat food right away in the a.m. but no problem evening.

I gave her another 1/2 dose, waited a bit and put out fresh kibble with canned chicken on top. She is eating it.

Also I noticed she was shaking all over (off and on) this a.m. Note she is so afraid of fireworks that last year it took weeks before she'd go outside to potty without being carried out. I started giving her 1/3 tablet of melatonin a few days ago to prepare her.

That is the only thing I introduced that is new so either she just needs the increased dosage of metoclopramide or the melatonin is affecting her. I'm thinking its the metoclopramide.

She ate the chicken thus far and left most of the kibble. Water intake yesterday was about 3/4 cup if that.

frijole

07-04-2010, 12:55 PM

StarDeb55

07-04-2010, 02:35 PM

Kim, I would not worry about the monocytes. These cells are in very low numbers anyway, & there numbers will fluctuate depending on the number of neutrophils. I will get to that in detail in a minute.

Hemolysis Index ++++ (Index of ++++ may increase AST and CPK by 25-50% and decrease ALP and GGT values by >50%) ????

This means that the blood draw wasn't worth a sh--, & a whole bunch of the RBC's were destroyed (hemolyzed). Most lab tests are done in analyzers that are measuring the amount of a certain color change in the serum when various reagents (chemicals) are added to the serum. When the serum is very red due to hemolysis, this process of measurement will be affected, how much is determined by the amount of hemolysis. What the above is telling you that due to the hemolysis the actual AST result is anywhere from 25-50% lower than posted, same with the CK result. CK result is actually somewhere between 170-256, probably meaning it's normal. The other alk phos result, using a baseline increase of 50%, is < or = to 363, not as elevated, but elevated. I think I might discuss the possibility of a repeat panel at no charge with your vet, if your up to it, because of this as, IMO, it makes accurate interpretation of the results a little dicey, at best.

Annie's absolute neutrophil count is 11.03. As long as that is within normal range, there is nothing to worry about. The % neutrophils are high, but you have to look at the total or absolute neutrophil count to determine whether or not there is a possibility of infection. The formula to figure out an absolute count is % x total WBC. The MCH & MCHC are specific measurements having to do with the amount of hemoglobin in the RBC's. As long as Annie's hemoglobin & hematocrit were within normal range, I wouldn't be concerned. The other thing is with 4+ hemolysis, these values may have been affected, also.

Hope this helps.

Debbie

frijole

07-04-2010, 03:25 PM

Thanks Deb. So tell me - what makes a blood draw bad? Vet side or lab side?

StarDeb55

07-04-2010, 03:31 PM

Vet side. They had trouble with draw which is termed a traumatic blood draw. This doesn't mean trauma to Annie, but the trauma that the RBCs underwent during the draw to hemolyze them.

Debbie

frijole

07-05-2010, 12:07 AM

So am I able to have any level of confidence in these results? The report is all from Idexx so I assume it was all done at their lab - included not just the CBC but the B12/Folate, thyroid, etc etc. I assume it would all be potentially off?

I am just sick about this. I was hoping to get her stomach issues under control so that I could then take her to my aunt's vet in Lincoln. She treated her dog for pancreatitus and diabetes and seemed on top of things. She knew about vetsulin being off the market way early and didn't push it on her, got the dog regulated in 4 days while treating him for pancreatitus. Figured I would interview her and try her for treating the tough issues and use the local vet for emergencies only.

Interesting... I just noticed that they gave me the ORIGINAL notes from the ultrasound as well as the film!?! Think they want me to find someone else to treat Annie?

I have spent all night reading up on SIBO, EPI, IBD, etc. I'm trying to find a forum like this one for SIBO... no luck yet. The thing that is weird about her results is that her B12 is HIGH. I couldn't find a single dog who had SIBO with elevated levels of both B12 and Folate. Those with low B12 supplement but I don't know what you do if it is high, if anything.

I did read something interesting that I will share:

"My vet said something that got me thinking today...She firmly insists that lots of the mysterious SIBO cases, out-of-the-blue colitis cases, and chronic diarrhea that seems to have no apparent consistant cause (sometimes a dog tests positive for SIBO, other times the exact same dog has normal test results but horrific symptoms again).. she says she is positive this is associated with stress chemicals in the body inciting inflammation, causing vitamin B12, absorption issues in the gut, etc etc... and she swears that any dog who is reactive, excitable, nervous, etc as part of basic temperament needs that problem addressed first. Then, she believes, the mysterious GI fiascos will be less and less. Maybe she is onto something? "

StarDeb55

07-05-2010, 12:24 AM

Kim, if any of the other results would have been affected by hemolysis, it should have been specifically stated on the report. If it didn't, those results are probably ok, but there's a big IF, here. I have learned a long time ago, never to assume anything. In your position, I think I would insist that the vet make a call to Idexx to verify just exactly what results could be affected by hemolysis, specifically asking about the B12 & folate. If the vet doesn't want to do it, I would insist on getting the phone number for the lab, & tell the vet that you'll do it yourself.

When it comes to this situation with humans, if a sample is not grossly hemolyzed, we will sometimes report out results, flag them in a similar manner like the vet lab does, but we don't say specifically what tests may be affected. We, then, leave it up to the docs to make the call as to whether or not they want the patient redrawn. We don't do this a lot, but I know we do it with the ER sometimes because the docs want the results that are "usable", & not be delayed waiting for a redraw.

Kim, this is it for me for the night as I have to go to work tomorrow. I will try to check when I get up in the AM, assuming I have a couple of minutes.

Debbie

Debbie

AlisonandMia

07-05-2010, 12:35 AM

Kim, I think that some tests are more effected by hemolysis than others - in fact some may not be effected at all. So some of the tests run a damaged sample may be reliable whereas others are totally useless. I'm sure Deb can give you more info on this but the lab usually puts a notation against the ones that can be thrown out by hemolysis.

Re the nervous temperament/stress thing, the gut does have its own nervous system, separate but not completely unlinked to the central nervous system so anything that can upset the brain can certainly affect the gut and how it functions. Very, very hard to cure a stressy temperament though, you can turn it down but you can never really turn it off. Zac is a stressy, reactive dog (:eek:"The sky is falling! The sky is falling!":eek:) and yes he seems to have a somewhat twitchy gut - nothing actually pathological but his insides seem to be more "reactive" like the rest of him when compared to any other dog I've ever known.

Alison

frijole

07-05-2010, 12:41 AM

Thanks Deb!

Alison - Zac and Annie should "hook up" but I guess she is too old for him? LOL

She was 1 when I got her and she had been abused. She is a total mommy's girl - suffers from separation anxiety - cries when I get home from work or come back from the store. Right now she is shaking like crazy from the fireworks... so I wonder if some of today isn't caused from fireworks. Remember last year I had to carry her outside to go to the bathroom for 2 weeks? It freaks her out.

I have the TV blaring and the air conditioner on HIGH to drown out the noise. :o:eek::cool::D

AlisonandMia

07-05-2010, 12:51 AM

Zac hates fireworks too - much worse than thunder storms. We got "caught" by some fireworks on a walk once - that is possibly why. Mia was with us then and was "Meh, fireworks who cares!" but even me and Mia both acting calm didn't seem to help him that much (would have been worse if one or both of us had freaked out though!).

Natalie has her Jack (stressy, high reactive fellow) on a small dose of Prozac I believe - it has a very good effect on anxiety in dogs. Zac isn't on anything but I wouldn't totally rule it out if it ever looked like he could benefit from it - ie if something in his environment changed that stressed him over much or he developed a real phobia/anxiety about something that couldn't be helped with either training or changing things. Would you consider something like that for Annie?

White noise from an FM radio off the station could help to block out bad sounds too.

Alison

frijole

07-05-2010, 01:05 AM

Just took a photo with my cell phone... it shows how whacked Annie's hind legs are. She doesn't even stand normally anymore. Her hind end is higher, her front legs are further apart than normal. She walks funny - rigid.

If I get this done right you will see how she is lying down sleeping with her hind legs in the position they would be when she is sitting up!

Dang, didn't work so go to my photo album because I put it there.

By the way....:( today is Annie's 14th birthday. Couldn't even give her any treats. Poor thing.

Here's picture of Annie added by Glynda

487

lulusmom

07-05-2010, 01:14 AM

Kim, I added Annie's picture to your post and wanted to say that she looks very patriotic in her red, white and blue bandana. :D She also looks like maybe her tummy hurts. With her legs in that position, it would take some pressure off of her tummy.

AlisonandMia

07-05-2010, 01:21 AM

frijole

07-05-2010, 01:24 AM

Zac (who is young and has no physical problems) often lies like that - especially when he is nervous and wants to be ready to get up and run away - also does it when he wants to be ready for action in some other way. He had a minor melt down over something last night (thought a hose hung on a wall was trying to fall on him:eek::rolleyes:) and when he lay down anywhere within 12 feet of it he'd lie like that.

AlisonThanks for the good old fashioned belly laugh... I needed that. Zac seems like a real piece of work!

Glad to know other dogs lie like that because it is a first for her and freaked me out. Annie is normally like the photo in my album - all about being laid out with legs fully extended more like a cat!

AlisonandMia

07-05-2010, 01:32 AM

Oh - he's a piece of work alright! He quite clearly had some sort of traumatic experience before we got him (at 4 1/2 months) - not deliberate mistreatment but some terrifying incident in an enclosed space when stuff fell on and around him - I think it involved an electric lead of some kind too from what he "tells" me - and something large and light colored too. It was months before he would go into the garage and didn't like other enclosed spaces either.... He's 95% ok now but has "flashbacks" when something reminds him of whatever the incident was. I'm sure a lot of dogs have had similar mishaps but his temperament is such that it freaked him out totally.

Hopefully Annie will start to lie normally when the fireworks go away - I guess they carry on for some time after July 4...:(:(:( - if indeed it is stress that is causing her to lie like that.

Alison

Harley PoMMom

07-05-2010, 01:34 AM

By the way....today is Annie's 14th birthday.

Happy 14th Birthday to Annie! Give her some hugs and kisses from Harley and me. Big hugs to you too.

Love and more hugs,
Lori

Franklin'sMum

07-05-2010, 02:42 AM

Happy Birthday Annie!!!
Hope you have a great day :) Belly rubs and smoochies from us here too :)

Jane, Franklin and Bailey xxx

Squirt's Mom

07-05-2010, 10:11 AM

Happy 14th Birthday, Miss Annie!

We hope you have a wonderful day today and maybe some of those birthday treats tomorrow!

Hugs,
Leslie and the girls - always

Roxee's Dad

07-05-2010, 11:59 AM

:D:D:DHAPPY BIRTHDAY ANNIE :D:D:D

No Treats :( but a day full of love.:D:D:D

labblab

07-05-2010, 01:10 PM

HAPPY, HAPPY, HAPPY, HAPPY BIRTHDAY to MISS ANNIE!!!!!!!!!!!!

:) :p :D :) :p :D :) :p :D:) :p :D :) :p :D :) :p :D

All best wishes to you and your wonderful mom :p :p :p :p :p
Marianne, Luna and Peg

sunimist

07-05-2010, 01:48 PM

Sorry I am late sweet girl, but....HAPPY BIRTHDAY!!!

Kim, like Glynda said, Annie's tummy might be hurting. Misty would lay like that when she had a tummy ache. Might not be the case at all with Annie though.

Shelba and Suni~~

addy

07-05-2010, 02:19 PM

oh, I'm late but still wishing Annie a Happy Birthday!!!

Zoe's test showed high B12 but her IMS said it was not SIBO. We have the phantom colitis with no apparent cause but no vomiting. Zoe is also reactive, high strung, fearful, and her second owner was arrested for I don't know what but animal control seized Zoe and would not give her back. That's how I adopted her. Did you see her jail photo? Her tongue was hanging out so far :eek:

When I tell a vet "she can't eat that or I have to supplement that food" they always look at me like I'm nuts and respond" well but she should be able to eat that" or "you should not have to supplement that". oh, the frustration of it all:)

Current IMS thinking is that even though Cushings does not cause diahrrea, Cush pups get infections frequently and she believes that is what happens to Zoe. She believes that once I control her Cushings, the chronic diahrrea will stop because she will have less infections.

Could it be something similar for Annie?

Hoping you find some answers,
Addy

lulusmom

07-05-2010, 05:48 PM

Kim, I did a little research and found a support group Exocrine Pancreatic Insufficiency but I noticed right away that people were talking about SIBO and B12. There is also an EPI Yahoo Group but their criteria to join is ridiculous. Your vet has to have diagnosed your dog with EPI and they say right up front that if that hasn't happened, your request is denied. That's just not right!

http://www.epi4dogs.com/apps/forums/topics/show/2934555-epi

gpgscott

07-05-2010, 05:58 PM

Hello, Kim and Annie,

Many happy returns.

:D

Scott

frijole

07-05-2010, 06:31 PM

I guess I am lucky because Annie does NOT have diarrhea like most SIBO dogs. In fact she is constipated. That comes from the nausea meds. Her only symptom is that sometimes you can tell she is in pain - the tummy. I hear no more rumblings, never smelled any gas. She only vomited twice (bile) and that was early on. So her stomach is just very sensitive right now.

Glynda I read at that site as well as a German Shepard site (prone to SIBO) and it was sad. I felt fortunate but it was scary.

The problem with SIBO is that they can't properly digest their food so even though they are starved and eating, they are not getting the nourishment from it. So they become skin and bones. I was horrified when I found out Annie was 14.5 lbs when diagnosed with cushings. She had always been 17-18 lbs. Her tummy is very round so it masks the weight loss. Now that I have seen the dogs with SIBO (photos) they look like those posters you see of starving kids in Africa and that is how Annie is starting to look. She is a TALL schnauzer and by now she is probably 14 lbs or less. Way to thin. I can see some of the bones protruding and it scares the heck out of me.

I just know that from reading almost all of them were using Tylan and said to go no less than 30 days the before thinking about weaning her off of it.

frijole

07-05-2010, 06:35 PM

Zoe's test showed high B12 but her IMS said it was not SIBO. We have the phantom colitis with no apparent cause but no vomiting.

Current IMS thinking is that even though Cushings does not cause diahrrea, Cush pups get infections frequently and she believes that is what happens to Zoe. She believes that once I control her Cushings, the chronic diahrrea will stop because she will have less infections.

Could it be something similar for Annie?

Hoping you find some answers,
Addy

Interesting. Were Zoe's FOLATES high? My understanding is that high folates and high B12 = SIBO. I do not have diarrhea or vomiting = just extreme pain in stomach. My vet is saying you can't treat the cushings because she can't eat (sensitive stomach) He also said that some treat SIBO with steroids so the cortisol is actually helping her. ???

The only thing I do not get is that she has extreme loss of muscle/strength in all legs but particularly the hind ones. Some days she jumps up the steps with ease (two of 'em on patio) and others she tries and falls flat on her face. I am assuming this is cushings.

addy

07-05-2010, 07:33 PM

littleone1

07-05-2010, 07:33 PM

I hope you had a very happy birthday Annie.

addy

07-05-2010, 08:01 PM

one more thought, not meant to alarm, her esophagus is okay right?
my neighbor just went throught that which is why came to mind.

Addy

frijole

07-05-2010, 08:17 PM

zoe's teset results

SubTest Name Normal Values Results
Folate 11.3
Serum Cobalamin (Vit B12) 962
TX AM B12/Folate Thu, 5 /27/2010 11:26 AM
Results/Comments
Normal Ranges:
Folate Fasting: 7.7-24.4 ug/L
Serum Cobalamin: 251-908 ng/L

she never lost weight when she had a flare up, usually does not vomit but when she does heavy panting, I know it is her tummy and she will have bad poops. Only other time she pants is when she is anxious.

I thought I read that you needed to keep them on tylan for six weeks but perhaps that was when diahrrea was a symptom. Stomach gets so inflamed takes quite awhile to heal. I also thought I read sometimes the ibd type problems are from the protein they eat. Food intolerance verses allergies perhaps.

or maybe she has just enought bacteria in her gut that it keeps giving her problems like Zoe perhaps has just enough bacteria in her colon to keep giving her issues? Did you say her tummy problems come and go?

AddySo it looks like Zoe has HIGH B12 but NORMAL Folates so that is NOT SIBO and your doc dx-ed colitis. Annie's are both HIGH.

If I stopped the reglan (Nausea) and Pepcid AC(gas) meds she would not be able to eat at all. Whenever she eats she gets stomach pains. I do not smell gas, hear gas, sometimes I hear growling but not always but clearly when she eats she is in pain.

The pills have allowed her to eat some food. The problem is that SIBO prevents her body from getting any nourishment from food. So even though she eats - it isn't doing her any good and she is losing weight. I did not notice it because I was dealing with my other dog Haley and Annie has the cushings round tummy making her look heavier than she is. BUT her tail end is starting to look just like this poor guy and it is scaring the crap out of me.

http://www.epi4dogs.com/epi.htm

frijole

07-05-2010, 08:18 PM

one more thought, not meant to alarm, her esophagus is okay right?
my neighbor just went throught that which is why came to mind.

AddySo far so good.

addy

07-05-2010, 09:02 PM

last year I talked to Sibo dog moms and they treated with tylan for six weeks.and switched proteins. They thought perhaps that was Zoe's problem. When I go back through your thread Annie was eating again when you started the tylan but stopped when you cut back the anti nausea pill. Maybe I missed part of the thread. Does she need the tylan for a longer period of time before you wean her off the anti nausea meds?

The only time metronidazole ever worked for a flare up for Zoe was to keep her on it for a good month, weaning her off very slowly. Otherwise, she went right back into a flare up. Maybe Annie needs the tylan for a much longer time. Better than the augmentin.

Addy

zoesmom

07-05-2010, 09:07 PM

Annie - Hope your 14th birthday was spectacular. (Luv your patriotic outfit, by the way!) Sue

Spiceysmum

07-06-2010, 12:07 PM

Kim,

My Springer Spaniel, Brin suffered from sibo last year. He had diarrhea for six weeks or so but antibiotics or bland diet didn't work so he had blood tests which showed he had a B12 deficiency. He lost so much weight. He started on a six week course of B12 injections along with another course of antibiotics and a change of food to Royal Canin Veterinary Sensitive Control (Blue whiting and tapioca). Almost overnight his diarrhea stopped and he gradually put the weight back on and has been fine ever since. You might have already said but has Annie had blood tests that would show up any deficiencies? (Just read through your recent posts again and noticed that Annie has high B12. Don't know why sibo could result in high or low B12 and cause so much weight loss.) Sorry, that's not much help then!

Linda and Spicey

O'Riley

07-06-2010, 12:30 PM

Spiceysmum....there is a new pill made by Metagenics that apparently works as maintenance after the B12 shot regimen. Read about half-way down the page:
http://www.epi4dogs.com/b12.htm

Did your vet use the Texas A&M lab?

~Rose

Spiceysmum

07-06-2010, 01:05 PM

Rose,

As Brin has been ok for over a year now I'm hoping that he never has to be treated for sibo again, but if he does it is handy to have that information, thanks. We are in the UK so no, we didn't use that lab.

Linda and Spicey

frijole

07-06-2010, 02:58 PM

frijole

07-06-2010, 03:01 PM

It is driving me nuts because I can't find any other dog whose B12 was HIGH. Mine was extremely high. I must not be choosing the right words in google. Sigh.

Spiceysmum

07-06-2010, 05:48 PM

Me neither, I can't find anywhere that high B12 relates to SIBO. :confused:

frijole

07-06-2010, 06:43 PM

Me neither, I can't find anywhere that high B12 relates to SIBO. :confused:

It said it on the Idexx lab report though so that made me feel better.

zoesmom

07-07-2010, 11:21 PM

Kim - I think that our IMS said that low b12 and high folate were the typical indications, but then when you first started discussing it with your vet, I think I saw on one website that both can be elevated in SIBO. Zoe only had elevated folate (her b12 was a little low but still in normal range) but she had all the symptoms so that's why we went ahead and treated. I'll see if I have any other pertinent info that I may have bookmarked back then.

Also, once Zo started the tylan, we never stopped it. So she ended up taking it for a year and a half. Of course, she had all those other unexpected 'side' benefits from it, so maybe that's why her IMS never said to stop it. I did skip it whenever she was on some other antibiotic. Don't know why - just did. Sue

frijole

07-08-2010, 12:09 AM

Thanks Sue. I have read of dogs that were on Tylan their entire lives without problems so that is good to know. Did you stick with the Solid Gold food during the SIBO ordeal? Annie seems to be having a hard time with it. Sometimes she leaves the kibble and eats the canned and sometimes she does the reverse. I no longer mix it up and that way she can choose.???

I put out a small dish with chicken broth, a bowl with both of the foods and let her choose. She is not eating it all. I leave what she doesn't eat out and when I come home it is usually, not always, eaten. I just want to make sure she gets enough to eat since she isn't digesting it properly. You can see the bones on her butt and that is scary.

She seems a bit better but we've been on the tylan for 2 weeks now and guess I was hoping she'd eat better.... thus my questions on diet.

Thanks

Bichonluver3

07-08-2010, 02:10 AM

I have my doggie for non-anesthetic cleaning every month. Their are techs who come to the animal clinic once a month to do this. It is much cheaper in the long run and no anesthetic which can be very hard on a dog. My Chloe & Sparky had teeth trouble too but are now happy to smile and show their pearly whites (now we have good breath too!)!
Just a suggestion:)
Carrol

addy

07-08-2010, 02:23 PM

Also, once Zo started the tylan, we never stopped it. So she ended up taking it for a year and a half. Of course, she had all those other unexpected 'side' benefits from it, so maybe that's why her IMS never said to stop it. I did skip it whenever she was on some other antibiotic. Don't know why - just did. Sue[/QUOTE]

Zoe's Mom- could I ask a favor and could you repost those unexpected side benefits on my thread? When I read that it really started me thinking about my Zoe and her problems. Thanks.

Annie's Mom - I looked everywhere for info on high b12 because Zoe had high B12 but normal folate, I did not turn up much either, everything was about low B12. I'll keep looking as well. We will get there!:)

Addy

frijole

07-10-2010, 12:48 AM

Update time. I have been reading as much as I can find (very little) on SIBO. Most dogs with SIBO have EPI (Annie does NOT) and so that is the main focus of the conversations. I read that sometimes you just don't know what caused the SIBO but the best way to treat it is to treat the underlying cause. Here are some causes:

Possible reasons for pathologic bacterial overgrowth include:

• Deranged gastric and small intestinal motility, (e.g., “gastric dumping” or small intestinal ileus)

• Deranged small intestinal defense mechanisms, as with the use of steroids
• Reduction and disturbance of the normal flora, as with the use of antibiotics

• Increased presence of unabsorbed nutrients, (e.g., in EPI or IBD

I also read that liver disease can contribute to SIBO.

OK if the above is true - to treat the SIBO I should heal the liver and reduce the steroids (cushings/cortisol) but I can't treat the cushings because she struggles to digest food due to SIBO.

:confused::confused::confused::confused::confused: :confused:

Her appetite is better but not consistent at all. I have to give her the nausea pills along with Pepcid AC. I wait 30 mins to feed her. She always WANTS to eat. She sometimes eats the kibble, sometimes eats the canned but she is NOT mixing them.

I read on Monica Segal's site and a few other places that you should pick ONE protein source and stick to it. (actually she says pick one your dog has never eaten - not one bite) Her kibble is lamb and the canned she is eating is chicken. I have to buy the food out of Minnesota and ship it here - not available locally. I buy a mixture of chicken, lamb and fish canned foods all from Solid Gold. I always gave just a small amount with the kibble.

I am almost OUT of the chicken which is what she has been eating. :eek:

There is no protein source that I can think of that Annie has Never had. (she's had bison and duck in addition to what I mentioned already)

So - food experts - WTH do I do?

Meanwhile - I am concerned that between the untreated cushings and the tumor on her liver that she should be getting treatment. I see my options as trying another vet that is NOT local - at least get a consult for direction. (My aunt's vet in Lincoln seems on the ball but that was for treating diabetes/pancreatitus ) Or I could email Feldman? Bruyette? Bruyette scares me as he is so anti lysodren.

I could go to Iowa State or K State (have heard Iowa is better for small animals) but I do not know anyone there so it would be a crapshoot.

Anyone have any ideas?

AlisonandMia

07-10-2010, 01:01 AM

Venison? And could you possibly get hold of kangaroo? (Which must be human grade - not the rubbish that is sold as pet food!)

Has she had pork?

It must be particularly hard with an older dog find a truly novel protein.

Alison

SasAndYunah

07-10-2010, 03:19 AM

I would suggest then that you use Royal Canin Hypo Allergenic. This food was especially designed for dogs that have an allergic reaction to all proteins. So what they did is, they "cut up" the proteins in such small pieces, the body doesn't recognise them anymore as being proteins :) It's called "hydrolysed".. So, no matter what protein source, Annie's system wouldn't recognise it as a specific protein she had before :) (I used this for my Sogno, with good succes)
Royal Canin also has a product named Sensitivity Control and in this product as well, the the meatproducts (fish and liver) are hydrolysed, again meaning the proteins are being made so small that they won't be recognised by the body. Another advantage for either of these is that "small proteins" are more easy to digest wich will help the actual foodabsorption and thus gaining weigth. At least the Sensitivity Control comes in both dry kibble and canned food. The Hypo Allergenic one has just dry kibble as far as I know. (but it has been a few years so maybe they have canned now too).

On top of that I would start adding probiotics to get the intestines as healthy as possible. A very good product/brand is "Protexin". I looked if it was available in the USA but found at least the UK headquarters. You can have a look at their site and all info will be written in English...that should help ;) And if I were you I would go for the Protexin Pro-Soluble for dogs. But just have a look around at http://www.protexin.com/vet/products.php?id=4

Hope this was of some help...

Sas and Yunah :)

ps forgot to mention that perhaps you are able to feed Annie 3 till 4 times a day, smaller portions, this may help getting more food in her more easily...

Spiceysmum

07-10-2010, 03:30 AM

marie adams

07-10-2010, 03:42 AM

Hi Kim,

Boy have you been all around the place with trying to figure out what to do for Annie. I hope you get some good answers soon. I know when I first started this journey I did call UC Davis and one of the Senior Grad students called me back with answers I needed. I hope Dr. Feldman can give you good info if you choose to contact him...

Take care and wish Annie Happy Belated B-day from Miss Maddie:D:D

frijole

07-10-2010, 09:12 AM

Hi,

The Royal Canin Sensitivity Control is the one that Brin is on and as it's Blue Whiting and Tapioca its definately a protein he'd never had before! I think it was the B12 that helped the most as the recovery was so quick but I am sure the food helped too. In fact Spicey is on it too now. She was always on a hypoallergenic food for her allergies but it is just easier to feed them both the same.

Linda and Spicey

Are you saying that RC's sensitivity control contains B12? Because Annie's B12 is extremely elevated (over 2000) and I worry about adding to it.

Linda - sorry but refresh my memory - did Spicey have SIBO or another tummy ailment. Thanks!

Harley PoMMom

07-10-2010, 09:17 AM

When I emailed Monica a while back about changing Harley's diet to a more liver-friendly diet she told me to we could do that. Harley's formulated diet...the proteins are skinless boneless chicken breasts and chicken gizzards, she said to make this more liver-friendly, switch to tilapia and hard-boiled eggs. Tilapia is a white fish.

frijole

07-10-2010, 09:18 AM

Harley PoMMom

07-10-2010, 09:23 AM

Other protein sources: buffalo, elk, ostrich.

SasAndYunah

07-10-2010, 09:27 AM

Kim,

I'm becoming a bit confused here, not uncommenly :D I tried to read back the entire thread but with temperatures over 104 degrees F and with broken metatarsul bones , that's next to impossible :)

Was anything ever diagnosed by a vet...the SIBO for example? Sibo goes hand in hand with low B12 levels. High B12 levels can be seen in liverdisease for example... What did your vet say about those levels? Was he/she concerned? What was his/her explanaition for the elevated levels? Was more testing done? For liverdisease for example? Because liverdisease can cause the exact same symptoms, nausae, low appetite, weigthloss, etc.

Sorry to be asking so many questions...:)

Saskia and Yunah :)

frijole

07-10-2010, 09:34 AM

Sas - the vet said nothing. :o The lab report from Idexx says "consistent with small int bacterial overgrowth". From everything I have read in MOST cases the B12 is LOW. That is why I have been reading like a maniac - Nothing that I have read says anything about what to do in case of HIGH B12s. Although I have seen it mentioned.

This is why I mentioned feeling the need to do something about the cushings to help her liver. Liver disease can cause SIBO if I am not mistaken. Between the cushings and the tumor on her liver I am sure it is in distress.

Gotta run for a bit. Checking in later! Thank you!

SasAndYunah

07-10-2010, 10:16 AM

Hmmmm...with SIBO you have to address the cause, not the symptoms. So even if Annie's liver is causing the SIBO, you still would have to address the liver (cause) and not the symptoms. Second thing would be..is the liver the result from (untreated) Cushing's or is it independantly excisting beside the Cushing's?

I personally am very much against the use of anti biotics (the Tylan) when it's not proven to be necessary. It makes matters worse, in the long run. Also it may have to do with a "cultural" difference in treating animals (humans too perhaps) as we do in Holland and as they do in the USA. For one, no anti biotic can be bought over the counter. Furthermore, anti biotics are only prescribed when there's a proven bacterial infection. So not getting any anti biotics here when you have a cold or the flu...first they will do a culture to make sure there's a bacterie involved. I personally am very pleased with this "conservative" approach. Oh well, that's another subject all together :)

But it may explain my hesitance to treat any living being with anti biotics if there really is no medical, proven need. "Treating symptoms" is another such difference. We're not accustomed to treat symptoms. We're raised with the "believe" that certain things just need be so...like having diarrhea. (Remember this is the country where women give birth at home, no epidurals, no nothing, giving birth does hurt, that's the way it is ;) ) Diarrhea happens some times. We're not giving them anything to stop the diarrhea and let nature take its course (unless of course the animal/human is becoming dehydrated, weak, etc) If the diarrhea doesn't ressolve after 24 hours of fasting and then slowly reintroducing the food, then we go look for the reason. And the logical path would be, fecal exam to rule out internal parasites, EPI check, blood tests to look at liver etc...resulting in finally a biopsy of the intestines. I notice the difference in approach rather often when a dog on this forum has IBD for example (or colitis) The vet will say (after perhaps some exams and blooddraws) it's IBD/Colitis. And that's usually it, except for maybe some diet chance. Here we pursue that diagnosis a lot more to find the exact cause for the IBD or Colitis. I went that route with my Sogno and it wasn't untill the biopsies we discovered that he was allergic to all proteins, animal and vegetable, very rare for a dog to be that extreme allergic. But it was either go the eintire "diagnostic" route and hoping for a definate answer or a lifetime of trying this, trying that, etc. and never really resolve the issue.

Not that this has anything to do with Annie but I wanted you to get a better understanding as to why I sometimes say what I say...I'm used to a different appraoch in these situations :)

So, from my point of view, I would go back to your vet (or another vet) and try and find a route together to get to the bottom of Annie's problems :)

All my best to you and Annie,

Saskia and Yunah :)

Spiceysmum

07-10-2010, 04:55 PM

Kim,

No, the Royal Canin Vetinerary Sensitivity Control doesn't contain B12 its just that we changed Brin's diet on the same day that he started the B12 injections so I can't be sure which worked the best but it could have been a combination of the two. It can be used just for a short time before re-introducing more foods but I have just kept him on it ever since even though it is more expensive. It is a low residue diet too so it has the advantage that their poo is alot firmer and doesn't smell as much!

Spicey has never suffered from tummy upsets. The only reason I started her on it was because it seemed to be costing alot more to buy two different foods and as she suffers from allergies I thought it would be good for her too.

Linda and Spicey

frijole

07-10-2010, 06:37 PM

Saskia, Yes I get your logic and don't disagree - and yes the US if pill happy.

Actually my vet wanted to do nothing. When Annie was not eating and the lysodren wasn't working he said to do nothing. I pushed for an ultrasound and got it done.

With the results from the ultrasound he said - don't treat the cushings because "studies are showing that treating it doesn't result in them living any longer" and there was nothing to be done for her tummy because she was already on a low fat diet and her body is producing cortisol which should help any inflammation.

That is when he gave up on my dog (or me). He said that he and the vet in Omaha discussed it and said this is what they would do if it were there dog. I said but she isn't eating ! At that point he gave us an rx for reglan for nausea. No follow plan - zilch.

When I phoned him to say - look something happens when she eats - cause and effect he really didn't want to do any testing I could tell. I threw out testing for pancreatitus because she is a schnauzer and I told him I wanted another CBC because she hadn't had once since Feb and she certainly wasn't the same as she was then. He phoned that infamous "board certified specialist that works for Idexx" and that guy suggested a Senior Panel and the B12/Folate test.

So as you see - I am the one pushing for tests. I actually thought that maybe the reason he ceased making recommendations was because there was cancer but he didn't want me to know since Haley had just passed.

Now - either I have pushed him to the upper limits of his knowledge or his patience - or both.

Anyway- when he came back with the antibiotic recommendation I did alot of reading and everything I read about SIBO indicated that in most cases the cause is never discovered. It might be because they don't really understand it. I read case after case where people spent months and tried multiple antibiotics to no avail and then they ended up using a non approved drug, Tylan (chicken antibiotic known for how it goes after primarily the bad bacteria).

Again, I called to ask if I could use it because he wanted to go another route. I think alot of vets, not all, have a certain "routine" and "comfort level" of what they treat and how they treat it. This clinic is busy as heck because people from small towns all over come to this "city" with their pets. The caring, concerned gent I met 4 yrs ago doesn't have time to do any more. Sad.

Anyway - at this point my goal is just to get her stomach in order enough for me to feel comfortable that she is maintaining her weight. I do need to get some probiotics and pre-biotics (fructo-oligosaccharides are great for sibo). I will do this on my own as well. If I ask this vet about it he will say it is a waste of money.

SasAndYunah

07-10-2010, 07:23 PM

Kim, thanks so much for explaining everything to me again :) I am very sorry to learn your vet shows so little cooperation and "dedication" or at least, that is what it sounds like to me...

I will tell you what I would do if I were left "all by myself" with a dog in Annie's situation, I would for now continue with the anti nausea medication but would most definately stop the Tylan because I firmly believe that giving anti biotics makes things worse eventually. The intestines should recover by themselves with some help in the right direction. I would start feeding one of the RC foods I mentioned before for no other reason then that they are easy and highly digestable and that it is not only easier on the intestines but easier on the liver as well. I would feed 4 small meals per day and add probiotics to help start healing/restoring the balance in the intestins. No snacks and stuff except for a hard boiled egg (egg white only) since the protein in eggwhites are of a very high quality and easy on the liver. You would help her intestines but also her liver if you were to do this. And since there is some liver involvement as well due to (untreated) Cushing's or something else, I would be happier to persue a treatment plan that would not focus on one aspect (the intestines) but on 2, intestines and liver. Not only is the food I mentioned easier on the liver, also stopping the Tylan will be beneficial to the liver. I personally am not convinced it is SIBO. SIBO is, like IBD, a term often used when vets don't really know what's wrong :) In 80% of SIBO, EPI is the primary cause. In the other 20% it's usually long term anti biotics use, long term internal parasites infection or due to long term bad feeding. And with some liverinvolvement in Annie's case, for whatever reason (and liver problems are known to show the exact same symptoms), with a high B12 that can be found in liverdisease and not in SIBO...I would not focus on the SIBO but would focus instead what would be healthy and beneficial to her overall health, intestinal and liverwise.

But that's me and the approach I would use. You have to do what you feel comfortable with and have faith in. Just want you to know there are different approaches but the choice is entirely and only yours :)

Hugs,

Saskia and Yunah :)

frijole

07-11-2010, 12:34 AM

Saskia, Thank you! I ordered the probiotics and enzymes. I am going to go boil some eggs right now so I don't forget. That is an awesome idea and easy to do too! I have to admit - not only have I doubted the SIBO dx, I have doubted the cushings dx wondering if that tumor on the liver could be doing sending out false test results. But for now I focus on boiling eggs. :D Thanks. Hugs from Annie too. Kim

addy

07-12-2010, 10:01 AM

When is Tylan Used?
Tylan is known as an antibiotic that belongs to the macrolide class, but it's better known as treatment for colitis and chronic diarrhea. Tylan has anti-inflammatory properties and in , it acts as a soothing agent for the large intestine.

Tylan is made up of Streptomyces fradiae, which is a bacterium. It may be an inhibitor of bacterial protein synthesis.

Tylan is not processed in the body, being eliminated through urine, so it is less likely to cause liver disease or worsen a pre-existing condition

As far as I understood, Tylan did not affect the liver, unless this info is wrong.

We use Culturelle 1/2 capsule one time per day. You can refrigerate but do not need to. Some use it only 3 times per week. You have to see what works best. You may also have to try different strains of probiotic, some work better than others, depends on your dog.

Also wondering, if canned is better than kibble for Annie. The Royal Canine canned food seemed to have better ingredients when I looked into it for Zoe.

I also looked at Dick Van Pattons Natural Balance canned vension and sweet potato as an alternative to Royal Canine.

Hope Annis is eating,
Addy

frijole

07-12-2010, 03:11 PM

Addy, you are right and that is why I selected Tylan vs what the vet recommended. So far I have not seen any difference since starting it. We are at day 20. :(

Annie will eat - and then she will NOT eat - because it hurts her to eat. I had a rough weekend trying up to 6 things at a time. I fed her multiple times in smaller doses each time.

Last night her stomach was really growling again. This morning she wouldn't touch anything - not even the egg white.

So she is afraid to eat.

I also noticed her poop in the yard had disappeared without me picking it up. She has never done this. I read that this is common when dogs are unable to get nourishment from food.

I need to decide who to take her to before she wastes away.

labblab

07-12-2010, 03:25 PM

Kim, I feel so helpless to know anything to suggest. I am so grateful that so many others have been able to share ideas with you, and I wish I could do the same. But these digestive issues are new territory for me, too...:o

But please know that I'm following every post and hoping so much that Annie will start eating again for you. I remember how it tortured me when Barkis wouldn't eat, and I'd give anything to spare you that!

So I'm still keeping all fingers crossed that you'll be able to find something to perk her up.

Many, many hugs to both you and sweetie Annie,
Marianne

O'Riley

07-12-2010, 04:10 PM

SasAndYunah

07-12-2010, 04:29 PM

I simply have to respond about the Tylan...I don't know how the "rules" are in the USA and if "not FDA approved for companion animals" means that it wasn't tested properly (since it's not approved, why test it?) but Tylan most definately can have certain side effects, gastro-intestinal upset for one, itchy skin being another. But also using Tylan can cause false high readings in liverlevels (ALT and AST) I'm not saying Tylan isn't good at doing what it should do but no medication does only "do good". And any medication that is, amongst other things, used as a growth "excelerator", which Tylan is used for in the large farm animals, is not a "harmless" drug.

"Tylan is not processed in the body, being eliminated through urine..."

I am not sure where that was written, where that comes from but...how does urine become urine? Through all kinds of processes in the body :) So in order for Tylan to leave the body through urine, the body has to process the Tylan first... Everything that enters our mouth, is processed by the body, one way or another :) If it wasn't processed by the body, it would be useless to even take it :)

Just thought I would clarify this...

Saskia and Yunah :)

frijole

07-12-2010, 05:13 PM

Just throwing this idea out there....but you might try this: Put a whole chicken in a stock pot with about four cups of water, a little celery, a little salt, a little fresh garlic, boil gently for a couple of hours, then give Annie some of the rich broth. You might have to put some broth in a syringe (without the needle, of course), to sort of "prime the pump." If the broth agrees with Annie, she might lap some up on her own out of her bowl.

Chicken broth is highly recuperative. After a day or so on broth, add a few cooked broad noodles, and tiny bits of the cooked chicken. This might help to gently ease her back in to more substantial meals.

~Rose
Thanks Rose. Actually I have quarts of this in the frig and freezer ready to use. Everytime she relapses and refuses to eat I use this and eventually rice to get her back. It is a cycle. We start with broth, add rice, then some foods. She tries food and it hurts and then she goes back to square one. :(

Roxee's Dad

07-12-2010, 08:20 PM

Hi Kim,
Haven't posted to you much because I can't offer up any advice. I will however keep Annie in my thoughts and prayers. Hoping for the best for your little girl.

frijole

07-12-2010, 08:57 PM

Sas, clipping a bit of info for you on Tylan. I do agree that it would be nice to have tried to identify possible causes of SIBO prior to going w/antibiotics. I also agree that SIBO can be a "catch all dx" for vets.

Snippets"

Tylan is a name brand version of the medication tylosin produced by the company Elanco. It is FDA approved for use with farm animals such as chickens, pigs and cattle. It is not approved for human use.
Sanctioned Use
Tylan powder is only approved for use as a broad spectrum antibiotic for farm animals.
Off-Label Uses
Tylan is sometimes prescribed for off-label uses such as a treatment for gastrointestinal problems in small animals, such as cats and dogs, and as a growth-promoting food additive.
Production
Tylosin is not a laboratory product, but a naturally produced substance. It is a byproduct made by the bacteria Streptomyces fradiae. Function
Petplace.com reports that Tylan works by inhibiting the protein synthesis ability of Gram-positive and Gram-negative microorganisms, as well as spirochetes, vibrios and mycoplasma.

Read more: About Tylan Powder | eHow.com http://www.ehow.com/facts_5585296_tylan-powder.html#ixzz0tVzMniiH

gpgscott

07-12-2010, 09:49 PM

Kim I wish I could help,

I do know that antibiotic treatments did increase Moria's appetiete, we are not sure why.

Scott

Franklin'sMum

07-13-2010, 09:32 AM

Hi Kim,

Hugs to you and Annie, and hope she is feeling better. Just catching up, and came across this about SIBO- it also has a different name
http://http://www.vin.com/proceedings/Proceedings.plx?CID=WSAVA2004&Category=1261&PID=8664&O=Generic (http://www.vin.com/proceedings/Proceedings.plx?CID=WSAVA2004&Category=1261&PID=8664&O=Generic)

Antibiotic-responsive diarrhoea (ARD)

Formerly termed small intestinal bacterial overgrowth, this syndrome is seen most commonly as an idiopathic problem in young, large-breed dogs, and especially in the German shepherd dog. Whilst controversy surrounds the issue of whether bacterial numbers are actually increased in these dogs, and how antibiotics provide effective treatment, there is no doubt there are a number of dogs with GI signs that respond to antibiotics2,3. Further discussion of this condition is the subject of another presentation.
Googling for ARD might give some extra information if you've hit a wall with 'SIBO'.
Thoughts and prayers are with you both,

Love, Jane, Franklin and Bailey xxx

addy

07-13-2010, 06:04 PM

Also going to through this out there, I came across it, written by Dr. Dodd, you probably already know about it:

Dr. Dodds website:Liver Cleansing Diet

•White potato + sweet potato (50/50) cooked
•White Fish lightly cooked eg: cod, halibut, mackeral, smelt, snapper etc
Ratio is 2/3 of potato mix with 1/3 of fish . Season with mixed Italian Herbs or fresh parsely, salt and pepper. Later chopped carrots and green beans ( both cooked) can be added as can scrambled eggs. Yellow squash can also be added. Give a liquid childs multivitamin or a supplement such as Missing Link ( source of calcium)

Note from Dr Dodds :- I have some patients that have been on the diet for 7 years now-- that were near death before-- and are thriving ! Testimonials are numerous, without one negative comment other than some won't eat fish and so we give chicken to them.

Addy

frijole

07-15-2010, 08:05 PM

Well guys, we are headed to Lincoln.

The last few days have been just awful with me trying up to 6 kinds of dry and canned food, rice, broth and even going to buy some babyfood last night. The only thing she has eaten every time is canned chicken and the boiled egg whites. She drank 3/4 cup water yesterday which was great because it was 3/8 the day before.

Right now I need a vet to take a look at the stomach issues and I am aware they might put her on electrolytes. I can stay at my aunt's house and if I have to leave her and come home she has a strong, dog loving support group to go visit her.

We will worry about cushings later.

She also has been sneezing the last 2 days and I am betting that is due to teeth issues. So I'm sure more antibiotics will be in order as well.

Please pray for us and thanks for being here for us. It means the world to me. Hugs, Kim

sunimist

07-15-2010, 08:18 PM

Prayers and love going with you and Annie to Lincoln. I pray you can get some answers and get that baby on the road to recovery.

Stay safe and know we are here for you.

Love,

Shelba and Suni~~

Harley PoMMom

07-15-2010, 08:30 PM

I, too, pray that this Dr will be able to help sweet Annie. Keeping you and Annie in my thoughts and prayers, always. Travel safe, my dear friend, and let us know anything as soon as you can.

Love and ((((hugs))))
Lori

addy

07-15-2010, 11:04 PM

Kim, it will be a pretty crowded trip to Lincoln because we are all going with you mentally .)

Maybe now you will get the answers you need.

Crossing our fingers and toes and paws for Annie,

Addy

Carol G

07-16-2010, 01:26 AM

Kim,

I'm with you too.

Carol

acushdogsmom

07-16-2010, 02:48 AM

Hoping that the Vet in Lincoln can figure out what is going on with your little Annie.

(((hugs)))

Spiceysmum

07-16-2010, 03:28 AM

Hope you get some answers soon. Sometimes its the not knowing thats the worst, when we know whats wrong we can deal with it.

Sending best wishes.

Linda and Spicey

littleone1

07-16-2010, 07:35 AM

Hi Kim,

I hope you can answers, also. I'm keeping you and Annie in my thoughts and prayers that there will be a resolution to the problems Annie is having.

mytil

07-16-2010, 07:36 AM

Kim, it will be a pretty crowded trip to Lincoln because we are all going with you mentally .)

Could not have said it any better, Kim.

(((((hugs)))))
T.

zoesmom

07-16-2010, 10:00 AM

Kim - we'll be with you and Annie in spirit, too. Got everything crossed that you'll get some answers. Sue

addy

07-16-2010, 10:35 AM

Kim,

One thought for the road. I was reading through the test procedures for University of Texas (Zoe's gastro panel was done there) and I came across this remark:

Cobalamin: Absorbed in the distal small intestine (specifically in the ileum). Values below the control range are often seen in patients with EPI, bacterial overgrowth in the upper small intestine, or disease affecting the distal small intestine. There is no known significance of values exceeding the control range

So, we were both worried about the high B12 on Zoe and Annie's tests. Unin. Texas is saying we don't have to be worried, no significance:D

One less thing to worry about for you!!!!!

Addy

frijole

07-16-2010, 01:02 PM

Met with the doc, a wonderful lady. We discussed Annie's history and then she did a physical exam.

First off - Annie's heart murmur is so loud you can hear it thru her lungs. 6 on a scale of 6.

She does not think the teeth are involved w/eating issues - maybe some infection but not pain.

She wishes we had stayed on lysodren maintenance dose to keep the cortisol at 19.

She thinks regardless of the tests it involves the pancreas. It is GI related and not a macro (her opinion)

Her concern is that between heart, thyroid, liver she said it is very complicated and not an easy case to treat. She was willing to try but recommended that I go to KState and said tests are cheaper there and they are specialists.

She called them right then and there. I am 2 1/2 hrs away if I stay here in Lincoln (I'm 2 hrs from home)

If I brought her in today they could start testing but would finish on Monday. If I bring her in Monday first thing we can do it in a day - more than likely. If I need to I can get in my car and just drive there in an emergency.

Right now she is refusing to take the nause pill and thyroxine. Am afraid to try feeding her without that nausea pill. Going to try to hide it in another source to see if that works.

So as of right now I am staying in Lincoln and departing for KState on Monday early early.

Kim

lulusmom

07-16-2010, 05:25 PM

frijole

07-16-2010, 08:21 PM

Hi Kim,

I think I like what this vet had to say but I'm sure sorry that you have to go elsewhere for the answers you seek. My heart is breaking for both of you. Prayers are still being said and positive thoughts continue to be sent your way.

(((Hugs)))

Glynda, this vet did a thorough exam and talked to me for one hour and charged me $33!!!!!!!!!!!!!!!!!!!!!! This lady is a flippin saint. She was willing to take it on but she was honest and told me my vet should have referred me earlier. No chit.

Annie looks like a young happy puppy when she isn't in pain. It only hurts when I eat is soooo true. We will figure this out. I am just glad that we have a referral from someone who will listen to what K State says. That was my catch 22.

Wish I didn't have to wait til Monday but I told Annie we are now on "vacation". (oh boy huh?) Went to a REAL pet food store where they have real selection and got her all kinds of neat stuff.. tonight we are trying that Blue Buffalo food that you hear so much about. Turkey Meatloaf is the flavor I chose. I bought her venison, duck and other varieties... none of which I can buy locally. I think she will be pleased.

It won't cure her but if she gets some enjoyment out of it and some nutrition then I am just fine with that. I am going to try to enjoy the next couple days and we will be all business on Monday when we go to Kansas State.

We are accepting all prayers.

Harley PoMMom

07-16-2010, 09:05 PM

We are accepting all prayers.

Mega-tons of prayers be said and sent your way.

Love and hugs,
Lori

Squirt's Mom

07-16-2010, 09:18 PM

Hi Kim,

I am so glad this vet listened and took her time with Annie! You both deserve no less. My prayers and thoughts go with you Mon.

Spoil her rotten til then...anything she will eat, let her - well, within reason. :p I hope you find a food she likes and a source for it when you go home.

Hugs,
Leslie and the girls - always

BestBuddy

07-16-2010, 09:20 PM

Kim,

Everything I have is crossed. I like the sound of this new vet and it has to be a good sign that you are finally getting someone to listen. Roll on Monday.

Jenny

SachiMom

07-16-2010, 11:58 PM

Kim,

Super-Mega tons of healing prayers for Annie. She deserves nothing less.

And a Super-Mom award for you. Being persistant in getting help for her.

Wishing you a very uneventful weekend.
Until Monday . . . .
Luv & Hugs
~Mary Ann

Buffaloe

07-17-2010, 12:14 AM

Kim,

Prayers are being sent from Phoenix for sweet Annie. Nice little road trip to Lincoln, then to Manhattan, pretty cool. 'Glad you found a pet food store with such great food. I'm hoping the people at K-State do a wonderful job for you and Annie.

Ken

SasAndYunah

07-17-2010, 03:22 AM

Dear Kim,

can't tell you how glad I am that Annie is getting and will be getting the right medical attention :) And my hat's off to you for all the effort you are taking to help Annie, you are the best! Hoping the weekend wil be uneventfull, that Annie will eat some and that Monday will bring you answers...

Saskia and Yunah :)

Carol G

07-17-2010, 03:26 AM

Kim,

I really feel like you have gotten the kind of help you need. My experience has made me believe that a really good GP vet knows when to refer.

I hope you and Annie have a great "vacation" -- you will be in my thoughts.

Carol

mypuppy

07-17-2010, 04:34 AM

Hi Kim,
I too want to wish you all the best at Monday's visit and I offer you and your precious Annie my prayers for ANnie's good health. We luv you bunches, tight hugs coming your way. Xo Jeanette and Princess

zoesmom

07-17-2010, 11:12 AM

Oh, Kim . . . .at last. A vet who is willing to listen and help. I am optimistic that you will come away from KS with some good advice and a treatment plan. All fingers, toes, paws, eyes crossed here in GA for Monday's visit. Sue

Dollydog

07-17-2010, 06:13 PM

Hi Kim, wishing you all the best with your appointment on Monday. Hope you and Annie have a great weekend! :)
Jo-Ann

marie adams

07-18-2010, 12:39 AM

Hi Kim,

As everyone has said all our prays are with you!!! You are the BEST MOM in the whole world---very patient and willing to go the extra yard!!!:):)

Take care of yourself, enjoy some fun time!!

Franklin'sMum

07-18-2010, 08:16 AM

Hi Kim,

Wishing you both the best luck and answers on your trip to KState. Hoping Annie approved of your food choices for her,
Love, hugs and prayers from across the pond,
Jane, Franklin and Bailey xxx

frijole

07-18-2010, 11:35 AM

Thanks everyone for your warm thoughts. Its been a rough couple days. She started refusing the pill pockets so I had to force the meds down her throat. :(

Food intake lower. Water... who knows (there's another dog here) but not much.

Can you believe I cannot locate the ultrasound film I brought with me????? I am pretty sure it is at the vet's office here. A gal took my file that I brought to photocopy and I bet she just put the envelope with the film in it in my file here in Lincoln and didn't return it. :confused:

I called the vet's home last night and left a message but no return call yet. Hope she didn't leave town... Thought that would be helpful at K State hospital.

Am getting nervous about tomorrow but can't wait to get there. Going to be a long day. Hugs from us to all of you. Kim and Annie

Carol G

07-18-2010, 01:40 PM

One of the techniques I used on McGill for pilling was to take a thin slice of cheese and warm it in the microwave until it was melting a bit and then wrap the melted cheese around the pill (be careful not to burn your fingers). Make a few fake pill balls out of the melted cheese too. Once the cheese cools, it is pretty solid around the pill. Next feed a couple of the plain cheese balls then the pill ball followed by a couple of the plain ones. Hopefully, the first couple get a little swallowing it whole action going.

One suggestion at the speciality pet food place I frequent was any food with tripe -- evidently dogs (and cats) love it -- but it does really stink.

Good luck,

Carol

littleone1

07-18-2010, 01:47 PM

Hi Kim,

I'm keeping you and Annie in my thoughts and prayers that everything really goes well tomorrow. Take a deep breath and try to relax.

Harley PoMMom

07-18-2010, 02:45 PM

Am getting nervous about tomorrow but can't wait to get there. Going to be a long day. Hugs from us to all of you. Kim and AnnieWe are all anxiously waiting with you, my dear friend, and wishing you both the best of luck. Big hugs to you and Annie.

Love and more hugs,
Lori

Loladog

07-18-2010, 02:53 PM

Hi Kim,

I wish you all the best tomorrow. What a difference having someone who listens makes!:) Have fun with your girl on your "vacation". What a nice bonding trip.:D Living in a rural area, I know how fun it is to find a "real" pet store. I hope Annie is enjoying her yummy food and treats.

Take care,

frijole

07-18-2010, 11:17 PM

Update regarding the missing ultrasound film that was left at the vet here in Lincoln... I called her home on Saturday night when I realised I didn't get it back when they made photocopies....

Vet just called - she had taken her family out of town and just arrived home. She drove to her office, found them and insisted on delivering them to my aunt's house because it was their mistake. WOW. Feel so much better to have them with me at Kansas State.

Anyway - what a neat human being.

SachiMom

07-18-2010, 11:22 PM

WOW is right!!! :D:D:D This is a positive sign...so I know things will go well tomorrow.
Sending mega tons of healing thoughts and prayers.
Luv & Hugs ~ Mary Ann

Bichonluver3

07-18-2010, 11:29 PM

A zillion prayers from us. Enjoy your "vacation" together and relax as much as you can. You are going to the absolute right place to folks who really know their "stuff".
Tons of love, hugs, prayers & tail wags,
Carrol & Chloe

marie adams

07-19-2010, 03:03 AM

Hi Kim,

It is good to know there are still wonderful people in the world!!!:) Glad you got your pictures/films back.

Good luck with everything tomorrow, but I think it is today for you right now.:D

Roxee's Dad

07-19-2010, 11:40 AM

We are hanging in there with you and Annie today. Keeping positive thoughts.

addy

07-19-2010, 07:00 PM

Hi!

Well, it is finally Monday!

Thinking of you and hope you are getting some answers. Been watching on and off all day :)

Addy

Squirt's Mom

07-19-2010, 07:46 PM

Hey Kim,

Hoping things are going well at KS today and that you leave with some answers and a plan in place.

Hugs,
Leslie and the girls - always

frijole

07-19-2010, 11:17 PM

Long day and Annie is still at the hospital. :( I am writing from a hotel lobby pc so have limited pc access... here is what I can share.

I checked in at 10 am and at 7 pm I knew I needed to get a hotel room.

I met with a student originally and then a doctor came in about 45 minutes later after they gave her an examination (physical) and reviewed my notes.

They wanted to redo some bloodwork and the ultrasound. At 3 pm I had a very brief meeting just to say they were still working on the tests. They were very busy - Mondays are backlogged.

She had bloodwork done and the only thing of note was her ALP was 245. Note that this is DOWN from last 2 test and she isn't being treated for cushings.

Ultrasound -I haven't seen the detailed report but what she told me is that they wanted to see that other adrenal that did not show up in Omaha. They saw it and it has a tumor on it. It does not appear to be malignant. One adrenal is enlarged and the other is normal size. She says it still points to pituitary cushings. (sorry I can't remember which was enlarged)

They also took chest xrays to look at the adrenals to get comfort regarding non malignancy and they are comfortable with it not being malignant.

Based on the ultrasound she does NOT think this is gastro intestinal. The next step is a CT scan to see if it is a macro tumor.

I brought up the small intestinal bacterial overgrowth and the tummy growling but this doc is by the book and want to eliminate a macro next.

I feel so sad... Annie is such a mommy's girl and I think she was only left one night with strangers and she has to be so scared. She was fasted and didn't eat today that I know of....and I didn't get her blankie in with her...:o:(

I asked what we do if it isn't a macro and she said we start working the gastro intestinal. I asked what if it is a macro and she said treatment is radiation. They have new equipment but she wasn't even sure they had used it.. great.

Please pray it isn't a macro. I only remember the one dog that was treated at TX A&M with radiation.

Meanwhile I pray and send out best wishes to all other cush dogs in distress... I just can't read anyone else's threads right now as I am not strong enough.

I just had dinner and some wine. Going to try to get some sleep before tomorrow's tests. The anethesiologist examined her tonight to make sure she was ready for tomorrow and her BP was normal.

Please pray for my baby Annie. Thank you.

sunimist

07-19-2010, 11:32 PM

Praying for you and sweet Annie and praying even harder that she doesn't have a macro. Hope you both can get some rest tonight.

Love and ((((hugs))))

Shelba and Suni~~

Roxee's Dad

07-19-2010, 11:48 PM

I am praying for you and your baby.

BestBuddy

07-19-2010, 11:48 PM

Kim,
Praying really hard for good news. Keep your chin up and hopefully there will be some answers soon.
Jen

Dollydog

07-19-2010, 11:52 PM

Praying for both of you tonight...hope you're able to sleep and that Annie is back with you very, very soon.
(((HUGS)))
Jo-Ann

frijole

07-19-2010, 11:58 PM

Thanks guys. If anyone has any thoughts regarding macros other than they suck - please let me know. I will check in again in the morning if this computer is available. Big hugs to you all. Kim

littleone1

07-20-2010, 12:12 AM

I am keeping you and Annie in my thoughts and prayers, Kim. I know it's difficult, but try to get some sleep. You need to get some rest. I'm hoping that you will be able to find out what's going on with Annie.

Harley PoMMom

07-20-2010, 05:43 AM

Keeping you and Annie in my thoughts and prayers.

Love and ((((hugs))))
Lori

Casey's Mom

07-20-2010, 06:33 AM

Praying for you and Annie Kim. I hope you slept okay last night and that she was not to stressed at the hospital. You must be worried sick about her being in the kennel overnight without her blankie.

We will all be waiting and praying for updates.

Love and many hugs,

frijole

07-20-2010, 11:05 AM

Just checked and the docs are not done with their a.m. rounds yet. Annie is 2nd in line for the CT scan this a.m. so they said to check in later this a.m.

sunimist

07-20-2010, 11:24 AM

Thinking of you and Annie this morning.

(((more hugs)))

Shelba and Suni~~

frijole

07-20-2010, 12:05 PM

The doc just called and wanted to ask me more questions about the eating issues. When they started, what happened when she eats etc. We discussed that at length and she said she'd like to do an endoscopy at the end of the CT scan if the results from the CT are not a macro.

I gave them the go ahead. She warned me that there is risk with this due to the anethesia but that they were right there and the best of the best. That sort of freaked me out.

So basically it looks like she'll go in about 11 am central and the procedure could take a couple hours.

I just printed out everything we have on macros to read. I do have a book to read as well. Long day ahead.

Squirt's Mom

07-20-2010, 12:17 PM

Oh Kim,

I so understand you concern over the anesthesia! That was my greatest fear with Squirt's knee surgery. Dr. Dew explained it like this to me...with geriatric babies and especially those with health issues, the risk is increased "500 fold"...HOWEVER, that still only adds up to a risk of 1/2 of 1%...which is amazingly low! That helped me not to worry quite so much while she was in surgery...that and the fact that I have the utmost respect and trust in Dr. Dew and his staff. I don't think she could have been in better hands.

You are a great mom who has taken the time to make sure Annie has the best of care available. She is in good hands at KS, just as Squirt was with Dr. Dew. So hold onto that fact and know we are all here with you both as the day passes.

Big hugs,
Leslie and the girls - always

Roxee's Dad

07-20-2010, 12:19 PM

Sending you both positive thoughts today.

When you see Annie, make sure you give her a gentle pat and hug from her cush family.

marie adams

07-20-2010, 02:45 PM

Hi Kim,

Take Care!! You are doing the best - it is what you have been waiting for RESULTS & ANSWERS to why....:) We just all have a hard time with the WAITING :(.

Maddie and I are sending good thoughts and prays your way!!!

addy

07-20-2010, 02:48 PM

Oh Kim,

Zoe and I will be praying very hard for sweet Annie.

Don't worry about the forum, everyone has it covered though we may not be as good as you:rolleyes:

Stay strong for Annie, this must be so hard for you being apart from her.

All our love,
Addy and Zoe and Koko too

littleone1

07-20-2010, 02:51 PM

Hi Kim,

I know how you feel about the anesthesia. I felt the same way when Corky had his teeth extracted and the masses removed from his mouth. His vet also assured me that the type they used has been used on many cush dogs. I'm sure Annie will be fine. They do monitor them very carefully.

Keeping you and Annie in my thoughts and prayers that everything goes well and that you will be able to find out what is going on with Annie.

frijole

07-20-2010, 03:35 PM

Vet called just about as I was to pull up to the hospital....

NOT a macro. YEAHHHHHHHHHHHHHHHHHh

They did the endoscopy and found "lots of bad bacteria" - sounded like different types. She also said the lining (esophogas?stomach?) was reptile like - not normal. They took biopsies of it but won't have results for a while.

They think the bacteria alone could give her cramp like symptoms and are putting her on some mega antibiotics for two weeks to see if that clears it up.

I was driving in traffic and couldn't think to ask many questions like how the heck did she get this bad bacteria, is she sure this is it etc.

So while still some uncertainty I guess it is the best outcome I could have hoped for?

She said Annie did fine during the procedures and they had just taken out the tube. She is in recovery. Earliest I can pick her up is 5. I came back to the hotel even though I checked out so I could post here and go sit on a sofa and read a bit.

If you have any thoughts or questions for me to ask.. I'll check back after a bit.

Roxee's Dad

07-20-2010, 03:46 PM

Hi Kim,
Well that is the best news we could hope for. Very happy for you and Annie. Hope the mega antibiotics do the trick. Still keeping you both in my thoughts until you get home safely.

marie adams

07-20-2010, 03:48 PM

Yeah!!! You now have some answers and good news!!! Looking forward to more news later. Take a nap on that couch--you probably need some sleep yourself--haha!!:D

Squirt's Mom

07-20-2010, 04:22 PM

Ahhhhh...sweet relief, huh? ;) It is astounding how good that phone call is that says they are waking up! Joy, joy, joy!!!! :D:D

Now to take what you learn and put it to use to help Annie as you always have. I have no doubt you will conquer this little bump in the road, too.

The description of the lining(s?) would have thrown any questions I might have had out the window. That is just weird. :confused: Like you, I would want to know if she had ever seen this or heard of it before; what could cause it; what can be done for it; will it spread to other membranes/linings; is it effecting her digestion and/or swallowing processes; is it causing her discomfort...that is all that comes to mind just now. If I think of anything else inquiring minds would want to know, I will be back. ;)

I am so glad Annie is in recovery! :cool::cool: You take that nap and try to relax a bit til you can pick her up...yeah, right, huh?

Hugs,
Leslie and the girls - always

Roxee's Dad

07-20-2010, 05:04 PM

She also said the lining (esophogas?stomach?) was reptile like

Wondering if it's like a type of "canine" diverticulitis?

Can be awfully painful in humans :eek: requires elimination of any food with seeds as they get caught up in the little pockets and start to get infected causing bacteria and extreme pain.

frijole

07-20-2010, 05:33 PM

Interesting John - never heard of that. I will bring it up. I guess this reminds me a bit of the small intestinal bacterial overgrowth dx and discussion... I would be interested in the root cause - example liver disease, etc so we don't just treat symptoms.

I'll be heading to the hospital in 30-60 mins in the off chance that they'll discharge her before 5pm... I have a long drive home tonight. Poor thing probably hasn't eaten in 2 days.

labblab

07-20-2010, 05:45 PM

Hi Kim,

I'm just now getting caught back up on things after having been away, and so haven't even had the chance to read back to find out all about Annie's testing. But I'm so relieved to just know that you're picking her up, that there is no macro, and that the testing is all behind you!!!!!!!!!!!!!

Please drive safely and give your little sweetie a big hug for me, OK? And I'll be anxious to catch up and find out all that's been going on over the last few days...!

Marianne

Dollydog

07-21-2010, 12:28 AM

Great news Kim....hope you're home and both resting peacefully!
Jo-Ann

frijole

07-21-2010, 01:15 AM

I just got home - long day. Annie hadn't eaten in over 48 hrs! I gave her some canned chicken and her THREE antibiotics. Wanted to check in here before hitting the hay.

I will give specifics tomorrow after I have caught up from this long journey but for now -

Annie had a bacteria - a very nasty one that is terribly hard to get rid of in her stomach. I saw the film from the endoscopy. There was blood as well. They said its hard to say where she picked it up but she could have had it for years and it just festered and got worse. This is why they gave me the 3 antibiotic "cocktail" for her. I'll name them later.

More details on the reptile like lining on her esophogas. It is the entire length of it from mouth to stomach. The guy doing the endoscope has done this for over 25 years as has another member of the team and NO ONE had ever seen this before. So yes, Annie will probably make a text book.

I can only describe it as looking like acne - someone whose face is full of reddish/grayish dots. They are very small and everywhere! They contain pus and blood! That is what they sent to be biopsied! :eek: They have no clue what it is. They said that was probably painful as well. (DUH lol) Hard to say when they'll have results as its never been tested before....

She said they assume the antibiotics will clear up these sores as well. The guy doing the endoscopy really wants her to come back so he can see if they went away w/the drugs. Vet said she understands it would be cost prohibitive just to appease his curiousity but anyway... K State might have more research to do.

Lastly she said she had been keeping the new vet in Lincoln up to date on everything. I should see some improvement in 2 days of these a/bs. 2-4 weeks after all is "normal" she would like me to have her tested for cushings again. She said she isn't sure she even has it. The B12/Folate numbers that were indicative of small intestinal bacterial overgrowth - WRONG - it was THIS bacteria that caused the elevation and it was NOT in the intestines at all. Stomach only.

So... we'll have some lively discussion on all of this no doubt. I am tired. Will name the bacteria and drugs for you tomorrow when I can find the paperwork... am going to crash now.

Thanks for your kind words and prayers - they really sustained me as I sat waiting for news. Kim

littleone1

07-21-2010, 06:46 AM

Hi Kim,

I'm glad that you and Annie are both home. I hope the antibiotics work and that everything will clear up. You both deserve a good night's sleep and some relaxation. I know this has been very stressful for both of you.

Sending positive and healings thoughts and prayers.

Casey's Mom

07-21-2010, 09:18 AM

Hi Kim - you certainly have a very interesting case with Annie. Does this mean no cushings?

Love and many hugs,

Squirt's Mom

07-21-2010, 11:59 AM

Please do get some of that rest you both have missed out on lately. It will do ya'll some good.

Poor Annie! That sounds painful. :( They are such stoic little souls, aren't they? They carry pain and discomfort without a word until they can't stand it any longer...

I so hope the AB's do the job and soon, so that she can get back on her feet asap.

Looking forward to the discussion to follow! ;)

Hugs,
Leslie and the girls - always

frijole

07-21-2010, 02:52 PM

Hi Kim - you certainly have a very interesting case with Annie. Does this mean no cushings?

Love and many hugs,

We won't know about cushings til we retest. They really suspect no cushings after doing the CT scan and putting pieces of puzzle together. They even told me to cease giving the thyroxine - not sure she is even hypothyroid. Interesting huh?

The bacteria strain is the Helicobacter. http://www.merckvetmanual.com/mvm/index.jsp?cfile=htm/bc/23310.htm

It is treated with powerful antibiotics because it is extremely difficult to kill. Annie is on metronidazole, clarithromycin and I can't remember the 3rd.

I'm going to see if the vet will email a photo from her esophagus. You won't believe it. No wonder it was painful.

She had the LDDS and 4 ACTH tests. If she has no cushings then this is a prime example of don't test your dog when they have another illness going on (course I didn't know there was one but...)

I am at work so can't post the full write up yet.

marie adams

07-21-2010, 02:59 PM

Hi Kim,

What a journey....wouldn't it be nice to have your little Annie off of all meds at some point??:D The way they talk to us is to not eat and get our attention, but darn the guessing game isn't an easy one or cheap one--time and money wise.

You have been so diligent I admire you for continuing to pursue the testing!:):)

Will if antibiotics work as fast in animals as they do in humans, Annie should be feeling better in no time.:D

Take care!!:)

StarDeb55

07-21-2010, 06:54 PM

Kim, this makes a huge amount of sense, now. Heliobacter in people is what they have found causes a great majority of ulcers in our stomachs, so I don't see why it wouldn't do it in a pup. For humans, they routinely do a Heliobacter screening any time a patient has anything like an endoscopy. If KState is so interested in a possible write-up on Annie, I think at a minimum they should cover follow-up treatment expenses, & possibly a per diem for you.

I'm just really happy that you appear to have gotten Annie on the right track.

Debbie

acushdogsmom

07-21-2010, 07:31 PM

More details on the reptile like lining on her esophogas. It is the entire length of it from mouth to stomach. The guy doing the endoscope has done this for over 25 years as has another member of the team and NO ONE had ever seen this before. So yes, Annie will probably make a text book.

She said they assume the antibiotics will clear up these sores as well.

The guy doing the endoscopy really wants her to come back so he can see if they went away w/the drugs. Vet said she understands it would be cost prohibitive just to appease his curiousity but anyway... K State might have more research to do.

Lastly she said she had been keeping the new vet in Lincoln up to date on everything. I should see some improvement in 2 days of these a/bs. 2-4 weeks after all is "normal" she would like me to have her tested for cushings again. She said she isn't sure she even has it.

The B12/Folate numbers that were indicative of small intestinal bacterial overgrowth - WRONG - it was THIS bacteria that caused the elevation and it was NOT in the intestines at all. Stomach only.I think I said way back in this thread somewhere that it was really strange that the ACTH stim test numbers would be exactly the same, especiallly after a Lysodren dose increase and I wondered at the time if maybe Annie didn't have Cushing's after all, because I remember reading somewhere that if a dog does not have Cushing's, that they would be resistant to the effects of the Lysodren.

She also never really had the ravenous appetite that is usually associated with Pituitary Cushing's, which did make me wonder if maybe there was another explanation for her diagnostic ACTH and LDDS test results (ie something other than Cushing's going on).

I sure hope that the antibiotics do the trick. And I also agree with Debbie - if the Vets that you just saw are really interested in following up on this case, being that it is so unusual, maybe they would agree do any follow-ups for free. They might even pay for your expenses to get there and for your hotel. Couldn't hurt to ask them, anyway.

frijole

07-21-2010, 08:36 PM

Cushy - fyi she does have a ravenous appetite but not the water. That was what made her not eating weird. She was dx-ed with hypothyroidism 2 yrs ago too. K State wants cushings retested first and then that. They told me to SKIP the thyroxine so am thinking they think that was a false positive as well.

And yes I remember you telling me that maybe it wasn't cushings when she didn't go below "normal" on the lysodren. AND you'd be proud of me because I shared that with the doc BEFORE they came back w/their final opinion. They originally thought pituitary.

OK - I have the report in front of me this time.

They found a nodule on the caudal pole of left adrenal. This adrenal was enlarged but the right was normal. They looked at the nodule and said not cancerous.

Endoscopy is where the action was:
multifocal mucosal nodules containing blood in the esophagus, inflamed mucosa and ulcerations in stomach and duodenum. Biopsies of stomach and duodenum were submitted to KSU for histopathologic examination.

She is on amoxicillan, metronidazole and Clarithromycin twice daily for 2 weeks.

No dx for leg weakness. I noticed it went away when we got her cortisol lowered to 19-20 (normal) so perhaps even if she isn't cushinoid the cortisol from everything else effected her hind legs? :confused:

We will test for cushings once she's had time to fully recoup from this awful journey.

I was truly impressed with the professionalism at K State and the vet in Lincoln already called me today to followup. That was nice.

Oh!!!! The very first time I posted about Annie on this thread it was about her teeth. She would quit eating and I assumed it was time for teeth cleaning and it was every 6 mos. I assumed that because she was eating again after the cleaning that was what she needed. BUT SHE ALSO WAS ON ANTIBIOTICS AFTER EVERY CLEANING!!! So DUH huh? It must have given her the relief she needed even though it didn't kill the bacteria.

So far so good - I came home tonight and she was crying to eat. She had to be starved. She ate all her canned chicken (1/2 cup) and an egg white. I am still giving her small meals and sticking with what I know she'll eat until we get further into the a/b treatment.... I'm no fool. ;)

It will indeed be interesting to see if in fact she doesn't have cushings... I refuse to get my hopes up yet. I am just relieved she is eating and we found a caring vet. Still not sure what to do in case of emergency for local care... ugh.

Anyway... thanks for continued support. We have so many dogs right now with eating issues - I hope that maybe sharing her story helps someone some day. Moral - it isn't always the pancreas, SIBO, or IBD. Hugs, Kim

SasAndYunah

07-22-2010, 02:07 AM

Oh Kim,

I am so happy and relieved they got to the root of Annie's problems :) Heliobacter is present in about 50% of the human population and in most cases without causing any significant problems. In times of stress or another ilness for example, it can raise it's ugly head. Not sure if the same applies to dogs...but the combo of anti biotics is the same as they would give to humans. Once you have the heliobacter in your stomach, you can't get rid of it but the goal is to restore the "balance" again. In other words, to let the stomach and the heliobacter co-excist again without causing inflammation.

And indeed, it isn't always IBD or SIBO, that's why I always urge people to have more research done. They are often "just names" given by vets in situations, where they don't really know what's going on :)

I'm pretty sure Annie will start to feel lots better pretty soon, with the right anti biotics for the right condition...You are probably exhausted by it all but you should be also very proud of yourself for doing what you did!

Hugs,

Sas and Yunah :)

BestBuddy

07-22-2010, 04:50 AM

Kim,

I have a really good feeling that you are going to see a great improvement in Annie. As they say...if wishes were horses then you'd better build a bigger stable.:D 'cos I'm sending lots.

Jenny

Franklin'sMum

07-23-2010, 01:48 AM

Hi Kim,

So happy that you finally have a diagnosis of what's been happening with Annie :D:D Hopefully the a/b's will clear that nasty heliobacter right up, and quick, too.
Hugs to you and Annie
Jane, Franklin and Bailey xxx

frijole

07-23-2010, 08:04 AM

Day 3 of abs and she is definitely eating well and not using the nausea pills at all. I have stuck w/canned chicken and tuna in a pouch. Added sweetpotato babyfood yesterday. Couple more days and I'll be brave enough to try dog food.

Squirt's Mom

07-23-2010, 11:39 AM

Wonderful news, Kim! I know you both are feeling much stronger today!

Can't remember if she is on kibble or canned but, if the kibble, I would take it really slow in transitioning back to it. The texture of the kibble may be an irritant to the lining. :eek:

I hope you see improvement each and every day til she is back to her usual self soon!

Hugs,
Leslie and the girls - always

Roxee's Dad

07-23-2010, 02:23 PM

We love the good news, Keep it coming :)

It is great to see the improvement after all this time. I bet you can tell she is even feeling better. :)

frijole

07-23-2010, 02:47 PM

Leslie - don't worry - the pictures of the thousands of tiny red/pussy sores that coated her entire throat have NOT left my mind! :eek: I am giving her food that is smooth. The sweet potatoes were babyfood that was pureed. I haven't even tried the babyfood with rice yet.

Last on the list will be kibble. Scary.

Yes it is a HUGE relief. She has a LOT of weight to gain though. She was lying on the floor last night and oh my... those ribs stick out a good 1/2 inch... sad. Every day we make a little progress. She ate real well this a.m. again so her hunger is back which must mean she has some relief from the ulcers in her stomach and those sores in her throat.

SasAndYunah

07-23-2010, 04:47 PM

Well, that's great news :) I am very happy to hear Annie seems to be feeling better already and is eating :)

Give her some hugs from us,

Sas and Yunah :)

littleone1

07-23-2010, 08:10 PM

Hi Kim,

I'm so glad to hear that Annie is improving. I'm glad that she is eating. You must feel very relieved that the cause of her problems has been found and that the treatment is working.

frijole

07-23-2010, 09:24 PM

K State vet, Dr Lomis called today with biospy results. I didn't understand the message so I called when I got home and she had left for the day and they got ahold of her and she called just now.

The biopsies were of the stomach and the duodenum. The pathologist saw no sign of change (they were normal) so she is resubmitting to see if there was heliobacter... in short she said it was not as remarkable as they would of thought given the photos. There was not much ulceration in the polyp they sent either.

So I guess that is all good? :confused:

She asked how she was doing with food and I told her she is getting there! Tonight she ate a whole 12 oz can of chicken breast! She still doesn't care for the babyfood sweet potatoes for some reason. I had some in a small dish on the kitchen floor and I forgot about it and kicked it over and it "splashed" all over the living room carpet.. nice. Orange too!

SachiMom

07-28-2010, 12:49 AM

Kim,

Need an Annie update.
:D:D:D:D:D:D:D:D:D:D:D
Please make me smile!!!!:D:D:D:D:D:D:D:D:D:D:D
:D:D:D:D:D:D:D:D:D:D:D
Luv & Hugs ~ Mary Ann

frijole

07-28-2010, 08:18 AM

Mary Ann :D:D:D

Miss Annie seems to be improving. I gave her a bit of canned dog food on Sunday night (a snack 2 hrs after her meal of tuna and sweet potato) to see if she'd eat it and she did.

Last night I gave her some canned for dinner and she ate a couple bites then stopped. My stomach came up to my eyeballs. Fed her tuna, she ate that. Tried a different type canned - did not eat it. Later I gave her some kibble and she ate it all!?!?! So she must not have liked the canned I guess.

We are at the one week point on the ab's. So far so good. Kim

Squirt's Mom

07-28-2010, 02:05 PM

Good news, Kim! :):) I know you are relieved to see improvement, even if she is showing some pickiness. LOL Let her pick as long as she eats! :p She's earned the right to some selectivity in her taste. ;):)

I hope you see her continue to improve day by day.
Hugs,
Leslie and the girls - always

marie adams

07-28-2010, 03:37 PM

gpgscott

07-28-2010, 05:32 PM

Kim,

Looking in and thinking about you both.:)

Scott

frijole

07-28-2010, 07:56 PM

Hi Kim,

Like Leslie said Annie has earned the right to be picky and we all know you will follow that lead--haha!!:D:D Of course I would do the same thing.:D

Keep up being a great servant to Miss Annie and take a little time for yourself!!!:):)

Servant is right on the money! ha. Fed her the same food tonight that she rejected last night and she chowed. Yeah.

Harley PoMMom

07-28-2010, 08:32 PM

Kim,

Looking in and thinking about you both.:)

Scott

Me too. Sending positive and healing energy your way. Big hugs to you and Annie from me and Harley.

frijole

07-28-2010, 08:39 PM

Me too. Sending positive and healing energy your way. Big hugs to you and Annie from me and Harley.

Well you owe us an update on your baby too! Hope he's better and eating well... do tell. Hugs to you both. Kim

littleone1

07-28-2010, 08:44 PM

I'm glad that Annie is eating better Kim. It sounds like she is well on the road to a full recovery.

addy

07-28-2010, 09:44 PM

Hi Kim,

I just want to put smiley faces on the calendar, Annie is eating!!!!!:D:D:D

I am so very glad for you.

Addy

frijole

08-02-2010, 08:53 AM

Yesterday Annie was back to finicky eating and not eating much. This morning she won't eat and she vomited bile.

The ONLY thing I have done that might have caused this is Saturday night I gave her a snack with some probiotics in it. ???? She was fine up until this point other than sneezing which has been going on before this appetite thing started.

Could the probiotics have knocked her out of balance? Thanks

frijole

08-02-2010, 09:18 AM

She is not well. Scares me that my vet is now 2 hrs away and I have to go to work. I will come home at lunch time. She got up a couple times and walked to me but just stood there. Took her outside but she just stood there also. I'm thinking upset stomach.

AlisonandMia

08-02-2010, 09:20 AM

Hi Kim,

I think they could have - the probiotics in combination with the antibiotics could possibly the the problem.

A lot of probiotics contain more than one type of organism - I've always been wary of giving probiotics with the antibiotics (while the antibiotics are in the system) because what if the antibiotic knocks out one component of the probiotic mix but not another, allowing (maybe) the surviving organisms to overgrow out of balance?

I don't know if that is how it can work but you do hear that you shouldn't give/take probiotics with antibiotics although I've never been clear as to whether it can do harm by the mechanism I just mentioned or if it is simply because the antibiotics will likely kill the probiotics, thus making the probiotics of no use. Usually the recommendation is to wait until after the course of antibiotics has finished and is out of the system.

Alison

Could be worth getting local vet (if possible) to do a pancreatitis test?

frijole

08-02-2010, 02:21 PM

Lori PMed me an article regarding giving them while on the triple antibiotic cocktail - looks ok so long as not at same time of day.. mentioned a couple hours. I gave 4 hrs post other antibiotics but perhaps that wasn't enough.

Anyway... I will hold off obviously for now.

Our internet is down at work - lightening took out the modem! I came home to check on Annie.

She had vomited again. She appears tired. Poor thing. Haven't heard from Kansas State. Calling Lincoln vet now.

Thanks

frijole

08-02-2010, 02:24 PM

Here's the article from Lori... interesting.

Triple-antibiotic therapy is used to aggressively eradicate Helicobacter pylori, the bacterium that causes gastric ulcers. Using probiotics between antibiotic courses repopulates the digestive tract with friendly bacteria and effectively inhibiting colonization of H. pylori.2

During antibiotic therapy, taking probiotics as well keeps the intestinal flora in proper balance. They can be taken together, but not at the same time of day. In order for the probiotics to be the most effective, they should be taken at least two hours after each dose of antibiotic. When the treatment has been completed, double or triple the probiotic supplements for about ten days or two weeks. Probiotics should be taken with food or shortly after eating as food dilutes the stomach acids enough for them to survive their trip through to the intestines where they belong.

When taking beneficial bacteria or an antimicrobial agent, pathogens begin to die off. This sometimes causes unpleasant side effects known as The Jarisch-Herxheimer Reaction, so named for the German dermatologist who first identified it. As pathogens begin to die, others try to escape by quickly exiting the body. When these microbes appear in large numbers, the exit routes from the body begin to clog -- much like rush hour traffic! It is at this point that the host may begin to experience headaches, bloating, gas, or allergy-type symptoms. Depending on the individual's level of tolerance for these unpleasantries, the dosage of probiotics may have to be reduced until the symptoms subside, and then increased slowly to the maximum recommended. Regardless of first appearances, it is important to realize that this reaction is a positive indication that all is going well.
Full article can be found here:
http://www.ispub.com/ostia/index.php...probiotics.xml