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petdrz, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 7325
Experience:  Over 30 years of experience caring for dogs and cats
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I took my 9-year-old Chocolate Labrador (spayed female) to

Customer Question

I took my 9-year-old Chocolate Labrador (spayed female) to vet Friday with symptoms including reluctance to eat, periodic vomiting, excessive swallowing with lip-licking. Urine and fecal were OK, no parasites. CBC showed good liver & kidney function. Eosinophils were 12%, up from a year ago at 1%. Vet suggested it may be IBD, requiring oral prednisone. My research aligns more closely with a diagnosis of eosinophilic esophagitis. I plan to discuss this with him when his office opens Monday.
I also have made arrangements to start her on hypoallergenic diet today.
Question: do you know of anywhere conducting research that we can access or treating canine EE with viscous Budesonide? I see it's working well in humans; the high-viscosity mucopalysaccaride holds it to the surface of the esophagas to provide topical treatment. My son has been on budesonide (Pulmicort) inhaler for allergic asthma, but that method wouldn't have the drug reach the esophagas.
Different research used Rincinol or Sucralose as the viscous agent in humans; which would be better in a dog if we compounded locally from tablets/capsules with a carrier for oral administration?
Submitted: 2 years ago.
Category: Dog Veterinary
Expert:  Camille-Mod replied 2 years ago.
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Expert:  petdrz replied 2 years ago.
I am sorry that you have been waiting for a response. I recently just logged onto the site and noted that your question hasn't yet been answered. I am a licensed veterinarian with over 25 years experience and would be happy work with you if you are still needing assistance but need a bit more information in order to better assist you if you don't mind.
Do you have the absolute eosinophil count (not expressed as a percentage) for the current and the previous bloodwork. If not, do you have the absolute WBC count for both? This is the most accurate way to evaluate any of the WBC parameters.
Which hypoallergenic diet are you using? Are you making sure to strictly follow an elimination diet protocol (no flavored treat or even meds of any kind, including heartworm prevention, flea prevention, etc.
Is she on Flea and heartworm prevention?
Has a heartworm test and a stool sample analysis been performed?
Has a chest xray been taken?
Thanks and I will respond further after you reply. There may be a slight delay while I formulate and type a thorough response or I may be offline, but if so, I will respond as soon as I am able.
Customer: replied 2 years ago.
Mace's stool sample was negative for parasites. Heartworm test last Friday was negative; she does test positive for Anaplasmosis (treated 2 years ago). I did not start the heartworm chew yet after the test with the other results, and would consult with our regular vet now before starting (he was off the weekend and Monday and I was out of town all day today). I also need to get the absolute blood counts from his staff.She'd had an intestinal blockage last fall, so chest/abdominal x-ray was done then, but nothing on Friday as we were looking broadly for explanations for her malaise, poor appetite, sensitivity around her throat, excessive licking without drooling, etc. She'd also had several broken teeth extracted late last summer, so we needed to check whether that might have been a factor (mouth seems good now though).She's always been feed a quality lamb-and-rice kibble, but my teenage boys also liked to give her their frozen yogurt cups to lick, apple cores (over my objection), beef steak bones occasionally as special treats. Last time she had a bone (about 5 weeks ago) she vomited the shards almost immediately, and was showing some of the other symptoms so I have not allowed her to have anything like bones or apple cores lately. The boys understand the ned to now eliminate averything except her regular food. Since the true hypoallergenic foods are prescription-only, on Sunday we got for her some limited-ingredient food with sources she's not had before: Wellness brand Limited Ingredient Salmon and Potato kibble. She's eaten all of it each time we've fed her and is acting much happier already. (While glad she seems better already, we're not so happy with the $70 per bag - tough on our budget!)I am still curious about the targeted / topical use of Budesonide in a viscous base, rather than a systemic corticosteroid, to treat the inflamation, particularly since esophagitis can cause problems with swallowing pills. I'm quite sure we could get her to lick it from a spoon as a "treat" for daily treatment. One of my questions would be whether the Sucralose (Splenda) used in the slurry is detrimental to dogs or not, or is tolerated on a limited-allergen diet. It is shown to work in humans, particularly children with esophagitis, and I wanted to have any research available to discuss with the vet. Thanks.
Expert:  petdrz replied 2 years ago.
Thank you for the response.
I am not convinced she has an esophagitis based on the symptoms that you describe. While dogs with esophagitis can exhibit these symptoms, so do dogs with gastritis, which is by far much more common. Also, inflammation secondary to food allergy triggers do not usually occur in the esophagus but more so in the gastric or intestinal mucosa. Inflammation in the esophagus is more often secondary to trauma, irritants, foreign bodies or gastroesophageal reflux. Unlike inflammatory conditions in the lower GI tract, even when esophagitis does occur, it is not treated with glucocorticoids as they can predispose to infection.
In regards ***** ***** elimination diet, there is nothing harmful in a limited ingredient diet, but keep in mind, in recent studies, most all over the counter limited ingredient diets showed cross-contamination with other ingredients. So... even though you are spending extra money, she is most likely still getting exposure to ingredients she has eaten before.
Finally, sucralose is not detrimental to dogs but I could find no studies in regards ***** ***** use of targeted localized treatment of esophagitis with glucocorticoids in dogs (probably because it is not treated with glucocorticoids). Once confirmed, esophagitis is usually better managed with medications like sulcrafate suspensions (to bind to the erosions and ulcers), prokinetics like cisapride (to increase esophageal sphincter tone and promote gastric emptying), and gastric acid blockers like omeprazole or famotidine.
I hope that helps..