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My little suffers with colitis and has done for the past two

My little ***** ***** suffers...
My little ***** ***** suffers with colitis and has done for the past two years I have tried everything possible in foods and now cook him chicken, obviously no fat and make his own little biscuits of oats grated cheese and bined with honey. He is on a steroid which I now have to give him every other day as it is getting worse. The blood is terrible that he passes and also is sick with blood in that as well. I am at my whits end knowing what else to try and am finding my vet now, not very helpful....can you please throw any more light on this. Many thanks Sandi
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Answered in 7 minutes by:
9/26/2017
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 30,799
Experience: University of California at Davis graduate veterinarian with 45 years of experience
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I'm sorry to hear of this with Ringo, Sandi. I understand your frustration at this time. There are protocols for addressing such a chronic diarrhea and now that you're also seeing both hematochezia and hematemesis (blood in the stool and vomit) time is of the essence in performing such a protocol. I don't what's been done on or for Ringo over the past two years and so I'm going to post my entire synopsis of how I address these dogs. Please pay particular attention to having Ringo's GI tract scoped and biopsied:

I would approach Ringo's chronic diarrhea in the following manner although the order in which I've listed the various approaches can vary:

1) Presumptively worm with over the counter fenbendazole (Panacur) available in many pet/feed stores. Fenbendazole addresses all of the nematodes (roundworms, hookworms, whipworms) as well as the protozoan Giardia. This should be done even if a fecal ova and parasite exam didn't reveal parasites. That exam is too often falsely negative.

2) If worming weren't helpful, perform a gastrointestinal diagnostic panel of blood and urine tests. This should include a specCPL blood test (most sensitive for detecting the presence of pancreatitis), a TLI blood test (to check for maldigestion), and serum folate and vitamin B12 levels (to check for malabsorption of nutrients). Fecal culture looking for the gastrointestinal pathogens Clostridium difficile, Clostridium perfringens, Campylobacter, and Salmonella can be considered as well.

3) If this testing didn't reveal anything untoward, an abdominal ultrasound should be considered. Ultrasound is the most sensitive and readily available imaging modality for the gastrointestinal tract itself. My concerns would be inflammatory bowel disease, lymphangectasia, and neoplasia (cancer) such as lymphoma and solid tumors such as adenocarcinomas.

4) Perform a hypoallergenic food trial in an attempt to identify food intolerance. Food intolerance/allergy is addressed with prescription hypoallergenic diets. These special foods contain just one novel (rabbit, duck, e.g.) animal protein or proteins that have been chemically altered (hydrolyzed) to the point that Ringo's immune system doesn't "see" anything to be allergic to. The over the counter hypoallergenic foods too often contain proteins not listed on the label - soy is a common one - and these proteins would confound our evaluation of the efficacy of the hypoallergenic diet. The prescription foods are available from her vet. There are many novel protein foods and a prototypical hydrolyzed protein food is Hill’s Prescription Diet z/d ultra (a hydrolyzed protein diet is my preference because it avoids the possibility of my patient being intolerant to even a novel protein). A positive response is usually seen within a few weeks if we’ve eliminated the offending food allergen. Food intolerance can arise at any age and even after our patient has been eating the same food for quite some time.

5. Scoping and biopsying of the gastrointestinal tract which isn't performed soon enough in too many of these patients.

Please respond with further questions or concerns if you wish.

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Customer reply replied 1 month ago
Dear Dr. Michaelthank you for your response. Both my dogs are wormed every three months and also take Bravecto every three months. He has been scoped and all the answer I got back was......."inflammation as I expected" from my vet!! I have tried him on all the various hypoallergenic foods over the last two years...In fact ask me what I haven't tried?!!!!! I now keep him on either fresh mackerel with rice or chicken with rice. I boil up the chicken carcus's and use the broth on his food. I also given him Manuka honey. We seem to go, anything from 36hours to 4 days and then it's back to the Prednisolone of which I give him half of a 5mg or when he has a flare up like Sunday night when he is sick with blood and then loads of blood from the rectum. It is so upsetting and I just don't seem to be getting anywhere......you do say an ultra sound I'm pretty sure that my vet has done that. I myself feel that there maybe a cancer for this surely can't be normal? I would think that the biopsying may be the next step what would you say?
It's just great to s[peak to some -one with some answers. I know it is a condition that people say cannot be totally solved but there must be more to Ringo's case than just the colitis would you say?Many thanks for your time dr. Michael, I appreciate it greatly
Sandi

Sandy, wasn't he biopsied when he was scoped? If not, yes, that's what needs to be done. I wouldn't bother with an ultrasound. I think you would have lost him long ago if cancer were present.

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Customer reply replied 1 month ago
No I don't think he was but I will check on that tomorrow. O.K thank you at least that would rule out the big 'C'!
This has been going on for two years and I had him on alternate medicine for a while which worked for 5 months and then wham....back to the drawing board again!! Its all the bleeding that concerns me most as this seem to be getting worse not better.

Yes, that bleeding is a negative prognostic sign. One last question for you...was Addison's disease discussed with you? Typical Addison's can be ruled out with normal serum sodium and potassium levels. Atypical Addison's would require an ACTH stim test to identify.

Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 30,799
Experience: University of California at Davis graduate veterinarian with 45 years of experience
Verified
Dr. Michael Salkin and 87 other Dog Veterinary Specialists are ready to help you
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Customer reply replied 1 month ago
No Addisons was never discussed but thank you so very much Dr. Michael you have been a great help to me. I shall now go and fire a few more questions at our vet!! How about you come and work in England....Chester?!!!!!!Take care

Thank you for your kind accept. I appreciate it. I can't set a follow-up in this venue so please return to our conversation - even after rating - with an update at your convenience. You can bookmark this page for ease of return.

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Dr. Michael Salkin
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