Archive for ‘Inflammatory Bowel Disease’

January 29, 2012

Gracie Health Update – Holding Steady

by goldengracie

Gracie Fascinated by Something

These days, our lives are pretty full with animal-related activities.  Gracie seems to be holding on, she’s pretty happy and sleeps a lot.  She is having some issues with her food interest (can you believe it) in the morning but that is largely due to her increased difficulty with gas and reflux in the morning.  We head back to the vet on the 20th of February for a check up on her protein levels.  She’s on ciproflaxin for the duration and that seems to have curbed the urinary issues.

A couple of weeks ago she had a groomer appointment after which she slept for 90% of the following two days.  She had zero interest in her morning meal and woke only to go outside or maybe switch positions on her chair.  This made me start to rethink our veterinary strategy.  You may wonder, “veterinary strategy?  what is that?”  Well, I will tell you.

Her regular vet used to be at the veterinary office (owned by a large corporation) about a mile from our house.  He has known Gracie since we got her.  He performed her surgery last summer (remember Frankenstina?) and referred us to our specialist vet who has saved Gracie’s life and given us these three years.  And, he was kind, gentle and not judgmental, which has been our experience of the other vets in that office.  He moved to another office…in a suburb about an hour away.  We were all set to go see him on MLK, Jr. day but canceled because there was too much going on and, probably because we had second thoughts about taking her all the way up there for veterinary services.  We rescheduled for February 20th and after the sleeping and sleeping and sleeping of two weeks ago we decided that it wasn’t a good idea to travel that far.

The big thing about all of this is that Gracie isn’t getting younger or more healthy, as you know.  It just started to seem ridiculous to imagine getting in the car with her when it was that time.  I shared all of this with a dear friend who suggested a home visiting vet.  What a novel idea.  I didn’t know if they would have such a thing in such an urban area as Chicago but sure enough there are a few.  We are going to ask our specialist if she knows anyone she would recommend, and we will set up an appointment.  When the time comes, we want to know the person coming into our home to take our baby.

This may seem morbid, but I really want us to make all of these decisions now…while things are not dire.

For now, Gracie is fine.  She’s sweeter than ever (or maybe I’m just even more appreciative of her) and more clingy.  She (and we) appreciate all of your warm thoughts for her comfort (and ours).

Keep  your loved ones close.

February 19, 2011

The 56 Pound Lap Dog

by goldengracie

Our Girl is a Lap Dog, Don't You Know

Miss Gracie thinks she’s about 15 lbs. but she is actually about 56 lbs.  Nonetheless, she’s a sweet girl and sometimes likes to sit on my lap.  Here’s a rare picture that includes me, Gracie’s Mama.

There have been evenings that I’ve had a cat or two in addition to Gracie on my lap.  Very cozy and homey.

Yesterday was “poop patrol” day.  You dog owners with yards probably know exactly what that means.  And, it wasn’t a small task since we’ve had a few layers of snow all of which has melted.  The yard was spotted, and now is clear.  Hooray!

Hope you are having a great weekend.

Oh, and P.S. we’ve been keeping up with Gracie’s Cyclosporine – yay us.

June 30, 2010

Gracie’s Newest Condition

by goldengracie

Partners in Crime

Gracie and Luna stole a Subway sandwich a couple of weeks ago which caused a little disruption to Miss Gracie’s system.  Her IBD is doing well other than that.

She has trichoepitheliomas, which I’ll let you read about here.

What this means is that the ones that have grown a lot will have to be removed…surgically.  We are worried about her immune system (because of the cyclosporine) and a recurrence of the IBD.
I will keep you posted.
November 10, 2009

Settling into our new Virtual Home (on WordPress)

by goldengracie

Here we are…we have moved to WordPress.  Huzzah!

February 11, 2008

Side Effects that Outweigh Therapeutic Benefit

by goldengracie

It was not an easy day yesterday. We believe that the side-effects of the steroid “therapy” are causing too many problems. We have a call in to the vet, and we have a fax ready to prompt their response. Here’s hoping for a PROMPT response.

She is well-cared for though. As you can see, when she was feeling too much weakness to get herself up, we brought the food and water to her. She is eating okay, but it has to be the canned stuff. The dry – even with water – doesn’t seem to stay down comfortably. We will have to determine a way to make it really mushy so she’ll be able to keep it down. She had a very tough morning yesterday, and the fact that the temperatures were the lowest in a LONG time did not help. She wanted to be outside to do her business but didn’t find a spot she “liked” so we were walking or standing outside for FAR too long.

After that, we came in and she slept much of the day. We held the steroid dose (she’s never missed a dose) and let her sleep. She’s getting all her other meds:

Cyclosporine Mod 100 mg twice a day
Spironolactone/HCT 20 mg twice a day
Pepcid AC 20 mg twice a day
Furosemide 6.25 mg in the morning
Denosyl 425 mg in the evening
and the blasted steroid.

Our goal today is to get the plan set for how to safely decrease (toward discontinuing) the steroid. We’d like to go back to the pill (pred) because the injection is so strong.

February 4, 2008

Gracie’s Belly Not So Bloaty

by goldengracie


Look, she’s not as bloated, the fluid is going away! She’s so skinny though so we are hoping she’ll start putting on some pounds soon. I’d gladly give her a few of mine…

January 30, 2008

It is Freaking Cold Out There

by goldengracie

This dog seems to LOVE the outside. Ever since the hospitalization, she has been very focused when she goes outside (out, down the stairs, do your business, and come back in). The last few days she has been dilly dallying and sniffing the air outside again. Even tried to sneak into the side yard (where I think there might be evil cat poop, I will have to go over and block that off today).

I’ve heard of people who put muzzles on their dogs with IBD and other illnesses that require strict diets. I just don’t want to do that…but I’ll tell you, sometimes she is FAST. I have been watching her like a hawk so I have been able to stop the “almost ate that sandwich from the sidewalk” caper of Monday afternoon. And, she listens to me when I tell her NO as she is contemplating the side yard.

Just some ponderings for today.

Oh, belly measurement is down to 29 1/4 from 30 over the weekend. I’ll keep you posted.

January 21, 2008

Doctor’s Notes – from Hospitalization

by goldengracie

Notes from the Specialist Vet:

Gracie is a 5 year old FS Golden Retriever that presented as a transfer on 1/14/08. She had 2 days history of polyuria/polydipsia, abdominal distension, and lethargy. Bloodwork at the rDVMhypoproteinemia. On presentation she had a temperature of 101.0, pulse 100, respiratory rate of 56, scleral injection bilaterally, a distended abdomen with palpable fluid wave and muffled lung sounds ventrally. Bloodwork showed hypoalbuminemia 0.3 g/dl (2.3-4.0 is normal), decreased cholesteral 30 mg/dl (110-320), decreased globulins 1.3 g/dl (2.5-4.5), and decreased total protein 1.6 g/dl (5.2-8.2). Thoracic radiographs showed a small amount of pleural effusion.

An abdominal ultrasound was performed and showed a moderal amount of abdominal effusion, a hypoechoic body of the pancreas consisten with pancreatitis, and the jejunum was questionably thickened and contained a slightly hyperechoic mucosal layer consistent with the possibility of protein losing enteropathy. The abdominal effusion was submitted for analysis and was faound to be consistent with a transudate secondary to hypoalbuminimea. An ACTH stimulation test was performed to test for Addison’s disease and was normal. Gracie was placed on IV fluids, hetastarch, famotidine, metronidazole, orgal aspirin, and given a plasma transfusion. G GI panel was submitted and showed an elevated TLI 38.5 ug/L (5-25) and decreased Cobalamin 231 ng/L (284-836), and Folate 4.2 ug/L (4.8-8.6) these findings are consitent with diffused small intestinal disease. Spec cPL was normal which is not consistent with pancreatitis.

On 1/15 bloodwork showed hypoalbuminemia 0.6 g/dl, Cholesterol 46 mg/dL, globulins 1.7 g/dL, total protein 2.3 g/dl. Endoscopy of her upper and lower GI tract was performed. The esophagus, lower esophageal sphincter, and cardia were all within normal limits. The fundus, body, antrum and pylorus of the stomach were within normal limits. The duodenum was craterous and roughened in its appearance. the colon was unremarkable. We were able to enter her ileum and obtained biopsies of that segment of her bowel as well. Biopsies of her stomach, duodenum, ileum and colon were submitted and are currently pending. Gracie was started on Cerenia (she had one episode of vomiting after the anesthesia) and given an injection of Vitamin B12.

On 1/16 bloodwork showed persistent low albumin 0.5 g/dl, globulins 1.4 g/dl, and total protein 1.8 g/dl. She was offered food and had a good appetite. Gracie was started on immunosuppressive therapy for her suspected inflammatory bowel disease.

On 1/17 bloodwork showed albumin of 0.9 g/dL, globulins of 1.7 g/dL, and a total protein 2.6 g/dL. She is being discharged on prednisone (steroid), metronidazole (antibiotic), famotidine, furosemide (diuretic) and spironolactone/Hydrochlorothiazide (diuretic). The results of the GI biopsies are pending. Her clnical signs and bloodwork are most consistent with a diagnosis of inflammatory bowel disease. The biopsies will help us come to a definitive diagnosis.

Follow Up care:

Recheck physical exam and bloodwork in 10 days.

January 21, 2008

Gracie’s Blog Post #1

by goldengracie


The purpose of this blog is to focus on Gracie’s health. Now that she has been diagnosed with a chronic health condition, Inflammatory Bowel Disease (not to be confused with Irritable Bowel Syndrome, which is something different), we will be monitoring her health MUCH more closely.

I will begin at the first signs of trouble and continue in chronological order.

Age of Dog: 5 years and 11 months DOB 2/27/2002
Breed of dog Golden Retriever
Male/Female Female
Name of dog Gracie

Sunday, January 13, 2008

We had no idea what was wrong. She had been drinking so much water and needing to go out to pee every couple of hours. She got so dehydrated that she was getting weak and her eyes were red. Her head started shaking ever so slightly and we took her to the Emergency Vet. I got there around 11:15 this morning, and I got home around 2:15. The took blood, x-rays. The don’t know what is wrong. It isn’t straightforward. There was talk of a heart problem, a tumor, liver or kidney problems, not that the vet was mean or anything. Just trying to be thorough. The cost for today was a $300 deposit toward the estimate of $900-1500. They are keeping her overnight to do an EKG, give her fluids and get a urine sample. Her electrolytes and proteins are out of whack, and the red blood cell count was high.

When I called for an update the vet said that she is stable, and “looks good from the outside but has a lot going on on the inside.” She has ascites, abnormal build up of fluid, in her abdomen. They have run a number of tests and worked to get her stable. Her proteins are low, tomorrow we will have to get her to our regular vet to start the next steps of diagnosis: an ultrasound of her liver.

Monday, January 14, 2008
6:30 am a wake-up call from the Emergency Vet. We were already awake and ready to get her. We were certain that we were in for decisions about whether we’d have to say goodbye.

8:00 am We open up our regular vet’s office. Gracie is barely able to stand up, she is exhausted and lays down at the first opportunity. We see the vet at 8:15 and are immediately referred to a specialist. The liver and kidneys were “ultrasounded” with few noted problems. But, her proteins continue to plummet. They will be doing an endoscopy and biopsy of the intestinal tract tomorrow. She’s likely to be in the hospital for three days.

Tuesday, January 15, 2008

We just got home from visiting Miss Gracie at the hospital. She is very weak, and was recovering from procedures and tests from today. They drained some of the fluid from her abdomen yesterday, poor thing.

Today, they did an endoscopy and a colonoscopy. The doctor told us “we got a lot of good biopsies.” I hope that this means they will find out what’s wrong and fix it. They also said that poor Gracie’s intestines are very diseased. They just don’t know with what.

Wednesday, January 16, 2008

The report from the vet today was that Gracie had solid food. Prescription food. They have been giving her some kind of digestive enzymes and she is feeling better.

Still no pathology reports, but they will know tomorrow by 10:30 am whether she’s coming home! I plan to take the afternoon to go up and 1) visit or (preferably) 2) take her HOME!

They are thinking this is a chronic condition treatable with prescription food and supplements.

Thursday, January 17, 2008

Gracie is on the couch dozing off…it took us over an hour to get home from the veterinary hospital. She is very relieved, as am I.

Anyway, we have 5 medications and a vitamin B12 shot as our discharge meds. And, special prescription canned dog food. The poor thing is on a mega dose of prednisone…

The pathology reports have not yet returned, but the doctor thinks this is Inflammatory Bowel Disease and that most dogs respond well to treatment. It is still possible that this is some kind of Cancer, but she is certainly looking and feeling much better. Cautious optimism.

discharge diagnoses:
hypoproteinemia
protein losing enteropathy
hypocobalaminemia
Suspect Inflammatory Bowel Disease

Medications:

Prednisone 25 mg in the morning
Common uses : This medicine is a corticosteroid used to treat severe allergies, arthritis, asthma, and skin conditions. It may also be used to treat other conditions as determined by your doctor.

Metronidazole (Flagyl) 250 mg every 12 hours
Common Uses: This medicine is an anti-infective used to treat infections.

Spironolactone/HCT 25:25 Tab 1 every 12 hours
Common Uses: Spironolactone is used as a diuretic to remove the excess fluid caused by congestive heart failure, cirrhosis of the liver, and kidney disease. It can also be used to treat elevated blood pressure in combination with other drugs and in resistant cases of low potassium (hypokalemia). Spironolactone is also used to counteract the effects of excessive adrenal aldosterone production. Aldosterone overproduction can occur from a tumor in the adrenal gland, or when enlarged adrenal glands produce an excessive amount of aldosterone.

Furosemide (Lasix) 12.5 mg tab: 1/2 tab (6.25 mg) every morning
Common uses : This medicine is a loop diuretic used to treat high blood pressure, congestive heart failure, and swelling due to excess body water. It may also be used to treat other conditions as determined by your doctor.

Famotidine (Pepcid AC) 20 mg twice a day
For tummy issues (poor doggie)

Vitamin B12 1000 mcg (1 ml) subcutaneously every 7 days for 3 more doses then every other week indefinately. Next dose 1/22/2008.

Friday, January 18, 2008

It isn’t cancer. It is Inflammatory Bowel Disease. We are to continue on the medications we were discharged with yesterday (listed above).

How was the diagnosis of IBD confirmed.:

Ultrasound of abdomen (kidneys, liver, etc.)
Ruled out Addison’s disease with ACTH stimulation test (was normal)
Endoscopy & Colonoscopy and biopsies which showed severely diseased small intestinal tissue.

Current Diet:

Hill’s d/d venison and rice canned food – 2 cans per day

What diet has your dog previously been on

Iams which we stopped due to chronic itchiness (feet)
Solid Gold Lamb and Rice most recently for the past 3-4 years.

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