A Diagnosis of Sorts and A Lot More Questions

[Karen, Jasper and Jackdoodle]

Jackdoodle's biopsy report came back yesterday; we now have a name for what this is, but no clear answer as to what caused it or what to do about it. His treatment plan is going to involve a collaboration between his internist, his allergist, and his regular vet, and apparently we may be getting the UC-Davis veterinary nutrition department involved, too. This being the weekend before Christmas, things are still on hold until his regular vet and I can talk to his allergist. The internist left town for the holidays yesterday. I would not have posted an update yet, but so many of you have asked about him, I wanted to up-date you.

JD has severe Inflammatory Bowel Disease, specifically the following conditions:

1. Lymphoplasmacytic Enteritis

2. Eosinophilic Enteritis

3. Chronic Hypertrophic Pyloric Gastropathy

How these conditions relate to each other, how he developed them and why, we don't know yet. There can be many causes, and sometimes there's no way of knowing which it is. There does appear to be an immune-mediated/allergic component.

Treatment will involve dietary changes and medications including some kind of immunosuppressant.

:(((

Some of the drugs being discussed are very heavy-duty drugs, with some very serious side-effects, and will probably cancel out his current immunotherapy treatment for his Atopic Dermatitis. Have to talk to his allergist to find out. And you can be sure I am going to do an awful lot of research before taking that route.

He also has developed a B12 deficiency, probably because of all the inflammatory/digestive issues, and will require B12 shots every week for a few months. That's the easiest and clearest part.

I am still a little bit shell-shocked and trying to sort all of this out and wrap my brain around the fact that my poor guy has to deal with yet another chronic illness, more meds, more lifestyle restrictions, etc. But so many of you have asked about him, I wanted to let you know what's going on.

And thank you all again for your caring and concern. He may be sick, but beyond a doubt, he has a lot of wonderful people who love him and and are rooting for him, and that has to count in his favor.

Hugs to you all.

[Karen, Jasper and Jackdoodle]

Thank you, Jane,

[Bonnie and Kona]

Dear Karen, I have been out all day. I am so sorry to hear that Jackdoodle is so sick.Thank you for posting today even though you don't have all the details. I hope and pray that the doctors can figure out the least complicated treatment possible. Poor Jack and poor you.   Lots of love to you both. 

[Karen, Jasper and Jackdoodle]

Thanks, Bonnie.

[Ricki and Tara (doodle)]

Wow Karen you must be just overwhelmed by this diagnosis! I feel a bit overwhelmed just reading about it! It's hard to understand how he can have so much going on inside and what could have triggered this situation!!! ?? I tend to be the type that wants to know the "WHY?" as well as the "WHAT" but I know it is not always possible to discover the "why". Frustrating! You two continue to be in our thoughts and hopes for a well tolerated and successful  treatment plan for Jack. Thanks so much for the update.

[Karen, Jasper and Jackdoodle]

You've said exactly what I'm feeling. Why? How could this happen, so fast? What would cause a dog who seemed to have no digestive issues to suddenly develop an inflammation so severe it closes off his pyloric opening? I have been told that even after we reduce the inflammation with the drugs and diet, there will still be scar tissue, that's how bad it is. He goes from eating and pooping normally to bringing up all of his food for weeks, no matter what kind, drastic weight loss, etc. from one week to the next? And except for last Friday, there has been no diarrhea at all this whole time from the beginning, none. Does that sound like IBD???? He ate nothing new, nothing changed.

The more reading I do, the more questions I have. Why didn't the ultrasound show the narrowing of the pyloric sphincter? What is he going to eat? How can you do a food trial when the dog is on steroids anyway, which are going to mask any symptoms? How will they even know if the pyloric sphincter is still narrowed without doing another scope? And some of these symptoms can be related to mast cell tumors, which worries me.

And the drug they are talking about is such a powerful immunosuppressant, it's given to organ recipients to prevent organ rejection. Why does he need something like that? This is that bad? And if he does need it, why then would he still have to be on a restricted diet?

Okay, gotta stop now, I've spilled too much of what's rattling through my brain here already.

Thanks, Ricki, for helping me get it out.

 

[Ricki and Tara (doodle)]

No problem~ :)

I am trying to remember the time line and I may have this all wrong but it seems like when this all started the problem was primarily in the upper g.i and the lower was working okay. Still pooping okay at that time.

Then after he started treatment (all those difficult to administer drugs!) for the upper that he started having problems in the lower g.i. Is that correct?

If it is, could it be possible that the lower situation was caused by a reaction to the drugs for the upper and perhaps the only true issue is the upper?

Brainstorming...

[Karen, Jasper and Jackdoodle]

No, it started with the regurgitating, and there was very little poop, because nothing was getting through. When anything did get through, i.e. he kept a decent amount of food down, the poop was mucus-y and a had a little bright red blood in it, but he only pooped a normal quantity 4 times in more than 3 weeks, even when he was keeping food down.

Then when he started with those awful drugs, which were absolutely the wrong thing for him as it turns out, there was nothing coming out either end until last Friday, when he just exploded, and we went in for the scopes.

But it does seem to me that the true problem was the narrowing of the pylorus; my question is, which came first, the chicken or the egg? Was the hypertrophic pyloric issue caused by the general gastrointestinal inflamation, or vice versa?

The internist said that the colon looked the worst, so I don't think that could have gotten so severe in a week or two.

[Ricki and Tara (doodle)]

Oh, I see, yeah, that kind of makes it  impossible to know where it all started. I sure wish our babies could talk sometimes (other times not so much! LOL).

[Martha & Cooper]

Sorry to hear about this diagnosis, but glad that you at least have one now.   Wishing you both better days ahead.

[Karen, Jasper and Jackdoodle]

Thanks, Martha.

[Joanne ~ Spud*]

Wow Karen.  My hugs go out to you.  May you continue to be the strong and healthy one throughout all this so he can gain more strength from you.  Unbelievable.  I'm so sorry and I hope he is feeling much better now that they have an idea what to do for him.  All I want--and of course, you want is his comfort. Whatever that will take.

[Karen, Jasper and Jackdoodle]

Thank you, Joanne.