Goldendoodle with IBD

[M Blair]

Hello everyone,

I am a new member.  I have two goldendoodles; Baci who is 10, and Coco who is 9.  We've had them since they were puppies.

My post today is concerning Coco who was diagnosed with IBD (Lymphoeosiophilic) in September, 2016, by a specialist.  Coco had been showing signs of IBD long ago by going through periods of vomiting blood.  Her stools were always fine (except when given some medications).  Coco also has environmental allergies.

Her current medications are Adequan (for joints), as she's had 2 TPLO surgeries and Cytopoint shots every 5 weeks for allergies (Apoquel gives her very frequent UTI's).  She also gets a B-12 shot every 4 to 6 weeks.  I have noticed that when her allergies flare, so does her IBD.  They seem to go hand in hand.  The seemingly odd thing is that Coco's IBD has flared at this exact same time of year for the past 3 years.

In the past, for Coco's IBD, we tried feeding her a 'hypoallergenic' dog food.  She developed horrible diarrhea because her intestines were absorbing too much water, so she's not able to eat the 'split protein' foods.  A novel protein for Coco is going to have to be VERY novel as she's had lots of different proteins.  I tried Rayne Nutrition Kangaroo and Potato for a food elimination trial, but she could not handle that, either.  For medicines, the vet suggested treating her symptomatically with Prednisone.  That worked the first 2 times, but when she flared again, Coco started having bloody diarrhea when given Prednisone.  I tried Prednisone again some time later, and she did the same thing after the second dose (20 mg).  Now she cannot take Prednisone.

Currently, the recommendation is to give her either Azathioprine or Atopica.  Since Atopica is very expensive, the vet suggested Azathioprine.  I know some of the side effects of these drugs, and I know they aren't good.  I started Azathioprine on Monday, and we're already down to an every other day dose.  She will have more bloodwork drawn in another week.  Coco is also getting Carafate twice a day and Zofran.

Coco does not want to eat.  She is hungry, goes to her bowl, then backs away.  She hasn't vomited for the past 4 days, which is a plus.  Other than not eating, she's acting pretty good, rather frisky.

I'm very worried about, well, everything.  I feel helpless.  I don't know if I'm doing to right thing.  I've tried going to the only 2 holistic vets in my area.  One waved a crystal over Coco.  That may be fine for some who believe in that, but that's not for me.  The other holistic vet talked to me about homeopathy, then charged me $100 for talking to me about it without telling me there'd be a charge just for all the blabbing she did.  So now here I am with medicines with scary side effects and a dog who is going through yet another period of not eating.

If anyone can tell me of some other direction to try, their experiences, point me to helpful posts, anything, I'd be grateful.

Sincerely,

Missy

[Karen, Jasper and Jackdoodle]

My Jack was diagnosed with IBD via endoscopy in December of 2011. He has been well managed for five years now, using a combination of medications, diet, and supplements. He also has Atopic Dermatitis. His IBD has also flared at the same time as his allergies, which makes sense because both diseases are immune-mediated. Our dogs have hyperactive immune systems. :( 

It's a very difficult disease to manage, because there are so many different variables: The type of inflammation, the location of the inflammation (area of the GI tract affected), the severity of the disease,  and then so many different types of drugs and diets. It does take some time to find the combination that works for your dog. I understand very well that feeling of helplessness and wondering if you are doing the right things. What helped me with that was an IBD Dogs support group on Yahoo groups.

In 80 percent of cases, you do have to use some type of immunosuppressant drug long term. There is a generic form of Atopica available which is less expensive. But this is an expensive disease to manage. There is also a drug called Budesonide, which is a steroid that works directly on the digestive system and doesn't have as many systemic side effects as prednisone. And there are others.  it takes some experimenting with drugs and dosage to find the one that does the trick for your individual dog. It really helps to have a good IMS who will work with you on this.

Probiotics are also very important. Jack has had wonderful results with a human probiotic called VSL#3. (See my discussion about this HERE: http://www.doodlekisses.com/group/healthandmedicalissues/forum/topi...)

If your IMS is not familiar with it, ask about it. 

Tylan is also really helpful, especially if the large intestine is affected, and it's a very benign drug with virtually no side effects. I would ask about that as well. 
Omega 3 fatty acids in the form of fish oil also help with inflammation.

Regarding food, has Coco had kangaroo or rabbit? There are single protein diets with both. 
Sometimes, you even need to experiment with different hydrolyzed protein RX diets. I know many people whose dogs could not tolerate Hill's Z/D or Purina HA but do beautifully with Royal Canin's HP. Have you tried that one? 
Here are a couple of good discussions from other members here whose dogs have been diagnosed with this awful disease:
http://www.doodlekisses.com/group/healthandmedicalissues/forum/topi...

http://www.doodlekisses.com/group/thefoodgroup/forum/topics/an-upda...

Hang in there, there is light at the end of the tunnel. 

[Lucy & AnnaBelle's Mom]

I know that Karen will chime in here (EDITED -- I see she already did now) with regard to all the meds and the IBD itself as she is very knowledgeable and has a dog with I believe IBD.  My thoughts in reading through though goes to the not eating.  When our Sophie had Lymphoma and was on Chemo we had a really hard time getting her to eat anything.  It seemed that she would eat something until she got queasy after eating and then she wouldn't ever eat it again.  We tried many things to try and get her to eat.  Has the Vet given anything for nausea?  I know many of these are stomach drugs, but wasn't sure if any were for nausea.  One thing that she would eat and I don't know if it would work for you was baked, smashed sweet potatoes.  Then all of a sudden she wouldn't eat them anymore.  I wish I could offer you more, but the best I can do is my thoughts, prayers, and hugs.

[Karen, Jasper and Jackdoodle]

I'm glad you mentioned this, Sheri. JD gets ranitidine (generic Zantac) twice a day before meals, which helps with nausea caused by excess stomach acids. When he flares, he gets 2 days worth of Cerenia tablets. 

Most IBD dogs I know are on some form of antacid for this. 

The OP"s dog is getting Zofran for nausea. M. Blair, you might also ask your IMS about an antacid. 

[M Blair]

That's exactly how Coco is acting.  She's definitely hungry but won't eat.  She is currently taking Zofran for nausea.

Thank you for the information and the sweet thoughts, prayers and hugs.

[Jane, Guinness and Murphy]

Let me start out by saying I totally understand the frustration you're feeling, but I have found there really is hope.  I found a Specialist in GI problems with dogs....she was the one who did Murphy's endoscopy where his IBD was first diagnosed.  She has been amazing.  She partners with my Vet on the ongoing treatment which helps since she is located an hour away.  I truly believe that IBD is so complex that holistic vets do not understand it.  Murphy has not flared in almost a year, and the last time it was stress induced because we were away.  He is managed on Prednisone (small dose at this point), an acid reducer, Tylan (antibiotic), B12, and VSL3 (probiotic).  At the first sign of a flare I increase his Prednisone and give him four days of Cerenia to eliminate any nausea.  He is on Royal Canin hydrolyzed food.  To make it more appealing to him I top it with pure rabbit (which is a novel protein for him).  I learned that his treats or his toppers have to be ONLY rabbit...anything added causes a flare to begin.  He also has seasonal allergies, mostly in the Spring.  He takes Apoquel for 3 to 4 months.  His IBD is well managed, and he really seems to feel really good at this point.  His coat is great and he has lots of energy.  He has one well formed BM each day at almost the exact same time.  This is such a difference from the dog that went through months (actually probably years) of vomiting, diarrhea, not eating, and low energy.  So there is hope...it's just finding the right combination of food and meds for your individual dog.  I think the first step is getting the right Specialist.  Good luck and please keep us posted.

[Karen, Jasper and Jackdoodle]

"He is managed on Prednisone (small dose at this point), an acid reducer, Tylan (antibiotic), B12, and VSL3 (probiotic).  At the first sign of a flare I increase his Prednisone and give him four days of Cerenia to eliminate any nausea."

This is very much like Jack's treatment plan. He is on 5 mg of prednisone every other day, which is a very tiny dose for a dog his size. He also gets Tylan, an acid reducer, and VSL#3 daily. He gets a B12 injection every 4 weeks. 

Jack is one of the few IBD dogs who can tolerate chicken. His diet is half Wellness Simple Solutions Salmon kibble, and half homemade white meat chicken & mashed sweet potatoes, with L-glutamine, psyllium fiber, and Omega 3 fatty acids added. He does better with smaller, more frequent meals, so he eats 4 times a day, with some of the meds/supplements given at each feeding. 

[M Blair]

What Omega 3 fatty acids are you using?

I just purchased VSL#3 and will start that tomorrow morning.  I also purchased Zantac.  There was someone else who used it and had luck with it, so I thought I'd give it a try instead of Prilosec.

[Karen, Jasper and Jackdoodle]

I use a fish oil called VRN and Jack also gets one 500 mg. evening primrose oil softgel each day, which is an Omega 6 fatty acid, GLA, that has been found to be beneficial against inflammation. These Omega fatty acids help with all of Jack's inflammatory conditions: the IBD, the allergies, and his orthopedic issues, which I haven't mentioned here, and have been recommended by all 5 of the specialists he sees on a regular basis. :) 

[Karen, Jasper and Jackdoodle]

The VSL#3 must be kept refrigerated, so hopefully they are conscientious about that at Costco .

[M Blair]

Hello everyone!

Thank you so much to all who have replied.  It is very appreciated.

Coco's IBD is located in the duodenum.  At the time of her endoscopy, she did not have evidence of cancer or Helicobacter.

Coco does take one generic Prilosec (20 mg) at night.  She is taking Zofran for nausea currently.  I have used Cerenia in the past, and actually, I am wondering if it works better.  I do give her a probiotic called Proviable, but I did look up VSL#3 and am very interested.  I used to give her fish oil but quit 2 IBD issues ago because I was afraid to give her anything 'extra'.

Currently, Coco is (was) eating The Honest Kitchen grain free turkey and doing well with it. I am pretty certain that what caused her to have IBD issues this time was that she was taking Temeril-P, and at the end of that course, she had to take Tramadol and Gabapentin (both for pain) due to badly limping on one of her knees that she had previously had TPLO surgery.  So, either the small amount of Pred that's in Temeril-P finally got to her, or it was the pain meds, or maybe it was just time.  It's so hard to tell.

The hydrolyzed food that Coco tried was Royal Canin.  She had such a bad reaction to it (I very slowly transitioned her) that the specialist suggested not bothering to try any other hydrolyzed foods.  I have no idea if that was sound advice.  I do have a bag of Rayne Nutrition Kangaroo kibble which is a complete diet (versus the Kangaroo that I had previously used for the food elimination trial).

Lucy and AnnaBelle's Mom, you hit the nail on the head.  Coco will eat something, then the next time I try to feed her, she will have nothing to do with it.  I am fairly certain that it's because of nausea, but it's been going on for longer than usual this time.  In fact, each IBD episode seems to be worse than the last.  

Another thing I don't know whether or not to do is to try to switch her food now while she's feeling bad.  She's not eating her normal food, so what do I do?  Did all of you wait until your dog was feeling better before you changed food?  Did your dog not eat for a few days?  Coco is already pretty skinny.  It pains me to see her lose more weight.  How did you know when you hit the jackpot on a food your dog could tolerate?  As far as novel proteins, I'm going to be into crocodile, elk, etc. She has had all the readily available proteins as well as rabbit and goat.

I know I sound like a hysterical, desperate dog mom. Thank you all for saying that there is hope.  

[Karen, Jasper and Jackdoodle]

I don't think you sound hysterical at all; I think you sound like a typical loving owner of a dog who has IBD. This is a really hard and confusing thing to deal with, especially at the beginning, and it's crazy-making. 

I spent a lot of time trying to figure out what caused Jack's IBD, and there were 3 or 4 things it could have been. A very wise friend who happens to also have commented on this discussion finally got me to realize that it really didn't matter what caused it, because there was nothing i could do about that now. What mattered was moving ahead with ways to help Jack feel better. :) The fact is, we will never know. 

I wouldn't change foods right now if she is doing well on it. I really have no suggestions on how to get her to eat, though. Jack was ravenous at the beginning, and the prednisone contributed to that.

Maybe trying the VSL#3 would help.

[Karen, Jasper and Jackdoodle]

I just remembered; there's a drug called Mirtazapine that's used to stimulate appetite in dogs, I think Jane's Murphy was on it for a short time. You might ask your IMS about it.