IBD Diagnosis: Food recs, etc

[Nicole and Teddy]

Hi there! Just left a long string in the Medical issues group as Teddy has received an IBD diagnosis. The GI panel results indicated cobalamin and folate are slightly low. Pancreatic lipase and TLI elevated. Findings are consistent with small intestinal disease like IBD, dietary hypersensitivity, small bacterial overgrowth, and others. They are recommending we begin a novel protein or hydrolyzed protein diet trial that has a lower fat content, starting vitamin B12 (either by injections or oral supplement), a good probiotic (he's on VSL), and folic acid supplement. I currently feed Teddy a home cooked diet but am now leaning towards a "regular" dog food to control the IBD. In addition to peace of mind with knowing where ingredients come from, I am worried whether Teddy will "like it as much" and gobble it up like he does the home cooked brew. Any recommendations/thoughts are much appreciated. Thank you!

[Karen, Jasper and Jackdoodle]

NO.

The whole point of the Rx food is that hydrolyzed protein is not recognizable by the body, so dogs with IBD don't have reactions to it and can absorb nutrients. 

The food you bought is chicken by products, rice, wheat and corn gluten. How would that be better for him than your homemade chicken and rice? What would be the point, except to throw out your money? And in fact, if anything would make an IBD flare worse, that would be it.

That's why I specifically said hydrolyzed when I suggested Rx food.  

PLEASE , for Teddy's sake, don't feed him that. Return it or throw it out. 

[Nicole and Teddy]

Ugh- so frustrating! The vet specifically mentioned a hydrolyzed protein diet so I thought that’s what she was giving me. I went back and exchanged the food. I guess she’s just a fill in vet while the normal vet is on vacation. Hopefully our next experience will be a better one. 

[Karen, Jasper and Jackdoodle]

Please keep us posted. Metronidazole may have mild anti-inflammatory properties, but it is not enough to suppress an IBD flare, and it may cause diarrhea when it's discontinued, because it is going to destroy whatever good gut bacteria Teddy still has. It's simply never used on its own for an IBD flare.

[Nicole and Teddy]

Thanks, Karen - I will keep you posted. Do you have any good sites where I can get educated on IBD in dogs? Tried searching online but most of the stuff I've found is written through the lens of "traditional" vet wisdom. Thanks again!

[Karen, Jasper and Jackdoodle]

Well, traditional vet wisdom is pretty accurate when it comes to IBD...provided the vet in question has specific, UTD knowledge and experience with IBD. 

It's unrealistic for us to think that a GP should or can know every single thing about every single disease, including the latest diagnostics and treatments for all of them. And also, be surgeons and dentists. We don't expect that from our own human doctors, why do we expect it from a vet? That's why there are specialists in both professions. :) 
IBD has many forms, and many treatment options. Successful management depends on what kinds of inflammatory cells are there and in which part of the GI tract. That's why you need a scope. Eosinophilic IBD is treated differently than lymphoplasmacytic IBD. (JD had both forms). IBD that primarily affects the small intestine is treated differently than IBD that mainly affects the large intestine. And then, there are multitudes of drugs and supplements and infinite combinations of them that may or may not be the most effective treatent for your individual dog. It's a very complicated disease, and there is no one "best" treatment for every dog. This is where an experienced IMS is so much more helpful and better at treating IBD than any GP vet. 
What is most important to know is that IBD is fatal in 20% of cases. These are the dogs whose disease cannot be managed long term by any combination of diet, drugs, or supplements. Another 20% can eventually be managed by diet & supplements alone. And the remaining 60% majority of dogs with IBD will require drugs, diet, and supplements for the rest of their lives. It's a hard thing to come to terms with, but it's fact. 
This is the most helpful article I have found for understanding IBD. It is not 100% up to date, but it may make things clearer for you.
https://www.2ndchance.info/inflambowel.htm

[Nicole and Teddy]

Thanks, Karen - I read that article and found it very informative. Teddy has been doing well the last few days and finished the round of metrozidanole. I still have him on the hydrolyzed protein diet and will continue that for another day or two. When I switch him to a different Zignature protein, how do I do that? Cold turkey or gradually? The relief vet we saw said to do it gradually but I honestly don't really trust anything she said at this point. Thank you!

[Karen, Jasper and Jackdoodle]

You never do a gradual switch with an IBD dog. It should always be cold turkey. 
However, I really wouldn't switch him yet. Wait until he's been symptom free for two weeks, at least. With the metronidazole discontinued, you want to be sure the symptoms don't come back before making another change.  

[Nicole and Teddy]

Will do- thanks again, Karen!