Stumped and Worried!! Need the DK experts for this case!!

[Kaleigh]

Hi DK world!

Our year and a half old goldendoodle Winnie has kept us on our toes (and stalking this website!) since she came to us at 10 weeks.  Since I've discovered DK, any time we suspected something was going on with her.. I would jump on here, peruse the discussions/groups and find a similar scenario that we were experiencing. Which calls for many thanks in advance for all the great advice!! I am currently stumped and very worried about our Winnie girl.  I'm looking for any and all suggestions as to what we should do!!!

A little bit about Winnie.. we have had some GI issues in the past.  Started out early with multiple bouts of diarrhea that originally we were going to our GP vet for.  After many rounds of metro, a food change from Merrick to Natural Balance and then a bout of bloody diarrhea/lethargy, we went to a GI specialist.  She had an U/S which showed dilated bowel and was hospitalized for ivf, antibx, protonix. Stools were negative, her cortisol level was normal so we did not need to do an ACTH stim test.  Since she was so young (6 mo at the time), the vet wanted to try to manage her GI symptoms with dietary changes first before the endoscopy/steroids route.  At the recommendation of the vet, we changed her to Royal Canin PR (rabbit and potato) and started giving her probiotics in the morning.  

We thought we were in the clear because she hadn't had any GI issues for a few months.  However at around 10 months old, Winnie started vomiting very early in the morning.  Otherwise stools/urination were normal, happy energetic , good appetite.  She was dx with bilious vomiting for which we tx with before bed snack followed by metoclopramide every night.  No more late night vomiting.  

In between those GI bouts since she was a baby, she has had allergy flare ups ie..ear infections, itchiness, runny nose.  We saw an allergist that recommended allergy testing.. unfortunately we couldn't financially swing it (since she had an ear infection so early before we got insurance coverage at 3months.. its a pre existing condition and is not covered).  So we've been treating her symptoms with evening primose oil/zyrtec and treating her ear infection flare ups.  

Fast forward to May of this year.. Winnie's now 18 mo.  She has had an amazing appetite (needs a slow feeder and will do anything for food), strictly eats the Royal Canin (no other treats/table scraps), takes probiotics/evening primose oil/zyrtec/metoclopramide, loves playing with her friends at a household daycare and is a very loving happy girl.  In early May, Winnie vomited up a piece of an artificial flower early in the morning.. she was more snuggly and sleepy than usual and wasn't finishing her food. She was having normal firm poops and was drinking/peeing normally.  Later that day she stooled out the fabric part of the flower (we found out that she had snuck this fake flower ingestion at daycare so we had a picture of what she had eaten).  Nonetheless, she wasnt acting herself so we took her in.  She had an US that was normal but her labs showed a decreased cortisol level.  So, at that time , given her history, we decided to test for addisons with acth stim test.. which came back normal.  

To entice her a little bit we started mixing in wet food with her dry food.. which she loved! Back to scarfing down food! Weaned her off wet food to all dry and she was back to her happy self for a few weeks.  Vet chalked it up to gi flare up with her ingested flower incident.  

Today, were back to not finishing meals.. even tried giving her all wet food.  This has been going on since saturday.. she has been drinking normally, firm poops, no vomiting, but would rather snooze at home then play. The interesting part is that she plays and scarfs down her meal at daycare.   

I am starting to wonder if it's stress at home.. I am currently 6 months pregnant with a big growing belly.  Winnie has always been a mamas girl.. she would follow me around and snuggle up to me whenever she had the chance.  But she's been mopey at home.. chooses to sleep on the rug instead of up on the couch with me, isn't as excited to play with us and not excited about food whatsoever.  

I'm so sorry about the long post but I wanted to give all the information I had about Winnie.  I'm feeling lost and not sure what else to do.  

Thank you all for your time!!!

[Karen, Jasper and Jackdoodle]

Unfortunately, it sounds to me like Winnie has inflammatory bowel disease. Much of what you are describing is very similar to what I experienced with my Jack, including the allergies. IBD is an immune-mediated disease, as is Atopic Dermatitis, and they are often seen in the same dog, as immune-mediated issues are usually the result of an overactive immune system, with some genetic components. Both diseases can be managed but not cured, and treatment is usually lifelong, although you can have periods of remission. I'd say that more than half the dogs I know with IBD also have allergies.

Ingesting the artificial flower may have exacerbated the problem. Even if it all came out, a foreign body in the gut is going to trigger the immune system to produce inflammatory cells, in much the same way that a sliver in your finger causes your immune system to produce inflammatory cells; that pus that surrounds an infection is composed of white blood cells, which is an immune response. The only way to calm that down is with immunoisuppressant drugs, such as prednisone. 
Unfortinately, in order to properly treat any immune-mediated disease (or really any disease), you need an accurate diagnosis. With IBD, that means an endoscopy, and if you found the cost of allergy testing expensive, it's nothing compared to what a scope costs. But hopefully, your insurance would cover that, since it sounds like it was not a pre-existing condition prior to getting the coverage. 
It's also possible that there is still a remnant of the flower in the gut, and that needs to be checked ASAP. 

Dogs with IBD often have ravenous appetites, or appetites that fluctuate wildly, so you really can't judge by whether they are eating or not. However, when a dog's energy levels or behavior suddenly change in the way you describe, chances are that they are not feeling well. 

You could try giving the probiotics again if you have not been doing so (dogs with chronic digestive issues require continuous probiotics) but if there is an inflammation present, no probiotic is going to fix that. 

Since three months from now you are going to be overwhelmingly busy, lol, I would strongly suggest that you contact the GI specialist again and schedule that scope. I think you need to know for sure what is going on with Winnie and get her on a solid treatment plan before the baby is born. 

[Kaleigh]

Thank you for the recommendation Karen! The GI vet did suspect IBD, I'm going to reach out to the vet and to insurance to see if they will cover scope.  I really appreciate your time! 

[Karen, Jasper and Jackdoodle]

I'm glad to help. I know from personal experience how worrisome and frustrating this can be. Please keep us posted. 

[Jane, Guinness and Murphy]

I also have one Doodle with IBD and would encourage you to go ahead with the scope.  I'm not sure who you are insured with but my Pet Plan policy did cover it.  When we got the diagnosis we were able to put a plan in place which includes meds and food. Murphy is now on an acid reducer, vitamin B12 (because IBD dogs require a supplement), Tylan (antibotic), and VSL3 (probiotic).  Murph also has the allergy issues, although his are seasonal which we treat with Apoquel when he's having a flare.  Since we have had him on this plan he has not had any more serious episodes.  We have to carefully control everything that he eats...even the wrong kind of treat is a huge problem.

[Kaleigh]

Thank you jane! We have Petplan as well.. I’m worried because she had diarrhea episodes when she was weeks old before coverage so they might consider it a “pre existing condition”. Nonetheless we are going to do the scope Friday! Hoping for some answers. Thanks again for your advice. 

[Jane, Guinness and Murphy]

I really think that's great...and would be surprised if it's not covered.  Please let us know....it really was the answer for us.  We struggled for a long time before we got the diagnosis and plan for treatment.

[Karen, Jasper and Jackdoodle]

I'm glad you're having the scope done. Please let us know what you learn. 

[Kaleigh]

Winnie got scoped today.. vet said it looks like she has delayed gastric emptying and her duodenum looked pretty irregular.. I believe she used the term “cobblestone appearing”. We sent off biopsy along with gi panel.  Vet wants to start her on low dose steroids to get her through (10mg/day) and wait to see what biopsies show.  Discussed the possibility of needing to change food as well.  How did your doods do on steroids? I’m nervous about the side effects but hopeful this will help her get better.  My next question for the DK experts is how did you get your pups to take all of their pills. Adding prednisone will be her 5th pill and we’re already having trouble getting her to take her regular ones (currently hiding them in pumpkin).  Also.. I know there are a TON OF discussions about food on here but what worked for the IBD doods of yours? Thank you in advance for your time and expertise!! 

[Karen, Jasper and Jackdoodle]

I'm not going to beat around the bush here. How you get your dog to take their pills is you put it down their throats. Period. You can coat it in something like pumpkin to help it go down easier and not stick at the back of the throat (I used mashed sweet potatoes), but forget about getting the dog to eat her pills voluntarily. These are medications that she needs, and she has to take them, and you have to get them into her whether she likes it or not. It's not mean, it may save her life. I firmly believe every dog owner needs to learn how to do this. At various times of his life, JD was taking 8 to 13 pills per day, and that was for years and years. He never ate them voluntarily. I pried his mouth open, put the pill(s) at the very back of his throat and held his mouth closed until her swallowed. Four times a day, every day. 

Regarding food, there is no such thing as "what worked" for anyone else's IBD dog, because it is all dependent on what type of IBD your dog has and what foods he/she has eaten in the past. The diet will almost always be a limited ingredient diet containing a single animal protein that the dog has never eaten before. Obviously, that is going to vary from one dog to another. Some people make their own food, others use Rx foods containing hydrolyzed protein, still others feed commercial LID diets containing a single "novel" protein like rabbit or kangaroo, etc. For some dogs, pork or duck might be a "novel" protein. Any treats or chews are going to be limited to single ingredient things that are non-allergenic for your individual dog, non-edible Nylabones, or hydrolyzed biscuits. It is very challenging. 

[Kaleigh]

Makes sense! Just wanted to make sure I wasn’t missing anything... I am terribly sorry about JD’s passing.. you and him have helped our family and we are very grateful for that! 

[Karen, Jasper and Jackdoodle]

Thank you Kaleigh. It's JD's legacy. :)

[Karen, Jasper and Jackdoodle]

Oh, and JD did just fine on steroids, which he took continuously from his diagnosis in Dec. 2011 until he died in Nov. 2017. He did have some mild side effects but they did not impact his quality of life.