IBD with PLE, now having setbacks :(

[amberw725]

Hi everyone!
I am new here to YorkieTalk, but I felt the need to come on and share a little about my baby and his health issues. I have spent hours scouring this site and the forums to find any additional advice I can add to what I've got from my vet.

My baby is Binky and he is 8 years old and only 3 lbs. Last September he got very bloated and started acting less interested in his food. I took him to my regular vet who diagnosed him with pancreatitis or a stomach virus. She gave us metronidazole and cerenia and said he should get better. Fast forward a week and my baby was more bloated and started having seizures. His first one lasted quite a while. I was with my mom at the time, so the closest vet to her house was the one she sees who is unfamiliar with Binky and his health.

After running some labs, they told us his seizure was likely caused by hypoglycemia, but they gave him dextrose to bring it up. They also told me he was likely in liver failure because his albumin, globulin and calcium were extremely low. They decided it would be best for me to take Binky to a vet hospital where they could keep him and run additional tests.

After 4 days at the hospital, we were thankfully able to rule out a lot of things. We ruled out liver failure, insulinoma, liver shunt, etc. We were sent to an internal medicine vet who also has an ICU in her office. He spent 3 days there, and we finally discovered he has protein losing enteropathy secondary to inflammatory bowel disease.

I was heartbroken over the diagnosis, but hopeful that it was one that can be treated with meds to add to their quality of life. It's been a long year, but for the most part, Binky has been doing great. He has required no other hospitalizations, and while he has had the additional flare up where we had to adjust medication dosages, he's been super stable.

This week I took him to fly out of town with me for Christmas after he had a lab check that showed he was having another flare up. Adjusted medications, and the vet OK'd it and sent me on my way with all his medical records should we need to see a vet out of town. She had me make an appointment for her to see him once back in town. I came back in town tonight and Binky had a seizure as I was pulling up to my home. I was able to stay calm enough to get him upstairs and administered Karo syrup and calm him until he was alert enough.

He isn't interested in his food, but he is eating plain chicken (the vet OK'd this if he isn't eating his food). Now, he's acting much better (I'm just happy he has an appetite), and he's sleeping next to me right now. I am worried the trip just added stress to his little self and it all caught up to him.

My appointment to see the specialist is Friday, she is out of office on Thursdays (tomorrow) so I am wondering.. do I stay home and nurse him myself tomorrow as long as he's stable? or should I take him in to see the regular vet or call them to see what they think since I can't get in touch with the specialist until Friday??

Thanks for taking the time to listen to my LONG story.
Amber

[pstinard]

Originally Posted by amberw725

Hi everyone!
I am new here to YorkieTalk, but I felt the need to come on and share a little about my baby and his health issues. I have spent hours scouring this site and the forums to find any additional advice I can add to what I've got from my vet.

My baby is Binky and he is 8 years old and only 3 lbs. Last September he got very bloated and started acting less interested in his food. I took him to my regular vet who diagnosed him with pancreatitis or a stomach virus. She gave us metronidazole and cerenia and said he should get better. Fast forward a week and my baby was more bloated and started having seizures. His first one lasted quite a while. I was with my mom at the time, so the closest vet to her house was the one she sees who is unfamiliar with Binky and his health.

After running some labs, they told us his seizure was likely caused by hypoglycemia, but they gave him dextrose to bring it up. They also told me he was likely in liver failure because his albumin, globulin and calcium were extremely low. They decided it would be best for me to take Binky to a vet hospital where they could keep him and run additional tests.

After 4 days at the hospital, we were thankfully able to rule out a lot of things. We ruled out liver failure, insulinoma, liver shunt, etc. We were sent to an internal medicine vet who also has an ICU in her office. He spent 3 days there, and we finally discovered he has protein losing enteropathy secondary to inflammatory bowel disease.

I was heartbroken over the diagnosis, but hopeful that it was one that can be treated with meds to add to their quality of life. It's been a long year, but for the most part, Binky has been doing great. He has required no other hospitalizations, and while he has had the additional flare up where we had to adjust medication dosages, he's been super stable.

This week I took him to fly out of town with me for Christmas after he had a lab check that showed he was having another flare up. Adjusted medications, and the vet OK'd it and sent me on my way with all his medical records should we need to see a vet out of town. She had me make an appointment for her to see him once back in town. I came back in town tonight and Binky had a seizure as I was pulling up to my home. I was able to stay calm enough to get him upstairs and administered Karo syrup and calm him until he was alert enough.

He isn't interested in his food, but he is eating plain chicken (the vet OK'd this if he isn't eating his food). Now, he's acting much better (I'm just happy he has an appetite), and he's sleeping next to me right now. I am worried the trip just added stress to his little self and it all caught up to him.

My appointment to see the specialist is Friday, she is out of office on Thursdays (tomorrow) so I am wondering.. do I stay home and nurse him myself tomorrow as long as he's stable? or should I take him in to see the regular vet or call them to see what they think since I can't get in touch with the specialist until Friday??

Thanks for taking the time to listen to my LONG story.
Amber

I'm sorry it took your post so long to show up. That usually happens with a new person's first few posts on Yorkietalk. To answer your question, I would probably call the regular vet and let them know what happened, but so long as the dog was doing well, I'd wait and take him to the specialist on Friday. Let us know what happens!

[Wylie's Mom]

Poor baby - PLE is tough, no doubt about it. Are you seeing the specialist today then? How is he doing?

[ladyjane]

I hope Binky is doing well.

I lost my beloved Cookie this year to lymphoma. She had IBD and PLN (lymphangectasia) since 2011; so, they can respond and do well! Here is a link to a thread about her...and in that link there is a link to her original thread:

http://www.yorkietalk.com/forums/sic...ia-update.html

Usually it is best to have them seen right away when you see them slipping back because this is an illness that can really take over quickly and they can be difficult to save if it gets to a point that they are getting fluids in their bellies. You don't realize it until it is too later. So, my thoughts are, when in doubt, call a vet!

Sure hope things are going well....

[amberw725]

Hi guys, thank you so much for your kind words and concern.
Binky has been super lethargic and only wanting to lay around and be cuddled. I was able to get him to eat some chicken and broth.
We took him to the specialist this morning, and she said he has lost over half a pound. Which seems like so much on a 3 pound baby
She wanted to keep him in her office to monitor him while she waits for the labs to come back. She says if she feels like it's something I can handle at home over a holiday weekend, I can come back to get him. But she said if his labs are bad and she feels like he needs IV meds and fluids, he will already be there with her to keep and hospitalize.
Lots of tears worrying about my baby, but I know he's in good hands.

[amberw725]

Hi there again, another update (not sure why my posts aren't being approved in a timely manner?) :-/ but the specialist called me to say that Binky's albumin has dropped along with his calcium, so she felt more comfortable hospitalizing him at her office so she could keep a closer eye on him and give him meds and fluids via IV. I went to the office to bring him a blanket and some of his babies (toys/stuffed animals) and I bawled seeing my poor baby sitting with an IV in his little arm. I held him and talked to him for a while. When I was leaving, he watched me until I walked out the door. I am so worried he will feel like I have abandoned him. My poor baby. I'm trying to stay positive, but I can't stop thinking about him and how badly I will sleep tonight without my little snuggle buddy.

[ladyjane]

New members' posts are monitored for a bit...hopefully that period of time has passed and your posts will show up more quickly.
SO sorry Binky isn't home with you but it sounds like he needs intensive care. I hope this is a specialty 24 hr hospital where he is.
Prayers for your boy.....

[amberw725]

Here with an update...
The vet called me yesterday to say that Binky was looking much better and eating better, however his labs were telling a different story. His calcium and albumin were still too low. So, he recommended keeping him overnight again to continue giving him medications. I had to work all day yesterday, but my boyfriend went to see Binky and he looked great! I was so happy to see him alert.

This morning the vet called to update me and said the same thing. Binky is looking so good, but his labs just don't correlate. He said he worries if he sends him home tonight, he will decompensate. So he recommended keeping him one more night to continue on IV medications.

They have switched his Prednisone to Budesonide. Vet said if his labs still aren't improved by tomorrow, they will likely switch back to Prednisone, or even another medication (that will have to be compounded due to Binky's small size).

It breaks my heart that his labs don't show him improving. I'm at a loss on what we should do/things to change. I am about to go and visit him now, and I am going to see what they have changed his food to. He was previously on Royal Canin low fat GI prescription diet, but stopped eating it. Vet said they were going to change it, but I haven't heard what they did change it to if anything. (yesterday they were giving chicken).

I'll take any and all advice on diet and meds/what has worked in your experience.

Thanks all!

[ladyjane]

One of the specialists I use always says to treat the pup, not the labs. Of course you don't want them to have a very low albumin. Maybe since he is feeling so much better it will start to go up.
I home cooked for Cookie. I did a consult with a vet nutritionist and she was on that diet from 2011 when she was diagnosed until March 2017 when she passed. It was sweet potatoes and tilapia plus supplements. If you have time to do that, I have to say it was wonderful for her. You could check this website out for a free recipe (as long as your vet approves it) :
https://secure.balanceit.com/tools/ez2/index.php?

[amberw725]

Thank you so much for the link! I just submitted a request so hopefully I will hear back soon!

Went to see Binky yesterday, and while he was happy to see us and seemed alert enough to be attentive, he was still very drowsy. It broke my heart. Vet said it's likely due to the low numbers and also because they probably don't get good sleep when in the hospital (as humans don't!). I spent most of my day crying yesterday because I'm so scared he's not going to get better.

Vet called this morning to say Binky started having some muscle twitching, so they re-ran his calcium and it dropped, again. He gave IV calcium and because of this, he wants to keep him so he can monitor his cardiac rhythms. He also said he hasn't been interested in eating, so he administered an appetite stimulant and asked that if we have anything at home he may like, to bring it in to see if he will eat for us.

My heart is breaking. I just want my baby to get better and come home! This is NOT the way I planned on starting my new year.

[amberw725]

I just added a photo to my account, so I wanted to send another reply so you guys could see my baby

[ladyjane]

Oh what an adorable little guy! I sure hope he gets better. I don't know what your vet gave him, but I have used Mirtazapine for pups who will not eat and had great results with it.
Hopefully he will eat when you visit....keeping them eating can be a challenge...but they must eat!
Maybe pick up some tilapia and sweet potatoes and see if he might like that?
Let us know after you visit....
Prayers for him and for you. It is so hard to see them so sick.

[ladyjane]

The following is a good link and does discuss the issues of anorexia in these pups. If you can get over that hurdle it's best. I suggest that when you go there, take a little buffet of foods with you so he can have options. I did that with one of my renal pups earlier in the year....surprisingly she opted for Hill's Science Diet kibble! I had all kinds of stuff on the plate....chicken, baby food, veggies, canned dog food...rice and chicken...and all she wanted was kibble! LOL


From the link:

"Acceptance of the diet is a critical issue in PLE dogs, particularly in the most severely
affected animals, which may be anorexic. For each patient, the veterinary care team needs to identify the most palatable diet. Initially, it might be more important to feed a less optimal diet that the dog will be interested in eating, and progressively transition to a more desirable diet."

http://www.bli.uci.edu/conti2013/Gaschen_text.pdf

[amberw725]

We lost him. My baby is gone. And I've never felt so devastated in my life. My heart is empty and so painful. I don't even want to me at home, it feels so empty without him.

His calcium levels were so low that he started having muscle twitching, so they opted to give him Calcium via IV to get it up quicker to avoid seizing. I went to see him and got to help the vet hold him and love on him while she bathed him (he kept having bad bouts of diarrhea) and kept him calm while she placed a new IV.

After this, I went to a room with him and offered him multiple foods. He kept refusing and coming up to me and pressing up next to my legs. I finally decided I was just going to snuggle him because that's what he was asking for.

I picked him up, head him against my chest and he fell asleep. He was so peaceful and content. I could've stayed there forever. Unfortunately I had to leave him so the vets and techs could continue treating him. I told him I had to leave so they could make him all better again so we could go bye bye! (the dog loved to go bye bye more than anything in this world!)

As I am getting home, I get a call from the vet that he has arrested and they are performing CPR and pushing emergency medications. He promised they were doing all they could, but he wanted me to know that once dogs arrest, it's rarely successful to get them back.

He called 5 minutes later to tell us they lost him.

My boyfriend and I went back up to the vet to get his things and to see him one last time. I think it helped to see him laying there so peaceful. While I know it wasn't him there, it comforted me that he wasn't uncomfortable or twitching or trying to find a good spot to lay to find comfort. I laid there with him and pet him until he started to get cold. My boyfriend finally decided that we should leave because that's not how we want to remember him.

Binky was my first pet, therefore he is the first pet I lost. I don't know how to cope with this. I feel as if I'll never get over it. I am numb and my heart literally hurts.

If you have any suggestions on how to cope with this huge loss, I'm all ears.

[ladyjane]

OMG I am SO sorry. My heart is breaking for you...I can feel the pain in your writing. There is no magical way to deal with it....my first one I lost had me in bed crying for four days. You just have to allow yourself to grieve.
Talk to him...ask him if he is ok....tell him to send you a sign. Sometimes they do....I have had it happen.
I will keep you in my prayers.....and pray that your happy memories with him will soon help to comfort you.
A favorite saying of mine: "Death leaves a heartache no one can heal, love leaves a memory no one can steal."
Godspeed Binky ...