Thank you for your response. Sorry to hear about Wylie.
We did a urinalysis. Vet says everything looks good. Urine specific gravity is on the low end of the normal range (ideal should be >1.035), but kidney concentration ability is adequate at 1.032. Her previous results were 1.031 (Jan and Dec 2017) and 1.030 (Jul 2017).
She sent me a copy of the results, and I noticed that her pH level has decreased to 5.0 from 7.0. I see TR for protein, which I believe means trace. WBC and RBC = *<1 HPF; bacteria, Cocci; bacteria, rods; squamous epithelial cells; non-squamous epithelial cells; calcium oxalate dihydrate crystals; struvite crystals; unclassified crystals = *None to rare; hyaline casts = *>1 /LPF; non-hyaline casts = *Suspect presence*. I don't know what all this means. Does "rare" mean some are seen?
Vet wants to retest kidney enzymes (urea, creat) and urine specific gravity in 1 month. If enzymes are still elevated (or higher), then a low protein (i.e. kidney) diet may be indicated. However, since she is on a strict hypoallergenic alligator diet, she would like the derm's input on her food and the recent results.
We haven't started the supplement yet, but her stool is now back to normal with reduced volume and frequency but still has some mucus at times after starting the new food. We may try the supplement in another week. On Monday her pad was covered in very loose stool with a little blood and mucus, and some of it was pale almost whitish, which I've never seen before. I emailed the vet, but she didn't comment on it. I read that it could mean stool moved too fast through the GI tract to pick up the bile which changes the color to the normal brown.
Vet said we could give her Sentinel if she's feeling better, but I decided not to give it to her today. I want to wait until we retest blood work and urine first as I don't want to overwhelm her system by putting more chemicals in it.
No, we haven't tried the Royal Canin Hydrolyzed Protein. It was suggested, but we didn't want to risk another allergic reaction and waste our money. Vet said chicken protein is too small for immune system to recognize, so she should not have a reaction to it. We only used a little of the Royal Canin GI Fiber response and had to donate the whole bag to a shelter because of Angel scratching. That is why we are trying Rayne Crocodilia.
We did an abdominal ultrasound on December 22, 2017:
"Abdominal Ultrasound Report
1. small intestine: normal wall layering and thickness, slight speckling and streaking of mucosal layer
2. spleen: normal size and shape, few small (0.4-0.6cm) slightly hypoechoic areas that do not deform the surface of the capsule. r/o nodular hyperplasia or extramedullary hematopoesis
3. kidneys: normal size and shape, slight dilation of right renal pelvis r/o incidental vs mild pyelonephritis, consider UA
A: The stomach, small bowel and colon are normal in appearance. The mucosal speckling and streaking is very subtle as may not be significant. No signs of neoplasia, FB, obstruction or poor motility. The mucosal speckling could suggest some degree of small bowel inflammation vs incidental finding. B12/folate levels if abnormal may help to cornirm some degree of small intestingal involvement, however the clinical signs sound mostly large bowel in nature. The normal appearing colon does not r/o inflammaiton but does make neoplasia less likely.
r/o: Colitis - Bacterial, parasitic, dietary (allergic or fiber responsive) and idiopathic IBD
recomm blood work to r/o metabolic dz including atypical addisons dz, B12/folate
if bloodwork is normal, treat for above causes of colitis:
1. tylocine (long term)
2. metronidazole bid x 6 weeks
3. consider deworming w/ panacur (repeat in 3 weeks)
4. change to balanced high fiber diet or hydrolyzed hypoallergenic diet w/ fiber supplementation
if poor response to tx, consider fecal culture and endoscopic biopsies" |