I know about stress. I also know that colitis and ibd are VERY closely related.

This is NOT why the scope was done. Of course....everyone realizes that small is vomiting and large is diarrhea.

Once again......she was vomiting BLOOD. Could have been any number of things. So it WAS needed.

Gastrointestinal Ulcerations in Dogs

with ulcers as they were concerned from metacam incident about that with dee dee they said to watch out for coffee ground looking stuff in her vomit and black tarry stool

but vomitting blood could be cause for concern for this as well - i just think ava is a very tough case sadly :(

she did tell him she almost gave up her dog yet he racked up 3500 cmon that is ridiculous to me -- I posted about the endoscopy as she stated he was trying to find out what kind of ibd it was like the biopsy was going to tell her what kind it was so he clearly did not explain it properly as there is no kind of ibd it is either large or small intestine and it was clearly small intestine by her symptoms never having diarhea. I agree it was good to rule other things out but this poor dog has been through so much just breaks my heart.

I read the blood work and all of it said cpli was normal which made me suspicious prior as well as i stated to elly as she never had pancreatitis :(

Ok....enough for me.

You were not there...maybe she interpeted it that way. But I seriously doubt the scope was done for that reason alone. Contrary to what you think, vets are a highly educated and very bright bunch. Some may be better diagnosticians than others, but they are not clueless.

I too feel awful for Ava and for Elly. I believe most of the problems have been with the original vets not coming up with a diagnosis. If she had not spent so much money on them and that EC, then maybe this would not have hit as hard...and Ava would not have been through so much.

Does not matter what you thought it was. I am saying that this vet was looking for a diagnosis and he was NOT out of line.

here is some more info on ibd

Pets and IBD - Cats and Dogs With IBD

was her amylase or lipase elevated on blood panel as our internal medicine specialist who is doing a study on this said they are finding ibd dogs are showing high amylase and lipase on blood work and can sometimes test positive on cpli test so just curious since her cpli was normal what was the amylase and lipase and if normal was it high normal?

yeah looks like the previous vets were highly educated bunch that racked up her vet bills so high the first time around gave the wrong diagnosis off the cpli which obviously they did not know how to read a cpli blood test telling her it was pancreatitis when it was not - sorry lots of educated idiots in the world - don't banfield vets go to vet school too?

I agree there are good vets and bad vets, good doctors and bad doctors, good mechanics and bad mechanics - The difference is when someone is truly passionate about what they do as they truly care about what they are doing is why they are better at diagnostics they are not just going through the motions to get a pay check

I do think this vet is much better but knowing this owner went through so much already almost gave up her dog I think he could have cut her a break the first time around knowing all she went through but i get it - it is business and it is always about the bottom line and guess who suffers the owners and dogs and rescues as they end up with them because the owners can no longer afford to properly care for their dogs

Tell you what...why don't you apply to vet school? Get a good look at their requirements. Trust me, vets are NOT stupid people.

I did say that they are not all good diagnosticians, but they are bright and your sarcasm about them is not necessary...but I have seen you do this before, time and time again. You said something the other day about physical exams as if to say they are not important. Doctors and vets should always give a good thorough physical exam...but that is another topic.

This thread has gotten off topic now and I think it is time to stop this banter. :)

i haven't read the whole thread, but thought I would share some of Sadie's history with vomitting and diarrhea episodes. i used to home make her food, it was a raw diet and it was great, but she kept getting sick with these episodes. the ER vet one night told us it was S-shaped bacteria in her digestive system spirochetes or something like that and i believe he mentioned colitis. anyways, she was on meds and got better for a bit, then got sick all over again. we took her to the reg. vet at banfield (yes unfortuneatley we are stuck with them until Aug. because of a wellness plan, i liked the vet i had, he left, and i'm ok with her current vet until we can change) anyways, the vet said she had the bacteria again, they wanted her on science diet something or other, i tried it and she got the worst case of itchies EVER, so i just did a bland diet, basically the exact same idea as the tummy science diet food, boiled chicken and white rice and she ate fine and got better, i did the probiotics from the vets, they helped and the meds. she's all better and we decided to change her diet from home made raw to nature's variety raw. since the switch, she's never been sick again. it's all because of getting good quaility raw meats and veggies i really believe that. i was fine with my home made stuff, but it couldn't provide her with as much variety, i wasn't able to give her nearly as perfectly measured amounts to maintain her weight, and i wasn't sure the raw hamb. in my home made was lasting in the fridge for as long as i expected it to and it could have been spoiling before she ate each small batch. ??? i don't know that, but i like the switch we made!!

my personal philosophy about tummy issues with our pups, and this is simply my own beliefs here...is that vets are amazing for medical stuff, but i don't trust them for nutrition all the time. i take what they say about diets and food with a grain of salt and research and come to my own conclusions about food. they will almost always recommend science diet or royal canin foods...but i don't agree that either of them are the "BEST" for my girl. i'm a raw natural feeder and 100% grain free. both RC and SD are almost fully grain or soy/wheat/corn protien and not meat protiens.

i hope that your poor dog is going to be ok, and that you can use my story to help with your situation in some way. i'm not really sure how much it relates at all, but thought i'd share it anyways.

not all are bright sorry like the one that could not read a cpli test - maybe she cheated her way through college or maybe they do not show you how to read a blood test in vet school i dunno. Or maybe she had a hot date that night and was rushing out since it was before thanksgiving lol.

I have agreed there are some good ones but there are some bad ones too.

I would think it would upset you as well since you do rescue seeing owners turn their dogs over to you because they cannot afford vet care or does this not happen alot?

Linda we will always disagree on this topic as we both feel differently and that is because you have a great vet you love and trust and i think that is great and you should feel very blessed you have that relationship but unfortunately alot of people that come on here are not as blessed as you. I feel lucky to have specialists i have the most respect for and trust completely but have been very disappointed in the vet profession. I do not think that makes either of us right or wrong it is just our experiences and I call it as i see it so if i see something that does not add up to me I will say something.

and trust me i think alot about going back to college to vet school as i feel sorry for pet owners and still young enough to have a second career so you never know but I am very successful at what i do now but i am very passionate about animal health as you can see and why in my off work time i try to help others with what i have learned

Let me know when you get accepted to vet school. :) It boggles my mind that you seem to think you know more than most vets.

I see so much misinformation on the internet and it is so sad, but not going to even go there.

Yep...we surely do disagree. :)

Are you thinking about becoming a Veterinarian?

Off topic...sorry, but I thought it might prove useful. :)

ok u guys; linda and deb please stop arguing. you both are smart and helpful and it's ok if u have different opinions. that's waht makes people unique.
i do agree that those tests should have been done the first time around when she vomitted blood; but of course instead the EC did the bile acid test, ultrasound, kept her for 3 days; so taht was 3000 right there; an endoscopy at that time wasnt necessary they said since they didnt see anything in ultrasound; but u can't see ibd in ultrasound; we live and we learn; i sure did and paid the price for it; over and over again.

i am upset about this vet's high bill; but i am glad that ava doesnt have any issues with her stomach; which was ruled out during endoscopy. vomiting blood is what drove me to accept all these tests. also i agreed to the allergy test because i want to make sure what she can eat what she can't ; i dont know much about this test and i didnt had time to research it.
anyway the biggest concern now is the food; she's not liking this low residue food much.
he mentioned yesterday we can try purina ha; or purina EN
anyone have any info on purina EN
by the way her ears look better today; i think because she was under the blow dryer there for a while.
lets hope she doesnt catch in infection.

actually the blood work didnt include amylase nor lipase
he said he doesnt depend on those values
instead he did the TLI (trypsin like immunoreact) and it was 25 (range 5-35); so that shows normal exocrine pancreatic function
he tested spec cpl it was 166 (anything less than 200) that shows concentration is normal
he also tested her cobalamin b-12 and folate and they were normal

her blood work is mostly clean; except for these (anyone knows what they mean)
HGB and HCT was a bit high
lymphocytes was high 40% (range 12-30%) maybe she needed antibiotic after all
Eosinophil and neutrophil were low
absolute lymphocyte were normal 3360 (range 1000-4800)
absolute eosinophil is low 84 (range 100-1250)

her biopsy result states:
the endoscopic biopsies of the duodenal mucosa contain diffuse infiltrates of lymphocytes and plasma cells throughout the lamina propria of the intestinal villi. the villi are somewhat thicker than normal and blunted as a consequence of the inflammatory infiltrates. the surface epithelium of the villi is intact and there no evidence of erosion, ulceration or neoplasia. the microscopic findings in the small intestinal mucosa are consistent with a moderately severe, diffuse lypmhoplasmacytic enteritis, i.e.. a chronic, idiopathic, inflammatory bowel disease.

it is too bad he did not run a full panel as the amylase and lipase can give you some indication and since this dog had no diarhea the tli was not ever a concern of mine as that is tied to epi which is different than pancreatitis and dogs with epi have diarhea not vomit. I would not do it now though as would be a waste since the endoscopy was done but dogs with elevated amylase and lipase can be an indication of ibd per our internal medicine specialist. I like that he did the cobalamin b-12 and folate as that is a test for sibo which is over bacteria in the digestive tract

EPI in Dogs

but again i think he was trying to rule out epi with the sibo and epi combo which those two diseases the dog always has diarrhea which she does not have. Due to cobalamin b-12 and folate tests being normal may be why he did not give antibiotics after all - did that test come back after he mentioned the metronidazole if so that may be why he did not prescribe it. My question would be why do those tests when she never had pancreatitis as epi is from getting pancreatitis over and over usually. He is being very thorough and someone with alot of money ok but i wish he would have tried to focus on the symptoms of dog and tried to minimize the cost as your dog showed no signs of epi :(

EPI in Dogs

small intestinal bacterial overgrowth

Exocrine Pancreatic Insufficiency in Dogs (EPI)

over using antibiotics is a bad thing and why probiotics should be given while on antibiotics as it kills the good and bad bacteria and probiotics put good bacteria back in so may be why he did not do the metronidazole and i am not a big fan of over using antibiotics myself and probiotics have always worked for dd diarhea episodes of clostridium and colitis so i always use those first.

because her vomiting blood he wanted to rule out as much as he can; he took blood tests when she was admited and he didnt know if she has pancreatitis or not; and he wanted to make sure; i am happy that he was thorough but he's very expensive; i thought he would cut me a break; but he charged for every little thing. he loves his money i know that for sure.

the bena bec gel they gave me is only for 15 days for $20 that's expensive. so i was looking at the purina fortiflora probiotic; anyone here uses it; any reviews on it?
purina has this GI HealthPack that has purina EN canned food and fortiflora. i think i should give it a try. the vet did suggest purina EN next if iams low residue didnt work. ava is not liking the low residue, so i think i might give purina EN a try. but not sure about the fortiflora

yeah your area and mine stink as they charge top dollar :( sad

the tli though did not rule out pancreatitis only epi the cpli rules out pancreatitis - epi is when a dog loses protein through diarhea and they have greasy stools she never had that so honestly that test was a waste :( and i am sure you paid at least $70 for that test alone

nope just had a pm today though from the 4th person on here i referred dds plus to that it stopped diarhea in their dog that had been battling it for a while that stuff works great used it for over 2 years and now that dd is back on it no diarhea love that stuff. 100 capsules for $17 and non-dairy

here is some info on blood work you had

Understanding Blood Work: The Complete Blood Count (CBC) for Dogs

in reading that looks like infection was present - was that test run before the others for sibo?

250 for the GI panel
i am telling u he's very expensive

Elly, I am going to give you the same advice I gave you after the last problem that Ava had. I understand that you are fearful of changing diets and that has kept you from going to a new vet; but, you really need a vet that you can depend on when Ava becomes ill. This was a last minute decision out of necessity....it was this one or the emergency clinic. If you are unhappy with this vet, it is important that you start looking for another one immediately if not sooner!

all vets in this area are expensive; so it wont make a difference if i look; plus i dont know anyone that could recommend a vet; so it will all be trial and error; and to be honest i dont want to keep taking her to different vets and stressing her out. so for now i will keep going to this guy and hopefully she will get better.

Oh, I surely hope she does as well, Elly. I think of her often...and of you. I know how hard this has all been.

I just want you to be sure you trust this vet! Also important is that you can talk with him.... and discuss options for Elly.

i can talk to him; but he doesnt know much about diet; that's the only thing; he even told me; i dont know what diet will be best for her; we just have to try
and my problem with that is i dont want her to keep getting sick everytime the food is no good for her
at least she doesnt need anymore tests; now we know what she has; so if this god forbid happens again; i will just take her for iv and meds for few days.
he gave me an emergency cell phone just in case; the nurse will be able to meet me at the hospital
i just wish he wasnt so expensive; oh well i have to find a part time job :)

i know you just spent a ton but once you save up a bit you may want to consult susan davis Holistic Veterinarian Pet Nutritionist Holistic Pet Care and many really like her on this group and she will analyze all blood work and put together a diet for you and work with you - I think she is $90 for a consult but many who have used her like her so worth a shot but you will have to most likely home cook or she will instruct a diet. It may be worth it to see what she says regarding diet. You do not have to follow but she is a good source of info to gather. I believe she has a degree in nutrition from ucdavis as that is a nutritional vet school.

luvmysissy on here consults her and she is very sharp so you may want to pm her as well she is very helpful and nice

I am sure you will find a food that works! Lots of suggestions on here.

And...wonderful that you can call them if there is an emergency....hopefully there won't be any more of them! :)

yeah he is and i pay top dollar here and it stinks :( but luckily after spending so much i figured out who is good and now have a good team of specialists that work with me and do not charge me as much now which is nice as i try to as much of my own homework before meeting with them and they appreciate it and we work as a team

This vet sounds good just very pricey i just think he shot with a shot gun doing everything at once instead of really focusing on what was really critical and minimizing costs for you since you are in a financial situation I wish he would have been more sensitive to that situation is all. I emailed my friend in New Jersey and asked her to send me a recommendation from her specialists for your area and i googled your area last night and you do not have a ton of options :( The garden state facility is too far which is what my friend recommended :( Just to make you feel a little better loll my friend has 6 dogs and is probably 70k in vet bills in your area :( she has been through the ringer too with her dogs so i know your area is very expensive too like mine :(

for now stick with him try to work with him and keep educating yourself and ask questions but best to fax all your questions on one sheet of paper to receptionist and have her ask him and call you back with answers as sounds like he is busy and rushed and does not have a lot of time this is what i do now and it works great and i think they appreciate it as you are not calling for each little thing - if he has an email or online website with email that might be even better as I email a few of mine and one i have two i have to fax as they do not have email or online websites with email. Hang in there you have some answers and future treatment should be less costly -

just a suggestion as another friend of mine did this if you are looking for pt work you may want to consider a vets office or er 24 hr hospital as then you can get reduction in treatment for her just a thought as that is what i would do first

If I may... What is the original anesthesia charge, how much do they charge for a teeth cleaning alone, and did you approve the cleaning before hand? Original charge for the endoscopy? Did you approve a second biopsy site? How long did they keep her under? And what gas did they use? If they used Halothane, and she survived... cancel the bile acid test. Did they do pre-op bloodwork (before anesthetizing?) Anything amiss with her liver enzymes?

Those add-ons sound like original charges, and I would def question them... the person who put that together on your bill could have been mistaken (usually not the vet). Usually additional charges are fractions of the original charges, like hourly for anesthesia (teeth cleaning takes 20 miutes at most and $100-$150 for an hour anesthesia. Normally would charge less as she was already under for different procedure) Tell him my vet could have pulled all her teeth and put in dentures for that amount (with a gold K-9 or 2)! For the endoscopy additional charge, tell him it's his fault he's slow, you shouldn't have to pay that much extra... usually $50 -$100 for an additional sight and no extra charge for use of the endoscope, and that includes lab fees to process it! Time for taking an additional biopsy: no more than 5 minutes including prep and handling/packaging for sending it to the lab. PS: Ask him if he's in the market for a new endoscope?

As for the allergy bloodwork... couldn't that have been added on to the bloodwork they already had? Some can some can't...worth asking about.

You do have a say and if they won't give you a refund you may be able to at least get a credit on your account for future services.

Also Nutrigest for Dogs and Cats - Pet Health Supplement - Nutrigest Pets you can buy it online cheaper. contains vitamins, minerals, and probiotics.
IMHO, the vitamins/minerals may not be necessary bc with the probiotics/enzymes alone her body will get more out of the food she eats.

I use Nature's Farmacy - Store - Product Details recommended to me by Wylie's Mom. This can be dissolved in liquid and given orally via syringe, or sprinkled on the food. No need to give it prior to feeding. They also carry Probiotic 911 for animals under stress, maybe better for her. Also, the amount given of the first product linked can be doubled for animals under stress.