Ava is sick and in hospital again; GI problems

[ladyjane]

Originally Posted by dwerten

actually the number one cause of colitis is stress

Colitis in Dogs

ibd info

Inflammatory Bowel Disease in Dogs

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

[ladyjane]

Originally Posted by dwerten

the endoscopy was to determine if large or small intestines but sadly you do not need that to determine this as a dog with ibd in small will vomit and in large will have diarhea this is why i opted not to do the endoscopy with dex as i knew it was small intestines as he never had diarhea like ava has not

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.

[dwerten]

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

[dwerten]

Originally Posted by ladyjane

My point was that you said the endoscopy was to figure out if it was large or small intestines and I beg to differ on that. The test was done to get a diagnosis and yes, if ibd, where.

I already had stated my opinion on the blood test for allergies. I think the vet is just covering all angles...I do NOT think he is money hungry...just looking for answers. He is going to do whatever he is allowed to do. That is why people need to question the whys of everything. This is the FIRST vet who has done for Ava what should have been done imo. Good grief, Banfield diagnosed pancreatitis from what Elly said...and there were no labs to support that from what she said.

I would not be dumping this vet if I were her. I would simply start questioning him a bit more and letting him know my pockets are not that deep.

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

[ladyjane]

Originally Posted by dwerten

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.

[dwerten]

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?

[dwerten]

Originally Posted by ladyjane

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.

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

[ladyjane]

Originally Posted by dwerten

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.

[RachelandSadie]

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.

[dwerten]

Originally Posted by ladyjane

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.

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

[ladyjane]

Originally Posted by dwerten

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.

[ladyjane]

Are you thinking about becoming a Veterinarian?

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

[ally173]

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.

[ally173]

Originally Posted by dwerten

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?

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.

[dwerten]

Originally Posted by ally173

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)