Snickers is sick....again. (Finally) diagnosed today, but in a lot of pain right now.
 

Just a basic overall: Snickers has been chronically sick on and off since April and we had him at UT last week for two days of diagnostic testing...he had a lot done to him! (He was a little stray and he’s had a lot of problems in the 6 months he’s been with us.They were even a little confused at some of his many symptoms. A lot didn't "fit" together).

Anyway, we just got all the test results back today and what they found was MVD and also an overgrowth ofclostridium perfringins, producing enterotoxin A.

His specialist at UT is Dr. Kirk, who called today and gave recommendations to my local vet. He is to be put on metronidazole for 10 days and then tylosin for a long-term period. She is also going to formulate a special diet for him.

This is what I need help with: Starting Friday, but especially last night, (before we found out the results) he had a fairly bad episode of vomiting and diarrhea...maybe one of the worst he has had yet. (Even though he does not have a fever this time as he normally does). He’s had more successive vomiting than in the past. He was still willing to take food and water and still had periods where he was interested in playing, although he became lethargic quite easily. The diarrhea he had was also worse than usual…a lot of mucous…he had about three accidents inside. Earlier today there was one time where it was completely solid red bloody mucous. I called Dr. Kirk immediately, as that has never happened before.


He was in to see his local vet earlier and was given fluids and his antibiotics.

After we got back from the vet today he seemed to be doing a little bit better. I gave small meals with extra water mixed in and he ate and was energized. He has not vomited again yet today. The last time I gave him food was around 9:00. He ate and then I told him it was time to go outside to go potty. He started trying to go upstairs (probably to see my husband, I thought) so I went to pick him up before he could get up there and felt he was shaking a lot. I carried him outside and he went potty, but did not want to get back up the one and only step he needed to climb to the house. I took him in and since he has been prone to fevers in the past, I took his temperature and it was normal (101). My husband noticed he had a lot of pain between his shoulder blades. We called the vet after hours and he told us he believed the pain was probably in that place from where he received the fluids. He thinks the shaking was probably from stomach cramps and pain and told me to give him 2cc of pepto bismol. I had also given him 1/2 Pepcid 5 hours earlier on recommendation of an on-call UT vet, which my local vet was aware of. He had had a really noisy stomach the last couple of days, up to this morning, but oddly, the past 14 hours or so, it has not been so bad. The pepto bismol did seem to lessen the shakes somewhat, but he does still have them and is seems very weak...or at least is in such pain to where he does not want to move at all.... even to lie down is effort. He did not want to raise his head...just sort of stares at the ground...just generally does not look good. He has been lying in the same spot for an hour and hasn’t moved at all.

Does anyone know what else I can do to make him more comfortable? Or...can you advise me to make me more comfortable? lol. I'm not sure how much I should be worrying (although according to my husband that is not going to do anything).
I'm just not sure what to do, since it is late at night, I've already consulted the vet...he's been to the vet earlier...he has eaten and drank recently. Could his blood sugar be low even after just eating? My husband didn't think it was a good idea to give him any Karo syrup or anything and overload him with sugar if he had food in him.

We had possibly wondered if the Hills i/d they had given us at UT would have upset his stomach at all...both my local vet and the intern I spoke with over the weekend at UT said that was pretty unlikely...anyone ever known this to happen. Initially they told me to mix the i/d with his regular food (which is just a home-cooked, bland diet) but when he started vomiting over the weekend, the girl at UT I spoke with told me to give only small amounts of the hills i/d. It didn't help. They also gave me some Purina e/n...would it be advisable to try this? Is this too many food changes? I thought it would be, but the info from the vets made it sound like changing to or adding these prescription foods should not be a problem...of course, this was a couple days before he started vomiting like crazy.

Any thoughts, ideas are appreciated. I will call again to UT in the morning. Also, is there anyone who has had any experience with a clostridium overgrowth?

I hope this post made some sense (especially as the chronological things happening are kind of confusing). There has just been so many things going on for so long that made this dogs diagnosis difficult. Lots of treatments with temporary results and I just need some support. It's so frustrating that he is getting sick again! Just as we finally think we are getting somewhere and I'm afraid it's gonna take too long for the antibiotics to help and he will lay around sick and I will be here worrying, not knowing if I need to rush him off to the vet after hours and twice in one day or not.

I told this dog on the way to the vet earlier that he was lucky that we were the ones who ended up with him, because a lot of other people wouldn’t deal with his craziness! My husband always says, “it’s a good thing you’re cute, Snickers”. Haha.

Poor little Snickers....and poor you. That is a lot for all of you to go through. He is very lucky to have you and your husband! You are correct that many people would have given up.

Given that he has MVD in addition to the GI problems, managing him might be tricky; but I am sure you will be successful. Listen closely to your vets!

The only thing I might consider if I were in your shoes, is a board certified veterinary nutritionist.

I know it is difficult when they are ill, but it is important for them not to know that we are worried....stress just increases their illness. It is also important to find a schedule for feeding and everything else....dogs do best in environments where there is less stress and where they know what to expect.

I will pray for your little guy and look forward to updates on his progress. :)

I am so sorry to hear that you and Snickers have been going through this.
The only thing I would add is to suggest that you speak with your vet about probiotics/enzymes. Clostridium Perfringens is normally found in the gut of both dogs and humans, however its overgrowth is what causes the production of the toxins, specifically 4 unique types. These 4 unique toxins can combine with other bacteria to produce a host of diseases. The Metronidazole/antibiotic/antiprotozoal will help to eliminate the CP however, these exact properties also eliminate the good-bacteria and natural flora that is already in the tract. To an already compromised system, this could accentuate the symptoms of pain, diarrhea, and vomiting. I would definitely talk with either your vet or a nutritionist, as ladyjane suggested, as I feel that correcting the disease(which is what the vet is doing) as well as helping the tract to heal through diet and probiotics would only increase the rate with which your Snickers would heal.
Once again, I am so sorry that you both are going through this, but I am thankful that he has such a caring devoted owner.
These unselfish qualities of devotion and love to one's pet never cease to be unrecognized and undervalued; except for here on YT. Best wishes, and please keep us updated.

I am sorry Snickers is still not well. Have they tested him for HGE. Cali had it and wa pooping blood, vomiting and very lethargic and in bad pain. I think the blood test they do for it is a PCV or packed cell volume. I hope you can get him feeling better soon.

Oh my goodness....thank the universe this kiddo found you! It sounds like this little stray has found a great family :). Poor guy...this does sound like digestive pain, and that can be miserable. Marcel had this kind of pain as a pup, post-giardia.

I wonder if the vet would be interested in giving him something to soothe his GI, like sucralfate or...? Also, was an ulcer ruled out?

I agree w/ FuFu in terms of repopulating the GI tract bc it's likely very much out of balance. If you have a PetCo near you, they carry BeneBac paste - which is a high-potency probiotic gel - and this can really help at times, esp during stress/sickness. I always pick up the size that's in the small animal/ferret area of PetCo - as I like this size better for yorkies. You get 3-4 small tubes for about $4; I keep BeneBac on hand at all times, in my ER kit - it's nice to always have around.

I so hope he feels better soon! :)

Good advice
 

I think you have gotten good advice here especially regarding probiotics.
Prayers & good wishes to all of you.
Marcy

Thank you all for your replies earlier. After I posted last night, Snickers developed a really sudden fever and he went from a normal 101 to 104.9 in such a short time. That is probably the highest it has ever been and it was so fast, I panicked and really I literally felt sick myself. I called my vet in the middle of the night and he instructed me to give him a dose of Prednisone, which he had given me to have on hand after one of his past fevers back in April. (He has always responded) well I stayed up all night watching him and monitoring his temperature and trying to cool him off with a wet wash cloth on his belly. He was eventually back down to within normal range by about 5 or 6am.

We decided to have me take him back to UT today and so we are spending the night in Knoxville, Snickers in the hospital, where they can monitor him. My husband didn't think he could survive another night like that.

He kept trying to get away from me today when I would try to pick him up to put him in the car, or move him. He yelped when I picked him up after taking him to potty when we stopped for gas. so it was obvious he was in a lot of pain.

By the time we got to Knoxville today, he had a bit of a fever again. Dr. Kirk said when they gave him some pain meds, his fever went down right pretty quick, so it seems to be pain induced. He had another x-ray done today also and I don't think they found anything too much out of the ordinary from that. She was considering doing another ultrasound, but was going to wait and see how the x-ray came out. I she will re-evaluate his condition in the morning and if he is still doing poorly, he'll probably get that done at that time.
She had also said that she had talked to another professor there, who is there top GI guy and they had discussed some of his symptoms.
I guess for me, right now, I am not really understanding how everything fits together...I really feel the need to understand how their two diagnosis fit together and I'm a bit overwhelmed with information right now...I think they are still not sure if they have found everything yet, because they've said all his symptoms and all the chronic stuff is a bit unusual...it's like there is no cut and dry point where they can exactly say, "that is what he has, that's what's making him sick and as soon as we fix that, he'll stop getting sick".

I am just so terrified about something else like last night happening; where the fever spikes to such a dangerous point in the middle of the night so quickly. I think it made me feel very much out of control to see it happen so fast like that....not that I was in control before, but we had been able to see it coming in a different way. This was more sudden and discouraging because he had only been at the vet's a few hours prior and had seemed like he was on his way to healing then he crashed again. I really felt more hopeless last night than I had previously.

Oh, and Dr. Kirk board certified in small animal nutrition. She's the head of nutrition at UT and formulated the diet for Hills l/d. So, as far as nutrition goes, I think we got lucky and got a vet who will know my dog and will have the knowledge to help in that realm. She did mention wanting to put him on a probiotic, but was talking about waiting until after a certain point....something about his diarrhea being what it is...I can't even remember exactly the reasoning, I was just trying to get a handle on all the info. over the phone yesterday...but, I plan to ask her about that again, because I had always thought it was wise to give a probiotic with digestive problems and especially when treating with antibiotics.

I will post when I find out something more...they'll probably try to observe him at least until tomorrow afternoon, I think.

How scarey!!! I will keep you guys in my prayers!

Oh gosh, you poor thing. I will keep all of you in my thoughts and prayers.
Poor little Snickers, I know that he is in good hands, and that they are bound to figure this issue out.

I hope today is a better day for little Snickers.

So sorry to hear what Snickers (and you and DH) are going through. Sending healing prayers and giant hugs your way. :(

So sorry to hear about poor Snickers. If the pain in his neck is not from the fluids, the combo of neck pain and not wanting to do stairs and yelping when picked up could point to Chiari, AAI or even GME. Did they do a spinal tap /MRI? These tests are normally used to rule these diseases out. Oh, I see they did an x ray and may do an ultrsasound. These may show indications and others tests may be scheduled.

Any upset in the digestive tract can cause some blood in diarrhea, and vomiting. Parasites are the number one cause. When the intestines become irritated and inflamed, some of the lining may slough off. The Metronidazole will help to get this under control.

Praying that he can get diagnosed quickly and be put on the right treatment so he can get back to feeling good again real soon!

Oh, poor Snickers! I am just seeing this thread.

An overgrowth of Clostridium is a suspected cause of HGE. Lady had HGE three times in four months a couple of years ago. Very scary.

Hemorrhagic Gastroenteritis (HGE)

In Lady's case, a homecooked diet and adding probiotics was the solution. She never had HGE again. I think having a nutritionist develop a diet for Snickers is a fantastic idea.

I am glad you took him back to U of T. He is in excellent hands. Diagnosing dogs with multiple health issues can be tricky.

Poor Snickers. It is frightening when they are sick and you don't get the answers immediately. At least you are close enough to take him to UT and it certainly sounds like he is in great hands.

And he is one lucky little dog to end up in the home that will love him enough to do everything you've done for him.

Snickers will be in my thoughts.

Poor little Snickers.:(
He is so very lucky to have you for his mommy.
I hope he is soon on the road to recovery.
I'll keep him and you in my prayers.
Please keep us posted.

Many times antibiotics are given then 2-4 hours later, double doses of live human probiotics are given to get the diarrhea under control and repopulate the intestines with normal flora to aid digestion (which should help curb the vomiting). Also flooding the system with probiotics can make it harder for the bad bacteria to remain in the system, as it helps to flush it out by taking up all the living space forcing the bad out. (if that makes sense)

In effect, with the good bacteria taking up space on the intestinal lining, the bad bacteria has no where to attach and gets pushed out. The antibiotics will kill all bacteria, so repopulation with good bacteria (probiotics) is needed on a regular basis to counteract the action of the antibiotics during treatment.

Update on Snickers? I hope he's feeling better.

How is Snickers doing?

I was very touched by your story. Your little guys is very lucky to have you. I can only say that I pray that all goes well with Snickers. And to all the responders I want to say - Thank you - I learned a lot. Very informative!

Snickers Mom
I'm so sorry about your Snickers.
I've been writing on the "Sickness/Emergency" forum and I'm not sure how all these forums work together...no matter...
My almost 5 year old, 5 pound yorkie, Lillymae, was diagnosed with a liver shunt at age 6 months and the vet recommended that we treat her through diet with Hills KD formula. She's been just fine up until a month ago - no vomiting, shakes, pacing, etc. I took her to the vet when she started eating grass and vomiting clear mucus (once or twice in the a.m.) . He told me to start feeding her more often and make sure she eats late at night. That has not solved the problem. For about a month, she hasn't wanted to eat early but will usually eat around noon. Prior to this she would get me up around 6 a.m. running to her food bowl.
Yesterday evening she started pacing and paced for several hours.. she wouldn't play and wouldn't let me hold her. She did, however, walk about 1/2 mile in our usual place this morning. It's after 1 p.m. my time and she still hasn't eaten today.

I'm getting really worried and I want to take her to UT. I'm not really satisfied with my vets here.

I would like to get an appointment with Dr. Kirk at UT. Do you think I could make one or would I need a referral from my vet?



the's

Fifi, I think you need to start another thread and ask about taking Lillymae to UT. If not, then I do think you should try calling UT to see if you can go ahead and make an appointment with Dr. Kirk. I'd call first thing Monday morning.

I am going to have Lillymae and you in my thoughts, please post an update if you get an appointment or not. I can tell you are worried, I hope all goes well.

Hi everyone,
Thanks so much again for your thoughts and prayers and advice. We really appreciate it!
Snickers is home now, and so far, seems to be feeling better. Nothing terribly concerning (or different from last week) showed up on the x-ray and so they opted not to do another new ultrasound. They said that once they gave him pain meds his fever went down pretty quick, so it seems his fever was probably pain induced, from what they could tell. Apparently after the fever went down and he stopped feeling so dopey all the drugs, he was wreaking quite the havoc on the ICU. They said he was quite "rambunctious" and the nurses had to watch him like a hawk the whole time because he kept playing with the tubes from his catheter and getting all wrapped up in them. Sounds like the normal, crazy Snickers I know!

They put him on a whole bunch of meds: He'll continue the Metronidazole until next Wednesday, has 6 days of Clavamox, 3 days of Metoclopramide, a week of Famotdine and 3 days of Fenbendazole with 3 more days to be repeated in 3 weeks. He'll start taking Tylosin next Thursday.

I asked Dr. Kirk about the probiotic and she said the reason she didn't want him on it now was because he had an "open gut". She had also known of cases, although rare, where a dog was given a probiotic when they already had an overgrowth of bacteria or infection and the probiotic had the opposite affect than intended, and then they had an even bigger problem to deal with. I think she wants him to start on a probiotic when he starts taking Tylosin.

Snickers is going to be on Hill's l/d for some time until he is more stable and then Dr. Kirk said she will formulate a special diet for him, if home-cooking is something I am still interested in. I'm not a super huge fan of commercial dog food, but my husband thinks the more "consistent" diet is a better choice. He thinks there is less variables when it comes from a can, I guess. He seems to like the l/d a lot, but I think he likes most anything that isn't crunchy kibble. I still prefer to know what is going into my dog’s food for sure.
Right now we have also cut out all treats. I was giving vegetables or boiled chicken as treats before, but we are cutting out all variables for a little while, until he has been stable with no problems for a few months. Eventually he should be able to have some cooked veggies or cheerios for treats.

The only one good thing that came out of all this chronic illness was that we were able to diagnose the MVD probably a lot earlier than we might have otherwise. They said his problems don’t appear to be related to primary liver disease, but his clinical signs may be increased with having MVD as a cofactor. I’m glad that we at least were able to catch the MVD at a young age so that we are aware of it and can start managing it now. Maybe we can prevent some future problems because of that.


So, I guess, for now, we just have to wait and see how it goes. Hopefully they have diagnosed everything now and there is nothing else we are unaware of. I think they felt he had a lot of unusual things going on and it wasn’t easy to say for sure that would be all, but at this point, they are hoping they have the needed diagnoses to take care of the problem. If he does happen to get sick again, the next thing they will suggest will be endoscopy and biopsy of the intestines. So, praying this works, because we will all be happy of Snickers can stay away from the doctor and any major tests and procedures!

(This picture is him on the way home from the hospital...he really does feel better than he looks by this point!)

You will have to get a referral from your vet. You might be able to make your own appointment time, but they definitely only take referrals in the small animal clinic. See here.

If your dog was diagnosed with a shunt, I don't know if you would see Dr. Kirk...I know when we first went there, we went to surgery first when they suspected a possible liver shunt. After they ruled out a shunt with scintigraphy, they did a biopsy (which later came back positive for MVD) and then sent Snickers to Dr. Kirk in Internal Medicine, because he had a lot of unusual symptoms, GI problems and a slow heartbeat and the liver folks had suspected that one thing he may have could be Addison's Disease, so they wanted medicine to test for that.

If you do go to UT, don't worry, they will send you to the right person for your case, based on the information from your referring vet. The great thing about going to a teaching hospital like that is that there are so many different specialty departments that can draw upon each other for help if your dog ends up having multiple disorders like mine.

Have you been to the yahoo support group for liver shunt/MVD? If not, you may want to check it out. There is a lot of good information there for the specific conditions. Here

Hope that helps and that you are able to get your dog the help she needs as soon as possible! They are really great at UT and have lots of experience with liver shunt dogs, so I think it would be a good place to go.

So happy to hear that little Snickers is doing better! :) Thank you for the update!

If he misses getting a treat now and then, perhaps you could keep a couple of little pieces of the L/D in a baggy in the fridge to give to him?? I do that with a little IBD foster I have. He gets bits of his prescription food and does not know the difference. He just likes that he gets a treat!

Hope things continue to go well...Snickers is a cutie pie! He is so lucky to have his parents who clearly love him SO much! :)

Your little Snickers is such a little cutie pie.
Glad to hear that he is home and doing better.
I will continue to keep him in my prayers.
Please keep us posted.

I'm so glad you let us know how Snickers is doing. He is a doll baby and one lucky little dog to have you and your husband. UT sounds fabulous.

You all have really made me feel so great reading your comments...it's so awesome to be able to connect with other dog people who understand what it's like to be so attached to an animal and care for them so much, that you are willing to do anything to make sure they live the happiest and healthiest lives possible. Some people don't understand it, but I value life so much...especially the life of a little dog who has done so much for me.

I told my mom on the phone the other day that I would rather live outside in a cardboard box with my dog, than in my nice, warm house without him. (Although, I don't know how he would feel about that...he is not a big fan of rain or cold weather).

In regards to treats, he doesn't really need them, except for the fact that I was trying to work on training with him and he is in the S.T.A.R puppy class and Canine Good Citizen...so it's kind of nice to have them just to work on his skills for that. I did find some info on the Yahoo Liver Shunt/MVD support group about how to bake the canned l/d to make it into pieces that could more easily be used for treats, so I may try that. If not, I'll just use the food as is, because he seems to quite like it.