PLE ?

[mjacob]

Nellie was adopted from the SPCA in 2009, a healthy beautiful whippet mix weighing 25 lbs. and only 9 months old. After bringing her home she quickly lost 6 lbs. and was skin and bones. Lots of test and food trials later she was finally diagnosed with EPI and started enzymes. This is when I searched out this forum and I know you have all been through the same struggles. She’s now 13 and has faced her share of challenges that we’ve been able to help her with. Until now her issues didn’t seem life-threatening but now she’s losing weight again. Nellie had been at a healthy weight between 34-37 lbs. She’s back down to maximum 27 lbs.
Her daily intake: Natural Balance Limited Ingredients Salmon & Sweet Potato, ¾ c. twice a day mixed with ¼ tsp slippery elm bark, 1 tsp. enzyme Diane, sits for 30 minutes in warm water. Morning meal is topped with a full capsule of Pet Factor B-12 each day. Each meal is preceded with ½ tablet of 75 mg carprofen.
FINALLY found an amazing vet that has taken an interest in helping sweet Nellie. In the last month we have had 3 panels of blood work and an ultrasound. She is now on a month-long regimen of steroids (oh my she can drive us crazy). We’re not quite half-way through. The blood work showed a low level of protein so the vet is thinking PLE? The ultrasound showed “increase of free fluid in abdomen”, “colon: angry, thick, inflamed” (which is why I think she is getting steroids), and the “exit of stomach is thicker”.
She often throws up a liquid mucous mix which is why we started the slippery elm and B-12. And when she gets excited she’ll often gulp it up in her throat, now doing this even in the middle of the night so she has a very sensitive stomach. It had significantly improved until the steroids. She isn’t throwing up her food though.
Please if you have any thoughts or suggestions I am all ears. I can’t let her down, please help. Thank You!

[jilbert57]

I am sorry your sweet whippet is having issues. I have sent a message to this sites founder who has familiarity with PLE.
Welcome.

Jill

[mjacob]

Thank you Jill!

[Olesia711]

Hi Maria,
I am so sorry that your Nellie is struggling with this

What you described sounds like this can be secondary PLE which is usually managed by diet (low fat) and meds.

THe primary drug for PLE is Prednisone or Prednisolone (steroids) which is what your dog is on... yes? However....if i understand your comment correctly, the "regurg" has gotten worse since the pred has been implemented?

The slippery Elm should help, i personally found that it actually it works better than carprofen..... are you giving Slippery Elm with every meal? if not, please do so to hopefully help with the "regurg". "when she gets excited she’ll often gulp it up in her throat, now doing this even in the middle of the night so she has a very sensitive stomach. It had significantly improved until the steroids. She isn’t throwing up her food though."

It sounds like your vet is doing what is recommended for PLE, .... but... if this regurg continues and if it is from the pred.... then ask your vet if maybe he/she thinks prescribing Cyclosporine in addition to the pred so that "maybe" lower the dose of pred.... or....what might happen is that just by adding Cyclosporine this may help alleviate the regurg...............

i hope these suggestions may be of some help to you........

Please keep us posted!

[mjacob]

Thank you for reading my long post and giving me some hope that we are going in the right direction.

Yes, Nellie is on prednisone 20 mg. Will this help her to retain protein and build her weight back up?

Nellie does get slippery elm with every meal. Maybe 1/4 tsp isn't enough?

She started carprofen about 10 years ago, she started yelping and crying when she ate or if she barked. X-rays didn't show anything and her vet said the next time he sees me I'll be asking to "put her to sleep"! Went to another vet (of course!) and he recommended carprofen and the rest is history. Every once in a while I'm asked to try not giving it to her and when I stop even 1 dose she yelps when she eats. I can't be for sure what is going on but since this has helped her for 10 years and her kidney is ok I'm not complaining.

Well you know our pups have quite the personality, and Nellie is no exception. She is kind of emotional and gets upset or excited easily. For instance if she is standing at the door to go out and I can't get to her as quickly as she would like she will spit up fluids. Thank goodness for hard floors! So I have learned that her stomach is quirky and I was thinking the steroids have made her emotions a little wacky. I know her appetite and thirst has increased. I was thinking of keeping some carrots and corn on hand to give her a little something in between meals and before bed.

I'm going to keep in mind the Cyclosporine. Thank You!

[Olesia711]

WOW!!!! If the carprofen has helped her that much and for that long.... i wouldn't change it either.

Regarding the Slippery Elm i would not increase it as too much can trigger also loose stools.....

Since she is having regurg episodes in the middle of the night.... do you or can you give her a few bites of something just before bed time to "maybe" alleviate this.. or ask the vet (since i am not sure if this woud be okay since she is on carprofen and with the possibility of PLE also going on..........) if adding something like a low dose of Omeprazole or Pepcid ac or Cholestyramine would be okay to try....... (Cholesryamine is an old drug thta is making a comeback and one that thy used to use successfully with EPI dogs to handle the acid reflux issue in EPI dogs..........

[Patsy]

Your vet sounds sensible, and adding an antacid would help, if you check with them for the dose . With the inflammation I would not give any carrot or sweetcorn. Being indigestible, they could irritate or cause blockages.
My dog had PLE when she started EPI. The PLE almost caused organ failure. Protein and Fluid in abdomen and chest cavity which can stifle the breathing and heart. BUT with prednisone she pulled through and epi enzymes worked their magic.
Marti didn’t have regurgitation. I wonder if you need to give three or more smaller meals to spread the quantity going through the gut? This helps for humans suffering from IBD who can tell us how they feel. Our pets are so dependent on us.

[Olesia711]

Thanks for your input Patsy... great suggestions with the smaller meals.............

[mjacob]

Oh my, I didn't realize the corn or carrots could cause such a problem. I gave her two snacks of corn yesterday, one in the afternoon and one in the evening. Is there anything else I could use for a snack that would be safe?

Three meals isn't easy to do with my work schedule. In addition it adds extra meds, supplements .... I know that's a small price to pay but I'm already $1500 in vet bills in the last month. And in the end, I just can't envision being able to give 3 small meals a day, every day.

Tried antacid a couple of years ago for the reflux and it didn't help. It was prescribed by the vet and over the counter. I can ask again. But the regurg had subsided for the most part until the prednisone started.

Why do some folks give antibiotics?

What else can be done for PLE, if that's what it is? How do I stop her from losing weight?

I know you all have so much experience and this is an amazing resource. I'll figure out the 3 meals if I have to. And look into the antacid also. Grateful to all of you and relieved to also have a vet that finally seems to care! God Bless!

[jilbert57]

Hi Maria,
Antibiotics are given because most all dogs with Epi also have SID(Overgrowth of bad bacteria in the gut) we recommend a 45 day course of 2 times a day Tylan.

https://epi4dogs.com/sidsibo-in-brief/

Are you still supplementing with oral B12 or injections daily?

Thanks
Jill