![Mr. Green :mrgreen:](./images/smilies/icon_mrgreen.gif)
I have a new little looney toon, Rylee. She is currently 6 months. Lab.
Since age 3 months, she's had 3 GI bleeds. The first was days before what turned out to be a partial intestinal blockage. Weather stripping foam. They said, ah. That explains it! The foam was churning around inside and caused irritation that formed an ulcer. That was treated, came off the meds and was fine (still recovering to do, but the black poops stopped). For the 2nd and 3rd bleeds, there's no explanation for those. After the 3rd bleed, we tried coming down off the meds, and acid reflux was terrible. Had to go back on meds. Vet just said keep her on Omeprazole for now, rather than dealing with the reflux or risking another bleed. (Was/is also on slippery elm, at different times of the day).
About 2 weeks ago everything started getting much worse. The acid reflux was terrible, despite the meds. (Slightly improved when going back to 4 meals a day. But still have problems in the mornings). Days that she plays too hard, she'll puke a lot. Mostly undigested food. The other problem starting at that time was her pooping out a lot of undigested food. Massive poops full of food. (Poops are pickupable, but Massive and too much food).
Today we went to Dr. second opinion. I went in armed with 2 poop samples. Tech took the poops back and the vet looked at it before coming to meet us. She came in showing an estimate for GI profile and started to try to explain it. I said let me help you out. I do know how to spell EPI. She was shocked and said yes, that's exactly what I am thinking. I said I don't believe it's EPI, because she's able to maintain weight; albeit with a LOT of food. I am not certain any EPI dog could. She thinks it's a lot more food than a dog her size should require to maintain weight. But this little looney toon has an insane amount of energy. And I highly doubt she could have that much energy if B12 were low! She burns a lot of calories.
She said the other possibilities were lymphangiectasia (never heard of that) or extreme food allergies. She said those almost never start at age 3 months, but it's not impossible. (X rays in December, although not diagnostic, did not show signs of inflammation. Intestines, stomach, heart, liver, etc, etc looked normal)
She's about 80% certain it's EPI. (I'm about 80% certain it's not). But my other boy went undiagnosed for way too long because the vet thought it unlikely. If I ever had a dog that went undiagnosed for long because I think it unlikely when a vet thinks it is, it's my fault. I could never forgive myself. Ergo, I likely will have the tests run after Easter. I'm still thinking it's somehow related to her body trying to recover from the foam. Possibly SIBO brewing after that; made worse by antibiotics given for gum infections from teething (she had terrible time teething. Still has minor irritation in the gums. But mostly completely healed).
She prescribed Tylosin for a week just to try to see if it could help if there is a bacteria issue that caused enough inflammation that digestion was affected. (I still have Tylosin nightmares from Chance. It scares me. But I have to remind myself that his reaction to it was abnormal. For him, Tylosin was much worse than SIBO ever could be. It was the stuff of nightmares). She did state that she's against prescribing it to a growing puppy; but said the risks of malnutrition would be a lot worse.
We had blood work to rule out pancreatitis. And poop samples going out to rule out any possible parasites that managed to survive all the de wormers. (We both think it highly unlikely; but worth ruling out). Although I am very largely opposed to prescription diets, I am also considering switching to a hydrolyzed hypo allergy food, just in case. So for the weekend, trying Tylosin. Possibly running EPI test after Easter. Next would be a specialist running a full ultrasound and switching foods.
I have NOT tried enzymes, largely because I am terrified it would make the acid reflux worse. Again, I don't believe it's EPI. but sometimes enzymes can help other things.
If I don't see improved digestion soon, I might have to give in and try enzymes. She's been on probiotics since before I got her; and especially after the blockage and after antibiotics. (Tried a few probiotics, but have yet to find the magic one). Gave Cerenia tablets to help with vomiting on her bad days. It really helps. Said to give it for a few days, giving Tylosin a chance to do its thing.