I’ve had quite a few questions regarding Leroy over the past few weeks so today I’d like to take the time to try and answer those as best as I can. While I’ve been sharing most of what we know about his condition I’m sure I have unintentionally left a few things out.
I’ll start with the most frequently asked questions and if I miss anything don’t be shy to ask!
What is Leroy’s diagnosis?
Leroy has been diagnosed with Inflammatory Bowel Disease, Protein Losing Enteropathy and he may also have a condition called Canine Intestinal lymphangiectasia.
Those are a lot of big words and conditions that you may not of heard of so I will do my best to break them down for you. Please keep in mind that this is all new to me and I’m still learning.
Inflammatory Bowel Disease also known as IBD and not to be confused with IBS, is a condition that causes inflammation in the intestines. Basically inflammatory cells invade the wall of the stomach or the intestines. This inflammation causes the intestines not to be able to absorb nutrients as well which can then lead to diarrhea, vomiting and weight loss.
IBD can be seen in any dog but is more commonly seen in middle aged and older dogs. There is normally no specific cause of IBD but sensitivities to certain foods and allergens are common.
There is no cure for IBD but in some cases it can be controlled with medication and diet but we will get to that in a minute.
Protein Losing Enteropathy also known as PLE is a condition where protein is lost through damaged intestines and it leaks out in the body and can cause diarrhea, edema, weight loss, lethargy, difficulty breathing due to fluid around the chest, vomiting, muscle loss and lack of appetite.
PLE can be caused by IBD, allergies, a problem with the lymph system, cancer, bacteria infections and several other gastrointestinal issues. PLE can be deadly if if not treated and can greatly shorten the life of a dog even with aggressive treatment.
PLE can be seen in any breed of dog but it is said that some dogs may be more prone to it such as the Soft Coated Wheaten Terrier, Basenji, Yorkshire and Norwegian Lundehund.
Leroy also has hypoalbuminemia, which is low albumin levels. Albumin is a protein that is formed in the liver and carried into the blood. Albumin regulates blood volume by controlling pressure in the blood compartment. It is a very important protein in the body and low albumin can be very dangerous. Leroy’s albumin was almost as about as low as it could go at 0.9. It was dangerously and scary low. Normal albumin usually ranges between 2.6-4.0
This is another condition that can be seen in any breed of dog and can be caused by many different things such as chronic liver disease, malnutrition, lymphoma, IBD, pancreatitis and several other conditions
There’s also the possibility that Leroy could also could have lymphangiectasia, secondary to the IBD.
Stay with me folks. We’re almost done.
I know it’s a lot to take in.
Believe me….I know.
So Canine Intestinal Lymphangiectasia or CIL is the dilation of the lymphatic vessels in the gastrointestinal tract-stomach, small and large intestines. The lymph vessels circulate a fluid called lymphs that contains white blood cells(lymphocytes). This fluid moves through the lymphatic vessels and picks up bacteria and other things from body tissues. The lymph also transports fat from the small intestines, empties them into the blood which then returns fluid from the tissues back into circulation.
When the lymphatic vessels become dilated it can obstruct the vessels resulting in a loss of proteins through the intestines.
Causes of CIL can be cancer, heart failure or a blockage in the lymphatic vessels
CIL can be seen in any dog of any age or breed but it is said to be seen mostly in Soft Coated Wheaten Terrier, Basenji, Yorkshire and Norwegian Lundehund, the same dogs that PLE can often be seen in.
So we know for sure Leroy has IBD, confirmed by the GI scope and biopsy. The IBD most likely caused the PLE and the hypoalbuminemia. We do NOT know for sure if Leroy has lymphagiectasia because that diagnosis would require several deep tissue samples from the intestines. He would have to be opened up and because of his issues with his albumin levels there is no way that his body would be able to heal itself from that type of procedure. I will not put him through that when he is stable either.
Treatment is ultimately the same as what we are in the process of doing which includes a prescription diet that is low fat and highly digestible. Everything that goes in needs to be low fat and easy to digest. We are currently working with a nutritionist to help us in this process.
It’s also recommended to do a novel protein with IBD but since Leroy has been on most of the more “common” novel proteins over his life span we would really have to step outside of the box to get to that novel protein and that could potentially cause more issues.
It’s all trial and error. No dog with IBD is the same and treatment and the outcome varies greatly between dogs.
So how did Leroy get to this point?
Leroy’s been sick on and off since his surgery to remove rocks from his stomach back in January. A few weeks after Leroy came home from his surgery he began vomiting one evening and seemed very sick so we took him into the vet and it was determined that he could be having a reaction to the antibiotics he was on.
After Leroy was taken off the antibiotics he seemed better until a month or so later when he began to develop edema in his back legs and abdomen. Back to the vet we went and it was thought that the most likely cause of the edema was a reaction to something like a bug bite OR less likely, a problem with the lymphatic system. Leroy was given a course of steroids and the edema went away after a few weeks.
Following that, a few months, Leroy started having intermittent diarrhea. Back to the vet we went and it was suggested that Leroy may just be having some issues from the surgery and we needed to settle his gut down. So probiotics and a bland diet was started. The diarrhea continued on and off and then the edema began to come back so we went back once again to the vet.
That’s when we found out that Leroy’s liver values were a mess and that he had low albumin. Treatment began for the liver issues and after a week or so there was no change in Leroy’s condition so it was determined that we would get an ultrasound done of his liver and a second opinion because the diagnosis of end stage liver failure began to be thrown around which was crazy to me seeing as his levels were normal a few months prior.
In between the time that I made the appointment for the ultrasound and the actual appointment date, Leroy’s condition greatly worsened and he was admitted to the ICU at the hospital where I was going to be taking him for his ultrasound and second opinion.
Leroy was considered to be in critical condition at that time and several tests were in the process of being done. Within 24 hours it was determined that Leroy did not have any issues with his liver or kidneys which left severe GI disease, which was confirmed by several tests and an upper and lower GI scope along with a biopsy.
Seriously Jen, how is Leroy doing now?
Seriously guys, as of Friday Leroy continues to improve but I’m still scared to death. His albumin is still rising and is at 2.3 and is almost back to normal! . His total protein levels are in the normal range! He dropped another 14 pounds and is currently weighing in at 121 pounds which is very much underweight for him. We’ve been given the go ahead to start him on the low fat prescription diet and try to very slowly get some weight and muscle back on him.
The diet is Royal Canin Gastrointestinal Low Fat. We will be using the dry and canned formula. I would be lying if I said I wasn’t nervous about feeding this food but right now the goal is to get Leroy stable and if this food does the trick than great! I’m not fussing about the ingredients because I prefer to have an alive Leroy than a dead Leroy. It sounds harsh but that’s the point that we are it.
Chances are this food will not work for him forever and we will have to switch to something else but from what I’ve been told, if you find something that works for an IBD dog than stick with it. Right now we hope that this food will help to stabilize Leroy enough to the point that he starts to safely gain weight.
I’m not messing around. I’m going with the proven facts and licensed specialists on this one.
If this diet doesn’t agree with Leroy will move on to a home cooked or a hydrolyzed protein diet.
We were able to lower his steroid dose but he will remain on these for an undetermined amount of time, hopefully with small decreases along the way.
So his current meds are Famotidine, Prednisone, Folate and B12 injections once a week. He is also being treated for an ear infection and we are still treating his pressure sores which are slow to heal due to his low protein levels and steroid use.
We are getting there. The vet said it’s a very good sign that Leroy’s levels are rising already. With some dogs, especially large dogs, it doesn’t happen that fast.
It will be an extremely slow process with bumps in the road and adjustments. There’s no cure for what Leroy has but with any hopes we will be able to manage his condition and provide him with a long, happy, healthy life.
Leroy has a lot going on and the odds are not in his favor to make a full recovery from this but it’s not impossible.
Next recheck is in 4 weeks. Until then we start the new diet and hope his body excepts it. We lower the pred dose and hope his body is ready to do some work on it’s own.
We hope and we hope some more.
Is Leroy playing with Sherman again?
Lol. Not exactly but he is annoying Sherman when he remembers to do so….like humping him when he tries to get a drink of water.
The boys are back to taking walks together. Short walks.
Has Leroy gained any weight?
That’s a negative but the weight gain will be slow as he needs to be on a low fat diet. Slow and steady wins the race. 🙂
Is there a chance Leroy could have cancer?
There was no evidence of neoplasia on the upper and lower GI scope and nothing seen on the biopsies that would suggest cancer at this time.
Do you think Leroy had IBD before his surgery?
It’s super hard to determine that but it is a possibility that Leroy had IBD which is why he ate the rocks and was stubborn about eating his food sometimes. Based on him having a history of abdominal x-rays due to rock consumption that spans over several years and routine bloodwork done at least once a year he did not show any clinical evidence of suffering from IBD. And believe me, I’ve went back and studied his records and nothing would point in the direction of IBD or any other conditions.
I hope this answers some if not all of your questions about Leroy. Please feel free to ask if I didn’t touch on something you wanted to know and I will do my best to give you an answer!
p.s. Some people have asked why Leroy looks so skinny in some pictures and not so much in others. It all depends. My phone camera sucks and so he always looks super skinny in those. Sometimes it depends on his facial expression and sometimes it depends on the angel that I’m taking the picture at. I can assure you he is super skinny and has muscle atrophy in every part of of his body.