This is a more detailed post of what is going on with Leroy. I like to write these posts because it gives me something to refer back to when medical issues come up and it also might help someone else who has a dog that goes through similar issues.
Leroy’s having an IBD flare-up. This flare-up is different than the little ones that he has periodically because his albumin is low. This flare-up is similar to the worst of the worst that he had a little over 2 years ago.
Leroy started having diarrhea about a week ago. He started off with soft stool that turned to water. Water meaning a forceful amount of liquid that came shooting out of his butt like a fire hydrant. I started a bland diet and Metronidazole immediately and gave it adequate time plus one day to take effect. (The plus one day is because I have a tendency to jump the gun.) I saw mild improvement for one day but then it reverted back to bad so we set up a vet appointment. Leroy was eating and acting fine most of this time. He’s a Newfoundland so he’s pretty stoic. Friday night he refused his food and was acting a bit sluggish.
Leroy’s appointment was Saturday morning. it included an exam, gram stain, and full blood panel. Gram stain showed mild bacteria which we expected, with the exam there were no significant findings and bloodwork was all good except the Albumin was 1.4. Normal is usually above 2.6. Weight was good at 150 pounds. Our regular vet was booked for 2 weeks so we were seeing a rookie vet. When I say rookie I mean just out of vet school within the last few months. I’ll be honest, this made me nervous. I know we all have to start somewhere but Leroy’s a “complicated” case so the most I could hope for was that she thoroughly reviewed his chart. She was great and we were lucky because Leroy’s regular vet just happened to be in the office at the same time so she was able to refer to him for a game plan and she told me she referred to him so whew!
Prednisone, Metronidazole, Probiotic and Vitamin B12 shots for at least 2 months. Recheck albumin in 3 weeks.
Now let’s talk about Albumin and why it’s not good when it’s low.
Albumin is one of those things that you really don’t pay attention to until there’s something wrong with it. You might never know what exactly it does if there’s not an issue with it and that’s a good thing.
Albumin is an important protein formed in the liver and carried into the blood, it is responsible for regulating blood volume by controlling pressure in the blood compartment. It is also important for retaining fluid in the vascular compartment. A lack of albumin can be life-threatening and can include dangerous fluid buildup.
Low albumin is called hypoalbuminemia. Hypoalbuminemia can be caused by a number of things but in Leroy’s case, it is caused by IBD. Leroy loses protein due to inflammation in his intestines. The protein leaks out into his body causing watery diarrhea and sometimes fluid build up (edema) in his extremities such as legs, stomach, ears and around the lungs. Because the protein is being lost and not absorbed he’s not getting the nutrition that he needs.
Back In Time
When Leroy had hypoalbuminemia 2 years ago, he had it bad. They had drained over 10 liters off of him in one day. The reason for this was because it went undetected for so long. (Our previous vet was treating the edema as an allergic reaction.) By the time he was correctly diagnosed he was almost drowning in fluid. It took Leroy over a full year to recover from that, but he did recover. This is why it’s so scary for me. Hypoalbuminemia can come on fast or over a long period of time.
Treatment of Hypoalbuminemia
Treatment depends on the cause. In Leroy’s case, we need to address the inflammation in his GI tract because it is not absorbing protein, it is leaking out into his body. The best way to do that is with a steroid. B12 injections are given so that he doesn’t get malnourished because his body is not absorbing any vitamins or nutrients. Metronidazole is to help with the overgrowth of bad bacteria in his gut. Physical therapy. It’s not really physical therapy but for Leroy, it’s key that he goes for walks a few times a day to keep the fluid from settling in one spot.
The Good News
I was pretty discouraged on Saturday. I felt we had taken a giant step back with Leroy’s health and felt defeated but many of you made comments that made me see the light. We caught this pretty early this time around. While Leroy does have protein floating around in his body he does not have a large amount in his stomach and there is no evidence that it is around his lungs. There are no signs of it accumulating in his legs. There was a little in his left ear but that has since gone down. We just had Leroy’s albumin checked 2 months ago and it was normal so this came on pretty fast, probably within the last 1.5 weeks based on his symptoms. We have months of treatment ahead but as long as we keep rechecking and monitoring we should be able to keep it from getting worse. We’ve been pretty careful with Leroy’s diet so I’m not exactly sure what threw him into another flare up. Maybe it was the loaf of bread he ate at Thanksgiving or the 2 french fries he got. I don’t know.
I’m hoping that as the inflammation heals and the leaking fluid drains out that Leroy won’t experience much weight loss. It’s too early to tell but it might not even be noticeable this time around.
I can’t begin to thank you all for your kind words and support. It means the world to all of us here and it really lifted up my spirits. I hope this helps you understand things a bit more. I know it helps me when I can write it out!