Last week Leroy started with an IBD flare-up. It’s the first flare-up in quite a while and I know it’s not the last but every flare-up is scary and different.
I had a feeling that it was coming because I felt some edema on his right ear flap. I kept a close eye on him as soon as I noticed but everything else seemed to be fine until he had a bout of diarrhea on our walk in Friday.
DO NOT PANIC
DO NOT PANIC
Is all that went through my mind as I stared at the pile of loose stool splattered on the sidewalk in front of me.
I was talking on the phone with my mom and she could tell I was frazzled so we said goodbye and I anxiously walked home.
Part of me wanted to just load Leroy up in the car and drive him straight to the vet but by the time I got home I had calmed myself down I went and checked the backyard to see if I could see any signs of when the diarrhea might had started. On my diarrhea exploration I found one pile of diarrhea which led me to believe, since I just did a full poop scoop 2 days prior, that the diarrhea had started in the morning.
Next I went, upstairs and grabbed the Metronidazole and began the emergency diarrhea protocol.
When Leroy has an IBD flare-up we either have an emergency diarrhea protocol or just a diarrhea protocol. The difference is if he is showing signs of edema. If he’s showing signs of edema and has diarrhea that means that things can go very bad very quick because the Lymphangiectasia is rearing it’s ugly head and it needs to be addressed and handled.
For those that are unfamiliar with Intestinal Lymphangiectasia, it is an intestinal disease in which the ducts carrying lymph leak protein and other substances into the intestinal tract. This can cause, abnormal fluid accumulations and weight loss. It can be a life-threatening condition if it’s not addressed as we learned the hard way 3 years ago. Leroy’s Lymphangietasia is secondary to his IBD, or so we are told.
So when that happens here is what we do:
Contact our veterinarian. The most important thing is to make contact with our veterinarian and discuss our options. In this case, since the diarrhea had just started and Leroy was still eating, the veterinarian felt that we could start the medications we have at home and give it the weekend to see if things improved.
Start Metronidazole. Metrondidazole ia flaygl and it’s like an antibiotic for the bowels. We always have this on hand in case of diarrhea.
Withhold food for 12 hours. This is an important step because it allows the bowels to settle down and have a rest. If you continue to feed a dog that has an upset stomach the inflammation doesn’t have time to settle down because the food keeps irritating it. Then add food gradually. You don’t want to feed the regular amount, you want to start off small and slowly increase to make sure that they can tolerate it. We usually start off feeding Leroy about 1/4-1/2 amount of his regular feedings.
Start a bland diet. Leroy’s already on a bland prescription diet but we have to get even blander and we have to keep his diet low-fat and low protein. Why? Because when fat is consumed it’s transformed into lymph. ( Lymph is the fluid that circulates throughout the lymphatic system). The lymph has to be carried through the ducts in the intestines but since the ducts are blocked the lymph has nowhere to go so it begins to build up in the intestines and then in the body.
By limiting a dog’s fat intake, we can reduce the amount of intestinal lymph that is formed, which reduces pressure in the ducts. Less pressure means less lymph leakage and a reduction of symptoms. The lymph that leaks into a dog’s intestines with Lymphangiectasia also contains a lot of protein so we want to limit that loss by limiting the amount of low quality protein that is being consumed. Any protein that is consumed should be of high quality.
We chose to do boiled chicken and rice because Leroy tolerates it well. As soon as his poop starts to firm back up we will add in mashed sweet potatoes in place of the rice since sweet potatoes contain many key vitamins that need to replenished in Leroy’s body in case they were lost. Treats all get cut except for his CBD/Hemp treats and fat-free/salt free rice cakes. Once he starts to get better I sometimes add in a little fat-free whipped cream to the rice cakes so that he doesn’t think that his life totally sucks.
Increase walking. In the winter our walks vary, if the weather is bad I tend to slack off. If Leroy is possibly having fluid build up and is physically able to walk, we walk to keep him moving. We’ll do short walks a few times a day. One thing I really pay attention to is that his legs aren’t swelling. If his legs are swelling he has a hard time walking and standing up and that means the fluid has moved to his limbs. In this flare-up there has been no fluid in his limbs which is great.
CBD/Hemp Oil. This will be the first time that I’ll be using CBD oil to specifically treat Leroy’s IBD so I’ve increased his dosed of treats and oil. Why? In current studies taking place, CBD has been shown to reduce inflammation and help intestinal disorders in dogs. If I can reduce Leroy’s inflammation by using a safer product like CBD/Hemp oil instead of steroids that would be wonderful and much better for his body.
Monitoring, monitoring, monitoring. It’s imperative that I monitor Leroy’s condition closely. I check his stool every time he goes and I check his legs for fluid build up several times a day. I make sure he’s eating and I check his vitals at least once a day. I check his vitals to make sure he isn’t having labored breathing which would be due to fluid accumulating around his lungs.
Probiotics. Leroy’s on a daily dose of probiotics year round to help keep the good bacteria in his gut.
The wrap-up. Leroy seems to be responding well to the treatment. His stool, while still a little soft, is almost back to normal and the edema in his ears is basically gone. He’s maintained his appetite through this whole flare-up which is great. As long as he continues to move in the right direction my next step will be to take him in to have his albumin levels checked to make sure that his protein levels are where they need to be.
Leroy has a scary condition and since Lymphangiectasia can be fatal if unresponisve to treatment, it’s taken me quite a few years to feel confident in the choices that I make for him on a daily basis. The more that I know about the condition and how Leroy reacts to the treatment increases my confidence that we can fight this disease successfully for years to come.
The reason why I share this information is not to give medical advice to anyone who is dealing with Intestinal Lymphangiectasia, but to share Leroy’s story and what has worked for him. There’s not a lot information out there about Lymphangiectasia and treatment seems to vary greatly from dog to dog. If 1 thing I mentioned here helps another dog, than that is awesome.
**As of 3/18/18 Leroy’s albumin was 1.7. Low normal is 2.6 in dogs. We’ve started him back on a full dose of steriods and have been able to adjust him down to 10mg once a day. We’ll recheck his levels again at the end of April. Everything else looks good and he’s maintaining his weight at 150 pounds so we’re hopeful he’ll rebound once again.
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He is certainly lucky to have someone who loves him so much and puts so much time and energy into figuring how to best handle his fragile issues. My mom would do the same if we had something going on, but so many wouldn’t expend the effort. We hope he continues to improve and is back to himself soon.
Thank you for the kind words! I know that your mom would do the same for all of you! <3
When our dogs aren’t at their very best, our world spins out of control. Your dogs are blessed to have you, and we are fortunate that you continue to share your IBD journey so that others can benefit and learn from your experiences. Thank you for sharing and best wishes for a speedy recovery Leroy…
That’s so true Cathy. In a way I feel like I’m always on the look out for something to go wrong with them. My biggest fear is Leroy getting as bad as he was and me missing something. I don’t want that to happen again.
Is there a specific test for this disease? My sister in law has a gsd that they have tested for everything and he is still suffering from diarrhea and has lost about 11 pounds. He is also 11 years old, very frustrating and scared.
They usually do a GI scope and intestinal biopsy do get a diagnosis but they also use symptoms and results of others tests from my understanding. Leroy had a scope and biopsy done about 3 years ago.
“Once he starts to get better I sometimes add in a little fat-free whipped cream to the rice cakes so that he doesn’t think that his life totally sucks.” – I laughed out loud here. As I was reading everything you do during these stressful flare ups I kept thinking “Leroy must hate this even more than Jen”. So bless you for being diligent and giving him a sunny spot. Nose bumps.
He seriously gets so bummed out when he can’t have his regular treats but he does love the boiled chicken-at least for a few days until he tires of it. Hahahaha
I don’t think I realized that Leroy had two different conditions going on. It sounds like a lot to deal with, and I admire that you have a clear plan in place. But I can also imagine how stressful it is while you’re implementing that plan, and waiting to see if it works. I’m so glad for you that it seems to be working, and hope that continues. You are a great dog mom. ♥
Thanks Jan. He hasn’t had a flare-up of the IL since he was first diagnosed. Some dogs go into remission for several years and then it comes back so while he has had a few IBD flare-ups that I talk about I haven’t mentioned the IL that much. It’s taken me a while to understand the way it works!
OMG, Jen, my heart sinks every time I read that Leroy is showing signs of an IBD flare-up. I’m so glad you caught it early and were able to help him fight it off.
I’ve never heard of lymphangiectasia. Thank goodness you know how to “tackle” it for Leroy! Give your boy a kiss for me and yourself a hug!
Thanks so much Sue! I know you can relate-it makes me so worried but I think we did pretty good with it this time!
How’s Leroy feeling now? Is he over the worst of the flare-up? I’ve been thinking of him – and you – since Shadow had a bit of what I call a “stress poop” on Sunday afternoon. She was back to normal later that day, but it still concerned me. And I thought about Leroy’s “issue” and thanked God that Shadow was back to her “old” self already. I hope Leroy’s back to his “old” self again by now. More kisses for him and hugs for you.
BTW, I thank you in my thoughts almost every day for having (nicely) told that one person off about the food I give both my girls. It was a LONG time ago, but your response that day made me feel a lot better about the food. Of course, I look at it and ask myself “how can they eat this *hit?!” but at least I know it’s what they need to stay healthy.
No, he’s not over it yet. It seems to be getting worse so I’ve started a course of steriods. He stopped eating last night 🙁
Good for you for standing your ground with the food! Sometimese it’s hard, I know!
You’re such a good doggie mom. Leroy is so lucky you and your vet take care of his conditions. Sending oodles of poodles POTP that Leroy is feeling closer to his usual self.
Thank you for the POTP! He seems to be doing well!
I have a Yorkie with lymphagiestacia, he was diagnosed June 2017. It is under control right now. Thank you for sharing your story. I also belong to a fb canine intestinal lymphagiestacia educational group and the support is awesome there as well.
Hi Rosemary. I’m so glad that it’s under control! That’s awesome! It took Leroy a little over a year to get right, he’s having a falre-up now but we’ve got a good handle on it-I hope! I’ve been meaning to join that FB group, do you have the name of it?
Nevermind, I see that the admin thinks “I’m dead wrong” about feeding Leroy a low fat/low protein diet that was recommended by a veterinarian nutrionist and internal specialist, both who follow his CIL case closely. Too bad, looks like a very informative and supportive group otherwise.
My dog was diagnosed with this a few months ago and is not responding to high dose medications. I would love to discuss with you what worked best for your dog…if you could contact me I would greatly appreciate it!!!
My 7 1/2 yr old Pug, Salley, was diagnosed with Lymphangiectasia. Her symptoms of smelly gas and very loose stools started over Thanksgiving weekend, 2017. Of course, I had no idea what was going on and had never heard of this disease, so one week later, we took her to our local vet, who started her on Prednisone and Metronidazole. Not much of a change in the first couple days, so I started researching. Changed her diet to rice and chicken, and then ground turkey and sweet potatoes. Slowly, her stools returned to somewhat normal. Then as soon as the meds were gone, the diarrhea started again, and she would lose her appetite no matter what I tried to feed her. We were on this vicious cycle for more than 2 months. My poor baby was losing weight and muscle tone pretty quickly. My vet then did a blood panel workup and found her protein levels extremely low and albumin levels horrible. I told her my pup could not keep going in this way as she was getting pretty weak, wasn’t her ornery self, and I just wanted my happy Pug back.
Finally my vet uttered that nasty word – Lymphangiectasia – and recommended an intestinal biopsy. So, we headed to K-State Vet College for an exam and procedure. Diagnosis was Protein-losing enteropathy and lymphangiectasia. Vets at K-State recommended Royal Canin Veterinary Diet Gastrointestinal Low Fat Dry Dog Food, prednisone, and metronidazole. She was on 15mg of pred a day, which scared the crap out of me because all I could read about were the effects of long-term use, etc. etc. Her appetite slowly returned, but during all this time, I could tell her muscle tone was deteriorating pretty rapidly. There was even about a month-period where she could not jump on a low couch or bed and had trouble walking up stairs. I was on the phone with Drs at K-State weekly. We upped the prednisone, I added high protein treats to the mix (did a lot of research into high protein/low fat foods and treats). I cried a lot!! Started making some of her food – quinoa, turkey, eggs and anything HIGH in protein – we tried everything. Slowly and methodically, we got her better. And then, as quickly as this all started, her stools returned to very pickup-able, and then finally solid – starting weaning her down from 15 to 10 to 5 and then to NO prednisone daily.
Salley is currently in remission. Her protein levels are up and all bloodwork is normal at this time. She is not on any meds. She does take a probiotic daily and I feed her Earthborn Holistic Grain Free dog food (Chewy.com), and Nutro Crunchy treats (maybe 6-8/day). She is gaining weight and the muscle tone is finally showing up again. She plays, runs, jumps just like her old self. Salley turned 8 on May 16, and I hope remission lasts for a long time, but if not, we know what to do. Get her on the meds quickly!!