Dog - ongoing stomach problems. No diagnosis, no treatment.

[Doggiemum]

Hi, this is my first post! I've created my account purely to ask here in the hope that someone can offer some advice.

My dog has had stomach issues for the past 12 months. The first episode was diagnosed as Haemorragic Gastroenteritis (blood coming out of his bottom and his mouth).
He was hospitalized for a week. No long term meds prescribed - no cause identified. He had a whole host of diagnostic tests which revealed nothing. I was advised to cut out anything that wasn't dog food from his diet.

5 months later - symptoms appeared again but I took him straight in before any blood appeared. He was put on prednisone (an anti-inflammatory steroid), pro-biotics (to balance the bacteria in his tummy) and a prescription diet (low fat). All seemed well.

4 months later (this week) - symptoms occurred again but I took him to the emergency vet before he vomited. They gave him an anti-nausea injection and a temporary medication to reduce stomach acid, told me to stop the prednisone as it can worsen the issue in some dogs. I was told that there is ''nothing that can be done'' with chronic inflammatory bowel disease in dogs (this is currently their best diagnostic guess).

From googling, there are other medications and there are other diagnostic options that haven't been explored (e.g. endoscopy/biopsy of the bowel).
I want to limit the chances of recurrence for his sake and because his insurers don't always pay out.

He doesn't eat anything other than a vet diet - nothing at all. He has his meals split up into small meals throughout the day. He is wormed/flead (by the vet, not over the counter) and has up-to-date vaccinations. He recently had a dental - his mouth is clean. I no longer allow him in the garden unsupervised (not even for 30 seconds) just to rule out any possibility that he licks/chews/eats anything when unsupervised. There is nothing in the house that is poisonous/harmful that he has access to. There are no other animals in the house. He stays on lead on walks and doesn't drink from anything other than a clean water bowl.
Pancreatitis was ruled out. A foreign object was ruled out. He is 5 yrs old.

Has anyone dealt with a dog with chronic inflammatory bowel disease/gastroenteritis and come up against this brick wall? There must be something to help him.

Thanks

Hi, my dog has this. He's quite a bit older than yours at 11. He's had the issues for the last year or so. He has steroid medication once a day and a vet diet, nothing else food wise. It is quite difficult to manage and it can feel very stressful. What has helped is using a muzzle at times when there might be things around like scraps of thrown away food on the ground, and lately having courses of vitamin B12 injections (4 injections at weekly intervals then a break of a few weeks). He's become very thin but still seems to enjoy his walks. The diagnosis is inflammatory bowel disorder. I believe there is no cure and it just has to be managed. I think it is an auto immune disease and what triggered it initially is unknown. The vet did do lots of tests earlier in the year and they also say they couldn't rule out cancer. I'd say my dog is generally still a happy boy in himself so I'm just carrying on with regular vet visits for B12 and steroids, and trying to be as vigilant as possible about scavenging.

@violets2 Hi, Thanks for your reply - that's really helpful. I'll ask my vet about B12 injections and switching him to another medication which suits his tummy. It's so odd because he can go for weeks/months being absolutely fine/energetic/happy and then suddenly it all changes within hours with no apparent cause and he looks like he's at deaths door - it's such a drastic change. Hopefully I can work with the vet to find a treatment that keeps it at bay and just carry on with his vet diet. I agree it can feel very stressful - it's the anxiety of not knowing when the next bout will occur and if he'll recover quickly etc. Thanks for your reply and I'm glad your dog is doing well after his diagnosis.

Thanks! Another thing I found helpful was trying to see the same person at the vet each time, it wasn't always possible but the lovely woman I see now is a small animal medicine specialist I think, initially it felt like all the different vets I saw was making it more confusing. He has had a scan under general anaesthetic but they were reluctant to do any kind of biopsy because of his age and generally weakened condition. Hope your dog improves - best of luck.

I know it might seem wacky but what sort of water bowl do you have? I read an article yesterday that said metal bowls are sometimes only coated with a stainless steel layer & it can come off when scratched. A few owners had swapped to ceramic & their dogs were much better.
Not saying it is that but it's a simple thing to try, it might help!

We have a young lab with a sensitive stomach. As a pup it took a little while to find a suitable food. She is brilliant on salmon and potato kibble which is grain free. Interestingly whenever she had a relapse and we used the old rice and chicken or prescription diet there was never any improvement. The vet and I came to the conclusion that it was probably the rice.
She had a serious dose of gastroenteritis ( stagnant water incident ) in the summer and we thought we were going to lose her. Again tried prescription and rice and chicken with no improvement, after 5 weeks and lots of tests she had prednisone and we put her back onto normal kibble. She recovered almost overnight. We have gradually reintroduced other protein sources and she has been fine but avoid wheat and grain based foods or treats.
She had a slight relapse after a stay at the kennels, although she ate her own food they were giving her wheat based treats/biscuits.
May be worth checking that the prescription diet is rice and grain free.

Hi OP, I'm a vet and would say the route that has been followed so far is appropriate, but you are right that there are more options. I would ask for a referral to recognised internal medicine specialist for further investigation. Bowel biopsy is a sensible next step but not without risk so I would want to talk it through with a specialist if I were you. Good luck!

Thank you everyone!

@Violets2 Yes, seeing the same vet each time would be ideal. I will request a particular vet for his next appointment when his meds are reviewed. Unfortunately when I take him in with his symptoms I just see whoever is available because it's quicker to get seen that way and time is of the essence. But that means that you have to start from the beginning and explain everything each time.

The vets I've seen since his first episode never saw him in that state and so I always feel like I have to really get the point across and emphasize how poorly he was and why I'm so serious about him having tummy grumbles which the last vet I saw called 'normal digestive noises' (they really weren't - I could hear them across the room and I know what's normal for him). The last vet I saw also asked me whether my dog had ever had stomach problems before and what I feed him, which was frustrating because it is in his notes that he has suffered a lot over the past year and that he is on a prescription diet. So yes, I'm finding it quite frustrating lately having to explain everything to different vets and feeling a bit like it isn't taken seriously sometimes because I take him in before the symptoms become severe. Hopefully when I talk to them about the next steps I will see a particular vet who has read his notes and who is understanding and positive.

@MissMarplesBloomers He has a ceramic water bowl - but that's something I never knew before about metal ones and I'll keep that in mind for the future, thank you!

@willdoitinaminute
Thanks I will check that - it's the Royal Canin GI food. He seems to be thriving on it but it is something to consider and I'll raise it with the vet. Did your girl stay on the prednisone indefinitely?

@rememberpurpleronnie
Hi, thanks - I will discuss a referral at his next appointment. My vets currently think that his tummy problems may be triggered by stress (all incidents were preceded by stress - 1st was a veterinary appointment, 2nd was bonfire night, 3rd was a dental procedure). Do you know how stress fits in with IBD? I was under the impression it was an auto-immune disease? My guess is that stress decreases the lining of the stomach and makes him more susceptible to the high concentration of immune cells in his tummy/intestines? I'm trying to educate myself more about it so that I can make the best decisions for him, but some of the information I get can be confusing.

Have you had him checked for Addison’s Disease , I had a colleague with a dog with recurrent bowel issues and that’s what he had .

Both my dogs have had digestive problems. One had many trips to the vet in her first year and I was told to put her on chicken and rice. Turned out she was allergic to chicken which is more common than people think. Unfortunately the vet couldn't help much. But I eventually put her onto Orijen fish and 9 years later the problems have never returned. Yes it is expensive dog food but not as expensive as regular trips to the vet.

So you may want to try another diet with ingredients that are new to your dog.

It sounds as if my other dog has something similar to your dog. She started with colitis when she was 3 years old and has had it sporadically after that over the following 4 years. I have a wonderful vet who thinks it is ulcerative colitis. If she gets stressed (for example in kennels) it may trigger an episode. I have changed her food a couple of times on the advice of my vet but not to prescription dog food. He thinks she becomes sensitised to certain ingredients. She is on Simpson chicken and potato now.

But importantly we have also found that metronidazole is like a miracle cure. It was suggested to me by a friend who has a german shepherd who is on a regular daily small dose of this medication, which is increased when symptoms worsen. So I was really pleased when my vet suggested we try it. We don't use it daily but if colitis occurs then she is given a enough for a full weeks supply plus more so we can gradually taper the medication off. So far it has worked every time unlike the other medication she has been given.

I do monitor her on walks and in the garden as she is a terrible scavenger. But she is allowed to run free and obviously on occasion eats something she should not. However, the bouts of colitis seem to come out of the blue so I am not convinced it is the occasional rabbit dropping etc that is necessarily the cause of her problems.

I currently have a foster dog that I've had since last May, she came to me in a state and had horrendous hemorrhagic diarrhea, she had a course of antibiotics which did nothing and I tried exclusion diets so one month I gave her chicken and veg, then beef and veg, fish and veg etc to try and see of it was allergy related. I immediately avoided grains and soy as they can be common causes of stomach upset.

I did a lot of research and found that fibrous foods such as peas, lentils, sweet potato, kale etc are very helpful for digestion. She did improve by feeding her these along with fresh cooked pork mince, other meats made it worse. The vet said she had colitis and put her on a 64 day course of salazopyrin which did absolutely nothing for her. Despite being a little better on a pork mince and veg diet she still had bleeding and diarrhea and I was told 5 weeks ago that nothing more could be done and she would have to be put to sleep, thankfully that night I had a call about another medication they could try after talking to some other vets and she started on a course of Baytril. 2 days into it she was clean overnight in her crate and she has since gone from strength to strength, no more bleeding, no more diarrhea, she is now gaining weight and she has energy. I don't know how long she will be taking the tablets for but I hope this has cured her. I'm back at the vet in 2 weeks.

The other thing I believe helped her was cooking bone broth, I bought a cheap slow cooker and got some bones from the butcher, you then chuck them in the slow cooker along with water to cover them and raw unfiltered cider vinegar. Then cook on low for 24 hours, remove bones and sieve what is left in the slow cooker, you get a jelly like substance which contains all the nutrients of bones. It is known for soothing the gut (google it for more info, I promise there is benefit to it). I wish you the best of luck with your dog, I know how horrible it is to see them like that.

I checked the royal canine GI diet and it is not cereal free. My lovely lab took the prednisone for about 6 weeks. As I said she had a slight relapse after staying at kennels (after she had finished prednisone), it may have been stress related but they did give her cereal based treats. She occasionally has a loose poo but does get the occasional scrap of bread or a biscuit despite strict instructions from me! (DH is a soft touch)
When she was ill she lost 4kg and was skin and bone. Her blood tests showed markers for intestinal inflammation and high protein. The vet suggested biopsy but first we decided to try prednisone and hypoallergenic diet avoiding common allergens. It has taken about 3 months for her to rebuild the lost muscle but she is now back to how she was before her illness. The vet thinks she had an autoimmune reaction to the initial infection that set off the colitis. It happens in about 1 in a 100 dogs.

My experience is in a cat but having just done a quick search (pubmed- i am a clinical scientist so have a background!) it also holds true for dogs.

My cat developed fairly severe IBD aged 11. Weight loss, faecal incontinence, bleeding, chronic diarrhoea. Managed by diet initially.

He had an extensive clinical history meaning he couldn’t have steroids. He was put on a month long course of antibiotics for another issue, during which it was also noticed he put on weight - he was pretty skeletal by that point- and the incontinence cleared up.

I happened to see a locum one day and during the discussion of his history she suggested we trial metronidazole daily as she’d read some study or other.

Anyway it worked very well. Within two weeks he’d gone from liquid poo to something approaching normal solids, no incontinence, able to tolerate a more varied diet, and generally much more energy and back to his normal self.

Worth asking about?

Thanks again everyone for your reply's, its really helpful to read other people's experiences and the things they've tried. Since my original post he became poorly again and he's been back to the vets and given another round of anti-nausea and pain-relief injections and is booked in for an endoscopy, ultrasound, x-ray and bloods this week. I'll let you know if anything thing is found/diagnoses. I'm really hoping that we can get an answer and just make him better.

@Floralnomad Other than vomiting he doesn't demonstrate any of the other symptom's associated with Addison's but I will raise it with the vets, thank you.

@Basquiatfan I had the same problem with my boy on chicken and rice - he was on it to rule out any reactions to his normal food and he did really well on it for a while and suddenly the vomiting/gas came back. It could have been the chicken or something that coincided with it, I'm not sure. That's when he was prescribed the Royal Cannin GI low fat diet. I read the back of the tin and it says 'chicken' but apparently it's processed in such a way that the molecules are digestible. I don't know if I'm 100% convinced but I'm terrified of changing his food because every time it is changed the symptoms come back with a vengeance. I will ask my vets advice on this again and look into Orijen and metronidazole.

@Blackbutler86 So glad that she made a recovery - that's lovely and you obviously really put the effort in to find the right diet for her. Thank you for sharing - I will look into bone broth.

@willdoitinaminute Thanks, I am concerned about his diet - I'm going to raise it again with the vet. It could be the chicken/the cereal - could be anything that's in his food I suppose. He seems to do well on plain white fish but I don't feed it everyday because I worry that it doesn't give him all the nutrition he needs. I need to get their professional opinion on a homemade diet or find a food and see what they think about it. If I switch his food abruptly he gets poorly, so it would need to be gradual. Recently I was convinced that it was stress related but then his most recent episode this week doesn't make any sense at all because I had the day off and he stayed home sleeping in his bed, ate his food, went for a short walk and slept. Nothing stressful at all. So I don't know anymore. Stress/diet/auto-immune are all possibilities but there is nothing obvious and specific setting it off - hopefully the investigations this week will reveal something to give a clearer idea.

@reallyanotherone Thank you, that's the 2nd mention of that medication so I will definitely inquire with the vet. Without getting too detailed about bowel movements - his are firm and he has no weight loss. His initial symptoms when he gets flare ups are disinterest in food, nausea, drooling, pacing, belching a lot (he belches regularly even when he's well) and vomiting. Since his first episode he's never had diarrhea because once he gets that, I know that it's all down hill very quickly from there (dehydration and lethargy) so I rush him to the vet as soon as any of the initial symptoms are apparent and persistent.

It's still a total mystery but hopefully I can update with something positive after his investigations.