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If you're worried about your pet's health, please speak to a vet or qualified professional.

So confused about IBD diet - 2nd vet opinion?

20 replies

HandyBendySandy · 23/01/2021 13:15

I have a 13 month old Border Terrier. He's been perfectly fit and well since birth, he was being fed Millies Wolfheart dry kibble. He occasionally had fresh cooked chicken as a treat and for recall training, along with the usual dentastix, yakkers chews etc etc.

2 weeks before Christmas he had an episode of being very, very sick. When the vomiting went beyond 24 hours and I saw flecks of blood/tissue in it, I took him to the vet. Vet saw he'd lost nearly half a kilo - the instant diagnosis was possible inflammatory bowel disease, put him on 100% hypoallergenic elimination diet immediately for a minimum of 6 weeks.

I thought that was a bit drastic based on a single incident but did as instructed and very grudgingly started introducing the prescription diet (which he loathed) over the next week.

But at one point in that 7 days, we did some recall training and without thinking much about it, let him have a load of fresh chicken (as he would have done any time in the past with no problem).

3 days later the vomiting started, followed by diarrhoea this time and a lot of abdominal pain. Took him to emergency vet on Christmas night, confessed I'd given him chicken despite being told to eliminate all meat proteins for 6 weeks, and he had anti-emetics and painkillers. But he deteriorated and ended up staying in for the following night.

Recovered from that and he's been on 100% prescription diet for 5 weeks now, no exceptions - no more diarrhoea and he's put weight back on, but he's still vomiting virtually every other day. Initially it seemed like he was bringing up all the food he'd eaten that day, and he have pain - more recently it's just been froth and mucus with no pain, whenever it's been more than a few hours since he's eaten. He's getting 5 meals a day and if he's licky and nauseous at 5.30am he gets a specially baked biscuit! But he is otherwise normal, bouncy and full of energy, eating and drinking normally with normal poos.

But because he is vomiting even on a hypoallergenic diet, he went back to the vet yesterday for 3 day poo sample and blood tests, checking for parasites and low B12 and folates. I asked what the next step would be if all the tests were normal, and vet said he'd be referred to a specialist.

My confusion is this - if he's vomiting on a fully hydrolysed diet, then he's not reacting to anything in food is he - it's something else, or the auto-immune version of IBD rather than an intolerance or allergy. So why does he have to stay on the diet, which is difficult to get hold of at the moment - why can't I try introducing a single novel protein now, like every other dog with IBD or pancreatitis has to eat? A vet at the sister practice recommended we start him on fish so I ordered samples from Fish4Dogs, but original vet talked me out of it. We're stuck with Hills, the dry version of which he'll only eat if I cover it with the canned version, and now you can't get the cans in the UK...I've managed to get some Purina Hypoallergenic tins from the vet, but 3 teaspoons of that since yesterday and his poo is already getting yellowy and mushy.

It's frustrating, the dog was fine on the poultry free food I was giving him before.

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BiteyShark · 23/01/2021 13:21

My dog was diagnosed with IBD after several episodes. He can eat pretty much most meats now but we really struggled at the beginning until we got his condition firmly under control using steroids.

HandyBendySandy · 23/01/2021 13:37

He hasn't been given any medication at all - I had to beg for 2 cerenia after he came out of hospital! I thought they might start him on something to relieve his nausea and potentially irritated stomach, just while we're waiting for results, but nothing. He just has to get on with it, bless him.

I think it's the attitude of this particular vet that's got me doubting...he doesn't listen and doesn't check the notes on a follow-up, so he treats us like new patients every time. He answers all my questions like I'm utterly thick. The vets at the main practice when he went in at Christmas were excellent though. I tried to circumvent him and speak to one of them, but we always get directed back to him. I don't want to be rude, he's nice enough and kind to ma dawg. But I wish he'd make sense.

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BiteyShark · 23/01/2021 13:53

I did push for invasive tests (endoscopy) after a few really bad episodes to confirm what we were dealing with. An elimination diet was discussed but wasn't really practical with my dog going to daycare and mixing with other dogs and environments. We therefore agreed to trail steroids and at the beginning started with a high dose which had its own issues (another long story) but any flare up is managed with a short few weeks of a medium dosages and then he is fine. Touch wood that we have not had any flare ups for over a year now.

HandyBendySandy · 23/01/2021 14:15

You see, I was given the impression that the elimination diet is the standard first step. My dog also goes to daycare, but I've baked him treats from his Hills food and give a supply of those to the walker, who is very good at not letting him have anything else.

So were your dogs blood and poop tests all normal - was it the biopsies that confirmed IBD? HandyDog seems to have more of a problem with the stomach end than the bowel end.

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BiteyShark · 23/01/2021 14:26

My vet says doing an elimination diet is very hard and has to be clearly controlled and as he is with other dogs and will lick their faces and scavenge for food on walks without me it would be very difficult and I said I didn't think I could control his environment enough.

He had several bad episodes with admissions and his bloods and poo samples were fine except he had a very high level of a certain cell type in his blood which indicated IBD. They had ruled out atypical Addison's, infections like campylobacter and lots of other conditions. The time when I said enough and I wanted biopsies to confirm they actually found in the stomach and intestinal biopsy different cells to those in his previous blood samples so thought he had a mix of different types of IBD but both required the same treatment.

I know when he is having an episode as he vomits more then diarrhoea but has both. At his worst he was vomiting and straining to poo every hour throughout the day and night.

I think you need to find a vet that will work with you to confirm diagnosis or a suitable treatment.

BiteyShark · 23/01/2021 14:44

Sorry probably didn't make it clear. They suspected IBD but the biopsy totally confirmed it and then we could stop speculating. The turning point is always steroids for us. He can be really ill, not thriving, in pain and straining to poo and vomiting but as soon as he gets a steroid shot with follow up tablets he is like a different dog.

He is 4 now and it's so long since he had his last attack that I can't tell you exactly when it was as I would have to look up his insurance claim to find out. After we got the diagnosis because we knew what it was any sign of it starting to get bad was stopped by steroids and the episodes just got less frequent. However we are still vigilant to make sure that any treatment or drugs for any other accidents etc don't aggravate this condition so have made decisions to withhold medication on a wait and see just to be extra cautious not to set the IBD off again.

PollyRoulson · 23/01/2021 15:36

One of my dogs has had IBD for years he is now 15 years old so in the long run it has done him no harm!

It took a while to get control of it and he lost weight very quickly when he had an attack.

We tried elimination diets medication etc. B12 injections or cobalamin injections helped a bit but did not have a long lasting effect.

He was on several hydrolzed diets and still had symptons. He is now on Purina HA and has been for years and it is the only food he can eat. He is a healthy slim weight now and pretty good shape for an oldie.

We didnt push for invasive tests but where offered them. It was pretty obvious with us that he was not "ill" as such but his symptoms were affected by what he ate.

I would not hesitate to change vets to one I felt comfortable with though. It is important that you work together especially on what may well be a chronic condition that needs managing. We are the same as Bitey and have to take into account any other medications or supplements etc (which he can not take) due to his IBD.

BiteyShark · 23/01/2021 15:56

We didnt push for invasive tests but where offered them. It was pretty obvious with us that he was not "ill" as such but his symptoms were affected by what he ate.

I think the difference for us was that it wasn't obvious it was food and he was really ill and suffering and when we rocked up to emergency vets they treated us like it was just a normal dogs stomach upset so we got the usual chicken and rice advice which solved nothing. I think this is why we said enough and wanted answers but yes I can see if there was an obvious trigger I wouldn't have put him through that.

HandyBendySandy · 23/01/2021 16:22

I don't think it's that obviously food either, if he's still not quite right on hydrolysed protein. Part of me is very tempted to just add a tiny piece of the Fish4Dogs food and see what happens - but then I remind myself of what happened when I thought the vet was crazy the first time and let the dog have some chicken, and remember I don't know better than a vet!

Even a really frustrating one who doesn't really listen. There is another surgery I could move to, but I don't want to upset anyone. Anyway - we're moving 200 miles north in a couple of months, so it's a bit academic anyway.

In the meantime I almost hope he does get referred, so I can talk to a specialist who might actually be interested in talking to me in more detail and taking a more practical approach.

Thank goodness he's insured and he's got a lifetime policy...

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BiteyShark · 23/01/2021 16:32

I think lots of things seemed to upset mine at the beginning but looking back I think any food was irritating his stomach and intestine.

Once it was controlled and his symptoms went we could feed him any food and in fact we now swop brands and proteins every day with no issues. It tends to take something external (usually when lots of dogs are coming down with infections and stomach bugs) to trigger it and tip him over the edge then we are back into anything upsets his stomach.

My advice is trust your own judgement and yes get advice from a specialist if you can. Fortunately my practice is large so they had lots of different vets trying to work out what was wrong and eventually we got there in the end.

HandyBendySandy · 23/01/2021 18:23

Interesting to hear that yours has stayed on Purina HA @PollyRoulson - now I can't get the Hills tinned anywhere and I'm on my last tin, I've had to order cans of Purina HA instead (Royal Canin HA is hydrolysed but it has twice the fat content of the others, and gave him dreadful yellow diarrhoea) - I've introduced tiny spoonfuls today and I'm watching what happens. He mainly eats the Hills kibble but only if I drench it in a wet food gravy as it's a bit grim on its own.

You see that makes sense @BiteyShark - I hadn't thought that if an initial infection triggered this intense irritation in his stomach lining and intestine, then everything is going to aggravate it until its fully healed isn't it, and with stomach acid that could take ages. No-one has ever said that! It might explain why he was still vomiting up the hypoallergenic food initially, but it is veeerrry slowly improving. Maybe I should stick with the diet until he goes a clear 7 days without vomiting - so far his maximum is 36 hours, but he's no longer bringing up food - only froth and mucousy bile, which is presumably stomach irritation (reflux?) when his stomach is empty.

That suddenly makes sense, why didn't the vet explain that?! He just keeps banging on about the diet without any further details, I like detail.

His assumption that I'm thick as mince is grating - I asked him how they could tell the difference between IBD and pancreatitis. He just said "Pancreatitis is inflammation of the pancreas."

Fucks sake. Hmm I said, I'm aware of that, what I mean is, how can you be sure it's IBD as opposed to pancreatitis?

He did answer that, he said his amylase would've been affected but the bloods they took at Christmas were all normal.

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BiteyShark · 23/01/2021 18:56

We have seen a few vets at the practice and most have taken lots of time to explain their reasoning which is so important.

Another thing that might help is one vet recommended feeding whatever we had at the time split between 10-12 servings over the day. For example if you fed 400g of food split it into 40g and feed every hour over 10 hours.

Do this for a few days and if no vomiting then make it 50g split over 8 hours for a few days. Gradually reduce the times and increase the amounts until you are feeding normally.

This was a game changer as ours could digest a little bit of food at regular intervals at his worst and I found he improved quicker and I always go back to this feeding technique when he is ill.

PollyRoulson · 23/01/2021 18:58

They would be able to tell if it is pancreatitis from a blood test.

I think you said on a previous thread that you are feeding small meals already. When is he usually sick?

Mine is on the dry Purina HA. It looks like rice krispies and smells sweet but is literally the only food he can eat.

PollyRoulson · 23/01/2021 19:01

We did the split feeding to start with. He was literally feed a tablespoon of food every two hours. For us it was important to feed like this for a week after an attack. For a labrador this was his idea of heaven Smile

Darklane · 23/01/2021 20:01

One of mine has had IBD from being young, she’s now thirteen.
In the early days she had all sorts of treatments & special vet diets but it never really went away. She’d be fine for a bit then it would flare up again. It was relentless & very expensive!
She’s been on salyzopirin for years which mostly keeps it under control with doses of pro kolin in a flare up which settles it. I no longer buy it from the vets but get it online as it’s cheaper & it doesn’t need a prescription Pro kolin

What I’ve fairly recently found makes the most difference is feeding her Chappie.....I know, I know!! The most basic, cheapest tinned good you can buy. It’s made an unbelievable difference. Incredible! Took some believing I can tell you.
If I relent & give her a bit of chicken, or once went back on “ special food” from the vet, back came the squirts with a vengeance.
She’s a tiny Yorkie so can’t afford to lose the weight that drops off her in a flare up & only eats a tiny bit being so small but luckily my Skyes will happily scoff what’s left in a tin along with their own food, they have cast iron constitutions thank goodness.

HandyBendySandy · 23/01/2021 20:59

@PollyRoulson @BiteyShark Thank you both so much, this has been so helpful in clearing up my thinking, which was exactly what I'd hoped for by posting! If the vet had even told me half the things you've said in your few posts I'd have understood the approach so much better.

He's not been sick since 6am Friday morning, so if he makes it past 6am tomorrow that'll be 48 hours - the longest in about 2 weeks. He was all over the place at first, the vomiting had stopped but he wasn't eating much, was skinny and had bad stomach pains, praying and stretching and hiding a lot - then that eased off, the yellow mushy poos from the royal canin cleared up when I removed it entirely and stuck to 100% Hills, and we had 4 days of looking like he was on the mend. Then he abruptly started throwing up a huge pile of food just after meal #3. I've been feeding him at 8am, 12pm, 5pm and 9pm (they never mentioned spreading that to 8 or 10 meals, even at the beginning - I wish I'd known that was a better plan), and for 3 alternate evenings he went outside somewhere between 6 - 7pm and threw everything up - it looked like everything that he'd eaten that day, partly digested. But he was still happy and playful and nagging for his 9pm meal because he was empty all over again, his poo was fine, he wasn't showing pain and there was no blood anywhere. I guess he just wasn't digesting very well.

Then the food was staying down, but he started getting licky/nauseous and vomiting yellow froth - typically early morning, between 3 - 6am (so 6+ hours after his last feed), but once at lunchtime around 1pm. I'd decided to walk him first and feed when we got back, but it must've been just a tiny bit too long. Now if a walk is going to straddle a meal time I'll give him half before and half after, so today he's had 6 tiny meals. This is only a 7kg dog, his total ration per day is 100g!

I went out with a torch to check his apres-dinner poo tonight (as I've been adding the Purina since yesterday, which is new) and it was absolutely beautifully formed and uniform in colour. Grin I usually do a quick scan down the side of the house where he likes to vomit, but no sign of anything returned...

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HandyBendySandy · 23/01/2021 21:06

Sorry @Darklane, cross-posted! Yes, I know about Chappie, I pulled a face too but apparently it's magic for sensitive stomachs!

I did check it out but it has chicken protein in it, so it won't work for this "elimination" (or healing) spell, but it's certainly something to keep in mind. I accidentally ordered a tray of Purina Gastrointestinal, which also has non-hydrolysed chicken in it, but my Dad swears by it when his dog has colitis flare ups so I thought I'd keep it for our emergency options in the future.

I've got an unopened 5kg bag of his old, perfectly good quality and poultry free kibble in the garage - I'm not chucking it out, I'm hoping he can get back to it someday!

Thanks for the Pro Kolin link, I've heard of that - at no time have the vets suggested it for him, I thought it was a standard prescription after a gastric problem. Hmm

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HandyBendySandy · 24/01/2021 10:06

Sadly we had a tiny froth vomit at 2.30am so he didn't make the 48 hrs clear. Sad He's fine, happy enough - delighted to be offered half a hypoallergenic biscuit straight afterwards!

Clearly we have to keep food in his stomach at all times...

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JamieFrasersSassenach · 25/01/2021 10:58

Hi @HandyBendySandy

I have a dog with IBD (suspected), she started off several years ago with explosive curry coloured poo that became blood streaked and then just like bloody water (the colour - I'm not swearing!)

To start with each time she had it my vet gave her metrobactin 2 x 250mg tablets twice a day for 5 days. It has an antibiotic in it but the vet said that wasn't the reason for using it - just that it really helps colitis - which was her first diagnosis. I should also say that Ddog has various allergies as well and so is on prednisone.

We also changed her food to various different types - raw, kibble that was supposed to be hypoallergenic, then Chappie and it seemed to be helping - she just had the odd flare up.

Then it just became constant - every month at least we were at the vets because she had blood streaked, mucusy yellow diarrhoea.

So the vet recommended Purina HA (we use the dry food), it has been brilliant - I buy it online and for a springer spaniel it costs me £50 every 6 weeks - very cost effective. We have only had a few episodes in the last 2 years - we think from where she has managed to snaffle something she shouldn't have!!

My vet also very kindly allows me to buy a pack of metrobactin twice a year (at Ddogs check ups) so that we have it for immediate use if necessary. I haven't touched the pack from last summer (yet!).

Anyway I would thoroughly recommend trying the dry HA - if you're anywhere near me I'm happy to give you some to try - I'm in the East of England.

Good luck - I hope you get the answers and treatment you need.

HandyBendySandy · 25/01/2021 17:52

That's really kind of you @JamieFrasersSassenach - I've started weaning him onto the wet Purina HA, to replace the wet Hills ZD which I can't buy anywhere, but he's still finishing up the remaining couple of kilos of dry Hills I've still got for now (I mix wet and dry).

Obviously if he has to stay on the hypoallergenic I'll probably switch to Purina HA (as much as it looks like breakfast cereal!), but I'm secretly hoping we can try some "normal" food - a single protein - first. If he relapses, then I guess it's the HA beyond that...

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