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I present to you Molly, female, spayed, 9 years. Her current issues are anorexia, & vomiting. We have suspected diagnosis of IBD and/or lymphoma.

Summary:

Molly has always had issues with a sensitive gut, and picky eating, adult onset epilepsy (very well controlled) and Borellia positive (Lyme). Molly would go through vomiting episodes that were generally short lived. All tests we had done on her were normal / negative. We have fed her for the last 5 years on Royal Canin H/E Gastro kibble and mixing gastro canned food +/- chicken, lean burger/moose, salmon, etc. Bland no spices. She is quite neurotic/sensitive, fireworks will cause her to shake uncontrollably for hours on end (we’ve used valium a couple times, it was that bad). Loud noises will send her off to a room or couch away somewhere in the house. Two years ago, we brought a baby home and Molly became kind of depressed (we tried Prozac), her vomiting episodes became more pronounced in intensity and duration. At 6 months old, our kid was throwing food on the floor and we’d sternly say no and this had a huge impact on Molly who developed a food aversion, she would shake when food was offered to her. We had to coax Molly from this point on to eat sitting on the floor hand feeding her 2 meals a day with varying results, we’d have to change it up between my wife and I and her mother. Molly would most reliably eat with my mother in law.

Three months ago, we brought home another daughter (I know we are selfish). Molly’s food aversion got worse. We spend more time coaxing her to eat than feeding our 2 children. “Luckily” I was unemployed for some of this and was able to spend the time needed to feed her. Once I began working (out of province) my wife could not devote as much effort with 2 young children in the mix.

Molly began to lose weight from a stable 58lbs to 56lbs. In the last two weeks she lost a further 8lbs and is now 48lbs. My wife called me the other night when I was at work, I had to rush home as Molly had an episode of non-productive retching. My wife suspected something was seriously wrong. Vet did an Xray and she was bloated! I got home just as that happened and we drove Molly to Atlantic Veterinary College in PEI. They stabilized her and performed a series of tests (all normal, go figure) and we did an ultrasound that showed inflamed intestines. After much consulting and deliberation we came up with the suspected diagnosis above. We did not want to open her up for biopsy so we opted to treat with steroids.

Molly began to show a drastic improvement, we transferred her to a vet hospital closer to home and we visited her often. She was like our old girl again. Exposing her belly for rubs (she hadn’t done this for a couple years when we thought of it). Molly would eat readily for the hospital staff (but not us). Molly did so well in hospital, they discharged her to us after two nights (3 nights in total since emergency). We took her home and she showed the food aversion again, shaking when we attempted to feed her broth, chicken and her recovery food. We have always tried different areas of the house instead of the kitchen floor and same results.

We’ve taken Molly back to the vet hospital this morning hoping that she would eat and begin to put some weight back on. Last update, still not eating, and shaking and hypersalivating when the staff are even discussing food. Latest update, my wife is taking her home tonight, we will hit her with more immunosupressants, mertazipine, tramadol and potentially another anti-depressant.

Anyone dealt with something like this before? We love our girl and its too early to say goodbye….close friends of ours offered to look after her at their home with their two dogs to hopefully teach her how they should eat. It’s a lot of ask of them…

Molly – Medical History

July 2009 – Dec 2013 – Got her spayed, pretty happy, easy going, no issues presented themselves.

Dec 2013 - MOLLY had a confirmed case of pancreatitis, which was severe and did require 24 hour hospitalization and care for 4 days. She recovered well. This developed 1 week after a sewage line rupture in our backyard (vet does not seem to think there is a link).

Dec 2014 - She began to develop seizure activity - partial at first with trembling and shaking of the hind end and then more generalized and grand mal. Full blood including T4/TSH unremarkable except for very mild increase in ALT. Her seizures slowly became progressively more intense. Shannon took MOLLY for TCM consult at this time and tried a supplement with no change. She was seen at AVC in September 2015 and had a work-up and CT and MRI. Diagnosed with idiopathic epilepsy. Started on Zonisamide, and she has done well on this with only a handful of seizures in total since starting treatment.

Started with episodes of anorexia as part of her post-ictal phases, but this progressed to many repeat episodes of vomiting/anorexia/+ or - diarrhea in the Winter of 2015. There used to only be a couple of episodes a year, but as time has gone on this has become a monthly struggle. Full blood work has been run MANY times, and mainly a mild persistent elevation in ALT has been the only abnormality. An ACTH stimulation test was run in May 2015 to assess for atypical Addison's disease and was normal. She had an U/S in September 2017, which showed no abnormalities.

MOLLY has been treated with many medications to try to help her GI symptoms:
Ranitidine, Famotidine, Sucralfate, Cerenia, Metoclopramide, Metrodidazole, Mirtazapine, Omeprazole, Cerenia, Fortiflora, Tramadol and Cisapride (Paige states we’ve tried Cisapride in her history – I don’t remember ever trying this). She often vomits food long after eating it and has been suspected of having underlying IBD and a possible gastric outflow restriction.

Summary prior to presenting to AVC on Dec 13, 2018:
MOLLY has now eaten little in 3 days and has lost 2kg in 3 weeks. She had blood work run today which showed a stress leukogram as well as her persistent increased ALT. A lateral abdominal view was obtained for peace of mind and showed a dilated stomach containing gas and the start of possible compartmentalization. A large amount of gas was noted throughout the intestines as well. MOLLY was actively passing gas both as flatulence and burping during the exam. She had vomited a small amount of bile twice before coming in as well.

Summary of Medications over the years:
- Mirtazapine
- Sucralfate
- Metronidazole
- Ranitidine
- Famotidine
- Omeprazole
- Cerenia
- Vit B12 inj (x1 at AVC)
- Dexamethasone inj
- Fortiflora
- Prozac
- L Theanine (Anxitane)
- Bio-calm
- Valium PRN
- Zonisamide
- Tramadol
- Holistic Meds (June 2015):
o Ban Xia Bai Zhu Tian Ma Tang
o Three seeds combination tabs
o Wei Ling Tang (spleen support)

** We have NOT tried CBD oil, it’s on order to arrive Dec 27, 2018 **

Summary of Diagnotic Testing over the years:
- Cortisols/ACTH Stim
- T4/TSH
- Full bloods – multiple times (elevated ALT only, and only slightly elevated)
- Urinalysis
- Urine culture – awaiting results from AVC
- Multiple CPLs – only one positive
- 4Dx – positive for borellia
- Lyme Quant6 – ran x2 … results always in the 70 range with no elevation (2016 and 2017)
- Fecals
- Fecal culture in 2013
- TLI, PLI, Cobalamin, folate – Awaiting results from AVC (sent to the states)
- Urine Protein:Creatinine (UPC) – Mar 31, 2016 = normal

Summary of Imaging over the years:
- Ultrasounds x 3
o Only the last taken at AVC showed inflammation of the bowels, etc. See report.
- X-rays (too many to count)
o Only one that has been abnormal is most recent –showing bloat
- CT/MRI
o Diagnostic of idiopathic epilepsy
 

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Discussion Starter #2
Molly is home with us. Prednizone does not seem to be working that effectively. We'll be trying CBD oil (does anyone have a dosage?) and Azothyaprine another stronger immunosurpressant that has a 15% chance of causing pancreatitis which will kill her.
 

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I have only gotten her to eat meatballs, frozen yougurt and cheese, plus her NG tube feeds. I'm able to get about 1000 kcal a day into her, her daily resting engery requirements is about 700 kcal.
 

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I am so sorry you have had so many health issues with Molly. No advice, just hugs from Houston.
 

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Oh my God, you and Molly have been through so much :'( Breaks my heart. I too am sending love. My Maizie has been a little fragile in health at times, but nothing to this extent. ((((((Hugs)))))
 

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I’m very sorry poor Molly is so sick. I really don’t have any medical advice, as her case is very specific and complex.

Two things come to mind though. First, could the meds be responsible for part of the problem ? In people with chronic illness, sometimes the medication itself is making the person worse because of side effects. Surely it’s the same for animals too. One thing to consider.

Second, since she had a drastic improvement at the hospital and she got worse again at home, I wonder if part of the problem could be behavioral. She could very well be over reactive to some very subtle negative energy, body language, anxiety, fear or other emotions you feel when feeding her. Which would be totally understandable given what grief you all have been through. Poodles are very sensitives dogs. It doesn’t take much to upset them. They’re very in tune with their people.

If I were you I would seriously consider letting your friends take care of her for a few weeks. And if she gets better, you know you have to change something within yourselves and/or in the home. You’ll need to find a good behaviorist to help you and there should be light at the end of the tunnel.

In any case I would definitely have a behaviorist come home and do an assessment and go from there.

I wish you the best and hope Molly gets better soon.
 

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Poor Molly, Poor YOU and your Family! I can't imagine what you have been through so far, and I know you must love your Molly a lot to not give up on her. All I can offer are my prayers to find answers and a way to help her! God Bless your big heart!
 

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Thoughts and prayers from Alabama - y'all have been through so much with your dear Molly. ((HUGS))
 

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I, too, am sorry for all the problems you have had with your Molly girl. What a conundrum! Sometimes a dog is just born more sensitive to change and then every time there is any change in their environment, their body does not handle it well. I wonder if flea/tick medication, or over-vaccination (following old protocol) could be a factor? Also, I would be wondering about her genetic background... Poodle Health Registry has an excellent database. Of course, none of this helps with the immediate problems, but it might help you to know that you are not to "blame" for Molly's problems. If you, and your family were not making such an effort with Molly she probably would not have even pulled through her bout with pancreatitis. My heart aches for you, as I know how hard it is to deal with family, life, and a beloved poodle who needs so much. Whatever happens,take time to nurture each other. Hugs.
 

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So this is slightly my field. This is going to sound a little strange but I started my business because of my son's epic battle with IBS and the measures we took to help him have helped many other people (and dogs and cats). So I get emails such as your post every day - only it is usually about people. I am a professional fermenter - I make highly probiotic sauerkraut, with the specific intention of restoring gut health. My products are not available to you in Canada but if you go to your nearest health food store - find a local brand that is not pasteurized and try to offer about a tablespoon of it.(don't buy Bubbies it is pasteurized!) Funny enough dogs tend to really like it - some would overeat it if you let them. Probiotics in general is what I would recommend. Kefir is another really rich source but lots of dogs don't do well on dairy. Btw you can make both things at home and get all the benefits as well. I know a few number of dogs (and have a few breeders on subscriptions) who offer my sauerkraut as a supplement year round and have brought back dogs with completely wiped out digestions (after many rounds of antibiotics and insane amounts of stress - many of them rescues). Hope this helps - All the Best to you and Molly!
 

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I have had no experience of the sort of problems you are going through, but to me it sounds as if stress is a large part of it. A sensitive dog, a new baby, new rules, unemployment, another baby, no doubt many other things going on, plus a pre-disposition to digestive problems - a potentially unhealthy mix. The fact that she was so relaxed at the vet hospital and eating well there would seem further evidence that she has come to associate her home with food being dangerous and potentially painful (as a long term sufferer from food intolerances and stress related IBS myself I can sympathise with her reluctance to eat in case it results in a painful reaction). Like Dechi, I would try the behaviourist route - a qualified, experienced, vet referred behaviourist, who can assess Molly at home and make recommendations - plus probiotics if your vet thinks they may help. I hope things improve soon - I cannot imagine coping with a toddler, a new baby, a husband working away from home and a sick poodle.
 
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That sounds so hard and I can hear your worry. Not a vet so no advice other than in humans there is not a lot of really good research on herbal remedies and alternative therapies and products not regulated well. Sometimes less in the mix is better for meds but I am sure you have researched everything well. I am curious and hopeful for you about the cbd... it seems to be helpful for anorexia and for many things in dogs but I am only hearing this from other people who use it and I can’t say I’ve done any research. Hope things get sorted for you!
 

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I may have missed it, but has Molly been checked for pancreatic insufficiency/EPI?

Not a medical professional, just know about this from online friends with GSDs. It can occur in any breed, as far as I know.

ETA, her location association with fear does seem like a veterinary behaviorist could be helpful. I agree with the others there.
 

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What wonderful dog parents you are to Molly. It seems you have really tried everything to help her. I admire all your efforts and resources spent on trying to achieve better health outcomes for Molly.

My vet has told me that CBD is not appropriate for dogs. I have not looked into the research on CBD and canines because I have not had a personal need to do so, but I encourage you to base your health choices on research.

Probiotics have been a great help for humans with GI disorders. If I were you I would continue to look into this.

Also, the offer from your friends is very generous and I would consider it. Perhaps this might offer behavioral support to a stressed Molly. Peer support has a good research-base in humans, once again I don't know about the research for dogs.

My best wishes for Molly's health! And warm regards for your whole family this holiday.
 

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I so feel for you and hope Molly is doing better. One thought I had is to do a phone consult with Dr. Jean Dodds at hemopet.org. She is a leading expert on nutrition, thyroid, vaccines, etc. and has helped many dogs overcome health issues. She is an integrative veterinarian and knows so much about different breeds and how they react to various meds. She also does Nutriscan which tests dogs for food sensitivities.
My thoughts are with you -- please let us know how your girl is doing.
 

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I too am so sorry for you and Molly.
The thing that strikes me most is the change when she is away from your home. Could this possibly be environmental? What's so different around your home from the hospital environment? You've tried so many things and done so much. Maybe the probiotics are a good idea? And CBD? I don't know anyone who has used that on a pet, but a friend with neurological issues has benefitted dramatically, almost as much as prednisone. Have you been able to find anything about CBD dosing?
 

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I too am so sorry for you and Molly.
The thing that strikes me most is the change when she is away from your home. Could this possibly be environmental? What's so different around your home from the hospital environment? You've tried so many things and done so much. Maybe the probiotics are a good idea? And CBD? I don't know anyone who has used that on a pet, but a friend with neurological issues has benefitted dramatically, almost as much as prednisone. Have you been able to find anything about CBD dosing?

This thread hasn’t been updated in three months. Hopefully they are doing better.
 
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