Sunday, June 5, 2011

Easing back to normal

The past few months have been a little bit hectic as of late, and perhaps the biggest challenge has been our girl's GI issues.  The week of April 18th Abby started with soft stools that were later accompanied by an urgency with her bowel movements.  We brought her to the her veterinarian and got a prescription for Metronidazole and had a discussion about the food that she has been on.  At the time Abby was eating Merrick's Grammy's Pot Pie, and she was doing relatively well with it.  However, I had noticed that it seemed as if Abby periodically had GI issues since we adopted her. 
When we first adopted Abby and brought her to her first veterinarian appointment, her fecal results came back positive for giardia.  We put her on fenbendazole that was to be mixed in with her Science Diet puppy kibble.  I don't know if there was a taste to her medicine, or she didn't like the texture of the medicine in her food.  Either way, she inevitably wanted no part of her food.  She made it through one week of medicine, and then stopped eating even without having medicine in her food.  At that time we tried to change her dry food in an effort to get her to think that if there was a new food, then there was a new MO.  Inevitably she really seemed to dig the Merrick's Puppy Plate.  She did well on this medicine, but after a few months got diarrhea one time.  Her stool sample came back clean and we put her on metronidazole, and eventually the problem cleared up. 

Over the next several months it seemed like we went through periodic issues with diarrhea.  The stool samples were always clean, and the metronidazole cleared up the urgency that accompanied the diarrhea and inevitably helped with the consistency of her stools.  But then this last bout hit in April and we were not able to clear up her problems. 

We did a week of metronidazole, and although it helped with the urgency it did not really affect the consistency of her stools.  The first stool while on metronidazole was solid, and after that they were about the consistency of soft serve (presuming it wasn't full blown diarrhea).  Additionally, when we spoke with the veterinarian, they said that they were seeing a lot of dogs that had problems with Merrick foods.  They said that the fat content in the Merrick foods was very high, and as a result a lot of dogs seem to develop this problem; as if their pancreases have enough and blow out.  We switched her food to a low residue (Iams) and gave her Forti Flora, a probiotic.  After a week when her stools hadn't improved, I tried switching the food to Science Diet I/D dry because she had previously done better on this food.  The stools improved a bit, but not enough.  I called the veterinarian back and they extended the metronidazole and set us up with an appointment for a complete blood panel including TLI and folates, as well as a broader fecal test. 

In true Abby fashion, all of her bloodwork and fecal tests came back fine.  All levels were where they needed to be, which meant that her pancreas was functioning fine and that we weren't having any issues with malabsorption or maldigestion.  At this point we went on an exclusion diet.  Abby would only eat Science Diet I/D dry and the hypoallergenic cookies, and all other treats and foods would be cut out.  Abby's stools did not improve at all on this diet at all.  So we decided to take things a step further. 

One of the vet techs at Abby's vet hospital suggested a nutritionist at Angell Hospital, and I was able to set up a phone consultation with her for this past Tuesday.  She had some very helpful suggestions.  She said that when dogs have problems with digestion, they always look to simplify everything as much as they can.  The fact that Abby had been on a low residue, low fiber food and not improved showed that low fiber was not the way to go.  Additionally, we should also look to switch her from dry food to canned food as the dry food would have a lot more non-nutrative items in it, including preservatives.  That said, the second thing that we should try is a higher fiber food.  She gave us two suggestions:  either Purina OM or half Science Diet I/D and half Science Diet W/D.  Providing this food worked for her, we could then introduce treats for her training such as carrots, rice cakes, or mini marshmallows.  If this did not work either, then we would simplify further and try a novel protein diet. 

While I waited for Abby's Purina OM to come in, I immediately switched her to Science Diet I/D canned food.  I immediately noticed an improvement in Abby's stools.  Abby's new food came in on Friday, and she started with that at dinner and really seemed to dig the taste of it.  I have to say that since switching Abby to canned food, she has been SUPER interested in food.  She is actually salivating for meals, and is even more food motivated than she was before. 

I still am not sure how mini marshmallows are a good treat for her given the amount of sugar in them.  But I'm thinking that if I cut these in half to make them even smaller, I could integrate them in combination with the other treats as a trail mix for her training.  All I know is that it is so wonderful to have her finally on the road back to normal. 

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