NicoleS
Posted : 9/25/2009 9:04:55 PM
Sorry for the late update -- we were at the vet from before our 7pm appt until 9 and then had a few stops to make on the way home. Last appt on a Friday night just isn't the time for something QUICK! There was also a family there with a really sick kitty (they are also a 24hr vet) so of course everything was off schedule.
Anyway -- Liked this vet a zillion times better, she was nice, explained everything and the WHY, didn't try to push only more RX foods -- in fact wants him OFF the z/d and on a simple bland diet, chicken and rice or the like. She feels the z/d often times causes GI issues like diarrhea and doesn't want that to complicate things. I mentioned Sammy used to have a bowel movement every 12 hrs but since being on z/d it's like once every 36 and she was like "yep z/d can do really strange things to certain dogs." The z/d has it's place, and we may or may not come back to it in the future with allergies, but the main concern is the PANCREAS. Which didn't make it across from the other vet. I also feel that we need to focus on the more important things and come back to allergies later.
We're going to put him on a totally bland diet, check the levels again in a week or so after the change. She totally pushed the probiotics as well, just like Callie said, which was a big thing compared to our previous vet. She also said that after we clear this up, THEN we could put him on a commercial diet and do something akin to an elimination diet (or make up a recipe from monica segal, etc, and homecook). She was way cool with that, whereas the last vet was all about the RX food and that's it. Much happier with her. I think she would prefer the homecooked, honestly, but something like a california naturals or such would be OK -- but all depends on how his pancreas levels react. At least a homecooked diet would allow me to control the fat levels better -- a limited ingredient diet AND low-fat, in a kibble? Not so easy. BUT, she thinks the allergies are more environmental anyway -- since he only chews his back paws. She said that's more likely to be environmental since with food allergies he would probably be chewing all four. I'm not convinced, yet, but once we get a frost (which might be sooner than we think, it gets into the 40s overnight sometimes now) we could see if they clear up then as well.
She also suggested an ultrasound, and we were all for it until I found out it's $400. So, we're going to see how he does. She suggested it just to put me at ease, more than thinking it was completely necessary. We could (and may) do xrays, but basically she was very encouraged that we're moving in the right direction since he hasn't vomited in several days. She also said we're doing good at keeping him hydrated and all that, and he seems good. If she really felt we needed an ultrasound, I would do it, but didn't seem concerned if we waited until we re-checked the bloodwork before going ahead with that. After u/s and x-rays we would move to a barium test if we wanted, and sometimes the barium alone helps the dog out.
The only thing was if he vomited, to fast him for 12 hours rather than keep feeding him. Honestly, although it makes sense, when the dog vomits 3 meals in a row, it's a bit hard to NOT want to feed him, but resting the gut would have been better. Intellectually, I know this but hard to know what to do at the time. She also wants to keep him on the pepcid but instead of 20mg once a day, to make it 10mg twice a day.
She seemed a little surprised at both Cipro AND amoxicilan, but we're to finish both those out as directed. He'll be nearly done with them by the time we re-test his blood next weekend.
So, all in all, we're not doing things drastically different -- but we have an action plan, which is what I needed -- and a vet who truly seems to understand where I'm coming from and help me help Sammy. Every person there was totally nice, and willing to answer each and every question (not like the old vet who said he was going to check into something and never come back, just send a tech in. I wasn't DONE yet!) and just overall very accommodating. They aren't much more expensive than any other vet we've been to, but they are much, much closer and I'm rather happy with them so far.
Thanks for all the good wishes! We greatly appreciate them, and keep your fingers crossed that he continues to do better and that his blood tests in a week also come back at least a little better. We'll have a better plan of action once we can establish a trend better, so I'm anxious to get some more test results. I feel so much more confident in our ability to help him, that's for sure.
ETA -- Karen just saw your post. Thanks for the information. The new vet wasn't concerned about any values being off in his blood work other than amylase and the lipase. Apparently allergies can send several of the numbers off as well. Until we can get his system calmed down, it's hard to trust a lot of it unless it's really, really out of whack. I guess these weren't off enough to cause concern unless they stay that way.