Hello Everyone, It has been almost 2 weeks since I have posted about Abby and I thought I would give an update. According to the clinical nutritionist at the Veterinary College here in Ontario, Abby is doing quite well. She and her supervisor were not really concerned with any of the slight abnormalities in Abby’s bloodwork, with the exception of a low B!2, something we all knew would be an issue for Abby as she lost her ileum (the section of the small bowel that absorbs B!2). Therefore we have restarted B12 injections every 2 weeks.
Abby’s appetite has picked up now that we are almost exclusively feeding her small meals of Hills z/d kibble (both canine and feline mixed ~75%/25%). we “flavour” the meals with ~ 5-8gm of a slurry of boiled lean ground beef (I boil 1 lb of ground beef in ~300-400 mL of water, after it is cooked and cooled in the fridge I remove as much fat as I can and then pulverize the whole pot of water and beef into a rather thick beefy broth. I freeze it in small containers and then measure it out per meal) We heat the slurry in the microwave for 5 seconds so it is warmed and thinned and then we coat the measured dry kibble with it before setting it down for her to eat. She loves it. I suppose it sounds like a lot of work but really boiling a pound of ground beef, separating the fat, blending it then freezing it is really pretty easy.
We have decreased the daily Fortiflora doses as I was concerned that it could be contributing to Abby’s diarrhea. The envelope that contains the daily dose is the same amount for a Great Dane as it is for Abby who is only about 6.35kg (14lbs) and I thought she might be getting too much. However there was really no difference in her number of poops after I stopped the Fortiflora so now I give her a bit on her morning feed every 2nd day or so just to give her a little healthy bacteria top up and that seems to be fine. Her weight loss has levelled off and we have seen a slight increase in the last 2 weeks.
I spoke to our clinical nutrition resident about soluble vs insoluble fibre (Thank you Susan) and since we had such bad luck with soluble fibre (metmucil) her suggestion was to just try what we can from natural sources (veg, fruit etc) but to always maintain a rule of 90% daily nutritional content from her kibble, and no more than 10% nutritional content from other things (ground beef and/or fruit veg etc). Now that she is getting the ground beef we no longer give Abby any canned z/d. We also discussed other hydrolysed dog foods and alternative protein source dog foods (again, thank you both pitlove & Susan) and the CN is going to modify Abby’s original diet report with alternate options, all under the supervision of the assistant professor of clinical nutrition at the OVC. We are pretty lucky to live so close to such a high level of care for our pup.
Abby continues to poop 4-6x a day, thickest in the morning, most watery at night. Our CN reminded us that because Abby has lost so much of her small bowel she will always have diarrhea and our goals should be to see a decrease in frequency, to maybe only 3x a day and hopefully one day poops that are consistently only a score of 5 on the Purina fecal scoring system chart. Currently Abby’s poops are usually a score of 6-7 with an occasional 5. http://www.epi4dogs.com/poopchart.htm
Just this past week we passed the 3month anniversary of Abby’s torsion and surgery. This date was a real milestone for me as everything I read online re:veterinary studies of dogs that had bowel resections and a loss of a large section of small bowel, would show that a dog that survived the first 3 months generally lasted until they were no longer being followed by the authors (i.e. a couple of years). Because Abby lost 70% of her small bowel, she is on the borderline of good vs bad outcomes. So three cheers for our wee Abby…she has survived the acute recovery period and now we are transitioning to chronic mode.
I have to admit this has all become quite an obsession for me this last 3 months but I am feeling pretty good right now. Abby is a happy active little dog, her quality of life is very good. Other good news is that the CN at the OVC also reviewed Abby’s BCS and gave her a 4/9 instead of a 3/9 as our family vet’s practice partner did. (I shouldn’t have even asked for it that day, she was a vet that didn’t know Abby and a BCS can be quite subjective) The CN told us that family vets often underestimate Body Conditioning Scores because they are so used to seeing dogs that are overweight. So a 4/9 is pretty perfect and I’ll take it!
The next steps are the modified diet plan, and Abby will be discussed at internal medicine rounds this week at the OVC re: would she benefit from another round of metronidazole and/or would she benefit from a low daily dose of an antidiarrheal. I know those seem like simple actions that any vet might do, but the opportunity to discuss it with a number of professors and vets at a university teaching hospital may have far reaching results…who knows, Abby may be the subject of a journal article some day.
Once again, thank you pitlove, Susan, & Tyrionthebiscuit for reading and offering your supportive comments and knowledge. It has been very helpful for me. I realize this is a rather long winded post but I am hopeful that if ever anyone else has to go through a similar experience with their dog, they will find this post and know that there are people out there willing to share their knowledge and experiences to help that family have a positive outcome. As our CN said, a lot of this is trial and error because many dogs don’t survive post surgery or their owners can’t afford the surgery so there isn’t a huge amount of information out there. I will continue to post updates about Abby’s progress, thanks all….Cheers for now
