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Hi Everyone, Karen here! (the good kinda Karen). It’s been almost 4 years since our sweet Abby suffer the loss of 70% of her small bowel. I’m happy to report that Abby is doing great and is transitioning into a middle aged dog. I never did get to writing an article about how we got her to this point but I have been doing some helpful things. I was interviewed about home made prescription diet dog food on a radio show called “The Urban Zoo” . If you are interested in listening to the interview the podcast link is below. I have also made some instructional videos on home made dog food. They aren’t terribly professional but each one is pretty short and I have lots of time saving tips on preparing and freezing the food. That link is here:
For episode 33 of The Urban Zoo go to:
I hope everyone is healthy and strong, I hope everyone’s beautiful dogs are also healthy and strong. Feel free to contact me if you have any questions about the videos etc…Cheers
Hello Lily and everyone,
Karen Here…Mom of Abby who is doing so great you would never know she lost 70% of her small bowel. Lily, What I have learned is Baker needs time to heal, It took close to 2 years before Abby was completely healed (and as a nurse I can tell you, even with humans, a wound may be closed but the healing underneath takes up to 2 years). Secondly, getting a good home made dog food recipe really made the difference for Abby. She hated all the prescription kibble and her poops were always watery and frequent, up to 10 times a day, when she was on some of those foods (Purina in particular)
Thirdly, Metronidazole daily helped to keep her gut flora in check. She was on Metronidazole 2 times daily for about 10 months. when we could see that she was improving we slowly weaned it….really slowly
Four: If Baker lost his ilium, he will need injections of B12 for the rest of his life. B12 is absorbed in the ilium so if you don’t have one anymore then you can’t absorb it.
Five: get Baker away from probiotics. We were giving Abby probiotics for a year after the injury thinking we were helping her but if you look at the type of bacillus in probiotics, at least half of the species are lactose-bacillus. Lacto bacillus is the most common bacteria in the stomach, duodenum, and jejunum. If Baker lost his lower intestines then giving him more of the bacteria he naturally produces in the upper intestines will overrun what little lower GI bacteria he can produce, which will contribute to more diarrhea and discomfort.
I can’t help you with the hind end pain problem, but certainly when Abby was pooping 10 times a day she wasn’t comfortable. Could it be a post surgical/scar tissue problem? That hurts.
Anyway, I am happy to send you any and all information I have. The prescription home made diet recipe was a game changer for Abby and I have shared this recipe with Stephanie too. I believe it also had a very good result for Maui. The recipe is specifically designed for dogs who have lost much of their small intestine (the part that absorbs most nutrients). It is a low fat, high carb, high protein, lots of veg diet and we add a vitamin supplement and a small amount of canola oil every meal (very small amount…1ml to each meal). The recipe was created by a clinical nutritionist veterinarian at the Ontario Veterinary College…which is 15 minutes away from where we live (The OVC saved abby’s life that fateful night, another regular vet office would not have been able to save her –her story has even been used in case studies at the OVC)
Finally, Abby’s weight dropped significantly in the first year after her surgery, she lost almost 25% of her post op weight after 6months. That is when we started the homemade diet and daily metronidazole and stopped the probiotics.
Let me know what you think….Karen
my email address is [email protected]
Gosh Hi Everyone! I didn’t get an alert from the last 3 posts so I had no idea that Cara and Laurence had joined and Susan had updated.
Firstly Abby is doing great. She was up to 17lbs at Christmas, so we have had to cut back on her daily food intake….what a glorious thing for me to write! She is now down to 16.4lbs and I think we will keep her at this weight over the Winter (it’s pretty cold outside now and she can use the extra fat). We will probably limit her food intake a little more in the Spring as her ideal weight is actually 15.2lbs.
Abby remains on our home made prescription diet. She gets 75mg metronidazole daily and 1ml B12 injection weekly. Our nutritionist Vet did a presentation about her at the OVC and asked me to write up how I prepared her meals, the cost and the time. If anyone is interested I can post that here. I have learned a lot about making a home made diet, I think it helps to be a little obsessive compulsive….keeping to the recipe exactly and weighing each item after cooking and draining is very important.
Because Abby lost 70% of her small bowel she can’t absorb fats. She only gets 1tsp of canola oil daily, and whatever fat is left over after meticulously draining the lean ground beef (I obsess about draining it very thoroughly because the prescription recipe called for extra lean ground beef but it’s expensive to buy 2kg of extra lean ground beef at a time and extra lean generally doesn’t come in large packaged amounts).
Another very important addition to Abby’s diet is a vitamin/mineral supplement. Abby was prescribed Balance IT by the OVC Vet. We have to order it on line from the U.S. which is a bit of an annoyance but The OCV trusts that the product is properly monitored in production and the ingredients are of good quality. I believe the standards for medications for animals are not as stringent as they are for humans so the OVC is careful about what they choose when prescribing an OTC product. (over the counter)
Laurence, the trick for us in decreasing poops and firming them up is the homemade diet. When Abby was on the Purina H/A her poop was still pretty watery. Thickest in the morning and then like water by evening. Looking back at my notes from a year ago Abby was pooping 4-10x a day. Currently she poops 2-3x day. Her first poop of the day looks like a normal dog poop and we are now back to carrying poop bags with us when we go for walks. in the evening her poop is the loosest and I’d say it is the consistency of pudding. (On the fecal score chart she is a 3 in the morning and a 5-6 in the evening) What a change in a year!
I think there are 3 main factors in Abby’s improvement: 1) time – time to heal 2) home made prescription diet & 3) a regular daily dose of metronidazole – I hate that we have to rely on an antibiotic to keep her gut flora under control but that is our reality. Currently she is on half the daily dose she was originally prescribed but if I try to wean her down to a lower dose she starts pooping more so I guess this is where we will stay for now.
Finally I want to say a couple of words about probiotics. Abby was started on Fortiflora almost immediately after her surgery. We didn’t know if it was helping but we hoped it was. Later our nutritionist Vet suggested we try Visbiome. Visbiome is a high quality probiotic for humans with ulcerative colitis and I.B.S. You order it on line and it is delivered in a styrofoam cooler with a cold pack inside (obviously great care is taken to keep the bacterium alive). It was kept in the fridge and we gave it to Abby everyday. However, when I was researching fecal transplants in humans (yes, Abby had a fecal transplant – it didn’t really help) I came across a journal article that stated in humans:
“SBS patients, with colon in continuity, harbor a specific fecal microbiota that we called “lactobiota” because it is enriched in the Lactobacillus/Leuconostoc group and depleted in anaerobic micro-organisms (especially Clostridium and Bacteroides )”
The ingredient list of Visbiome states that over half the bacillus species in the probiotic supplement were in the Lactobacillus group! So essentially we were giving Abby more of the same bacteria that she already had an overabundance of!
Fortiflora has a lot of filler ingredients but only the Enterococcus faecium is the active one. Which is a strain of gram + streptococcus (which is naturally occurring in the gut of animals and humans)
Needless to say, we stopped the probiotics and she hasn’t had any since. I’m not saying this is the case for every person and every dog, but I believe the probiotic was not helpful for Abby. As an addendum I would just say that dogs and people, being both mammals there isn’t a heck of a lot of difference between them when it comes to the GI system.
Okay, I’ve written a lot here so I better stop. If anyone wants my recipe notes or even the link to the journal article about lactobacillus let me know
Cheers for now….Karen
Oh my gosh Stefanie, I’m so glad to hear that Maui is still alive! Our stories sound very similar. I will email you
I just thought I would drop a quick line to say that Abby is doing great. It was a long and worrisome Winter and Spring but she has survived and I think it is safe to finally say she has even thrived. She is gaining weight and pooping 2-3x a day now. We have kept records on every intervention we tried, when, how much and her response. I am planning to write it all up in a document so that it can be shared with others who may be going through a similar experience. We know that many Vets recommend euthanasia for dogs when they develop torsion as the survival rate is very low and we hope our story will help to advance research.
To recap: Abby suffered mesenteric torsion on October 13th 2017. approx. 7 hrs later she had surgery at the Ontario Veterinary College where they removed 70% of her small bowel. She remained in ICU x 6 days and was discharged home to us. We have been followed and advised by a Vet at the OVC who is doing her Masters in clinical nutrition. She has been through several different feeds, meds, injections and even a fecal transplant. it’s quite a story and I am really excited about writing this up….not sure about the best way to do it, but I sure do want to ensure that others can benefit from our experience. Any suggestions? A Blog? A story? An article? I would love some advise. Has anyone else formally written of their experiences?
Hi Stefanie, I agree with anon101. Maui’s body has been through a lot of change and suffering and it would be very good if you could keep close contact with the veterinary nutritionist. Is the surgeon still available to you for Maui’s post operative care? I have found with Abby that we have to be very careful about making changes because her body reacts quickly when she is fed something new, and the reaction is usually more diarrhea, which we all want to avoid. Also, Maui isn’t even a month since all the surgeries started. He is still acutely recovering from surgery and should be getting lots of rest. For the first few weeks after Abby’s surgery we were hand feeding her very small amounts 6-8 times a day. also, I would watch to make sure she was getting enough water because she was losing so much through her bowels. The first food Abby was eating was Royal Canin gastrointestinal both canine and feline both wet and dry(dogs can eat cat food but cats can’t eat dog food- the cat food has a higher protein content) and we also tried to give her more of the dry food because we hoped it would absorb some of the water in her bowels. When we started to see the clinical nutritionist at the veterinary college here in Ontario (Canada). Abby was switched to a hydrolysed protein diet. Originally we gave her Hills z/d – both dog and cat but she didn’t like it very much. Now she is eating Purina H.A. and she likes it a lot. But she has to eat almost 3 times the amount recommended for a dog her size. We carefully measure and record every meal she eats and we never give her more than 40gms per meal. She still eats 6-8 times a day. You will have to monitor Maui’s weight as well, it sounds like he lost a lot. To answer your questions we did not have a lot of luck with the metamucil Abby continued to poop like crazy with it. Also, we were giving Abby Fortiflora but the internal medicine service at the vet college has suggested we try Visbiome instead. I have just ordered it so I can’t tell you how good it is yet but it looks like it is very well regulated and produced. Again, I would check with your vet about switching foods and go slow if you do. Maui may never have formed stool. Abby rarely does. It’s a big job you have ahead of you but hopefully Maui will recover enough to enjoy his life. That is our priority with Abby. I hope this is helpful. I am happy to share our experiences with you but I think the best thing you can do is follow your vet nutritionist’s instructions, monitor ins and outs carefully and keep records of them for the nutritionist, and enjoy every minute you have with Maui….Cheers for now, Karen
Hi Susan, Turkey sounds like a great idea. We buy our beef from a farm so I just grabbed what I had in my freezer based on what we saw at the Vet hospital.
I’m sorry to hear that Patch isn’t doing so well. Our dogs are like our children, I knew that was the case before Abby got sick but I had no idea how emotional I would get and how much I realized I loved her until we almost lost her. I imagine you have similar feelings. You have obviously put so much thought and time and money too, into keeping Patch as healthy as he can be. I hope that Patch isn’t in any pain and you find out what is wrong soon. I also hope that it will be a fixable problem.
Thanks for the suggestions about the Purina foods. I think that is one of the foods our CN is going to write up in the report. Royal Canin is always in the back of peoples minds here because the head office is about 10 minutes from the Vet school and they give scholarships etc to the UofG for the OVC. I’ve heard a lot of talk about kangaroo and alligator but haven’t seen any of those foods yet. In Australia I imagine, they are plentiful….or at least the kangaroo is, my husband worked on a farm in Toowoomba when he was a student and he says the famers used to go out and shoot the Kangaroos just to keep the population down. So I’d say the dogs of Australia get a real treat….We don’t really have anything running around Southern Ontario like that….Hmmm, raccoon maybe haha.
Your meatballs sound wonderful. Does Patch eat kibble as well as the food you prepare? what is the ratio? The extras we give to Abby are such a small amount of her overall diet it’s a little hard to add more than one ingredient per feed. To maximize absorption we have to give her small feeds throughout the day instead of one or two big feeds. She eats 5-6x a day. She does love veg and veg has virtually no calories so she can have squash and broccoli and red peppers (her favourite) as much as we wish to give her. I give them to her partially cooked now, to cut down on the gassy aftereffects.
Well I better finish and get ready for work. I will keep my fingers crossed for Patch. All the best….Karen
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
Hi Susan, thank you for all the info. I have read some of your other posts about Patch and I’m really glad to read that he is doing well.
The diarrhea is definitely a major problem but we were told even before the surgery that Abby may have loose poops for the rest of her life (if she lives). Loosing 70% of her small bowel really speeds up gastric emptying….trying to slow it down is definitely a major priority and all the suggests you have made r/t fibre content and other kibbles gives me lots of questions to ask when we see the nutritionist. I find it interesting that you asked if the probiotic was working. I have been giving Abby fortiflora religiously everyday but today I thought I might try a day without to see how she does and so far she has eaten 7 small meals (~20-30gm of z/d mixed with 5gm cooked ground beef) and only pooped 3 times. It could be a coincidence but is it possible that the fortiflora could be contributing to her frequent BMs? I would be curious to know. As for the cheese. We only give her 5-6gms grated on her food. just to entice her to eat, and not every meal because she seems to prefer the beef so I don’t think that is contributing to the diarrhea, but its a good thing to keep in mind. Her bloodwork results have come back and although most of her results are normal there are a few that are high or low, but who knows, maybe those numbers are good for a dog who has been through such a traumatic surgery. I will look up K-9 Kitchen and K-9 Nutrition. Both sound like great resources. Thank you so much for all your suggestions Cheers for now,
Hi pitlove, thank you for replying. We started with Royal Canin gastrointestinal moderate energy but the nutritionist thought the hydrolysed protein in the z/d would be better for absorption. Occasionally Abby has produced a little soft poop but we don’t know why or when it is going to happen. the 6-8x a day has been the norm for us for the last 6 weeks or so, before that it was 10-12! We did bloodwork on Friday and next week after we get the results we are going to make an appointment with the nutritionist to really take a look at what she needs and if this diet is right for her. I have read a lot of posts on line about a homemade diet being the best thing for short gut and the nutritionist said that could be an option but she wanted to start with the ready made stuff first. unfortunately for us, Abby is a fussy little thing and for a while she wasn’t eating enough food to maintain her weight but things are better now that we can add the ground beef or cheese. Anyway, thank you for your suggestions, It’s tough worrying about this all the time and not being able to talk to many people about it. I really appreciate you replying 🙂