Question for Dr. Karen Becker

I have a 6 year old yorkshire terrier with IBD diagnosed via scope.  The scope results stated "unusually destructive lymphocytic gastritis" with no real findings of changes elsewhere in her bowel, however she did present with mucousy bowel movements so scope may have missed the section demonstrating this pathology.  Since this scope, we have her on a veterinary computerized diet of white fish, squash, yams and green beans.  As well as TYLOSINE and FAMOTODINE 5mg 2x/day.  She is doing very well on this and we have avoided prednisone thank god!!!!!!!!

My question is do you think the daily famotodine is harmful for her ?????????  I am afraid of what will happen to her stomach without it!!!!!  Also do you think long term Tylsine is harmful???(we tried without and her stools were very loose and mucousy and loud stomach noises so we had no choice.)

Thanks so much

Tony

Hi Tony,

I’m sorry this didn’t get answered.  I was hoping Dr. Becker would comment but I’ve noticed she hasn’t had any input in Facebook or Mercola?  May be tied up?

My Pom had/has ulcerative colitis.  We were able to figure out that the NSAID drug Metacam caused the colitis and subsequently seemed to have caused food allergies to multiple proteins (six in total).  Once allergic to a food, if eaten, it would cause colitis about 8 to 10 hours after eating.  I had a foster dog that developed IBD after being on an antibiotic for an extended period of time (he was only eight weeks old and is now allergic to everything - even grass).  It's apparently not uncommon for medications to cause IBD - something to keep in mind.  Could also be food intolerance/allergies plus. 

My holistic vet gave me a homeopathic called “Phosphorus” which would immediately stop the diarrhea.  This made it possible, in her case, to determine what set off the colitis.

IBD Overview

Inflammatory bowel disease or IBD includes Crohn's disease and ulcerative colitis, which causes inflammation in the digestive tract. The causes of IBD are unknown. Inflammatory bowel disease symptoms include abdominal cramps, bloody diarrhea, and fever. Other symptoms of IBD include weight loss. The goal of IBD treatment is to suppress inflammation.

http://www.webmd.com/ibd-crohns-disease/default.htm

I’m confused as to why an antacid would be given for IBD?  The antacid, obviously, keeps the stomach from producing as much hydrochloric acid – but, what benefit would it bring to the colon where the inflammation is?  Antacids are not anti-inflammatory to my knowledge?

The Tylosin may be killing bacteria in the colon if that is the cause of the IBD but will also be killing off the probiotics as well which will just add to the overall issue….  If the bacteria is causing the inflammation this may be a temporary fix but it will likely cause continued issues.

Sally had a previous thread regarding colitis and what helped a case she was working with.  May be beneficial?  The dog was able to stay off all drugs…

Giving probiotics, SeaCure and keeping Gizmo off reactive foods and medications (NSAIDs) is what helped her.  Now that the colon is repaired she can eat five of the six foods she reacted to infrequently and rarely has a case of colitis/diarrhea.

Good luck - I can honestly say I know how frustrating this condition can be!!!!

Sorry, I just answered my question.

Lymphocytic gastritis is a rare gastritis primarily diagnosed by the surgical pathologist. There is a peculiar infiltration of benign lymphocytes into the glands and surface mucosa. It may be associated with celiac disease and Helicobacter infection of the stomach. There are case reports of clearing of the disease by treatment for Helicobacter infection in the stomach.  http://www.thedoctorsdoctor.com/diseases/stomach_lymphocytic_gastritis.htm

The antibiotic given to kill off helicobacter and the antacid to relieve the irritation from acid on stomach lining.  Missed the lymphocytic gastritis in your post - sorry again....

I found site after site that connected lymphocytic gastritis to celiac disease as well as h pylori - did the previous food include gluten grains?

Hi Tony: I'm really glad your yorkie is doing well without pred! Certainly the antacid and Tylan powder are far less toxic then steroids, but always good to think about long term effects of all drugs (and supplements). The good news is that the lining of the GI tract regenerates quickly, once the underlying reason for the irritation is resolved. Because we don't know specifically why your dog acquired IBD it's hard to say (without re-scoping, which I would never recommend you do) if the bland diet alone has resolved her issues. I'm not sure what you were feeding her before her diagnosis, but I would venture to guess it probably contributed to some of her pathology. The new "novel" protein, no grain diet is probably a blessed break for her intestinal tract and much of reason she's doing so well. The Tylan powder "wipes the slate clean" on a daily basis....it's actual founded purpose was in hog production (it's a broad spectrum antibiotic that reduces stress based "scours," diarrhea that occurs on factory farms). You are probably aware of the problems with long term antibiotic use, and Tylan is no different. Vets use Tylan when an animal's body is unbalanced enough that it can't regulate it's own gut flora levels. So, to be able to wean her off the Tylan we must focus on building GI defenses. The antacids are on board to reduce acid irritation in the stomach, but you're also probably aware of the issues with longterm antacid use (hence you posting the question :). Short term antacid use is a really good idea, but this is the first medication I would recommend you talk with your vet about weaning her off of. Once any erosions are healed antacids can contribute to maldigestion and malabsorption, and issue you'd probably like to avoid in the future. Talk with your vet about reducing her dose slowly, over several weeks, and watch her closely. If you don't have an integrative vet you consult with, now is a good time to consider adding one (www.ahvma.org). Adding digestive enzymes can often times really help. After she's off of the antacid and doing fine you can consider replacing the Tylan powder with probiotics (which also keep the opportunistic, "bad" GI flora at bay in many cases). Sometimes using other GI support (glutamine, aloe, slippery elm, etc.) can be beneficial, but you should discuss this with your vet. Last (but certainly not least), your diet is not currently balanced. It's fine to feed an unbalanced, bland diet (devoid of calcium, omegas and trace minerals) for a while (up to 2 months, if your dog is not a puppy), but after that you need to balance the diet (consider visit www.balanceit.com for suggestions on how to do this with your current diet).

One last thought: 4 of the 5 forms of IBD are lymphocytic inflammation secondary to a food allergy. Changing diets is obviously a part of controlling the problem, however, if you don't rotate her diet in the future you could see the same allergic response. I recommend owners rotate proteins and veggie sources every 3 months. You would wean very slowly, in her situation, but I do recommend some nutritional variety to prevent the issue from flaring again in the future. Good luck!!

Hi  Dr. Becker,

THANK-YOU SO MUCH FOR YOUR RESPONSE TO MY QUESTION.  I REALLY CAN'T TELL YOU HOW MUCH THIS IS APPRECIATED.  (I apologize for the delay in response but I was away on vacation.) 

(Further to my original question, I forgot to tell you that she is on BalanceIT as well as probiotics, digestive enzymes, glutamine etc. in the form of "Rxvitamins" NUTRIGEST (nutritional support for gastrointestinal mucosa) and RXZYME (therapeutic enzyme formula) as well as calcium.)I have a few quick questions pertaining to your answer if you have a moment.

1)  How would I know if she had "malabsorption/digestion issues" secondary to famotodine use?  ( Her annual blood work is normal as of 1 month ago.)  Is there a way to test for this??/are there clinical signs and symptoms?

2)You have recommended trying to slowly wean off tylan powder and replace with probiotics.  Unfortunately, she is taking probiotics and we were unable to wean her off the tylan (1/4 teaspoon  2x/day for a 17lb dog).  This was even with trying homeopathic injections at relevant acupuncture sites. 

If worst case scenario is staying on Tylan powder am I to anticipate a shortened life span???, or can I hope that the probiotics are replacing some of the "good flora"

3) Also, you recommend trying to rotate her protein source.  Unfortunately, we tried many sources (venison, salmon, turkey and duck) with no success until we increased her tylosine dose and at that time also switched to talapia.   She is doing well on this regimine- probably due to the increase in tylan powder?   If  there are  no longer any novel protein sources for her, should I still try to rotate to them??     THANKS AGAIN---TONY

tHANKS FOR YOUR REPLY!!!!!!!!!!  (sorry for the delay ibn response but I was away)

I believe (hope) the internal medecine specialist who did her scope would have tested for this bacteria.  I can only assume this would be standard procedure to test for this but I will certainly double check.  Thanks very much for your information.

Yes, the previous food did contain gluten!!!!!!! unfortunately-

 sounds like you have delt with this issue with your own dog?????

thanks for your response and sorry for the delay in replying.  If you read Dr. Becker's response most of the answers are there.

In response to your question re: why antacid use in IBD, it is because her scope showed "gastritis", meaning the primary issue for her was  in her stomach ie. she had vomiting +++ and then later on also developed colitis type symptoms.  Due to the gastritis they put her on a "gut protector"/famotodine.

I would LOVE  to be able to get her off her antacids and meds as you were able to do with yours but as her case is severe I am not sure she will be able to.

Thanks for your input- much appreciated!!!

Do a web search for Slippery Elm Bark in dogs.  I use this for my cat for her stomach issues that accompany her hyperthyroidism.  My husband I use it as well.  It has gotten my husband off of his prescription antacids.  It is also good for a lot of other things including joint health.  You can get a great brand of it from www.vitacost.com.  NSI brand.  It is very affordable and effective.  Good luck.  =^..^=