Good morning,
Some may remember all the problems we had with Rayder and diarrhea when we first got him and for months afterwards: coccidia, giardia, clostridium, continued diarrhea despite resolution of all those. His poop finally normalized on Hills w/d and remained ok when I switched him to Royal Canin gastrointestinal fiber response. However, every time I have tried to switch him to a puppy food everything went haywire again and we were back to metronidazole and high fiber food. I had made peace with his not being able to be on puppy food.
Fast forward to now: he is missing his left mandibular fourth premolar and I arranged for a visit with a veterinary dentist to anesthetize him, x-ray the area, and remove the tooth if it was impacted, or just wake him up if the tooth was just not present (the much more likely scenario). In case you don't know, you cannot just leave an impacted tooth because it can cause what is called a dentigerous cyst which can destroy surrounding bone and teeth.
I ran some pre-op blood work on Rayder (the appointment isn't until April, but I wanted to get it over with). In all the previous diagnostics we did on him, including a visit to an internist, blood work has not been done (lots of varied and expensive stool tests, ultrasound, urinalysis, but no blood). The results came back fairly normal, but his protein was a tad low, and in a puppy you would expect it to be on the high side, certainly not below normal, even if it is just slightly. Low protein can cause problems with healing, especially if it were to get worse between now and any possible dental procedure, and given his history of GI problems can indicate a problem with absorption.
I ran a further GI blood panel looking at vitamin b12 which can be low in malabsorption, pancreatic enzymes, resting cortisol (a screening test for Addison's disease which would be super duper weird and rare and unexpected in an 8 month old). At this point I am really glad I got insurance for him!
Those results came back today: low b12 indicating lack of absorption, and his cortisol was super low, despite the excitement of being at the vet and the stress of restraint, blood draw, etc. There is a very good chance he has Addison's disease, plus or minus some other intrinsic intestinal problem. I am doing an ACTH stim test tomorrow which is the definitive test for Addison's. Addison's is low adrenal function and would require that he have some sort of steroid supplementation for life (there are 2 types of steroid they can be missing: glucocorticoid and mineralocorticoid (the worse of the 2) and he would appear to be glucocorticoid (prednisone) deficient if he is indeed addisonian, but could always convert to the other kind in the future). He is also going to have to receive b12 injections. Once all these results come back, I am going to reconfer with the internist to see if anything else (like intestinal biopsies) is indicated.
This is so much for an 8 month old to be facing and I am feeling overwhelmed and guilty and stressed. Thanks for reading this far!
Some may remember all the problems we had with Rayder and diarrhea when we first got him and for months afterwards: coccidia, giardia, clostridium, continued diarrhea despite resolution of all those. His poop finally normalized on Hills w/d and remained ok when I switched him to Royal Canin gastrointestinal fiber response. However, every time I have tried to switch him to a puppy food everything went haywire again and we were back to metronidazole and high fiber food. I had made peace with his not being able to be on puppy food.
Fast forward to now: he is missing his left mandibular fourth premolar and I arranged for a visit with a veterinary dentist to anesthetize him, x-ray the area, and remove the tooth if it was impacted, or just wake him up if the tooth was just not present (the much more likely scenario). In case you don't know, you cannot just leave an impacted tooth because it can cause what is called a dentigerous cyst which can destroy surrounding bone and teeth.
I ran some pre-op blood work on Rayder (the appointment isn't until April, but I wanted to get it over with). In all the previous diagnostics we did on him, including a visit to an internist, blood work has not been done (lots of varied and expensive stool tests, ultrasound, urinalysis, but no blood). The results came back fairly normal, but his protein was a tad low, and in a puppy you would expect it to be on the high side, certainly not below normal, even if it is just slightly. Low protein can cause problems with healing, especially if it were to get worse between now and any possible dental procedure, and given his history of GI problems can indicate a problem with absorption.
I ran a further GI blood panel looking at vitamin b12 which can be low in malabsorption, pancreatic enzymes, resting cortisol (a screening test for Addison's disease which would be super duper weird and rare and unexpected in an 8 month old). At this point I am really glad I got insurance for him!
Those results came back today: low b12 indicating lack of absorption, and his cortisol was super low, despite the excitement of being at the vet and the stress of restraint, blood draw, etc. There is a very good chance he has Addison's disease, plus or minus some other intrinsic intestinal problem. I am doing an ACTH stim test tomorrow which is the definitive test for Addison's. Addison's is low adrenal function and would require that he have some sort of steroid supplementation for life (there are 2 types of steroid they can be missing: glucocorticoid and mineralocorticoid (the worse of the 2) and he would appear to be glucocorticoid (prednisone) deficient if he is indeed addisonian, but could always convert to the other kind in the future). He is also going to have to receive b12 injections. Once all these results come back, I am going to reconfer with the internist to see if anything else (like intestinal biopsies) is indicated.
This is so much for an 8 month old to be facing and I am feeling overwhelmed and guilty and stressed. Thanks for reading this far!