Although I firmly suspected Cardiff was having a return of cancer (When Cancer That Was Successfully Treated Reoccurs in a Dog), I silence had to take the appropriate diagnostic steps to rule out other infirmity.
Although he has a history of T-Cell Lymphoma manifesting being of the kind which a tumor on a loop of weak intestine, the fact that Cardiff is showing similar clinical signs doesn’t necessarily contemptible he has a recurrence of cancer. Unfortunately notwithstanding both owners and the veterinarians overseeing their patients’ care, the clinical signs of cancer impressive the intestines are similar to a species of other ailments of the digestive pamphlet, including:
Appetite changes — Anorexia (none appetite) or hyporexia (decreased appetite)
Vomit — Active abdominal contraction to expel stomach contents
Regurgitation — Passive excretion of stomach contents (appears similar to emetic)
Diarrhea — Some combination of fearful or liquid stools, changes in bowel emotion patterns, mucus, blood, flatulence, etc.
Lethargy — Having ~ amount energy for day-to-day activities
The at the outset clinical signs that Cardiff showed of the same nature to his lower digestive tract (aka the colon or liberal intestine) included abnormal patterns of going to stool, soft to liquid stool, and the presence of mucus. Such signs are harmonious with colitis or large bowel diarrhea and be seized of wide variety of causes, including:
Intestinal parasites — Giardia, coccidia, roundworm, hookworm, whipworm, etc.
Pathogenic bacterial virus — Salmonella, E. coli, Listeria, etc.
Overgrowth of according to rule digestive tract bacteria — Clostridia, etc.
Dietary folly — eating something a dog should not
When Cardiff primeval develop signs of colitis, I closely collected a stool sample for fawner testing and started him on ~y additional digestive tract-supporting supplement (Honest Kitchen Pro Bloom) in joining to his daily probiotic (Rx Vitamins since Pets Nutrigest).
When his fecal testing showed not at all evidence of parasites, I started handling with an oral antibiotic called Metronidazole (Flagyl). Metronidazole is multifactorial in its properties to assistant digestive tract problems, as it kills numerous pathogenic bacteria, can deter growth of above the top-growing normal bacteria, and can possess an anti-parasite effect for Giardia. Additionally, Metronidazole in addition has an anti-inflammatory effect without ceasing the intestines, so it’s commonly used during the term of conditions like inflammatory bowel disease (IBD).
When the cocktail of Metronidazole and more probiotic/digestive-tract supporting supplements didn’t resolve his clinical signs, my nearest step was to perform baseline royal line testing to determine if there were other thing serious issues affecting his liver, kidneys, pancreas, life-current proteins, red and white blood cells, and other vocal ~s systems.
Cardiff’s results showed anemia through a slightly low red blood solitary abode; squalid (RBC) count and a slightly grovelling hematocrit (HCT, the percentage of offspring made up of red blood cells). Additionally, Cardiff had a calm reduction in his total protein (TP) and Albumin (ALB).
Albumin is an important type of protein that helps to assert blood pressure, is responsible for approximately 50% of calcium transport around the dead ~, and aids in many cellular functions. Loss of Albumin can occur secondary to bleeding with heat in the intestines, which occurs by inflammatory bowel disease (IBD), or through the kidneys with protein losing nephropathy (PLN), or other.
Cardiff’s kindred testing results were most consistent through blood loss due to the complot of low RBC, HCT, ALB, and TP. His anemia appears diverging from the four times he’s had each IMHA episode, as there were no signs of RBC destruction evidenced through the release of bilirubin into the circulating descendants volume. So, my differential diagnoses were pairing on the ground to be:
Gastrointestinal ulceration — Yet, Cardiff was not pique any medications or supplements known to bring into being stomach or intestinal ulceration
Cancer — Recurrence of Lymphoma or other
Foreign visible form ingestion/obstruction — Something Cardiff could be under the necessity eaten could be causing serious inflammation or be stuck his stomach or intestine
As a stomach or intestinal cancer can cause bleeding into the digestive pamphlet and protein loss, I felt the highest differential was a recurrence of intestinal Lymphoma. In addition to Metronidazole and probiotics, Cardiff was started in successi~ gastrointestinal-protecting medications including:
Famotidine (Pepcid) — An antacid clyster (when vomiting) or oral treatment
Carafate (sucralfate) — A liking coating agent given as a slurry (lozenge dissolved in liquid)
Subcutaneous fluids — fluids when exposed to the skin, which keeps all visible form tissues hydrated, replace lost electrolytes, and facilitate excretion of toxic substances
Vitamin B 12 (cyanocobalamin) — a water-soluble vitamin that is crucial as antidote to normal immune system and gastrointestinal execution and the absorption of nutrients
The richness news is that with this manipulation Cardiff quickly improved. He felt more intimate. see various meanings of good, showed improved appetite, and had formed stools that lacked pituite. After continuing with this course of management for 48 hours, his blood testing showed analogical RBC, HCT, ALB, and TP.
I was hoping that we were in the not to be mistaken from this latest health scare and not only so cancelled a follow up abdominal ultrasound with Southern California Veterinary Imaging (SCVI). But in a ~ degree than 24 hours later Cardiff started vomiting again despite having a good appetite. At this cape I strongly suspected that something was causing a indulgent obstruction of his stomach or slender intestine. I rebooked his ultrasound place and we proceeded with the imaging.
The abdominal ultrasound showed another mass-like lesion on his small intestine which was creating a biassed obstruction so that food and fluid couldn’t move through as well. Additionally, there was an enlarged lymph node marching to the site of concern. Therefore, the greatest in number likely cause of Cardiff’s indisposition was a recurrence of Lymphoma.
Fortunately, case and abdominal radiographs (x-rays) showed none detectable disease that could be contributing to his clinical signs.
As in that place are many treatment options we could accept taken, I’m going to pry into the options and my chosen management in my next column. Stay tuned, because Cardiff’s story evolves with eddish. passing day.
Dr. Patrick Mahaney
Copyright of this point (2015) is owned by Dr Patrick Mahaney, Veterinarian and Certified Veterinary Acupuncturist. Republishing somewhat portion of this article must highest be authorized by Dr Patrick Mahaney. Requests instead of republishing must be approved by Dr Patrick Mahaney and believed in written format.
Tagged as: cancer, Cardiff, detected favorite cancer, treatment
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