Can I just say....my head hurts?The short version:
Hormones, probably SIBO, and possibly (genetic?) pulmonary disease.***********
The long version:
First, Dr. Plechner has sent recommendations for my vet to treat the hormonal syndrome that Max has. I have not yet talked to the acupuncture vet yet, and I hope that she will do this. Jean, you were right about the dosage on the shot, scary high for someone like me. I'm willing to take this leap of faith.
So, today, I was prepared to be disappointed, but I wasn't. Very open, very intelligent, confident, without that annoying ego
and of course experienced, because he works at a referral only clinic with all the tough cases. Of course, without any testing, everything is kinda a hunch at this point. Btw, his "hunches" with Indy, about 11 years ago, were right on.
He saw three things that he was concerned about with Max.
Certainly the low cortisol, and, while Max isn't Addison's, he's "Addison's like" and would recommend being treated in that way. He did not think that any fluids would help Max, and, in fact, might not be good for him, since whatever is causing his hypovolemic-like issues, the extra fluid might just kick that into overdrive. Since I am going to (hopefully) be doing Plechner's protocol, we didn't talk about the hormones that much.
He doesn't think that Max is truly hypovolemic (lost blood or fluid), he thinks that the blood is pooling somewhere in his body. He doesn't think it's the enlarged spleen, because it would have to be massively enlarged to have this effect. The large organs capable of doing this, would be the skin, the veins, or the abdominal area/GI system.
He thinks it's the veins, that Max's vascular structure is dilated, from inflammation. His conjecture, is that it's from, guess what? A new twist on an old demon: SIBO.
He said that with SIBO, two things happen. Their body will start reacting to it, much like an allergen, and also that it doesn't stay in the gut. It will travel through the bloodstream, and it doesn't have to be alive to cause this kind of damage, it can be remnants of killed stuff, or by-products. He believes that it's in his bloodstream and that his body is reacting to that. He also said that they are finding some nasty types of e.coli in some SIBO cases. He likes to start with Tylan, 3 times a day. If that doesn't work, sometimes they even have to use Baytril.
He did want me to run a folate/b-12 test, just to see what it shows. He also recommended weekly B-12 injections if it shows low B-12, give the first injection the day of the test, and then see what the results say. 1,000 mcg for a dog Max's size. We didn't run the test on Max because it requires a fast. An EPI test would be good, just to know, but since I give him enzymes, not very valid.
I should note, the blood abnormalities started to show up a bit after I stopped the tylan, used to help with the fistula.
We talked about a biopsy of the digestive tract, how it would probably show the same type of inflammation that every other part of his body has shown, that lymphocytic stuff...same thing he lost his dew claw to.
The noisy breathing, in the esophagus, he thinks is from esophagitis, an irritated esophagus from the GI issues. I think it's possible that the doxy is contributing to this (can you say rock and a hard place?)
The last thing, he just had a feeling, was pulmonary fibrosis. He said that the xrays don't support this, but many of the pulmonary fibrosis cases don't show up on xrays, the only way to diagnose is with a lung biopsy. He noted, if this were the case, it could progress very slowly, or very rapidly, and we both knew what he was trying to say. ***********
So, my hope is, treat for the hormonal stuff (hope the vet will do this
), check and treat for SIBO, and look to alternative ways to support the lungs (more googling!).