Canine Lymphangiectasia (CIL) discussion

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My name is Mary and my dog, Charlie has an appointment tomorrow with a nutritionist from Red Bank Veterinary Hospital.  I would like to ask the group to help me prepare with what questions I should be asking the vet.

Charlie's albumin level has been low for the last year.  My vet has prescribed B12 shots and adding egg whites to Charlie's diet.  His blood work on 4/25 showed an albumin level of 1.9 so we increased the B12 injections to once a week and 2 egg whites a day.  Since the middle of May, Charlie has had a decrease in appetite and within the last week, the only thing he will eat is potatoes with low fat ricotta cheese.  He has not lost weight and does not have diarrhea.

An x-ray and ultrasound this week show a thickening of the intestine walls thought to be from inflammation not lymphoma with a possible diagnosis of Inflammatory bowel disease and/or Lymphangiectasia.  I don't want a biopsy done because of the risk of not healing due to low albumin levels.

In a perfect world, I do not want Charlie on prednisone because of the side effects.  Charlie also has epilepsy which currently is under control but he needs to take phenobarb and Potassium Bromide so I am very hesitant to add medications.  I am hoping to address the inflammation and protein absorption with diet.  Charlie started Flagyl this morning and seems to feel better tonight with more of an appetite. 

So, what do I ask the doctor tomorrow?  Do I have the option of no steroid?  Royal Canin vs Hills zd?  Home cooked?  Probiotic? (Does Fortiflora have additives?) I-glutamine?  Slippery Elm?  I am anxious that I will not have the answers and will end up watching my little brown dog waste away and not be able to help him.

Thanks for listening and your suggestions,
Mary
My 6.5 lbs. Yorkie, Ernie, has been going strong on a very low dosage of prednisone (1.25mg) every other day, a probiotic and royal canin low fat canned. Although I don't like giving him such a commercial dog food and the prednisone, he's doing great so before you say no to prednisone, I would weigh your options. It also depends on the severity of your dog's results. Ernie was aggressively losing proteins through his intestines so I had to take drastic measures to get him under control. Dogs have been know to live for years on this regimen so I'm hopeful he will do just fine. And before making your own food, I highly recommend the RC low fat. It's formulated for CIL. And also is pork instead of chicken.

Here's the link to the probiotic I use: http://www.probios.com. It has no fat.
(07-07-2016, 03:22 PM)Geraldine Wrote: [ -> ]My 6.5 lbs. Yorkie, Ernie, has been going strong on a very low dosage of prednisone (1.25mg) every other day, a probiotic and royal canin low fat canned. Although I don't like giving him such a commercial dog food and the prednisone, he's doing great so before you say no to prednisone, I would weigh your options. It also depends on the severity of your dog's results. Ernie was aggressively losing proteins through his intestines so I had to take drastic measures to get him under control. Dogs have been know to live for years on this regimen so I'm hopeful he will do just fine. And before making your own food, I highly recommend the RC low fat. It's formulated for CIL. And also is pork instead of chicken.

Here's the link to the probiotic I use: http://www.probios.com. It has no fat.
Thanks, Geraldine.  I'm glad Ernie is going strong!  I tried Charlie on Royal Canin low fat and he wouldn't eat.  Tried Purina HA, wouldn't eat.  Tried Tilapia and potatoes and he ate just a little. He's lost a pound since Sunday.  He ate pasta and pork loin tonight.  Nutritionist just wants him to eat low fat protein and a carb right now to get him eating then we'll figure a diet.  I'm not saying I won't do prednisone, just hoping not to.  Thanks for the advise on probiotic because Fortaflora that I had been using has protein based flavoring.  I'm hopeful my little guy will keep eating and we can figure it out.  It's so hard to not have him eat.
FYI: FortiFlora has fat.