# Desperately seeking advice (issue has been ongoing for 12+ months)



## Craig010203 (Jul 20, 2021)

To summarise things briefly, we have seen a number of different veterinarians and specialists over the past 12 months, and have had a range of tests too (varying from an MRI of his lower back, X-Rays of his stomach and hips, blood work, countless examinations) but we have never been able to determine the underlying cause. The examinations/tests always come back unremarkable.

Since April 2020 - Max will have these ‘episodes’ that typically occur every 15-20 minutes (but it is common for him to have multiple attacks within minutes of each other as well) where he can be sleeping, resting or standing, and then immediately jolt up and begin pacing uncontrollably whilst (if severe enough) whimpering in pain. During this time he will be licking his lips repeatedly, occasionally have a very arched back, and will also place his head very low to the floor (please see videos attached for referencing). After a few days it will then miraculously go away (the episodes will widen in frequency) to the point where it then stops and he can rest. After several weeks/months it will then return again seemingly randomly.

As you can appreciate, having to deal with this for so long (particularly when it is severe) is already distressing enough for the dog, and he is also unable to sleep during these periods as well. We’re desperately just looking for some guidance on what we can do next and as to whether anyone has seen this type of behaviour before within a goldenn. Our finances have been completely drained as a result of this, and we’re willing to try anything in an attempt to get this under control. It is both mentally and physically exhausting not only for the dog, but us as well. 

Following the events over the past 12 months, we have followed a range of recommendations from various specialists and Vets - such changing to various foods (from AVA, to Royal Canin Golden Retriever, to Royal Canin Hypoallergenic and now Royal Canin Gastrointestinal), a strict diet, regime and limited exercise – but none of this has helped our situation. Max is currently on Royal Canin Gastroinestional and is fed 8:15, 13:45 & 18:45 (each portion is 115g which is weighed electronically and eaten via a maze bowl). The reason why I am highlighting his food is, on all of the occasions where we have taken Max to the vets (even when he is experiencing the most severe episodes) the examinations always come back unremarkable and we assume due to the adrenaline and the dislike for the vets, it overrides the pain responses. Ultimately, I am convinced the area of concern is his stomach or at least something internal. My observation would be like a sharp pain or something giving him grief. We have witnessed him roll over onto his back on some occasions because the pain is so significant but the worst part is the level of discomfort and the overall duration of it, it can last for days, and it is pure hell for him. Here are some videos of it:

Videos:

Violent pacing again (violent pacing and restlessness)


More pacing (pacing in the house, discomfort)






 (resting and then pacing)






 (head down, back arched and licking of lips)


Pacing starting (pacing and discomfort)


Dog Pacing (severe pacing with audible crying and discomfort which is quite common)






 (pacing)






 (Mild episode whilst upstairs and relaxing/sleeping)






 (episode with access to the garden (typically attempts to roll over to minimise discomfort)


Behaviour after pacing (after an episode. Will just repeatedly walk in patterns and cannot rest for hours)

Have you seen this before, do you know what it could be? No one is able to tell us.


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## CAROLINA MOM (May 12, 2009)

Bumping up


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## pawsnpaca (Nov 11, 2014)

I'm so sorry you and Max are dealing with this. I agree it's very bizarre and it sounds like you've already pursued most of the traditional routes to try to resolve this.

So.... All I have left is some "out there" suggestions:
1. When traditional vet medicine fails me, I always default to holistic medicine. Have you tried taking him to a holistic vet? Or tried acupuncture? This may be as simple as a pinched nerve that isn't showing up on MRI/x-ray.
2. If you think it's digestive, and you have no reason to believe he might be sensitive to milk, you might want to try a round of colostrum therapy
3. Would you consider using an animal communicator? (I've had mixed success with this - some have been completely off base and others have been absolutely amazing and spot on. If you try a holistic vet, they might be able to refer you to someone who they feel is "legit." If you get one that is good, they may at least be able to tell you what the dog is experiencing so you can narrow it down to digestive, pain, spine, etc.).

I hope you get some answers soon!


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## Prism Goldens (May 27, 2011)

That would have me soooo worried. Pain, anxiety, seizure, whatever it is is not good. I think I would see a neurologist- who may try anxiety meds after bloodwork.. I'm so sorry. I know this is frightening.


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## Craig010203 (Jul 20, 2021)

> Bumping up


Thank you for that, it is appreciated!



> I'm so sorry you and Max are dealing with this. I agree it's very bizarre and it sounds like you've already pursued most of the traditional routes to try to resolve this.
> 
> So.... All I have left is some "out there" suggestions:
> 1. When traditional vet medicine fails me, I always default to holistic medicine. Have you tried taking him to a holistic vet? Or tried acupuncture? This may be as simple as a pinched nerve that isn't showing up on MRI/x-ray.
> ...


Thank you for your reply. We will certainly look to explore these areas.



> That would have me soooo worried. Pain, anxiety, seizure, whatever it is is not good. I think I would see a neurologist- who may try anxiety meds after bloodwork.. I'm so sorry. I know this is frightening.


Thank you for your reply. Interestingly, we have had him cleared by neurology but they did not explore this in the way of scans. All of his practical examinations went well, so they opted not to go down this route. It is definitely very distressing to watch and deal with though, mostly because there is nothing that we can do when it is happening. He is usually a very calm dog and loves his sleep so when he is like this, we immediately know something is not right.


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## nolefan (Nov 6, 2009)

I'm so sorry. My first thought was some sort of seizure behavior. How old was he when this started? I wish I had something to offer other than sympathy. Have you considered a homecooked diet or raw where he had single source of protein and reduced or limited carbs? Trying only beef for 2 weeks or trying only lamb or duck etc. for two weeks with some rice? Have you consulted with a chiropractor? He appears to be a healthy weight.... does he have good quality of life when this isn't happening? Enjoy walks and outings? Play?
Has the vet offered some sort of sedative or pain reliever for when these episodes occur so that he can rest? Are you doing something to keep him in a part of the house so you can get sleep when this happens? I know it must be hard to separate from him when he's in pain but if you don't get rest and keep your strength up, you can't help him. I am so sorry for him and for you. Please update us on what you ultimately find to give him relief, it may help someone else in the future who is searching for answers.


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## Selkie (May 9, 2021)

Another super out there thought ... did you travel anywhere with him in the three months or so before this happened? There aren't many infectious diseases or toxic plants or what have you where the symptoms would last THIS long and be intermittent. But I'm sure there are some, and if they aren't found in your local area, the vet might not know about them.


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## Craig010203 (Jul 20, 2021)

nolefan said:


> I'm so sorry. My first thought was some sort of seizure behavior. I wish I had something to offer other than sympathy. Have you considered a homecooked diet or raw where he had single source of protein and reduced or limited carbs? Trying only beef for 2 weeks or trying only lamb or duck etc. for two weeks with some rice? Have you consulted with a chiropractor? He appears to be a healthy weight.... does he have good quality of life when this isn't happening? Enjoy walks and outings? Play?
> Has the vet offered some sort of sedative or pain reliever for when these episodes occur so that he can rest? Are you doing something to keep him in a part of the house so you can get sleep when this happens? I know it must be hard to separate from him when he's in pain but if you don't get rest and keep your strength up, you can't help him. I am so sorry for him and for you. Please update us on what you ultimately find to give him relief, it may help someone else in the future who is searching for answers.


Based on the most recent recommendation from the vet, we have switched him to gastrointestinal low fat (just in case there is an underlying acid reflux issue of some sort that is silent) but given the way he is during those videos, I find it difficult to associate it with that. You raise an interesting point about a possible seizure, as it has been said a couple of times before (from people observing the footage) but neurology do not believe that this is the case. 

He is a perfectly healthy dog outside of this, goes on for 3 hour walks a day (loves running, very playful, eating and drinking well, etc). Everything we have been prescribed during these episodes doesn't seem to have any impact yet. 

The sleeping arrangements (or should I say lack of) is pretty bad when he is having episodes. I usually try to sleep downstairs but if the pacing is really violent, it is impossible to sleep. If he is crying in pain too, it is even more unpleasant and distressing to deal with. 

So we have an otherwise very healthy dog that can be fine for weeks/months but then suddenly deteriorate rapidly.


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## Craig010203 (Jul 20, 2021)

Selkie said:


> Another super out there thought ... did you travel anywhere with him in the three months or so before this happened? There aren't many infectious diseases or toxic plants or what have you where the symptoms would last THIS long and be intermittent. But I'm sure there are some, and if they aren't found in your local area, the vet might not know about them.


No travelling at al but I appreciate your input. We've just been doing our usual routes for the past 3 years with no changes at all.


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## PalouseDogs (Aug 14, 2013)

I am surprised the vets ruled out epilepsy. It looks a little like some type of focal seizure. Or maybe a pinched nerve? Have any of the vets suggested a trial period of phenobarb? If the episodes stop while he's on PB for a period of a few months, it's probably epilepsy. If not, epilepsy is unlikely. If it's a pinched nerve or something similar, a trial period of Rimadyl might help. 

If you think it's food related, maybe he's having mild bloating episodes that resolve when he's moving around. If that's the case, he will eventually torsion, which is a disaster. You could try a home-made diet or add canned food and/or table scraps to his kibble. (There is some evidence that canned food and table scraps added to dry food decrease the incidence of bloat/torsion.)


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## Craig010203 (Jul 20, 2021)

PalouseDogs said:


> I am surprised the vets ruled out epilepsy. It looks a little like some type of focal seizure. Or maybe a pinched nerve? Have any of the vets suggested a trial period of phenobarb? If the episodes stop while he's on PB for a period of a few months, it's probably epilepsy. If not, epilepsy is unlikely. If it's a pinched nerve or something similar, a trial period of Rimadyl might help.
> 
> If you think it's food related, maybe he's having mild bloating episodes that resolve when he's moving around. If that's the case, he will eventually torsion, which is a disaster. You could try a home-made diet or add canned food and/or table scraps to his kibble. (There is some evidence that canned food and table scraps added to dry food decrease the incidence of bloat/torsion.)


Would those seizures typically cause a pain response as well? I say that because on the occasions where it is very severe, he will be whimpering quite loudly (as you can see from the one of the recordings). Starting to get worried if this is indeed seizure related but it's just so odd because I have watched various videos online of seizure and epilepsy but Max doesn't do anything like that at all. We have given him Rimadyl but I'm afraid it does absolutely nothing for Max. He has even had gabapentin for nerve pain and it barely made a difference.

We have obviously poked and probed him at home when he is like this but never get a response from his belly, etc. Currently we're trialling omeprazol and Suculfrate for acid reflux but if that doesn't work, I guess it wouldn't harm him to go on phenobarb and explore this instead. Are they any implications I should be aware of for this, is it possible if this is seizure related it'll get worse over time?


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## ceegee (Mar 26, 2015)

I'm sorry you're dealing with this. If only they could talk.

You seem to have explored all the usual avenues, but with no answers in sight. So I'll throw in a couple of "out-of-the-box" suggestions just in case. First, after watching the videos, the pacing looks a lot like an anxiety response. I'm wondering if this might be his problem, because you mention in your original post that he's perfectly fine outside the "episodes" and enjoys his walks, play sessions, etc. It might be something weird, in his environment, that is causing him to have anxiety episodes. For example, one common element in most of your videos is the television playing in the background. Dogs are extremely sensitive to specific types of noise, some more than others. I wonder if there might be some kind of high-pitched noise or whatever, from the television, that triggers these episodes? Or a specific program that includes certain types of noises? My dog went through a short but extreme fear period as an adolescent, and he would react in a similar way to your dog (hunching, drooling, pacing, cowering, whining) to high-pitched noises (squealing car brakes, a dog howling, etc.). He really, truly looked like he was in physical pain, but it was in fact a fear/anxiety response.

Following the same line of thought, you've done pretty much everything you can to check out his digestive system, and all the tests have been normal, but have you had his ears examined? For example, dogs can suffer from conditions such as tinnitus, which is very disconcerting to them and can trigger the types of reactions you're seeing from your dog (whining, rolling, pacing). Or is there something in the environment surrounding your house that might produce sporadic, anxiety-inducing noises or emissions? Power transmission lines? Gas lines? Factories/industries? Mining activity? An underground rail system? It might be something quite far away, or something you don't hear or notice.

A dog suffering an anxiety attack looks a lot like your dog. It can look like physical pain, but isn't.

Best of luck with this. It must be horrible to watch this and not be able to help him. I really hope you find some answers.


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## Craig010203 (Jul 20, 2021)

ceegee said:


> I'm sorry you're dealing with this. If only they could talk.
> 
> You seem to have explored all the usual avenues, but with no answers in sight. So I'll throw in a couple of "out-of-the-box" suggestions just in case. First, after watching the videos, the pacing looks a lot like an anxiety response. I'm wondering if this might be his problem, because you mention in your original post that he's perfectly fine outside the "episodes" and enjoys his walks, play sessions, etc. It might be something weird, in his environment, that is causing him to have anxiety episodes. For example, one common element in most of your videos is the television playing in the background. Dogs are extremely sensitive to specific types of noise, some more than others. I wonder if there might be some kind of high-pitched noise or whatever, from the television, that triggers these episodes? Or a specific program that includes certain types of noises? My dog went through a short but extreme fear period as an adolescent, and he would react in a similar way to your dog (hunching, drooling, pacing, cowering, whining) to high-pitched noises (squealing car brakes, a dog howling, etc.). He really, truly looked like he was in physical pain, but it was in fact a fear/anxiety response.
> 
> ...


Thank you for your message.

As much as I wish it was this, I do not believe it is the case in this instance. It would go completely against his tendencies and characteristics as a whole. Outside of the vets (where nerves are understandably high) he is a very calm dog at home, loves sleeping, very playful, etc. The actual first recorded event of this 'episode' was on a walk as well, so it is not directly associated with being at home. I have even been keeping a diary and I cannot see any link or pattern, it is very odd. Hopefully we can get there one day, I am just taking each days as it comes with Max.


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## pawsnpaca (Nov 11, 2014)

Hmmm. If it happened on a walk... might it be possible that he picked up something (A thorn maybe? Or a metal sliver of some sort?) that most of the time does not bother him but if he shifts a certain way, stabs him and makes him afraid he's being "attacked" by something? If it's something tiny or organic, it might not be picked up on an x-ray...


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## Craig010203 (Jul 20, 2021)

pawsnpaca said:


> Hmmm. If it happened on a walk... might it be possible that he picked up something (A thorn maybe? Or a metal sliver of some sort?) that most of the time does not bother him but if he shifts a certain way, stabs him and makes him afraid he's being "attacked" by something? If it's something tiny or organic, it might not be picked up on an x-ray...


I could understand that if it was perhaps the one occasion but this has been ongoing for well over 12 months and is seemingly random throughout the year.


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## pawsnpaca (Nov 11, 2014)

Craig010203 said:


> I could understand that if it was perhaps the one occasion but this has been ongoing for well over 12 months and is seemingly random throughout the year


I understand, but I know I've occasionally picked up a splinter or something that doesn't bother me 90% of the time... until something pushes against it or catches it and then suddenly it hurts like hell. I also occasionally get a rib out of whack that doesn't bother me until I turn a certain way and then suddenly I have a sharp pain in my side that lasts anywhere from seconds to hours (I usually need my PT to put it back where it belongs). If Max has something like that going on and it's in a spot that doesn't often come in contact with something that irritates it, it could conceivably be something that comes and goes... 

Anyway... just a thought...


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## Winnie’smom (Jul 16, 2020)

I would take him to another neurologist. This could certainly be a type of focal seizure, they can present very strangely, and there are many different types. We have a child with epilepsy and it’s not easy. Im sorry you are dealing with this, and glad that your pup seems great otherwise. Please keep us updated!


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## ceegee (Mar 26, 2015)

Craig010203 said:


> As much as I wish it was this, I do not believe it is the case in this instance. It would go completely against his tendencies and characteristics as a whole. Outside of the vets (where nerves are understandably high) he is a very calm dog at home, loves sleeping, very playful, etc. The actual first recorded event of this 'episode' was on a walk as well, so it is not directly associated with being at home. I have even been keeping a diary and I cannot see any link or pattern, it is very odd. Hopefully we can get there one day, I am just taking each days as it comes with Max.


My other thought, apart from anxiety, was a cardiac issue. Again, the symptoms are not unlike your dog's. If you're still stuck for answers, it might be worth having his heart checked out. Heart problems can show up sporadically and would cause the type of reaction you're seeing.

Again, best of luck with this.


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## cwag (Apr 25, 2017)

Are there any veterinary schools anywhere near you that might take him on as a diagnostics training patient?


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## nolefan (Nov 6, 2009)

I can hardly imagine the amount of money you've spent..... is the suggestion of a teaching hospital or vet school an option? And you didn't specify exactly but I'm guessing you've had second and third opinions on this? Asked your vet if he would share the video with colleagues? I just feel so bad for you and for your boy....

Also, the reason I mentioned the idea of a home made diet with single protein and low carbs is that I have seen people who have mentioned in discussion groups that they have dogs with seizures who absolutely are triggered by high carb food. The keto diet was originally developed for helping people with epilepsy. It just made me wonder if that would be something to think about.


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## PalouseDogs (Aug 14, 2013)

The problem with all the suggestions that we are tossing out (mine included) is that the vets have probably thought of them, too. If the Rimadyl, gabapentin, etc., had no effect, it's probably not a pinched nerve.

I had a standard poodle that had focal seizures. They don't present like the more generalized type. My poodle didn't do the classic whole-body twitching. Focal seizures affect only part of the brain. He could tell one was coming and would come stand next to me looking worried. He would briefly lose control on his hind limbs and bladder but was aware of his surroundings throughout the seizures. However, your dog doesn't even present like a focal seizure, since he doesn't seem to lose control of any of his limbs. Also, focal seizures are more common in some breeds (poodles included) than others. I don't know about goldens. If the vet thinks it is a realistic possibility, you could try the phenobarb for a couple of months, but I wouldn't hold out much hope that it would help.

Ceegee's suggestion of a cardiac issue is something to think about. I can imagine some kind of sporadic arrhythmia that might be hard to detect unless he's having an episode. Have you tried a Holter monitor?

Since it has happened on walks, it makes some household environmental cause unlikely (fluorescent lights, ultrasonic humidifiers, etc.).

Sounds like you've already spent a fortune on diagnostics. If you ever figure out what's happened, give us an update.


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## Prism Goldens (May 27, 2011)

oooh... Holter is a great idea- 
OP, if you could touch base w any Dobe people, they often own the Holters and can rent them to others, and they know the cardios who read them via phone line.


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## Berna (Jun 14, 2016)

Not an expert but to me this looks like some type of seizure or a dementia episode. Did the MRI show something? Did you MRI the brain or the spine or both? I don't think this is food related, I don't understand why some vets concentrated on that.


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## Craig010203 (Jul 20, 2021)

Berna said:


> Not an expert but to me this looks like some type of seizure or a dementia episode. Did the MRI show something? Did you MRI the brain or the spine or both? I don't think this is food related, I don't understand why some vets concentrated on that.


The MRI of his lower back did not show anything at all. Every test, every examination, it's always all clear. It started happening again randomly this morning.

Dog was perfectly well last night, went to sleep, woke up again this morning, we went for a brief walk (no signs of injury or sickness) got back, he was resting for a few moments and I noticed a minor jolt type behaviour but didn't think anything of it. Fed him at the usual time and 30 minutes later they were back again happening every 15-20 minute. Just the usual sitting down, walking or resting, then immediately starts pacing violently with his head really low to the floor.

I am so exhausted dealing with this. It has only been 36 days. Royal Canin Gastroinestional has made no difference at all and even if I treat him with antepesin and omeprazol like I have done today, it still continues.

We have reached out to so many different vets, forums, even reddit, but no one knows what it is. I have already spent a small fortune trying to narrow things down but the list is endless and it just isn't practical. Struggling to know what to do now..


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## Craig010203 (Jul 20, 2021)

Hi All, 

It's been a few months now and I thought I would provide an update. Unfortunately Max is still experiencing episodic behaviour, and it is getting progressively worse. It has gone from every 2-3 months, to monthly, to weekly and now as of recently, every other day (over the past week). Most of them have been severe episodes as well that occur randomly but fortunately, all of them have died out within a day rather than the typical 2-3 days.

As per some of the recommendations in this thread, we have visited a holistic vet who does chiropractor but did not have much success here. We have also been trialling Max on phenobarbital (currently on day 3 day of this) following a new vet visit. We have been told that if this is related to seizures or epilepsy (in which some of you have alluded too) it can take up to 2 weeks before the levels in the blood of this drug have effectiveness. I have also included some more videos below. Failing all of the above, we have Max booked in for one final specialist appointment in hope we can get to the bottom of this otherwise, we're not really sure what else we can do for him. It has been quite the journey over the past 18 months.





 (after episode behaviour)




 (episodic behaviour)




 (episodic behaviour)


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## nolefan (Nov 6, 2009)

My heart goes out to you, I am just so sorry for you and for Max. For all that Max has been terribly unlucky with his health, he has been incredibly lucky to have an owner who is so loving and caring. I wish so much you had happier news to share with us.


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## aesthetic (Apr 23, 2015)

What do his stools look like? Does he poop after these episodes?

My 6 year old, equally “medical mystery” dog has episodes quite like this, except his are almost always when he has to poop but he thinks it will be uncomfortable or painful. He’ll run around like your boy until he finally can’t hold it anymore. Kaizer also does the lip licking and head down quite often. Have you tried cerenia or pepcid for that? Both work well for Kaizer to stop the nausea. Kaizer has been diagnosed with IBD through endoscopy. Honestly the videos of your boy pacing around look exactly like what Kaizer does.

Kaizer has a very long list of symptoms (including neurologic symptoms) and most of them don’t have a definitive cause. Like your boy, MRI of his brain/spine came back perfect. Actually for Kaizer, all of the tests come back perfectly. I just started taking him to UPenn to see an Internal Medicine Specialist there. Vet schools always see the weird/complicated cases, so if you have one near you, I’d suggest making an appointment there with an Internal Medicine Specialist.

Kaizer is on Gabapentin and I don’t feel like it helps very much. I suspect that any pain he feels is probably severe abdominal discomfort. Like your boy too, he is very stoic at the vets. It’s incredibly difficult (impossible) to get any kind of pain or discomfort response from Kaizer on palpation/manipulation alone.

So this is my incredibly longwinded way of saying I get it, I’m in the same boat, and I’m incredibly sorry that your boy is also suffering.


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## Craig010203 (Jul 20, 2021)

aesthetic said:


> What do his stools look like? Does he poop after these episodes?
> 
> My 6 year old, equally “medical mystery” dog has episodes quite like this, except his are almost always when he has to poop but he thinks it will be uncomfortable or painful. He’ll run around like your boy until he finally can’t hold it anymore. Kaizer also does the lip licking and head down quite often. Have you tried cerenia or pepcid for that? Both work well for Kaizer to stop the nausea. Kaizer has been diagnosed with IBD through endoscopy. Honestly the videos of your boy pacing around look exactly like what Kaizer does.
> 
> ...


Thank you for your message, and I am sorry to hear that you’re experiencing something similar. How long have you been dealing with it for? I’m up to month 18 now and it is at a stage where I am mentally and physically exhausted almost everyday. The anxiety and worry is something that I am struggling with daily as we have no means of providing him relief. Each day I’m thinking to myself “is it going to happen” and the thought of taking off more time at work worries me. 

In terms of Max’s stools and how regular he goes, it is mostly clockwork. Always one in the morning and one at night. Never has any issues going to a toilet either, always firm and healthy. We have switched from AVA to Royal Canin Golden, Royal Canin Hypoallgenic and Royal Canin Low Fat Gastrointestinal but symptoms have persisted throughout. Just at a total loss of what the issue is.

We have tried the likes of Omeprazol and Suculfrate for reflux, gabapentin, and various other pain medication but none of it does anything at all.

Max has also been to the royal veterinarian university in Cambridge but we have had no luck either. Our last ditch hope is another specialist centre where he will be examined by internal medicine.


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## aesthetic (Apr 23, 2015)

Kaizer got sick 6 months ago and it’s just gotten worse since. He has a lot more symptoms besides what I described before.

I’m glad his stools are fine, but still I wonder if the pacing is abdominal pain related somehow? I’m pretty sure Kaizer’s is, and none of the meds you’ve used have worked for him either. Kaizer suffers from a couple different GI-related issues along with his IBD, so he’s got no shortage of abdominal pain. I just haven’t found anything that works for him. I’m sorry if you mentioned it in the thread, but have you had an ultrasound done on him yet?


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## Craig010203 (Jul 20, 2021)

aesthetic said:


> Kaizer got sick 6 months ago and it’s just gotten worse since. He has a lot more symptoms besides what I described before.
> 
> I’m glad his stools are fine, but still I wonder if the pacing is abdominal pain related somehow? I’m pretty sure Kaizer’s is, and none of the meds you’ve used have worked for him either. Kaizer suffers from a couple different GI-related issues along with his IBD, so he’s got no shortage of abdominal pain. I just haven’t found anything that works for him. I’m sorry if you mentioned it in the thread, but have you had an ultrasound done on him yet?


Sorry to hear that and I hope you get the bottom of it as well. I wouldn’t wish this upon my worst enemy

We have queried the abdomen before but it always soft upon examination, so no ultrasound has been performed. I think I am going to push for an endoscopy next and then whatever tests are required thereafter by the specialist. At his stage I’m willing to try just about anything.. 

Do you have any videos that you are willing to share of Kaizer’s symptoms?


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## aesthetic (Apr 23, 2015)

Craig010203 said:


> Sorry to hear that and I hope you get the bottom of it as well. I wouldn’t wish this upon my worst enemy
> 
> We have queried the abdomen before but it always soft upon examination, so no ultrasound has been performed. I think I am going to push for an endoscopy next and then whatever tests are required thereafter by the specialist. At his stage I’m willing to try just about anything..
> 
> Do you have any videos that you are willing to share of Kaizer’s symptoms?


Kaizer’s abdomen has always been soft/non-painful too. See if maybe you can get an ultrasound done before doing an endoscopy - cheaper and may get you answers. Either way, I think the endoscopy is a great idea! I did one for Kaizer and that’s how we got the IBD diagnosis. As a warning, endoscopies can only go so far since they can’t take full-thickness biopsies. Kaizer is about to get his 3rd ultrasound in 6 months on Wednesday since we just aren’t getting everything fixed.

Yes, I definitely have videos of him pacing! Give me a second to upload them to YouTube and I’ll share them.

Apparently this is the only video I have. I guess I just don’t usually video when he does this? I know for sure he’s done this at least 2 other times (when he suddenly, randomly, couldn’t pee). I call it his “distress run” cause I know something is happening when he starts going like this. In this video, it was when he was having uncontrollable liquid diarrhea. He was hospitalised for 2 days for it. Kaizer Pacing 03.20.21


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## Craig010203 (Jul 20, 2021)

aesthetic said:


> Kaizer’s abdomen has always been soft/non-painful too. See if maybe you can get an ultrasound done before doing an endoscopy - cheaper and may get you answers. Either way, I think the endoscopy is a great idea! I did one for Kaizer and that’s how we got the IBD diagnosis. As a warning, endoscopies can only go so far since they can’t take full-thickness biopsies. Kaizer is about to get his 3rd ultrasound in 6 months on Wednesday since we just aren’t getting everything fixed.
> 
> Yes, I definitely have videos of him pacing! Give me a second to upload them to YouTube and I’ll share them.
> 
> Apparently this is the only video I have. I guess I just don’t usually video when he does this? I know for sure he’s done this at least 2 other times (when he suddenly, randomly, couldn’t pee). I call it his “distress run” cause I know something is happening when he starts going like this. In this video, it was when he was having uncontrollable liquid diarrhea. He was hospitalised for 2 days for it. Kaizer Pacing 03.20.21


What a poor dog. I genuinely hope he feels better soon. Do you have to deal with this daily? I can't imagine what it is like when you're trying to sleep. Well, I say that, but I have had my fair share of endless nights watching my dog pace repeatedly and cry in discomfort. It is truly awful. Thank you for your suggestions, I am currently preparing an e-mail now for our urgent referral on Wednesday. I will keep you updated.


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## aesthetic (Apr 23, 2015)

Craig010203 said:


> What a poor dog. I genuinely hope he feels better soon. Do you have to deal with this daily? I can't imagine what it is like when you're trying to sleep. Well, I say that, but I have had my fair share of endless nights watching my dog pace repeatedly and cry in discomfort. It is truly awful. Thank you for your suggestions, I am currently preparing an e-mail now for our urgent referral on Wednesday. I will keep you updated.


Thankfully he has not woken me up at night in a couple months. Interestingly, most of his various episodes happen right when we wake up or right before bed. He’s been crated at night recently because he keeps trying to eat the cat litter, so I wonder if that’s why he’s not been waking me up.

I’m sorry your boy is having such a tough time. I hope the appointment with the specialist will provide some answers. I wish I had better input for you, but unfortunately, Kaizer is also a big fat question mark. His new IMS called him a “complicated case”, which probably doesn’t bode well for getting easy answers lol


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## Craig010203 (Jul 20, 2021)

Max had his internal medicine appointment yesterday. After briefing them they were largely undecided but have suggested a few possible causes:

1. Seizure activity (which they suspect is unlikely based off of the videos. They advised he seemed alert and implied it could be more to do with spinal or gut but could not rule it out completely. I guess we will know soon as Max is currently on day 7 of his seizure meds).

2. Spinal/Neurology (Back pain was present during his examination which has always been the case on appointments. Interestingly, though, even when he has the most severe episodes, I never see any issues with mobility and sometimes I see him running! The plan is to look back at the MRI imaging of this and discuss the possibility of it being nerves, etc)

3. Gut (endoscopy may be required, a food test with dye to then perform x-rays and various other tests but given that is appetite remains largely unchanged, even when unwell, it may not be this). 

I don't blame them for not knowing as everything contradicts itself. I have to report back in 2-3 weeks and then we will discuss further what to do.


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## Craig010203 (Jul 20, 2021)

So it's now been 40 days since we started phenobarbital as a trial. Thankfully, he tolerated it quite well and aside from being quite sleepy initially, he didn't really have any other side effects.

Two days into the trial Max experienced just one episode (which is quite unusual in itself) and then was okay for about 38 days but this morning, an hour after eating, he started experiencing really severe episodes again with crying, violent pacing, licking of the lips, and a low head position with his back arched. This has continued throughout the morning and we now have him booked in for an endoscopy and ultrasound tomorrow.

Based on his responsiveness during these episodes, I suspect it is not seizures or epilepsy but you just never know. Glad we have at least ruled that out, though. Will provide another update tomorrow should anyone else's dog be experiencing such a rare, complex case.

We are starting to run out of money now. I imagine we're in line for another $6,000 bill...


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## aesthetic (Apr 23, 2015)

Have they ever checked his blood pressure? A totally “out there” type thought, but I wonder. We’ve discovered that when Kaizer’s having his neurologic issues, his blood pressure shoots up (180), but it’s fine when he’s not having an episode (118). Of course, no one really knows what to do about that but..


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## Craig010203 (Jul 20, 2021)

aesthetic said:


> Have they ever checked his blood pressure? A totally “out there” type thought, but I wonder. We’ve discovered that when Kaizer’s having his neurologic issues, his blood pressure shoots up (180), but it’s fine when he’s not having an episode (118). Of course, no one really knows what to do about that but..


As far as I am aware, this has always been within normal levels but I can feel is heart beating rather fast during episodes. We actually had to rush him to the specialist again this evening (where is staying the night) due to the repeated attacks. They still seem to think it is some form of a seizure or type of reflux but I'm not convinced on either of these. 

Tomorrow he will be having an endoscopy and ultrasound with an estimated cost between £2000-3000. Ouch! 

How are things going with yourself regarding the pacing, is it neurological then?


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## aesthetic (Apr 23, 2015)

Craig010203 said:


> As far as I am aware, this has always been within normal levels but I can feel is heart beating rather fast during episodes. We actually had to rush him to the specialist again this evening (where is staying the night) due to the repeated attacks. They still seem to think it is some form of a seizure or type of reflux but I'm not convinced on either of these.
> 
> Tomorrow he will be having an endoscopy and ultrasound with an estimated cost between £2000-3000. Ouch!
> 
> How are things going with yourself regarding the pacing, is it neurological then?


Kaizers had an endoscopy and three ultrasounds between March and October, so totally hear you on the costs!

Kaizers episodes also include circling to the left. I’ve done the MRI and it came back fine, so we really have no idea. We’ve ruled out neurologic causes, pain (muscle, orthopedic, and abdominal pain), and blood pressure (i’m told his blood pressure has to be consistently high to officially have hypertension as the reason for his issues). Best guess I’m told is that he could be throwing small blood clots or experiencing TIAs. Since he has no symptoms outside of the episodes, his vets are hesitant to put him on blood thinners. So we just sit and wait for episodes, and I send pictures/videos to his vets, and they choose next steps from there.


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## Piper_the_goldenpuppy (Aug 26, 2016)

Craig010203 said:


> As far as I am aware, this has always been within normal levels but I can feel is heart beating rather fast during episodes. We actually had to rush him to the specialist again this evening (where is staying the night) due to the repeated attacks. They still seem to think it is some form of a seizure or type of reflux but I'm not convinced on either of these.
> 
> Tomorrow he will be having an endoscopy and ultrasound with an estimated cost between £2000-3000. Ouch!
> 
> How are things going with yourself regarding the pacing, is it neurological then?


Ok, I'm reading though this thread now--and I'm so sorry you're been going through this with your dog. This may be way off base, but has anybody considered syringomyelia? An MRI of the lower back might not show it--he might need an MRI of his entire spine/brain. It more commonly affects cavalier king charles spaniels and a couple other small breeds, but some of the symptoms are similar. Poor baby.


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## Craig010203 (Jul 20, 2021)

aesthetic said:


> Kaizers had an endoscopy and three ultrasounds between March and October, so totally hear you on the costs!
> 
> Kaizers episodes also include circling to the left. I’ve done the MRI and it came back fine, so we really have no idea. We’ve ruled out neurologic causes, pain (muscle, orthopedic, and abdominal pain), and blood pressure (i’m told his blood pressure has to be consistently high to officially have hypertension as the reason for his issues). Best guess I’m told is that he could be throwing small blood clots or experiencing TIAs. Since he has no symptoms outside of the episodes, his vets are hesitant to put him on blood thinners. So we just sit and wait for episodes, and I send pictures/videos to his vets, and they choose next steps from there.


How frequently are you having to deal with this? It sounds like a living nightmare. Poor Kaizer. What I genuinely find the most difficult about all of this (particaurly in my case) is that I literally have to watch my dog suffer for 24-48 hours because the case is so complex that know one knows what to do. Everything we have tried so far has failed in terms of medications and whenever we take him to the vets when he is unwell, they can be so spaced apart that they think Max is completely fine.


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## Craig010203 (Jul 20, 2021)

Piper_the_goldenpuppy said:


> Ok, I'm reading though this thread now--and I'm so sorry you're been going through this with your dog. This may be way off base, but has anybody considered syringomyelia? An MRI of the lower back might not show it--he might need an MRI of his entire spine/brain. It more commonly affects cavalier king charles spaniels and a couple other small breeds, but some of the symptoms are similar. Poor baby.


Interestingly, he was checked by neurology again last night and this morning. They do not think it is spinal now as he always has perfect mobility. Having said that, you just never know. It really is so complex. I'm just hoping they can find something today from the endoscopy and ultrasound... They're convinced it is some form of a seizure or intestinal issue as outside of episodes, Max's head is always very low to the floor.


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## aesthetic (Apr 23, 2015)

Craig010203 said:


> How frequently are you having to deal with this? It sounds like a living nightmare. Poor Kaizer. What I genuinely find the most difficult about all of this (particaurly in my case) is that I literally have to watch my dog suffer for 24-48 hours because the case is so complex that know one knows what to do. Everything we have tried so far has failed in terms of medications and whenever we take him to the vets when he is unwell, they can be so spaced apart that they think Max is completely fine.


For whatever reason, Kaizer doesn’t seem to be having any issues outside of his usual issues right now. Couldn’t tell you what changed or why he’s suddenly okay, but that seems to be his thing anyway. Hoping this lasts awhile.

The circling behavior seems to happen every 1.5-2 months. We’ll see if the trend continues, since the last episode started Sept. 13.

I hear you about episodes being so far apart, no one knows what to make of them. Our initial trip to the neurologist was because his IMS thought maybe his bloating was neurologic in nature somehow (after meds and diet did nothing to stop the frequency). Then he had two episodes in a week where he couldn’t express his bladder despite a full bladder and no obstruction (no one knows what that all was about). Then finally the circling episodes. Throw in his liver, spleen, potentially kidneys, and his lymph nodes, and no one really knows what’s wrong with him.


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## 4goldengirls (Jun 10, 2014)

Craig010203 said:


> So it's now been 40 days since we started phenobarbital as a trial. Thankfully, he tolerated it quite well and aside from being quite sleepy initially, he didn't really have any other side effects.
> 
> Two days into the trial Max experienced just one episode (which is quite unusual in itself) and then was okay for about 38 days but this morning, an hour after eating, he started experiencing really severe episodes again with crying, violent pacing, licking of the lips, and a low head position with his back arched. This has continued throughout the morning and we now have him booked in for an endoscopy and ultrasound tomorrow.
> 
> ...


I have a 14-1/2 yr old girl that has larpar along with thyroid cancer. She goes thru bouts of similar behavior with pacing, lip licking, licking just about anything along with low head position.

I do know how stressed and uncomfortable she gets with her reflux so I've learned to adjust when she gets which medication.

Perhaps your pup can try Pepcid (famotidine) instead of omeprazol. Try giving the sucralfate with a small meal an hr before other meds. Also, maybe try no kibble while he's having an episode. I offer boiled chopmeat with ditalini pasta, Ive tried oatmeal, anything bland. We've gone from two meals daily to many smaller meals thru the day.

I'm sure you've tried everything but just thought if not, one or more of what I've tried could help.


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## Craig010203 (Jul 20, 2021)

Thank you for all your responses. 

Max has now had is endoscopy and ultrasound. The ultrasound was unremarkable, so we swiftly moved onto the endoscopy discussion with our consultant. This is where it is interesting. Although still largely uncertain, he advised that the intestines did not look quite right and has taken biopsies as a result. We were also advised of certain elevated blood levels to suggest an issue is present but we do not know the underlying cause. He could not see any signs of reflux (even though Max was experiencing episodes that day).

He's had a range of very expensive blood tests that we are currently waiting to hear back on (as well as the biopsies). So it'll certainly be interesting to see what happens now.


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## cwag (Apr 25, 2017)

I hope they come up with some answers and treatments for sweet Max.


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## aesthetic (Apr 23, 2015)

I was just coming to ask how the ultrasound/endoscopy went! Glad the U ultrasound was unremarkable! Do you know what was wrong with the intestines/what was elevated in the bloodwork?


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## Craig010203 (Jul 20, 2021)

aesthetic said:


> I was just coming to ask how the ultrasound/endoscopy went! Glad the U ultrasound was unremarkable! Do you know what was wrong with the intestines/what was elevated in the bloodwork?


Unfortunately we haven’t got the report just yet, I suspect the consultant is waiting until we get the biopsy and blood results before sending it though. A lot of the terminology used was beyond me but as soon as I have an update, I’ll forward it on.

I’m just incredibly anxious about the results. One part of me hopes nothing comes up but at the same time, I NEED some sort of answer or diagnosis. The financial burden, the anxiety and overwhelming amount of stress. The thought of watching him continually suffer and not have any form of relief is heart breaking. Fingers crossed.


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## aesthetic (Apr 23, 2015)

Craig010203 said:


> Unfortunately we haven’t got the report just yet, I suspect the consultant is waiting until we get the biopsy and blood results before sending it though. A lot of the terminology used was beyond me but as soon as I have an update, I’ll forward it on.
> 
> I’m just incredibly anxious about the results. One part of me hopes nothing comes up but at the same time, I NEED some sort of answer or diagnosis. The financial burden, the anxiety and overwhelming amount of stress. The thought of watching him continually suffer and not have any form of relief is heart breaking. Fingers crossed.


The biopsy report came back pretty quickly for Kaizer, maybe a couple days. I remember how anxious I was waiting for the results! The internist also said Kaizer’s intestines definitely were not great looking, that for him meant fluid-filled and inflamed. I get needing a diagnosis too. I’ve said for months that I would accept even a bad diagnosis if it meant definitively knowing options for treatment and prognosis - better than being in limbo. Here’s to hoping you get answers and that they’re the good kind!


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## Craig010203 (Jul 20, 2021)

aesthetic said:


> The biopsy report came back pretty quickly for Kaizer, maybe a couple days. I remember how anxious I was waiting for the results! The internist also said Kaizer’s intestines definitely were not great looking, that for him meant fluid-filled and inflamed. I get needing a diagnosis too. I’ve said for months that I would accept even a bad diagnosis if it meant definitively knowing options for treatment and prognosis - better than being in limbo. Here’s to hoping you get answers and that they’re the good kind!


What do you think you're going to do if things remain the same or get worse and no diagnosis is found? This is ultimately my worst fear at the moment. I think if it gets to that stage for me (given the violent pacing, crying and how frequent it is), I may have to discuss with the consultant quality of life if no medication can provide relief. He is otherwise a perfect dog but the level of suffering is so distressing, it would just be cruel.


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## aesthetic (Apr 23, 2015)

Craig010203 said:


> What do you think you're going to do if things remain the same or get worse and no diagnosis is found? This is ultimately my worst fear at the moment. I think if it gets to that stage for me (given the violent pacing, crying and how frequent it is), I may have to discuss with the consultant quality of life if no medication can provide relief. He is otherwise a perfect dog but the level of suffering is so distressing, it would just be cruel.


I have, unfortunately, already had the quality of life talk with my vet. She agrees that I have already done all the tests that are warranted at this point and it wouldn’t be wrong of me to just keep him on palliative care until something happens and I have to make the decision for him. I agreed, but I will say that it’s decidedly much harder to practice that LOL. More than anything, I refuse to have him continually suffer. 

I’m choosing to believe that when he’s ready to go, he will make it so obvious to me. There are things I’ve drawn a line at - if he ever stops eating or has a seizure, I’ll call it. Kaizer is my absolute perfect boy, I swear that boy was somehow made for me. I so wish I didn’t have to think about this (and I’m sure you do too!!) but I want to do right by him. I don’t think talking to your vet is a bad idea.

I’m not sure what to do if he has another circling episode though. He really has such a hard time with them and the side effects last a couple days. Don’t know what causes them or how to stop them, best guess is (as I’ve mentioned) that he throws blood clots, which are usually deadly. I don’t know how this boy lives through things that are normally fatal (throwing blood clots, continuous air bloat without twisting..somehow).


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## Craig010203 (Jul 20, 2021)

aesthetic said:


> I have, unfortunately, already had the quality of life talk with my vet. She agrees that I have already done all the tests that are warranted at this point and it wouldn’t be wrong of me to just keep him on palliative care until something happens and I have to make the decision for him. I agreed, but I will say that it’s decidedly much harder to practice that LOL. More than anything, I refuse to have him continually suffer.
> 
> I’m choosing to believe that when he’s ready to go, he will make it so obvious to me. There are things I’ve drawn a line at - if he ever stops eating or has a seizure, I’ll call it. Kaizer is my absolute perfect boy, I swear that boy was somehow made for me. I so wish I didn’t have to think about this (and I’m sure you do too!!) but I want to do right by him. I don’t think talking to your vet is a bad idea.
> 
> I’m not sure what to do if he has another circling episode though. He really has such a hard time with them and the side effects last a couple days. Don’t know what causes them or how to stop them, best guess is (as I’ve mentioned) that he throws blood clots, which are usually deadly. I don’t know how this boy lives through things that are normally fatal (throwing blood clots, continuous air bloat without twisting..somehow).


Really sorry to hear that.

It's so bizarre how a dog can be otherwise perfect for weeks/months and then suddenly have unexpected turns that are seemingly random with no pattern. I will never be able to grasp or understand this, even after all of the money that has been spent. If it wasn't for the issues above, Max would be a perfectly healthy dog...I really wish you the best. I will provide another update when we receive one from the consultant.


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## Craig010203 (Jul 20, 2021)

Following a conversation with the consultant this afternoon, I just wanted to update you all.

In short - they appear to have identified two abnormalities following the biopsy results. One of them appears to be a form of 'fungi' that is present in the stomach lining (which they believe is unrelated to the episodic behaviour) but have listed this anyway. I need to perform a de-worming to see it will clear it (something we previously stopped in an attempt to rule out if it was the underlying cause). 

The second abnormality, which is probably the most significant finding, is that certain cells appear to be present in the intestine that are also scattered (which may be causing inflammation). I have been advised that it is unlikely that these cells are cancerous (due to positioning of them) but given how unusual these results are, they have reached out to an international private forum for further advice. Apparently they may be a reaction of the immune system, so they have suggested we trial Purina HA Dry (due to it having specialised proteins and being gluten free). We have tried these sorts of diets in the past but not this brand or protein I believe, so we now have some on order. 

Failing all of the above, I believe the next step is steroids - but this is something that I am concerned about given how well documented the side effects are. Apparently this may help to counter the immune system but we will go down that road after this new food trial. We're also still waiting for some blood results as well (they are taking a little longer than anticipated).


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## aesthetic (Apr 23, 2015)

Do you know which cells or can you get a copy of the biopsy report?

Kaizer had a similar-ish report. He had H.Pylori in his stomach (which is arguably found in everyone’s stomach/not likely to be an issue, but we put him on antibiotics anyway) and the various parts of his digestive tract had various inflammatory cells throughout - Kaizer has lymphoplasmacytic gastritis and lymphoplasmacytic/eosinophilic enteritis “Lymphoplasmacytic” refers to the inflammatory cells found, lymphocytes and plasma cells. Eosinophilic refers to the eosinophils found. “Gastritis” is inflammation of the stomach, “enteritis” is inflammation of the small intestines. Both of Kaizer’s conditions fall under the umbrella term “Irritable Bowel Disease”, which is thought to be an autoimmune condition in dogs.


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## Craig010203 (Jul 20, 2021)

aesthetic said:


> Do you know which cells or can you get a copy of the biopsy report?
> 
> Kaizer had a similar-ish report. He had H.Pylori in his stomach (which is arguably found in everyone’s stomach/not likely to be an issue, but we put him on antibiotics anyway) and the various parts of his digestive tract had various inflammatory cells throughout - Kaizer has lymphoplasmacytic gastritis and lymphoplasmacytic/eosinophilic enteritis “Lymphoplasmacytic” refers to the inflammatory cells found, lymphocytes and plasma cells. Eosinophilic refers to the eosinophils found. “Gastritis” is inflammation of the stomach, “enteritis” is inflammation of the small intestines. Both of Kaizer’s conditions fall under the umbrella term “Irritable Bowel Disease”, which is thought to be an autoimmune condition in dogs.


I will definitely share that as soon as it is available. I have been advised that if the food does not work, our next step is some form of steroids. Have you tried that yet or was it not applicable?


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## aesthetic (Apr 23, 2015)

Craig010203 said:


> I will definitely share that as soon as it is available. I have been advised that if the food does not work, our next step is some form of steroids. Have you tried that yet or was it not applicable?


Kaizer was on 60mg/day of prednisone (just a hair under 2mg/kg, that’s considered an immunosuppressive dose) from April-June. He did really well on it as far as symptom reduction, but the effects kicked his butt on such a high dose for so long. We tried reducing the pred over time, but anything lower than that wasn’t helpful. We just ended up taking him off of it completely since it was all or nothing. Some dogs have to be on pred lifelong but you can usually get them on a much smaller dose.

There are pred alternatives too that may work, although Kaizer has never tried them. Budesonide is a steroid that is specifically used to treat IBD in dogs. From what I’ve been told, it’s absorbed entirely in the GI tract (vs through the liver), so the side effects are a little less. I’m not sure why none of Kaizer’s various vets have tried him on it.

There’s also cyclosporine (Atopica). It’s an immunosuppressant, super expensive, but seems to work fairly well. We’re considering that next for Kaizer (since he has other issues outside of his GI tract that the cyclosporine could potentially help).

Unfortunately, IBD (and all the things that fall under it) is super dog-specific. What one dog responds to, another might not. Hopefully the food change works for your boy! We knew going into this that Kaizer is not food-responsive, but he’s on the special prescription diet anyway (Royal Canin Ultamino, it’s called Anallergenic in your neck of the woods).


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## Craig010203 (Jul 20, 2021)

aesthetic said:


> Kaizer was on 60mg/day of prednisone (just a hair under 2mg/kg, that’s considered an immunosuppressive dose) from April-June. He did really well on it as far as symptom reduction, but the effects kicked his butt on such a high dose for so long. We tried reducing the pred over time, but anything lower than that wasn’t helpful. We just ended up taking him off of it completely since it was all or nothing. Some dogs have to be on pred lifelong but you can usually get them on a much smaller dose.
> 
> There are pred alternatives too that may work, although Kaizer has never tried them. Budesonide is a steroid that is specifically used to treat IBD in dogs. From what I’ve been told, it’s absorbed entirely in the GI tract (vs through the liver), so the side effects are a little less. I’m not sure why none of Kaizer’s various vets have tried him on it.
> 
> ...


Thank you for that information. You certainly appear to have explored everything you can, what sort of side effects was he getting? I commonly hear about steroids and how badly it can impact them.I still don't know what to think of our results overall. Max never seems to lose his appetite, so if it was intestinal related, I'm surprised he still wants to eat so consistently. Unfortunately with Max, we always are led to believe it is possibly one thing but it is always counteracted by him behaving differently than what they would expect.


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## aesthetic (Apr 23, 2015)

Craig010203 said:


> Thank you for that information. You certainly appear to have explored everything you can, what sort of side effects was he getting? I commonly hear about steroids and how badly it can impact them.I still don't know what to think of our results overall. Max never seems to lose his appetite, so if it was intestinal related, I'm surprised he still wants to eat so consistently. Unfortunately with Max, we always are led to believe it is possibly one thing but it is always counteracted by him behaving differently than what they would expect.


Kaizer has never lost his appetite in his entire life lol. Even the night he had HGE (blowout blood coming out instead of stool) and had to be hospitalized for 2.5 days, he never stopped eating. I’ve learned that I can’t use whether or not he’s eating as a good indicator of how he’s feeling. Some dogs are just like that ¯\_(ツ)_/¯. The only appetite related thing I’ve noticed is that he won’t take his pills easily anymore, I have to actually put them in a pill pocket now. He used to just take them as treats (lol) or eat them out of his bowl.

Side effects: it was the panting, total lack of energy, and the insanely increased appetite that made me take him off of the pred. He wouldn’t do anything but sleep or rest. And then of course, he tried to eat everything. Paper towels, wrappers, cat litter. He was breaking into bags of dog food, treats. He was trying to steal food off peoples plates (!). I had to put him back on a short course of a smaller dose (5mg) for non-GI issues and I found out that he still has those side effects even on that smaller dose, so I doubt I would’ve kept him on it anyway. He also had muscle wasting but that continued post-prednisone too, so hard to say if it was entirely the prednisone that caused it.

There can be some liver issues associated with long term use of prednisone. Kaizer’s liver values increased while he was on it, but went back to normal after he was taken off. He does have an enlarged liver now, but that is not likely to be pred-related as an ultrasound done in late July (almost 2 months post-pred) showed a normal liver. We found the enlarged liver on accident in his October ultrasound. There are like a million other side effects of prednisone but Kaizer didnt really experience any of them (coat loss, ulcers, infections, calcinosis cutis, etc.)


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## nolefan (Nov 6, 2009)

I've been following your stories for months now... Craig and Aesthetic, just wanted to tell you both that I admire your tenacity and fighting spirit in trying to do the bests you can for your dogs. The cost, emotionally and financially, is extreme and I wish you both the best.


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## Craig010203 (Jul 20, 2021)

nolefan said:


> I've been following your stories for months now... Craig and Aesthetic, just wanted to tell you both that I admire your tenacity and fighting spirit in trying to do the bests you can for your dogs. The cost, emotionally and financially, is extreme and I wish you both the best.


Thank you very much for your kind words.


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## Craig010203 (Jul 20, 2021)

aesthetic said:


> Kaizer has never lost his appetite in his entire life lol. Even the night he had HGE (blowout blood coming out instead of stool) and had to be hospitalized for 2.5 days, he never stopped eating. I’ve learned that I can’t use whether or not he’s eating as a good indicator of how he’s feeling. Some dogs are just like that ¯\_(ツ)_/¯. The only appetite related thing I’ve noticed is that he won’t take his pills easily anymore, I have to actually put them in a pill pocket now. He used to just take them as treats (lol) or eat them out of his bowl.
> 
> Side effects: it was the panting, total lack of energy, and the insanely increased appetite that made me take him off of the pred. He wouldn’t do anything but sleep or rest. And then of course, he tried to eat everything. Paper towels, wrappers, cat litter. He was breaking into bags of dog food, treats. He was trying to steal food off peoples plates (!). I had to put him back on a short course of a smaller dose (5mg) for non-GI issues and I found out that he still has those side effects even on that smaller dose, so I doubt I would’ve kept him on it anyway. He also had muscle wasting but that continued post-prednisone too, so hard to say if it was entirely the prednisone that caused it.
> 
> There can be some liver issues associated with long term use of prednisone. Kaizer’s liver values increased while he was on it, but went back to normal after he was taken off. He does have an enlarged liver now, but that is not likely to be pred-related as an ultrasound done in late July (almost 2 months post-pred) showed a normal liver. We found the enlarged liver on accident in his October ultrasound. There are like a million other side effects of prednisone but Kaizer didnt really experience any of them (coat loss, ulcers, infections, calcinotis cutis, etc.)


That is interesting. Very informative as well, so thank you for that. Please keep me updated as to how you get on. Do you have a particular section on the forum where you post regular health updates? I will look to update you as and when we hear more. Max's new food arrived today, so we have already started to introduce this in slowly. I haven't got high hopes (given we have trialled about 6-7 different kinds already) but I will keep this thread updated.


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## aesthetic (Apr 23, 2015)

nolefan said:


> I've been following your stories for months now... Craig and Aesthetic, just wanted to tell you both that I admire your tenacity and fighting spirit in trying to do the bests you can for your dogs. The cost, emotionally and financially, is extreme and I wish you both the best.


Thank you!! I appreciate it. Kaizer’s my “once in a lifetime” dog, he deserves the very best I have to offer him


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## aesthetic (Apr 23, 2015)

Craig010203 said:


> That is interesting. Very informative as well, so thank you for that. Please keep me updated as to how you get on. Do you have a particular section on the forum where you post regular health updates? I will look to update you as and when we hear more. Max's new food arrived today, so we have already started to introduce this in slowly. I haven't got high hopes (given we have trialled about 6-7 different kinds already) but I will keep this thread updated.


I started this thread when I thought I was gonna have to make a decision soon: End of Life “Bucket List”

I hope Max’s food transition goes well!! And hopefully the food helps with something.


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## Craig010203 (Jul 20, 2021)

I just wanted to let everyone know that Max was peacefully put to sleep this evening. Unfortunately we just couldn’t get to the bottom of it and he was suffering tremendously. Thank you for all your help.


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## FurdogDad (Mar 30, 2021)

I'm sorry to hear about your loss of Max. I know you tried to do everything possible to treat his health issues and give him better quality of life.


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## aesthetic (Apr 23, 2015)

oh Craig, I’m so sorry . I’m a firm believer in dogs ending up where they’re supposed to. I know Max ended up with your family because someone knew how hard you’d try for him.


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## Winnie’smom (Jul 16, 2020)

I’m so sorry to hear this news. Max was so lucky to have you. Thank you for ending his suffering, I know he was surrounded with love until the very end.


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## CAROLINA MOM (May 12, 2009)

I am so very sorry to hear Max has crossed the Rainbow Bridge. 
This is the ultimate gift of love you gave him to end his suffering. 

God Bless you..


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## cwag (Apr 25, 2017)

I am very sorry. Try not to second guess your choice, you did so much for him and ultimately made the most humane choice to end his suffering. I hope you can get some rest now.


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## goldy1 (Aug 5, 2012)

Craig you did everything humanly possible for Max. He is no longer suffering. You made the hardest decision that was also the kindest one.
I am so sorry for your loss.


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## Craig010203 (Jul 20, 2021)

Thank you all for your kind words. I still can’t quite believe it.

When I’m in a better mental state, I’m going to update this page because a lot changed within a short amount of time. They were ultimately leaning towards a brain abnormality in the end, something in which he may have been born with but caused issues further down the line.

I appreciate there are many variables to pacing and behaviours but in the incredibly circumstances where your dog is behaving like Max did, it may help.


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## Craig010203 (Jul 20, 2021)




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## Prism Goldens (May 27, 2011)

Craig, your story will help someone someday - and you have to know you did everything possible to give this precious soul a good life.


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## Craig010203 (Jul 20, 2021)

Thanks again, all.

Just a small update for those that are interested. The specialist centre (Dick White Referrals) have offered to send Max to a university for a post-mortem free of charge (I'm assuming this was done due the overall complexity of his case, and the idea that they may learn from this if possible). We're then receiving his remains 6-8 weeks later. The last possible diagnosis we had was a possible brain abnormality, a tumour, or something else underlying (despite initially being cleared from Neurology in 2020 when we visited The Queen's Veterinary School in Cambridge!).

Hopefully we will get something back but I will update this once I know more. Just goes to show how unusual the whole situation was. We took Max to two of the most highly regarded places in the country (one of which is leading in Europe) but it just wasn't right to allow our dog to keep suffering. Even when he was in the best place possible, he was still suffering as they had no means of treating him.


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## nolefan (Nov 6, 2009)

Craig010203 said:


> I just wanted to let everyone know that Max was peacefully put to sleep this evening. Unfortunately we just couldn’t get to the bottom of it and he was suffering tremendously. Thank you for all your help.


I have the utmost respect for how hard you worked for Max and my heart goes out to you on all you've been through. I am so sorry there couldn't be a happy ending, I hope so much that a post mortem will bring you some answers to help you heal and to potentially help someone else in the future. I'm so sorry for your loss.


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## mylissyk (Feb 25, 2007)

You truly tried everything you could to help him. I'm so sorry this was the outcome. You loved him enough to give him the rest he needed. My heart goes out to you.


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## goldy1 (Aug 5, 2012)

I too admire your perseverance doing everything within your power to get to the root cause and a treatment. The postmortem offers hope that other dogs maybe helped down the road. I would want to know if it was at all possible.


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## Craig010203 (Jul 20, 2021)

Thank you all for your comments. I still find myself watching these videos every so often (as well as new ones) and keep saying to myself, this had to be brain related. Now that I have had a chance to look back with a clear head, I feel absolutely terrible for prolonging the WHOLE situation and not being forceful with the Vets. It was such a battle just for them to understand how serious this was, and I'm deeply annoyed that they never suggested imaging his brain up until the very day he was put to sleep. 

I still haven't had anything back regarding the post-mortem yet. I plan to chase next week if nothing comes back in the meantime.


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## goldy1 (Aug 5, 2012)

Don't beat yourself up too badly. I know exactly what you mean though. I had a cat (a rescue I took through the vet's office).
She had just been through a surgery and they placed her with us bc one of our cats had just passed. Well she was okay for a while (weeks) and then began losing weight and being more finicky than she had been. As she was losing weight, we checked back regularly with the vet we got her from to see if there was a preferred food, having her examined again, etc.
Mostly my husband was doing the running to the vet with her and buying tastier and tastier food and things continued to go south. What the vet was telling him is they find nothing clinically wrong with her. She recovered nicely from her surgery, no infections, etc. She is just finicky - she will eat if you stop catering to her whims. Keep in mind we didn't really "know" her particular personality yet - but I know cats.
So I finally said to my husband, I'm bringing her in (to the vet) tonight - this has gone on long enough. We won't even be having this conversation if we wait any longer.
So I went into the waiting room (no appointment) and said I wanted to talk to the Dr about DiDi cat. Of course, without an appointment they made me wait but that was okay with me.
Finally when Dr came out to see me and we conversed for a time, I handed DiDi to her and said "You tell me that's okay" (meaning her weight/thinness).
Dr. said "Well she is thin . . ."
I said I want you to do whatever you have to do but we have to find the reason bc this is "not okay".
The next day they did an ultrasound and I will never forget getting the call at work "DiDi needs emergency surgery for a blockage (tumor) in her intestine."
She had the surgery, eventually gained the weight back and then some, and lived another 12 years until she was 15.

Sorry for the long post but bottom line is from that point on I never waited when my gut told me something was wrong even when a vet tells me things are okay. What it was - that was a very busy time at work and I was grateful my husband was doing so much of the legwork for our new little rescue.

But I learned a life lesson from this experience:
I am their advocate, they only have us. And I have never been sorry that I push for something when I believe it's needed.

Again, don't feel terrible and beat yourself up. I did that but learned from it. Even if things don't turn out well and they don't sometimes, life teaches us in many ways.


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## Craig010203 (Jul 20, 2021)

goldy1 said:


> Don't beat yourself up too badly. I know exactly what you mean though. I had a cat (a rescue I took through the vet's office).
> She had just been through a surgery and they placed her with us bc one of our cats had just passed. Well she was okay for a while (weeks) and then began losing weight and being more finicky than she had been. As she was losing weight, we checked back regularly with the vet we got her from to see if there was a preferred food, having her examined again, etc.
> Mostly my husband was doing the running to the vet with her and buying tastier and tastier food and things continued to go south. What the vet was telling him is they find nothing clinically wrong with her. She recovered nicely from her surgery, no infections, etc. She is just finicky - she will eat if you stop catering to her whims. Keep in mind we didn't really "know" her particular personality yet - but I know cats.
> So I finally said to my husband, I'm bringing her in (to the vet) tonight - this has gone on long enough. We won't even be having this conversation if we wait any longer.
> ...


Thank you, it means a lot. I'm pleased things worked out for you in the end as well.


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## mylissyk (Feb 25, 2007)

Craig010203 said:


> Thank you all for your comments. I still find myself watching these videos every so often (as well as new ones) and keep saying to myself, this had to be brain related. Now that I have had a chance to look back with a clear head, I feel absolutely terrible for prolonging the WHOLE situation and not being forceful with the Vets. It was such a battle just for them to understand how serious this was, and I'm deeply annoyed that they never suggested imaging his brain up until the very day he was put to sleep.
> 
> I still haven't had anything back regarding the post-mortem yet. I plan to chase next week if nothing comes back in the meantime.


Did you ever get a report back?


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## Craig010203 (Jul 20, 2021)

mylissyk said:


> Did you ever get a report back?


Surprisingly not, I am going to ask for an update on Monday. We were told 6-8 weeks.


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## Craig010203 (Jul 20, 2021)

Not entirely sure how I should feel about this but we received Max's report back today. Interestingly, the autopsy showed nothing. No issues with his organs, no abnormalities of the brain, all perfectly normal. I was really hoping we would be able to get answer as to what it was. It's really dishearting to think he was otherwise a perfectly healthy dog. 

This will probably be my last post but thank you again for all the support.


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## nolefan (Nov 6, 2009)

Craig010203 said:


> Not entirely sure how I should feel about this but we received Max's report back today. Interestingly, the autopsy showed nothing. No issues with his organs, no abnormalities of the brain, all perfectly normal. I was really hoping we would be able to get answer as to what it was. It's really dishearting to think he was otherwise a perfectly healthy dog.
> 
> This will probably be my last post but thank you again for all the support.


I am utterly floored. I'm so sorry. I was hoping you'd get some sort of information that would give the answers. I appreciate the time and effort you made over the past several months to update us and discuss this. It will be in the archives and maybe someday it will be found and help steer someone else on a difficult journey. I know it is cold comfort, but I admire so much your love and loyalty to your boy. My condolences again on your struggle to get answers and for the loss of Max.


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## aesthetic (Apr 23, 2015)

I’m so sorry the report didn’t come back with anything of note. I was so hoping they’d find something for you


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## CAROLINA MOM (May 12, 2009)

Craig010203 said:


> Not entirely sure how I should feel about this but we received Max's report back today. Interestingly, the autopsy showed nothing. No issues with his organs, no abnormalities of the brain, all perfectly normal. I was really hoping we would be able to get answer as to what it was. It's really dishearting to think he was otherwise a perfectly healthy dog.
> 
> This will probably be my last post but thank you again for all the support.


I am so sorry, this has been such a hard journey for you and Max.


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## goldy1 (Aug 5, 2012)

Feel sad that you didn't get an answer. Admire you so much for doing all you could do. I know that's little consolation. Take care.


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## mylissyk (Feb 25, 2007)

Quite obviously they missed something. I'm so sorry you didn't get any answers. I know that makes it hurt even more.


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