Tully's not doing well

Still wondering how little Tully is doing. It has been quite some time since your last update. Hoping all is well
Overall Tully's happier, I've taken her out in the stroller a few times and she's had little walks. She loves it but she isn't great afterwards. I think she's getting nauseous a lot from being off the steroids. I could be wrong, I just know she's got some pain by the way she lays. This morning we see the surgeon to get her stitches out. Tully licked off half the bandage yesterday, but I think she's leaving the stitches alone - just as well for her because I stupidly through out her baby onesie a month ago.
 
Good to hear she's improved Caro...I guess it's going to take time but she's probably better without the gallbladder than with it. I bet she'll be happy to have those stitches out, I know whenever I've had stitches they get so itchy when the skin is healing!
 
Got Tully's biopsy results back. I must say I'm a little confused. Her gallbladder results said mild papillary hyperplasia (prob from infection) and a few areas of mild mucus accumulation. So it doesn't look like she actually needed her gallbladder out. She went into ER because she got a gallbladder infection, and was put on 2 antibiotics for that and it was me who suggested putting her on Ursodiol. Whatever the specialist saw in the scans, it either cleared with the antibiotics or Ursodiol. I'm disappointed, Tully has been through so much already and it was a lot to put her through, but I was led to believe it was urgent.

Her intestinal results showed that her canine enteropathy (IBD) is largely being controlled by the steroids but her liver is showing 'moderate to marked hepatocellular swelling' - a significantly inflammed liver - and the report says this is probably from the steroids.

So now where do I go? She's either perpetually ill and her intestinal problems advance to the point of not being able to absorb nutrients, or she ends up with liver disease. There was an immunosuppressant that we did try a year ago, but it sent her pancreatic lipase levels literally off the chart, it was a wonder she survived that. Now the IMS is thinking about trying it again now the gallbladder is out and there is no longer the issue with her food (eating something she was allergic to), he never believed it was the immunosuppresant causing the pancreatitis, but I did find research articles finding incidents in humans with ulcerative colitis (a gastrointestinal/IBD autoimmune disease).
 
Got Tully's biopsy results back. I must say I'm a little confused. Her gallbladder results said mild papillary hyperplasia (prob from infection) and a few areas of mild mucus accumulation. So it doesn't look like she actually needed her gallbladder out. She went into ER because she got a gallbladder infection, and was put on 2 antibiotics for that and it was me who suggested putting her on Ursodiol. Whatever the specialist saw in the scans, it either cleared with the antibiotics or Ursodiol. I'm disappointed, Tully has been through so much already and it was a lot to put her through, but I was led to believe it was urgent.

Her intestinal results showed that her canine enteropathy (IBD) is largely being controlled by the steroids but her liver is showing 'moderate to marked hepatocellular swelling' - a significantly inflammed liver - and the report says this is probably from the steroids.

So now where do I go? She's either perpetually ill and her intestinal problems advance to the point of not being able to absorb nutrients, or she ends up with liver disease. There was an immunosuppressant that we did try a year ago, but it sent her pancreatic lipase levels literally off the chart, it was a wonder she survived that. Now the IMS is thinking about trying it again now the gallbladder is out and there is no longer the issue with her food (eating something she was allergic to), he never believed it was the immunosuppresant causing the pancreatitis, but I did find research articles finding incidents in humans with ulcerative colitis (a gastrointestinal/IBD autoimmune disease).
Oh, Caro.... my head is just spinning reading your post! I completely understand you being at odds of what to do next! It must all be a blur now! My thoughts and prayers go out to you and Tully! She is so brave!
 
Wow that is a challenge Caro. I'd be mad if I put my senior, ill dog through a surgery they might not have needed. I don't know what to say or what I would do. Are you supporting her liver with milk thistle? I know Ann swears by that. I had a similar challenge when Ally was ill. Chronic pancreatitis and then kidney failure, with the food restrictions being the exact opposite of each other. It was a huge challenge. My heart aches for little Tully being dealt all these bad cards. The gallbladder is a real head-scratcher, sounded like that was the source of a lot of her issues from reading your posts. I'm so sorry you are both going through this.
 
I agree with everyone else, I'd be angry knowing I put my elderly dog through surgery but you did what you thought was best with the information you had at the time.
It's funny, Riley had an inflamed liver as well, even showed up on X-rays and of course we did an ultrasound as well but were never able to determine the cause, and he was never on steroids.
I understand your concern now with giving meds that could affect the liver, we had that dilemma as well.
I do agree that adding milk thistle is a good idea. How are Tully's liver enzymes? Riley's had been through the roof and they dropped to normal after starting milk thistle, although his liver was still inflamed.
 
Her liver enzymes are elevated - not sure the levels, I must get a copy of the bloods. I have Denamarin for her, just been waiting for her stomach to stabilise. The problem with Enteropathy is it only takes one small change to the diet and their gut can't cope. The specialist is a bit ascerbic with humans, great with dogs, and is also the only one in my area. So unfortunately I can't get him off side. I'm seeing him next week so it will be interesting to hear his response. Still, what's done is done and can't be undone.

We went for a walk at lunchtime at one of our old rural haunts (a showground and pony club that isn't used during the week). Tully was so happy so I let her potter off lead. The puppy was ecstatic as she has really only walked close to home. I let Kismet off lead, and half way I even let Della off lead. Tully limped back to the car, but she so wanted to keep walking. Della and the puppy would not get into the car, they were having too much fun. Tully now is out cold, utterly exhausted and I think maybe a little nauseous. So hard to balance things when they are old and infirm.

I think I'll go back again while we have more gorgeous Spring days (it was a perfect 23 celcius). The puppy needs more off lead practise and I'll take the stroller next time. Tully really misses seeing people and being outside, we've all been stuck inside for months. I feel sad for Della as I usually don't take her for walks with Kismet, so she may have to stay at home. There is a chance of running into other dogs and I don't want puppy to pick up the anxiety. In another month, when the frosts stop, it will be no more off lead anyway as the snake babies hatch and snakes come out of hibernation. We have a lot of deadly snakes here.

I forgot to take a photo, silly me.
 
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