The Saga: Part Deux

I forgot to provide the results of the fecal received yesterday!!! So working in WADDL I had the inside, unofficial results. 10 oocysts (a cyst containing a zygote of the parasite) per gram of coccidiosis. So of course I tell Dr. Costa and the problem is it is not enough to be pathogenic. However, never hurts to treat! So he got Drontal Plus (anti-parasitic) as well as Albon an antibiotic.

And now for today. I bring him in early and Marcie (the awesome and stupendous 4th year student on his case!) tells me they have two options for his endoscopic biopsy. At 11am or 3pm. So of course at 11 I call and find out he is going in. Not even 30 minutes later I get another call, Guimauve's stomach was full of food! So I get the (nice) Spanish Inquisition as to how he might have grown opposable thumbs and opened a refrigerator door to get to the canned food. For everyone's knowledge he is on z/d at the moment. z/d is a food for dogs with allergies so it is pretty much hydrolyzed chicken (easily absorbed) corn starch and water with vitamins and minerals. Guimauve practically inhales it though!

+1 on the problems list. Delayed gastric emptying. (I can't help but picture House and his white board and thinking "One of these problems is not like the others"). The food in his stomach prevented them from getting a biopsy. I talked with Dr. Costa and Marcie about our weekend strategy when I picked Guimauve up. The top of the differential list is still a protein losing enteropathy.

So we have several directions to go now. First choice was to put him on metoclopramide to treat the vomiting that occurred from a full stomach and going under anesthesia as well as increase gastric motility for the weekend. Continuation of the plan is to have him off food and medication on Sunday night/Monday morn. Then he goes through a Barium study. Barium is a mineral that will show up on x-ray or in his case fluoroscope. Fluroscope is like an x-ray type machine that gives "real time" x-rays. This way they can determine strength of gastric contractions, motility and measure the amount of time it takes for food to pass through his digestive tract.

Once the time is determined we will then know how long to fast him before the endoscope and potentially solve why he has reduced gastric motility.

Plus Guimauve is becoming a blood donor, he gets to donate again Monday for cobalamin/folate levels. These tests measure the amount of cobalamin/folate absorbed. Folate is absorbed in the proximal intestine while folate is absorbed in the distal small intestine. This may help pinpoint where the problem is in the intestine. Another test is the trypsin-like immunoreactivity (TLI) which is an indicator of pancreatic function.

So that is where we stand now!

Thanks to everyone for your good wishes and for stopping by and visiting me and Guimauve!