DEAR DR. FOX: We have a 7-year-old pit bull (male), who has been diagnosed as having pancreatic insufficiency. The vet has recommended pancreatic enzyme Concentrate, plus fat-soluble vitamins consisting of lipase, protease, amylase and vitamins A, D3 and E. He gets three tablets before each meal, so nine tablets daily. His meals consist of chicken breasts, rice and yogurt.
He is still having diarrhea. Can you offer any other alternatives? It would be greatly appreciated. — F.M.A., Ocean View, Delaware
DEAR F.M.A: The yogurt in your dog's diet is a good idea, provided it is not pasteurized, because of the beneficial bacteria in "live" yogurt and kefir. Alternatively, a daily dose of probiotics may help your dog's overall condition.
Pancreatic enzyme insufficiency is all too common in dogs, and I attribute this primarily to their diets being too high in starches (corn and other cereals).
Try my home-prepared diet on my website, DrFoxVet.com, and cut the rice and grain content by 75 percent. Give your dog three or four pieces of canned pineapple daily. This fruit contains digestive enzymes that will help compensate for your dog's deficiency. Use lean meat and poultry and low-fat yogurt, because a high fat intake could possibly trigger an episode of pancreatic inflammation or pancreatitis, which can be extremely painful.
DEAR DR. FOX: In response to the letter from J.M., I had a similar problem with a cat who had kidney failure.
She was 13 years old at the time it was diagnosed, and I was told to use fluids under the skin twice a day. My vet said he'd heard from someone who had used Azodyl successfully. We decided to try this with Pepcid AC twice each day, along with the fluids.
She is now 17 years old, and her latest blood work shows everything within normal ranges. She eats like a healthy, happy cat!
Azodyl is a dietary supplement made by Vetoquinol and is made in the United States. It's worth considering. — J.J.L., Silver Spring, Maryland
DEAR J.J.L.: I appreciate your letter attesting to the benefit of Azodyl for helping alleviate your cat's chronic kidney disease. This proprietary supplement, which includes probiotics, does indeed seem to be of significant value in helping cats with this condition and is being more widely prescribed by veterinarians.
Of course, there is no panacea for this all-too-common feline malady. Judicious application of various interventions is called for, including a special diet; vitamin D, potassium and thiamine supplements; blood pressure monitoring and medication as needed; and a phosphate binder if blood tests indicate this is needed. Fish oil may help improve kidney function. A high-quality dietary protein is advisable, since protein deficiency and dramatic loss of weight and muscle mass occurs with some forms of kidney disease. An injection of various hydrating and nutritious solutions under the skin is a key in helping cats enjoy some quality of life when their kidneys begin to fail.
DEAR DR. FOX: I read recently about the 14-year-old Chihuahua-rat terrier's skin problem and felt it might be useful to let you know how we brought our terrier's similar skin problem to a comfortable and manageable level.
When our now-14-year-old female was about 8 years old, she had extremely itchy, "alligatored" and crusted skin — mainly on the belly, teats, legs and ears. She was an emotional wreck, and I think the vet mentioned Cushing's disease. There was no mange found after many tests, and I don't think her thyroid was a problem. We worked through her extreme terror, and with carefully measured exercise and diet, she took about 22 pounds off her now-65-pound frame.
Apparently, she doesn't have Cushing's — at least not now. I think the vet could have figured that out. We tried many medications for the skin problem that remained, overhauled her diet (she is now on a no-grain Merrick chicken and yam diet) and started giving her supplements.
We really saw a tidal change for the skin when she went to the vet, who administered the following: an allergy shot of dexamethasone and depo-medrol; antibiotics Cefpodoxime and Ampicillin; a small but long-lasting dose of prednisone; and GentaSpray for the very occasional flare-ups.
Even though she may never be totally cured of the propensity toward this trouble, she is, and has been for quite a while now, a very comfortable and happy girl. I thought this might help someone else for what seems to be a rather common problem. — C.R., Freehold, N.J.
DEAR C.R.: Chronic skin problems can often be difficult to diagnose, and in many cases, it is of significant cost-savings to first try the double whammy of antibiotics and judiciously prescribed corticosteroids.
While I have frequently addressed the harmful side effects of this latter class of hormonal medications, with careful prescribing, small miracles can be accomplished. Such hormonal treatment helps the body re-establish varying degrees of normality, the skin of the dog being a reflection of a number of underlying health issues.
Corticosteroids are an important part of veterinary and human medicine, especially because of their potent anti-inflammatory properties.
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