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At wit's end with chronic diarrhea

12K views 35 replies 19 participants last post by  _Zero_ 
#1 ·
Hello all-

This is my first post here, although I've been lurking for a while. I have a neutered 2 year-old GSD x Border Collie that has been suffering with chronic diarrhea now for months. I know that GSDs can be particularly susceptible to GI issues and I've read through many of the "chronic diarrhea" posts on the forum, but have noticed that most threads seem to taper off without any resolution. I'm curious as to whether anyone has experienced this type of saga with their own GSDs and if so, what was the most successful approach in resolving it?

Rigby has always been an apathetic eater, with relatively frequent two-ish day bouts of anorexia. I rescued him at apx. 12 months old, and about seven months later (in November of last year) I noted he'd lost a bit of weight, although his stools were normal. I chalked it up to the stress of moving around a bit, did satin balls for a while, and started adding canned food to his dry (Kirkland Brand Salmon and Sweet Potato), and he gained the weight back, although he was still skinny.

In the spring of this year I was becoming concerned with his weight again, but many people suggested that it's not uncommon for young GSDs to be really skinny, and that he would fill out around 3 years old. Then... the diarrhea started.

At first it was just occasional loose stools. He'd have a normal BM in the morning, but in the evening he would go two or three times back to back, with the second and third rounds increasingly sloppy. This went on for a while, and then it started increasing in frequency, to where he was going three times a day. He then had a bout of liquid diarrhea. I fasted him and put him on white rice and boiled chicken before slowly reintroducing his kibble, and he seemed to bounce back, but his stools were still unformed and soft. He also seemed to be very uncomfortable after eating, curling up in a ball, moaning when lying down or when repositioning, and stretching (downward dog/upward dog, or Halloween cat) a lot more than usual.

Off to the vet. Fecal test for parasites, including an ELISA test for giardia, all negative. Did a one-week course of metronidazole just in case, but it didn't help the diarrhea at all. Back to the vet. Tested him for EPI. cTLI, cobalamin, and folate levels were all normal. His GP started him on prednisone for anti-inflammatory effects and probiotics, as well as a feeding trial-- Natural Balance Limited Ingredient Diet Sweet Potato and Venison (a novel protein for him). We saw immediate improvement on the steroids-- his stools became formed again, although they were still too soft. He had bad side effects on the pred, panting, polydipsia, and his moaning and stretching had not abated, so the next week we were back to his general practitioner. She seemed to think he was doing much better and attributed the discomfort to the steroids, so switched him to medrol.

One week later and no improvement. His stools were still formed but very soft, no change in his apparent discomfort (stretching and moaning). GP added metronidazole back in with the medrol, and took abdominal x-rays, which showed no apparent torsion/blockage/swelling/etc, and bloodwork-- thyroid was a little low (consistent with him not feeling well), but otherwise his blood cell count and blood chemistry were unremarkable.

We then went to an internal medicine specialist, who suscpected a bacterial infection and/or SIBO. Did a fecal test for major types of bacteria (coccidia, campylobacter, etc.), all negative. She switched him from metronidazole to doxycycline, and continued with the medrol. The doxy seemed to help firm up his stool a bit more. Specialist then started him on a fiber trial, with psyllium fiber added to his food. This also seemed to help a bit, although he was still pooping, large volume, three or four times a day, still moaning/seeming uncomfortable. He had gained a bit of the weight back.

After about two weeks he began refusing his food if fiber were added to it. I dropped the fiber and it didn't seem to make a difference one way or another in terms of his stool. A little over a week and a half after that his full-fledged diarrhea came back, sloppy, wet, and mucousy, for three or four days. I'd be watching him very closely and I'm pretty sure he hadn't gotten into anything or eaten anything other than his kibble. It took four or five days for him to get back to the "formed but soft stage." Then he began refusing his kibble... Hand feeding worked for a while, but then he outright refused it regardless of what I'd try. He'd also been losing weight again, and started eating grass.

He had a five-day course of Panacur, and we took him in to have an ultrasound, which didn't show anything abnormal, and more bloodwork and an ACTH test, which all came back normal/negative. The specialist suggested I do whatever it took to get him to eat, so I switched him to white rice and boiled beef. She also wanted me to double up his antibiotics and double his dose of steroids. We live in a pretty remote area, so it can be hard to get meds. We'll have to wait until next week when more medrol is delivered to increase the dose.

Recently, several folks have suggested I try raw, so yesterday I switched him to BARF model raw, which he has been eating. He hasn't yet had a BM, so I guess I'll have to wait and see what that's like, but he has still be uncomfortable (moaning/streching, especially early morning~ 3:00/4:00 AM), and maybe a bit gassy (although I have a really bad sense of smell and have a hard time telling), and has also continued to eat grass. I don't expect miracles on raw, but I did hope that maybe he wouldn't seem so uncomfortable after eating it. But perhaps the transition will just take the time and he'll improve in a week or so...?

So this is where we are: He's had diarrhea now off and on since March or April and continuously since late May/early June. He's been tested for EPI, Addison's, bacterial infections, and parasites, all negative. He's had Panacur, been on a fiber trial and a feeding trial, had abdominal x-rays and an ultrasound and bloodwork twice, all normal. He's currently getting metronidazole and doxycycline twice daily (morning/evening), probiotics (FortiFlora) midday, and medrol in the morning (to be increased to twice daily next week).

His energy has been more or less fine. He's skinnier than he should be (probably needs four or five extra pounds- can see his ribs, spine, hips). And he's experiencing some kind of discomfort or pain after eating, whether that be gas pains/bloating, or something else, as well as in the early morning. Because of the nature of his diarrhea and the fact that he hasn't vomited at all, the specialist suspects something intestinal.

Has anyone experienced ANYTHING like this? In the end, what did the diagnosis end up being? Or what was tried that ended up helping? I love this dog like nothing else. For a two year-old, this shouldn't be happening. I'll do whatever it takes, but I'm running out of funds for meds and testing and consults, and patience. I've been worried sick over him being sick.

Thank you all for reading through this novel of a post, and I would really appreciate any insight or advice.
 
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#3 ·
Wow, all of that sounds extremely frustrating and i know its hard to see your boy going through that. Give the raw diet a few days & see how it goes. With my dog I noticed that if it took a little longer before he went poop it was a good sign that the food wasn't going right through him. I don't know what the stretching and moaning is about though, sorry. All I can add is that grain free & raw has really worked for us. Hopefully someone else will chime in with more ideas.


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#5 ·
Like what vwitt said, i would give the Raw diet a little while longer.
Have you considered seeing a holistic vet? Sometimes they stand from a different view point and have different ideas and how to manage or cure the problem.
I am very sorry for this stressful time. I know how it is, i am too worried about my girl. For a while she was having diarrhea more than half the time i've had her. For the past few weeks, it has been normal to soft, and i can take that. The skinniness does scare me with my girl. I have her on chicken/rice boiled with her BB chicken puppy kibble food. I am switching to TOTW because it is grain free and good quality food for price, i believe it is 6 star whereas BB is 5 star unless it is BB wilderness which is also 6+ star.
Slow transition to any food is vital for these types of dogs.
It really sounds like you tried pretty much everything else that I could think of. You are a really good dog parent, stay strong, please keep us updated!
:paw:
 
#6 · (Edited)
Wow, you have been through a lot. I think it is a good sign that he has not yet had
a BM. That means the food is actually being digested instead of running right through him.
Diarrhea is because of an inflamed digestive tract. What I would do at this point s step back and stop all the medications being pumped into this dog, especially since all the tests came back normal.
I would look at food, which is more than likely the source of his gut sensitivity.
Raw was a good move, and it is a good place to start.
The only thing I would add is a slippery elm "glue" to soothe his stomach and intestines, since he is moaning and stretching so much.
Amazon.com: Now Foods Slippery Elm Powder, 4-Ounce: Health & Personal Care

You boil a cup of water, add a heaping teaspoon of slippery elm powder, stir well, let cool, and keep it in the fridge. Top his raw with some, one tablespoon or so should do it.

Perhaps add probiotics and digestive enzymes, but not yet. Give the raw a week or two and see how he does. Here's hoping he will be fine soon.

PS-- people have also have had good luck with Perfect Form and Cocci Free, when nothing else has worked.
 
#7 ·
Wow, you have been through a lot. I think it is a good sign that he has not yet had
a BM. That means the food is actually being digested instead of running right through him.
Diarrhea is because of an inflamed digestive tract. What I would do at this point s step back and stop all the medications being pumped into this dog, especially since all the tests came back normal.
I would look at food, which is more than likely the source of his gut sensitivity.
Raw was a good move, and it is a good place to start.
The only thing I would add is a slippery elm "glue" to soothe his stomach and intestines, since he is moaning and stretching so much.
Amazon.com: Now Foods Slippery Elm Powder, 4-Ounce: Health & Personal Care

You boil a cup of water, add a heaping teaspoon of slippery elm powder, stir well, let cool, and keep it in the fridge. Top his raw with some, one tablespoon or so should do it.

Perhaps add probiotics and digestive enzymes, but not yet. Give the raw a week or two and see how he does. Here's hoping he will be fine soon.

PS-- people have also have had good luck with Perfect Form and Cocci Free, when nothing else has worked.
Sunflowers is awesome! :thumbup: I am gonig to buy slippery elm powder for more than likely future purposes. :)
 
#8 ·
Thanks for the replies. He finally did have a BM this morning, around 48 hours after starting raw, although it might have had more to do with the increase in the metronidazole than with the food. The first half was soft and sloppy. The second half was firmer... hard to describe the texture. Compact, but stringy? If that makes any sense? All of the grains went straight through undigested.

I'm planning on giving raw at least two weeks to see how he does. Still moaning and stretching.

I've given slippery elm before and it does seem to help, but the vet suggested I not give it with the meds in case it interferes with absorption. I really want to get him off all these drugs! I could stop the antibiotics now but the steroids I'd have to wean him off over a period of a couple weeks.

I'm open to seeing a holistic vet but there isn't one within 900 miles of here.
 
#9 ·
Someone else suggested enzymes and probiotics. I will second that! My GSD had chronic diarrhea no matter what food he was on and no matter how slowly I switched him until I started adding enzymes (Prozyme) and probiotics in the form of Kefir. I have to add the enzymes with every meal, but only occasionally give him Kefir. His stool is absolutely normal now.


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#10 ·
What I would do. I would continue raw, take him off current antibiotics since they are not working and probably your dog doesn't tolerate at least one of them (I suspect metronidazole. When you started metro it didn't work so why did the vet put him on metro again?). I would give slippery elm for a few days, put your dog on Tylan twice a day long term, and continue with fortiflora or other probiotics. Be prepared that it will take a long time to rebuild his GI tract since it's probably all inflamed right now and irritated by the drugs and food changes. Remember to taper steroids.
 
#11 ·
If it persists, ask the vet if he could be suffering form Peri Anal Fistulas. He has the same symptoms as WD had; diarrhea and the straining. What does his butt look like? Does he lick it frequently? That is also a tell tale sign.
I hope that is not the case tough.
 
#12 · (Edited)
Ask your vet about Tylosin. Its an antibiotic, used off label for dogs. That was the drug that ended up clearing up my guys case of chronic diarrhea. He'll have to be on it twice daily for probably a month or longer, but you'll know if it clears it up. Ive found it wasn't as hard on my dogs GI tract as the metronidazole was. Also, if he does have Giardia, it can be really hard to treat/eliminate from the environement, and he can keep re-infecting himself. It is NOT shed in every stool, so you could get a negative stool sample, but he could be positive for giardia.

Also, sorry if you mentioned this, but maybe try an LID food. Potatoes were causing over growth of yeast in my guys body, and was making his stools smelly/loose. He is on Zignature now (wish he would eat raw... but he's been refusing it) and his stools are normal. A raw diet should accomplish the same thing.

Possible yeast overgrowth could be causing the issue. Especially with all the meds hes been on (metronidazole, panacur, doxy) those are taking a HUGE toll on his GI tract, and killing ALL bacteria, good AND bad. So, the yeast can take over. If he is not already, I'd put him on a really good probiotic, and digestive enzymes.
 
#13 ·
#14 ·
Thanks again to everyone for your continuing suggestions.

I would like to take him off all meds, but not sure it's the best move at that point. I'm torn between not wanting him on any medication at all, and trying to trust the specialist to know what's she's doing and help get him back on track.

He ate pretty well yesterday, raw BARF mix morning and evening and a meaty beef bone midday. I'm not sure if the beef bone set him off, but he does NOT feel well this morning. Wouldn't finish his breakfast and has been really uncomfortable all morning. Maybe he can't handle meaty bones yet? I'd like to feed him chicken necks and backs and turkey necks to help keeps costs down, but now I'm reluctant because I have no idea whether this "flare up" of sorts is because of the bone or just general.

I guess the good news is that he's only going once a day right now. His BM this morning was relatively compact. The inner texture was odd... stringy? foamy? I'm not sure I can describe it properly. And every grain and seed went straight through undigested. Right now I'm feeding a pre-mix made by a local woman who feeds her own dogs raw. I'm not sure grains and starches like potato are the best for him, but I'm also not nearly confident enough to attempt to try and make up a raw diet for him myself.

I did order some digestive enzymes, more probiotics, more slippery elm, and some B12 and bovine colostrum this morning. Hopefully all that and some l-glutamine will help soothe his GI tract a bit.

The specialist is out of town this week. I'm going to try as she suggested and bump his steroids to 2x daily. But if he hasn't improved by next Monday, I think I'll call in and request that we stop all his current meds, and perhaps try tylosin.
 
#15 ·
I would not add any supplements except probiotics and B12 shots if he's deficient at this point. If he's reacting to something you will have no idea why if you introduce too many things at once. My dog did not tolerate colostrum, did not tolerate fish oil, even though these supplements are supposed to be very good.

I don't see why the only solution the specialist has is to keep your dog on high dose of steroids if there is no improvement. Tylosin will work, and it can be used long term for dogs with chronic colitis.
 
#16 ·
Thought I'd drop back in and update this thread. We did a 45-day course of Tylan without any improvement. At the end of October we weaned him off the steroids and stopped all antibiotics. It was clear that they weren't doing him any good. He's been eating boiled chicken and white potato for 9 weeks now. He loves it and never refuses (unlike kibble). We briefly tried transitioning him to Purina HA (a hydrolyzed protein kibble) but it really made him hurt, so we stopped.

We've taken a trip to the lower 48 to visit friends and family for the holidays, so we were able to meet with an internal medicine specialist. He had endoscopy with biopsies. The IMS didn't give it a "diagnosis" but said he had significant swelling throughout his stomach and small intestine, primarily lymphocytes but also eosinophils. Although it was not given a name, I suppose it would be considered IBD.

The hard part for us is that traditional treatment for IBD is a combination of a novel protein diet, steroids, and antibiotics. Rigby, for the past six months, has already been through many combinations of steroids and antibiotics of different types and doses, with limited success, as well as an 8-week novel protein food trial (with a venison-based kibble, which he eventually refused). I am not sure that the chicken is great for him (and it's definitely not a balanced diet) but he's excited to it eat and never refuses, and his stools are more consistent on it (only once or twice a day, though too soft). He is still in pain-- groaning and repositioning, lots of gas, etc.

The IMS wants to try him on chlorambucil since steroids have not worked for him. Hopefully it will actually help him and then we can switch him over to a more nutritionally complete food.
 
#18 ·
WOW. Too many drugs, flip flopping, increasing, changing with no breaks. Your dogs GI tract is inflamed no doubt.

Back to basics. RAW, but go low fat and no grains, no fibre unless maybe 1-2 tblsp. of pure pumpkin (canned), no veg, no fruit, no yogurt

Enzymes should contain pancreatin or better pancrelipase (lipase breaks down fats)
Probiotic
Kocci free was mentioned - treats coccidia and giardia, is natural and has been used by many on here where drugs failed.
Start using the L-glutamine for repair to villi
bovine colostrum, if you have it - use it. In addition to colostrum, you should look at a product called SeaCure, the company (Proper Nutrition) also has a colostrum/seacure combo called SeaVive

Did any specialists question the pancreas as in pancreatitis (not EPI). What colour are the poops?

Another supplement you could consider is Milk Thistle - your poor dog is going to need this after what the pharmaceutical cocktail has done to his liver (also an enzyme producing organ)
 
#19 ·
Wow, sounds similar to what me and my dog have been through. Currently, I have him on a single protein food (pork) and really just give him a crap ton of probiotics/enzymes. He is also in the middle of a course of Kocci Free (good results so far, although not sure if its due to that or other measures I have been taking) he gets canned pumpkin, and he gets slippery elm to soothe his GI tract. No treats, no chews....nada. Its hard.


As GatorBytes has mentioned, all those things are great. I've been trying to get some L-Glutamine and colostrum.
 
#20 ·
Perhaps you should consider doing a phone consult with a holistic vet, you can fax/email records, blood work, test results and then discuss over phone treatment plan.
 
#21 ·
We are interested in seeing a holistic vet, but this will probably have to wait until next month. Between the travel costs to get down here, the chicken, the IMS visit, endoscopy, new meds, etc. my bank account is more or less dry. Luckily we should have some time after the holidays to meet with someone.

We have not tried Kocci Free, but we have tried l-glutamine, slippery elm, bovine colostrum, probiotics, and pancreatin. At the time he was eating raw (skinless split chicken breasts and thighs), but was also still on steroids and antibiotics.

He has had cPL and does not have pancreatitis. His most recent bloodwork was normal.

We are currently using SeaCure. It hasn't helped with his weight but does seem to improve his energy.

We did try Honest Kitchen, both the Thrive and the Embark. I really wish he would have done well on it because I think it's a solid company and I wouldn't mind feeding him the dehydrated permanently. Very convenient, especially while traveling. Unfortunately, he couldn't handle it. Even after soaking it in more water than it needed, soaking overnight, blending it, and adding digestive enzymes both varieties went straight through him more or less undigested. He went from one BM a day to three or four, and each had completely undigested chunks of carrots, potatoes, parsley, kale, etc.

I would love to manage this completely holistically, but I am just not confident enough in those treatments to forgo Western medicine. If I can get him stable using traditional drugs and then consult with a holistic vet for long-term management, I'll be perfectly happy.

I would love to do raw long-term, too, but I don't think it's practical for where I live in Alaska. We get very few protein sources (really only chicken and beef, and neither are affordable) and no organ meats at all.
 
#22 ·
I second zignature turkey. My allergy prone dog does well on it. I had a dog that had to be treated with 2 giardia meds at the same time to get rid of it. Are there any veterinarian teaching hospitals around you? Also, my dog can't handle raw bones...too rich, the marrow makes her sick.
 
#24 ·
Hi Zero!
I am so sorry your dog is this sick!
While the Chicken & Potato is working for him, he is lacking in ESSENTIAL vitamins and minerals. You may want to consider this product: Animal Essentials - Premium quality supplements for dogs and cats "We use organically produced herbs and other ingredients whenever possible, avoid genetically modified (GMO) materials whenever possible, and use wild harvested ingredients that are ethically produced, socially responsible and environmentally sustainable."
Guaranteed Analysis (min. per teaspoon/2300mg): Vitamin A 1500IU, Vitamin C 38mg., Zinc 1.5mg, Manganese 1.5mg, d-pantothenic acid 1.3mg, Vitamin B2 0.9mg, Vitamin B6 0.9mg, Folic acid 11mcg, Vitamin D3 150IU, Niacin 7.5mg, Vitamin E 15IU, Copper 1.5mg, PABA 0.9mg, Vitamin B12 15mcg, Biotin 7.5 mcg, Selenium 6 mg.

Herbal Ingredients: Ground stabilized flaxseed, Chia seed, Barley grass, FOS, Lecithin, Yucca root, Garlic.

I wish you the very best with his health issues.
Moms:)
 
#25 · (Edited)
Another update! Rigby has now been on chlorambucil, 2mg every other day, for nearly eight weeks now. I also started him again on Tylan, as he got into something and had a colitis issue, and then the specialist suggested I just continue giving it as an added anti-inflammatory.

For the first three weeks or so I was concerned the chlorambucil wasn't doing any good. I wasn't seeing any positive changes in his stool or demeanor. His BMs ranged from liquid to formed but soft, but never anything ideal. His appetite was good, though, and he seemed to be moaning and stretching less, so I kept on.

Right around Christmas I thought that if I looked at him at the right angle, he seemed less skeletal. The vet gave me the go-ahead to add in some kibble for nutrients and for added calories. I started him on 1/2 cup of Wysong Epigen and 1/2 cup of Authority grain free chicken and potato, spaced out over four feedings per day. He seemed to tolerate it well so I upped it gradually to 3/4 cup of each spaced out over four feedings, in addition to his cooked chicken and potato. By the week after Christmas he started to look less gaunt, and by the beginning of January I knew he was gaining weight. I was also able to add in coconut oil to his diet, slowly. He blew his coat like nothing I'd ever seen, but the benefit was that he shed his dry, short, brittle fur and grew in a nice, soft, shiny coat.

We went in for a re-check with the specialist the end of the first week in January. He had gained nearly six pounds from when he was last weighed (during his endoscopy in November). We had his blood work checked and it was all perfect, so he is currently suffering no side effects from the meds. The specialist suggested I could play around with his diet a bit. I very slowly transitioned him to a limited ingredient canned food (currently Evanger's chicken and rice dinner) and off of the home cooked. He's now eating the Evanger's, coconut oil, and a bit of cooked chicken (as he's become a spoiled brat) just three times a day, and is nine pounds heavier than he was at his worst. He looks fantastic, nearly a perfect weight, and now I have to figure out how much to cut out to make sure he doesn't get fat!

He will stay on chlorambcuil and Tylan now for several months. Once he hits his ideal weight (just about a half pound or so to go) I will decrease his food intake. If he maintains his weight, I will decrease the dose of the chlorambucil to 2mg every third day. Hopefully he can someday be weaned off the meds and go on to live a normal doggy life, but only time will tell. So long as he suffers no side effects, I have no qualms with keeping him on the meds long-term. His condition and energy between now and this past year are night and day, really! This is by far the heaviest he's ever been. As of last week his BMs are nearly perfect! The right color and consistency, for the first time in a LONG time.

It took us more than 6 months to find something that worked for him, but he finally did. I feel for all of those struggling with dogs who are having digestive issues. That there are no clear treatment protocols or guidance has always been the most frustrating part to me. I cannot imagine what I would have done would we gone even a month more without him improving. This whole experience has been both emotionally and financially draining. I am so pleased with how he is doing now (knock on wood) that, of course, it almost (but, really, only just) seems worth it. But we've been through the wringer to get to this point.

What makes it nice now is for me to just look at him and admire how good he looks. Almost like a real dog! ;)
 
#26 · (Edited)
Another update in case anyone else ever chooses to read through this thread. Rigby has now been on chlorambucil since mid-December. He is no longer taking Tylan, although I keep it on hand for those occasions on which he gets into something he's not supposed to have (I'm looking at you, rotten fish pieces...) and develops colitis. Luckily these diarrheal episodes are few and far between now, are attributable directly to something nasty he's eaten, and clear up in a few days with a week long course of Tylan.

About a month and a half ago the specialist and I tried to wean Rigby off of chlorambucil, since at the time he'd been stable for more than three months. By the time the dose dropped to once every five days, his loose stools and discomfort made a reappearance. So it looks like chlorambucil for life... or at least for a good while longer.

I am perfectly content with this, as he is happy and healthy. He never lost his good humor during his illness, and was always energetic, but his energy has clearly gone up a notch now that he's well. With the chlorambucil, he's 11 pounds heavier than he was at his worst. Last fall, he hovered around 54 pounds, and now he's at 65. He gets 2 mg of chlorambucil every three days, and he now eats 1.5 to 2 cans of Evanger's Classics Chicken and Rice Dinner each day, plus 2 Tbs coconut oil. And his coat is fantastic.

I got a lot of advice and encouragement on the forums here, mainly in the form of private messages, and I greatly appreciated each and every one. Last year was horribly stressful for Rigby and I both, especially since we live in such a remote area. For anyone that does happen to read through this thread searching for answers for their own dog, please know that I am happy to respond to any questions you might have-- send me a PM and I'll gladly reply. There are so many GI issues in dogs that have the same suite of symptoms. It is a truly trying process of elimination to get to the right diagnosis. It can be incredibly frustrating and heartbreaking to watch a dog waste away and not know how to fix it. BUT, once you do finally hit on the right combination of food, meds, supplements, whatever, the change is wonderful to see.
 
#29 ·
Another update in case anyone else ever chooses to read through this thread. Rigby has now been on chlorambucil since mid-December. He is no longer taking Tylan, although I keep it on hand for those occasions .

About a month and a half ago the specialist and I tried to wean Rigby off of chlorambucil, since at the time he'd been stable for more than three months. By the time the dose dropped to once every five days, his loose stools and discomfort made a reappearance. So it looks like chlorambucil for life... or at least for a good while longer.

I am perfectly content with this, as he is happy and healthy.

This is a Chemotherapy drug. Kills cancer cells and healthy cells. So "for life"...that may be a lot shorter then you think.

Chlorambucil (Oral Route) Description and Brand Names - Drugs and Supplements - Mayo Clinic
 
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