C O L D  R I V E R  V E T E R I N A R Y  C E N T E R

Natural therapy for inflammatory bowel disease, lymphangitis

CASE REPORTS

• Allergies in a dog

• Allergies in a cat

• Arthritis

• Colitis. otitis

• Cushings disease

• Ear infections

• Feline chronic renal failure

• Heartworm

• Inflammatory bowel disease

• Kennel cough

• Kidney failure, disc disease

• Lymphangitis

• Lymphoma

• Oral papillomas

• Vestibular disease

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Poppy is an 11 year-old spayed female Greyhound mix who became infected in May 2001 with Heterobilharzia americana, a blood parasite (trematode or fluke) that causes liver disease. Her initial signs were a lack of appetite and diarrhea, but after several weeks the infection left her thin and suffering from chronic diarrhea. Her weight fell from 52 pounds to 43 pounds until she was treated with a 3 week course of fenbendazole and praziquantal (wormers). Her appetite remained poor and she was unable to tolerate a second round of worming medications without vomiting. In June 2001 Poppy was placed on metronidazole, amoxicillin, enrofloxacin, and cephalexin (4 antibiotics) and 40 mg. prednisone daily. She started to improve over a 3-week period but still had a spotty appetite. Endoscopy and laparoscopy examinations then revealed extensive inflammation and scarring of her intestines. She was treated in July 2001with more metronidazole, amoxicillin, enrofloxacin (Baytril), 20 mg prednisone daily, S-adenosyl-methionine, Ursodial (a bile acid medication), and a diet of turkey and pasta. She remained on this regimen more or less for the next 4 months. She was wormed on 4 more occasions with praziquantal from July 2001 to January 2002. Metronidazole and enrofloxacin antibiotics continued in February and March, 2002. Upon recommendation from Janet Hicks, an animal communicator, the owner contacted Cold River Veterinary Center March 26, 2002 for a new approach. Poppy had been on prednisone for almost 10 months. Her current medications were prednisone 15 mg daily, Budesonide 3 mg daily, metronidazole 250 mg twice a day, Ursodial 300 mg every other day, Pepcid AC 20 mg twice a day, Desmopressin (DDAVP) 2-3 drops daily, Hill's prescription food a/d, and Pet-Tinic vitamins. Her diarrhea had been almost constant since May 2001.

New treatment plan

Dr. Kruesi had a telephone consultation with Poppy's owner to determine her current condition and review some of the 113 pages of medical records. Complete chemistry profiles and blood cell counts had been measured every 2 weeks for 10 months, with no signs of improvement. We recommended a diet of fresh, whole foods to replace the prescription food a/d that Poppy would not eat. 

'Poppy' - February 2001 (after rolling in dry grass!)

Poppy's caregivers had to syringe-feed her for the first 3 days. Dr. Kruesi recommended tapioca as a starch, and Poppy liked that! We prepared 1 liter of sterile fluids with vitamins based on Poppy's blood tests to start the healing process. These were administered by subcutaneous injection for a few days until she could tolerate oral supplements as prescribed in her BioMedical Profile.

Fax transmittal - April 2, 2002 

To: Neil (Poppy's owner)

From:  Konrad Kruesi, D.V.M.

From charting a dozen of her chemistry profiles and blood cell counts it is clear that she will not improve with the same therapy. Months of Baytril, metronidazole, prednisone, amoxicillin, etc., have never addressed her fundamental weakness and surely will not resolve the profound mineral deficits, hormonal depression, and dysfunctional gut. Indeed the therapy is very much causal in depleting zinc, calcium, and magnesium, antagonizing thyroid, pituitary and pineal hormones, suppressing immune function/disease resistance, and much more. Her anemia, high platelets, etc. suggest functional hypothyroidism. She has all the markers of dysbiosis and intestinal permeability (leaky gut syndrome) and is at risk of sepsis and gastric/duodenal ulcer (if not there already). These conditions do not resolve with antibiotics or steroids. Her blood test of March 25, 2002 is suggestive of hypochlorhydria (insufficient stomach acid)- inactivity of proteolytic enzymes (protein maldigestion)- and chronic protein-loss enteropathy.

Fax transmittal - April 4, 2002 

To: Neil

From:  Konrad Kruesi, D.V.M.

We greatly appreciate the updates from you on Poppy. She is at a critical stage and without exaggerating, between life and death. Her blood tests are not entirely compatible with life. Nevertheless we proceed cautiously not aggressively, with therapy that supports rather than works against homeostasis and healing.

We treat lymphangitis [inflamed lymph vessels] and inflammatory bowel disease with flavonoids such as rutin and escin to repair lymphatic vessels and lacteals [intestinal lymph ducts]; a nutritious diet of home foods; unsaturated fats, vitamin C, proline (an amino acid) and so forth- NOT prednisone which weakens all connective tissue, disrupts synthesis of hormones, and promotes aging rather than repair. Please, no heartworm medication. No more drugs. Call if you need help.

Fax transmittal - April 8, 2002 

To: Konrad Kruesi, D.V.M.

From: Neil

Poppy is doing reasonably well since starting the new regimen. Although not always eating heartily of the new diet she definitely shows interest... The look in her eye is brighter, her attitude is better. Thanks again for all of the wonderful support from all of you.

Fax transmittal - April 19, 2002 

To: Konrad Kruesi, D.V.M.

From: Neil

Poppy continues to improve every day! Her appetite improves with something new added every other day or so. She now gets liver (which she inhales), occasional baked potato and sour cream, and we continually look for additional items to add. Her strength also seems to be returning.

Fax transmittal - June 4, 2002 

To: Neil

From: Konrad Kruesi, D.V.M.

After 8 weeks of home food and nutritional therapy, Poppy's 10-month history of declining health, constant diarrhea, hair loss, anemia, and drug dependency has not only been reversed, but substantially repaired. Her blood tests and urinalysis honestly and objectively reflect a wonderful transformation. Her thyroid level is perfect, liver and gall bladder disease has resolved, anemia resolved, mineral deficiencies corrected, pancreas inflammation gone. As I mentioned  in Poppy's first nutritional analysis (BioMedical Profile): no amount of drugs, prescription pet food, or artificial hormones would reverse her condition but fresh foods and nutritional supplements have. Good work!

Telephone call - June 24, 2002

Poppy is doing beautifully! She goes on 3-5 mile runs daily with Joannie, played in the creek over the weekend.

Letter - August 3, 2002

From: Neil, Joannie, Poppy & Molly

To: Dr. Kruesi, Kate, Molly & Laura

Joannie, Molly and I would like to thank you for returning Poppy to our family. You cannot know what she has meant to each of [us] individually and collectively, to our family. She is Molly's playmate, older sister, and guide to life. She is Joannie's running partner, protector, and much, much more. And to me- well, she has taught me how much nobility, loyalty, love, and beauty can exist in a dog.

You cannot know the heartbreak we experienced watching her once trim and athletic body wither away while we searched for a diagnosis. It took six weeks to learn of the parasite that had ravaged her internal organs. Then over the next six months watch her gain some of her strength back only to become dependent on the constantly changing array of drugs that we were told would be necessary to keep her alive. And that she would remain on them for the rest of her life. Then, in March to see her wither once more with no hope that she could come back a second time.

Knowing what you do about the state she was in when we contacted you, I am sure you can imagine what our year has been like. There were many difficulties, challenges and heartbreaking moments in just keeping her alive for much of that time.

So it is with the perspective of that long year, and the fears that it brought us, that we can say that what you have done for her in the four short months since taking her case has been nothing short of miraculous. Her weight has returned to pre-parasite normal, she is back to running with Joannie, fishing in her favorite creek (in clean rain water), playing with all of her favorite toys, and with Molly. She is BACK!! And what is most remarkable is that she is off all of the drugs- this is the most difficult to believe and the most wonderful. We cannot thank you enough for what you have given us.

Poppy - April 2, 2002   (before nutritional therapy)                 Poppy - June 7, 2002  

(after 8 weeks of nutritional therapy)

Life cycle of a fluke

The life cycle of H americana starts with eggs (miracidia) shed in the feces of a vertebrate host (such as raccoons and feral dogs). The eggs produce larvae that survive on vegetation. The larvae infect aquatic snails. The snails release larvae (cercariae) into the water. These larvae can penetrate the skin of domestic dogs. Once in the dog, larvae mature into adult worms, which can be found in the liver approximately 40 days after infection. From the liver, adult flukes can spread to distant sites via the mesenteric veins and seed themselves throughout the abdomen. Detection of an infection in dogs is by saline sedimentation of feces and microscopic examination. Extensive injuries to the intestines and liver are common.

Serum chemistry profiles                          

    *These values are at one end or outside of the reference range for dogs.

** These values are significantly outside the reference range for dogs.

Blood cell counts (CBC)

    *These values are at one end or outside of the reference range for dogs.

References

Flowers, JR et al. Heterobilharzia americana infection in a dog. JAVMA, Vol 220 No. 2, January 15, 2002: 193-196

Inflammatory bowel disease, Proceedings of the seminar, "Concepts of Nutritional Medicine", 2001

William Konrad Kruesi, D.V.M., C.V.A.  /2002