Deciding How to Help a German Shepherd with Perianal Fistula

[VandanaB]

My dog of 7 years has recently developed Piles and has been prescribed Stomorgyl & Neoral 100. Our dog has had discomfort around his stomach, he has diarrhea, has mucus in his stool. He also has a very sensitive stomach and is a picky eater. He doesn’t Normally eat fruits and vegetables. We currently feed him Hills digestive care cans (Look below For photo) and Boiled organic chicken with broth. Any suggestions or advice on how to deal with this issue. Replies would be greatly appreciated.

 

[Dr. Jeff]

Welcome, and good morning (in NZ) Vandana.

I'm sorry that we missed you on Zoom this weekend, but I'll see both you and Zeus when we have our HMDM chat later this week. In the meantime, posting on the forum is fantastic.

When did your pup start having any stool or rectal issues?

Does he have any rectal discomfort? Licking the area, scooting on his butt?

The piles description by your vet could be either anal sacculitis or perineal fistulas.

Can you share a picture of the area under his tail and around his anus?

 

[VandanaB]

He has had loose/inconsistent stool for about 3 weeks now. This past week it has gotten worse. Yes he has rectal discomfort he has been trying to lick and scout that area! The Vet said it was perineal fistulas. He has prescribed Neoral 100mg and Stomorgyl. Since the medication he has been trying to go poop with nothing but loose stool coming out. He also not eating his regular digestive cans but we have been feeding him boiled chicken with broth. We will get back to you shortly with photos that our vet had taken recently of Our dog as he won’t allow us to lift his tail or get near the infected area. Help would truly be appreciated.

 

[Dr. Jeff]

Have you ever tried feeding fresh, other than chicken, or raw food Vandana?

You might also want to see if he tolerates 1/4 cup of the wild blueberry-kale smoothie in his meals:

Organic kale and wild blueberry smoothie

Hi everyone- Amelia just asked about diet recommendations for her pet with cancer, and I advised the 1:1 kale + wild blueberry antioxidant blend. It's been mentioned on this forum before, but here's exactly how to make it for cancer, arthritis, allergy and other general diet support: Steam or...

www.holisticactions.com

 

[VandanaB]

Unfortunately he’s a very picky eater and doesn’t eat most vegetables or fruit. However, we will try to put the smoothie over his cooked chicken today and see. Is there anything else you could suggest? Should we keep giving him the medication?

 

[Dr. Jeff]

Hi Vandana-

Regarding foods, are there any fresh ones that he will eat on a regular basis?

If there's a treat, or anything, that he loves then you can add it on top of the food.

Also, you might even want to start with a few teaspoons of the smoothie mixed with his food since he's so picky.

Was there ever a time when he ate whatever you gave him?

Regarding, foods that German Shepherd's tend to eat, @beccak may have other ideas.

As far as the meds are concerned, the answer to using any medication depends on your HMDM Step 1 goal.

HMDM is the 3 step Holistic Medical Decision Making protocol that you can learn more about here:

HMDM2.pdf

drive.google.com

For example, if your goal is to do everything your vet advises to help with any specific symptom or diagnosis, then yes.

The Neoral is an anti-inflammatory designed to stop the immune attack on his peri-anal tissues. However, it works systemically against all of immunity:

Cyclosporine: Side Effects, Dosage, Uses, and More

Cyclosporine (Gengraf, Neoral, Sandimmune) oral capsule is a prescription medication used to treat rheumatoid arthritis and psoriasis. Learn about side effects, warnings, dosage, and more.

www.healthline.com

In people it was first used to prevent the immune rejection of transplanted kidneys. It has since been used for many immune-related imbalances.

Here is the introduction to a scientific article about its' use in dogs:

Cyclosporine is a potent immunosuppressive drug indicated for the treatment of autoimmune diseases and for organ transplantation. In dogs, cyclosporine is used to treat a spectrum of chronic inflammatory and immune‐mediated diseases. Cyclosporins (up to 9 different molecules, A–I) are cyclic polypeptide macrolides that were originally derived from the soil fungus Tolypocladium inflatum (Beauveria nivea), but are also produced by other fungal organisms. Cyclosporine A is the molecule developed for commercial use as an immunosuppressive agent.1, 2, 3 Discovered by Sandoz Laboratory in 1972, the use of cyclosporine as an immunosuppressive agent was first described in humans to prevent rejection of renal allografts.3, 4 Since that time, cyclosporine has become the cornerstone of immunosuppression for organ transplantation.4, 5 Cyclosporine was approved by the U.S. Food and Drug Administration (FDA) in 1983 for treatment and prevention of transplant rejection in human medicine.6 In veterinary medicine, Novartis Animal Health received FDA approval in 2003 for oral cyclosporine capsules (Atopica) for the treatment of canine atopy. However, by this time cyclosporine had already been used in an extralabel fashion for many years for renal transplantation in dogs and cats,7, 8, 9, 10 and for the treatment of a variety of inflammatory and immune‐mediated conditions.11, 12, 13, 14

Here is the full article:

Oral Cyclosporine Treatment in Dogs: A Review of the Literature

.


Doing all of this research is HMDM Step 2 and will help you decide what to do.

The last step of HMDM is implementing a holistic action, so regarding this drug as well as the two anti-biotics in the Stomorgyl, I wonder if they are helping so far? When did you start them?

Anti-biotics can worsen diarrhea by altering the normal bacterial balance in the intestines. It's often a good idea to use a pro-biotic along with them and continued for at least a month afterward.

In addition, a pinch of a fiber like Metamucil or 1-2 tsp. of canned pumpkin added to his food can help firm it up.

Perhaps for now continue what you are already doing and reevaluate in 1-2 weeks.

There are also some wonderful general holistic vets in New Zealand with whom you may want to consult.

Here's a partial list:

Holistic Vet Directory New Zealand

CIVT's referral list to put animal carers in touch with New Zealand veterinarians and other practitioners who are members or associate members of CIVT.

www.civtedu.org

We'll also Zoom further during your HMDM call this week.

 

[VandanaB]

My dog of 7 years has recently developed Piles and has been prescribed Stomorgyl & Neoral 100. Our dog has had discomfort around his stomach, he has diarrhea, has mucus in his stool. He also has a very sensitive stomach and is a picky eater. He doesn’t Normally eat fruits and vegetables. We currently feed him Hills digestive care cans (Look below For photo) and Boiled organic chicken with broth. Any suggestions or advice on how to deal with this issue. Replies would be greatly appreciated.

 

[VandanaB]

Hi Vandana-

Regarding foods, are there any fresh ones that he will eat on a regular basis?

If there's a treat, or anything, that he loves then you can add it on top of the food.

Also, you might even want to start with a few teaspoons of the smoothie mixed with his food since he's so picky.

Was there ever a time when he ate whatever you gave him?

Regarding, foods that German Shepherd's tend to eat, @beccak may have other ideas.

As far as the meds are concerned, the answer to using any medication depends on your HMDM Step 1 goal.

HMDM is the 3 step Holistic Medical Decision Making protocol that you can learn more about here:

HMDM2.pdf

drive.google.com

For example, if your goal is to do everything your vet advises to help with any specific symptom or diagnosis, then yes.

The Neoral is an anti-inflammatory designed to stop the immune attack on his peri-anal tissues. However, it works systemically against all of immunity:

Cyclosporine: Side Effects, Dosage, Uses, and More

Cyclosporine (Gengraf, Neoral, Sandimmune) oral capsule is a prescription medication used to treat rheumatoid arthritis and psoriasis. Learn about side effects, warnings, dosage, and more.

www.healthline.com

In people it was first used to prevent the immune rejection of transplanted kidneys. It has since been used for many immune-related imbalances.

Here is the introduction to a scientific article about its' use in dogs:



Here is the full article:

Oral Cyclosporine Treatment in Dogs: A Review of the Literature

.


Doing all of this research is HMDM Step 2 and will help you decide what to do.

The last step of HMDM is implementing a holistic action, so regarding this drug as well as the two anti-biotics in the Stomorgyl, I wonder if they are helping so far? When did you start them?

Anti-biotics can worsen diarrhea by altering the normal bacterial balance in the intestines. It's often a good idea to use a pro-biotic along with them and continued for at least a month afterward.

In addition, a pinch of a fiber like Metamucil or 1-2 tsp. of canned pumpkin added to his food can help firm it up.

Perhaps for now continue what you are already doing and reevaluate in 1-2 weeks.

There are also some wonderful general holistic vets in New Zealand with whom you may want to consult.

Here's a partial list:

Holistic Vet Directory New Zealand

CIVT's referral list to put animal carers in touch with New Zealand veterinarians and other practitioners who are members or associate members of CIVT.

www.civtedu.org

We'll also Zoom further during your HMDM call this week.

Hi Dr jeff
Photos attached as promised.

 

[Dr. Jeff]

Fantastic Vandana that you found Dr. Liza, and already had a consult with her!

She'll individualize diet and supplements for Zeus.