Case 8

Looks like Misou is responding well to her treatments. Her abdominal incision is well healed, and her stomach tube site looks great. It has been eight days since surgery, so you decide to start Misou on prednisone to treat her inflammatory bowel disease. You start at 1 mg/kg twice daily, discontinue the antibiotics, and continue the other medications.

Over the course of the next week, the owners notice that Misou is eating more on her own, so you instruct them to start decreasing her tube feedings by 25% over the next four days if she continues to eat well on her own. They can also start giving her medications orally at this time in preparation for tube removal.

Misou is brought in for a recheck visit after having been completely off of tube feedings for three days. She has gained another 0.5 lb and she looks great. Since she appears to be eating well on her own, you discuss with the owners transitioning her slowly to a hydrolyzed protein diet that will be better suited to managing inflammatory bowel disease. Even though they are not using the tube, you decide it would be best to keep it in case any problems occur with the diet transition.

Fortunately, everything goes well and you see Misou the next week for tube removal. The owners report she is back to her usual self, is eating well, and is playful.

Your long-term plan for Misou is to continue the famotidine, cobalamin (the owners are taught how to give subcutaneous injections), and hydrolyzed protein diet and reduce the prednisone to the lowest dose that will control her clinical signs. Misou's response to the first dose reduction can be assessed in the next two to four weeks.

Congratulations on another well-managed case, doc!

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