Fiona Health Update Part 2

Fiona had her specialist appointment with an internist, and we were really grateful for the insight she was able to give us.  She sat down with us and went through all of Fiona's history, gave us her honest opinions, and answered all of our questions thoroughly.  

The good(ish) news - she does not think that the issue is with Fiona's kidneys.  Her kidneys aren't great, but they seem stable and its not presently as classic CKD (chronic kidney disease).  However she is clearly very sick and losing a ton of weight.  
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So, what is it then?

The internist feels it's most likely some type of chronic GI disease.  The two most likely candidates are IBD or, unfortunately, cancer.  However if it is cancer it has not grown into any masses that have been visible on either of the two ultrasounds, so it is likely slow growing.  

The next diagnostic step would be an endoscopy to find out exactly what is going on in her GI tract and take samples for biopsy.   

Before we take that step, we are starting Fiona on steroids to see how she responds, as it's the main treatment protocol for IBD and any chronic inflammatory GI disease.  Unfortunately, certain types of GI cancers like lymphoma also respond to steroids, so a positive response won't rule that out completely. 
The endoscopy will cost $4,000 and also require anesthesia, which isn't great for dogs with kidney disease.  However it still may be the next best step for her.  

Fiona still requires anti-nausea medicine every day just to stay comfortable, and we are trying to give her a variety of plain foods just to find something she is willing to eat and keep calories coming in.  Right now she is loving plain noodles (?!) but we are just glad to see her eating something.    

We are starting her on the steroid today (fingers crossed please!!!) and her next follow-up appointment with the internist is on August 17th.  If the steroids help, we should start to see improvement in about a week.