Need Advice Dog Is Very Unwell - Update

[mushroom 13,268]

 

 

have they checked theres nothing stuck inside his stomach-had a dog get lamb bone in the side wall and he was very ill they missed it first time. atb

Nah mate he's had full body x-rays and a full body ultrasound surely a bone or obstruction would show up somewhere (I did ask several times and was assured no)

only takes a tiny fragment

That's exactly what I said and was assured there was nothing there

 

 

 

 

 

 

 

Not really my field but I’d be inclined to second socks in the first instance as the symptoms you describe sound about right for pancreatitis, I take the bloods were negative for this?

 

A couple of points, an enlarged pancreas and spleen can be linked, in pancreatitis the pancreas becomes enlarged and can, not uncommonly, press on the blood vessel that drains the spleen, this reduces out flow causing it over fill and swell. Also pancreatitis can be linked to gastritis. Lastly the physical symptoms of digestive problems and declination to eat would also fit. Did they check the calcium?

You could discuss with your vet trying a diet for pancreatitis for a time to see if it eases symptoms.

 

An alternative diagnosis are multitude and would include an on going gastrointestinal infection causing a more generalised inflammation, sometimes these types of bugs can go on for a long time but one would expect bloods to show indication of infection.

 

Next would be an autoimmune type problem or a chronic inflammation of the gastric tract, something like an IBS or gastritis

 

? poisoning but again most would show changes in bloods in one form or another.

 

Is the dogs abdo tender or does it have a slightly hunched stance when it has eaten?

Is there jelly type stuff in the stools?

Has it passed any blood or black stools?

Recheck the urine, is there still blood, a secondary urine infection could muddy the waters.

 

Sometimes the vet needs to go back and reconsider the possibilities when nothing shows and think about treating symptomology as well as test results.

 

Hope it settles s.

 

Hi Sandy

 

Ok....

 

Jelly type crap in er the crap yes sometimes and not a lot but noticeable.

 

Absolutely no pain or tenderness showing but this dog is a nob when it comes to pain as in the bugger doesn't seem to show it, but the lack of has been confirmed by umpteen vet visits complete with pokes prods.

 

As mentioned he's on mild antis and omeprazol? (something for the stomach) this is for the mild Gastritis.

 

Since Socks mentioned Pacreatitis I had a word with the vet and he doesn't think this is the issue but I have been feeding him a diet akin to one fed to a dog with it.

 

No black poos just dark ones sometimes and not often.

 

Lara

 

His poos are soft but not liquid.

 

His pee seems normal just maybe pees a little more than I would expect given the amount of water he drinks (I've been measuring everything everyday so I know where I'm at).

 

Diabetes has been ruled out

jelly like stools can be caused when the lining of the stomach becomes inflamed/irritated this can be caused by corn or wheat in its diet have you tried bland old rice and chicken?

Aye at the moment he's getting a small amount of pasta mixed in with a large amount of rice, fresh veg (and some fruit), tuna and sardines (with Olive oil) bit of salt. I blend all this together with water and feed through a syringe at intervals plus I'm also giving 500g fresh mince split throughout the day.

 

From what I can see there is no corn in his diet and minimal wheat in there (the small amount of pasta would be the only source).

pasta is made from wheat :laugh:

Can you bloody read lol it says pasta and yes wheat in the same sentence :laugh:

I'm giving less than a handful of the twists each day

might be worth knocking the pasta on the head for a while and see if it makes a difference, dogs dont need carbs like we do anyway, i use it more a s a filler in spring and summer

Done I'll try anything mate, no more pasta from now on

[Blackbriar 8,569]

My wife has asked me to post this - she has been following Trev's plight with some concern. Anyway, her Mum used to have a GSD that went like this every time there was a bitch in heat on the street. Sometimes, he'd be like it for weeks on end, then suddenly right as rain. They did loads of vet visits - nothing. It was only when it kept happening that they realised what was going on.

We're not dog experts, but hope this might help, and hope Trev gets better soon.

[mushroom 13,268]

My wife has asked me to post this - she has been following Trev's plight with some concern. Anyway, her Mum used to have a GSD that went like this every time there was a bitch in heat on the street. Sometimes, he'd be like it for weeks on end, then suddenly right as rain. They did loads of vet visits - nothing. It was only when it kept happening that they realised what was going on.

We're not dog experts, but hope this might help, and hope Trev gets better soon.

Tell your wife she's a love and thanks

 

Aye this is something been playing on my mind since baw mentioned it but we are now entering week 4 surely surely the daft cnut would start eating out of sheer survival

[gnipper 6,546]

He's not just being a spoilt little shite is he coz he knows he can? You say he comes running when he sees a biscuit. Like when people have dogs that will 'only' eat cooked chicken, have you encouraged him to be like it without realising? What's he like with a big bowl of raw mince? Can you get tripe over there?

[sandymere 8,263]

 

Mucus in the stool is likely from the colon, basically the protective lining being sloughed off which would point to colitis. I did a general bit on this which I’ll put below for your info..

 

As to pancreatitis if you want to go for the diet approach drop the mince as it will likely be very high fat. You want a low fat protein source and even then fed minimally.

 

It could just be a virus that will settle in it's own time.

 

Pm me if there’s any questions.

Regards s

 

First let me say I am not a vet and this is a layman’s prospective.

Colitis means inflammation of the colon, the colons role is the absorption of water and salt, the production of various hormones and the fermentation of dietary fibre which produces short chain fatty acids (SCFA). It contains a large population of bacteria to carry out the fermentation process and protect against harmful bacteria. After this process the muscular colon moves the residual waste to the rectum for storage prior to emptying. Colitis is not uncommon in dogs and the reasons are not entirely known but it is thought to be generally an immune mediated reaction to such things as bacteria or parasites with dietary factors often being involved. If there is a found causative factor then treatment will be based around the diagnosis but in many cases no definitive cause can be found.

Some dog have functional diarrhoea often associated with stressors without physical changes to the gastric tract in line with IBS in humans. Canine IBS is most commonly found in working dogs but any highly strung animal can be at risk and removing the stress can often bring a cessation of symptoms but as this is only part of the problem a multi action treatment is often needed. Drugs are often required to bring about remission and the vet is where one needs to go as the first point of contact, as the underlying cause cannot always be found treatment is aimed a managing symptoms rather than cure and diet is also thought to play a major part. One method is the use of novel protein diets along with fermentable fibre and polyunsaturated fatty acids to give long term management.

Elimination diets, prepared at home, provide a new protein with an appropriate carbohydrate, usually rice fed exclusively for at least 4 weeks. Once symptoms settle other foods can be added and response noted to identify any hypersensitivity. No extras in the form of supplements should be used during this period. Over the counter hypoallergenic diets follow the novel protein route with a variety of sources available such as rabbit, fish, duck etc and come with the option of added fibre. A second novel protein can be substituted for the first after a few weeks and maintained in the longer term.

There is evidence to suggest that appropriate fibre has a role to play and that the fermentability of fibre is important in aiding nutrient absorption, colonic health and formation of the SCFA. Moderately fermentable fibre is suggested as best in producing adequate SCFA to maintain health and reduce incidence of colorectal tumours, commercial feeds use beet pulp to fulfil this role. In home prepared meals whole grain rice, wholemeal pasta or oats may be appropriate once symptoms are in remission. Another area with some evidence is the use of polyunsaturated fatty acids with studies showing a reduction in symptoms of some animals when fish oils is added to the diet.

Dietary intervention is not a cure but it may help but please bare in mind it is not an easy option. One of the biggest problems faced by vets in treating this type of illness is poor owner compliance in that treats, table scraps, supplements etc being introduced whilst still in the elimination phase which makes the exercise fail so if an owner is considering a dietary approach to management then I would recommend a discussion with the vet, proper plan and very very strict adherence to that plan.

[baw 4,360]

Let the dog get his end away

[mushroom 13,268]

He's not just being a spoilt little shite is he coz he knows he can? You say he comes running when he sees a biscuit. Like when people have dogs that will 'only' eat cooked chicken, have you encouraged him to be like it without realising? What's he like with a big bowl of raw mince? Can you get tripe over there?

I don't think so mate his diet was pretty much barf until all this.

 

Every morning when I take him out I stop for a "special coffee" which comes with a biscuit I always give him a bit and he loves it so when he sees one he comes hoping he'll get some.

,

[chook1 184]

Bloods don't always show for pancreatitis - you need to do the other test, a serum test called canine pancreatitis lipase immuninol reactivity - the fact he has an enlarged pancreas would suggest to me there is something going on, instead of pasta give mashed sweet potato with either fish or chicken (without skin).

 

The mucus in his stools can be caused by lack of food, my bitch had the same when she was being syringe feed, due to recovering from septicemia

she didn't eat for 3 weeks by herself.

 

http://www.marvistavet.com/html/body_canine_pancreatitis.html

[socks 32,253]

My shepherd had a stool test to diagnose pancreatic problem .......

[mushroom 13,268]

Firstly everybody thank you for your input I really appreciate it

 

Ok Just got back from the vet's

 

Pancreatitis has been totally ruled out.

 

What apparently the problem is, is his intestine is inflamed this is having allsorts of side effects. The actual cause of the inflamation is yet to be confirmed but could of started with something as simple as a normal stomach upset.

 

The results I got today were for the Nutrient absorption, stomach Bile and tbh a shed load of other things I can't remember, but the main outcome was that he is seriously low on Vit B12 and Folic Acid this points to piss poor absorption.

 

It turns out that my vet has been in full consultation with 3 other vets regarding this problem and all three have seen the tests and ultrasound results and come to the same conclusion that it's his intestines.

 

So now have a shitload of medication for him ranging from 60 days of Cortizone, to complex vitamins tablets you couldn't fit in labs arse they're that big (really pleased with the price of the meds less than 30€ for everything).

 

His diet is as was mentioned before no wheat just rice and protein so I chose small fresh mackerel and has to stay like this until at least he starts to eat himself. long road ahead by the looks of it with no guarantees

 

ATB Shroom

[LaraCroft 863]

I know it's a long road to recovery, but glad they have found a reason behind it. Fingers crossed he is on the way back to full health soon

[paulus 26]

 

 

Not really my field but I’d be inclined to second socks in the first instance as the symptoms you describe sound about right for pancreatitis, I take the bloods were negative for this?

 

A couple of points, an enlarged pancreas and spleen can be linked, in pancreatitis the pancreas becomes enlarged and can, not uncommonly, press on the blood vessel that drains the spleen, this reduces out flow causing it over fill and swell. Also pancreatitis can be linked to gastritis. Lastly the physical symptoms of digestive problems and declination to eat would also fit. Did they check the calcium?

You could discuss with your vet trying a diet for pancreatitis for a time to see if it eases symptoms.

 

An alternative diagnosis are multitude and would include an on going gastrointestinal infection causing a more generalised inflammation, sometimes these types of bugs can go on for a long time but one would expect bloods to show indication of infection.

 

Next would be an autoimmune type problem or a chronic inflammation of the gastric tract, something like an IBS or gastritis

 

? poisoning but again most would show changes in bloods in one form or another.

 

Is the dogs abdo tender or does it have a slightly hunched stance when it has eaten?

Is there jelly type stuff in the stools?

Has it passed any blood or black stools?

Recheck the urine, is there still blood, a secondary urine infection could muddy the waters.

 

Sometimes the vet needs to go back and reconsider the possibilities when nothing shows and think about treating symptomology as well as test results.

 

Hope it settles s.

 

Hi Sandy

 

Ok....

 

Jelly type crap in er the crap yes sometimes and not a lot but noticeable.

 

Absolutely no pain or tenderness showing but this dog is a nob when it comes to pain as in the bugger doesn't seem to show it, but the lack of has been confirmed by umpteen vet visits complete with pokes prods.

 

As mentioned he's on mild antis and omeprazol? (something for the stomach) this is for the mild Gastritis.

 

Since Socks mentioned Pacreatitis I had a word with the vet and he doesn't think this is the issue but I have been feeding him a diet akin to one fed to a dog with it.

 

No black poos just dark ones sometimes and not often.

 

Lara

 

His poos are soft but not liquid.

 

His pee seems normal just maybe pees a little more than I would expect given the amount of water he drinks (I've been measuring everything everyday so I know where I'm at).

 

Diabetes has been ruled out

jelly like stools can be caused when the lining of the stomach becomes inflamed/irritated this can be caused by corn or wheat in its diet have you tried bland old rice and chicken?

 

 

Firstly everybody thank you for your input I really appreciate it

 

Ok Just got back from the vet's

 

Pancreatitis has been totally ruled out.

 

What apparently the problem is, is his intestine is inflamed this is having allsorts of side effects. The actual cause of the inflamation is yet to be confirmed but could of started with something as simple as a normal stomach upset.

 

The results I got today were for the Nutrient absorption, stomach Bile and tbh a shed load of other things I can't remember, but the main outcome was that he is seriously low on Vit B12 and Folic Acid this points to piss poor absorption.

 

It turns out that my vet has been in full consultation with 3 other vets regarding this problem and all three have seen the tests and ultrasound results and come to the same conclusion that it's his intestines.

 

So now have a shitload of medication for him ranging from 60 days of Cortizone, to complex vitamins tablets you couldn't fit in labs arse they're that big (really pleased with the price of the meds less than 30€ for everything).

 

His diet is as was mentioned before no wheat just rice and protein so I chose small fresh mackerel and has to stay like this until at least he starts to eat himself. long road ahead by the looks of it with no guarantees

 

ATB Shroom

that will be 3 pints and a bag of pork crunch please im glad they have diagnosed the reason at least they can get on and treat it now

[mushroom 13,268]

 

 

 

Not really my field but I’d be inclined to second socks in the first instance as the symptoms you describe sound about right for pancreatitis, I take the bloods were negative for this?

 

A couple of points, an enlarged pancreas and spleen can be linked, in pancreatitis the pancreas becomes enlarged and can, not uncommonly, press on the blood vessel that drains the spleen, this reduces out flow causing it over fill and swell. Also pancreatitis can be linked to gastritis. Lastly the physical symptoms of digestive problems and declination to eat would also fit. Did they check the calcium?

You could discuss with your vet trying a diet for pancreatitis for a time to see if it eases symptoms.

 

An alternative diagnosis are multitude and would include an on going gastrointestinal infection causing a more generalised inflammation, sometimes these types of bugs can go on for a long time but one would expect bloods to show indication of infection.

 

Next would be an autoimmune type problem or a chronic inflammation of the gastric tract, something like an IBS or gastritis

 

? poisoning but again most would show changes in bloods in one form or another.

 

Is the dogs abdo tender or does it have a slightly hunched stance when it has eaten?

Is there jelly type stuff in the stools?

Has it passed any blood or black stools?

Recheck the urine, is there still blood, a secondary urine infection could muddy the waters.

 

Sometimes the vet needs to go back and reconsider the possibilities when nothing shows and think about treating symptomology as well as test results.

 

Hope it settles s.

 

Hi Sandy

 

Ok....

 

Jelly type crap in er the crap yes sometimes and not a lot but noticeable.

 

Absolutely no pain or tenderness showing but this dog is a nob when it comes to pain as in the bugger doesn't seem to show it, but the lack of has been confirmed by umpteen vet visits complete with pokes prods.

 

As mentioned he's on mild antis and omeprazol? (something for the stomach) this is for the mild Gastritis.

 

Since Socks mentioned Pacreatitis I had a word with the vet and he doesn't think this is the issue but I have been feeding him a diet akin to one fed to a dog with it.

 

No black poos just dark ones sometimes and not often.

 

Lara

 

His poos are soft but not liquid.

 

His pee seems normal just maybe pees a little more than I would expect given the amount of water he drinks (I've been measuring everything everyday so I know where I'm at).

 

Diabetes has been ruled out

jelly like stools can be caused when the lining of the stomach becomes inflamed/irritated this can be caused by corn or wheat in its diet have you tried bland old rice and chicken?

 

 

>Firstly everybody thank you for your input I really appreciate it

 

Ok Just got back from the vet's

 

Pancreatitis has been totally ruled out.

 

What apparently the problem is, is his intestine is inflamed this is having allsorts of side effects. The actual cause of the inflamation is yet to be confirmed but could of started with something as simple as a normal stomach upset.

 

The results I got today were for the Nutrient absorption, stomach Bile and tbh a shed load of other things I can't remember, but the main outcome was that he is seriously low on Vit B12 and Folic Acid this points to piss poor absorption.

 

It turns out that my vet has been in full consultation with 3 other vets regarding this problem and all three have seen the tests and ultrasound results and come to the same conclusion that it's his intestines.

 

So now have a shitload of medication for him ranging from 60 days of Cortizone, to complex vitamins tablets you couldn't fit in labs arse they're that big (really pleased with the price of the meds less than 30€ for everything).

 

His diet is as was mentioned before no wheat just rice and protein so I chose small fresh mackerel and has to stay like this until at least he starts to eat himself. long road ahead by the looks of it with no guarantees

 

ATB Shroom

that will be 3 pints and a bag of pork crunch please im glad they have diagnosed the reason at least they can get on and treat it now

 

Stomach and intestines different thing ya numpty

 

In light of that how does a packet of SFA sound?

 

I'm glad at least we have a diagnosis as Lara said long road ahead to a full recovery. The vet did said I should see a marked improvement within 5 days so fingers crossed

[paulus 26]

 

 

 

 

Not really my field but I’d be inclined to second socks in the first instance as the symptoms you describe sound about right for pancreatitis, I take the bloods were negative for this?

 

A couple of points, an enlarged pancreas and spleen can be linked, in pancreatitis the pancreas becomes enlarged and can, not uncommonly, press on the blood vessel that drains the spleen, this reduces out flow causing it over fill and swell. Also pancreatitis can be linked to gastritis. Lastly the physical symptoms of digestive problems and declination to eat would also fit. Did they check the calcium?

You could discuss with your vet trying a diet for pancreatitis for a time to see if it eases symptoms.

 

An alternative diagnosis are multitude and would include an on going gastrointestinal infection causing a more generalised inflammation, sometimes these types of bugs can go on for a long time but one would expect bloods to show indication of infection.

 

Next would be an autoimmune type problem or a chronic inflammation of the gastric tract, something like an IBS or gastritis

 

? poisoning but again most would show changes in bloods in one form or another.

 

Is the dogs abdo tender or does it have a slightly hunched stance when it has eaten?

Is there jelly type stuff in the stools?

Has it passed any blood or black stools?

Recheck the urine, is there still blood, a secondary urine infection could muddy the waters.

 

Sometimes the vet needs to go back and reconsider the possibilities when nothing shows and think about treating symptomology as well as test results.

 

Hope it settles s.

 

Hi Sandy

 

Ok....

 

Jelly type crap in er the crap yes sometimes and not a lot but noticeable.

 

Absolutely no pain or tenderness showing but this dog is a nob when it comes to pain as in the bugger doesn't seem to show it, but the lack of has been confirmed by umpteen vet visits complete with pokes prods.

 

As mentioned he's on mild antis and omeprazol? (something for the stomach) this is for the mild Gastritis.

 

Since Socks mentioned Pacreatitis I had a word with the vet and he doesn't think this is the issue but I have been feeding him a diet akin to one fed to a dog with it.

 

No black poos just dark ones sometimes and not often.

 

Lara

 

His poos are soft but not liquid.

 

His pee seems normal just maybe pees a little more than I would expect given the amount of water he drinks (I've been measuring everything everyday so I know where I'm at).

 

Diabetes has been ruled out

jelly like stools can be caused when the lining of the stomach becomes inflamed/irritated this can be caused by corn or wheat in its diet have you tried bland old rice and chicken?

 

 

>>Firstly everybody thank you for your input I really appreciate it

 

Ok Just got back from the vet's

 

Pancreatitis has been totally ruled out.

 

What apparently the problem is, is his intestine is inflamed this is having allsorts of side effects. The actual cause of the inflamation is yet to be confirmed but could of started with something as simple as a normal stomach upset.

 

The results I got today were for the Nutrient absorption, stomach Bile and tbh a shed load of other things I can't remember, but the main outcome was that he is seriously low on Vit B12 and Folic Acid this points to piss poor absorption.

 

It turns out that my vet has been in full consultation with 3 other vets regarding this problem and all three have seen the tests and ultrasound results and come to the same conclusion that it's his intestines.

 

So now have a shitload of medication for him ranging from 60 days of Cortizone, to complex vitamins tablets you couldn't fit in labs arse they're that big (really pleased with the price of the meds less than 30€ for everything).

 

His diet is as was mentioned before no wheat just rice and protein so I chose small fresh mackerel and has to stay like this until at least he starts to eat himself. long road ahead by the looks of it with no guarantees

 

ATB

Shroomlockquote>

that will be 3 pints and a bag of pork crunch please im glad they have diagnosed the reason at least they can get on and treat it now

Stomach and intestines different thing ya numpty

 

In light of that how does a packet of SFA sound?

 

I'm glad at least we have a diagnosis as Lara said long road ahead to a full recovery. The vet did said I should see a marked improvement within 5 days so fingers crossed

 

there both in the gut so 1 pint and a bag of dry roasted

[mushroom 13,268]

 

 

 

 

 

Not really my field but I’d be inclined to second socks in the first instance as the symptoms you describe sound about right for pancreatitis, I take the bloods were negative for this?

 

A couple of points, an enlarged pancreas and spleen can be linked, in pancreatitis the pancreas becomes enlarged and can, not uncommonly, press on the blood vessel that drains the spleen, this reduces out flow causing it over fill and swell. Also pancreatitis can be linked to gastritis. Lastly the physical symptoms of digestive problems and declination to eat would also fit. Did they check the calcium?

You could discuss with your vet trying a diet for pancreatitis for a time to see if it eases symptoms.

 

An alternative diagnosis are multitude and would include an on going gastrointestinal infection causing a more generalised inflammation, sometimes these types of bugs can go on for a long time but one would expect bloods to show indication of infection.

 

Next would be an autoimmune type problem or a chronic inflammation of the gastric tract, something like an IBS or gastritis

 

? poisoning but again most would show changes in bloods in one form or another.

 

Is the dogs abdo tender or does it have a slightly hunched stance when it has eaten?

Is there jelly type stuff in the stools?

Has it passed any blood or black stools?

Recheck the urine, is there still blood, a secondary urine infection could muddy the waters.

 

Sometimes the vet needs to go back and reconsider the possibilities when nothing shows and think about treating symptomology as well as test results.

 

Hope it settles s.

 

Hi Sandy

 

Ok....

 

Jelly type crap in er the crap yes sometimes and not a lot but noticeable.

 

Absolutely no pain or tenderness showing but this dog is a nob when it comes to pain as in the bugger doesn't seem to show it, but the lack of has been confirmed by umpteen vet visits complete with pokes prods.

 

As mentioned he's on mild antis and omeprazol? (something for the stomach) this is for the mild Gastritis.

 

Since Socks mentioned Pacreatitis I had a word with the vet and he doesn't think this is the issue but I have been feeding him a diet akin to one fed to a dog with it.

 

No black poos just dark ones sometimes and not often.

 

Lara

 

His poos are soft but not liquid.

 

His pee seems normal just maybe pees a little more than I would expect given the amount of water he drinks (I've been measuring everything everyday so I know where I'm at).

 

Diabetes has been ruled out

jelly like stools can be caused when the lining of the stomach becomes inflamed/irritated this can be caused by corn or wheat in its diet have you tried bland old rice and chicken?

 

 

>>>Firstly everybody thank you for your input I really appreciate it

 

Ok Just got back from the vet's

 

Pancreatitis has been totally ruled out.

 

What apparently the problem is, is his intestine is inflamed this is having allsorts of side effects. The actual cause of the inflamation is yet to be confirmed but could of started with something as simple as a normal stomach upset.

 

The results I got today were for the Nutrient absorption, stomach Bile and tbh a shed load of other things I can't remember, but the main outcome was that he is seriously low on Vit B12 and Folic Acid this points to piss poor absorption.

 

It turns out that my vet has been in full consultation with 3 other vets regarding this problem and all three have seen the tests and ultrasound results and come to the same conclusion that it's his intestines.

 

So now have a shitload of medication for him ranging from 60 days of Cortizone, to complex vitamins tablets you couldn't fit in labs arse they're that big (really pleased with the price of the meds less than 30€ for everything).

 

His diet is as was mentioned before no wheat just rice and protein so I chose small fresh mackerel and has to stay like this until at least he starts to eat himself. long road ahead by the looks of it with no guarantees

 

ATB

Shroomlockquote>

that will be 3 pints and a bag of pork crunch please im glad they have diagnosed the reason at least they can get on and treat it now

lockquote>

Stomach and intestines different thing ya numpty

 

In light of that how does a packet of SFA sound?

 

I'm glad at least we have a diagnosis as Lara said long road ahead to a full recovery. The vet did said I should see a marked improvement within 5 days so fingers crossed

 

there both in the gut so 1 pint and a bag of dry roasted

 

Would you settle for one peepee touch???

 

 

 

 

Trevor would oblige I'm sure