Grey Losing Weight, Can't Figue It Out

[Guest Matt]

My dogs only seem to have medical mysteries... I need some help here, not sure the vet is going the right way.

 

Gromit is a 10 1/2 year old grey, we've had him 7 1/2 years. Generally very healthy, in 2007 he was very sick, Bartonella was the best diagnosis although he tested negative for it, azythromycin (sp?) took care of it. Nothing new until last November, he started limping, was stiff, less energy, shorter walks. Arthritis was suspected (Deramaxx prescribed), condition worsened. Went to an ortho specialist in Feb 2011, ruled out bone cancer (whew!), diagnosed cervical issues, root reference, groin pull, treated with drugs (Gabapentin, Tramadol), rest, PT, acupuncture. Significant improvement noted.

 

In June 2011 he started losing weight, energy level dropping fast. Continued losing significant weight (80 down to 72.4 lbs), but appetite was good, ate as much as usual, no vomiting or diarrhea. Thirst increased, urination seemed down. Began poop eating (never done this before). Energy levels continue to drop.

 

Blood tests negative. 6/19 Xray indicated possible spleen tumor. 6/20 ultrasound showed enlarged spleen, no tumor, nothing else remarkable. IDEXX TLI, B12, Folate-canine blood tests were negative for pancreatic enzyme problem, indicated either IBD or lymphoma. Began treating for IBD (Metronidazole, Proviable DC, Vitamin B12 shots, hypo-allergenic diet; Deramaxx stopped). Appetite still very good; vomiting on 6/22, started Cerenia that evening, no further vomiting. Since then his attitude seems to have improved, walks are a little longer, acting a little more normal.

 

The vet would like to do a biopsy to determine whether it's lymphoma or IBD. I'm hesitant since Gromit is 10+ years old, and if it's lymphoma I'm not sure I'd want to put him through chemo -- if IBD is confirmed we’re already treating for that, so why put the dog through surgery? But more than that, I'm not sure about the direction we're going. The combination of strong appetite, no diarrhea, almost no vomiting, and substantial weight loss does not seem consistent with IBD or lymphoma -- weight loss, loss of appetite, vomiting and diarrhea are symptoms of both, Gromit only has the weight loss. Since he's not losing weight due to an inability to keep the food in, is there something else we should be suspecting?

 

Although he seems a bit better, I find it hard to believe that it's because the new diet and drugs had that much effect on IBD in 3 days time (and it took me 3 days to transition to 100% new food). I can't get past the fact that everything that's suspected now has vomiting/diarrhea/loss of appetite in the symptom list -- Yeah, I know that you don't necessarily have all the symptoms, but these seem like some important symptoms not to have.

 

Any suggestions would be greatly appreciated -- including 2nd opinion references for central Maryland (Howard County). Thanks much

[CaliforniaGreys]

In June 2011 he started losing weight, energy level dropping fast. Continued losing significant weight (80 down to 72.4 lbs), but appetite was good, ate as much as usual, no vomiting or diarrhea. Thirst increased, urination seemed down. Began poop eating (never done this before). Energy levels continue to drop.

This right here screams Cushings to me

ETA: Cushings also messes with the thyroid

Edited June 26, 2011 by CaliforniaGreys

[RobinM]

thyroid? Full panel. Lethagic and weight loss are signs of low thyroid and easy enough to check. Just please, don't just have your vet check his T4. It has to be the whole panel in order to get an accurate diagnosis. Is your vet grey savvy? I have 2 hounds with hypothyroid. One diagnosed at 2 and one diagnosed at 7.

 

 

 

I have a true IBD greyhound, diagnosed by open exploratory surgery. This does not sound like it although no 2 cases are the same,

[greyhead]

In June 2011 he started losing weight, energy level dropping fast. Continued losing significant weight (80 down to 72.4 lbs), but appetite was good, ate as much as usual, no vomiting or diarrhea. Thirst increased, urination seemed down. Began poop eating (never done this before). Energy levels continue to drop.

 

Blood tests negative. 6/19 Xray indicated possible spleen tumor. 6/20 ultrasound showed enlarged spleen, no tumor, nothing else remarkable. IDEXX TLI, B12, Folate-canine blood tests were negative for pancreatic enzyme problem, indicated either IBD or lymphoma. Began treating for IBD (Metronidazole, Proviable DC, Vitamin B12 shots, hypo-allergenic diet; Deramaxx stopped). Appetite still very good; vomiting on 6/22, started Cerenia that evening, no further vomiting. Since then his attitude seems to have improved, walks are a little longer, acting a little more normal.

 

The vet would like to do a biopsy to determine whether it's lymphoma or IBD. I'm hesitant since Gromit is 10+ years old, and if it's lymphoma I'm not sure I'd want to put him through chemo -- if IBD is confirmed we're already treating for that, so why put the dog through surgery? But more than that, I'm not sure about the direction we're going. The combination of strong appetite, no diarrhea, almost no vomiting, and substantial weight loss does not seem consistent with IBD or lymphoma -- weight loss, loss of appetite, vomiting and diarrhea are symptoms of both, Gromit only has the weight loss. Since he's not losing weight due to an inability to keep the food in, is there something else we should be suspecting?

 

Although he seems a bit better, I find it hard to believe that it's because the new diet and drugs had that much effect on IBD in 3 days time (and it took me 3 days to transition to 100% new food). I can't get past the fact that everything that's suspected now has vomiting/diarrhea/loss of appetite in the symptom list -- Yeah, I know that you don't necessarily have all the symptoms, but these seem like some important symptoms not to have.

 

Any suggestions would be greatly appreciated -- including 2nd opinion references for central Maryland (Howard County). Thanks much

We have an IBD dog, diagnosed by ultrasound. We declined the surgical biopsy too, because he was too depleted to survive it, I feared, and the results wouldn't have changed the treatment anyway. Ultrasound showed the problem was too far into the intestines for an endoscopy to reach either. Prior to the IBD diagnosis, the cobalamin/folate test indicated intestinal malabsorption, as it apparently did for your dog. The poop eating our dog did was a function of that, along with chewing on wood. The shots made *immediate* improvement, but continued improvement is expectable as you keep giving them. Our dog requires the shots every two weeks on an ongoing basis even after three years, even though the standard treatment would have him down to every four weeks long ago. We have to treat our dogs as individuals, is the name of that tune. At a minimum, the weight loss would be symptomatic of intestinal malabsorption. Putting weight back on these guys is a slow process. We never went with the hypoallergenic diet for various reasons. We feed Natural Balance venison and sweet potato because NB formulas are very simple. We also feed 1/2 of his diet as raw venison (Primal Pet brand), though for most of these years it was only 1/3. (We use venison because he developed an inflammatory response to chicken, beef, buffalo, salmon and rabbit. And he never liked duck. We can still feed whitefish products.) So the key is once you know or suspect it's IBD, give the dog a novel protein and stick to it. I say this because it may be easier to put weight back on this way than with hypoallergenic food. Also, not all dogs do well on hypoallergenic food, for whever reason. We put 12 pounds back on our dog fairly quickly, after he had lost 20.

 

Basically, I think treating it as if it's IBD is a sound approach for now-- unless it proves not to work. Even then, you may just need to add an immunosuppressant. (We use budesonide to good effect. Prednisone tends to cause more weight loss but works for some.) I think you're right to skip the biopsy. We decided it was mostly something to make the vets feel they'd done everything the textbook calls for; but even when it's done, treatment seems to be about trial and error as to what works for your individual dog. And if you don't think you're going to get your dog back from the procedure, what's the point? And I agree that a thyroid panel is a good idea, especially as thyroids tend to slow down with age.

 

As to symptoms, we didn't have vomiting either. It does sound weird that there wouldn't even be any diarrhea, though. And did the ultrasound look hard at the intestines to see if there was any thickening of any of the wall or any swollen lymph structures (lymphangiectasia)? If it is IBD, something should have shown up besides the spleen. But if they got distracted by the spleen and thoughts of lymphoma, they may not have paid enough attention to the intestines. Perhaps you need to ask about that and hope you get a straight answer. In any case, you have all our best wishes for your dog's continued recovery from whatever it is.

Edited June 27, 2011 by greyhead

[mychip1]

Many good thoughts to you.

 

Claudia does have an interesting point on the Cushings.....Don't know if they tested for that.

[Batmom]

I would be looking for a second opinion and might want to redo the ultrasound for another look at that spleen before much else. Also urinalysis.

 

How long has the weight loss been going on? Is he eating the same number of calories he was before? If you feed more, will he eat more?

[Guest LindsaySF]

What type of blood tests did you do? Test for tick-borne diseases? Test for Cushings, Diabetes, etc? Do any fecal exams?

[greyhoundlov]

I would be looking for a second opinion and might want to redo the ultrasound for another look at that spleen before much else. Also urinalysis.

 

How long has the weight loss been going on? Is he eating the same number of calories he was before? If you feed more, will he eat more?

 

Yeah - spleen and liver.

[tbhounds]

Did you de-worm your hound recently???

[JJNg]

Has he been tested for exocrine pancreatic insufficiency (EPI)?

[KF_in_Georgia]

In cases of intestinal malabsorption, I think the food just travels past some damaged intestinal tissue before hitting the healthy part where it can be absorbed. So Gromit could eat the same as he always has, and just not be getting all the calories out of it.

 

If he'll eat more, try just feeding more of what he's used to getting. You can do this while you're testing for other issues that folks have mentioned here. But sometimes the most effective--and safest--way to get more weight on a dog is to just give more of what he's been eating if he's eating it with no ill effects.

 

My 11-year-old dropped 10 percent of his body weight during the winter. I just increased his normal kibble (he's got a terrific appetite), and he put the weight back on in a couple of months. (The vet had already run regular lab work and found nothing worrisome.)

[Jiffer]

I second a full thyroid panel!

 

Atlas started losing weight about two years ago (he was 10 at the time). I had him checked out for everything. His appetite was good, and still he lost weight. On a hunch, my vet tested him for thyroid. Sure enough, he was barely reading on the scale. We started him on meds and he's gained weight and energy back. He's needed a few med adjustments along the way but he's doing so much better.

 

Worth a shot.

[Guest Matt]

Wow, a lot here to think about.

 

* I haven't been involved enough in what tests and why -- last week was kind of a whirlwind. I'm going to take notes from this thread and other things I've read and discuss the details on our next visit. We did do a fecal test, urinalysis, and he tested negative for EPI.

 

* Just did his annual physical last month -- negative for heartworm and TBD. But I know from my previous experience with Bartonella that TBDs can be very tricky...

 

* No second opinion yet -- I've got a recommendation from a local greyhound volunteer, turns out that vet is on the list of vets at the top of this board, so I'll be making an appointment with him. I've also sent an email to the OSU greyhound consult service.

 

* I'm feeding him more to see if that will get his weight up at least a little.

 

* Symptoms get very confusing -- Cushings and hypothyroid both have weight gain listed as symptoms, which is not the problem here. But Jiffer, your experience with Atlas was weight loss, and the same age as mine -- I will definitely be following up to make sure we do a full panel for the thyroid and ask about Cushings.

 

I keep coming back to the fact that among the standard symptoms for IBD and lymphoma are weight loss, loss of appetite, vomiting, and diarrhea. Presumably the loss of appetite, vomiting, and diarrhea are responsible for the weight loss. So if all we have of the four is the weight loss, then there must be something else causing it.

 

We seem to have leveled off for now -- something is wrong but I think we have time to think first, then treat. I'll continue to treat for IBD (can't hurt), not rush into surgery, and will follow up on what tests we've done, thyroid full panel, and a 2nd opinion. Many thanks to you all for your time and suggestions, I'll let you know what happens.

[CaliforniaGreys]

Wishing you luck and will look forward to hearing the outcome. Just a note on Cushings, my little girl lost weight with Cushings as did a friend of mine's boy. Weight and muscle mass

[Guest Matt]

Wishing you luck and will look forward to hearing the outcome. Just a note on Cushings, my little girl lost weight with Cushings as did a friend of mine's boy. Weight and muscle mass

 

Muscle mass? One of the things the ortho vet noted when treating Grom's root reference was a loss of muscle mass. Anybody think there's a link here? I can't find any reference to limping/stiffness as Cushings' symptoms, it doesn't seem likely that if this is Cushings it would have anything to do with the earlier problems that were diagnosed as cervical/root reference. I've wondered whether these two episodes are linked, but as I age I'm discovering that you can have multiple things hurt for different reasons at the same time.

 

No thyroid or adrenal tests have been done. I have a second-opinion with the greyhound vet scheduled for tmrw AM, will talk with him about these tests.

Edited June 28, 2011 by Matt

[Batmom]

I'm sure it has happened occasionally -- there are exceptions to every rule -- but it is extremely unlikely that a truly hypothyroid dog with no other pathological condition would *lose* weight. That's contradictory to what thyroid hormone does in the body. In hypothyroidism, your metabolic rate decreases and you retain salt (and thus water); you maintain or gain weight rather than lose it.

 

You would more likely see weight loss with Cushing's disease.

 

Certainly never hurts to ask about tests that the vet doesn't mention himself/herself, but I'd let the vet review the dog's records and history before leading the discussion.

 

Best luck in getting to the bottom of things!

[NeylasMom]

I'm sure it has happened occasionally -- there are exceptions to every rule -- but it is extremely unlikely that a truly hypothyroid dog with no other pathological condition would *lose* weight. That's contradictory to what thyroid hormone does in the body. In hypothyroidism, your metabolic rate decreases and you retain salt (and thus water); you maintain or gain weight rather than lose it.

 

You would more likely see weight loss with Cushing's disease.

 

Certainly never hurts to ask about tests that the vet doesn't mention himself/herself, but I'd let the vet review the dog's records and history before leading the discussion.

 

Best luck in getting to the bottom of things!

 

Matt, weight loss could also be from reduced activity due to the injury, might be tough to tell in this situation. You might have a gut feeling either way though. With Cushing's I believe you also often see a distended chest, but Grom is such a barrel-chested dog to start with!

 

I hope Dr. Benson can help you out.

[Guest Matt]

In the words of the great Emily Latella... "never mind".

 

I got two second opinions -- one from the greyhound-savvy vet (kind of an old-school guy, very direct, liked him a lot) and one from a boarded internist at a referral internal medicine group (the one in Annapolis for anyone from the area) who specializes in GI. They both said that the blood test that my vet said means either IBD or lymphoma -- doesn't mean that. His reading is a little lower than the normal range, but not enough to be significant. The internist doesn't think the ultrasound view of the spleen is particularly significant -- he does not see an enlarged spleen. They agree his symptoms do not say IBD at all. Both agree that every other test result is right where it should be for a greyhound.

 

So why the weight loss? Still a mystery -- neither thought a thyroid test was needed, they agree with Batmom, hypo would mean weight loss, for hyper you'd be able to palpate the tumor responsible. Neither felt Cushings was at work here.

 

Grom's weight is well in the range for a healthy greyhound, he's not skeletal, just less than he used to be for no apparent reason. The old-school vet said feed him more, he's fine. The internist said we could do a biopsy, or we could wait and monitor. He's gained back a pound or two and his attitude is definitely better. We're still going on short walks, but with the cervical issues it's hard to be sure what's causing the short walks.

 

So I'm going to take him to the vet weekly and weigh him, give him plenty of food, and see what happens. Oh, and never use that particular vet in the practice again.

 

Many thanks for all the suggestions and good thoughts, this may be one of those things where we never find out what happened. But I'll keep a close eye on things.

[robinw]

Maybe it wouldn't be a bad idea to try a different kind of food. My bridge hound, Phoenix, would start to lose weight for no apparent reason until I changed food.

[Mystella]

did they check him for giardia? Jeffy lost a bunch of weight we did a fecal and it was negative. Did another one, a 3 day fecal and it came back positive for giardia.

 

that being said Jeffy is now giardia negative and still losing weight or gaining it then losing again, currently he's on tylan powder daily to see if that will help him 'keep' and going in for monthly weight checks.