Mystery Gastro Illness, Please Help!

[Guest Renrus]

Hello,

 

this is my first time posting on this forum, but I need some help and so far my usual (smaller) forum is kind of stumped and so are my vets so far. I'll past my initial post w/ pertinant updates.

 

Hi everyone,

 

First, an update on Velvet: The good news is that she has an excellent appetite and she has been keeping everything down since Sunday morning, except for a small bile regurgitation during the night on Wednesday and a very small vomit right before breakfast Thursday morning that we think is from a medication mix-up the night before. Also, this week is the first time that she hasn’t lost weight between weigh-ins, but unfortunately she hasn’t gained either. Lastly, her poops are infrequent and controlled but are completely diarrhea.

 

3:05am this morning:

 

"I’ll make it as brief as I can, but it will be long…

 

Velvet started to have a rumbly/noisy stomach and began to regurgitate very small amounts of bile July 28. We attributed it to a change in diet and having just come back from a week at the cottage. Changing frequency/timings of feeding and eliminating treats made no change, and there were no other symptoms. Then August 8th she began to vomit profusely and had a fever, was lethargic, had decreased appetite and the stomach noises and bile increased. Oddly enough, poops were still great. We attempted OTC remedies, monitored vitals (temp, breathing rate and pulse… I’m a paramedic btw) and fasted her for 24hrs. With no positive results, we went to the vet. There she was given a metacam injection (for fever) and a cerinia injection (for vomit), and was given plasma IV as she was slightly dehydrated. They took x rays to look for a foreign body or for any bloat or other irregularities, none found other than a slightly inflamed stomach. They also did tests for pancreatitis and did a blood panel, all came back normal. They observed her for the afternoon and then sent her home for me to monitor her and to continue to give her the plasma IV for the next 24hrs. She was also given selcrate (a kind of pepto) and cerinia pills. That night she only vomited a small amount (she was still being fasted), but the bile was profuse and frequent, and the stomach very noisy. She ran a fever which we manually cooled. That morning symptoms lessened again but I called the vet and they let me pick up a metacam injection for the fever and instructed me to continue with the other meds. I also picked up more plasma to continue giving her IV. That night she suddenly had diarrhea and started to vomit again so we went to the emerg vet as per my other vets’ directions with concerns of a blockage. There she was given hydromorph (fancy morphine) and they did barium xrays on her digestive tract. The barium glows in the xrays and shows the digestive tract better, and they watch its progress looking for blockages. Once again, all normal. The barium seemed to also remedy the problem and by that night they were ready to try feeding her, but she turned her nose up at everything offered. Now, I know what my princess wants when she’s sick, so at 2 in the morning I brought some cooked ground beef to my vet’s and Velvet inhaled it  Later that morning she had pulled out her IV twice and was searching the vet’s for food, so they called me and said I could take her home at once. She was put on antibiotics and cerinia. Her poops were good for one day and then became progressively runnier, and the bile and stomach noises started again the day after she came home, but the bile was only once a day. We fed her frequent and small meals of a canned food that she did well on once before when she was recovering from a bug/flu. (She’s normally fed a grain free kibble) The fourth day after being discharged from the vets she was home alone for a 3 and ½ hrs when we came home to find four large piles of vomit, each one progressively larger and more digested, along with a very happy looking/prancing Velvet! Back to the vet’s we went where we discovered that she had lost 2.5lbs in 5 days, and she wasn’t dehydrated so it wasn’t just water weight. The vet put her on a plasma IV again for me to monitor and we made an appt at the hosp with an internal medicine specialist. Oddly enough during the 24hr that we waited for the appt, and during which Velvet had to fast again, no problems at all! My vet was thinking that she needed an endoscopy but the specialist did an ultrasound and chest xrays, to check for foreign bodies/blockages and to check for megaesophagus. All were normal. He also tested for Addison’s disease, hypothyroidism, blood glucose levels and did a blood panal, all were negative or normal. I also had her tested for any tick diseases, again normal. He proscribed Velvet an antacid, omeprazole, and something to tighten the esophageal stoma and to effect the stomach motility, metaclopramide. He also recommended that we start the usual post-fasting drill of feeding very small meals frequently and gradually increasing. 24hrs after being on the pills all the bile issues have resolved (except last Wed’s glitch), however she was back to vomiting. We tried giving her the selcrate before meals, no change. We switched her food to just plain cooked ground beef and then switched to pepto instead of selcrate, and she seems to be doing better, but not gaining weight. We’ve increased the time between pepto and food to increase the food absorption in hopes that she will gain weight, but only time will tell.

 

Now, I wrote this overly detailed account with the hopes that maybe someone will recognize this and maybe figure out what is (was hopefully?) wrong with Velvet. I had planned to do this earlier, while she was very sick, in hopes of some help, but I’ve just been too tired. Now it’s maybe irrelevant, as she might be all better, but we’ll find out for sure as we slowly start to come off of the meds.

 

Lastly, thank you to everyone for their well wishes and support!"

 

8:44am today:

 

"Another update, while I was at work Velvet started gagging throughout the night and puked once. She also is now bringing up bile that smells of feces...very bad. We are at the emerge vets now."

 

7:05pm today:

 

"Thanks everyone. Here's the latest; at the emerg vet I sat and discussed the situation with two vets and since the symptoms had resolved prior to me going to the vets they agreed that she would be monitored just as well at my home then as at their clinic, they would just be giving her a possible cerinia injection which hasn't worked in the past, and she wasn't appearing to be nauseous at that time anyways. Also, although it's not a good sign, apparantly fecel smelling and streaked bile isn't as bad in dogs as it is in people, which was why I paniced so much and headed straight over even though she seemed to be feeling better. She's eating once again and we are monitoring her until Monday when I will visit my regular vet again. Sorry I didn't update earlier but I had to get some sleep before going back to work tonight!

 

Campgreyhound-I'm going to have my vet send a report to OSU on Monday, maybe they can help.

 

GreyPoopon-It is possible that this is a food intolerance as the new kibble that I tried at the beginning of all of this had chicken in it, and she hasn't had a chicken kibble for a few years. Additionally, the vet's gastro canned food which we tried after the barium xrays and the canned food that she's done well on in the past all have chicken, so we have switched to the plain beef with which she is doing better on, but still some problems. I'm probably going to try switching from pepto on Monday (after discussion w/ the vet of course) to give the beef a chance without it as that might be causing the decreased motility that allowed the fecel emesis to occur. Monday I'm off for a few days and can deal with whatever results the lack of pepto causes...

 

Lastly, I don't think it's quite the same as what you went through Sandysfarm as this is more chronic and less acute, and there's been no blood as of yet, nor severe abdo pain, just abdo discomfort since the bile has been controlled.

 

Thanks again for your ideas and support, and now I'll go set up an account on Greytalk!"

 

Thanks for making it all the way through this, and any ideas/experience would be appreciated.

[duncan41]

Wow! You and Velvet certainly have had a time of it, haven't you? Welcome to GT!

 

I don't have any constructive advice, but I don't see where she was prescribed Flagyl. Did I miss it somewhere? If this is the beginnings of IBD, Flagyl is a staple. I am sure others will chime in with their experiences.

 

In the meantime, we are sending healing white light for Velvet and hugs of comfort for you. Please keep us posted on her progress.

[MaryJane]

Was she ever put on Flagyl? It doesn't mention it in your post but, I might have missed it.

[Guest LindsaySF]

I skimmed because I'm short on time. Has your vet considered an ulcer or Helicobacter infection? The inflamed stomach and vomiting make me think it's that versus a lower GI issue. Did they scope her? Is she on a stomach protectant (Carafate, etc) or just an antacid?

 

Is the vomit streaked with blood? I wasn't sure from your post. That sounds ulcer-ish to me....

 

If they suspect lower GI or IBS they usually give Flagyl. Some vets give Flagyl for any diarrhea of unknown origin. Did they ever prescribe that? It has anti-inflammatory properties as well as anti-bacterial properties.

[tbhounds]

Personally, I think it's time to scope your hound. Hopefully, OSU will have some insight to help.

[Guest Renrus]

She was put on flagyl after the barium X-rays, but it's only effect was to worsen the diarrhea. The flagyl round was complete the day she had the massive amount of vomit and then went to the specialist. My vet sent me to the specialist for an endoscope, but he preferred to do an ultrasound instead. Will talk to my vet on Monday and see if he is available for an endoscope as they were overbooked last time so I went to the specialist. Also no blood in either the vomit, bile or stool.

[OwnedBySummer]

Hi! Welcome to GT! Just letting you know we are thinking of sweet Velvet and hoping that Greytalk can help. There are some wonderful people here and I'm sure you'll get some great ideas. Glad you posted here!

[Time4ANap]

I see all of the advanced tests they did, but am wondering if they tried the simple stuff first. Since you had just come back from a cottage, my mind immediately goes to Parasites like Giardia or bacterial infection (I'm assuming some exposure to "nature" during the trip) . She may have other issues as well from the symptoms you describe, but if she has parasites or worms on top of it, you will be in a vicious cycle. Also, did they check for a bacterial infection in the stomach using a fecal bacteria test? Did she swim in a lake or drink from a stream or puddle?

 

Is she on flagly (metronidazole) at this point. You might also try an allergy free food like Purina HA instead of something meat based to entirely rule out a food intolerance.

 

I'm just throwing out things here in no particular order, but these are the things that came to mind reading your post. You may already have checked for these things, but i didn't see it in the post.

 

Hope she is feeling better soon.

[MaryJane]

Did they do a stool culture? Did they check for tick diseases (Lyme especially). The water borne parasites are also something to check as someone already mentioned.

 

Another possibility - could something have bitten her .. I'm thinking maybe a snake or a spider maybe even a lizard. Sometimes reactions to bites can be difficult to diagnose. Also, is there a possibility that she ate something like a frog?

 

One last item is that if this was at a lake and the temperatures were hot, she may have gotten heat stroke (greyhounds are very sensitive to heat) but, that should have resolved after a few days. I only mention the heat stroke because the symptoms would likely have been vomiting and diarrhea. You mentioned doing OTC treatments at the beginning - what were they?

[Guest Renrus]

Haven't done a stool culture yet, will have to try that on Monday, as she definitely was playing in the water lots. I don't think she was bitten/stung by anything, and she usually has a very low pain tolerance (read "Diva") so she let's us know about every scrape and pain, but it's always a possibility.

 

The OTC meds in the beginning were pepto and fumatadine(sp?). Also she has been on probiotics and digestive enzymes for approx 1wk.

Edited August 26, 2012 by Renrus

[OwnedBySummer]

Since you mentioned water, I'll throw leptospirosis into the mix?

Edited August 26, 2012 by OwnedBySummer

[MaryJane]

Haven't done a stool culture yet, will have to try that on Monday, as she definitely was playing in the water lots. I don't think she was bitten/stung by anything, and she usually has a very low pain tolerance (read "Diva") so she let's us know about every scrape and pain, but it's always a possibility.

 

The OTC meds in the beginning were pepto and fumatadine(sp?). Also she has been on probiotics and digestive enzymes for approx 1wk.

 

Where was the cabin - is it a tick area?

[Guest BrianRke]

Has she eaten any treat like chicken jerky that was produced in China? Waggin Train, Milo's Kitchen, etc...

[RedHead]

Any updates on Velvet?? I hope you can get in contact with OSU. I was thinking she may have picked up some parasites from the lake (giardia etc.) but I wouldn't think that vomiting would be the main symtom of that. It sounds a lot like when my old dog had pancreatitis, but I think you mentioned they tested for all of that. Maybe keep her on a bland diet and hopefully you can get this puzzle solved.

[Guest Renrus]

I'll have to research leptospirosis, we haven't looked into that one.

 

The cottage is in haliburton, Ontario. Ticks are possible although I didn't notice any. Also we did test negative, although there's always false negatives from what I've read!

 

No chicken treats from anywhere but Ontario...I think.

 

For an update, she's been doing great. Eating well, good level of activity, drinking lots but only a tiny little "pudding poop" in over 24hr. And tummy is still gurgling, but not super loud, only medium volume. Still feeding the plain ground beef. FYI, she won't eat any rice or potatoes that we might try to throw in. We haven't tried this time around because whenever we've had her recovering from stomach troubles before she will actually pick the meat out from whatever mixture and will spit out anything else! She once even got into a Quiznos sub and only ate the cheese and lunch meat, leaving everything else for her sister Scarlette!

[silverfish]

Gosh, it sounds a bit like what we've gone through with Jeffie..

 

First - check for parasites like giardia (that was my first thought too), and if she's not vaccinated, by all means, Lepto, though I think by now she'd be sicker than this if that's what the problem was. Check for TBDs. Think about food allergies - I was wondering about that, too, especially hearing that she's happy and prancing after vomiting. You've done bloodwork and urines I think.

 

Anyway, back to Jeffie. He had reams of tests, including the barium series and blood, urine and faecal tests. Absolutely nothing showed up, meanwhile he was either actively losing weight or simply 'failing to thrive' and was looking like a walking skeleton. Monitoring him like a hawk I began to notice a pattern: every time something happens to stress him (particularly being left at the kennel for a night, or me going out for more than a couple of hours) he vomits. Once he's vomited he's as happy as larry, but until he does, I can tell he has a sour stomach. He'll go out and, not so much eat grass, as try to mow the lawn with his teeth - it's as if he thinks he's a sheep! IF I can give him an Antepsin (same thing as sulfacrate, I think) in a cheese ball before he eats too much grass, it'll often head off the vomiting. I'm particularly keen to do this because when he vomits he feels he has to bury it, to the point where he'll wear his nose out and leave bloody streaks on the carpet.

 

I've plugged in a DAP (Adaptil/Comfort Zone) diffuser now, and he does a LOT better. When it ran out recently, he was back to vomiting within days.

 

It may be nothing like the same reason with Velvet, but I tell you all this just in case it is. It's such a simple fix, and would be great to know that there was nothing more serious wrong with her! I just wish I'd figured it out for Jeff before we put him through all the testing.

[Guest LindsaySF]

Famotidine is generic Pepcid AC (an antacid). I'd keep giving it. Is the gurgling coming from the stomach? I'd look into antibiotic treatment for possible stomach infection/ulcer, if you've ruled out everything else. The vomiting, stomach noises, fever, and inflammed stomach are pointing to a stomach issue like an infection IMO. The Pepcid and the Pepto Bismol are part of the treatment protocol for Helicobacter, the final part being antibiotics given for at least 3 weeks. I might have missed it, but I don't see if she was ever on any antibiotics besides Flagyl, and the course of Flagyl might not have been long enough.

[MaryJane]

If she won' eat rice/potatoes, try giving oatmeal - use the 5 minute type and add a touch of molasses. give her a few tablespoons of oatmeal to start with. Oatmeal is added into many of the "sensitive stomach" foods and has fiber - both of these can help calm the tummy and firm up the poop.

 

As someone mentioned, the treats could have been made in China - actually, the chicken could have come from china, or they could have processed the meat there, or ingredients to process the chicken could have come from China - so you want to look for labels that state the chicken is from the Americas, the processing factories are from America, and all other ingredients are from America - Otherwise, "china stuff" can still creep in there. Bad treats could cause the vomiting and diarrhea that you have been experiencing.

[silverfish]

 

As someone mentioned, the treats could have been made in China - actually, the chicken could have come from china, or they could have processed the meat there, or ingredients to process the chicken could have come from China - so you want to look for labels that state the chicken is from the Americas, the processing factories are from America, and all other ingredients are from America - Otherwise, "china stuff" can still creep in there. Bad treats could cause the vomiting and diarrhea that you have been experiencing.

 

True. That happens in the UK too.

[Guest Renrus]

I think we may have turned a corner, so to speak...knock on wood.

 

 

Velvet has been doing well, great appetite, good level of activity, and we've had two poops this morning! I'm beginning to think that it was a food sensitivity to chicken. Since we've had her on the beef she has been doing better, not 100%, but better. And we took her off of the pepto (she's still on omeprazole and metoclopramide) yesterday as we think she might have become constipated, she was producing such tiny and infrequent poops. Today she's pooped twice, small but mostly solid, and the best part is that about 1hr after eating her tummy is actually quiet! And to add to that, she has gained 1/2 a lb!!! Except for right after the barium xrays, her tummy/gut hasn't been quiet for 4 weeks! Still going to have a fecal culture done, but I think I'm going to hold off from sending a report to OSU for now. Also she was vacinated for lepto so I don't think that's it. And her treats are all from "Nothing Added" which are single ingredient treats all dehydrated and made here in Ontario from human quality chicken, so I don't think that any chinese chicken was in her treats, but who knows about the kibble she ate at the cottage... Thanks again for all the support and ideas, they've been very helpful.

 

And to put a face to all of this, here's my girl roaching a few days ago.

 

 

And the sisters together, Velvet (black) and Scarlette (brindle)

 

[silverfish]

Oh, that's good news! Jeffie (of the stress-induced vomiting) is also probably sensitive to pork. It's fairly easy to avoid one type of meat!

 

Beautiful girls!