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Can't Control Constant Regurgitation


Guest TonyB
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In July our greyhound Edy(pronounced Eedee) broke her leg and had surgery for a grade 2 distal tibial and fibular compound fracture. 5 rods with external fixators were placed at the fracture site. At that time she was given 750mg Cephalexin 3X daily ,750mg Ciprofloxacin 2X daily & 50mg Tramadol 3X daily. For 2 months we gave her these medications. Her leg was healing fine until early September she started to regurgitate a foamy mucus. 1st diagnosis was complications from the medications she was on. Edy was then admitted to the hospital 2X for dehydration. She had no appetite and everything she drank or ate never made it to her stomach due to the constant regurgitation. She was scoped and ultrasound was performed and no strictures or blockage was found. A biopsy was taken from her intestines and was found to have an inflammatory bowel disease. Now her new medications Metoclopramide 10mg 3X daily, Sucralfate 1gm in water 3X daily, Prednisone 20mg 1X daily and famotidine 20mg(pepcid) 1X daily. Edy still would regurgitate and medications that were given had no effect due to the fact they never got to her stomach. 1 week later Edy was re-admitted to the hospital for dehydration. At this time a feeding tube was placed in her stomach. This tube has now been in her for a week and food and water stay in her stomach and is digested but she still regurgitates this foamy mucus. Still nothing will pass her mouth because it gets regurgitated back up 5 minutes later. Since the feeding tube was placed and medications are being properly dispensed I see no improvement in her condition and I have to wonder if inflammatory bowel disease was the right diagnosis. Before all this started she was 71lbs now she is 42lbs and when I see her I fear that we may lose her. Has anyone heard of this condition in a greyhound?

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Guest alannamac

Good heavens this sounds quite serious. There are several vets on this forum, please keep bumping it up to the top so they see your topic.

 

Are her other vitals ok? If you have data for her blood values it would be helpful to post those and any other medical info. Like if they xrayed her chest, checked her oxygen intake that sort of thing.

 

Wishing you and Edy the best.

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Have they done a barium study yet? Meaning they feed her barium laced food/treat & then do a radiograph series to study her upper GI system. If not, that might be the next diagnostic step.

 

Though I've not heard of this condition in a Greyhound I did have a dog with a neurological disease that presented early on with regurgitation. Along our vet met road together I learned that there are many, many factors that can cause regurg. One worry for your dog is megaesophagus. It could be a cause of her problems or it might be possible for her to develop it as a result of food remaining in her esophagus & not making it to her stomach.

 

You are in a very frightening situation. I completely understand you worries. Has she been seen by or have you considered taking her to a neurologist?

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Hi, and welcome to the Greytalk board; what a difficult and important first post for anyone cominng on here!

 

It's very hard to secondguess a veterinary patient history as detailed and complicated as that where they would seem to have ruled out any foreign body stuck in the Oeophagus, strictures, Megaoesophagus, Pharyngeal Pouches, or tumor.

 

Are you entirely sure that this is regurgitation rather than vomiting? If not then this, from Merck, could be worth considering: The vomiting reflex is initiated by conditions that stimulate the emetic center of the medulla. Vomiting can be initiated centrally by intracranial stimuli (head trauma, increased intracranial pressure, or psychic stimuli) or by stimulation of the vestibular apparatus (motion sickness, vestibulitis). Toxins or drugs, such as digoxin and anticancer drugs, directly stimulate the chemoreceptor trigger zone (CTZ) because it is not protected by a complete blood-brain barrier. Acetylcholine is the primary neurotransmitter acting on the emetic center. The CTZ is stimulated by dopamine, α2 -adrenergic drugs, serotonin, and histamine.

 

 

The IBD and lack of adequate food absorbtion is very worrying and urgent. All I can suggest is a through check of Kidney function (weight loss and vomiting being sypmptomatic) and also think carefully about Tick Borne diseases which can also cause vomiting. Perhaps also a brain scan of the Medulla. Sorry i can't be more helpful - I hope you can soon find a solution to your poor dog's problems.

(NB: My Degree is Zoology - not Vet. so these are just rational suggestions.)

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Just came back because one possibility struck me. Have they done an ACTH stimulation test? This would be to test for Addison's disease. While it seems like a long shot, more than one vet had recommended it for my dog even though his blood chem values didn't indicate it. This was done even before the barium swallow. Of course, his symptoms & case were different overall.

 

ETA: Another thought would be myasthenia gravis. Again it sounds like I'm out in left field but these two diseases can be associated with regurg & both produce some seemingly odd symptoms. Many vets, no matter how good, may not have encountered a patient, or enough atypical patients, with these diseases.

Edited by kudzu
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Acetylcholine is the primary neurotransmitter acting on the emetic center.

 

And acetylcholine plays a big role in many diseases related to regurg. With too little acetylcholine at the neuromuscular junction the muscles may not have the strength to move the food through the upper GI system properly.

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Sounds like a very complicated and serious situation. Lots of good ideas already submitted above. Are you currently working with any veterinary specialists? Such as an internal medicine specialist? Is she being fed an adequate amount via the feeding tube and has she lost more weight since the tube placement? How are her stools? How old is Edy?

 

I would also recommend a free consult with the OSU greyhound program, which can be accessed through their Consultation Service web page.

Jennifer &

Willow (Wilma Waggle), Wiki (Wiki Hard Ten), Carter (Let's Get It On),

Ollie (whippet), Gracie (whippet x), & Terra (whippet) + Just Saying + Just Alice

gtsig3.jpg

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Guest MnMDogs

I saw thinking megaoesophagus. I would hope they will consider a barium study.

 

Yes. This. Was an X-ray done on her esophagus? Our sweet sweet Mara developed megaesophagus over night (literally) at 8 years old. We did everything we could, including the feeding tube. Sadly she couldn't even keep down food fed directly into her stomach and we let her go 2 weeks after diagnosis. That was over 2 years ago, and I still cry when think of her. Please email me if you'd like to clev25 @ gmail (dot) com.

 

We did cisipride, reglan, everything that was recommended...

 

I don't have a lot of time during the day, but will reply.

Ets - this was an idiathic megaesophagus (I think that's the term). There was no reason the vets could find for her developing this. Also l I notice in your post that you said the food from the tube isn't coming back up, so it doesn't sound like the issue Mara had. I do hope you find some answers for your girl

 

Edited by MnMDogs
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If your girl's leg is healed you may want to consider a set up similar to a Baily Chair. http://baileychair.blogspot.com/

 

The goal is to keep the dog in that type of position for long enough after meals that gravity gets the food through the esophagus & into the stomach. For my dog I didn't build a Bailey Chair because he didn't have megaesophagus. He did have a lower motor neuron disease that caused, laryngeal, pharyngeal & esophageal problems. By keeping his head up for a while after meals we were able to greatly reduce the regurg problems. Also, many, many small meals were required as his entire GI system ran slow & out of synch.

 

How is your girl today?

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We have had every test done to Edy and everything is normal but the IBD. The doctors that are treating her are baffled; they have never seen this or heard of what is happening. We had Edy at the vet yesterday to check her feeding tube, she is now 37lbs. The doctor has increased her food intake hoping she will start to gain some weight. Edy is digesting the food that is going through her feeding tube .The regurgitation seems to be occurring less now and the foamy mucus has turned to just thick mucus with a bad smell to it.

 

Everything from megaesophagus to cancer to blockages and strictures has been ruled out. I have been in contact with a doctor from OSU and she seems to think that IBD may be the right diagnosis.

Edited by TonyB
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Some of us with IBD greyhounds (like my Spencer) have done much better using budesonide as an immunosuppressant instead of prednisone. The pred seems to lead to a degree of weight loss that these dogs can't handle. But they have to be weaned off the pred before the budesonide can be administered, and I don't know whether that's feasible in your situation or not. Additionally, not many vets seems knowlegeable and comfortable using budesonide, so they tend to just not do it. Nonetheless, I feel obliged to mention this alternative. Also sending lots of prayers for you and your Edy. I know how hard this is. :hope

 

ETA: The other thing one absolutely needs to know is that greyhounds should only get half the dose of budesonide that non-sighthounds would get.

Edited by greyhead
Mary with Jumper Jack (2/17/11) and angels Shane (PA's Busta Rime, 12/10/02 - 10/14/16) and Spencer (Dutch Laser, 11/25/00 - 3/29/13).

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I can't help but feel that the Cephalexin is the source of Edy's condition. Taking into consideration that it can cause problems in dogs who already suffer with gastrointestinal issues it would suggest that at such a high dosage that she was on could also cause such problems where there were none before.

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  • 2 weeks later...

Metoclopramide is one of the drugs she is on. Now the doctors think she may be having seizures and put her on Phenobarbital. Edy's condition is worsening, It is a hard decision but we may have to let her go. She has difficulty standing up and can barely walk. Her 8th birthday was on Saturday and it broke our heart watching her lay there.

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This is so very sad. What a terrible situation for you all. I'm so sorry for all you are going through.

 

You haven't mentioned whether they have tested her for myasthenia gravis or tried a cholinesterase inhibitor such as pyridostigmine (Mestonin). If it has not already been discussed it would be well worth bringing the subject up.

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I don't think she was tested for that but I will mention it to her doctors. Right now she is so weak she can hardly stand. I think at this point, if she doesn’t start gaining weight any effort to save her may not work.

 

I also would like to thank everyone for their thoughts & prayers for Edy.

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Guest 2dogs4cats

I don't have any experience with this and it sounds like the vets are doing what they can. That is a tremendous weight loss. It seems like her body is digesting the food but not absorbing the nutrients. I send my prayers and white light. I know how hard it is.

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Guest OPointyDog

Oh no! I'm so sorry you had to let your girl go! It's particularly difficult when you don't have good answers about what is happening.

 

You have my deepest sympathies.

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