Persistent Vomiting: Need Suggestions

[KF_in_Georgia]

Jane, formerly WW’s Aunt Jane, is an 8-year-old brood bitch who came to me the first week in November, after I lost my much-loved Silver. Jane (out of Trent Lee x Aunt M) raced at Wheeling December 2009 to August 2011 for owner Julia Ward, and after an undistinguished racing career she retired and produced an April Fool’s litter of 7 or 8 puppies in 2012. (Seven puppies are listed on the database, but one of them is an “H” dog, so I’m assuming there was another.)

 

Jane wound up at Blu Too Kennel (no idea how) and was there until July 2016, when she came to SEGA to find a new home. She was in a foster home until November, when I adopted her. She was not very affectionate to begin with: I was just the human she dragged through the neighborhood on a leash every day. She tolerates my timid 4-year-old boy greyhound, but they’re not buddies. Towards the end of December, she became a bit more cuddly and decided that I’m really her human after all.

 

In the two months she’s been here, she’s had no health issues: no diarrhea, great appetite, no SA, etc. But she threw up on January 2 and has thrown up at least once a day every day since then. This doesn’t seem to bother her as much as it bothers me: she eats the soggy kibble back down (yuck) and is fine until the next time. She started with vomiting maybe a small mouthful of food, with very little bile. It has progressed to about a cup of food (an entire meal), with more bile. The vomiting occurs anywhere from 2 to 10 hours after her previous meal (usually about 7 hours), and doesn’t happen after every meal or after the same meal every day; and since she’s always vomiting kibble, this isn’t the usual sort of empty-stomach problem you often see. She has a very noisy stomach, but she sometimes sounds like she’s swallowed a full orchestra and then doesn’t vomit at all. Pepcid (20 mg, twice a day) and a probiotic (once a day) have not made any difference, and she’s as likely to vomit a meal that had Pepcid as to vomit one without. She had Interceptor for her heartworm meds on January 1, but she had Interceptor without a problem in December. (Was taking ivermectin capsules while under SEGA’s care.) She hasn’t had any flea/tick meds with me; I was going to start her on Bravecto last week (when the boy was due for his next dose), but I held back on both of them. She’s a chronic pillow-licker, but that’s not new with her and she’s shown no interest in eating stuffies or socks or anything else bad for her.

 

We went to the vet last week. He couldn’t find anything useful. Her stomach was noisy that day, but she didn’t vomit until many hours later. A fecal revealed an unexpected quantity of plant matter. We’re in a condo with no fenced yard, so she’s leash walked always (and on a short leash): she’s not grazing on vegetation here (no house plants, either), and I’m not feeding her vegetable snacks. Apparently, she’s not digesting plant matter well, but we don’t have a prior sample for comparison, so I don’t know if this is a new issue or not. They checked the fecal for parasites and didn’t find any.

 

She gets three meals a day—one cup of kibble at each--and one Dentastix as a treat. (The fiber content on the kibble is 4.0%; the Dentastix is 4.5%.) Dog cookies sometimes at meet and greets, but we haven’t been to one of them since December 18. She gets 2 fish oil capsules and 2 glucosamine tablets at breakfast (but often leaves the glucosamine). Other than those pills, which are packaged for humans, she’s getting no people food. (Confession: each dog got a squirt of whipped cream during the ice storm, when I was having mocha coffee.) Breakfast is anywhere between 7 and 11am; Dentastix in the afternoon; dinner between 6 and 7; nighttime meal between 10 and midnight. We’ve been on this schedule all along. There’s a longish stretch between bedtime and breakfast, but since she’s vomiting food, she clearly isn’t going too long between meals; and she sometimes has vomited just a couple of hours after eating.

 

The one thing that changed was the kibble itself. The dogs were eating Nature’s Recipe Venison and Rice formula. That’s $52/bag, so I tried the less expensive Nature’s Recipe Lamb and Rice (about $35/bag). We started the L&R about Christmas, and she first vomited a week later. Thinking perhaps she had a low tolerance for lamb, we donated the remaining L&R to charity and went back to the Venison and Rice, but she’s still vomiting. She and the boy dog eat the same meals and pills at the same time (except he gets a cup more kibble every day); the boy is fine. And I’m having a hard time blaming this on the kibble since she was fine one day and not-fine the next on a brand of kibble she’s eaten for two months.

 

I’m reluctant to try pumpkin since she’s already not digesting plant matter well. Besides, orange vomit… Ew! Bad enough that since she’s gotten cuddly, she wants to share the vomit with me. (My reflexes are great. Sound asleep to vertical and moving away from her in mere seconds.)

 

Any ideas on what this might be or how we might investigate further? Is it ultrasound time? Lab work? My vet sees no signs of pancreatitis, and Jane seems to feel fine, even while she’s upchucking her previous meal.

[macoduck]

Try Gas-X for when you hear the noisy tummy.

[cleptogrey]

mmmm....vet didn't find anything? how about a bland diet for a while, boiled white rice and either boiled chicken breast or boiled ground turkey. then a different base food if her stomach settles down. if her stomach doesn't settle down there are other PPIs out there(i know since most seem not to work for me). Pepcid may not be the right one for her. do consult w/ your vet and ask him/her what other PPI (acid reducer) you can use. Meanwhile I would cut out the Dentastix, it's a lot of roughage and maybe she can't tolerate it. Also, try no supplements what so ever, i'm thinking reduction to a bland bland diet and proceed from there, very s-l-o-w-l-y!

[FiveRoooooers]

I'd be concerned that somewhere along the way Jane ingested something that is now bothering her. We've all heard the stories of leashes or pieces of collars showing up years after ingestion. Angel Andy was a classic garbage hound and upon his arrival here he promptly pooped out two humongous rags. To start, I'd get some abdominal x-rays and probably an ultrasound. Good luck with Jane, I hope this can be figured out. Glad she's with you!

[Roo]

I'd be concerned that somewhere along the way Jane ingested something that is now bothering her. We've all heard the stories of leashes or pieces of collars showing up years after ingestion. Angel Andy was a classic garbage hound and upon his arrival here he promptly pooped out two humongous rags. To start, I'd get some abdominal x-rays and probably an ultrasound. Good luck with Jane, I hope this can be figured out. Glad she's with you!

 

This is kind of what I was thinking, too. Perhaps she ate something somewhere along the line that's been sitting in there, and for some reason it's now aggravating her tummy. I would assume that vomiting food sometimes so long after eating it means she's having trouble digesting, which could point to something foreign hanging out in there. Then again, it may also be nothing, but an x-ray to make sure wouldn't be a bad thing!

Edited January 11, 2017 by Roo

[Remolacha]

I also think it sounds like there is something (non food!) in there that is bothering her digestion. I think I'd ask for an ultrasound.

[KF_in_Georgia]

Okay, you guys suggesting a nonfood issue are thinking what I originally suspected. Calling her vet. Today's his surgery day, but we should be able to see him tomorrow.

 

I work from home, and Jane generally is on the Slumberball right next to me all day. When I'm not home, she's crated. But she could have gone for a stroll at night sometime, or she could have brought a previous indiscretion with her.

 

Hurray for Care Credit and Healthy Paws.

 

 

ETA: Appointment for 3pm Thursday. I'm asking for x-rays, and we'll see about an ultrasound. Feed her a normal breakfast so he can see what's not moving on after 7 or 8 hours?

Edited January 11, 2017 by KF_in_Georgia

[Newgreymom]

Daisy had chewed on a plastic container. She started vomiting every morning for several weeks. Bile and food. Had her checked, and there was a small piece of plastic stuck. I would definitely get her checked....

[XTRAWLD]

I agree the potential is there for some foreign matter than has now started to bug her. Keep us posted after her Thurs appt.

[Remolacha]

Good luck tomorrow, hope you get an answer. I would go ahead and feed her normally.

 

BTW, Jane is beautiful

[Batmom]

Make sure the x-ray includes her esophagus if they don't find anything in the stomach/bowel area.

 

Best luck!

[3greytjoys]

I'd call the vet re: feeding breakfast. I'd be inclined to skip breakfast thinking a mass of kibble might slightly obscure something small in the x-ray(?).

[Scoutsmom]

If your vet doesn't see anything in the x-ray, I would suggest you ask him/her to have a radiologist take a look.

 

My Henry had a sewing needle stuck in the lining of his stomach. My vet didn't see it in the x-ray but the radiologist noticed it and let us know.

My vet then saw what it was that the radiologist had noticed and pointed it out to me--for the life of me I could not see it. The moral is that radiologists have more training/experience in interpreting x-rays than most vets. (Poor Henry did have to have surgery and I now keep the needle as a souvenier.)

[FiveRoooooers]

Jane is so pretty! I'm glad you were able to get an appt this week, and I wouldn't feed her breakfast that morning.

[cleptogrey]

I'd call the vet re: feeding breakfast. I'd be inclined to skip breakfast thinking a mass of kibble might slightly obscure something small in the x-ray(?).

if they are x-raying her she will need to be put under, no food, right???

[3greytjoys]

if they are x-raying her she will need to be put under, no food, right???

Yes, excellent point! So probably no food for at least 12 hours prior to her vet appointment.

[Batmom]

She shouldn't have to be put under for the x-ray! Or for an ultrasound, if that turns out to be advisable.

 

But no food would be best -- a full tummy/intestines can obscure things, and you want all that to be as clear as possible.

[Blaidd49]

She should not need to be put under for either an x-ray or US but still, no food for 12 hours

OOPS, guess I replied at the same time as Batmom

[3greytjoys]

I suppose it depends on the tolerance and medical condition of the individual dog. One of our hounds was required to be under anesthesia for x-rays or other medical tests that normally don't require anesthesia.

[KF_in_Georgia]

I'll stay up tonight working, and she can have a meal about 3am. And if she throws it up, I just have to swoop in before she can gobble it up.

 

I'm trying to pretend I'm not worried by having lost two greyhounds in the past 10 months. Or that three of the five greyhounds I've lost were 8 years old when they died.

[3greytjoys]

I'm trying to pretend I'm not worried by having lost two greyhounds in the past 10 months. Or that three of the five greyhounds I've lost were 8 years old when they died.

We'll keep positive thoughts for your beautiful Jane.

Edited January 13, 2017 by 3greytjoys

[juliemac]

good luck tomorrow!

​fwiw, Dentastix haven't come into my home in years ... 3 of my 4 previous hounds would not digest them well. Hoping for a simple problem that can be solved with minor diet changes

[3greytjoys]

In the two months she’s been here, she’s had no health issues: no diarrhea, great appetite, no SA, etc. She had Interceptor for her heartworm meds on January 1, but she had Interceptor without a problem in December. (Was taking ivermectin capsules while under SEGA’s care.)

 

Depending on Jane's x-ray result; might be worth a second look at a possible adverse reaction to Interceptor. Since it stays in the body for a month(+/-), it might be a reason for Jane's sudden daily vomiting. No need to answer these questions here, just a few thoughts for you to consider/discuss with your vet:

 

Was last December's Interceptor dose administered with food?

What time of day was Interceptor administered on January 1, and was it given with food?

When was her first vomiting episode thereafter on Jan. 2?

Has vomiting improved whatsoever 11 days later?

Where was the Interceptor purchased?

If on-line source, how long did it sit in a mailbox or on porch (possibly exposed to sun or temperatures out of drug's safety range)?

(You probably already know that many drug manufacturers will not guarantee medications if bought on-line due to counterfeit drugs; lack of supplier's storage safety control; and shipping problems. In contrast, manufacturers often pay for dogs' treatment if their guaranteed product caused a problem or didn't work to prevent a heartworm infestation.)

 

Questions for your vet:

What is Interceptor's life and half life?

Does any of the drug accumulate within the body from month to month?

Could Jane's prior Ivermectin dose overlap/react to Interceptor?

 

Quote (re: active ingredient in Interceptor):

"The most common clinical signs reported include ataxia, tremors, lethargy, vomiting, mydriasis, disorientation, and hypersalivation". End quote.

Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4152460/

Edited January 12, 2017 by 3greytjoys

[KF_in_Georgia]

I've got time to respond to some comments since I'm up to give Jane her "breakfast" 12 hours before her vet appointment. Some notes:

 

Both dogs are crated when they have their Dentastix. Both dogs are good about chewing their sticks completely. Jane eats hers more slowly than the boy does, but since the dogs are crated, neither has to worry that the other dog is going to steal the stick. And she hasn't vomited any of the Dentastix. What she produces is recognizably undigested kibble.

 

About Interceptor:

 

Jane had Ivermectin the first of November. (To save money over retail heartworm meds, SEGA uses capsules compounded by their vet's office for heartworm prevention in our foster dogs.)

 

Jane had Interceptor the first of December, then again the first of January. In January, she had it right after breakfast that Sunday morning, and I listened to make sure she was chewing it rather than swallowing it whole. (I have a friend whose dog once pooped out an entire Interceptor tablet, so I listen for the crunch.) Jane's first vomiting was late Monday night (so maybe 36 hours later). The vomiting seems worse lately: originally she vomited a small mouthful; now, she's vomiting pretty much an entire meal (but still vomiting just one time a day). But other than the vomiting, Jane hasn't demonstrated any of the other symptoms listed for dogs sensitive to Interceptor's ingredients. Even Interceptor/ivermectin-sensitive breeds (like Collies) can take 10 times the regular preventative-dose without ill effects; it's the stronger heartworm treatment-dose that's riskier.

 

The Interceptor was purchased from Drs Foster & Smith (my vet doesn't carry Interceptor, but it was the one oral heartworm med where the flavoring didn't give my old girl, Silver, diarrhea). It would have arrived in late June, but my mailbox is completely in the shade, so the outdoor temperature wouldn't have been an issue (and I work from home; mail doesn't sit outside for long since I retrieve it when I take out the dogs during the day). The product expiration date on the remaining tablets I have is 08/2017, which is the date on the Interceptor in stock now at F&S.

[FiveRoooooers]

Whatever she may have ingested that may be causing Jane's symptoms most likely happened prior to her being on your watch. Good luck this afternoon, will be checking in for an update.