Non Grey Vomiting

[Busderpuddle]

I have a 23 month old Poodle mix who has had issues with vomiting since we brought her home as a puppy. We switched foods a million times (plenty of time with each change), took to the vet hundreds of times, she has had labs, been scoped, had an ultrasound, was tested for liver duct twisting (? I can't remember what it was called), and was down to eating boiled organic chicken, all to no avail. After too many food switches, I realized that she is allergic to chicken and all poultry. The new vet I took her to thought we should try her on Royal Canin Hydrolyzed protein diet, which seemed to really calm things down. She has never had diarrhea, but the vet thinks she may have IBS. About 3 months went by without any vomiting, and I thought we were in the clear. Her vomiting started up again with a vengeance recently and I took her back in, and she was given Metronidazole for the bacteria in her gut, and also Sucralafate twice a day for a week. Here we are 2 days after finishing all meds, and she is back to vomiting. She is wanting to be held all the time, a bit lethargic, but still runs and chases the toys, loves her walks. Yesterday she had a full senior lab panel done, and all was great. 

Any ideas of what I can do or where we should look ? The vet wants to put her on a months worth of antibiotics, and that just isn't sitting well with me. I do trust the new vet though, but antibiotics are tough on tummies. She now weighs 11.9 lbs, down from 12.8 lbs 3 months ago. She is well hydrated. I cannot bear the thought of losing my puppy, and I know she just feels miserable. Insight from the experts please....

[KF_in_Georgia]

Has she had an ultrasound with this recurrence of the vomiting? Could she have swallowed something when she was feeling better and now be suffering the consequences?

Have you tried smaller meals more often? When Jane had swallowed a sock (I didn't know), she didn't have room for a cup and a half of kibble at meal time; after about an hour, she'd wake up, vomit, and go right back to sleep.  I wound up going to one cup of kibble, three times a day, and she was able to keep down her food. She finally vomited up the first sock after a month (there was another one 11 days later), and suddenly she could eat a cup and a half of kibble without vomiting.

Good luck.

[Bizeebee]

I would definitely exhaust options for checking for a foreign body - as KF said. And wrack your brain for what may have been happening right before the vomiting started up again again after 3 months of not.

 

If you and the vet feel pretty confident that she didn't ingest anything weird, then well, I have a few questions:

What kind of vomit are you seeing? Whole or mostly whole kibble pieces? Water/mucus? Bile? Partially digested combo of food/liquid?

What kind of volume of vomit are you seeing? What percentage would you say she's actually absorbing (and pooping out) versus vomiting?

When does the vomiting happen? Is it consistently before or after meals, after activity, etc?

Does she act like she feels like absolute crap after vomiting? Or does she just go about her day like nothing happened?

I'm not a vet, but I'd also be wary of continuing antibiotics without a culture result (or something data-driven) that made me confident that a bug was the problem. Is there anti-nausea medication the vet could recommend - I vaguely remember that Dramamine might actually be ok for dogs (check on that though)?

Our previous grey would do more than his fair share of vomiting, usually of the bile/water/whole kibble variety, and we came to the conclusion that it was a reflux-type issue. We split his food into three meals a day instead of two, so that his tummy wasn't as empty overnight, and did a few 2week courses of omeprazole (Prilosec) when it seemed like he was having a flare up. That helped cut down on the vomiting quite a lot.

 

This is totally left field, but has your vet checked her ears for infection/injury? One other thing I can think that would cause nausea/vomiting, that doesn't have a microbial component, is that your dog could have bad vertigo - which could be caused by ear infection (or other, more rare issues). I don't know what antibiotics she's been on, but at least according to my vet, there are definitely different ABs for different things. So just because she's been on AB for her gut doesn't mean they'd kill bugs somewhere else, like the ears.

[cleptogrey]

VET!!!  or if you do not agree w/ your vet a NEW vet. small dogs crash much faster than large dogs. 

Edited May 14, 2019 by cleptogrey
miss spell

[GreytMom]

Have you seen a GI specialist? Or internal medicine specialist? That’s what I’d be doing. You may have - given the number of tests that have already been done. I saw a neurologist yesterday and it looks like he picked something up in my hound that my regular vet, who sees lots of greyhounds, missed. So, I’m all about specialists when necessary.

Only other thought... because I’m a behaviorist... did anything change in her environment? Could it be any type of stress reaction? Is there anything different in her world now than there was during the 3 months she was doing well?

Hope she gets to feeling better soon. Poor little thing. Sounds miserable. For both of you.  

[Busderpuddle]

Thank you for your replies....let me see if I can answer all the questions. 

Yes, she had another ultrasound 1 week ago, and I know she has not swallowed a foreign object. She is a VERY picky eater, and she only eats small amounts when the mood strikes. She is a nibbler, small amounts all afternoon and evening. She has food available all the time, and gets small amounts of canned food twice a day, but doesn't eat it very often.  She doesn't like food in the morning, so I am thinking she wakes up with nausea?  Had Sucralfate (sp?) last night  like she has had the last week+, this morning wolfed down her food, then vomited it up within a few minutes. 2 fairly large amounts of undigested food, so regurgitated food actually, tubes of food covered in mucous. She has had a scope to see if there is any stricture in her throat and it was normal. 

This started over a week ago with clear vomit X 3, then 6 more episodes of vomiting the same day,  she went to the vet that afternoon. She was given fluids, a shot for nausea, and the Metronidazole and Sucralfate  for 10 days. She is still on it. She has kept all of her food down since starting the meds until today. The vomiting is random, not usually after activity, just here and there. She occasionally wakes up from a nap and vomits. After an episode, she is a bit quiet for her, but she will pep up and want to play. She still tears around the yard playing ball, and other inside games. She still loves her walks and gets very excited. She is much quieter this last week. Wants to sit in my lap or go lay in her crate. I know she is feeling crummy most of the time. Pooping is completely normal.  Yes, she has been looked at for an ear infection and things look clear. I had them check for that after reading online. She also does not mess with her ears.  She gets car sick and we use Dramamine for long car rides, but it knocks her out, so we don't want to use that daily. 

She has been to the vet 3 times since this started. Yesterday she had a full senior panel lab, and all results were normal. She has lost 1 lb, and now weighs a bit more than 11 lbs. 

Prior to this episode, she had several visits to an Internal Medicine vet. She is the one who did the scopes and one of the ultrasounds. There is nothing new in her world at all. She is a pretty happy and calm pup. 

Thank you all for your ideas.....I appreciate the help. I keep thinking that someone will have the answer. We are on our 3rd vet and I trust the one she is seeing now. She is great about taking my calls and researching things to check with her. 

Edited May 15, 2019 by Busderpuddle

[Bizeebee]

If the vomiting/regurgitating seems random I would try keeping a journal of the events - writing down when she vomits, and what she was doing right before, how many hours since she'd eaten, since the last incident, really any details you can remember. A pattern might reveal itself once you can look at the details en masse.

[Shannon]

Did she have GI biopsies when she was scoped?  Stomach, small intestine and large intestine? 

If biopsies weren’t done, that’s what I’d suggest next.

Just my opinion, but this sounds a lot like IBD (my dog has IBD). X-rays, ultrasound and standard blood tests can all be normal in a dog with IBD.  

You might test  her blood protein/albumin (because of the weight loss), folate and  B12. But those can also be normal in a dog with IBD.  

 

 

 

 

 

[Busderpuddle]

The diary is a good idea, I will start that today.

She had a stomach and small intestine biopsy, and they said it showed inflammation. That was about 14 months ago. My vet does suspect IBS.  I will see if the labs you suggest were done, thank you

[Bizeebee]

2 hours ago, Busderpuddle said:

The diary is a good idea, I will start that today.

She had a stomach and small intestine biopsy, and they said it showed inflammation. That was about 14 months ago. My vet does suspect IBS.  I will see if the labs you suggest were done, thank you

Maybe ask about an anti-inflammatory that would work in the gut? Obviously some anti-inflammatory drugs are bad for the gut, but can they all be?

This is totally anecdotal, but the last time I got the stomach flu I had horrible nausea but we didn't have anything but the "natural" Dramamine in the house - which is basically powdered ginger I think. It shockingly did work, so you might ask your vet about otc things that might work for the nausea - especially if she's now/still throwing up while on the other meds.

[Busderpuddle]

20 hours ago, Bizeebee said:

Maybe ask about an anti-inflammatory that would work in the gut? Obviously some anti-inflammatory drugs are bad for the gut, but can they all be?

This is totally anecdotal, but the last time I got the stomach flu I had horrible nausea but we didn't have anything but the "natural" Dramamine in the house - which is basically powdered ginger I think. It shockingly did work, so you might ask your vet about otc things that might work for the nausea - especially if she's now/still throwing up while on the other meds.

When she was a young pup, we were told to feed her a ginger cookie from Trader Joes an hour before trips in the car. Worked great, but she will no longer eat them. 

[Bizeebee]

4 hours ago, Busderpuddle said:

When she was a young pup, we were told to feed her a ginger cookie from Trader Joes an hour before trips in the car. Worked great, but she will no longer eat them. 

Will she still drink water? If you use a box grater on a chunk of ginger and then squeeze the grated bits you can get a decent amount of "juice" and see if she'll still drink water with just a little of it in there.

[Busderpuddle]

20 hours ago, Bizeebee said:

Will she still drink water? If you use a box grater on a chunk of ginger and then squeeze the grated bits you can get a decent amount of "juice" and see if she'll still drink water with just a little of it in there.

I have tried ginger in treats and in her water, she won't touch it. 

[cleptogrey]

zofran or cerenia are great for nausea. some vets administer anti-nausea by shot. mine prescribes the pills.

[tbhounds]

Have you been to an internal medicine Dr??  

[Busderpuddle]

17 hours ago, tbhounds said:

Have you been to an internal medicine Dr??  

Yes, they are the ones who did the scope and the original ultrasound.

She was given a shot the day she vomited 9 times, and then we have Sucralfate that she was on twice a day for 10 days. No vomiting for 2 days with no meds so far. Keeping my fingers crossed. I also started a probiotic yesterday

[Shannon]

Hi Busderpuddle,

How’s your girl today?

Among the other many things I’ve learned having traveled a long, hard, and actually totally worth it journey with an IBD dog for the past 6.5 years, is that upper GI inflammation causes vomiting!  The fact that your dog has confirmed (biopsied) upper GI inflammation leads me to believe that its probably the upper GI inflammation that’s causing the vomiting.  

Treating the inflammation will help control the vomiting. 

It’s worth trying medical therapy if the hydrolyzed food isn’t controlling things well enough on its own.  

I hope you figure out what works for your girl.  I think you will.  

Take care!  

[Shannon]

Hi Busderpuddle,

How’s your girl today?

Among the other many things I’ve learned having traveled a long, hard, and actually totally worth it (worth it because we’ve had this time with our boy) journey with an IBD dog for the past 6.5 years, is that upper GI inflammation causes vomiting!  The fact that your dog has confirmed (biopsied) upper GI inflammation leads me to believe that its probably the upper GI inflammation that’s causing the vomiting.  

Treating the inflammation will help control the vomiting. 

It’s worth trying medical therapy if the hydrolyzed food isn’t controlling things well enough on its own.  

I hope you figure out what works for your girl.  I think you will.  

Take care!  

[Busderpuddle]

3 hours ago, Shannon said:

Hi Busderpuddle,

How’s your girl today?

Among the other many things I’ve learned having traveled a long, hard, and actually totally worth it (worth it because we’ve had this time with our boy) journey with an IBD dog for the past 6.5 years, is that upper GI inflammation causes vomiting!  The fact that your dog has confirmed (biopsied) upper GI inflammation leads me to believe that its probably the upper GI inflammation that’s causing the vomiting.  

Treating the inflammation will help control the vomiting. 

It’s worth trying medical therapy if the hydrolyzed food isn’t controlling things well enough on its own.  

I hope you figure out what works for your girl.  I think you will.  

Take care!  

5 days with no vomiting !!!! I have made sure she only has the RX food and treats, and so far she is doing better. Meds are finished now too.  I am curious what kind of anti inflammatory you are referring to ? I know some can cause irritation. Thank you

[Shannon]

On 5/14/2019 at 2:11 PM, Busderpuddle said:

Here we are 2 days after finishing all meds, and she is back to vomiting.

 

On 5/14/2019 at 2:11 PM, Busderpuddle said:

The vet wants to put her on a months worth of antibiotics, and that just isn't sitting well with me.

Glad she’s been better eating only the hydrolyzed food.  

Metronidazole is an antibiotic, but it also has anti inflammatory properties.   I just meant that if the hydrolyzed food doesn’t continue to maintain things, you might consider the longer trial of metronidazole, as recommended by your vet.