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Dr. Joey
Dr. Joey, Board Certified
Category: Dog Veterinary
Satisfied Customers: 4677
Experience:  15 yrs in practice, specialist canine/feline medicine
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Customer Question

Submitted: 4 years ago.
Category: Dog Veterinary
Expert:  Dr. Peter replied 4 years ago.
Hello, I am Dr. Peter a licensed Veterinarian. I would like to help. I need to ask you a few questions to be well informed and give you the best advice. There is no additional charge for information request.

1- How is she walking?
2- Any vomiting?
3- Take a look at her gums and see if they are pink or pale?
4- Can you take a rectal temperature?
5- Is she on any medications?
Customer: replied 4 years ago.
she is walking okay,her gums are hard to tell cause she has black looking gums, i am an R.N. i can take a rectal temp.what is a normal temp for dog? she weighs 11 pounds incase you need to know. she does knaw at her back legs and licks her back legs and lower flank areas as if biting fleas.
Expert:  Dr. Peter replied 4 years ago.
When we see shaking as you describe it can be a sign of pain or a fever. Pain can be either secondary to neuromuscular pain or abdominal pain. To take a rectal temperature this is what you can do:

1- Lubricate thermometer tip with ky jelly, vaseline or soap and water.
2- Insert in rectum about 1 inch and gently press tip up against rectal wall.
3- Wait a minute or until it beeps.
4- Normal temperature for a dog is 99.5-102.5 F.

If her temperature is normal, you can give her Aspirin 81mg every 12 hours with some food. If she is not better by the morning, have her checked by your family veterinarian.

Hope the above helps, if you have additional questions I will be glad to answer them.

Dr. Peter
Customer: replied 4 years ago.

Relist: Answer quality. if she has a fever how is it related to foul smelling breath and dry mouth (she keeps dry mouth even if she is drinking normally)what about the frequent knawing of her back legs lower flanks?and the change in her stools?

just took her rectal temp which is normal 100.3

Expert:  Dr. Joey replied 4 years ago.
Hello, I'm Dr. Zoe. It sounds like we have a few issues going on with Harley Ann.

First, with the trembling and lethargy this is concerning. It is unclear based on what has so far been discussed how long these symptoms have been occurring (just today or off-and-on); but sounds like it has been recurring. As Dr. Peter mentioned trembling can be a sign of fever or pain. It can also be a sign of an endocrine condition called Addition's disease, but I really would expect to have other signs start to develop such as diarrhea, although if she only has corticosteroid deficiency then the trembling alone is possible. I'm also not certain if this could be related to her other for now let's talk about the two other issues you mentioned.

Foul smelling breath? This could indicate significant dental disease. This breed is notorious for having significant periodontal disease and abscessed teeth. If you see heavy calculus on her teeth and/or pus at her gumline then she has bad dental disease and this could be the source of the bad breath. If you are confident that this cannot be the case (her teeth are great or she just had them cleaned by your vet recently), then the bad breath may be an indication of an internal illness such as kidney disease or diabetes.

Chewing at hind limbs/flanks? I'm not sure this is related to her other issues. If she has skin lesions then I worry that this reflects a skin condition. But suspect since you didn't mention lesions that this is not the case. Fleas is certainly a good thought as it does cause spontaneous chewing/biting at these areas. But in a dog of this size you should be able to fan through her fur around her neck and base of the tail and either see the fleas or flea dirt (black dirt that if you put on a piece of white paper and then ran a wet finger through it would smear red...digested blood). What could perhaps link back to trembling is if she is experiencing lower back or sacral pain. Then it is possible for her to bite at these areas. Your vet may be able to detect this with a physical exam.

Stool change? Smaller than normal stool likely reflects her reduced intake, and dehydration. ARe her gums tacky to the touch or dry which would correlate with dehydration? What is good is that the stool is formed. Was it of normal color (not black or lacking color)? I assume so since this wasn't mentioned.

Overall, I'm quite concerned. If she was my patient I would strongly recommend some screening lab work, if this hasn't been done in the past 2 weeks. THis would include a CBC, cHemistry profile and urinalysis which would screen for diabetes, electrolytes (if off or high potassium then Addison's disease comes back into question), liver/kidney, etc. It's really a starting point. As well your vet can take a look at her mouth to determine if the source of odor could be a tooth (or teeth) and check her skin to determine if there is an underlying problem such as infection (bacteria, yeast, mites).

At this point I need your input to let me know your questions.
Dr. Joey, Board Certified
Category: Dog Veterinary
Satisfied Customers: 4677
Experience: 15 yrs in practice, specialist canine/feline medicine
Dr. Joey and 4 other Dog Veterinary Specialists are ready to help you
Customer: replied 4 years ago.
she had lab work done 2 wks ago and everything was WNL per vet, she had a cbc,chem10,LipaseSNAP only thing noted on teeth was some tarter. normal coat,skin,lymph nodes,eyes,ears,nose and throat musculoskeletal,heart,lungs,abdomen,gastrointestinal tract,Urogenital and neurological.
Expert:  Dr. Joey replied 4 years ago.
I am very relieved to hear that her most recent testing looked good as did her exam. But it is certainly frustrating for her to continue to have issues, despite normal values.
Did her panel include electrolytes? This is not something done standard on all chemistry profiles (not a Chem10...we have that machine in our lab and you have to do electrolytes separately). I ask this because Addision's disease is still on my list until we prove her potassium level is normal (and sodium-potassium ratio is higher than 24). It's a long shot but it would cause dehydration and trembling.

Since here teeth look good per her vet, then this odor is not from her teeth. This indicates internal disease. Some people are better at detecting this smell than others, and this is concerning.

So, where to go from here? I would recommend check on if electrolytes were run. If so, then we can rule out this problem. I would discuss doing a trial with an analgesic (pain relief) with your vet to determine if the trembling is pain-related. THis is a common way to tackle this problem. There are many choices for us but I would actually recommend use of a drug that your vet could prescribe over aspirin, which was mentioned previously. Now, if you wanted to start something now you can certainly try the aspirin. However, my concerns with this are that it can potentially irritate the stomach more than other non-steroidal anti-inflammatory drugs designed for dogs, and an NSAID may not be the right choice for her. This is something your vet is much better equipped to answer since this person recently examined her.

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