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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 27350
Experience:  University of California at Davis graduate veterinarian with 44 years of experience
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Since the middle of April my elderly dog has been vomiting

Customer Question

Since the middle of April my elderly dog has been vomiting intermittedly. They thought it was pancreatitis and adviced to try Science Hill I/d food. She continued to vomit every 4-5 days and stopped eating the dry food. So I tried the wet food. She ate that for a little while and won't eat that at all. So then they tested for pancreatitis and said it was negative but gave her antibiotics anyway. They also advised a rice and boiled hamburger or boiled chicken meal. She stopped eating at all by Friday, except I did get her to eat a little chicken. Saturday I decided she was constipated and the vet gave her some stool softener. She puked again on Sunday morning and I did not feed her last night or this morning except her pills. When I went home at lunch she had puked up with pills. (Pills - she has some nerve damage in her spine and arthritis and is on tramadol and gabapentin and Dasaquin chews. Since she keeps throwing up those pills are not all in her system and her lameness is returning so that is a concern too.) I forgot, they did have me add a Pepcid to her pills too. In April they did blood tests to make sure the pills for her lameness were not affecting her and they said the blood test was fine. So I think I need another opinion on the vomiting and constipation. She is drinking water. Today she acted interested in food although I did not feed her. She seems alert and oriented. We don't know her age because she was adopted but probably around 12. She is a brown lab/cheseapeake bay retriever mix. Thanks!!!
Submitted: 1 year ago.
Category: Dog Veterinary
Expert:  Dr. Michael Salkin replied 1 year ago.
I'm sorry that your question wasn't answered in a timely manner. When my patient demonstrates chronic gastrointestinal distress in the form of inappetence, vomiting and/or diarrhea yet diagnostics in the form of blood and urine tests reveal nothing untoward, I proceed to ultrasound my patient's abdomen. I'm particularly interested in the gastrointestinal tract itself and ultrasound is quite sensitive in detecting changes in the GI tract such as the inflammation associated with inflammatory bowel disease (IBD) and malignancies such as lymphoma and solid tumors such as gastrointestinal adenocarcinoma - all of which should be important considerations at Maggie's age. Alternatively, you might presumptively treat IBD with either prednisone, the antiinflammatory antibiotic metronidazole or both. You also have the option of scoping and biopsying her GI tract which should be definitive but I do understand how invasive that is for an elderly dog such as Maggie and costly for you. Dosing orally at this time sounds problematic, however, because of her vomiting and our not knowing if she can retain oral medications. In such cases, I'll dispense an antiemetic drug such as maropitant (Cerenia) temporarily in order to quiet down the vomiting reflex.A food intolerance is always a consideration and it can arise at any age and even after my patient has been eating the same food for some time. I wouldn't consider food intolerance as important as either IBD or malignancy, however, at her age. Food intolerance is addressed with presumptively hypoallergenic diets. I prefer the hydrolyzed protein diets available from her vet. Please respond with further questions or concerns if you wish.