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Welcome to Justanswer! I am Dr. Altman and happy to assist you both today!I am sorry to hear Morsel is not feeling wellUnfortunately I have several patients that have chronic issues as you describe (acid reflux, increased acid production) that pepcid has helped calm their stomach a bit. Is it possible to reinstitute the pepcid?Has he had bloodwork done to rule out metabolic causes of his vomiting and reduced appetite?Is there a certain time of day that he is vomiting, perhaps first morning before or after breakfast for example?Any additional information you can provide will hopefully help determine why Morsel is showing these changes and how best to assist you both
You mentioned cancer has been ruled out, has he had an abdominal ultrasound? What other medications have been tried to stimulate his appetite?Perhaps a transition to prilosec (omeprazole) will help since the pepcid helped for a while. The dose is 0.5 mg/ pound daily. If he is vomiting in the evening primarily then it would be ideal to administer late afternoon in hopes of controlling his symptoms
Yes and I am surprised that has not been tried. It is called cerenia and it is once daily as needed for nausea, typically we start with a five day course. It does require a prescription but your veterinarian should have itUnfortunately x-rays are not definitive there isn't something going on in the abdomen. When I have a dog in Morsel's situation I always want an abdominal ultrasound. It is much more definitive looking in the abdomen. For example, how thick is the stomach wall? Are the lymph nodes of the intestinal tract enlarged? How is his motility of the gut? All these questions are too finite to see on an x-ray and require an ultrasound. In some cases they are normal and the next step is endoscopy or a camera into the stomach and proximal small intestine to get biopsies since there are some patients that everything looks perfectly normal and diagnosis has to be made at the cellular level.Both of these steps require referral to a specialty clinic. The ultrasound done by a veterinary radiologist and if necessary endoscopy by an internist... hopefully the ultrasound will give you answers and that will be all that is needed but I agree cerenia should be started at this pointPlease let me know how else I can assist you both today, any additional questions I can clarify
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Do you have any questions re the prilosec dose or do you feel comfortable calculating this?
And using the prilosec in replacement of the pepcid...
Please let me know if I can be of any further assistance to you both today!
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Good morning, I am checking in on you and Morsel to see how he is doing with my suggestions?I would love an update when you are able...If you are satisfied with my responses please rate or accept to compensate me for my time. Thank you!
I am so sorry your beloved is having such a difficult time, I cannot imagine how trying this has to be on you... it sounds like his appetite might be related to nausea still but why he is having these episodes I cannot grasp. It might be worthwhile discussing mirtazipine an appetite stimulant with your veterinarian if it is safe for Morsel...