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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 27966
Experience:  University of California at Davis graduate veterinarian with 45 years of experience
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Well my 2 year old French Bulldog became ill last Sunday.

Customer Question

Well my 2 year old French Bulldog became ill last Sunday. Sudden onset of vomit and diarrhea, pretty much all night. Hadnt seen him get into anything or no diet change, Was able to get him in Monday morning to the vet, put him on Metronidazole and some nausea pills. Well things got worse Mon night and he became really dehydrated.
Tuesday, blood work, stool samples x rays all came back good! X rays did show intestine full of gas.
Tuesday, was on IV fluids all day at Vet, got him on probiotics, made a really good recovery better by the day and was actually really good by Friday, seemed mostly normal Saturday, now today "Sunday" he will eat but wont drink. Was shaking some this morning, Getting lethargic again. He has urinated everytime went outside but no poops. I can see the writing on the wall we are going down the same path. He absoloutely has abdominal pain or something, not bloated but can tell he's not comfortable. Walking stiff legged.
He is fully up to date on vaccines, has not had a diet change since after this happened I have been feeding him white rice,boiled chicken today.
I'm really concerned the xray may have missed something or he has an infection or some kind.
Submitted: 1 year ago.
Category: Dog Veterinary
Expert:  Dr. Michael Salkin replied 1 year ago.

Can you upload a copy of his test results to our conversation? I understand that you might not have a copy of the results at home but his vet should be able to give you one which you could scan into your computer and give me the link or you can photograph the page(s) and upload the images by using the paperclip icon in the toolbar above your message box (if you can see such an icon) or by using an external app such as dropbox.com. I not only review the test results but also note which tests should have been performed but weren't.

Customer: replied 1 year ago.
I do not have the test results printout, but I did see them and all the numbers fell in the range that was on the side of each test per say. My bill says comprehensive bloodwork " Chem +CBC" I was able to attach pic of xray
Expert:  Dr. Michael Salkin replied 1 year ago.

Thank you for the films. There's a large amount of gas in the transverse and descending colon and gas in the fundus of the stomach. Gas appears to be dissecting ingesta in the pyloric area of the stomach. I don't see other pathology but an ultrasound of Boomer's GI tract will be more sensitive and should be considered if he spirals downward once again. Make sure that a specCPL blood test was performed which is most sensitive for detecting the presence of pancreatitis in patients such as Boomer. Please continue our conversation if you wish.

Customer: replied 1 year ago.
I wont be able to get the exact test list till tomorrow .... Doesn't this sound strange? About the only thing he could get into was maybe a little rabbit shit, one of his favorite's no matter how hard we try to keep yard clean he still seems to find some a few times a month
Expert:  Dr. Michael Salkin replied 1 year ago.

No worries. Please note that he could be as normal as can be by tomorrow. His eating is a positive prognostic sign. Rabbit feces could certainly instigate his GI distress. Please return to our conversation tomorrow with an update.

Customer: replied 1 year ago.
Thank you very much and I will follow up with his bloodwork specifics in the morning, Vet opens at 8 and I already have a msg in for him, I will be there by 830 if I don't have a response from him right away in the a.m! I agree an ultrasound may be the way to go... I hope they did the most comprehensive bloodwork they could as I told them find something dont leave a rock unturned!
Expert:  Dr. Michael Salkin replied 1 year ago.

That's what I'm going to check for you. I'll watch for your next post. I'm chained to my computer by evil gnomes.

Customer: replied 1 year ago.
sorry took so long for bloodwork. This is where we stand.
Last time we talked he was full of gas, went to vet again and he was full of poop. It was soft and after that all passed he seemed to be feeling really good. Well we are back to the same lethargic not wanting to eat or drink dog... This is driving me crazy . I don't know what to do but hes definatly not feeling good. Small diarehha and he puked again this morning... Here are the blood tests and latest x ray from Monday when he was full of poop, but hes passed that out f his system now!
Expert:  Dr. Michael Salkin replied 1 year ago.

Thank you! A lot of normal! We need to see a specCPL blood test too. This test is most sensitive for detecting the presence of pancreatitis which is an important consideration in such a patient as Boomer. Please continue our conversation if you wish.

Customer: replied 1 year ago.
That's what my Vet keeps saying, he said there should be other signs to point at the pancreatitis. Does anything else come to mind with these conditions? I scheduled an appointment at a different vet tomorrow but dang its getting out of hand!
Expert:  Dr. Michael Salkin replied 1 year ago.

I can't imagine what other signs would be needed to consider pancreatitis. Primary gastrointestinal disorders such as inflammatory bowel disease and specific colitises are other considerations at his age. Primary GI disorders are poorly reflected in blood tests. We often resort to ultrasounding the GI tract and even scoping and biopsying it if the disorder becomes chronic.

Customer: replied 1 year ago.
Sinc it was dark this morning when took this I didn't see it till now, little red specs pic in link,,, concerning,, now 5 minutes ago it was yellow mucus looking pic attched..... Any signals here?http://i1095.photobucket.com/albums/i477/Customer/this%20morn.jpg
Expert:  Dr. Michael Salkin replied 1 year ago.

The red specs (hematochezia) and mucus are highly indicative of colitis. The colon is rich in mucus-producing glands and the red blood arises from the distal end of the GI tract.

Customer: replied 1 year ago.
This migh be getting me somewhere,,, good or bad its something!!!
Expert:  Dr. Michael Salkin replied 1 year ago.

Correct!

Customer: replied 1 year ago.
My concern is its coming from an infection we are not finding...... If it was colitis I would assume it would be gone after aprox 1.5 weeks
Expert:  Dr. Michael Salkin replied 1 year ago.

Perhaps. We consider Clostridium, Campylobacter, and Salmonella, mainly. There are many colitises that are chronic and last longer than 1.5 weeks.

Customer: replied 1 year ago.
Is the typical treatment antibiotics or just simple fasting and changing dog food... He hasn't had signs of worms and has been to ill for me to try and deworm him,, I would imagine whipworms could have given a false test and he could have them . Or do you think we could rule that prolly out?
Expert:  Dr. Michael Salkin replied 1 year ago.

I regularly presumptively worm these patients with fenbendazole (Panacur) which you can find over the counter in pet/feed stores. Fenbendazole addresses all of the nematodes - roundworms, hookworms, whipworms - as well as the protozoan Giardia. I treat daily for 7 consecutive days. Antibiotics should be avoided in the GI tract unless a specific indication for antibiotics has been found.

Customer: replied 1 year ago.
I would be safe to assume you first would try to deworm him? And I was actually wondering how they treat >
We consider Clostridium, Campylobacter, and Salmonella
Expert:  Dr. Michael Salkin replied 1 year ago.

Yes, presumptive anthelminthic therapy in the form of fenbendazole makes sense. The bacteria are treated predicated upon the results of bacterial culture and sensitivity testing.

Customer: replied 1 year ago.
Can you dumb this down for me a bit> The bacteria are treated predicated upon the results of bacterial culture and sensitivity testing.Like are you saying I should go get a sample of that mucus poop and have it tested? Or am I way off
Expert:  Dr. Michael Salkin replied 1 year ago.

First let's see how the fenbendazole affects your Frenchie. If you didn't see a positive response to its use, culturing fresh stool obtained by his vet should be considered. If a bacterial pathogen is found, the lab will proceed to perform an antibiotic sensitivity on that pathogen which tells us which antibiotic is best to prescribe.

Customer: replied 1 year ago.
Gotcha that make more sense thanks,,, I just hate how many articles I read about dogs dying when treated with dewormer when they are sick! Just makes me so nervous, I do appreciate it but man is there a ton of bad stuff about treating when sick!
Customer: replied 1 year ago.
hes not eating so these packets could be next to impossible for me to get him to eat! Man I thought these use to be pills? Now all I can find is 4gram pouches!
Expert:  Dr. Michael Salkin replied 1 year ago.

But if the sickness is caused by intestinal parasites it only makes sense to treat with a safe and well-tolerated wormer. The days of awful purgative and debilitating wormers are over...or should be. There's also a 10% suspension of fenbendazole available but it comes in very large and costly bottles. If you can't get the powder into him, you can find pyrantel pamoate suspensions in pet/feed stores which are broad spectrum against nematodes but don't address Giardia.

Customer: replied 1 year ago.
How effective do you think it will be? I hand fed him white chicken and rice 30 minutes ago and this is the outcome!http://i1095.photobucket.com/albums/i477/Customer/vomit.jpg
Expert:  Dr. Michael Salkin replied 1 year ago.

You won't be able to treat orally at this time. If he can't retain food, consider hospitalizing him so he can be "fed" intravenously and drugs administered parenterally (in any manner except orally).

Customer: replied 1 year ago.
he was hospitalized again on Thursday all day on IV fluids,,, What are your thoughts on this acth test? Borderline enough to be conclusive?
They prescribed him 5mg prednisone and Fludrocortizone also. Hes still on his prescription of metrodonizole also. He has drank and ate some since Friday and hasn't puked yet, has had a few loose stools but not pure direahaa but struggles to get it out... Seems to be urinating way more than fluid takes in... Seems pretty lethargic but that may be normal for being on all these meds?Still fighting to figure this out!
Expert:  Dr. Michael Salkin replied 1 year ago.

Those results aren't indicative of Addison's. Baseline serum cortisol concentrations greater than 2 ug/dL are inconsistent with the disease. A post-ACTH cortisol concentration of 6-18 ug/dL is normal. Prednisone may be helpful if inflammatory bowel disease exists but fludrocortisone is inappropriate - particularly if his sodium and potassium levels are normal which I suspect is the case because you told me that his tests were in the normal range. Prednisone will cause polydipsia (increased volume of urine) but so will a host of metabolic disorders. I still want to review any test results you can upload to our conversation.

Customer: replied 1 year ago.
Okay well today he started vomiting again. Took him to the lets say better educated Vet in town, Blood test again come back normal as did xrays.... Was reffered to animal hospital in town for a ultrasound..... Guess what. Normal.... Now they want me to bring him back for a $3k colonostopy and stomach scope... They were not able to tell me what they would look for beside liegins and polups ... And if they found those they would suggest a change of diet and some other stuff... I thought why in the hell wouldn't I try a change of diet to see if that helps before spending $3k. Here are the blood tests from today. I also have his digital xrays from today but they didn't show anything. I will try and get them off this disk and email after thisLong story short I am so frustrated and concerned it is making me sicker than my dog!
Expert:  Dr. Michael Salkin replied 1 year ago.

Oh my. I understand.

You uploaded the old CBC report. Please try again with today's blood tests.

Customer: replied 1 year ago.
shoot sorry. Heres todays
Expert:  Dr. Michael Salkin replied 1 year ago.

I'll review them and get right back to you.

Expert:  Dr. Michael Salkin replied 1 year ago.

Only the new CBC and electrolytes posted. I need to see his biochemistries - blood glucose, liver, pancreas, and kidney tests, etc.

Customer: replied 1 year ago.
I don't know that I have a copy of them. What is that test called please?
Expert:  Dr. Michael Salkin replied 1 year ago.

A serum biochemical profile. It contains everything other than a CBC and electrolytes (sodium, potassium, chloride).

Customer: replied 1 year ago.
I don't know that they did another one of them today! The vet is calling me back before 9pm she hoped.
Expert:  Dr. Michael Salkin replied 1 year ago.

Ask her about it, please. I'm helpless without it. If everything truly is normal (including a specCPL blood test which is most sensitive for detecting the presence of pancreatitis) I see no recourse other than initiating a hypoallergenic food trial or scoping and biopsy. Food intolerance/allergy is addressed with prescription hypoallergenic diets. These special foods contain just one novel (rabbit, duck, e.g.) animal protein or proteins that have been chemically altered (hydrolyzed) to the point that Boomer's immune system doesn't "see" anything to be allergic to. The over the counter hypoallergenic foods too often contain proteins not listed on the label - soy is a common one - and these proteins would confound our evaluation of the efficacy of the hypoallergenic diet. The prescription foods are available from his vet. There are many novel protein foods and a prototypical hydrolyzed protein food is Hill’s Prescription Diet z/d ultra (a hydrolyzed protein diet is my preference). A positive response is usually seen within a few weeks if we’ve eliminated the offending food allergen. Food intolerance can arise at any age and even after our patient has been eating the same food for quite some time.

Customer: replied 1 year ago.
Prescription Diet z/d ultra <<< is what the animal referral hospital gave me! The vet earlier today gave me a/d and the animal hospital said do not give him that and t use the z/d. I will be asking her tonight and if one has not been done then there will no doubt be one done tomorrow morning without a doubt I will demand it! Thanks much and anticipate a response as I will be digging into this big time!
Thanks much Dr. Salkin
Expert:  Dr. Michael Salkin replied 1 year ago.

Thank you. A food intolerance isn't likely in Boomer, then. Keep me posted, please.

Customer: replied 1 year ago.
I mean we just started the z/d today! like he just ate his first little bit.... Would you recommend anything like low sodium broth or something for me to mix my probiotic with to get him to take them.
Expert:  Dr. Michael Salkin replied 1 year ago.

Ah! You mustn't mix anthing into the z/d or it's not likely to remain hypoallergenic. That includes probiotics. A vegetable broth should be OK unless it happens to contain soy protein.

Customer: replied 1 year ago.
Okay I'm stepping on eggshells Dr. So I should keep the probiotics away from him? Then there would be no reason for me to get the broth as that was the idea to get him to take the probiotics. He did eat a few pieces of boiled chicken to get 1 doe of prednisone in him and 1 dose of metro... I want to follow your directions to a T ,,, I just don't want to mess up!
Expert:  Dr. Michael Salkin replied 1 year ago.

Correct. You'll have to stop the chicken, too. (Don't tell Boomer I said so.) The most common offending food allergens are beef, chicken, corn, wheat, eggs, rice, and soy.

Customer: replied 1 year ago.
Okay .... now its going to be a whole new chore for meds. I cant think of a way to get him to take a pill without the aid of something,, IE-chicken,hot dog something.....As as today he hasn't ate a treat yet,,, just hasn't wanted to ,,, and when he does feel up to it he is gona be pissed at me when he doesn't get one... As I assume you mean no treats either!
Expert:  Dr. Michael Salkin replied 1 year ago.

There are hypoallergenic treats. His vet may carry them. Hill's makes them: http://www.hillspet.com/products/pd-canine-hypoallergenic-treats-treats.html and if you google the keywords "dog, hypoallergenic, treats" you're likely to find a plethora of them. (I got to use the word "plethora"!)

Customer: replied 1 year ago.
Thanks Doc, I'll keep you posted... You don't know how much your input means to me.. Your wealth of knowledge helps me make gut decisions..... I appreciate it so muchAnd also the vet hospital told me today that my Addisons test wasn't a good enough response to dictate and put a tag on my dog that he has it! Just thought you would like that!
Expert:  Dr. Michael Salkin replied 1 year ago.

It's my pleasure. Thanks for the info!

Customer: replied 1 year ago.
just another Kudo. This was a different vet " 28 yr" from same clinic that called me back and also confirmed your feeling on the addisons side that it just wasn't enough info to make that call. She didn't agree with the diagnosis either. But she strongly felt going ahead with the strict diet was the direction to go and see what road that takes us down rather than spend $3k on colonostopy first! I told he I wanted more labs done pronto also!Thanks again we will be in touch soon with HOPEFULLY progress!
Expert:  Dr. Michael Salkin replied 1 year ago.

I appreciate it!

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